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Vaucher Paul

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Interdisciplinary conversation

Intervenant externe

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Haute école de santé - Fribourg
Route des Arsenaux 16a, 1700 Fribourg, CH

MSc HES-SO en Ostéopathie - Haute école de santé - Fribourg

Travail de Master

2024

Les étapes clefs de l’examen physique ostéopathique dans un contexte de lombalgie :

Scientific paper ArODES

une étude qualitative

Elina Pittet, Katia Iglesias, Jean-Baptiste Pellissier, Paul Vaucher

Mains Libres, 2024, 1, 110-123

Link to the publication

Summary:

Contexte : Les modèles existants pour expliquer les étapes de l’examen physique en ostéopathie restent peu développés et ne permettent pas de comprendre les processus en jeu. Objectif : En se focalisant sur la lombalgie, cette étude vise à décrire les différentes étapes du raisonnement clinique de l’examen physique ostéopathique et d’identifier les éléments qui influencent ce processus. Méthode : Des entretiens semi-structurés auprès de douze ostéopathes francophones travaillant en Suisse ont été effectués. Les unités de sens pertinentes ont été extraites en effectuant une analyse thématique. Les résultats ont été affinés et validés par les participants à l’aide d’un processus de consensus en deux tours. Résultats : Cinq étapes clefs ont été identifiées : l’investigation générale, l’exploration de la plainte, l’orientation fonctionnelle, l’identification des paramètres spécifiques et l’évaluation de l’intégration des changements. La routine d’examen physique serait modifiée par les valeurs du patient, l’idée préalable du fonctionnement du patient, ses attitudes et schémas ainsi que ses ressources. Ces résultats ont été validés par les ostéopathes ayant participé au consensus. Conclusion : L’étude a permis de décrire un processus de raisonnement en cinq étapes pour l'examen physique ostéopathique dans un contexte de lombalgie. Ces résultats pourraient dépasser la lombalgie et indiquer un possible consensus dans le raisonnement de l’examen physique en général. La complexité du processus met en avant l'importance du vécu du patient, en mettant l'accent sur la réévaluation et la ratification post-traitement. L’utilisation de ces résultats pourrait favoriser la communication entre professionnels de la santé.

Usual light touch osteopathic treatment versus simple light touch without intent in the reduction of infantile colic crying time :

Scientific paper ArODES

a randomised controlled trial

Dawn Carnes, Philip Bright, Kevin Brownhill, Karen Carroll, Roger Engel, Sandra Grace, Steven Vogel, Paul Vaucher

International journal of osteopathic medicine, 51, 100710, 1-8

Link to the publication

Summary:

Background: Many parents seek osteopathic care for their infants with colic. Our aim was to test the effectiveness of usual light touch osteopathic treatment on crying time for infants with ‘colic’. Methods: A superiority, two arm, single blinded (parent) multi-centre (UK, Australia and Switzerland), randomised controlled trial, included healthy infants between 1 and 69 days of age who excessively cried, fussed, or were distressed and difficult to console. The Test intervention consisted of usual light touch osteopathic treatment, the Control intervention simple light touch to random body locations with no treatment intent. Both groups received best practice advice and guidance. The primary outcome was the daily crying time, reported hourly by parents in a diary, for two-weeks. Secondary outcomes were parenting confidence, global change, satisfaction, and experience of care. Results: Sixty-six infants were recruited (32 Test: 34 Control group). Mean average daily crying time in the Test group was 124 min (SD = 69, n = 26) and in the Control 115 min (SD = 49, n = 29). After adjustment, infants in the Test group cried 2.2 min more per day than those in the Control group (CI95 % 􀀀 20 to 25 min, p = 0.849). Parents’ perceptions of global change in symptoms, satisfaction with, and experience of care were high and similar in both groups. There were no serious adverse events related to the treatments or the trial. Conclusion: Usual light touch osteopathic treatment was not superior to simple light touch without treatment intent. The biomechanical explanatory models and underpinning assumptions about the mechanisms of osteopathic intentional light touch care may require reconsideration. Trial registration: ACTRN12620000047998 (January 22, 2020).

2023

Recommendations for the development, implementation, and reporting of control interventions in efficacy and mechanistic trials of physical, psychological, and self management therapies :

Scientific paper ArODES

CoPPS Statement

David Hohenschurz-Schmidt, Lene Vase, Whitney Scott, Marco Annoni, Oluwafemi K Ajayi, Jürgen Barth, Kim Bennell, Chantal Berna, Joel Bialosky, Felicity Braithwaite, Nanna B Finnerup, Amanda C de C Williams, Elisa Carlino, Francesco Cerritelli, Aleksander Chaibi, Dan Cherkin, Luana Colloca, Pierre Côté, Beth D Darnall, Roni Evans, Laurent Fabre, Vanda Faria, Simon French, Heike Gerger, Winfried Häuser, Rana S Hinman, Dien Ho, Thomas Janssens, Karin Jensen, Chris Johnston, Sigrid Juhl Lunde, Francis Keefe, Robert D Kerns, Helen Koechlin, Alice Kongsted, Lori A Michener, Daniel E Moerman, Frauke Musial, David Newell, Michael Nicholas, Tonya M Palermo, Sara Palermo, Kaya J Peerdeman, Esther M Pogatzki-Zahn, Aaron A Puhl, Lisa Roberts, Giacomo Rossettini, Susan Tomczak Matthiesen, Martin Underwood, Paul Vaucher, Jan Vollert, Karolina Wartolowska, Katja Weimer, Christoph Patrick Werner, Andrew S C Rice, Jerry Draper-Rodi

British Medical Journal, 2023, vol. 381, no. e072108, pp. 1-16

Link to the publication

Post-mortem changes of the vascular system :

Scientific paper ArODES

a thanatological study using multidetector computed tomography

Coraline Egger, Kim Wiskott, Paul Vaucher, Laurent Suppan, Francesco Doenz, Pierre Bize, Silke Grabherr

International journal of legal medicine, 137, 4, 1109–1115

Link to the publication

Summary:

Forensic pathologists have to deal with post-mortem changes of the human body. Those post-mortem phenomena are familiar and largely described in thanatology. However, knowledge about the influence of post-mortem phenomena on the vascular system is more limited, except for the apparition and development of cadaveric lividity. The introduction of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the forensic field and the expansion of their usage in medico-legal routine, allow for exploring the inside of corpses differently and may play a part in the understanding of thanatological processes. This study aimed to describe post-mortem changes in the vascular system by investigating the presence of gas and collapsed vessels. The study investigated post-mortem MDCT data of 118 human bodies. Cases with internal/external bleeding or corporal lesion allowing contamination with external air were excluded. Major vessels and heart cavities were systematically explored and a trained radiologist semi-quantitatively assessed the presence of gas. Collapsed veins were observed in 61.9% of cases (CI95% 52.5 to 70.6) and arteries in 33.1% (CI95% 24.7 to 42.3). Vessels most often affected were for arteries: common iliac (16.1%), abdominal aorta (15.3%), external iliac (13.6%), and for veins: infra-renal vena cava (45.8%), common iliac (22.0%), renal (16.9%), external iliac (16.1%), and supra-renal vena cava (13.6%). Cerebral arteries and veins, coronary arteries, and subclavian vein were unaffected. The presence of collapsed vessels was associated with a minor degree of cadaveric alteration. We observed that arteries and veins follow the same pattern of gas apparition for both the quantity and the location. In post-mortem radiology, collapsed vessels and intravascular gas are frequently visualized and as a result of all post-mortem changes, the assessment of the distribution of blood can be confusing. Therefore, knowledge of thanatological phenomena is crucial to prevent post-mortem radiological misapprehensions and possible false diagnoses.

2022

Éviter la diffusion de quatre irrégularités pour donner du sens aux preuves :

Scientific paper ArODES

les erreurs, les mauvaises interprétations, les fausses déclarations et les fausses informations

Jerry Draper-Rodi, Paul Vaucher, David Hohenschurz-Schmidt, Chantal Morin, Oliver P. Thomson

Mains libres, 2022?; vol. 3, pp. 166-176

Link to the publication

Summary:

Context: With the emergence of evidence informed prac tice, clinicians are committed to interpreting research and deciding whether it is trustworthy and transferable to their clinical practice, which has a complex nature. This issue is further complicated by the increasing exposure to mis information (deliberate or otherwise) and misrepresentations that are easily propagated, including via social media. Sharpening critical thinking skills when reading scientific literature would facilitate informed decision making. Objective: This article provides recommendations to empower clinicians to appraise research for themselves, detect common errors, and increase researchers’ account ability regarding accurate communication of their findings. Method: Mistakes, misinterpretations, misrepresentations, and misinformation are discussed for the following study designs: case studies, clinical trials, qualitative research, and systematic reviews. A critical reading approach is proposed to avoid bias and form an objective opinion. Conclusion: The guidance and examples in this paper should enable clinicians to optimize the use of their time (and that of their patients) when they encounter potential sources of evidence.

Exploring lumbo-pelvic functional behaviour patterns during osteopathic motion tests :

Scientific paper ArODES

a biomechanical (en)active inference approach to movement analysis

Mathieu Ménard, Marien Couvertier, Lea Awai, Jorge E. Esteves, Benoit Bideau, Paul Vaucher

International Journal of Osteopathic Medicine, 2022, vol. 45, pp. 8-16

Link to the publication

Summary:

Background: Observing how individuals actively adapt to their environment may provide additional insights into traditional clinical tests. Rather than using tests that only identify joint mobility limitations, it seems relevant to use clinical motion tests that assess global biomechanical functions more generally and identify functional behaviours. Objectives: This study explores whether different functional kinematic behaviour patterns appear when executing a new complex motor task and whether those observations are consistent over multiple executions. Methods: Marker-based kinematic analyses of the lumbo-pelvic complex were conducted on 29 asymptomatic athletes during two active self-induced motion tests: the one-sided tilt test and a modified version of this test limiting the trunk axial rotation. Marker data served as an input for a full musculoskeletal model to compute the lumbar and lower limb joint angles. Latent class analysis and intraclass correlation coefficients were calculated to identify different classes of functional kinematic behaviour and assess the reliability between measurements. Results: The methodology allowed us to identify four distinctive classes of possible movement combinations based on these two functional tests: standard movement, low knee and lumbar engagement, high pelvis engagement and high lumbar flexion. All ICCs for the lumbo-pelvic complex degrees of freedom were higher than 0.6, suggesting a moderate to good reliability for the overall test. Conclusion: It remains unknown whether the observed reproducible patterns emerging from the motion test relate to motivation and prior experiences. Further exploration is required to investigate whether these behaviours can be correlated to empirical clinical observations, past experiences, and future vulnerabilities for musculoskeletal conditions

4?M's to make sense of evidence :

Scientific paper ArODES

avoiding the propagation of mistakes, misinterpretation, misrepresentation and misinformation

Jerry Draper Rodi, Paul Vaucher, David Hohenschurz-Schmidt, Chantal Mori, Oliver P. Thomson

International Journal of Osteopathic Medicine, 2022, vol. 44, pp. 29-35

Link to the publication

Summary:

Osteopaths are expected to keep up to date with research evidence relevant to their clinical practice and to integrate this knowledge with their own experience and their patients' values and preferences. One of the potential challenges when engaging with research is to make sense of it, to decide if it is trustworthy, and if it is applicable to the complex and context-sensitive nature of clinical practice and the care of individual people. Clinicians are increasingly exposed to (deliberate and undeliberate) misinformation and overstatements which propagate easily, including via social media. This masterclass aims to facilitate critical thinking and engagement in research for clinicians to make better-informed decisions with their patients. It was developed to support osteopaths facing these questions with the aim of empowering them to judge research themselves, detect common fallacies in the conduct and reporting of different research designs, and to increase researchers' accountability. Ultimately, we hope that by reading and considering the guidance and examples in this paper, clinicians will be better equipped to optimise the use of their (and their patients’) time when facing potential sources of evidence. Mistakes, misinterpretation, misrepresentation and misinformation are discussed for each of these methods/methodologies: case reports, clinical trials, qualitative research, and reviews

Functional assessment of the stomatognathic system. Part 2 :

Scientific paper ArODES

role of dynamic elements of analysis

Carlo Massimo Saratti, Giovanni Tommaso Rocca, Paul Vaucher, Lea Awai, Andrea Papini, Sascha Zuber, Enrico Di Bella, Didier Dietschi, Ivo Krejci

Quintessence international, 2022, vol. 53, no. 1, pp. 90-102

Link to the publication

Summary:

Objectives: To review the dynamic analytical elements used in the functional assessment of the stomatognathic system, summarize the available scientific evidence, and consider interrelations with body posture and cognition. Method and materials: A thorough literature search was conducted using PubMed, the Cochrane Library database, and Google Scholar. Peer-reviewed articles and literature reviews provided up-to-date information addressing three topics: (a) the available knowledge and recent evidence on the relationship between the morphologic aspects of dental/craniofacial anatomy and oral function/dysfunction, (b) mandibular dynamics, considering mobility, functional activity, and existing methodologies of analysis, and (c) a possible correlation between the stomatognathic system, body posture, and cognition. Results: Modern dentistry may be regarded as a human adaptation strategy, helping to conserve healthy teeth for much longer without risking overall health. It is futile to treat patients using a mechanistic, sectorial approach that misrepresents patient behavior and requests, just as it is to affirm the absence of any structure-function relationships. However, it is also evident that there is a lack of general consensus on the precise functional assessment of the stomatognathic system, mostly due to the methodologic heterogeneity employed and the high risk of bias. Despite the abundant evidence produced with the aim of providing solid arguments to define dynamic models of functional assessment of the stomatognathic system, it is yet to become highly empirical, based as it is on operator experience in daily clinical practice. Conclusions: Further efforts from the scientific and clinical community, with the help of progress in technology, remain should this gap be filled and should substantial data on differences between pathologic and physiologic dynamic models of function be provided. Dentistry needs to employ – on a larger scale – objective, dynamic methods of analysis for the functional evaluation of the stomatognathic system, embracing concepts of “personalized medicine” and “interprofessional collaborations.”

2021

Functional assessment of the stomatognathic system :

Scientific paper ArODES

part 1 : the role of static elements of analysis

Carlo Massimo Sarratti, Giovanni Tommaso Rocca, Paul Vaucher, Lea Awai, Andrea Papini, Sascha Zuber, Enrico Di Bella, Ivo Krejci

Quintessence international, 2021, vol. 52, no. 10, pp. 920-932

Link to the publication

Summary:

Objectives: To review the elements of static analysis in the functional assessment of the stomatognathic system, as promoted for more than a century by gnathologists, and summarize the available scientific evidence, including anthropologic observations. Method and materials: A thorough search was conducted using PubMed, the Cochrane Library database, and Google Scholar. From peer-reviewed articles and other scientific literature, up-to-date information addressing three topics was identified: (a) the anthropologic perspective with particular consideration for the role of progressive dental wear over time, (b) descriptions of gnathologic principles and evidence on their scientific validity, and (c) the methodologic inaccuracies introduced by seeking to correlate variables directly rather than allowing for causal inference. Results: For decades gnathology attempted to describe a structure-function correlation within the stomatognathic system by means of a model whose principles were static and mechanistic references. No scientific validation was ever achieved, placing clinical and research consensus out of reach. Conclusions: A historical perspective helps to place the fundamentals of gnathology into context: They were conceived to solve technical difficulties but were then assumed to be physiologic stereotypes. This misconception led to a decades-long promotion of mechanistic theories to describe oral function, but the evidence available today supports a more flexible and adaptable approach. Gnathologic arguments have been relegated to become exclusively of technical relevance in oral rehabilitation.

Assessment of cognitive screening tests as predictors of driving cessation :

Scientific paper ArODES

a prospective cohort study of a median 4-year follow-up

Ioannis Kokkinakis, Paul Vaucher, Isabel Cardoso, Bernard Favrat

PLOS ONE, 2021, Vol. 16, no. 8, e0256527

Link to the publication

Summary:

Background Assessing fitness to drive and predicting driving cessation remains a challenge for primary care physicians using standard screening procedures. The objective of this study was to prospectively evaluate the properties of neuropsychological screening tests, including the Trail Making Test (TMT), Clock Drawing Test (CDT), Montreal Cognitive Assessment (MoCA), Useful Field of View (UFOV), and Timed Up and Go (TUG) test, in predicting driving cessation for health reasons in drivers older than 70 years of age. Design and methods This prospective cohort study, with a median follow-up of 4 years for drivers of 70 years old or older with an active driving license in Switzerland, included 441 participants from a driving refresher course dedicated to volunteer senior drivers. Cases were drivers reported in the national driving registry who lost their license following a health-related accident, who were reported as unfit to drive by their physician or voluntarily ceased driving for health reasons. Survival analysis was used to measure the hazard ratio of driving cessation by adjusting for age and sex and to evaluate the predictive value of combining 3 or more positive tests in predicting driving cessation during a 4-year follow-up. Results A total of 1738 person-years were followed-up in the cohort, with 19 (4.3%) having ceased driving for health reasons. We found that participants with a TMT-A < 54 sec and TMT-B < 150 sec at baseline had a significantly lower cumulative hazard of driving cessation in 4 years than those with slower performance (adjusted HR 3, 95% CI: 1.16–7.78, p = 0.023). Participants who performed a CDT ≥ 5 had a significantly lower cumulative hazard of driving cessation (adjusted HR 2.89, 95% CI: 1.01–7.71, p = 0.033). Similarly, an MoCA score ≥ 26, TUG test <12 sec or a UFOV of low risk showed a lower but not significant cumulative risk at a median follow-up of 4 years. When using tests as a battery, those with three or more positive tests out of five were 3.46 times more likely to cease driving (95% CI: 1.31–9.13, p = 0.012). Conclusions The CDT and the TMT may predict driving cessation in a statistically significant way, with a better performance than the UFOV and MoCA tests during a median 4-year follow-up. Combining tests may increase the predictability of driving cessation. Although our results are consistent with current evidence, they should be interpreted with precaution; more than 95% of the participants above the set threshold were able to continue driving for 4 years without any serious incident.

L’apprentissage par le service communautaire :

Book chapter ArODES

une possibilité de répit pour les personnes proches aidantes et une opportunité de formation pour les futurs professionnels de la santé

Sylvie Tétreault, David Bellagamba, Daniel Ducommun, Paul Vaucher, Sylvie Meyer, Martine Bertrand Leiser, Justine Tinguely, Lucas Minisini, Lorraine Aviolat, Nicolas Kühne

Dans Ludwig Catherine, Oulevey Bachmann, Annie, Tétreault, Sylvie, Proches aidant·e·s : des alliés indispensables aux professionnels de la santé (pp. 322-379). 2021, Genève : Georg

Link to the publication

Summary:

Le soutien offert aux PPA doit être accru afin d’éviter leur épuisement. Le présent projet concerne le développement d’un programme d’apprentissage par le service communautaire, intitulé Proches Aidant·e·s : un Service des Étudiant·e·s en Santé (PAuSES). Il vise à soutenir les PPA et impliquer des étudiants en santé. Ce programme permet à des étudiants des professions de santé d’offrir gratuitement quarante heures de soutien non professionnel à des personnes proches aidantes (PPA). Il applique une stratégie d’apprentissage par le service communautaire (service learning). PAuSES offre des périodes de répit aux PPA et contribue à un meilleur équilibre occupationnel. Les étudiants, qui ont participé au projet, comprennent mieux le quotidien et le rôle d’aidant. PAuSES peut potentiellement contribuer à améliorer l’efficience de soins qui impliquent des PPA – et atténuer les effets de la pénurie de professionnels de la santé. Le programme PAuSES semble prometteur et mériterait d’être étendu à d’autres régions, institutions d’enseignement et formation.

Osteopathy: italian professional profile :

Scientific paper ArODES

a professional commentary by the european community of practice

Francesco Cerritelli, Christian Lunghi, Jorge E. Esteves, Paul Vaucher, Patrick van Dun, Gerard Alvarez, M. Biberschick, Agathe Wagner, Olivier Merdy, Menard Menard, Paola Tavernier, Cyril Clouzeau, Andreas Risch, Nuria Ruffini, Alexandre Nunes, Rui Santiago, Peter Marett, Robert Grech, Oliver Thomson

International Journal of Osteopathic Medicine, 2021, Vol 40, pp. 22-28

Link to the publication

Summary:

Osteopathy became recently regulated as a healthcare profession in Italy. The Italian legislation classifies osteopathy as a healthcare profession, which focuses on health prevention and maintenance with a role in rehabilitation and functional psychosocial recovery. The legislative framework also lays down the osteopathic professional profile. Osteopaths are described as healthcare practitioners who deliver osteopathic person-centred care focused on the musculoskeletal system and the concept of somatic dysfunction. Despite these positive developments in the legislation for osteopathy, the Italian law raises critical points regarding the validity of osteopathic care models, namely the concept of somatic dysfunction and the role of osteopaths in health promotion and prevention. The legislative developments currently occurring worldwide must be informed by a critical appraisal of osteopathic conceptual models and grounded on robust research. In the article, a panel of European osteopaths involved in clinical and academic practice, research and regulation, present this professional commentary to facilitate a critical discussion on the role, competencies and scope of practice of osteopaths in the light of the recently published Italian osteopathic professional profile.

Exploring the utility of motion analysis in osteopathic clinical trials :

Scientific paper ArODES

a school-based pilot study on jaw and cervical range of motion

T. Bagory, Paul Vaucher, H. Mhadhbi, M. Ménard

International Journal of Osteopathic Medicine, 2021, vol. 41, pp. 27-36

Link to the publication

Opposing vaccine hesitancy during the COVID-19 pandemic :

Scientific paper ArODES

a critical commentary and united statement of an international osteopathic research community

Oliver P. Thomson, Andrew MacMillan, Jerry Draper-Rodi, Paul Vaucher, Mathieu Ménard, Brett Vaughan, Chantal Morin, Gerard Alvarez, Kesava Kovanur Sampath, Francesco Cerritelli, Robert Shaw, Tyler C. Cymet, Philip Bright, David Hohenschurz-Schmidt, Steven Vogel

International Journal of Osteopathic Medicine, 2021, vol. 39, pp A1-A6

Link to the publication

Summary:

The trusted role and professional standing that osteopaths have with their patients and within their wider communities requires that the information and messages they communicate are informed by and congruent with current evidence, public health guidance and scientific consensus. This expectation is even more critical during the COVID-19 pandemic, particularly in relation to sharing information and decisions with patients regarding vaccination. All osteopaths have a social, moral and professional duty to contribute to the prevention of the transmission of infectious diseases. Practitioners must be critically aware when traditional osteopathic theories, principles and ideology may appear to contradict public health advice. Osteopaths should correct erroneous reasoning, false claims or misleading messaging to ensure that their professional practice and advice follows the most robust and recent evidence, public health advice and regulatory requirements.

2020

The importance of rigour in the reporting of evidence for osteopathic care in Covid-19 papers

Scientific paper ArODES

Jerry Draper-Rodi, Paul Vaucher, Oliver P. Thomson

Explore, 2021, vol. 17, no 3, pp. 184-185

Link to the publication

Summary:

The value of incorporating research evidence into clinical practice is in part, to help acknowledge, accept and manage uncertainties. The urgency related to the Covid-19 pandemic has changed usual publication process and information sharing. The rapid knowledge exchange between theory, research and clinical recommendation has occurred with the hope of preventing Covid-19 related mortality and reducing morbidity. However, expediting knowledge transfer should not occur at the expense of accuracy and cautious interpretation of the research evidence. Such carelessness only serves to inundate the public and health professionals with false or misleading information. Such inaccuracies, especially when relating to potential therapeutic strategies for Covid-19 are likely to have severe negative consequence on people's health. There is therefore a need to avoid speculation and favour scientific rigour and intellectual honesty in claims made about evidence on benefits of manual treatment for Covid-19 patients. This letter to the editor questions overstatements found in Marin et al.'s published narrative review and focuses on three avoidable types of errors: misinterpretation, cherry picking and lack of methodological rigour.

Crying Unsettled and disTressed Infants Effectiveness Study of osteopathic care (CUTIES trial) :

Scientific paper ArODES

pragmatic randomised superiority trial protocol

Dawn Carnes, P. Bright, K. Brownhill, K. Carroll, R. Engel, S. Grace, S. Vogel, Paul Vaucher

International Journal of Osteopathic Medicine, 2020, vol. 38, pp. 31-38

Link to the publication

Standardized on-road tests assessing fitness-to-drive in people with cognitive impairments :

Scientific paper ArODES

a systematic review

David Bellagamba, Line Vionnet, Isabel Margot-Cattin, Paul Vaucher

PLoS ONE, 2020, vol. 15, no. 5, 26 p.

Link to the publication

Summary:

Objective : The on-road assessment is the gold standard because of its ecological validity. Yet existing instruments are heterogeneous and little is known about their psychometric properties. This study identified existing on-road assessment instruments and extracted data on psychometric properties and usability in clinical settings. Method : A systematic review identified studies evaluating standardized on-road evaluation instruments adapted for people with cognitive impairment. Published articles were searched on PubMed, CINHAL, PsycINFO, Web of Science, and ScienceDirect. Study quality and the level of evidence were assessed using the COSMIN checklist. The collected data were synthetized using a narrative approach. Usability was subjectively assessed for each instrument by extracting information on acceptability, access, cost, and training. Results : The review identified 18 published studies between 1994 and 2016 that investigated 12 different on-road evaluation instruments: the Performance-Based Driving Evaluation, the Washington University Road Test, the New Haven, the Test Ride for Practical Fitness to Drive, the Rhode Island Road Test, the Sum of Manoeuvres Score, the Performance Analysis of Driving Ability, the Composite Driving Assessment Scale, the Nottingham Neurological Driving Assessment, the Driving Observation Schedule, the Record of Driving Errors, and the Western University’s On-road Assessment. Participants were mainly male (64%), between 48 and 80 years old, and had a broad variety of cognitive disorders. Most instruments showed reasonable psychometric values for internal consistency, criterion validity, and reliability. However, the level of evidence was poor to support any of the instruments given the low number of studies for each. Conclusion : Despite the social and health consequences of decisions taken using these instruments, little is known about the value of a single evaluation and the ability of instruments to identify expected changes. None of the identified on-road evaluation instruments seem currently adapted for clinical settings targeting rehabilitation and occupational priorities rather than road security alone.

Models and theoretical frameworks for osteopathic care :

Scientific paper ArODES

a critical view and call for updates and research

Jorge Esteves, Rafael Zegarra-Parodi, Patrick van Dun, Francesco Cerritelli, Paul Vaucher

International Journal of Osteopathic Medicine, 2020, vol. 34, pp 1-4

Link to the publication

Inverted Classroom as innovative international educational technology in teaching doctors in global challenges era

Scientific paper ArODES

Natalja Valerjevna Krasilnikova, Paul Vaucher, Nina Pavlovna Vanchakova, Andrei Anatoljevich Bogatyrev, Elizaveta Aleksandrovna Vatskel, Anna Aleksandrovna Baraboshina

Advances in Economics, Business and Management Research, 2020, vol. 131, pp 755-760

Link to the publication

Summary:

The research is based on the accomplishment experience of The international Swiss-Russian TICOM project – Transcultural Inverted Classrooms in Osteopathy and Medicine, focused on testing modern technologies for inverted classes. The investigation is dedicated to the topical issue of upgrading doctors’ vocational skills and providing medical vocational training in international context, meeting European Union demands and standards for medical workers. Modern competence-based conception of the vocational education and training integrity leads to distinguishing between hard skills and soft skills of a doctor, having to solve both bodily treatment and interpersonal communication tasks. These two groups of tasks are tightly interconnected in many ways and modes, vehemently influencing the efficiency of medical help in intersubjective and “bio-psycho-social” paradigm. So ‘medical treatment of the whole patient’ has become a point of competitiveness in vocational sphere. The complexity of the task of providing modern patient with proper medical treatment leads logically to introducing of meta-competences level of professional preparedness as a tool of vocational education expertise and designing new approaches and solutions to teaching students medical profession. At the same time new educational content demand new forms and methodology of teaching. The educational task of fostering holistic approach in doctor-topatient communication was tried in Swiss-Russian Inverted Classroom educational and research project, challenging the preparedness of medical students for vocational activity to follow such values as “openness, professional integrity, and warmth”. The analysis of effectiveness of the approach, educational form (i.e. Flipped Classroom), educational tools and techniques used is discussed in the report.

Recours à l'imagerie lors de la prise en charge de lombalgies aiguës :

Scientific paper ArODES

recommandations et directives internationales

Juliette Meier, Paul Vaucher

Mains libres, 2020, no. 1, pp. 39-43

Link to the publication

Summary:

State of knowledge : The added value of medical imaging for patients with acute low back pain has been questioned for the past 15 years. Today, it is accepted that imaging remains an exception to be used only in the presence of «red flags». However, practice is struggling to follow these recommendations as 1/3 of examinations are performed unnecessarily and 60 % of patients presenting signs that justify imaging are not investigated. Objectives : The aim of this Masterclass is to summarize the current guidelines in terms of recommendation for imaging in common acute low back pain. Recommendations : Considering the remarkably high number of false positives in medical imaging (> 80 %) and the lack of added clinical value of imaging in first-line treatment, it is useful to explain to patients why it is counterproductive to use imaging in the absence of signs of fracture, infection, neoplasia, or neuropathy with advanced neurological signs. Conclusion : During the first 6 weeks, the use of imaging in acute low back pain should remain exceptional.

Recommandations générales pour la prise en charge en première intention de troubles musculosquelettiques :

Professional paper ArODES

au-delà des cloisonnements professionnels

Paul Vaucher

Mains libres, 2020, vol. 37, no. 1, p.52

Link to the publication

2019

Analyse biomécanique du complexe lombo-pelvi-fémoral complex during the one-sided tilt test :

Scientific paper ArODES

a pilot study in triathletes

Mathieu Ménard, Paul Vaucher, Pierre Chenaut, Ludovic Lancelot, Launay Francois, Marylène Bourgin, Benoit Bideau

Mains Libres, 2019, no. 3, pp. 19-26

Link to the publication

Summary:

Introduction: The evaluation of the risk of low back pain remains complex as it lacks evidence-based recommendations and a reliable functional test. The one-sided tilt test can provide additional information on the dynamics of the lumbo- pelvic complex. However, little is known about the expected movement. This study aims to identify different patterns of movement during the test in a healthy population of triathletes and provide preliminary normative values. Method: Twenty-tvvo asymptomatic triathletes were instructed to perform the right and left one-sided tilt test. Three-dimensional kinematics were obtained from a 24-camera motion analysis system. This made it possible to mode! the range of motions of the torso, the pelvis, the hips and the kneesusing OpenSim. Latent class analysis was then used to identify different classes of movement combination. Results: Four classes of possible movement combinations w ere identified. Knee flexion was most limited with reduced range of pelvis tilt motion, then rotation, and fina lly list. These patterns were different between the left and right side in 31.8% of the studied population. Discussion: This approach enabled the ident ification of athletes with limited range of motion on the lumbar-pelvic-femoral complex. Conclusions : Polyarticular functional movement could help understand different strategies and kinematic adaptations linked to over- or under- mechanical load of specific joints.

Modélisation de la cinématique articulaire et musculaire de la région lombaire lors du test de la commère :

Scientific paper ArODES

une étude de preuve de concept

Mathieu Ménard, Pierre Chenaut, Ludovic Lancelot, Paul Vaucher, Benoit Bideau

La Revue de l'Ostéopathie, 2019, no. 22-1

Link to the publication

Tester la dysfonction sacro-iliaque :

Scientific paper ArODES

effet et fiabilité des tests d’allongement-raccourcissement du membre inférieur (test de Downing) sur une population symptomatique

Paul Vaucher

Mains libres, 2019, vol. 36, no. 1, pp. 21-30

Link to the publication

Summary:

Introduction: sacroiliac joint tests are commonly used for the diagnosis of sacroiliac joint dysfunction (SIJD) despite the fact that most dynamic and structural palpation tests appear to be unreliable. The aim of this study was to differentiate the effects of a quantitative dynamic test of the sacroiliac joint, known as Downing’s test, applied to symptomatic joints versus asymptomatic joints, and to evaluate the intra-tester and inter-tester reliability of the leg-lengthening and leg-shortening tests. Methods: a test-retest study using a single-group, random-order, repeated-measures design was planned to evaluate intra- rater and inter-rater reliability of the lengthening-shortening test. A convenience sampling method was used to find six volunteer patients with sacroiliac syndrome defined by the presence of 3/5 positive sacro-iliac pain provocation tests. Intra-class correlation coefficients were calculated by testing all 12 joints six times by one rater for intra-rater reliability and five times by five active osteopaths to determine inter-rater reliability. Three different measuring methods were used to evaluate the effects of each test: relative leg length measured at mid-calf height using a caliper rule, leg length between the anterior-superior-iliac-spine and the external malleolus using a measuring tape, and the relative leg length measured under the feet using a specific device designed for this study. Results : in total, 14 joints were studied with a total of 1980 measures. Functional lengthening or shortening of lower limb were not less significant on the side of the symptomatic joints compared to the asymptomatic side (lengthening: 6.9mm vs. 5.2mm, p=0.004; shortening: 3.9mm vs. 3.9mm, p=0.981). Results also showed poor intra-rater reliability for the lengthening test (ICC=0.47; CI95%: 0.23 – 0.74) and for the shortening test (ICC=0.27; CI95% 0.08 – 0.58). Inter-rater reliability was decreased with respectively an ICC=0.15 (CI95% -0.04 – 0.48) and an ICC=0.02 (CI95%: -0.11 – 0.32). The lack of reliability was not due to changes over time due to repeated measures. Discussion: this study raises further doubts on the validity and reliability of the Downing test. We believe that observed effects on leg lengths result from pelvis side-tilt rather than from sacroiliac joint play. Conclusion : the results of this study do not justify the use of the lengthening-shortening test to detect SIJD.

2018

Soutenir les proches-aidants :

Professional paper ArODES

exploration des services à offrir par des étudiant-e-s de la santé et du social

Romain Bertrand, Nicolas Kühne, Sylvie Tétreault, Daniel Ducommun, Paul Vaucher, Sandrine Pilhet

Recueil annuel d'ergothérapie, 2019, no. 11, pp. 59-71

Link to the publication

Summary:

Description : les proches aidants expriment régulièrement des besoins de répit. Un apprentissage expérientiel avec des étudiants en santé, particulièrement en ergothérapie, permettrait de répondre à cette demande. But : cette étude documente les attentes et les disponibilités des étudiants envers une implication communautaire destinée aux proches aidants. Méthodologie : il s’agit d’une recherche exploratoire de type quantitatif, qui a utilisé un sondage auprès de 250 étudiants du domaine de la santé ou du social en Suisse romande. Résultats : les répondants se disent prêts à investir du temps personnel pour soutenir les proches aidants. Toutefois, ils souhaitent une rétribution sous forme d’argent ou de crédits d’études, un aménagement de leur horaire pour avoir davantage de temps à offrir. Ils aimeraient suivre des cours sur la situation du proche-aidant et avoir le soutien d’un mentor. Conséquences : un projet de programme communautaire permet d’offrir du répit aux proches aidants et de répondre à un besoin d’expériences concrètes de la part des étudiants.

2020

Digitalization of the last mile of a humanitarian supply chain

Conference ArODES

Maurizio Caon, Omar Abou Khaled, Paul Vaucher, Dany Mezher, George Mc Guire

Proceedings of the 2nd International Conference on Human Interaction and Emerging Technologies: Future Applications (IHIET – AI 2020)

Link to the conference

Summary:

The digitalization of humanitarian supply chains allows overcoming one of the greatest difficulties faced by NGOs and governments in managing health equipment in crisis situations: the visibility of stocks and consumption at the end of the chain. This paper presents the design process of the health equipment inventory management system developed to support the humanitarian crisis related to the Syrian refugees in Lebanon. The prototype was tested at the pharmacy of the ICRC Weapon-wounded Trauma and Training Centre in Tripoli, Lebanon, where it was demonstrated to be easy to use and able to facilitate the work related to the management of medicament stocks and orders.

Achievements

PEOPLE@HES-SO
Directory and Skills inventory

Vaucher Paul

Intervenant externe

Main skills

Clinical predictive rules

Digital Transformation

Ambulatory care research

Musculoskeletal health

Psychosocial health

Interdisciplinary conversation

Active communication

Intervenant externe

PEOPLE@HES-SO Directory and Skills inventory

Vaucher Paul

Intervenant externe

Main skills

Clinical predictive rules

Digital Transformation

Ambulatory care research

Musculoskeletal health

Psychosocial health

Interdisciplinary conversation

Active communication

Intervenant externe

PEOPLE@HES-SO
Directory and Skills inventory