Evidence-Based, Implementable Motor Rehabilitation Guidelines for Individuals With Cerebral Palsy.

BACKGROUND: Cerebral palsy is a life-long condition that causes heterogeneous motor disorders. Motor rehabilitation interventions must be adapted to the topography of the symptoms, ambulatory capacity, and age of the individual. Current guidelines do not differentiate between the different profiles of individuals with cerebral palsy, which limits their implementation. OBJECTIVES: To develop evidence-based, implementable guidelines for motor rehabilitation interventions for individuals with cerebral palsy according to the age, topography of the cerebral palsy, and ambulatory capacity of the individual and to determine a level of priority for each intervention. METHODS: We used a mixed methods design that combined a systematic review of the literature on available motor rehabilitation interventions with expert opinions. Based on the French National Authority for Health methodology, recommendations were graded as strong, conditional, or weak. Interventions were then prioritized by the experts according to both the evidence and their own opinions on relevance and implementability to provide a guide for clinicians. All recommendations were approved by experts who were independent from the working group. RESULTS: Strong recommendations as first-line treatments were made for gait training, physical activities, and hand-arm bimanual intensive therapy for all children and adolescents with cerebral palsy. Moderate recommendations were made against passive joint mobilizations, muscle stretching, prolonged stretching with the limb fixed, and neurodevelopmental therapies for all children and adolescents with cerebral palsy. Strong recommendations as first-line treatments were made for gait training for all adults with cerebral palsy and moderate recommendations as moderate importance interventions for strengthening exercises and ankle-foot orthoses for motor impairment of the feet and the ankles. DISCUSSION: These guidelines, which combine research evidence and expert opinions, could help individuals with cerebral palsy and their families to codetermine rehabilitation goals with health professionals, according to their preferences.

Diez recomendaciones para promover la francofonía en salud / Ten recommendations to promote the use of the French language in the field of healt

La francofonía es un bien patrimonial amenazado por la universalidad anglófona que excluye toda dualidad lingüística. El riesgo de reducción y corrupción del conocimiento influye en la formación, la investigación y las prácticas sobre el terreno. Para promover la francofonía en el ámbito de la salud, se proponen 10 recomendaciones: 1) publicar sistemáticamente en francés la relación de estudios realizados por equipos francófonos; 2) traducir al inglés los títulos, resúmenes y palabras clave de los artículos francófonos; 3) favorecer la difusión de las producciones científicas y técnicas francófonas; 4) presentar en francés los soportes de presentaciones orales cuando se dirigen a un auditorio francófono; 5) subtitular en francés las presentaciones de trabajos francófonos presentados en otra lengua; 6) citar las fuentes bibliográficas francófonas cuando se trata de referencias prínceps; 7) impulsar las iniciativas y trabajos científicos francófonos en sinergias de colaboración; 8) emplear los términos y expresiones francófonos que existen; 9) redactar en francés los elementos auxiliares de comunicación electrónica (mensaje de ausencia, firma, filiación, diplomas, etc.), y 10) mejorar permanentemente el dominio de la lengua francesa. Estas recomendaciones pretenden garantizar el empleo del francés en la vida profesional y social como un factor de cohesión, lo cual depende de la responsabilidad de cada uno

The French language is a cultural asset, which is being threatened by the universal use of English, therefore excluding all linguistic duality. The risk of reduction and corruption of knowledge has an impact on training, research and practice. In order to promote the use of the French language in the field of health, 10 recommendations are proposed: (1) To systematically publish reports of studies conducted by French speaking teams, in French; (2) To translate titles, abstracts and keywords from French articles into English; (3) To promote the dissemination of scientific and technical materials in the French language; (4) To provide support in French during talks and presentations given to French-speaking audiences; (5) To use French subtitles when the work of a native French speaker is presented in another language; (6) To cite bibliographical references in French when using princeps references; (7) To work closely on scientific work and initiatives in the French language in collaborative synergies; (8) To use French language terms and expressions that exist; (9) To use written French in emails (out of office reply, signature, affiliations, qualifications, etc.); (10) To constantly improve our command of the French language. These recommendations aim to ensure the use of French in professional and social life as a cohesive factor, something which is everyone's responsibility