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PEOPLE@HES-SO – Directory and Skills inventory

PEOPLE@HES-SO
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Terrier Philippe

Terrier Philippe

Professeur-e HES assistant

Main skills

Sciences du mouvement

Healthy aging

Signal processing

Data Science

Essais cliniques

Statistical learning

  • Contact

  • Research

  • Publications

  • Conferences

Main contract

Professeur-e HES assistant

Haute Ecole Arc - Santé
Rue de la Jeunesse 1, 2800 Delémont 2, CH
DSAN
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Completed

Développement de la confiance dans les équipes interprofessionnelles de soin : dimensions, facilitateurs et obstacles (Re-soumission) 
AGP

Role: Collaborator

Requérant(e)s: Santé

Financement: HES-SO Rectorat

Description du projet : L'interprofessionnalité, définie comme une collaboration efficace et une optimisation des compétences communes, est un concept très présent actuellement dans le domaine des soins, notamment, dans les cursus de formation des soignants en Suisse. Dans la réalité du terrain, la collaboration interprofessionnelle est toutefois complexe à mettre en 'uvre. Son succès dépend de multiples facteurs relatifs au contexte, à l'activité, au partage des responsabilités et à la culture

Research team within HES-SO: Salamin-Plaschy Isabelle , Hannart Stéphanie , Juvet Typhaine , Weissbrodt Rafael , Corbaz-Kurth Sandrine , Terrier Philippe , Krsmanovic Bozica

Partenaires académiques: Santé; VS - Institut Santé

Partenaires professionnels: CHUV; CMS Centre médico-social Régional Sierre

Durée du projet: 01.09.2021 - 31.05.2023

Montant global du projet: 101'480 CHF

Statut: Completed

Promotion de la Santé à La Chaux-de-Fonds_Phase 2
AGP

Role: Collaborator

Requérant(e)s: Santé, Pedrotti Marco, Santé

Financement: Service de santé et promotion de la santé - SSPS

Description du projet : En vue d'améliorer la connaissance des différents services de promotion de la santé auprès de la population de La Chaux-de-Fonds, la HE-Arc Santé procédera à un recensement des services existants, effectuera une enquête auprès de la population afin d'établir le niveau de connaissances des différents services, et élaborera une stratégie de communication. Il s'agit de la phase 2 du projet PromSAN dont l'état des lieux a'est déroulé de juillet à 0ctobre 2018.

Research team within HES-SO: Segessemann Martine , Francillon Christophe , Seghairia Françoise , Pedrotti Marco , Terrier Philippe

Partenaires académiques: Management; Santé; Pedrotti Marco, Santé

Durée du projet: 06.12.2018 - 31.05.2019

Montant global du projet: 7'250 CHF

Statut: Completed

2024

Validity of Linear and Nonlinear Measures of Gait Variability to Characterize Aging Gait with a Single Lower Back Accelerometer
Scientific paper ArODES

Sophia Piergiovanni, Philippe Terrier

Sensors,  2024, 24, 7427

Link to the publication

Summary:

The attractor complexity index (ACI) is a recently developed gait analysis tool based on nonlinear dynamics. This study assesses ACI’s sensitivity to attentional demands in gait control and its potential for characterizing age-related changes in gait patterns. Furthermore, we compare ACI with classical gait metrics to determine its efficacy relative to established methods. A 4 × 200 m indoor walking test with a triaxial accelerometer attached to the lower back was used to compare gait patterns of younger (N = 42) and older adults (N = 60) during normal and metronome walking. The other linear and non-linear gait metrics were movement intensity, gait regularity, local dynamic stability (maximal Lyapunov exponents), and scaling exponent (detrended fluctuation analysis). In contrast to other gait metrics, ACI demonstrated a specific sensitivity to metronome walking, with both young and old participants exhibiting altered stride interval correlations. Furthermore, there was a significant difference between the young and old groups (standardized effect size: −0.77). Additionally, older participants exhibited slower walking speeds, a reduced movement intensity, and a lower gait regularity. The ACI is likely a sensitive marker for attentional load and can effectively discriminate age-related changes in gait patterns. Its ease of measurement makes it a promising tool for gait analysis in unsupervised (free-living) conditions.

Effects of metronome walking on long-term attractor divergence and correlation structure of gait :
Scientific paper ArODES
a validation study in older people

Sophia Piergiovanni, Philippe Terrier

Scientific Reports,  2024, 07, 14, 15784

Link to the publication

Summary:

This study investigates the efects of metronome walking on gait dynamics in older adults, focusing on long-range correlation structures and long-range attractor divergence (assessed by maximum Lyapunov exponents). Sixty older adults participated in indoor walking tests with and without metronome cues. Gait parameters were recorded using two triaxial accelerometers attached to the lumbar region and to the foot. We analyzed logarithmic divergence of lumbar acceleration using Rosenstein’s algorithm and scaling exponents for stride intervals from foot accelerometers using detrended fuctuation analysis (DFA). Results indicated a concomitant reduction in long-term divergence exponents and scaling exponents during metronome walking, while short-term divergence remained largely unchanged. Furthermore, long-term divergence exponents and scaling exponents were signifcantly correlated. Reliability analysis revealed moderate intrasession consistency for longterm divergence exponents, but poor reliability for scaling exponents. Our results suggest that longterm divergence exponents could efectively replace scaling exponents for unsupervised gait quality assessment in older adults. This approach may improve the assessment of attentional involvement in gait control and enhance fall risk assessment

Head-mounted eye tracker videos and raw data collected during breathing recognition attempts in simulated cardiac arrest
Scientific paper ArODES

Marco Pedrotti, Marc Stanek, Louis Gelin, Philippe Terrier

Data in Brief,  2024, 05, 110530

Link to the publication

Summary:

This paper presents data collected by Pedrotti et al. (2022, 2024) [1,2], which includes videos captured using a Dikablis head-mounted eye tracker (Ergoneers GmbH, Germany), along with the corresponding raw data. The data collection aimed to assess participants' ability to recognize breathing in a simulated cardiac arrest scenario. Equipped with the eye tracker, participants entered a room where a manikin was positioned on the floor. Their task was to determine if the manikin was breathing and respond accordingly, such as initiating cardiopulmonary resuscitation if the victim was not breathing. Our analysis focused on examining looking time on the manikin's thorax by inspecting the videos. Potential applications of the dataset [3] include identifying fixation and saccades using custom algorithms, analyzing pupil diameter data, and conducting secondary analyses involving participant characteristics like age and gender as independent variables.

Replication Study of “Visual Fixation on the Thorax Predicts Bystander Breathing Detection in Simulated Out-of-Hospital Cardiac Arrest”
Scientific paper ArODES

Marco Pedrotti, Marc Stanek, Louis Gelin, Philippe Terrier

International Journal of First Aid Education,  2024, 7(1), 1-12

Link to the publication

Summary:

Background: Early cardiopulmonary resuscitation (CPR) by lay responders is associated with improved survival from Out-of-Hospital Cardiac Arrest (OHCA). Recognition of OHCA, i.e., a victim who is unresponsive and not breathing, is essential to begin CPR as soon as possible. In 2022, we published a simulation study (Study 1; n = 96) which found that instructing lay responders to look at chest movement enables them to detect breathing. To expand the evidence and available data on this topic, we attempted a replication (Study 2; n = 73). Pedrotti et al. International Journal of First Aid Education DOI: 10.25894/ijfae.2307 2 Methods: Participants equipped with an eye tracker entered a room where a manikin, randomly set as breathing or unbreathing, laid on the floor. After the first simulation (pre-allocation), participants were randomly allocated to a video debriefing intervention with (experimental group) or without (control group) their recorded gaze overlay, in which they reviewed their thorax examination behavior. After debriefing, the simulation was repeated (postallocation). The main outcome was success in detecting breathing. Results: Study 2 was underpowered and failed to support the findings of Study 1. Pooling together the results of the two studies (n = 170) supports the findings of Study 1: Success rate at post-allocation did not differ between the experimental (83%) and the control group (80%), but it significantly increased from pre-allocation (65%) to post-allocation (81%; χ2 = 10.88, p .001). Each second spent examining the thorax increased the odds of success by 16% (OR = 1.16, 95% CI, 1.04–1.29). Median diagnosis time was 17.9 seconds (range = 2–119 seconds). Conclusions: Educating lay responders on how to look for chest movement enhances breathing detection performance.

2023

Restoring walking ability in older adults with arm-in-arm gait training :
Scientific paper ArODES
study protocol for the AAGaTT randomized controlled trial

Mathilde Gigonzac, Philippe Terrier

BMC Geriatrics,  542

Link to the publication

Summary:

Context Falls are a significant problem among older adults. While balance and functional exercises have been shown to be effective, it remains unclear whether regular walking has specific effects on reducing the risk of falls. Rationale Older people who fall frequently have impaired gait patterns. Recent studies have suggested using interpersonal synchronization: while walking arm-in-arm, an older person synchronizes steps with a younger person to reinstate a better gait pattern. This method of gait training may reduce the risk of falls. Objective The aim is to assess the efficacy of an arm-in-arm gait-training program in older people. Design The arm-in-arm gait training trial (AAGaTT) is a single-site, open label, two-arm, randomized controlled trial. Participants We will enroll 66 dyads of older people and their younger “gait instructors”. The older participants must be > 70 years old with adequate walking ability. They must have experienced a fall in the year prior to study entry. Intervention Dyads will walk an indoor course for 30 min either side-by-side without contact (control group) or arm-in-arm while synchronizing their gait (intervention group). The gait training will be repeated three times a week for four weeks. Outcomes The main outcome will be the walking speed measured in five-minute walking trials performed at baseline and at the end of each intervention week (week 1 – week 4), and at week 7. Gait quality will be assessed using accelerometers. We will also assess perceived physical activity and health using questionnaires. Finally, we will monitor fall incidence over 18 months. We will evaluate whether outcomes are more improved in the intervention group compared to the control group. In addition, interviews will be conducted to assess the perception of the gait training. Expected results Recent advances in the neurophysiology of motor control have shown that synchronizing gait to external cues or to a human partner can increase the efficiency of gait training. The expected benefits of arm-in-arm gait training are: reduced risk of falls, safe treatment with no adverse effects, and high adherence. This gait training program could be a low-cost intervention with positive effects on the health and well-being of seniors.

Raw eye tracking data of healthy adults reading aloud words, pseudowords and numerals
Scientific paper ArODES

Marco Pedrotti, Anne-Françoise de Chambrier, Paolo Ruggeri, Jasinta Dewi, , Myrto Atzemian, Catherine Thevenot, Catherine Martinet, Philippe Terrier

Data in Brief,  2023, vo. 49, 109360

Link to the publication

Summary:

This paper describes data from de Chambrier et al. (2023). The dataset [2] contains raw eye tracking data of 36 healthy adults, collected using an EyeLink 1000 (SR Research Ltd., ON, Canada) during an on-screen reading task. Participants read 96 items including words, pseudowords and numerals. Each item was presented at the center of the screen until the participant produced an oral response and pressed the keyboard's space bar. Part of the data were analyzed to extract key metrics such as fixation number, fixation duration, saccade number, and saccade amplitude identified by the EyeLink 1000 [1]. Reuse potential includes (but is not limited to) pupil diameter data analysis, identification of fixations and saccades using custom algorithms, and secondary analyses using participant demographics (age, gender) as independent variables.

Reading numbers is harder than reading words :
Scientific paper ArODES
an eye-tracking study

Anne-Françoise de Chambrier, Marco Pedrotti, Paolo Ruggeri, Jasinta Dewi, Myrto Atzemian, Catherine Thevenot, Catherine Martinet, Philippe Terrier

Acta Psychologica,  2023, vol. 237, 103942

Link to the publication

Summary:

We recorded the eye movements of adults reading aloud short (four digit) and long (eight to 11 digit) Arabic numerals compared to matched-in-length words and pseudowords. We presented each item in isolation, at the center of the screen. Participants read each item aloud at their pace, and then pressed the spacebar to display the next item. Reading accuracy was 99 %. Results showed that adults make 2.5 times more fixations when reading short numerals compared to short words, and up to 7 times more fixations when reading long numerals with respect to long words. Similarly, adults make 3 times more saccades when reading short numerals compared to short words, and up to 9 times more saccades when reading long numerals with respect to long words. Fixation duration and saccade amplitude stay almost the same when reading short numerals with respect to short words. However, fixation duration increases by ~50 ms when reading long numerals (~300 ms) with respect to long words (~250 ms), and saccade amplitude decreases up to 0.83 characters when reading long numerals with respect to long words. The pattern of findings for long numerals—more and shorter saccades as well as more and longer fixations—shows the extent to which reading long Arabic numerals is a cognitively costly task. Within the phonographic writing system, this pattern of eye movements stands for the use of the sublexical print-to-sound correspondence rules. The data highlight that reading large numerals is an unautomatized activity and that Arabic numerals must be converted into their oral form by a step-by-step process even by expert readers.

2022

Effectiveness of rib fixation compared to pain medication alone on pain control in patients with uncomplicated rib fractures: study protocol of a pragmatic multicenter randomized controlled trial-the PAROS study (Pain After Rib OSteosynthesis)
Scientific paper ArODES

Jean Yaniss Perentes, Michel Christodoulou, Etienne Abdelnour-Berchtold, Wolfram Karenovics, Angèle Gayet-Ageron, Michel Gonzalez, Thorsten Krueger, Frédéric Triponez, Philippe Terrier, Benoît Bédat

Trials,  2022, vol. 23, no. 1

Link to the publication

Summary:

Background: Persistent pain and disability following rib fractures result in a large psycho‑socio‑economic impact for health‑care system. Benefits of rib osteosynthesis are well documented in patients with flail chest that necessitates invasive ventilation. In patients with uncomplicated and simple rib fractures, indication for rib osteosynthesis is not clear. The aim of this trial is to compare pain at 2 months after rib osteosynthesis versus medical therapy. Methods: This trial is a pragmatic multicenter, randomized, superiority, controlled, two‑arm, not‑blinded, trial that compares pain evolution between rib fixation and standard pain medication versus standard pain medication alone in patients with uncomplicated rib fractures. The study takes place in three hospitals of Thoracic Surgery of Western Switzerland. Primary outcome is pain measured by the brief pain inventory (BPI) questionnaire at 2 months postsurgery. The study includes follow‑up assessments at 1, 2, 3, 6, and 12 months after discharge. To be able to detect at least 2 point‑difference on the BPI between both groups (standard deviation 2) with 90% power and two‑sided 5% type I error, 46 patients per group are required. Adjusting for 10% drop‑outs leads to 51 patients per group. Discussion: Uncomplicated rib fractures have a significant medico‑economic impact. Surgical treatment with rib f ixation could result in better clinical recovery of patients with uncomplicated rib fractures. These improved outcomes could include less acute and chronic pain, improved pulmonary function and quality of life, and shorter return to work. Finally, surgical treatment could then result in less financial costs.

2021

Visual Fixation on the Thorax Predicts Bystander Breathing Detection in Simulated Out-of-Hospital Cardiac Arrest, but Video Debriefing With Eye Tracking Gaze Overlay Does Not Enhance Postallocation Success Rate
Scientific paper ArODES

Marco Pedrotti, Philippe Terrier, Louis Gelin, Marc Stanek, Olivier Schirlin

Simulation in healthcare : journal of the society for simulation in healthcare,  to be published

Link to the publication

Summary:

Introduction: Bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest is associated with higher survival rates. Even trained health care staff cannot assess breathing well enough to detect cardiac arrest. Recognition of cardiac arrest by lay rescuers might be overlooked in adult basic life support resuscitation guidelines, which explain what to do, but not how to do it. The 2015 Adult Advanced Life Support Resuscitation Guidelines recommend to “look for chest movement.” We hypothesize (1) that instructing lay rescuers to look for chest movement allows detecting breathing (or lack thereof); (2) that showing a person their own recorded gaze overlay during a video debriefing intervention enhances breathing detection at postallocation; and (3) that the more time spent looking at a cardiac arrest victim's chest, the greater the probability of detecting breathing (or lack thereof). Methods: Monocentric, blinded, prospective, 2-arm parallel randomized controlled trial with balanced randomization (1:1). The design entailed a preallocation simulation, an intervention (video debriefing with or without gaze overlay), and a postallocation simulation. A follow-up simulation took place after 6 months. The main outcome measured was success in detecting breathing. Participants were all prospective students of a bachelor's degree program in nursing. Results: All participants performed better at postallocation (success rate at preallocation = 59%, postallocation = 79%, χ2 = 7.22, P 0.01) regardless of viewing their own gaze overlay during video debriefing. We failed to obtain a sufficient number of participants for the follow-up simulation. Instructing lay rescuers to look for chest movement allows them to detect breathing (or lack thereof). Each second spent looking at the thorax increased the odds of successfully detecting breathing by 38%. Mean thorax gaze duration significantly increased by 5.95 seconds (95% confidence interval = 4.71–7.31) from preallocation (3.46 seconds, SD = 4.16) to postallocation (9.41 seconds, SD = 5.98). Laypersons' median diagnosis time was 15.5 seconds (range = 2–63 seconds), similar to another study (13 seconds, range = 5–40 seconds). Conclusions: This is the second study in which the median time to decision exceeded the maximum 10 seconds recommended. International guidelines should consider increasing the time allowed for the “check breathing” step of bystander cardiopulmonary resuscitation procedures.

Predictive factors of recovery after an acute lateral ankle sprain :
Scientific paper ArODES
a longitudinal study

Philippe Terrier, Sébastien Piotton, Ilona M. Punt, Jean-Luc Ziltener, Lara Allet

Sports,  2021, vol. 9, no 41

Link to the publication

Summary:

A prominent feature of ankle sprains is their variable clinical course. The difficulty of providing a reliable early prognosis may be responsible for the substantial rate of poor outcomes after an ankle sprain. The aim of the present study was to evaluate the prognostic value of objective clinical measures, pain, and functional scores for ankle sprain recovery. Fifty-two participants suffering from lateral ankle sprain were included. Sprain status was assessed four weeks following injury and included evaluations of ankle range of motion, strength, function, and pain. Seven months following injury, a second assessment classified the patients into recovered and non-recovered groups using ankle ability measures. Following a predictor pre-selection procedure, logistic regressions evaluated the association between the four-week predictors and the seven-month recovery status. Twenty-seven participants (52%) fully recovered and 25 did not (48%). The results of the logistic regressions showed that walking pain was negatively associated with the probability of recovering at seven months (odds ratio: 0.71, 95% CI: 0.53–0.95). Pain four weeks after ankle sprain had relevant predictive value for long-term recovery. Special attention should be paid to patients reporting persistent pain while walking four weeks following sprain to reduce the risk of chronicity

2020

The role of hip abductor strength in identifying older persons at risk of falls: a diagnostic accuracy study
Scientific paper ArODES
a diagnostic accuracy study

Simone Chantal Gafner, Caroline Henrice Germaine Bastiaenen, Serge Ferrari, Gabriel Gold, Andrea Trombetti, Philippe Terrier, Roger Hilfiker, Lara Allet

Clinical interventions in aging,  2020, vol. 15, pp. 645-654

Link to the publication

Summary:

Background/Objectives: Early detection of fall risk in persons older than 65 is of clinical relevance, but the diagnostic accuracy of currently used functional tests (eg short physical performance battery [SPPB] and timed up and go test [TUG]) to assess older persons’ fall risks remains moderate. Recent literature highlights the importance of strong hip abductors to prevent falls. We thus aimed to assess the diagnostic accuracy of hip abductor strength measures to assess older persons’ fall risks. Methods: Hip abductor maximum voluntary isometric strength (ABD MVIS), rate of force generation (ABD RFG), and the SPPB and TUG functional fall risk assessments were assessed in 60 persons aged over 65 years (82.0 ± 6.1 years). The diagnostic accuracy (area under the curve [AUC], sensitivity [sens], specificity [spec], positive predictive value [PPV], negative predictive value [NPV], and positive and negative likelihood ratios [LR+, LR−]) was evaluated at a clinically important 90% sensitivity level. Cut-off values for clinical use were calculated. Results: In our population, hip ABD MVIS (AUC 0.8, sens 90.6%, spec 57.1%, PPV 70.7%, NPV 84.2%, LR+ 2.1, LR- 0.2, and cut-off value ≤ 1.1 N/kg) and hip ABD RFG (AUC 0.8, sens 90.6%, spec 46.4%, PPV 65.9%, NPV 81.3%, LR+ 1.7, LR- 0.2, and cut-off ≤ 8.47 N/kg/s) show diagnostic accuracy comparable to other fall risk assessments (SPPB and TUG) and a high net sensitivity when used in a test battery. Conclusion: Hip ABD MVIS or RFG shows good diagnostic accuracy to differentiate between older fallers and nonfallers compared to the chosen external criterion history of falls. The high net sensitivity when hip ABD MVIS or RFG is combined with currently used fall risk assessments shows promise in contributing value to a test battery and should be investigated further in longitudinal studies.

Gait Recognition via Deep Learning of the Center-of-Pressure Trajectory
Scientific paper ArODES

Philippe Terrier

Applied Sciences,  2020, 10, 774, pp. 1-21

Link to the publication

Summary:

The fact that every human has a distinctive walking style has prompted a proposal to use gait recognition as an identification criterion. Using end-to-end learning, I investigated whether the center-of-pressure trajectory is sufficiently unique to identify a person with a high certainty. Thirty-six adults walked on a treadmill equipped with a force platform that recorded the positions of the center of pressure. The raw two-dimensional signals were sliced into segments of two gait cycles. A set of 20,250 segments from 30 subjects was used to configure and train convolutional neural networks (CNNs). The best CNN classified a separate set containing 2,250 segments with 99.9% overall accuracy. A second set of 4,500 segments from the six remaining subjects was then used for transfer learning. Several small subsamples of this set were selected randomly and used for fine tuning. Training with two segments per subject was sufficient to achieve 100% accuracy. The results suggest that every person produces a unique trajectory of underfoot pressures and that CNNs can learn the distinctive features of these trajectories. Using transfer learning, a few strides could be sufficient to learn and identify new gaits.

2019

Complexity of human walking: the attractor complexity index is sensitive to gait synchronization with visual and auditory cues
Scientific paper ArODES

Philippe Terrier

PeerJ,  7

Link to the publication

Summary:

Background. During steady walking, gait parameters fluctuate from one stride to another with complex fractal patterns and long-range statistical persistence. When a metronome is used to pace the gait (sensorimotor synchronization), long-range persistence is replaced by stochastic oscillations (anti-persistence). Fractal patterns present in gait fluctuations are most often analyzed using detrended fluctuation analysis (DFA). This method requires the use of a discrete times series, such as intervals between consecutive heel strikes, as an input. Recently, a new nonlinear method, the attractor complexity index (ACI), has been shown to respond to complexity changes like DFA, while being computed from continuous signals without preliminary discretization. Its use would facilitate complexity analysis from a larger variety of gait measures, such as body accelerations. The aim of this study was to further compare DFA and ACI in a treadmill experiment that induced complexity changes through sensorimotor synchronization.

Differences in the miRNA signatures of chronic musculoskeletal pain patients from neuropathic or nociceptive origins
Scientific paper ArODES

Camille Florine Dayer, François Luthi, Joane LeCarré, Philippe Vuistiner, Philippe Terrier, Charles Benaim, Jean-Paul Giacobino, Bertrand Léger

PLOS One,  2019, 14, 7, e0219311, 1-21

Link to the publication

Summary:

Background The quality of life for millions of people worldwide is affected by chronic pain. In addition to the effect of chronic pain on well-being, chronic pain has also been associated with poor health conditions and increased mortality. Due to its multifactorial origin, the classification of pain types remains challenging. MicroRNAs (miRNA) are small molecules that regulate gene expression. They are released into the bloodstream in a stable manner under normal and pathological conditions and have been described as potential biomarkers. In the present study, we aimed to investigate whether pain may induce an aberrant, specific dysregulation of miRNA expression, depending on the origin of the pain. Methods and findings To do so, we measured the expression changes of 184 circulating miRNAs (c-miRNAs) in the plasma samples of patients with different origins of chronic musculoskeletal pain. After statistical analyses, we identified seven c-miRNA candidates that were differentially expressed depending on the nociceptive or neuropathic origin of the pain. We then developed a two c-miRNA signature (hsa-miR-320a and hsa-miR-98-5p) that was able to correctly classify the pain type of 70% of the patients from the validation set. Conclusions In conclusion, circulating miRNAs are promising biomarkers to identify and characterize the chronic pain type and to further improve its clinical management.

Influencing walking behavior can increase the physical activity of patients with chronic pain hospitalized for multidisciplinary rehabilitation : an observational study
Scientific paper ArODES

Philippe Terrier, Caroline Praz, Joane Le Carré, Philippe Vuistiner, Bertrand Léger, François Luthi

BMC Musculoskeletal Disorders,  2019,20,188

Link to the publication

Summary:

Background: Physical therapy and exercising are key components of biopsychosocial rehabilitation for chronic pain. Exercise helps reduce pain and improve physical functions. In addition, a high level of physical activity benefits quality of life and emotional well-being. However, the degree to which hospitalization for extensive rehabilitation effectively increases physical activity has not yet been studied. Therefore, we investigated the physical activity level and the walking behavior of inpatients with musculoskeletal pain. The objectives were 1) to compare physical activity level and walking with or without rehabilitation, 2) to evaluate whether pain site influences physical activity level, and 3) to measure the association between physical activity and pain-related interference with physical functioning. Methods: During a rehabilitation stay, 272 inpatients with lower limb, spine, or upper limb pain wore an accelerometer over 1 week. We assessed the daily duration of the practice of moderate physical activity and walking. Weekend days, during which the participants went home (days off), were used as a reference for habitual activities. We also evaluated 93 patients before the hospitalization to validate the use of days off as a baseline. Pain interference was measured with the brief pain inventory questionnaire. Generalized linear mixed models analyzed the association between physical activity and walking levels, and 1) rehabilitation participation, 2) pain sites, and 3) pain interference. Results: Weekend days during the stay have similar physical activity level as days measured before the stay (73 min / day at the clinic, versus 70 min / day at home). Rehabilitation days had significantly higher physical activity levels and walking durations than days off (+ 28 min [+ 37%] and + 32 min [+ 74%], respectively). Mixed models revealed 1) a negative association between physical activity and pain interference, and 2) no effect of pain sites. Overall, patients increased their physical activity level independently of reported pain interference. Conclusions: Despite their painful condition, the inpatients were able to engage themselves in a higher level of physical activity via increased participation in walking activities. We conclude that walking incentives can be a valid solution to help patients with chronic pain be more physically active.

Influence of single and dual tasks on gait stability and gait speed in the elderly
Scientific paper ArODES

Slavko Rogan, Jan Taeymans, Christian Bangerter, Sven Simon, Philippe Terrier, Roger Hilfiker

Zeitschrift für Gerontologie und Geriatrie,  2019, vol. 52, no. 1, pp. 23-27

Link to the publication

Summary:

Background : Gait stability during dual tasks is important for elderly persons, especially for elderly individuals in need of care. A study was conducted to assess gait stability by using Lyapunov exponents (λS) during single task and dual task conditions in independently living elderly people (Go-Goes) and elderly people in need of care (No-Goes). Material and methods : This study was conducted with 26 participants (average age 82 ± 9.4 years) who were allocated to the Go-Goes or No-Goes group. Outcomes were mediolateral and vertical Lyapunov exponents (λS) from accelerometer data and gait speed under single task and dual task conditions. Results : In both groups significantly higher mediolateral and vertical Lyapunov exponent values as well as significantly lower walking speeds under dual task conditions were found in both groups. The effect sizes were small to moderate for mediolateral λS and large for vertical λS and these differences remained when the analyses were adjusted for walking speed. Conclusion : Elderly people showed lower gait stability and gait speed under dual task conditions compared to single task conditions.

2018

Intra-rater reliability of hip abductor isometric strength testing in a standing position in older fallers and non-fallers
Scientific paper ArODES

Anne-Violette Bruyneel, Simone Chantal Gafner, Serge Ferrari, Gabriel Gold, Dominique Monnin, Philippe Terrier, Caroline H. Bastiaenen, Lara Allet

European review of aging and physical activity,  2018, vol. 15, no 9, pp. 1-10

Link to the publication

Summary:

Background : Reduced hip muscle strength has been shown to be a major factor related to falls in older persons. However, comprehensive assessment of hip abduction strength in the clinical setting is challenging. The aim of this study was to investigate the feasibility and intra-rater reliability of a quick and simple hip abductor strength test in a functional standing position. Methods : Individuals over 65 years of age were recruited from the geriatric department of a university hospital and an outpatient clinic. Thirty-two older subjects, including 16 fallers (≥1 fall during the last 12 months) and 16 non-fallers were included. Maximum voluntary isometric strength (MVIS) and rate of force generation (RFG) of the hip abductors of the right leg were evaluated in a standing position using a hand-held dynamometer. Two test-sessions were carried out. All hip strength values were normalized to participants’ weight. Reliability was determined using the intra-class correlation coefficient agreement (ICCagreement), the standard error of measurement (SEM) and a Bland and Altman analysis (BA). Results : All participants completed the strength tests, which took a mean 2.47 ± 0.49 min (one limb). Intra-rater reliability was higher for MVIS (0.98[0.95–0.99]) than RFG (ICC = 0.93[0.87–0.97]) for the entire sample. In the non-fallers, ICC was 0.98[0.95–1.00] (SEM = 0.08 N.kg− 1) for MVIS and 0.88[0.75–0.96] for RFG (SEM = 1.34 N.kg-1.s-1). In the fallers, ICC was 0.94[0.89–0.98] (SEM = 0.11 N.kg− 1) for MVIS and 0.93[0.84–0.98] (SEM = 1.12 N.kg− 1.s− 1) for RFG. The BA plot showed that the MVIS and RFG values did not differ across test-sessions, showing that no learning effect occurred (no systematic effect). The mean differences between test-sessions were larger and the LOA smaller in the fallers than in the non-fallers. Conclusion : Assessment of hip strength in a standing position is feasible, rapid and reliable. We therefore recommend this position for clinical practice. Future studies should investigate the diagnostic value of hip abductor strength in standing to discriminate between fallers and non-fallers, and to determine if change in strength following a falls prevention program reduces the risk of falls.

2017

Hip muscle and hand-grip strength to differentiate between older fallers and non-fallers :
Scientific paper ArODES
a cross-sectional validity study

Simone Chantal Gafner, Caroline H. Bastiaenen, Serge Ferrari, Gabriel Gold, Philippe Terrier, Roger Hilfiker, Lara Allet

Clinical interventions in aging,  2018, vol. 13, pp. 1-8

Link to the publication

Summary:

Background: Hip muscle weakness in older people seems to be an influencing factor of falls. Currently, it is unclear which muscles out of the hip muscle group play an important role in older people. A validating process in the measurement regarding muscle strength related to falls is necessary before answering that question. Objective: Firstly, we aimed to investigate which hip muscle group strength shows an acceptable level of distinction between older adult fallers and non-fallers compared to a predefined external criterion regarding falling. Secondly, we aimed to compare the same outcomes and questions for hand-grip strength in relation to the same external criterion. Design: This study was a cross-sectional validity study. Methods: The maximum voluntary isometric strength (MVIS) and the rate of force generation of hip abductors (ABD), adductors, internal and external rotators, extensors, and flexors were measured with a dynamometer fixed to a custom-made frame as well as hand-grip strength with a Martin Vigorimeter in 60 older people aged over 65 years (38 females and 22 males). Results: The area under the curve (AUC) and the results of the mean decrease in Gini index assessed by random forest approach show that of all the assessed parameters, hip ABD MVIS showed the highest discriminative value regarding the chosen external criterion in older people (AUC ABD MVIS 0.825, 95% confidence interval: 0.712–0.938). Conclusion: Results indicate that ABD MVIS is a useful measure to distinguish between older adult fallers and non-fallers regarding the chosen external criterion.

Evaluation of hip abductor and adductor strength in the elderly :
Scientific paper ArODES
a reliability study

Simone Chantal Gafner, Caroline H. Bastiaenen, Philippe Terrier, Ilona Punt, Serge Ferrari, Gabriel Gold, Rob de Bie, Lara Allet

European review of aging and physical activity,  2017, vol. 14, article 5, pp. 1-9

Link to the publication

Summary:

Background : In elderly individuals an increased muscle strength contributes to the diminution of the falls risk and associated adverse events. An increasing interest in lateral control exists due to the fatal consequences of postero-lateral falls. Therefore a proper assessment of frontal plane hip muscle strength in elderly is important but remains challenging. Therefore we aimed to investigate the feasibility and repeatability of a hip abductor and adductor maximum voluntary isometric strength (MVIS) and rate of force generation (RFG) test in elderly. This represents an initial step in the development process of a new and clinically relevant test that could lead to more specific treatment protocols for this population. Methods : In this measurement focused study hip abduction (ABD) and adduction (ADD) MVIS and RFG were tested twice within one to three hours with a dynamometer fixed to a custom made frame in a geriatric population including fallers and non-fallers. Intraclass correlation coefficient (ICC agreement), standard error of measurement (SEM), and smallest detectable difference (SDD) were determined. Results : All recruited persons (N= 76; mean age (SD) 80.46 (7.05) years old) completed the tests. The average time needed to complete the strength tests was 10.58 min.(1.56) per muscle group. The reliability of the hip ABD and ADD was high with ICC’s agreement ranging from 0.83 to 0.97. The SDD varied between 18.1 and 81.8% depending on the muscle group and type of strength that was evaluated. Conclusion : Hip abductor and adductor strength measures in older person are feasible and reliable. However, the significance of moderate changes in these measurements may be limited by the large SDD and SEM. Therefore, physical therapist should be careful when using this measure for assessing the progress of an individual person in a daily clinical use.

2022

Reliability of a novel method to assess correlation structure among consecutive stride intervals using a low-back accelerometer: A test-retest study
Conference ArODES

Philippe Terrier, Sophia Piergiovanni

Gait Posture

Link to the conference

Summary:

Detrended fluctuation analysis (DFA) is the classical method to assess correlation structure among consecutive gait cycles of human walking. DFA has been applied in the context of fall risk in elderly and gait disorders. For accurate results, however, DFA requires long time series of over 500 strides. DFA is therefore mostly restricted to treadmill experiments. In ecological gait monitoring, we recently suggested that DFA could be favorably substituted by analyzing continuous acceleration signal with the attractor complexity index (ACI) method that consists in computing the long-term attractor divergence exponent (DE, maximal Lyapunov exponent, local dynamic stability LDS)

A novel method to assess correlation structure among stride intervals using a low-back accelerometer: A validation study in older adults
Conference ArODES

Philippe Terrier, Sophia Piergiovanni

Gait Posture

Link to the conference

Summary:

In human walking, consecutive strides exhibit a fractal correlation structure. When gait is paced with a metronome, the structure changes to an anticorrelated one [1]. Detrended fluctuation analysis (DFA) is the classical method to highlight these structures from time series of stride intervals. DFA is restricted to lab applications. In ecological gait monitoring, we recently suggested that DFA could be favorably substituted by analyzing continuous acceleration signal with the attractor complexity index (ACI) method that consists in computing the long-term attractor divergence exponent (DE, maximal Lyapunov exponent, local dynamic stability LDS).

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