[Study of risk factors of permanent functional limitations on 210 hemodialysed patients]

The aim of the study is to identify risk factors that can worsen the disability in chronic hemodialysis patients. A transversal study was conducted on a total of 210 patients. Data was collected using a 42-item questionnaire, and univariate and multivariate statistical analyses were conducted. Univariate analysis reveals that male sex, advanced age, small stature, low weight, unemployment, lifestyle, lack of sport, hypertension or diabetes, co-morbid conditions, polysulfane filter, time on dialysis, diffuse and chronic pain with high analog visual score are all aggravating disability. Multivariate study confirms advanced age, male sex, hemiplegia, cardiac failure and high analog visual scale as factors aggravating handicap in hemodialysis patients. Modifiable and non modifiable factors can be identified in the disability of dialysis patients. The approach for such patients should be targeted and multifactorial with emphasis on the role of physical rehabilitation and exercises

[Specific problem related to oro maxillo facial sphere and hwaring in 340 Lebanese musicians practicing wind instruments]

The aim of this study is to detect the problems related to wind instruments in order to determine the contributing factors. This study is a prospective study of a sample of Lebanese wind-instruments musicians. Questionnaire of 17 items about personal data, musical activities in general and specific problems related to wind instruments. 340 response out of 400 [85%]. Gender: male 100%. Age: 28.5 +/- 6.5 years [13-50]. Practice of any physical activity: 57.5%. Smokers: 40.5%. Data about musical practice-Years of practice: 6.5 +/- 5.5. Daily practice: 2.5 +/- 1.5 hours with 35 +/- 2 rest periods of 16.5 +/- 15 minutes. Weekly practice: 5 +/- 2 days. Data about medical problems-Hear loss 34%; respiratory difficulties: 19.5%; wound of lips muscles: 5%; gums and tongue lesions: 7.8%; myospasms of the cheeks and lips: 34.5%; dental problems: 30.7%temporo-mandibular disorders [TMD]: 22.5%. There is a high association between risk factors and pathology. Risks related to the instrument's use: hear loss [p=0.001], traumas to lips muscles [p=0.065], myospasms [p=0.064], TMD [p=0.000]. Other factors: physical activity is beneficial; smoking is harmful [breathing difficulties, spasms, headaches]. Factors influencing the different problems: age [31 +/- 7 years]; years of practice [9 +/- 6]; hours of practice per day [2 +/- 15]; days of practice per week [4.5 +/- 2.5]. Wind instruments are related to problems of mouth, facial muscles and hearing. This may lead musicians to stop their activities or to irreversible professional disabilities. A medical follow-up during the musicians training is needed to prevent these problems

particularites de la maladie de Scheuermann de l'adulte. A propos de 45 patients

Our aim was to find out which factors favor the occurrence of pain in adult patients with Scheuermann's disease -a juvenile manifestation of osteochondrosis of the spine, to study the clinical and radiological signs, the role of rehabilitation and the means to avoid the recurrence of pain. Patients and methods: Descriptive and retrospective study about 45 adults treated by rehabilitation. A data sheet listed the patient's occupation, current practice of sport, antecedents [violent sport, traumatism, pain], presence of a family form, motive of consultation, clinical and paraclinical examinations and immediate and long-term results of rehabilitation. Average age 35 years [18 to 65], male predominance [1.8: 1], occupational risk factors: 16%; only 24% practiced sports currently. Antecedents: sports 49%, spinal column traumatism 13%, dorsal and lumbar pain during adolescence 16%. Consultation motive: abnormal posture 4% and pain 96%.According to the examination: abnormal spinal column in 80% of cases. According to radiography, our patients were divided into 49% who were carriers of growth vertebral dystrophy and 51% who were carriers of the real Scheuermann's disease. The immediate results of rehabilitation were satisfactory, 75% of the results were very good and good. Between six months and four years, 70% of the results were very satisfactory. Exercises were observed in only 11% of the cases, and stopped after two months on average. Schcucrmann's disease in adults is a different entity from that of the teenager for the major manifestation is pain and not aesthetic quality. The patients occupation is rather sedentary; sport is beneficial. The functional rehabilitation is the basic treatment and recourse to surgery or dorso-lumbar braces is rare

Handicap et reeducation fonctionnelle chez les hemodialyses hospitalises: Etude descriptive a propos de 20 patients

Twenty hemodialyzed patients, received rehabilitation while they were hospitalized. They were all handicapped in the beginning; when they left the hospital, 10 patients were completely independent, six needed help at home and 4 were completely dependent. The authors search, from their own practice, the etiologies of handicap with hemodialyzed patients and how to prevent this handicap, with the target of giving to their patients the best quality of life. The rehabilitation is very important in the strategies of global care of these patients

Reeducation du syndrome de la traversee thoraco-brachiale. A propos de 60 malades

Sixty patients were treated by physical therapy for thoracic outlet syndrome [TOS] between 1995 and 1999. Females were predominant [76%] the average age was 34.5 years [I8 to 60]. Risk factors were hypermobility, cervical traumatism and profession. Neurological signs were predominant and positive provocation tests were found Adson [4S%], sonnette [62%], E.A.S.T. [51%]. Thoracic pain inaugurated the symptoms in 3 times pseudo-angina [2], dyspnea [1]. Radiological results were positive for cervical rib [8], apophysomegaly of C7 [25], clavicular traumatism [1]. Electromyogram was positive in 2 out of 3 patients, RMI in 2 of 4, and dynamic echo doppler in 3 of 4. After rehabilitation, immediate results were satisfactory in more than 70% of cases. After six months one patient had recurrence of symptoms, 66% were compliant with treatment, and 84% were satisfied. At one year the symptoms recurred in 2 patients, 15% were still compliant, and 81% were satisfied. Surgery was needed in 4 patients with cervical ribs