Faculté de médecine – Travaux et publications
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Cette collection accueille les publications savantes et d’autres types de travaux d’auteur.e.s associé.e.s à cette unité. Voir aussi les collections Thèses et mémoires et Production étudiante de l'unité.
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Item Accès libre Do activity level outcome measures commonly used in neurological practice assess upper limb movement quality?Demers , Marika; Levin , Mindy F.; Université de Montréal. Faculté de médecine. École de réadaptation (Sage, 2017-07-05)Background: Movement is described in terms of task-related end point characteristics in external space and movement quality (joint rotations in body space). Assessment of upper-limb (UL) movement quality can assist therapists in designing effective treatment approaches for retraining lost motor elements and provide more detailed measurements of UL motor improvements over time. Objective: To determine the extent to which current activity level outcome measures used in neurological practice assess UL movement quality. Methods: Outcome measures assessing arm/hand function at the International Classification of Function activity level recommended by neurological clinical practice guidelines were reviewed. Measures assessing the UL as part of a general mobility assessment, those strictly evaluating body function/structure or participation, and paediatric measures were excluded. Results: In all, 15 activity level outcome measures were identified; 9 measures assess how movement is performed by measuring either end point characteristics or movement quality. However, except for the Reaching Performance Scale for Stroke and the Motor Evaluation Scale for Upper Extremity in Stroke Patients, these measures only account for deficits indirectly by giving a partial score if movements are slower or if the person experiences difficulties. Six outcome measures neither assess any parameters related to movement quality, nor distinguish between improvements resulting from motor compensation or recovery of desired movement strategies. Conclusion: Current activity measures may not distinguish recovery from compensation and adequately track changes in movement quality over time. Movement quality may be incorporated into clinical assessment using observational kinematics with or without low-cost motion tracking technology.Item Accès libre Retrospective analysis of task-specific effects on brain activity after stroke : a pilot studyDemers, Marika; Varghese, Rini; Winstein, Carolee; Université de Montréal. Faculté de médecine. École de réadaptation (Frontiers media, 2022-06-01)Background: Evidence supports cortical reorganization in sensorimotor areas induced by constraint-induced movement therapy (CIMT). However, only a few studies examined the neural plastic changes as a function of task specificity. This retrospective analysis aims to evaluate the functional brain activation changes during a precision and a power grasp task in chronic stroke survivors who received 2-weeks of CIMT compared to a no-treatment control group. Methods: Fourteen chronic stroke survivors, randomized to CIMT (n = 8) or non-CIMT (n = 6), underwent functional MRI (fMRI) before and after a 2-week period. Two behavioral measures, the 6-item Wolf Motor Function Test (WMFT-6) and the Motor Activity Log (MAL), and fMRI brain scans were collected before and after a 2-week period. During scan runs, participants performed two different grasp tasks (precision, power). Pre to post changes in laterality index (LI) were compared by group and task for two predetermined motor regions of interest: dorsal premotor cortex (PMd) and primary motor cortex (MI). Results: In contrast to the control group, the CIMT group showed significant improvements in the WMFT-6. For the MAL, both groups showed a trend toward greater improvements from baseline. Two weeks of CIMT resulted in a relative increase in activity in a key region of the motor network, PMd of the lesioned hemisphere, under precision grasp task conditions compared to the non-treatment control group. No changes in LI were observed in MI for either task or group. Conclusion: These findings provide preliminary evidence for task-specific effects of CIMT in the promotion of recovery-supportive cortical reorganization in chronic stroke survivors.Item Accès libre A longitudinal study of auditory comprehension in poststroke aphasiaSalvas, Camille; Paré, Jacinthe; Brambati, Simona Maria; Osa García, Alberto; Brisebois, Amélie; Marcotte, Karine; Université de Montréal. Faculté de médecine. École d'orthophonie et d'audiologie (American speech-language-hearing association, 2025-06-13)Objective: Most studies documenting the longitudinal recovery of auditory comprehension in poststroke aphasia begin in the subacute phase. The present study aimed to address this gap by exploring the longitudinal changes in auditory comprehension from the acute to the chronic phase and their neural correlates. Method: Twenty-one Laurentian French persons with aphasia (PWA) following a first left middle cerebral artery stroke underwent three language assessments (acute: 0–72 hr, subacute: 7–14 days, chronic: 6–12 months postonset). Auditory comprehension was assessed at each time point using two tasks, sentence–picture matching and sequential commands. From the sentence–picture matching task, four measures were extracted (single-word, subject–verb, canonical subject–verb–object, and noncanonical subject–verb–object comprehension), while one measure was derived from the sequential commands task, totaling five measures. Lesion–symptom mapping (LSM) was used to identify the brain regions associated with comprehension impairments. Results: All five auditory comprehension measures showed significant positive changes between acute and chronic phases. Persistent comprehension impairments with canonical sentences and sequential commands were more likely to occur in the chronic phase. LSM analyses revealed that comprehension of noncanonical sentences was associated with lesions in the supramarginal gyrus and extended to the superior temporal gyrus (STG) and middle temporal gyrus (MTG). Similarly, the comprehension of sequential commands was associated with lesions in the MTG, extending to the STG and insula. Conclusion: The current findings suggest that PWA with more severe impairments in the acute phase reach a similar performance in the chronic phase than people with milder aphasia and suggest a critical role for the left MTG in the recovery of auditory comprehension, especially with complex stimuli. Supplemental Material: https://doi.org/10.23641/asha.29202788Item Accès libre A perspective on the use of ecological momentary assessment and intervention to promote stroke recovery and rehabilitationDemers, Marika; Winstein, Carolee; Université de Montréal. Faculté de médecine. École de réadaptation (Taylor and Francis, 2020-12-03)Motivated by recent advances in technologies, ecological momentary assessment (EMA), and ecological momentary intervention (EMI) have seen a rise in behavioral medicine research that in real-time, informs the context for the behavior and prompts interventions to change that behavior in the natural setting when necessary. However, EMA and EMI have yet to be fully embraced in the field of stroke rehabilitation. Our objective is to provide a theoretically based perspective for the combined and synergistic use of EMA and EMI to promote person-centered, recovery-based durable changes in functional movement behaviors of stroke survivors. Research abounds for non-stroke populations with emerging evidence for the benefits of using real-time data capture techniques (i.e. EMA) coupled with EMI to better customize the content and timing of interventions to the inherent fluctuations in state and context that encompass the target behavior. We review existing EMA and EMI literature broadly in behavioral medicine and psychological science to identify how real-time repeated sampling technology has been used in the context of stroke rehabilitation and to delineate the pros and cons of this approach in general with non-stroke populations. We propose a coupled EMA and EMI strategy be used in conjunction with existing stroke recovery and rehabilitation practices. There is tremendous potential to effectively personalize recovery-promoting interventions to achieve durable behavior change, and importantly, shift the focus of rehabilitation practice from the health-care provider and clinical environment to the individual and their lived experience in the home and community.Item Accès libre Advancing stroke rehabilitation : the role of wearable technology according to research expertsCain, Amelia; Gunby, Tanisha; Winstein, Carolee; Demers, Marika; Université de Montréal. Faculté de médecine. École de réadaptation (Taylor and Francis, 2025-01-28)Background: Advancements in wearable technology have created new opportunities to monitor stroke survivors' behaviors in daily activities. Research insights are needed to guide its adoption in clinical practice, address current gaps, and shape the future of stroke rehabilitation. This project aims to: (1) Understand stroke rehabilitation researchers' perspectives on the opportunities, challenges, and clinical relevance of wearable technology for stroke rehabilitation, and (2) Identify necessary next steps to integrate wearable technology in research and clinical practice. Methods: Using a phenomenological qualitative design, two 90-minute focus groups were conducted with 12 rehabilitation researchers. The focus groups consisted of semi-structured, open-ended questions on functional movement behavior, motor performance and benefits and pitfalls of wearable technology. The transcribed focus groups were analyzed using inductive thematic analysis. Results: Three main themes were derived from the analysis: (1) Assessing activity performance is critical to inform interventions, (2) The demonstrated benefit is not commensurate with the added hassle, (3) Collaboration is needed between the industry, academia and end-users. Necessary future steps were recognized including the identification of intuitive and actionable metrics, and the integration of sensor-derived data with electronic health records and into clinical workflow to support self-management strategies. Conclusion: Wearable technology shows great potential to complement and support stroke rehabilitation. Many key barriers to clinical adoption remain which underscore the necessity to foster collaborations between industry, academia, and the participants we serve.Item Accès libre Interventions to promote bimanual activities and participation in daily life activities in children with cerebral palsy : a scoping reviewDavid, Anne Claire; Fournier-Poisson, Laura; Robert, Maxime T.; Demers, Marika; Université de Montréal. Faculté de médecine. École de réadaptation (Taylor and Francis, 2025-05-08)Aims: To identify rehabilitation interventions and outcome measures that target bimanual activities and autonomy in activities of daily living (ADLs) in children with cerebral palsy. Methods: This scoping review followed the Arksey and O'Malley framework. The literature search was conducted in five medical databases. Inclusion criteria were studies of children with cerebral palsy that delivered rehabilitation interventions targeting upper limb function and used valid outcome measures assessing bimanual activities or ADLs. The exclusion criteria were pharmacological or surgical interventions, reviews, expert opinions, protocols and qualitative studies. Two independent researchers screened titles/abstracts and full texts. Data related to the study participants, interventions, outcome measures and results were extracted. Results: Eighty-nine publications were included in this review. Out of the 17 interventions identified, the most frequent were constraint-induced movement therapy (n = 29), virtual reality (n = 22), hand-arm bimanual intensive training (n = 12), bimanual intensive training (n = 11) and action observation (n = 6). All five interventions showed significant improvements on bimanual function, whereas all but action observation showed improvements in autonomy in ADLs. We identified 15 outcome measures capturing bimanual activities and 6 capturing autonomy in ADLs. Conclusion: This scoping review provides essential information for the improvement of rehabilitation interventions for children with cerebral palsy.Item Accès libre Predicting mortality among critically ill patients with acute kidney injury treated with renal replacement therapy : development and validation of new prediction modelsLi, Daniel H.; Wald, Ron; Blum, Daniel; McArthur, Eric; James, Matthew T.; Burns, Karen E. A.; Friedrich, Jan O.; Adhikari, Neill K. J.; Nash, Danielle M.; Lebovic, Gerald; Harvey, Andrea K.; Dixon, Stephanie N.; Silver, Samuel A.; Bagshaw, Sean M.; Beaubien-Souligny, William; Université de Montréal. Faculté de médecine (Elsevier, 2019-12-18)Purpose Severe acute kidney injury (AKI) is associated with a significant risk of mortality and persistent renal replacement therapy (RRT) dependence. The objective of this study was to develop prediction models for mortality at 90-day and 1-year following RRT initiation in critically ill patients with AKI. Methods All patients who commenced RRT in the intensive care unit for AKI at a tertiary care hospital between 2007 and 2014 constituted the development cohort. We evaluated the external validity of our mortality models using data from the multicentre OPTIMAL-AKI study. Results The development cohort consisted of 594 patients, of whom 320(54%) died and 40 (15% of surviving patients) remained RRT-dependent at 90-day Eleven variables were included in the model to predict 90-day mortality (AUC:0.79, 95%CI:0.76–0.82). The performance of the 90-day mortality model declined upon validation in the OPTIMAL-AKI cohort (AUC:0.61, 95%CI:0.54–0.69) and showed modest calibration. Similar results were obtained for mortality model at 1-year. Conclusions Routinely collected variables at the time of RRT initiation have limited ability to predict mortality in critically ill patients with AKI who commence RRT.Item Accès libre Profiles of children’s social behaviors and peer victimization in early elementary school : sex differences and stability over timeChaput-Langlois, Sophie; Parent, Sophie; Castellanos-Ryan, Natalie; Tremblay, Richard Ernest; Seguin, Jean; Université de Montréal. Faculté de médecine. Département de psychiatrie et d'addictologie; Université de Montréal. Faculté des arts et des sciences. École de psychoéducation; Université de Montréal. Faculté des arts et des sciences. Département de psychologie (American Psychological Association, 2025)Research suggests that younger children engage in fewer peer victimization roles, compared to their older peers (e.g., aggressor, victim, defender). Still, the development of these roles throughout early elementary school remains unclear. Additionally, aggression and social behaviors evolve differently in boys and girls, yet sex differences in these roles are not well understood. This study examined children’s profiles of involvement in physical and relational aggression, prosocial behaviors, and peer victimization in kindergarten, first and second grade by using latent profile analyses and testing profile similarity across sex and school years. Then, it examined the stability of profile membership from kindergarten to second grade before testing how early socioeconomic status predicted profile membership. The sample included 1757 children of various sociodemographic backgrounds, mostly white, from a longitudinal birth study in Canada. Boys’ profiles aligned with a four-role typology that remained consistent from kindergarten to second grade: Prosocial, normative, moderately aggressive-victimized (AV), and highly AV profiles. In kindergarten, girls’ typology also included four profiles: Prosocial, normative, relationally aggressive, and AV. By first grade, a fifth profile emerged: Victimized girls. Profile membership for both boys and girls was generally very stable over time, and low socioeconomic status predicted higher odds of belonging to any AV profiles compared to prosocial ones. These findings underscore both developmental similarities and distinctions in boys’ and girls’ social behaviors and experiences in early elementary school and the precocity of stable membership in at-risk profiles. They highlight socioeconomic status as an early risk factor that could inform prevention research. This study suggests that there are distinct, relatively stable groups of boys and girls characterized by different configurations of social behaviors and peer victimization experiences, from kindergarten through second grade. Of particular concern is the stability across time of the classification into aggressive-victimized groups, suggesting a need to identify these children early for prevention purposes, before these social behaviors and experiences become crystallized. It also highlights sex differences, where only girls showed early emergence of a combination of prosocial and aggressive behaviors, and a pattern of victimization in the absence of aggressive behaviors.Item Accès libre Athletes’ lived experiences recovering from and returning to sport following a sport-related concussion : a meta-synthesis of qualitative studiesCadotte, Gabrielle; Duncan, Lindsay R.; Caron, Jeffrey; Université de Montréal. Faculté de médecine (Taylor and Francis, 2024-11-25)A small, but growing body of qualitative studies have explored athletes’ lived experiences with sport-related concussions (SRCs). For this meta-synthesis, we reviewed and synthesized qualitative, peer-reviewed studies on athletes’ lived experiences during recovery from and/or return to sport following SRC. Following PRISMA guidelines, we initially identified 5062 articles through PsycINFO, Embase, MedLine, SportDiscus, and Web of Science. After eliminating duplicates, screening titles, abstracts and full texts, 33 peer-reviewed articles matched our inclusion criteria. Subsequently, the authors appraised the quality of the included articles using the Critical Appraisal Skills Program. We followed guidelines for thematic synthesis, in which we initially developed 16 descriptive themes, each rooted in the original data extracted from the 33 articles. Subsequently, we developed four analytical themes that were informed by the descriptive themes and existing models and frameworks in the sport and exercise literature: (a) SRC characteristics: Identifying SRC features, (b) SRC consequences: Understanding the impact of the injury, (c) SRC outcomes: Discovering paths to recovery, and (d) Influential factors: Exploring the contextual factors affecting SRC consequences and outcomes. Our findings offer a comprehensive description of qualitative evidence on athletes’ lived experiences with SRC, including gaps in knowledge and insights for future research in the field.Item Accès libre Leaving the mark : FMOs as an emerging class of cytokinetic regulatorsLacroix, Léa; Goupil, Eugénie; Smith, Matthew James; Labbé, Jean-Claude; Université de Montréal. Faculté de médecine. Département de pathologie et biologie cellulaire (Taylor and Francis, 2025-04-08)Posttranslational modification of proteins plays a fundamental role in cell biology. It provides cells a means to regulate the signaling, enzymatic or structural properties of proteins without continuous cycles of synthesis and degradation, offering multiple distinct functions to individual proteins in a rapid and reversible manner. Modifications can include phosphorylation, ubiquitination or methylation, which are widespread and simple to detect using current approaches. More challenging to identify, one modification of growing significance is the direct oxidation of cysteine and methionine side chains. Protein oxidation has long been known to occur spontaneously upon the accumulation of cellular reactive oxygen species (ROS), but new data are providing insight into the targeted oxidation of proteins by flavin-containing monooxygenases (FMOs). Here, we review how oxidation of cellular proteins can modulate their activity and consider potential roles for FMOs in the targeted modification of proteins shaping cell division, with a particular focus on two families of FMOs: MICAL and OSGIN.Item Accès libre Impact of expressive intentions on upper-body kinematics in two expert pianistsTurner, Craig; Mailly, Robin; Dal Maso, Fabien; Verdugo, Felipe; Université de Montréal. Faculté de médecine. École de kinésiologie et des sciences de l'activité physique (Frontiers Media, 2025-01-13)Introduction: Expression is a key aspect of music performance. Studies on pianists’ gestures and expression have mainly documented the impact of their expressive intentions on proximal segments and head linear kinematics. It remains unclear how pianists’ expressive intentions influence joint angular kinematics as well as exposure to risk factors of injury, such as poor overall posture and distal jerky movements, two kinematic factors linked to injury. The first objective of this exploratory case study was to analyze the influence of pianists’ expressive intentions on proximal and distal joint range of motion (ROM) across different musical contexts. The second objective was to evaluate the impact of expressive intentions on the posture of joints that are commonly injured in pianists, as well as distal joint angular jerk. Methods: Two expert pianists (P1 and P2) performed six musical excerpts (E1–E6) in two experimental conditions: normal condition (including expressive intentions) and the control condition (strictly playing the composer’s notations written in the score with no subjective interpretation). An inertial measurement unit system recorded upper body kinematics. Methods: Two expert pianists (P1 and P2) performed six musical excerpts (E1–E6) in two experimental conditions: normal condition (including expressive intentions) and the control condition (strictly playing the composer’s notations written in the score with no subjective interpretation). An inertial measurement unit system recorded upper body kinematics. Results and discussion: Both proximal and distal joint ROM increased when pianists incorporated expressive intentions. Participants exhibited more static, non-neutral wrist postures when incorporating expressive intentions (right and left wrist for P1 and P2, respectively), suggesting an increased risk of distal injury. On the contrary, the thorax exhibited more dynamic, neutral flexion postures, suggesting a reduced risk of proximal injury. These results suggest that expressive intentions may impact proximal and distal postures differently. Incorporating expressive intentions also led to jerkier, less smooth wrist movements in lyrical, non-virtuosic musical excerpts (E1–E4). However, in more virtuosic excerpts (E5–E6), there were generally no differences between conditions. Spatiotemporal constraints might explain these discrepancies between non-virtuosic and virtuosic musical excerpts. These results provide evidence of the impact of expressive intentions on the entire kinematic chain, while highlighting the implications of the subjective dimension of music expression in relation to exposure to risk factors of injury.Item Accès libre Chromatin dynamics and DNA replication roadblocksHammond-Martel, Ian; Verreault, Alain; Wurtele, Hugo; Université de Montréal. Faculté de médecine (Elsevier, 2021)A broad spectrum of spontaneous and genotoxin-induced DNA lesions impede replication fork progression. The DNA damage response that acts to promote completion of DNA replication is associated with dynamic changes in chromatin structure that include two distinct processes which operate genome-wide during S-phase. The first, often referred to as histone recycling or parental histone segregation, is characterized by the transfer of parental histones located ahead of replication forks onto nascent DNA. The second, known as de novo chromatin assembly, consists of the deposition of new histone molecules onto nascent DNA. Because these two processes occur at all replication forks, their potential to influence a multitude of DNA repair and DNA damage tolerance mechanisms is considerable. The purpose of this review is to provide a description of parental histone segregation and de novo chromatin assembly, and to illustrate how these processes influence cellular responses to DNA replication roadblocks.Item Accès libre p75NTR modulation prevents cellular, cortical activity and cognitive dysfunctions caused by perinatal hypoxiaChattopadhyaya, Bidisha; Lee, Karen K. Y .; Carreño-Muñoz, Maria Isabel; Paris-Rubianes, Andrea; Lavertu-Jolin, Marisol; Berryer, Martin; Longo, Frank M.; Di Cristo, Graziella; Université de Montréal. Faculté de médecine. Département de neurosciences (Oxford University Press, 2025-03-04)Children who experienced moderate perinatal hypoxia are at risk of developing long-lasting subtle cognitive and behavioural deficits, including learning disabilities and emotional problems. Understanding the underlying mechanisms is an essential step for designing targeted therapy. Fast-spiking, parvalbumin-positive (PV) GABAergic interneurons modulate the generation of gamma oscillations, which in turn regulate many cognitive functions including goal-directed attentional processing and cognitive flexibility. Due to their fast-firing rate, PV cell function requires high levels of energy, which may render them highly vulnerable to conditions of metabolic and oxidative stress caused by perinatal hypoxia. Here, we show that adult mice that experienced moderate perinatal hypoxia (MPH) have decreased cortical PV expression levels in addition to specific impairments in social behaviour, recognition memory and cognitive flexibility. We further found that the expression level of the neurotrophin receptor p75NTR, which limits PV cell maturation during the first postnatal weeks, is increased in MPH mice. Genetic deletion of p75NTR in GABAergic neurons expressing the transcription factor Nkx2.1, which include PV cells, protects mice from PV expression loss and the long-term cognitive effects of MPH. Finally, treatment with a p75NTR inhibitor starting after MPH and lasting for a week, prevented PV expression loss and the occurrence of cognitive and cortical activity deficits in adult mice. Altogether our data reveals p75NTR-mediated signaling, as a potential molecular target, for the treatment of the cognitive alterations caused by MPH.Item Accès libre Participation at home of adults with multiple disabilities and influencing factors from their parents' perspectiveCutnam, Gabrielle; Iavorova Kroumova, Elisa; Rochette, Annie; Université de Montréal. Faculté de médecine. École de réadaptation (Taylor and Francis, 2025-02-03)To understand participation at home of adults with multiple disabilities and the indicatorsof their engagement from the parents’ perspective as well as to explore the influencing environmentalfactors.Methods: A qualitative, descriptive design was used. Participants had to be the parent of an adultpresenting multiple disabilities aged between 21 and 65 with no degenerative diagnosis. Semi-structuredinterviews were conducted using an interview guide, anchored in the Human Development Model –Disability Creation Process and developed through an iterative process. Data were analyzed using a6-step qualitative analysis process.Results: The majority (5/8) of participating parents were aged between 56 and 61 years and were theparents of an adult with multiple disabilities aged between 21 and 41. Two themes for participationwere generated: communication to build relationships, and they are disabled, but not so much whereasfour themes relating to environmental factors were generated: context as a determinant of meaningfulactivity, the effects of the caregiver’s attitude on social participation, the importance of the relationship oftrust, and facilitating participation through adaptations.Conclusion: Non-verbal communication and context of realization of activities of adults with multipledisabilities should be considered as they contribute to making participation meaningful.Item Accès libre Perceived training needs of municipal stakeholders in Quebec (Canada) relating to universal design action plansRochette, Annie; Vermeulen, Perrine; Boucher, Normand; Roussel, Nathalie; Simard, Nathalie; Grondin-Gravel, Gabrielle; Morissette, A.; Lamontagne, Michel; Fougeyrollas, Patrick; Université de Montréal. Faculté de médecine. École de réadaptation (Taylor and Francis, 2025-02-21)Quebec (Canada) municipalities with ≥15 000 inhabitants are legally required to produce an annual action plan to reduce barriers encountered by person with disabilities. Actual tools for universal design are diverse and not harmonised between cities, leading to important training needs. We thus aimed to identify priority training needs among municipalities of all sizes. We use a two-phase sequential descriptive design starting with an online survey (Phase 1) anchored into dimensions of inclusive access followed by focus group discussions (Phase 2). Descriptive statistics and a semi-inductive content analysis for qualitative data were used. A total of n = 114 municipalities responded to Phase 1 including nearly half (37/78) of municipalities with a population ≥15 000 inhabitants. The top five priority needs were 1) Needs assessment, 2) General knowledge, 3) Practical and organisational knowledge, 4) Design/planning phase and 5) Know-how, attitudes, mentalities, culture of the municipalities. Participants (n = 10) to Phase 2 insisted on their needs for practical knowledge, including authentic, contextualised examples coming from other cities. No major differences in needs to prioritise emerged when contrasting larger and smaller size’s municipalities. Results highlighted a variety of training needs, including the importance of prioritising practical contextualised knowledge anchored in authentic experience.Item Accès libre Attenuating hyperammonemia preserves protein synthesis and muscle mass via restoration of perturbed metabolic pathways in bile duct-ligated ratsBosoi, Cristina R.; Kumar, Avinash; Oliveira, Mariana M.; Welch, Nicole; Clément, Marc-André; Tremblay, Mélanie; Ten-Have, Gabriella A. M.; Engelen, Marielle P. K. J.; Bémeur, Chantal; Deutz, Nicolaas E. P.; Dasarathy, Srinivasan; Rose, Christopher; Université de Montréal. Faculté de médecine. Département de médecine (Springer, 2025-01-23)Sarcopenia and hepatic encephalopathy (HE) are complications of chronic liver disease (CLD), which negatively impact clinical outcomes. Hyperammonemia is considered to be the central component in the pathogenesis of HE, however ammonia's toxic effects have also been shown to impinge on extracerebral organs including the muscle. Our aim was to investigate the effect of attenuating hyperammonemia with ornithine phenylacetate (OP) on muscle mass loss and associated molecular mechanisms in rats with CLD. Six-week bile duct-ligated (BDL) rats and Sham-operated controls were treated with OP (1 g/kg, oral) for 5 weeks. Body composition, assessed by EchoMRI, and muscle protein fractional synthesis rate were evaluated. Signalling mechanisms regulating protein homeostasis, ATP content and metabolic intermediates in the tricarboxylic acid cycle (TCA) in skeletal muscle were quantified. OP treatment attenuated hyperammonemia, prevented brain edema and improved locomotor activity in BDL rats. Increased muscle ammonia, reduction in lean body mass, decreased muscle protein synthesis rate and ATP content were restored in OP-treated versus saline-treated BDL rats. TCA cycle intermediary metabolite, α-ketoglutarate, alterations of molecular markers regulating protein homeostasis including mTOR signalling and autophagy, were also preserved in muscle of OP-treated BDL rats. OP attenuated hyperammonemia, preserved muscle protein synthesis and prevented muscle mass loss in a preclinical model of CLD through restoration of perturbed signalling responses and altered TCA intermediary metabolites. Ammonia-lowering strategies have the potential for rapid clinical translation for simultaneous neuroprotection and sarcopenia prevention in patients with CLD.Item Accès libre How have neck muscle vibration effects on visuospatial behavior and spatial neglect been explored? A scoping reviewDuclos, Noémie C.; Sorita, Eric; Poncet, Frédérique; Duclos, Cyril; Jamal, Karim; Université de Montréal. Faculté de médecine. École de réadaptation (Taylor and Francis, 2024-11-28)Introduction: Neck muscle vibration (NMV) has been proposed as a bottom-up intervention toenhance visuospatial exploration in post-stroke patients with unilateral spatial neglect (USN). Whilesome studies report enlarged visual exploration during NMV application, others find no significantimpact, highlighting inconsistencies in the literature. The diversity in NMV application methodsand the variation in visuospatial outcome measures may contribute to these conflicting findings.This study aimed to overview the methodological approaches used to investigate NMV’s effects onvisuospatial behavior in USN patients, focusing on aspects beyond sample size and study design.Methods: Among the seven databases, studies that applied NMV and assessed visual or perceptualoutcomes were included in the analysis. Two independent reviewers screened titles and abstractsto select the studies to analyze. Data about the publication, population, modalities of application,and outcomes were extracted and synthesized.Results: Twenty-five publications from 1988 to 2023 were included, involving a total of 512participants, of whom 114 (22.3%) had USN. The presence of USN was assessed based on paper-and-pencil tests. The frequency of NMV was set between 80 and 125 hz. In 22 studies, NMV wereapplied on the left side of the neck muscles. Six studies proposed multiple NMV sessions, lastingbetween 5 and 50 minutes/day, 3–5 times/week, for 2–4 weeks. One study included a follow-upperiod of up to 1.4 years. The tasks during NMV often involved indicating the subjective straightahead (SSA, n = 8), pointing out targets, or no specific activity (n = 7, each). The SSA and cancella-tion tests were the most frequent outcomes.Conclusions: NMV application modalities varied widely across studies, with only vibration fre-quency showing consistency. The tasks performed during NMV and the outcome measures werediverse and generally unrelated to activities of daily living. Therefore, NMV effects during moreecologically valid tasks should be explored.Item Accès libre Effect of a whole-group intervention on children’s participation in interactive book readingMcMahon-Morin, Paméla; Nasri, Bouchra; Verduyckt, Ingrid; Rezzonico, Stefano; Gingras, Marie-Pier; Université de Montréal. Faculté de médecine. École d'orthophonie et d'audiologie (Taylor and Francis, 2024-09-12)This study examined the effects of an SLP-delivered whole-class interactive book reading intervention and a professional development program on children’s self-initiated participation. Eleven kindergarten teachers and the children in their classes participated in this quasi-experimental study. They were filmed during book reading at pre- and post-intervention, and follow-up. Children’s types of spontaneous comments appeared to be more diverse after the intervention, and the types that increased or emerged were consistent with the language targets of the interactive book reading. Nonparametric statistical tests were conducted. Significant changes were found in the number of hands raised by children to make a spontaneous comment and in the number of spontaneous comments after the intervention and at follow-up. Results for child-initiated interaction sequences were mitigated. This study invites school-based SLPs to foster children’s self-initiated participation in their tier-1 intervention and to support teachers in using children’s spontaneous comments to further scaffold children’s learning.Item Accès libre Improving pelvic floor muscle training with AI : a novel quality assessment system for pelvic floor dysfunctionEl-Sayegh, Batoul; Dumoulin, Chantal; Leduc-Primeau, François; Sawan, Mohamad; Université de Montréal. Faculté de médecine. École de réadaptation (MDPI, 2024-10-29)The first line of treatment for urinary incontinence is pelvic floor muscle (PFM) training, aimed at reducing leakage episodes by strengthening these muscles. However, many women struggle with performing correct PFM contractions or have misconceptions about their contractions. To address this issue, we present a novel PFM contraction quality assessment system. This system combines a PFM contraction detector with a maximal PFM contraction performance classifier. The contraction detector first identifies whether or not a PFM contraction was performed. Then, the contraction classifier autonomously quantifies the quality of maximal PFM contractions across different features, which are also combined into an overall rating. Both algorithms are based on artificial intelligence (AI) methods. The detector relies on a convolutional neural network, while the contraction classifier uses a custom feature extractor followed by a random forest classifier to predict the strength rating based on the modified Oxford scale. The AI algorithms were trained and tested using datasets measured by vaginal dynamometry, combined in some cases with digital assessment results from expert physiotherapists. The contraction detector was trained on one dataset and then tested on two datasets measured with different dynamometers, achieving 97% accuracy on the first dataset and 100% accuracy on the second. For the contraction performance classifier, the results demonstrate that important clinical features can be extracted automatically with an acceptable error. Furthermore, the contraction classifier is able to predict the strength rating within a ±1 scale point with 97% accuracy. These results demonstrate the system’s potential to enhance PFM training and rehabilitation by enabling women to monitor and improve their PFM contractions autonomously.Item Accès libre Management of physical impairments, activity limitations and participation restrictions in survivors of childhood acute lymphoblastic leukemia: perspectives from physiotherapistsBrochu, Annie; Hébert, Luc J.; Fiscaletti, Melissa; Kairy, Dahlia; Université de Montréal. Faculté de médecine. École de réadaptation (Lippincott, 2024-10-04)Background: Survivors of childhood acute lymphoblastic leukemia (cALL) present a high risk of long-term neuromusculoskeletal (NMSK) sequelae. Clinical guidelines for specific management of these complications are still lacking. The aim of this study is to (1) describe current physiotherapy practice with cALL survivors at one of Canada’s specialized pediatric oncology centers, (2) explore perceived optimal management of long-term NMSK sequelae by physiotherapists, and (3) identify the barriers and facilitators for its in-clinic implementation. Methods: This qualitative descriptive study with a focus group using a semi-structured interview guide was conducted with physiotherapists (n = 6) from one of Canada’s specialized pediatric oncology centers. We performed a hybrid analysis including both a deductive and an inductive approach using the International Classification of Functioning, Disability, and Health and Consolidated Framework for Implementation Research. Results: Even though the participants were experts in managing NMSK sequelae in survivors of cALL, standardized management of these patients is lacking. Physiotherapists described their perceived optimal management of NMSK sequelae as systematic and interdisciplinary. Barriers (eg, relative priority and availability of resources) and facilitators (eg, relative benefit and commitment) for implementing this perceived optimal management were identified. Conclusion: Physiotherapy management could improve care and services offered to survivors of cALL. The identification of barriers and facilitators to best practice offers relevant potential solutions to explore in order to improve and optimize management of this patient group.