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Abstract
Introduction : afin d’acquérir et de maintenir leur autonomie, les patients souffrant de lésion médullaire doivent améliorer leur équilibre assis, pré requis pour réaliser les Activités de la Vie Quotidienne. Notre objectif est de déterminer quels sont les moyens physiothérapeutiques à disposition pour travailler l’équilibre assis dynamique chez cette population et quelles sont leurs preuves d’efficacité selon le stade de réadaptation (aigu/chronique). Méthodologie : nous avons inclus des études quantitatives trouvées sur les bases de données PEDro, Pubmed et Cinhal. Les études traitant de personnes souffrant de lésion médullaire, d’équilibre assis et de physiothérapie ont été sélectionnées. Résultats : 7 études ont été retenues, dont 3 RCT, 1 cohorte et 3 séries de cas. Deux se déroulent durant le stade aigu et cinq durant le stade chronique. Les moyens de traitement utilisés sont la thérapie orientée sur la tâche, la boxe sur Nintendo Wii®, le kayak, le kayak ergomètre ou des jeux sur ordinateur. Toutes les études démontrent une amélioration de l’équilibre assis post intervention. En stade aigu, cette amélioration n’est pas supérieure à celle constatée lors d’un réentraînement des AVQ uniquement. Conclusion : selon les études retenues, nous concluons qu’en stade aigu, un travail spécifique de l’équilibre assis n’apporte pas de bénéfice additionnel. En stade chronique, un réentraînement spécifique de l’équilibre assis est efficace et peut se réaliser au travers d’une thérapie orientée sur la tâche avec alternance du support d’assise. Des études supplémentaires seraient nécessaires pour confirmer ces conclusions.
Introduction : in order to regain and to maintain a certain degree of independance, patients suffering from spinal cord injuries must improve their balance in the sitting position, a must to be able to undertake their basic requirements. Our objective is to discover the means we dispose of in physical therapy to retrain postural balance in the aforementioned patients and to evaluate their effectiveness during the various stages of the reeducation (acute/chronic). Methodology : based on the quantative studies of PEDro, Pubmed, and Cinhal databases, these findings relate to spinal cord injuries patients, postural balance and physical therapy. Results : 7 studies were retained, 3 RCT, 1 cohort study and 3 case-series. Two deal with the acute stage and five with the chronic. Means of treatment used include specific task training, boxing on Nintendo Wii®, kayak, kayak ergometer or various computer games. All the studies confirm an improvement in postural balance after treatment. However, in the acute stage this improvement equals but does not supercede that which is demonstraded during conventional training for daily activities. Conclusion : evidence emanating from our chosen studies denotes no noteworthy improvement while using therapy based on balance retraining in the acute phrase, the postural capacity remains comparable to that obtained by conventional therapy. In the chronic stage, postural balance training has proved its effectivness and is more efficient if undertaken while alternating sitting supports during specific task training. Futher studies are required to confirm these conclusions.
Introduction : in order to regain and to maintain a certain degree of independance, patients suffering from spinal cord injuries must improve their balance in the sitting position, a must to be able to undertake their basic requirements. Our objective is to discover the means we dispose of in physical therapy to retrain postural balance in the aforementioned patients and to evaluate their effectiveness during the various stages of the reeducation (acute/chronic). Methodology : based on the quantative studies of PEDro, Pubmed, and Cinhal databases, these findings relate to spinal cord injuries patients, postural balance and physical therapy. Results : 7 studies were retained, 3 RCT, 1 cohort study and 3 case-series. Two deal with the acute stage and five with the chronic. Means of treatment used include specific task training, boxing on Nintendo Wii®, kayak, kayak ergometer or various computer games. All the studies confirm an improvement in postural balance after treatment. However, in the acute stage this improvement equals but does not supercede that which is demonstraded during conventional training for daily activities. Conclusion : evidence emanating from our chosen studies denotes no noteworthy improvement while using therapy based on balance retraining in the acute phrase, the postural capacity remains comparable to that obtained by conventional therapy. In the chronic stage, postural balance training has proved its effectivness and is more efficient if undertaken while alternating sitting supports during specific task training. Futher studies are required to confirm these conclusions.