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VAN CANT Joachim
Units
Research Unit in Rehabilitation Sciences
Our research unit aims to study the physiological and physiopathological aspects of the lympho-venous, musculoskeletal, cardiovascular and respiratory systems. At the heart of our interests are the evaluation of function, imaging, and the effects of physiotherapy prevention and rehabilitation. Research in these 3 areas is the responsibility of: JP Belgrado: Project Lymphology / Main subject: lypoedema J Van Cant: Project Musculoskeletal physiotherapy / Main subject: The runner G Deboeck: Project Cardiovascular and respiratory rehabilitation / Main subject: Vascular adaptation during aerobic training
Projetcs
Elaboration of a New Method to Assess the Shoulder Sense of Force in Healthy People
Proprioception is the ability to detect body positioning and movement, as well as force and velocity, in the absence of visual feedback. These afferent information arising from internal peripheral areas of the body contribute to postural control, joint stability, and several conscious sensations. Generally, three proprioception submodalities are described including joint position sense, kinesthesia, and sensation of force. Joint position sense is the appreciation and interpretation of information concerning one’s joint position and orientation in space. Kinesthesia is the ability to appreciate and interpret joint motions. Sensation of force is the ability to appreciate and interpret force applied to or generated within a joint. Due to its vast mobility, proprioception is crucial at the shoulder joint to ensure optimal function. Proprioception deficits may result in a decrease in shoulder stability and alteration in the control of the shoulder, and eventually to injuries, pain and disability. Therefore, in clinical settings, all aspects of shoulder proprioception should be objectively measured to characterize the proprioceptive deficits that need to be rehabilitate in order to improve prevention and treatment outcomes. Research on shoulder proprioception has so far mainly focused on joint position sense(JPS) and kinesthesia, while only few studies have looked shoulder sense of force (SSF). However, because the glenohumeral joint primarily relies on dynamic control to maintain stability, the evaluation of SSF could be of particular clinical interest. Indeed, neuromuscular control of the rotator cuff is important to stabilize the joint and limit the risk of injury. Although some reliable measurement techniques have been proposed to assess SSF, mostly using stationary dynamometers, their implementation in clinical practice is limited due to the equipment and the time needed to perform these evaluations making them difficult to implement. In contrast, hand-held dynamometers (HHD) are reliable, relatively cheap and quick and easy to use. To date, no study has evaluated psychometric properties of HHD for the assessment of SSF. The purpose of the project is to assess applicability, validity and reliability of SSF assessed with HHD. Project in collaboration with M. Xavier Amen
Elaboration of a New Method to Assess the Shoulder Sense of Force in Healthy People
Proprioception is the ability to detect body positioning and movement, as well as force and velocity, in the absence of visual feedback. These afferent information arising from internal peripheral areas of the body contribute to postural control, joint stability, and several conscious sensations. Generally, three proprioception submodalities are described including joint position sense, kinesthesia, and sensation of force. Joint position sense is the appreciation and interpretation of information concerning one’s joint position and orientation in space. Kinesthesia is the ability to appreciate and interpret joint motions. Sensation of force is the ability to appreciate and interpret force applied to or generated within a joint. Due to its vast mobility, proprioception is crucial at the shoulder joint to ensure optimal function. Proprioception deficits may result in a decrease in shoulder stability and alteration in the control of the shoulder, and eventually to injuries, pain and disability. Therefore, in clinical settings, all aspects of shoulder proprioception should be objectively measured to characterize the proprioceptive deficits that need to be rehabilitate in order to improve prevention and treatment outcomes. Research on shoulder proprioception has so far mainly focused on joint position sense(JPS) and kinesthesia, while only few studies have looked shoulder sense of force (SSF). However, because the glenohumeral joint primarily relies on dynamic control to maintain stability, the evaluation of SSF could be of particular clinical interest. Indeed, neuromuscular control of the rotator cuff is important to stabilize the joint and limit the risk of injury. Although some reliable measurement techniques have been proposed to assess SSF, mostly using stationary dynamometers, their implementation in clinical practice is limited due to the equipment and the time needed to perform these evaluations making them difficult to implement. In contrast, hand-held dynamometers (HHD) are reliable, relatively cheap and quick and easy to use. To date, no study has evaluated psychometric properties of HHD for the assessment of SSF. The purpose of the project is to assess applicability, validity and reliability of SSF assessed with HHD.
Patellofemoral pain (PFP) is one of the most common problems among physically active individuals between the ages of 15 and 30. PFP affects 23% of the entire population, from young to older adult, and a rate of 17% for all patients presenting knee problem in general practice. Based on current evidence and clinical practice, clinicians are encouraged to offer an individually tailored multimodal treatment including mainly exercise therapy and education. However, despite the reported benefits of multimodal treatment for PFP, longer-term follow up data indicates that a large number of individuals with PFP continue to experience symptoms and unfavourable outcomes. Indeed, the proportion of those reporting chronic symptoms is alarming, from 40% after 1-year follow-up, 57% after 5-8 years and up to 91% after 18 years. Implications of this poor prognosis are severe, patients with PFP have major limitations of daily activities, work, and athletic participation and Blønd & Hansen, (1998) reported that 74% of individuals experiencing PFP will limit or stop sport participation. Numerous authors highlight that poor long-term outcomes for the treatment of patient with PFP are explained by several major factors concerning the implementation of exercise therapy : lack of individualization of the exercises in terms of type, frequency, intensity, mode, time and rest intervals (1); insufficient duration of the exercise program in weeks (2); patients with poor adherence and no interest in exercises (3)15. The dose–response association between adherence to exercises and recovery suggests that adherence is highly important and that the more often exercises are performed, the greater the odds of recovery11. However, the longer the duration of the intervention the lower the adherence obtained in the individuals that underwent the program. With the aim of increasing the long-term adherence to physical exercise, it seems that there is a need for alternatives to escape from routine and avoid interventions that could bore or overwhelm the patients. In this context, the overall objective of the project is to develop a mobile application and to evaluate its interest for the management of patients with PFP.
Patellofemoral pain (PFP) is one of the most common problems among physically active individuals between the ages of 15 and 30. PFP affects 23% of the entire population, from young to older adult, and a rate of 17% for all patients presenting knee problem in general practice. Based on current evidence and clinical practice, clinicians are encouraged to offer an individually tailored multimodal treatment including mainly exercise therapy and education. However, despite the reported benefits of multimodal treatment for PFP, longer-term follow up data indicates that a large number of individuals with PFP continue to experience symptoms and unfavourable outcomes. Indeed, the proportion of those reporting chronic symptoms is alarming, from 40% after 1-year follow-up, 57% after 5-8 years and up to 91% after 18 years. Implications of this poor prognosis are severe, patients with PFP have major limitations of daily activities, work, and athletic participation and Blønd & Hansen, (1998) reported that 74% of individuals experiencing PFP will limit or stop sport participation. Numerous authors highlight that poor long-term outcomes for the treatment of patient with PFP are explained by several major factors concerning the implementation of exercise therapy : lack of individualization of the exercises in terms of type, frequency, intensity, mode, time and rest intervals (1); insufficient duration of the exercise program in weeks (2); patients with poor adherence and no interest in exercises (3)15. The dose–response association between adherence to exercises and recovery suggests that adherence is highly important and that the more often exercises are performed, the greater the odds of recovery11. However, the longer the duration of the intervention the lower the adherence obtained in the individuals that underwent the program. With the aim of increasing the long-term adherence to physical exercise, it seems that there is a need for alternatives to escape from routine and avoid interventions that could bore or overwhelm the patients. In this context, the overall objective of the project is to develop a mobile application and to evaluate its interest for the management of patients with PFP.
Running is a simple physical activity, inexpensive and accessible to the entire population. It is currently one of the most popular sports practices in the world. However, despite its many health benefits, the incidence of running-related musculoskeletal injuries is significant. Videbæk et al. report an incidence of 7.7 injuries per 1,000 hours of practice and Nielsen et al. point out that 11 to 85% of runners are injured each year. These injuries limit the runner's ability to engage in regular physical activity and therefore limit the health benefits. In this context, preventing and treating these injuries represents a major public health issue. However, despite several decades of research on this issue, the results of running injury prevention programs are disappointing and fail to reduce the incidence of injuries or prevent their recurrence. Among the possible reasons for these disappointing results is that either these programs target only one risk factor despite the multifactorial nature of running injury, or they only offer a universal approach. , including several risk factors, but not taking into account the individual specificities of each runner. Indeed, the conclusions and recommendations of the latest studies on the subject are all in line with the need to offer runners prevention programs including targeted and “tailor-made” interventions according to the risk factors of each runner. The overall objective of the project is to evaluate the effectiveness of a running injury prevention program including one or more targeted interventions based on the risk factors identified in each participating runner in comparison with a universal approach. classically proposed in the literature.
Running is a simple physical activity, inexpensive and accessible to the entire population. It is currently one of the most popular sports practices in the world. However, despite its many health benefits, the incidence of running-related musculoskeletal injuries is significant. Videbæk et al. report an incidence of 7.7 injuries per 1,000 hours of practice and Nielsen et al. point out that 11 to 85% of runners are injured each year. These injuries limit the runner's ability to engage in regular physical activity and therefore limit the health benefits. In this context, preventing and treating these injuries represents a major public health issue. However, despite several decades of research on this issue, the results of running injury prevention programs are disappointing and fail to reduce the incidence of injuries or prevent their recurrence. Among the possible reasons for these disappointing results is that either these programs target only one risk factor despite the multifactorial nature of running injury, or they only offer a universal approach. , including several risk factors, but not taking into account the individual specificities of each runner. Indeed, the conclusions and recommendations of the latest studies on the subject are all in line with the need to offer runners prevention programs including targeted and “tailor-made” interventions according to the risk factors of each runner. The overall objective of the project is to evaluate the effectiveness of a running injury prevention program including one or more targeted interventions based on the risk factors identified in each participating runner in comparison with a universal approach. classically proposed in the literature.
