ABSTRACT
INTRODUCTION: Spondyloarthritis (SpA) is a serious chronic inflammatory rheumatism implying different painful and crippling symptoms that require a multidisciplinary approach for the patient. Fatigue is one of the less well treated symptoms, even if its repercussion on everyday life is noticeable. Shiatsu is a Japanese preventive and well-being therapy that aims to promote better health. However, the effectiveness of shiatsu in SpA-associated fatigue has never been studied yet in a randomized study. METHODS AND ANALYSIS: We describe the design of SFASPA (Etude pilote randomisée en cross-over évaluant l'efficacité du Shiatsu sur la FAtigue des patients atteints de SPondyloarthrite Axiale), a single-center, randomized controlled cross-over trial with allocation of patients according to a ratio (1:1) evaluating the effectiveness of shiatsu in SpA-associated fatigue. The sponsor is the Regional Hospital of Orleans, France. The two groups of 60 patients each will receive three "active" shiatsu and three sham shiatsu treatments (120 patients, 720 shiatsu). The wash-out period between the active and the sham shiatsu treatments is 4 months. PLANNED OUTCOMES: The primary outcome is the percentage of patients responding to the FACIT-fatigue score. A response to fatigue is defined as an improvement, i.e., an increase of ≥ 4 points in the FACIT-fatigue score, which corresponds to the "minimum clinically important difference" (MCID). Differences in the evolution of activity and impact of the SpA will be assessed on several secondary outcomes. An important aim of this study is also to gather material for further trials with higher proof of evidence. TRIAL REGISTRATION: NCT05433168, date of registration, June 21st, 2022 (clinicaltrials.gov).
ABSTRACT
Certificate of absence of medical contraindication to the practice of a sport. Doctors are often called by their patients for certificate of absence of medical contraindication to the practice of a sport. They essentially see it as an administrative process, when it is a real reason for medical consultation. Appreciating the aptitude of a person, young or adult, to practice a sport, cannot be done between two doors, or by trying to read in the eyes of the applicant. What does this certificate mean? What is the legal support? Is there a protocol to follow?
Certificat d'absence de contre-indication médicale à la pratique d'un sport. Les médecins traitants sont souvent interpellés par leurs patients pour la rédaction d'un certificat d'absence de contre-indication médicale à la pratique d'un sport. Ils y voient essentiellement une démarche administrative, alors qu'il s'agit d'un véritable motif de consultation médicale. Apprécier l'aptitude d'une personne, jeune ou adulte, à pratiquer un sport ne peut pas se faire entre deux portes, ou en tentant de lire dans le regard du demandeur. Que signifie ce certificat ? Quel est le support juridique ? Existe-il un protocole à observer ?
Subject(s)
Physicians , Sports , Adult , Contraindications , HumansABSTRACT
PURPOSE: The recreational and competitive practice of acrobatic sports, that is, trampoline, tumbling and acrobatic gymnastics (ACRO), is growing rapidly around the world. Many studies described the injuries affecting young artistic gymnasts, but only few concerned acrobatic sports. METHODS: During a 5-year period, 357 traumatic events were collected in young acrobats practicing trampoline, tumbling or ACRO. Accident characteristics, level of expertise and training, injury location (upper limb, spine and lower limb), type of tissue injured (bone, cartilage, muscle, ligament and tendon) and provoking factors (intrinsic/behavioural and extrinsic) were investigated. RESULTS: Acrobats of national and international levels were mostly injured. Injuries occurring in acrobatic sports concerned predominantly the lower limbs and concerned in this body part mainly damages to ligaments. Forearm and knee injuries were preferentially related to trampoline. Ankle injuries were preferentially related to tumbling. Wrist injuries were preferentially related to ACRO. Upper limb bone damage and upper limb tendon damage were preferentially related to trampoline and ACRO, respectively. Intrinsic/behavioural factors were the main injury determinant in the three acrobatic sports. CONCLUSIONS: The main injuries in acrobatic sports (i.e. lower limbs) are similar to those observed in artistic gymnastics. Specific injuries may result from falls and incomplete and/or erroneous figure's landing and may also depend to the type of the landing surface. LEVEL OF EVIDENCE: II.
