References of "Kaux, Jean-François"
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See detailFrench translation and validation of the Cumberland Ankle Instability Tool, an instrument for measuring functional ankle instability
Geerinck, Anton ULiege; Beaudart, Charlotte ULiege; Salvan, Quentin et al

in Foot and Ankle Surgery (in press)

Background: Ankle sprains are one of the most common musculoskeletal injuries, and can lead to chronic ankle instability (CAI). The Cumberland Ankle Instability Tool (CAIT) measures a subset of CAI ... [more ▼]

Background: Ankle sprains are one of the most common musculoskeletal injuries, and can lead to chronic ankle instability (CAI). The Cumberland Ankle Instability Tool (CAIT) measures a subset of CAI, functional ankle instability (FAI).Because no French version existed, we set out to translate and validate the CAIT in French. Methods: The CAIT was translated using a forward-backward methodology. We examined its psychometric properties and calculated a cut-off score for FAI in a sample of 102 subjects (median age 22 years). Results: The CAIT was translated without significant problems. The CAIT-F can discriminate between those with and without FAI (p<0.001), with a cut-off score of ≤23 points. The test-retest reliability is excellent (ICC=0.960), as is the internal consistency (α=0.885). Construct validity was confirmed. No floor or ceiling effects were detected among subjects with FAI. Conclusions: The CAIT is now available in French, and is a valid and reliable instrument. [less ▲]

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See detailPlatelet-rich plasma (PRP) and tendon healing: comparison between fresh and frozen-thawed PRP
KAUX, Jean-François ULiege; Libertiaux, Vincent; Dupont, Laura ULiege et al

in Platelets (in press)

Platelet-rich plasma (PRP) is increasingly used in the treatment of musculoskeletal diseases. Its preservation by freezing it for the realization of multiple injections in clinical use has never been ... [more ▼]

Platelet-rich plasma (PRP) is increasingly used in the treatment of musculoskeletal diseases. Its preservation by freezing it for the realization of multiple injections in clinical use has never been discussed. Calcaneal tendons of rats were surgically sectioned. Platelet concentration of the PRP was 2.5 x 106/μl with autologous plasma of rats. Frozen-thawed PRP was prepared by performing two cycles of freezing and thawing on PRP aliquots. Both platelet preparations were injected in the lesion. Biomechanical and histological evaluations were carried out after 7, 20 or 40 days post surgery. After 7 and 40 days, no significant difference was observed between the PRP and the frozen-thawed PRP group. There is however a difference 20 days after surgery: the ultimate tensile strength (UTS) was greater in the fresh PRP group. No obvious difference with histological aspect was observed between the two groups. In conclusion, fresh PRP and frozen-thawed PRP injections can lead to similar results in the healing process of section calcaneal tendons of rats. Improvements with fresh PRP are slight. PRP could thus be frozen to be preserved if multiple injections are needed (e.g. osteoarthritis). [less ▲]

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See detailCross-cultural adaptation, translation, and validation of the functional assessment scale for acute hamstring injuries (FASH) questionnaire for French-speaking patients
Locquet, Médéa ULiege; Willems, Tom; Specque, Clément et al

in Disability and Rehabilitation (in press)

Study design: This consisted of a translation and validation study. Background: Acute hamstring injury is a frequent muscle strain in sports that require high explosive strength, impulsion or running ... [more ▼]

Study design: This consisted of a translation and validation study. Background: Acute hamstring injury is a frequent muscle strain in sports that require high explosive strength, impulsion or running phases. Therefore, the Functional Assessment Scale for Hamstring Injury questionnaire was developed to assess pain, physical activity level and ability to perform various exercises in patients with hamstring injuries. The Functional Assessment Scale for Hamstring Injury questionnaire is currently available in English, German, and Greek. Objectives: The goal of this study was to provide a cross-culturally adapted French-translation of the FASH questionnaire and to assess its psychometric performance. Methods: The French-translation and cross-cultural adaptation process were based on international recommendations, following six rigorous steps: (a) two initial translations from English to French; (b) synthesis of the two translations; (c) back-translations; (d) comparisons between the back-translations and the original questionnaire by an expert committee; (e) pretest; and (f) approval of the final French version of the Functional Assessment Scale for Hamstring Injury questionnaire. To validate this French version, 116 subjects (17 pathological patients, 19 patients with other muscle injury, 40 athletes at risk, and 40 healthy control athletes) were recruited to complete the Functional Assessment Scale for Hamstring Injury questionnaire. The Short Form Health Survey (SF-36) was used as a comparative questionnaire. The psychometric properties of the questionnaire were evaluated by determining the test-retest reliability after a 48–60-h interval, internal consistency, construct validity, and floor/ceiling effects. Results: All of the items of the Functional Assessment Scale for Hamstring Injury questionnaire were translated without any major difficulties. The questionnaire showed excellent discriminative power by obtaining significantly different scores from the four groups (p¼0.01). Regarding psychometric performances, the test–retest reliability was excellent (IntraClass Coefficient Correlation of 0.997). Very high internal consistency was also observed (Cronbach’s alpha of 0.969). Correlations with the physical health subscales of the SF-36 were significant and considered to be strong, indicating an excellent convergent validity. The other subscales of the SF-36 (mental health) were weakly correlated with the FASH, reflecting good divergent validity. No floor or ceiling effects were observed. Conclusion: The French-translation of the Functional Assessment Scale for Hamstring Injury questionnaire and its cross-cultural adaptation can be considered to be successful. Functional Assessment Scale for Hamstring Injury-French questionnaire is now a reliable and valid tool for patients suffering from acute hamstring injury, and its application in clinical practice is particularly relevant. IMPLICATIONS FOR REHABILITATION The FASH-F can be considered to be discriminant, reliable and valid for the evaluation of the severity of symptoms and sports ability in individuals with hamstring injuries. FASH-F is now a reliable and valid tool for French-speaking patients suffering from acute hamstring injury, and its application in clinical practice is particularly relevant. A limitation of our study could be that the distribution between the different study groups was not homogeneous implying that our findings may not be fully representative of the general population. [less ▲]

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See detailType 2 diabetes mellitus and osteoarthritis
Veronese, Nicola; Cooper, Cyrus; Reginster, Jean-Yves ULiege et al

in Seminars in Arthritis and Rheumatism (in press)

OBJECTIVES: Type 2 diabetes mellitus (T2DM) and osteoarthritis (OA) are common diseases that frequently co-exist, along with overweight/obesity. While the mechanical impact of excess body weight on joints ... [more ▼]

OBJECTIVES: Type 2 diabetes mellitus (T2DM) and osteoarthritis (OA) are common diseases that frequently co-exist, along with overweight/obesity. While the mechanical impact of excess body weight on joints may explain lower limb OA, we sought to explore whether T2DM is linked to OA outside of excess weight and whether T2DM may play a role in OA pathophysiology. The consequence of T2DM on OA outcomes is a question of research interest. METHODS: We conducted a critical review of the literature to explore the association between T2DM and OA, whether any association is site-specific for OA, and whether the presence of T2DM impacts on OA outcomes. We also reviewed the literature to assess the safety of anti-OA treatments in patients with T2DM. RESULTS: T2DM has a pathogenic effect on OA through 2 major pathways involving oxidative stress and low-grade chronic inflammation resulting from chronic hyperglycemia and insulin resistance. T2DM is a risk factor for OA progression and has a negative impact on arthroplasty outcomes. Evidence is mounting for safety concerns with some of the most frequently prescribed anti-OA medications, including paracetamol, non-steroidal anti-inflammatory drugs, and corticosteroid injections, while other anti-OA medications may be safely prescribed in OA patients with T2DM, such as glucosamine and intra-articular hyaluronic acid. CONCLUSIONS: Future research is needed to better understand whether diabetes control and prevention can modulate OA occurrence and progression. The selection of therapy to treat OA symptoms in patients with T2DM may require careful consideration of the evidence based to avoid untoward safety issues. [less ▲]

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See detailFrench translation and validation of the exercise-induced leg pain Questionnaire
Beaudart, Charlotte ULiege; Hagelstein, Thibaut; Van Beveren, Julien et al

in Disability and Rehabilitation (in press)

Objective: The “Exercise-Induced Leg Pain” questionnaire was developed (in German) for the evaluation of the severity of symptoms and sports ability in individuals with exercise-induced leg pain. The ... [more ▼]

Objective: The “Exercise-Induced Leg Pain” questionnaire was developed (in German) for the evaluation of the severity of symptoms and sports ability in individuals with exercise-induced leg pain. The purpose of the present study was to translate and cross-culturally adapt this questionnaire into French and to study the reliability and validity of this French-language version. Methods: The translation and cross-cultural adaptation of the original “Exercise-Induced Leg Pain” was performed according to established guidelines. The translation part was carried out in six stages: (i) two initial translations from German to French; (ii) synthesis of the two translations; (iii) backward translations; (iv) comparison between the backward translations and the original questionnaire by an expert committee; (v) pretest; and (vi) approval of the final version of the French-language “Exercise-Induced Leg Pain” questionnaire. To validate this questionnaire, 84 subjects were recruited (28 pathological patients with a confirmed diagnosis of chronic leg pain, 28 asymptomatic sport students, and 28 healthy control athletes). The discriminative power of the questionnaire was tested, as well as its reliability (internal consistency and test–retest reliability after a 7–10-day interval), construct validity and floor/ceiling effects. Results: The French version of the “Exercise-Induced Leg Pain” questionnaire was generated without any major difficulties. The ability of the questionnaire to discriminate between the three groups of subjects was demonstrated with a total score of 61.0 ± 18.5 for the pathologic group; 93.9 ± 7.57 for the asymptomatic group and 94.1 ± 9.79 for the control group. A high internal consistency (Cronbach's alpha of 0.93) and an excellent test–retest reliability [intraclass coefficient correlation: 0.98 (95% confidence interval: 0.97–0.99, p < 0.001)] indicated that the “Exercise-Induced Leg Pain” is reliable. The questionnaire also demonstrated good construct validity against different subscales of the Short Form-36 questionnaire, a generic quality of life questionnaire, with more than 87% of the prespecified hypotheses confirmed. Finally, no floor effects or ceiling effects were observed. Conclusion: The French version of the « Exercise-Induced Leg Pain » was successfully translated and cross-culturally adapted. The questionnaire is consistent, valid and reliable for evaluating French-speaking patients with chronic exercise-induced leg pain. Implications for rehabilitation The “Exercise-Induced Leg Pain” questionnaire aims to assess the severity of symptoms that impact the function and sports ability of patients with exercise-induced leg pain; The French version of the « Exercise-Induced Leg Pain » was successfully translated and cross-culturally adapted. The questionnaire is consistent, valid and reliable for evaluating French-speaking patients with chronic exercise-induced leg pain. [less ▲]

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See detailProposal of a new tDCS safety screening tool TSST (Transcranial direct current stimulation Safety Screening Tool)
Bornheim, Stephen ULiege; Croisier, Jean-Louis ULiege; Maquet, Pierre ULiege et al

in American Journal of Physical Medicine and Rehabilitation (in press)

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See detailChronic lateral ankle instability increases the likelihood for surgery in athletes with os trigonum syndrome
D'Hooghe, Pieter ULiege; Alkhelafi, Khalid; Almusa, E et al

in Knee Surgery, Sports Traumatology, Arthroscopy (in press)

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See detailTendinopathies, ce qu’il ne faut faire et ne pas faire
Kaux, Jean-François ULiege

Conference (2019, May 12)

Le médecin généraliste est souvent confronté aux tendinopathies. Leurs nombreuses formes ou localisations compliquent sa tâche lorsqu’il faut décider du traitement adéquat. La compréhension de la ... [more ▼]

Le médecin généraliste est souvent confronté aux tendinopathies. Leurs nombreuses formes ou localisations compliquent sa tâche lorsqu’il faut décider du traitement adéquat. La compréhension de la pathologie tendineuse par le modèle du continuum de Cook et Purdam, ainsi que la notion d’hétérogénéité ont permis de proposer des stratégies thérapeutiques, adaptées aux différents phénotypes. Dans un premier temps, il est essentiel d’obtenir une antalgie satisfaisante et de la poursuivre dans un second temps par une rééducation physique, associée ou non à un traitement biologique, tel que les ondes de choc ou l’injection de plasma riche en plaquettes, stimulant la régénération. L’objectif étant d’obtenir une récupération optimale en terme de douleur et de fonctionnalité ainsi que de limiter les récidives. À l’aide de l’analyse et de la compréhension de l’évolution de la tendinopathie à travers les 3 stades ainsi que les mécanismes d’action des différents traitements, il est possible de poser les indications thérapeutiques les plus adaptées. Dans leurs études Cook et Purdam divisent leur modèle de continuum en plusieurs catégories thérapeutiques : • réactionnelle et début des remaniements structurels « early disrepair » ; • remaniements structurels avancés « late disrepair » et remaniements dégénératifs. Early disrepair (stade réactionnel et début desremaniements) Dans la première catégorie, nous allons nous orienter vers des traitements antalgiques et anti-inflammatoires qui vont diminuer la prolifération cellulaire et la synthèse protéique, afin de renverser les mécanismes liés à la surcharge. Il est impératif de diminuer la charge à laquelle le tendon est soumis par un repos relatif ou une adaptation du programme d’entrainement des sportifs en compétition. Nous pouvons avoir recours à une prise ponctuelle d’AINS, en particulier l’ibuprofène ou à une injection de corticostéroïdes si les douleurs sont incontrôlables et ne permettent pas une rééducation adéquate. Les étirements, qui augmentent la compression du tendon, ou les programmes d’exercices excentriques qui entretiennent le mécanisme de surcharge, ont tendance à aggraver la pathologie dans sa phase aigüe. Late disrepair (stade des remaniements avancés et dégénératifs) Dans la seconde catégorie, après le contrôle de la phase aigüe hyperalgique, il est important de stimuler la régénération tendineuse. C’est à ce moment que les traitements biologiques tels que les ondes de choc et les injections de PRP ou de HA, en fonction de la localisation anatomique des tendinopathies, prennent toute leur importance. Dans cette catégorie, il faut néanmoins se poser la question de la capacité de régénération réelle du tendon lésé et s’il n’est pas plus avantageux d’orienter le traitement vers une amélioration de la résistance à la charge des zones saines adjacentes dans les stades dégénératifs. Les revues systématiques et RCT mettent en évidence l’importance d’une réhabilitation physique après un traitement antalgique ou biologique stimulant. En effet, seule la mise en charge du tendon permet une stimulation et une réorganisation correcte de la matrice et des fibres de collagène. L’alignement optimal des fibres de collagène va permettre d’augmenter la résistance aux contraintes du tendon et ainsi éviter les récidives fréquentes ou l’évolution vers la chronicité. Les traitements excentriques et à charge lourde sont basés sur un programme de réhabilitation progressif de la mise en charge, en fonction de la douleur tolérée par le patient. Dans ce cadre, on pourrait recommander la réalisation d’une séance de contraction isométrique à visée antalgique avant chaque séance afin de permettre une augmentation des charges appliquées et d’améliorer l’efficacité du traitement. Stade réactionnel sur un tendon dégénératif La révision de leur modèle de continuum par Cook et Purdam met en évidence la possibilité de manifestations réactionnelles dans les portions saines d’un tendon dégénératif. Dans un premier temps, la prise en charge, identique à celle d’un épisode réactionnel sur un tendon sain, se fait par repos relatif et utilisation de traitements à visée antalgique. Par la suite, il faut tenir compte de la faible réversibilité des lésions dégénératives sous-jacentes. Les traitements devront, alors être orientés vers une amélioration de la résistance globale à la mise en charge et au bon alignement des fibres du tendon plutôt qu’un traitement biologique stimulant, ciblé sur la zone dégénérative. Ainsi, les programmes de réhabilitation vont permettre de diminuer le nombre d’épisodes réactionnels sur un tendon dégénératif et freiner la progression de la pathologie sur le continuum. Extrait de « Sauvant C, Kaux JF. Prise en charge des tendinopathies en médecine générale. La Revue de la Médecine Générale n° 346, pages 6-14. » [less ▲]

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See detailFrench translation and validation of the “Anterior Knee Pain Scale” (AKPS)
Buckinx, Fanny ULiege; Bornheim, Stephen ULiege; Remy, Gaël et al

in Disability and Rehabilitation (2019), 41(9), 1089-1094

Purpose: To linguistically and cross-culturally translate the Anterior Knee Pain Scale into French and to evaluate the reliability and validity of this translated version of the questionnaire. Methods ... [more ▼]

Purpose: To linguistically and cross-culturally translate the Anterior Knee Pain Scale into French and to evaluate the reliability and validity of this translated version of the questionnaire. Methods: The translation part was performed in six stages, according to international guidelines: (i) two initial translations from English to French; (ii) synthesis of the two translations; (iii) backward translations into the original language; (iv) expert committee to compare the backward translations with the original questionnaire; (v) pre-final version testing and (VI) expert committee appraisal. To validate the French version of the Anterior Knee Pain Scale, we assessed its validity, reliability and floor/ceiling effects. To do this, volunteer patients from the French part of Belgium and from France, with patellofemoral pain were asked to answer the French version of the Anterior Knee Pain Scale at baseline and after 7 days, as well as the generic SF-36 questionnaire. Results: The Anterior Knee Pain Scale was translated without any major difficulties. A total of 101 subjects aged 34.5 ± 11.4 years (58.4% of women) were included in this study. Results indicated an excellent test-retest reliability (Intra-class correlation coefficient (ICC) = 0.97, 95%CI: 0.96–0.98), a high internal consistency (Cronbach’s alpha = 0.87), a consistent construct validity (high correlations with the SF-36 questionnaire were found with domains related to physical function (r = 0.80), physical role (r = 0.70) and pain (r = 0.64)) and low or moderate correlations with domains related to mental health (r = 0.26), vitality (r = 0.32) and social function (r = 0.41). Moreover, no floor/ceiling effects have been found. Conclusions: A valid French version of the Anterior Knee Pain Scale is now available and can be used with confidence to better assess the disease burden associated with patellofemoral pain. It was successfully cross-culturally adapted into French.Implications for rehabilitationThe results on psychometric properties of the French Anterior Knee Pain Scale are comparable with six validated versions obtained for the Finnish, the Turkish, the Chinese, the Dutch, the Thai and the Persian populations.The French translated version of the Anterior Knee Pain Scale is a reliable and valid instrument for assessing the functional limitations associated with patellofemoral pain.The test–retest reliability of the French Anterior Knee Pain Scale was excellent, the internal consistency was high and the construct validity was consistent. There were no floor/ceiling effects. © 2017 Informa UK Limited, trading as Taylor & Francis Group [less ▲]

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See detailInfluence of a hamstring eccentric training on strength and flexibility: a randomized controlled trial
Delvaux, François ULiege; Schwartz, Cédric ULiege; Decréquy, Thibault et al

Poster (2019, April 28)

Introduction Muscle imbalances and poor flexibility are frequently described as risk factors for hamstring injury. Preventive strategies should include eccentric exercises (2, 3), but the influence of ... [more ▼]

Introduction Muscle imbalances and poor flexibility are frequently described as risk factors for hamstring injury. Preventive strategies should include eccentric exercises (2, 3), but the influence of multiple, on-field eccentric exercises on these risk factors remains unclear. The main purpose of this study was to investigate the efficacy of an on-field hamstring eccentric program on strength, passive and active flexibility of hamstring muscles. Methods Twenty-seven male amateur athletes (22.7±1.9 years, 182±9 cm, 75.1±10.4 kg) were randomly assigned to intervention (n = 13) or control group (n = 14). The intervention group was instructed to perform 15 sessions of four progressively increased eccentric exercises (single-leg Roman dead-lift T-drop, slide leg exercise, Askling’s “glider” and Nordic Hansmtring exercise) during a 6-week period. Both groups were assessed as follows: isokinetic (hamstring and quadriceps) strength and hamstrings-to-quadriceps ratios (Cybex Humac Norm® dynamometer (CSMI, Stoughton, USA)), ranges of motion during passive flexibility (straight leg raise - SLR) and active flexibility (Askling’s H test)(1) using an optoelectronic 3D system (Codamotion® CX1 units (Charnwood Dynamics, Rothley, UK)). Results In the intervention group, passive SLR was significantly increased by 11.4° (+12.7%, p<0.001, large effect size), but not active flexibility (+3.1%, p>0.05)(Figure 1). Hamstring eccentric peak torque (+7.1-8%), eccentric body weight normalized peak torque (+7.6-8%) and functional ratios (+8.9-9.3%) were significantly increased (p<0.05, small to medium effect size) in both dominant and non dominant legs of the intervention group participants. No modifications of strength or flexibility were observed in the control group (p>0.05). Conclusions A 6-week eccentric program, including four on-field exercises for hamstring muscles, is an effective method of improving several hamstring injury risk factors such as passive flexibility, eccentric strength and functional ratios. As this program may be easily implemented in a real-world context, an association of multiple eccentric exercises might be useful in an injury prevention strategy, especially in amateur athletes. References (1) Askling CM, Nilsson J, Thorstensson A. A new hamstring test to complement the common clinical examination before return to sport after injury. Knee Surg Sports Traumatol Arthrosc Off J ESSKA. 2010; 18(12):1798–803. (2) Guex KJ, Lugrin V, Borloz S, Millet GP. Influence on Strength and Flexibility of a Swing Phase-Specific Hamstring Eccentric Program in Sprinters’ General Preparation. J Strength Cond Res. 2016; 30(2):525–32. (3) van der Horst N, Smits D-W, Petersen J, Goedhart EA, Backx FJG. The preventive effect of the nordic hamstring exercise on hamstring injuries in amateur soccer players: a randomized controlled trial. Am J Sports Med. 2015; 43(6):1316–23. [less ▲]

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See detailTraining load management: effects on injury prevalence in high level rugby center
Paulus, Julien ULiege; Laly, Arnaud; Guns, Sébastien et al

in Football Medicine meets the universe of sport (2019, April)

Introduction : According to some theoretical integrative models, fatigue is considered as harmful for the ability to perform (fitness-fatigue) while in other ones it is complementary to it, or even a ... [more ▼]

Introduction : According to some theoretical integrative models, fatigue is considered as harmful for the ability to perform (fitness-fatigue) while in other ones it is complementary to it, or even a precursor. Whatever the paradigm, the injuries, possibly except those resulting from collisions, can be considered as an inadequacy, acute or chronic, between stimuli and sportsman’s (recovery) capacities. The objective of this study was to measure the effects of using a decision-making tool based on a daily, dematerialized but centralized, quantification of training load on the occurrence of players’ injuries in a rugby-training center. Methods : Each training session is characterized by a Workload Index (WI) with a scale ranging from one to five units. When the cumulative sum of the WI of a player exceeds a semi-individualized threshold, he enters in a recovery phase (reduction in training and addition of hydrotherapy sessions). The 35 players integrated into the Training Center are selected from the best Belgian rugby players of their age category (16.3 ± 1.1 years / 81.1 ± 18.3kg / 176.7 ± 5.6 cm for Y-1 season; 16.4 ± 1.1 years / 83.7 ± 15.1kg / 179.8 ± 6.5 cm for Y season). Each lesion resulting in medical consultation or practice restriction is considered an injury. Results : Competitive data of the Training Center players are slightly higher in the second season analyzed: the total playing time, the number of matches played and the average playing time per game increased by respectively 17%, 11% and 5% (non-significant). A sharp and significant decrease (74%) in the number of match injuries was observed between the two seasons. The season prior to the use of the decision-making tool, the Training Center players were injured during games, on average, 1.9 times per season against 0.5 during the Y season. Whether during the first or second competitive block, the number of match injuries is lower during the Y season. The correlation between the number of match injuries and playing time is respectively (very) strong and moderate for Y-1 and Y seasons: 0.899 [0.620 / 0.976] (p <0.001) and 0.617 [-0.020 / 0.900] (p = 0.051). Y-1 season Y season Total playing time (minutes) 27 873 32 480 Games 488 542 Injuries 68 18 Players injured during season 71% 31% Table 1: epidemiological data Conclusions : To our knowledge, this study is the first to evaluate, with an experimental research model, the effects of quantifying training load on the prevalence of match injuries over a significant number of rugby elites players. Our results show that during the Y season, following the introduction of the quantification of the training load, the players played more and were injured 4.5 times less in a match than during the previous season. We can not exclude that confounding variables might have influenced these results, nevertheless, they are unable to explain the drastic reduction in the number of injuries. A retrospective analysis revealed that (1) during the Y-1 season, players had periods of relative rest while the cumulative training load did not necessarily require it which could possibly have led to an under-training status [3], increasing the risk of injury [1] ; (2) at the opposite, the players could, during the Y-1 season, exceed the maximum workload threshold that we would have defined, in Y season, for these same players [2]. In the Y-1 season, 81% of the variance in match injuries was explained by the variance of playing time while in Y season, this percentage dropped to 38%. Before the introduction of training load quantification, the playing time appeared to be the main cause of the number of match injuries. Indeed, an increase in playing time seemed to lead to an increase in the number of match injuries suffered by players. During Y season, an increase in competitive playing time no longer seemed to increase the number of match injuries so directly. That could explain the increase in the number of games played per player (+1.6 games per season) and the playing time per game (+3 minutes per game). The reduction in player unavailability has resulted in an increase in the number of hours of deliberate practice, match and training situation, which is itself beneficial in the player's training process. The respect of training optimization principles through the individualization of relative rest periods has therefore resulted (1) in a very significant reduction in the number of injuries during Y season and (2) in a primary prevention action, so needed. References : 1. Drew, M.K. and C.F. Finch, The relationship between training load and injury, illness and soreness: a systematic and literature review. Sports Med, 2016 ; 46. 2. Drew, M.K. and C. Purdam, Time to bin the term 'overuse' injury: is 'training load error' a more accurate term? British Journal of Sports Medicine, 2016 ; 50(22): p. 1423-1424. 3. Gabbett, T.J., et al., If overuse injury is a 'training load error', should undertraining be viewed the same way? British Journal of Sports Medicine, 2016 ; 50(17): p. 1017-8. [less ▲]

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See detailPRESEASON ASSESSMENT OF ANAEROBIC PERFORMANCE IN ELITE SOCCER: ISOKINETIC VERSUS FUNCTIONAL TESTS
Delvaux, François ULiege; Kaux, Jean-François ULiege; Schwartz, Cédric ULiege et al

in XXVIII Isokinetic Medical Group Conference - Football Medicine meets the universe of sport (2019, April)

Introduction Isokinetic and functional jump tests are frequently performed for assessing physical qualities of soccer players during preseason(1, 3). The main purpose of this investigation was to explore ... [more ▼]

Introduction Isokinetic and functional jump tests are frequently performed for assessing physical qualities of soccer players during preseason(1, 3). The main purpose of this investigation was to explore, in a high-level soccer players population, the relationships between isokinetic strength and functional jump performances. Methods Thirty-eight male soccer players from a belgian first division professional soccer club were included (mean age: 24±6 years; height: 183±8 cm; weight: 77±7 kg). The test battery was composed of: an isokinetic knee assessment (Cybex Humac Norm® dynamometer (CSMI, Stoughton, USA)) in concentric (CON) mode (60 and 240°.s-1) for quadriceps and hamstrings, and in eccentric (ECC) mode for the hamstrings only (30°.s-1)(2); one-leg hop tests for distance (single hop (SH), triple hop (TH) and triple crossover hop (TCH)); one-leg vertical jump tests (counter movement jump (CMJ) and drop jump (DJ) on force plates (Kistler®, Kistler Group, Switzerland)). Results No correlations were found between all the isokinetic (absolute or relative performances) and the jump parameters (r<0.40). Players with a low bodyweight normalized (BWN) quadriceps (Q) strength (<2.71N.m.kg-1, first quartile) showed significant reduced jump performances (maximal height of CMJ, absolute and relative peak vertical ground reaction forces of DJ, all hop test performances; p<0.05) compared to the players with high BWN Q strength (>3.14N.m.kg-1, third quartile). Hamstrings-to-quadriceps ratios were not correlated with hop or vertical jump performances (r<0.40). In the past injured group (n=17), greater bilateral differences between uninjured and past injured lower limbs were found with isokinetics (Q CON 60 (mean bilateral difference (MBD): 10.3%; p<0.01), Q CON 240°.s-1 (MBD: 9.9%; p<0.05), H ECC 30°.s-1 (MBD: 16.1%; p<0.001)) than with functional tests (MBD: 2 to 9%; p>0.05) excepted for TCH (MBD: 8%; p=0.01). Concerning the group without past injury, no statistical differences were found between dominant and non dominant sides for all the isokinetic or functional variables (p>0.05). Conclusions According to our results, it might be appropriate to associate vertical jump tests or hop tests with an isokinetic assessment during a preseason soccer players screening. Furthermore, given that bilateral differences between past injured and uninjured limb were mostly highlighted by the isokinetic test than by functional tests, the isokinetic test seems to be an essential tool for preseason assessment. Finally, as a low BWN quadriceps peak torque at 60°.s-1 is related to a weak jump performance, strength and conditioning professionals should take into consideration this parameter in the player’s assessment. References (1) Bogdanis GC, Kalapotharakos VI. Knee Extension Strength and Hamstrings-to-Quadriceps Imbalances in Elite Soccer Players. Int J Sports Med. 2016; 37(2):119–24. (2) Croisier J-L, Ganteaume S, Binet J, Genty M, Ferret J-M. Strength imbalances and prevention of hamstring injury in professional soccer players: a prospective study. Am J Sports Med. 2008; 36(8):1469–75. (3) Menzel H-J, Chagas MH, Szmuchrowski LA, Araujo SRS, de Andrade AGP, de Jesus-Moraleida FR. Analysis of lower limb asymmetries by isokinetic and vertical jump tests in soccer players. J Strength Cond Res. 2013; 27(5):1370–7. [less ▲]

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See detailWhat’s new in tendinopathies? - Which efficacy for the new treatments?
Kaux, Jean-François ULiege

in Abstract Book - WORLD CONGRESS ON OSTEOPOROSIS, OSTEOARTHRITIS AND MUSCULOSKELETAL DISEASES (2019, April)

Tendinopathy is a major problem in medicine. It is due, inter alia, to mechanical overload. Painful and disabling, it frequently leads physical workers to impair their quality of life. It remains a chal ... [more ▼]

Tendinopathy is a major problem in medicine. It is due, inter alia, to mechanical overload. Painful and disabling, it frequently leads physical workers to impair their quality of life. It remains a chal- lenge for the medical world, to the extent that its frequent resist- ance to conventional treatments rarely gives the patient a favour- able outcome following therapeutic management. It is the reason why new treatments have been developed... Platelet-rich plasma (PRP) is blood plasma with a high concen- tration of autologous platelets which constitute an immense res- ervoir of growth factors. The clinical use of PRP is widespread in various medical applications. Although highly popular with athletes, the use of PRP for the treatment of tendinopathies re- mains scienti cally controversial, particularly due to the diversity of products that go by the name of ‘PRP.’ Recently, the viscoelastic properties of hyaluronic acid (HA) on liquid connective tissue have been proposed for the treatment of tendinopathies. Some fundamental studies show encouraging results on hyaluronic acid’s ability to promote tendon gliding and reduce adhesion as well as to improve tendon architectural or- ganisation. Some observations also support its use in a clinical setting to improve pain and function. [less ▲]

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See detailDetermining the force required in arthroscopic evaluation to assess the stability of syndesmotic ankle injury: a cadaveric study
D'Hooghe, Pieter ULiege; Chambers, Monique; Hogan, MaCalus et al

in Journal of ISAKOS: Joint Disorders and Orthopaedic Sports Medicine (2019), 4(2), 100-104

Introduction: The diagnosis of isolated distal tibio bular syndesmotic ankle instability proves to be a challenge. Although diagnostic imaging has added value, it is limited in the detection of distal ... [more ▼]

Introduction: The diagnosis of isolated distal tibio bular syndesmotic ankle instability proves to be a challenge. Although diagnostic imaging has added value, it is limited in the detection of distal syndesmotic ankle instability. The gold standard remains intraoperative testing through arthroscopic probing while externally stressing the ankle in a sagittal direction. However, no validated arthroscopic guidelines have been established to distinguish a stable from an unstable syndesmotic ankle joint. This cadaveric study presents anatomical and biomechanical data that can help surgeons correctly identify isolated distal syndesmotic ankle instability. Objective The purpose of this study is to quantify the necessary forces applied during ankle arthroscopy to evaluate syndesmotic instability in freshly frozen cadaveric ankles. Methods: A total of 16 fresh frozen cadaveric (age 58–74 years) ankles were included in the study. A dynamometer was used to measure the force necessary for the shaver tip to be inserted into the distal tibio bular joint with the ankle in a neutral position. Measurements were performed rst with the syndesmosis intact, and again following progressive transection of the syndesmotic ligaments, along with distal fixation. Results: Signi cant differences were noted in the mean force required between the anterior inferior tibio bular ligament (AITFL)+interosseous ligament (IOL) and no ligament cut methods (p<0.001 between the AITFL+IOL and AITFL cut (p<0.001; 95% CI 44.80 to 50.70), and between the AITFL+IOL and AITFL+IOL+ PITFL cut (p<0.001). There were also significant differences in the necessary mean forces applied between the one-SB and two-SB methods (p<0.001), between the one-SB and one-screw methods (p=0.010), between the one-SB and two screw methods (p=0.01), between the two-SB and two-screw methods (p=0.003) and between the one-screw and two-screw methods (p<0.001). Signi cant differences were found between the AITFL+IOL cut and the one-SB (p<0.001), the two-SB (p<0.001), the one-screw (p<0.001) and the two-screw (p<0.001) methods. Conclusions: This cadaveric study provides biomechanical data that can assist the surgeon in the arthroscopic evaluation of syndesmotic injuries. The data from this study need to be clinically correlated to ultimately assist in improving the outcome of patients with syndesmotic ankle injuries. Our study offers to bridge the gap to the development of arthroscopic tools that can identify the need for surgical xation to the syndesmosis based on the laxity of speci c ankle ligaments that contribute to subtle instability. [less ▲]

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See detailLinks between the level of consciousness and swallowing: what can we learn from patients in altered states of consciousness?
MELOTTE, Evelyne ULiege; MAUDOUX, Audrey ULiege; DELHALLE, Sabrina ULiege et al

in Abstract Book - IBIA 2019 (2019, March)

Introduction: The aims of this study were to document the extent and characteristics of dysphagia in patients with disorders of consciousness (DOC) and to evaluate the link between consciousness and ... [more ▼]

Introduction: The aims of this study were to document the extent and characteristics of dysphagia in patients with disorders of consciousness (DOC) and to evaluate the link between consciousness and different components of swallowing. Method: We collected and analyzed 10 criteria in link with oral-feeding, respiratory status and Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in 103 DOC patients (43 women; mean age 39±13years) admitted consecutively to the University Hospital of Liege (Belgium) for a one-week multimodal assessment of consciousness. The inclusion criteria were: to have had a coma and severe acquired brain injury, to have performed a FEES, and to have a diagnosis of DOC (unresponsive wakefulness syndrome (UWS)1 or minimally conscious state (MCS)2) confirmed by at least 5 assessments with the Coma Recovery Scale-Revised3 and by positron emission tomography (presence or absence of metabolic activity in the fronto-parietal network bilaterally). We performed a univariate logistic regression between several swallowing related parameters and consciousness diagnosis (UWS or MCS). Logistic regression was adjusted for age, time since insult and etiology. Results: Thirty-one patients were UWS (13 females, 11 with traumatic etiology, 16 post-anoxic and 4 others; 25±23 months post-insult) and 72 were MCS (30 females, 43 from traumatic brain injury, 12 post-anoxic and 17 others; 40±34 months post-insult). Compared with MCS patients, UWS patients had more frequently a tracheotomy still in place (68% UWS vs 24% MCS, p=0.002), pharyngo-laryngeal secretions (60% UWS vs 28% MCS, p=0.032), salivary aspiration (39% UWS vs 13% MCS, p=0.039) and the absence of an efficient oral phase (lip prehension, lingual propulsion and the absence of buccal stasis after swallowing) (0% UWS vs 62% MCS, p=0.003). The other observed parameters (i.e., the presence of an exclusive enteral-feeding, poor sensibility in the pharyngo-laryngeal area, hypertonia of the jaw muscles, basic oral phase of swallowing and thick/liquid aspiration) were not significantly influenced by the level of consciousness in our cohort. Conclusion: some components of swallowing correlate with the level of consciousness in our population of patients with DOC, particularly the efficacy of the oral phase of swallowing. This criterion should be considered as a sign of consciousness, and consequently, it should be taken into account in the diagnosis of DOC. The study also emphasizes the severity of dysphagia in DOC population and highlights the importance of correctly managing these disorders. 1 Bruno et al. (2011). From unresponsive wakefulness to minimally conscious PLUS and functional locked-in syndromes: recent advances in our understanding of disorders of consciousness. Journal of Neurology, 258(7), 1373-1384. 2 Giacino et al. (2002). The minimally conscious state: definition and diagnostic criteria. Neurology, 58(3), 349-353. 3 Giacino et al. (2004) The JFK Coma recovery scale-revised: measurement characteristics and diagnostic utility. Arch Phys Med Rehabil, 85, 2020–2029. 4 Bodart et al. (2017) Measures of metabolism and complexity in the brain of patients with disorders of consciousness. NeuroImage: Clinical, 14, 354‑362. [less ▲]

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See detailReprise du sport après tendinopathie traitée par infiltration de PRP
Lehane, Florence ULiege; Delvaux, François ULiege; Croisier, Jean-Louis ULiege et al

in Journal de Traumatologie du Sport (2019), 36(1), 28-33

Platelet rich plasma (PRP), a platelet concentrate obtained by centrifugation of autologous blood, has many properties that promote hemostasis and tissue healing. While its clinical effect is still being ... [more ▼]

Platelet rich plasma (PRP), a platelet concentrate obtained by centrifugation of autologous blood, has many properties that promote hemostasis and tissue healing. While its clinical effect is still being discussed today, PRP is increasingly used in the context of tendinopathies resistant to conventional treatments. In order to resume the practice of sports under optimal conditions, a Decision-Based RTP Model has recently been proposed. We will discuss the different criteria of return to play and risk factors involved in order to optimize the return to play and effectiveness of this treatment with PRP. © 2019 Elsevier Masson SAS [less ▲]

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See detailDémembrement des pathologies chroniques de la hanche du sportif
Maillard, Bérengère ULiege; Kaux, Jean-François ULiege

in Journal de Traumatologie du Sport (2019), 36(1), 40-54

Hip pain is common in athletes, acute or chronic, macro or micro-traumatic, articular or ab-articular and even projected. The short and long-term consequences are sometimes serious. The causes, very ... [more ▼]

Hip pain is common in athletes, acute or chronic, macro or micro-traumatic, articular or ab-articular and even projected. The short and long-term consequences are sometimes serious. The causes, very diverse, are also variable according to the age of the patient. The clinical examination is insufficiently discriminating, which makes the use of imaging almost systematic. The identification of the precise etiology will allow to establish a personalized treatment and limit the impact on sports performance. Conservative and surgical therapeutic techniques exist. © 2019 Elsevier Masson SAS [less ▲]

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See detailIs the triple stimulation technique a better quantification tool of motor dysfunction than motor evoked potentials in multiple sclerosis?
GIFFROY, Xavier ULiege; DIVE, Dominique ULiege; KAUX, Jean-François ULiege et al

in Acta Neurologica Belgica (2019), 119(1), 47-54

The triple stimulation technique (TST) was rarely used in multiple sclerosis (MS). This study aimed to compare TST and motor evoked potentials (MEP) for the quantification of motor dysfunction. Central ... [more ▼]

The triple stimulation technique (TST) was rarely used in multiple sclerosis (MS). This study aimed to compare TST and motor evoked potentials (MEP) for the quantification of motor dysfunction. Central motor conduction based on MEP (four limbs) and TST (upper limbs) was assessed in 28 MS patients with a median Expanded Disability Status Scale (EDSS) of 4. EDSS, timed 25-foot walk (T25FW), grasping strength and motor components of the MS functional composite (MSFCm) were evaluated. Regression analysis was used to assess the relationship between MEP, TST and clinical findings. TST was negatively correlated with EDSS (r = -0.74, p<0.0001) and to a lesser extent with T25FW (r = -0.47, p<0.05), and grasping strength (r = -0.43, p<0.05). A multiple regression analysis underlined the better correlation between clinical data and TST (R2 = 0.56, p<0.0005) than with MEP (0.03<R2<0.22, p>0.05). This study evidenced the value of TST as a quantification tool of motor dysfunction. TST appeared to reflect a global disability since it was correlated not only to hand function but also to walking capacity. [less ▲]

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See detailComparison of cardiac biomarker dynamics in marathon, semimarathon and untrained runners: what is the impact on results interpretation?
Le Goff, Caroline ULiege; Lennartz, Lieselotte; VRANKEN, Laura ULiege et al

in Journal of Laboratory and Precision Medicine (2019), 4(6), 10

Background: Cardiac biomarkers elevations have been described after running exercise. Objective of our study was to check cardiac biomarker dynamics in well trained athletes and untrained middle aged ... [more ▼]

Background: Cardiac biomarkers elevations have been described after running exercise. Objective of our study was to check cardiac biomarker dynamics in well trained athletes and untrained middle aged apparently healthy men and to highlight the impact on the lab results interpretation in emergency department. Methods: Cardiac biomarkers for ischemic condition, cardiac stretch and fibrotic processes were tested in different type of runners before, directly after and 3 hours after running. Markers for inflammation, muscle disease and renal function were also measured. Results: Cardiac biomarker levels between groups were not statistically different in the pre-exercise samples for natriuretic peptides [B-type natriuretic peptide (BNP), N-terminal Pro BNP (NT-ProBNP)] and galectin-3 (Gal-3), only Troponin I levels were higher. Directly after exercise, all cardiac biomarker levels were higher compared to the baseline, Gal-3 and BNP levels decreased 3 hours after completion of the run.Troponin values continued to increase with highest levels 3 hours after exercise. Troponin T, NT-Pro BNP and Gal-3 also showed significant correlation to markers of inflammation, fibrosis and renal function. Conclusions: Exercises of different intensity can be associated with biochemical abnormalities and longterm consequences are unknown. In chest pain patients presenting to the emergency department possible impact of exercise on test results, especially Troponin, should be checked. [less ▲]

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See detailTraduction et analyse par des experts d'une brochure consacrée à l'auto-gestion après un « Whiplash »
Demoulin, Christophe ULiege; Taret, R; Otero, J et al

in Kinesitherapie, La Revue (2019, February), 19(206), 105-106

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