Dance with the senses. A dance class with visual impaired and sighted children in a conservatory: one-year experience.

BACKGROUND: Children with visual impairment very often have additional motor disorders and developmental delays. They are less active than typical children of a similar age, even though physical activity is essential for their well-being. METHODS: A weekly dance class for 1 year was offered to 4 visually impaired and 5 sighted children in a conservatory. RESULTS: The children's satisfaction was excellent, and they perceived an improvement in their mood, walking, balance and coordination, and felt more physically active. The walking speed, balance and posture were improved. CONCLUSION: This original project, with its full integration in a dance conservatory and by mixing children with and without visual impairment, showed excellent feasibility.

Feasibility, criterion and construct convergent validity of the 2-minute walk test and the 10-meter walk test in an oncological context.

Objective: To examine the feasibility, the criterion, and the construct convergent validity of the 2-Minute Walk Test (2MWT) and the 10-Meter Walk Test (10MeWT) against the 6-Minute Walk Test (6MWT) to assess walking capacity in people with cancer. The criterion concurrent validity of a self-test version of the 10MeWT (10MeWTself-test) was also evaluated against the 10MeWT. Methods: Fifty-six people with cancer performed the 2MWT, the 10MeWT at comfortable and fast speeds, the 6MWT, and the 10MeWTself-test. The feasibility of the tests was assessed using safety, adverse events, space requirements, time taken to administer and interpret the tool, equipment or training required, cost, and portability as criteria. Validity was assessed using Pearson correlation coefficients and Bland Altman plots. Results: The 2MWT, 6MWT, 10MeWT, and 10MeWTself-test were feasible for people with cancer. The 2MWT and the 10MeWT results were moderately to strongly correlated with the 6MWT results (0.61 < r < 0.84, p < 0.001). The 10MeWTself-test results were strongly correlated with the 10MeWT results at comfortable and fast speeds (r = 0.99, p < 0.001). Conclusions: The 2MWT, 10MeWT, and 10MeWTself-test are simple, rapid, and feasible tests for use in people with cancer. The strong correlation between the 2MWT and 6MWT results indicates that the 2MWT can be used as an alternative walking capacity assessment tool. The 10MeWT results moderately correlated with those of the other two tests, suggesting that it partially measures the same construct of walking capacity in walking-independent outpatients with cancer. The 10MeWTself-test showed promising results but needs further investigations in ecological settings.

Dance after stroke improves motor recovery in the subacute phase: A randomized controlled trial.

Purpose: The objective of this study was to investigate the effects of a dance program, combined with conventional treatments, on the motor recovery and quality of life of stroke survivors in comparison with conventional treatments alone. Materials and methods: A total of 16 subacute stroke survivors were randomized into two groups: a dance group (DG) and a conventional treatments group (CG). Stroke severity, cognitive abilities, and motor capacities were assessed at baseline. For six weeks, all participants underwent standard rehabilitation. However, in the DG, participants attended an additional weekly dance class. In both groups, the Mini-BESTest, Functional Independence Measure (FIM), ABC-Scale, Lower Extremity Motor Coordination Test (LEMOCOT), quadriceps strength, and Stroke-Specific Quality of Life Scale (SS-QOL) were measured at weeks 4 and 6. Nonparametric statistical tests were applied. Results: Compared to the CG, the DG significantly improved recovery of balance, coordination, and FIM after four or six weeks. No differences were observed for quadriceps strength, SS-QOL, or cognition. Participants were completely satisfied with the dance class, and no adverse effects were observed. Conclusions: This study was discontinued following the COVID-19 health crisis. However, the analysis revealed numerous beneficial effects of dance practice for subacute stroke survivors. The results contribute significantly to the advancement of artistic practices in stroke rehabilitation.

Identifying physical and psychological risk factors for musculoskeletal pain in student musicians to tailor the curriculum: a cross-sectional study protocol.

INTRODUCTION: Insufficient identification and understanding of risk factors make musicians engaging in professional practice particularly vulnerable to musculoskeletal pain. To support positive music learning and good mental, physical, and social health, student musicians need health support tailored to their needs and their instrumental practice. However, these preventive actions must be based on sound scientific approaches that reliably identify the most relevant risk factors. MuSa is a cross-sectional study examining contextual and internal risk variables associated with playing-related musculoskeletal disorders in student musicians. METHOD AND ANALYSIS: The design is a monocentric cross-sectional study involving student musicians in Bachelor's 1, 2, 3 and Master's 1, 2. Free-form questions will identify students' lifestyle characteristics and work habits, and validated questionnaires will evaluate the interaction between pain due to music practice and psychological and physical risk factors. All data will first be analysed descriptively. Psychological network analysis will be used to explore the overall correlational structure of the dataset. A subgroup comparative analysis will be then applied according to the instrumental subcategories and work postures, including singers. ETHICS AND DISSEMINATION: The full protocol was approved by the Swiss Ethics Committee 'Commission Cantonale d'Ethique de la Recherche sur l'être humain de Genève' (CCER, no. 2022-02206) on 13 February 2023. Outcomes will be disseminated through publication in peer-reviewed journals and presentations at conferences.

Pulmonary rehabilitation improves sleep efficiency measured by actigraphy in poorly sleeping COPD patients.

Chronic insomnia is reported by up to 50% of chronic obstructive pulmonary disease (COPD) patients. This may be attributable to several factors including nocturnal dyspnea, reduced physical activity, and less time outside. Pulmonary rehabilitation (PR) is recommended in COPD to improve both physical and psychological conditioning. The aim of this study was to assess the effect of PR on sleep efficiency (SE, measured by actigraphy) in COPD patients. COPD eligible for PR were prospectively included. Baseline and post PR (30 sessions) assessments included incremental and maximal exercise testing, 6-min walking distance test (6MWT), actigraphy, and questionnaires [Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety Depression scale, St George Respiratory, and modified Medical Research Council dyspnea scale]. Sixty-one patients were included, and 31 patients completed the study protocol (68% of males, age 63 ± 9 y, FEV1 44.2 ± 12.3%). After PR, SE remained unchanged, p = 0.07, as well as PSQI score (p = 0.22), despite improvements in exercise capacity (incremental exercise test, 6MWT) and dyspnea. However, SE improved significantly in the poor sleeper subgroup (SE < 85%, n = 24, p = 0.02), whereas the PSQI remained unchanged. The present study shows, in COPD patients included in a PR program, that improvement in exercise capacity was disappointingly not associated with a better SE assessed by actigraphy. Subjective sleep quality was also unchanged at the end of PR program. However, SE improved significantly in the poor sleeper subgroup (SE < 85%). Further studies are required to better characterize the origin of sleep disturbances in COPD and the potential benefit of some (non-)pharmacologic interventions.

Pulmonary Functional Outcomes at 3 Months in Critical COVID-19 Survivors Hospitalized during the First, Second, and Third Pandemic Waves.

INTRODUCTION: Despite improved management of patients with COVID-19, we still ignore whether pharmacologic treatments and improved respiratory support have modified outcomes for intensive care unit (ICU) surviving patients of the three first consecutive waves (w) of the pandemic. The aim of this study was to evaluate whether developments in the management of ICU COVID-19 patients have positively impacted respiratory functional outcomes, quality of life (QoL), and chest CT scan patterns in ICU COVID-19 surviving patients at 3 months, according to pandemic waves. METHODS: We prospectively included all patients admitted to the ICU of two university hospitals with acute respiratory distress syndrome (ARDS) related to COVID-19. Data related to hospitalization (disease severity, complications), demographics, and medical history were collected. Patients were assessed 3 months post-ICU discharge using a 6 min walking distance test (6MWT), a pulmonary function test (PFT), a respiratory muscle strength (RMS) test, a chest CT scan, and a Short Form 36 (SF-36) questionnaire. RESULTS: We included 84 ARDS COVID-19 surviving patients. Disease severity, complications, demographics, and comorbidities were similar between groups, but there were more women in wave 3 (w3). Length of stay at the hospital was shorter during w3 vs. during wave 1 (w1) (23.4 ± 14.2 days vs. 34.7 ± 20.8 days, p = 0.0304). Fewer patients required mechanical ventilation (MV) during the second wave (w2) vs. during w1 (33.3% vs. 63.9%, p = 0.0038). Assessment at 3 months after ICU discharge revealed that PFTs and 6MWTs scores were worse for w3 > w2 > w1. QoL (SF-36) deteriorated (vitality and mental health) more for patients in w1 vs. in w3 (64.7 ± 16.3 vs. 49.2 ± 23.2, p = 0.0169). Mechanical ventilation was associated with reduced forced expiratory volume (FEV1), total lung capacity (TLC), diffusing capacity for carbon monoxide (DLCO), and respiratory muscle strength (RMS) (w1,2,3, p < 0.0500) on linear/logistic regression analysis. The use of glucocorticoids, as well as tocilizumab, was associated with improvements in the number of affected segments in chest CT, FEV1, TLC, and DLCO (p < 0.01). CONCLUSIONS: With better understanding and management of COVID-19, there was an improvement in PFT, 6MWT, and RMS in ICU survivors 3 months after ICU discharge, regardless of the pandemic wave during which they were hospitalized. However, immunomodulation and improved best practices for the management of COVID-19 do not appear to be sufficient to prevent significant morbidity in critically ill patients.

Does texting while walking affect spatiotemporal gait parameters in healthy adults, older people, and persons with motor or cognitive disorders? A systematic review and meta-analysis.

BACKGROUND: Smartphone use during postural-locomotor tasks is an everyday activity for individuals of all ages in diverse environmental situations and with various health conditions. Nevertheless, the use of smartphones during walking is responsible for many accidents. RESEARCH QUESTION: This systematic review and meta-analysis examined spatiotemporal gait parameters during the dual-task situation "texting + gait" versus isolated gait task (single task) in adult persons (>18 years). METHODS: Electronic database searches were performed in PubMed, Embase, CINHAL, and LISSA. Two examiners assessed the eligibility and quality of appraisal with the Downs and Black checklist. The standardized mean difference (SMD) with 95 % confidence intervals was calculated to compare single- and dual-task situations. The pooled estimates of the overall effect were computed using a random or fixed effects method, and forest plots were generated. RESULTS AND SIGNIFICANCE: A total of 25 studies were included. All studies included healthy adults, with four studies including older persons and three including people with pathological conditions. The walking task was with (N = 4) and without (N = 21) obstacles and in laboratory (N = 21) or ecological conditions (N = 7). The quality scores were 6-8/16 for eight studies, 9-12/16 for seven studies, and more than 12/16 for three studies. During the "texting + gait" tasks, the meta-analysis highlighted a significant impairment of gait speed, step and stride length, cadence, and double and single support (p < 0.05). The spatiotemporal parameters of gait were systematically altered during the texting task regardless of the population and test conditions. However, the quality of the studies is moderate, and few studies have been conducted for people with motor deficiencies. The impact of texting on walking should be better considered to develop prevention actions.

Obstructive sleep apnea is not associated with diabetic retinopathy in diabetes: a prospective case-control study.

PURPOSE: Diabetic retinopathy (DR) is the most common ocular complication of type 2 diabetes mellitus (T2D) and is associated with diabetes duration, glycemic control, and hypertension (HTN). Obstructive sleep apnea (OSA) is frequent in T2D and is associated with poor glycemic control. However, it is unclear if there is an association between OSA and DR. This study aimed to assess whether or not the presence of OSA in patients with T2D was associated with DR. METHODS: In this prospective case-control study, consecutive patients with DM attending the ophthalmology clinics were recruited to include patients with DR (cases) and without DR (controls). OSA was diagnosed by attended polysomnography (PSG). Blood pressure and a fasting morning blood sample, including glycosylated hemoglobin (HbA1c), were recorded. Patients were matched for age, body mass index (BMI), gender, and T2D duration. RESULTS: Thirty diabetic patients with DR were matched with 30 controls. In all patients, the prevalence of moderate-to-severe OSA was 57%. In the logistic regression analysis, DR was associated with increased HbA1c (OR 2.63, 95% CI 1.35-5.16, p = 0.004) but not with any PSG parameter. In the DR group, PSG parameters were not associated with the severity of ocular disease (non-proliferative, proliferative, presence/absence of macular edema). The proliferative aspect of DR was correlated with age (p = 0.017). DR occurred more frequently in uncontrolled diabetes compared to well-controlled diabetes (80% vs 38%, p = 0.029). CONCLUSIONS: In patients with T2D, the presence of DR is not associated with OSA, but with poorly controlled T2D.

Health-Related Quality of Life Improves in Parallel with FEV1 and 6-Minute Walking Distance Test at Between 3 and 12 Months in Critical COVID-19 Survivors.

Background: In COVID-19 intensive care unit (ICU)-admitted patients, multiorgan acute complications lead to long-lasting sequelae. The aim of this study was to assess (1) changes in chest CT, pulmonary function test (PFT), functional capacity (6-minute walking distance test (6MWT)), and health-related quality of life (HR-QoL) among ICU COVID-19 survivors at 3, 6, and 12 months after ICU discharge and (2) predictors of persistent impairment/improvement in 6MWT and HR-QoL. Methods: ICU COVID-19 survivors were prospectively included. Outcomes at 3, 6, and 12 months included PFT, 6MWT, respiratory muscle strength (RMS), HR-QoL (SF-36), Medical Research Council dyspnea scale (mMRC), and post-COVID Functional Status scale. Results: Eighty-seven survivors were included, from June 3, 2020, to September 2, 2021. At 12 months, 50% of PFT were normal, 46% were restrictive, and 22% showed reduced diffusing capacity for carbon monoxide (DLCO). Impaired DLCO was associated with ICU length of stay and age. In mixed linear model analysis, improvements in RMS and mMRC persisted over time regardless of the adjustments applied (P ≤ .050). SF-36 improved in parallel with FEV1 and 6MWT between 3 and 12 months (P ≤ .044), while increment in DLCO correlated with changes in FEV1 and total lung capacity (TLC) (p ≤ 0.026). Conclusions: This longitudinal study demonstrated that improvements in SF-36 occur in parallel with improvements in FEV1 and 6MWT between 3 and 12 months post-ICU discharge in a sample of critically ill COVID-19 patients. However, PFT remained, however, abnormal in 50% of patients. Based on continued improvements observed from 3 to 12 months, it is anticipated that COVID-19 ICU patients will continue to recover similarly to ARDS patients.

Validity and reliability of center of pressure measures to quantify trunk control ability in individuals after stroke in subacute phase during unstable sitting test.

Objective: The objective of this study was to assess, for individuals with hemiparesis after a stroke in subacute phase, the validity and reliability of center of pressure (CoP) parameters measured during sitting balance on an unstable support. Materials and methods: Thirty-two individuals after stroke were included in this observational study for validity and reliability (mean age: 64.34 ± 9.30y, 23 men, mean post-stroke duration: 55.64 ± 27days). Intra-Class Correlation (ICC) and Bland Altman plot assessed intra-rater reliability and inter-rater reliability of CoP parameters during unstable sitting balance test (anteroposterior or mediolateral imbalance). Validity was established by correlating CoP parameters with the Modified Functional Reach Test, trunk strength, Balance Assessment in Sitting and Standing and Timed Up and Go tests. Results: The findings highlighted significant correlations between CoP parameters and trunk strength for anteroposterior seated destabilization. Good to excellent intra and inter-rater reliability (0.87 ≤ ICC ≤ 0.95) was observed for all CoP length parameters and CoP mean velocity in both mediolateral and anteroposterior imbalance conditions. CoP parameters for mediolateral unstable sitting condition were more reliable than for anteroposterior instability. Conclusion: Trunk control assessment during unstable sitting position on a seesaw is a reliable test for assessing trunk control ability in individuals after a stroke. CoP length and mean velocity are found to be the best parameters.

Reliability and validity of the trunk position sense and modified functional reach tests in individuals after stroke.

The psychometric qualities of the proprioception and dynamic trunk control tests have rarely been studied in individuals after stroke. OBJECTIVE: To investigate the reliability and validity of the Trunk Position Sense Test (TPS) and Modified Functional Reach Test (MFRT) in persons after stroke. METHODS: Thirty-two participants were included. The TPS and MFRT were assessed by two physiotherapists during a first session. After resting, a second session was conducted. The intraclass correlation coefficient (ICC) was calculated to assess the test-retest (ICC3,k) and inter-rater reliability (ICC2,k). Pearson correlations coefficients were calculated between TPS/MFRT performances and clinical tests (trunk strength, Timed Up and Go and Balance Assessment in Sitting and Standing Positions - BASSP). RESULTS: The TPS inter-rater reliability was good for vertical error (ICC = 0.75 [0.50-0.88]) while it was moderate for horizontal error (ICC = 0.48 [0.10-0.75]) as well as for test-retest reliability (0.39 ≤ ICC ≤ 0.59). As for the MFRT, inter-rater (0.76 ≤ ICC ≤ 0.90) and test-retest reliability (0.71 ≤ ICC ≤ 0.91) were good to excellent for anterior, paretic et non-paretic displacements. Horizontal errors for the TPS (-0.26 ≤ r ≤ -0.36) and anterior MFRT (0.38 ≤ r ≤ 0.64) values correlated moderately with trunk strength. CONCLUSION: The MFRT is a reliable test for persons after stroke with trunk control impairments. The TPS does not appear to be relevant for post-stroke individuals. This can be explained by the fact that its procedure is not easily applied for individuals after stroke - who may have significant motor and cognitive impairments.

Tailored individual Yoga practice improves sleep quality, fatigue, anxiety, and depression in chronic insomnia disorder.

BACKGROUND: Chronic insomnia disorder (CI) is a prevalent sleep disorder that can lead to disturbed daytime functioning and is closely associated with anxiety and depression. First-choice treatment is cognitive behavioral therapy (CBT-I). Other mind-body interventions, such as Tai-chi and Yoga, have demonstrated subjective improvements in sleep quality. The purpose of this study was to assess the efficacy of Yoga for improvement of subjective and objective sleep quality as well as measures of anxiety, depression, sleepiness, and fatigue in patients with CI. METHODS: Adults with CI were prospectively included in this single group pre-post study. Baseline assessments included home polysomnography (PSG), 7-day actigraphy, and questionnaires (Pittsburgh Sleep Quality Index questionnaire (PSQI), Hospital Anxiety Depression scale (HADS), Epworth Sleepiness Scale (ESS), Pichot fatigue scale (PS)). Patients practiced Viniyoga, an individualised Yoga practice with daily self-administered exercises, for 14 weeks. Assessments were repeated at the end of Yoga practice. RESULTS: Twenty-one patients completed the study. Objective sleep measurements revealed no change in PSG parameters after Yoga practice, but a decrease in arousals on actigraphy (p < 0.001). Subjective symptoms improved for all questionnaires (PSQI, p < 0.001; HAD-A, p = 0.020, HAD-D, p = 0.001, ESS, p = 0.041, PS, p = 0.010). In univariate correlations, decrease in PSQI was associated with increase in sleep stage N3 (p < 0.001) on PSG. CONCLUSIONS: We have demonstrated a positive impact of individualized Yoga practice on subjective parameters related to sleep and daytime symptoms in CI, resulting in fewer arousals on actigraphy. Yoga could be proposed as a potentially useful alternative to CBT-I in CI, as it is easy to practice autonomously over the long-term. However, given the design of the present study, future prospective controlled studies should first confirm our results. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03314441 , date of registration: 19/10/2017.

Pressure adjustment is the most useful intervention for improving compliance in telemonitored patients treated with CPAP in the first 6 months of treatment.

PURPOSE: Telemonitoring (TMg) for patients treated with continuous positive airway pressure (CPAP) is now routine care in some sleep labs. The purpose of the present study was to identify technical interventions associated with improved CPAP compliance in a real-life cohort of newly telemonitored patients with obstructive sleep apnea (OSA) during the first 6 months of treatment. METHODS: All patients with moderate-to-severe OSA (apnea-hypopnea index (AHI) ≥ 15/h) who were newly treated with CPAP were included in the study and telemonitored. A group educational session was scheduled after 1 month. Technical interventions were performed at the patient's request and during scheduled visits and the impact of each intervention on CPAP therapy compliance was collected. RESULTS: Between May 2018 and Dec 2019, 349 patients newly diagnosed with OSA were hospitalized in the sleep lab for CPAP titration and 212 patients were included (mean age 54.6 ± 13.1 years, mean BMI 31.7 ± 5.8 kg/m2, mean AHI 42.8 ± 22.0). TMg acceptance rate was 87%. Mean 6-month compliance was 275 ± 154 min, 13% stopped CPAP, and 17% were non-compliant. Correlations were observed between BMI (r = 0.15, p = 0.029), median and 95th percentile leaks (r = -0.23 and -0.18, p = 0.016 and 0.002), and CPAP compliance. During follow-up, 92 interventions were required, mainly for mask change (n = 80). Pressure modification (n = 16) was the only intervention that increased CPAP use > 30 min/night, p = 0.021. CONCLUSION: Pressure modification was the only adaptation that significantly increased CPAP compliance during the first 6 months. Remote TMg allows providing daily, accurate, and immediate feedback that could help clinicians to confirm that the CPAP treatment is effective.

Influence of chemotherapy on postural control and quality of life in women with gynaecological cancer: a protocol of a prospective observational study.

INTRODUCTION: Chemotherapy-induced peripheral neuropathy is a frequent side effect of some chemotherapies that can cause postural control disorders and has a serious impact on quality of life (QoL). An enhanced understanding of postural control dysfunction could help build a systematic and accurate assessment as well as specific exercises to limit the impact on QoL. This study aims to assess the influence of chemotherapy on postural control and the QoL for women with gynaecological cancer. METHODS AND ANALYSIS: This prospective observational study will include 37 participants with cancer treated using neurotoxic chemotherapy. Their postural control in various conditions (rigid and foam surfaces, eyes open and closed, with and without tendon vibration, and dual tasks), limits of stability, QoL and modified Total Neuropathy Score will be assessed. A linear mixed model will compare postural control pre-chemotherapy and post-chemotherapy. ETHICS AND DISSEMINATION: This study was approved by an ethical review board in Geneva (CCER-2020-01639). The study findings will be disseminated through conference presentations and publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT04692168.

Best Quantitative Tools for Assessing Static and Dynamic Standing Balance after Stroke: A Systematic Review.

Purpose: Our objective was to examine the psychometric qualities (reliability and validity) and clinical utility of quantitative tools in measuring the static and dynamic standing balance of individuals after stroke. Method: We searched four databases (PubMed/MEDLINE, PEDro, Embase, and CINAHL) for studies published from January 2018 through September 2019 and included those that assessed the psychometric properties of standing balance tests with an adult stroke population. We evaluated the quality of the studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and assessed each test on a utility assessment scale. Results: A total of 22 studies met the inclusion criteria, and 18 quantitative tools for assessing static or dynamic standing balance of individuals with stroke were analyzed. Findings support good or excellent reliability for all tests, whereas correlations for validity ranged from weak to strong. Study quality was variable. Dynamic balance tests had better clinical utility scores than static ones. Five tests had complete psychometric analyses: quiet standing on a force platform, five-step test, sideways step, step length, and turn tests.

Objectif : examiner les qualités psychométriques (fiabilité et validité) et l'utilité clinique d'outils quantitatifs pour mesurer l'équilibre statique et dynamique en position debout après un accident vasculaire cérébral (AVC). Méthodologie : leschercheurs ont extrait des études évaluant les propriétés psychométriques de tests d'équilibre en position debout dans une population d'adultes ayant eu un AVC de quatre bases de données (PubMed/MEDLINE, PEDro, Embase et CINAHL) entre janvier 2018 et septembre 2019. Ils ont évalué la qualité des études au moyen des directives COSMIN (acronyme anglais de normes consensuelles pour sélectionner les instruments de mesure en santé) et l'utilité clinique pour chaque test. Résultats : au total, 22 études respectaient les critères d'inclusion. Les chercheurs ont recensé et analysé 18 tests d'équilibre statique ou dynamique en position debout pour la population d'adultes victime d'un AVC. Tous les tests étaient d'une bonne ou excellente fiabilité, alors que les corrélations de validité étaient de faibles à fortes. La qualité des études était variable. Les tests d'équilibre dynamique donnaient un meilleur score d'utilité clinique que les tests d'équilibre statique. Cinq tests étaient dotés d'une analyse psychométrique complète : l'équilibre bipodal sur une plateforme de force, le test des cinq pas, les tests des pas latéraux, la longueur d'un pas et le demi-tour. Conclusion : les tests quantitatifs d'équilibre en position debout ont de bonnes qualités psychométriques et une validité modérée après un AVC. Les tests d'équilibre dynamique ont de meilleures propriétés psychométriques et de meilleurs scores d'utilité clinique que les tests d'équilibre statique. Pour évaluer pleinement l'équilibre après un AVC, il faut toutefois effectuer les deux types de tests.

Obstructive Sleep Apnea Syndrome Phenotyping by Cluster Analysis: Typical Sleepy, Obese Middle-aged Men with Desaturating Events are A Minority of Patients in A Multi-ethnic Cohort of 33% Women.

OBJECTIVE: Several clinical obstructive sleep apnea syndrome (OSAS) phenotypes associated with heterogeneous cardiovascular risk profiles have been recently identified. The purpose of this study was to identify clusters amongst these profiles that allow for the differentiation of patients. METHODS: This retrospective study included all moderate-to-severe OSAS patients referred to the sleep unit over a 5-year period. Demographic, symptom, comorbidity, polysomnographic, and continuous positive airway pressure (CPAP) adherence data were collected. Statistical analyses were performed to identify clusters of patients. RESULTS: A total of 567 patients were included (67% men, 54±13 years, body mass index: 32±7 kg/m2, 65% Caucasian, 32% European African). Five clusters were identified: less severe OSAS (n=172); healthier severe OSAS (n=160); poorly sleeping OSAS patients with cardiometabolic comorbidities (n=87); younger obese men with sleepiness at the wheel (n=94); sleepy obese men with very severe desaturating OSAS and cardiometabolic comorbidities (n=54). Patients in clusters 3 and 5 were older than those in clusters 2 and 4 (P=0.034). Patients in clusters 4 and 5 were significantly more obese than those in the other clusters (P=0.04). No significant differences were detected in terms of symptoms and comorbidities. Polysomnographic profiles were very discriminating between clusters. CPAP adherence was similar in all clusters but, among adherent patients, daily usage was more important in cluster 1 (less severe patients) than in cluster 5. CONCLUSION: This study highlights that the typical sleepy obese middle-aged men with desaturating events represent only a minority of patients in our multi-ethnic moderate-to-severe OSAS cohort of 33% females.

Postural organization and inter-limb coordination are altered after stroke when an isometric maximum bilateral pushing effort of the upper limbs is performed.

BACKGROUND: Postural strategies of the trunk and the lower limbs are linked to upper limb motor activities. The objective was to analyze the postural organization at the lower limbs as well as the inter-limb coordination during isometric maximal bilateral pushing of upper limbs. METHODS: Fifteen individuals after stroke and 17 healthy participants were assessed with an instrumented exerciser paired with an instrumented sitting surface while they executed isometric bilateral pushes with the upper limbs. The anteroposterior, vertical and mediolateral forces were recorded at the handles, the thighs and the feet. Force values at maximal bilateral pushing efforts at each segment and inter-limb coordination between sides were compared. FINDINGS: During the isometric pushes, the paretic maximal forces at the handles for stroke participants were lower than the nonparetic side and lower than both sides of the control participants (p < 0.036). The control and stroke participants had moderate to good coordination for the anteroposterior forces (hands and thighs). While they used similar postural strategies to the controls except for a decreased weight on the paretic foot, vertical forces were less coordinated at the handles and feet in the stroke group (p < 0.050). The inter-trial variability was also higher in the stroke group. INTERPRETATION: Bilateral pushing with gradual efforts induces impaired postural strategies and coordination between limbs in individuals after stroke. It may reveal to be a promising strategy to assess and train post-stroke individuals in a clinical setting. Also, providing feedback would help better control symmetry during efforts.

Bariatric Surgery: Consequences on Functional Capacities in Patients With Obesity.

Introduction: Bariatric surgery leads to loss of fat and fat-free mass (FFM). To preserve FFM it is recommended that weight loss interventions are accompanied by physical activity. However, it remains unknown if functional capacities spontaneously improve after a substantial weight loss. Study's aim was to assess the effect of bariatric surgery on strength, functional capacities and quality of life of participants with a body mass index (BMI) ≥ 35 kg/m2. Method: Anthropometric parameters (weight, BMI, waist circumference), physical functions (quadriceps strength, walking capacity, spatio-temporal gait parameters, dynamic balance, lower limb power) and quality of life were assessed before and at three months after the bariatric surgery in 33 individuals who did not follow any physical activity program. Results: The anthropometric parameters, quality of life and three functional abilities (walking capacity, normal gait speed and lower limb power) improved significantly three months post-surgery. In contrast, fast gait speed, absolute strength, normalized strength, and dynamic balance did not improve. Discussion: A massive weight loss should be accompanied by an exercise program aiming to maintain FFM and to enhance muscle strength and balance. Such a program might also enhance functional capacities and help to sustain the weight loss over time.

Post-discharge critical COVID-19 lung function related to severity of radiologic lung involvement at admission.

Lung function impairment persists in 55% of critical COVID-19 patients three months after ICU discharge. Patient lung function, exercise capacity, radiologic, and quality of life data suggest impairment is related to radiologic lung involvement at admission.

Curriculum Development, Implementation, and Evaluation During the COVID-19 Confinement Period in France.

Since March 2020 Europe has faced the COVID-19 epidemic. General confinement measures imposed by governments have had a strong impact on cultural practices, including within dance schools. This article describes the actions implemented by the Dance Department of the Lyon National Conservatory of Music and Dance (CNSMDL, France) in order to ensure pedagogical continuity during the confinement period. The study focused on the 12 preparatory-year students in contemporary dance. Despite numerous constraints-primarily small workspaces, unstable Internet connections, and the difficulty of correcting technical dance moves at a distance-all students and teachers were able to maintain pedagogical follow-up through a series of constructed activities. Students appreciated the social aspect (the relationship with their teachers and fellow students) and day-structuring component of the scheduling. The online activities helped to avoid student isolation, and motivation seemed unaffected. While online exercises can never replace "in the flesh" dance classes, this crisis provided an opportunity to develop pedagogical innovations and tools that could be reused in face-to-face dance instruction in other contexts such as injuries and intermittent work conditions.