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Vaucher Paul

Intervenant externe

Compétences principales

Interdisciplinary conversation

Intervenant externe

Bureau: 5.52

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 :

Article scientifique ArODES

une étude qualitative

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

Mains Libres, 2024, 1, 110-123

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Résumé:

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 :

Article scientifique 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

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Résumé:

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 :

Article scientifique 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

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Post-mortem changes of the vascular system :

Article scientifique 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

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Résumé:

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 :

Article scientifique 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

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Résumé:

Contexte : Avec l’émergence de la pratique éclairée, les cliniciens s’engagent à donner du sens à la recherche, de décider si elle est digne de confiance et si elle est applicable à la nature complexe de leur pratique clinique. Ceci est rendu plus difficile par l’exposition croissante à la désinformation (délibérée ou non) et aux extrapolations qui se propagent facilement, y compris via les réseaux sociaux. L’aiguisement de la pensée critique et la lecture de travaux scientifiques favoriseraient la prise de décision éclairée. Objectif : Cet article propose un guide de lecture pour donner aux cliniciens les moyens de juger par eux-mêmes de la qualité des articles scientifiques issus de la recherche, de détecter les irrégularités courantes, et d’accroître la responsabilité des chercheurs pour communiquer correctement leurs résultats. Méthode : Les erreurs, les mauvaises interprétations, les fausses déclarations et les fausses informations sont discutées pour chacun des quatre devis d’étude suivant : les études de cas, les essais cliniques, les recherches qualitatives et les revues systématiques. Une approche critique de la lecture est proposée pour éviter les biais et se fonder un avis objectif. Conclusion : Les compétences acquises à la lecture de ce guide devrait permettre aux cliniciens d’optimiser l’utilisation de leur temps (et celui de leurs patients) lorsqu’ils sont confrontés à des sources potentielles de preuves.

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

Article scientifique 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

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Résumé:

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 :

Article scientifique 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

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Résumé:

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 :

Article scientifique 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

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Résumé:

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 :

Article scientifique 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

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Résumé:

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 :

Article scientifique 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

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Résumé:

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 :

Chapitre de livre 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

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Résumé:

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 :

Article scientifique 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

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Résumé:

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 :

Article scientifique 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

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Opposing vaccine hesitancy during the COVID-19 pandemic :

Article scientifique 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

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Résumé:

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

Article scientifique ArODES

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

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

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Résumé:

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) :

Article scientifique 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

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

Article scientifique ArODES

a systematic review

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

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

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Résumé:

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.

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

Article scientifique ArODES

recommandations et directives internationales

Juliette Meier, Paul Vaucher

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

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Résumé:

État des connaissances : L’utilité de l’imagerie médicale lors de lombalgie commune a été remise en cause durant les 15 dernières années. Aujourd’hui, il est admis que l’imagerie reste une exception à n’utiliser qu’en cas de présence de « red flags ». Force est de constater que la pratique peine à suivre ces recommandations avec 1/3 des examens faits inutilement et 60 % des patients présentant des signes justifiant l’imagerie qui n’y ont pas recours. Objectifs : Ce Masterclass vise à résumer les recommandations actuelles en matière de délégation pour imagerie lors de lombalgie commune aiguë. Recommandations : Vu le nombre impressionnant de faux positifs en imagerie médicale (> 80 %) et le manque de plusvalue clinique en première ligne de traitement, il est utile d’expliquer aux patients les raisons pour lesquelles il est contre-productif de recourir à de l’imagerie en absence de signes évoquant une fracture, une infection, une néoplasie, ou une neuropathie avec des signes neurologiques avancés. Conclusion : Durant les six premières semaines, le recours à l’imagerie lors de lombalgies aiguë devrait rester exceptionnel.

Models and theoretical frameworks for osteopathic care :

Article scientifique 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

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

Article scientifique 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

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Résumé:

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.

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

Article professionnel ArODES

au-delà des cloisonnements professionnels

Paul Vaucher

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

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2019

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

Article scientifique 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

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Résumé:

Introduction: L’évaluation du risque de lombalgie demeure complexe, car elle manque de recommandations fondées sur des données probantes et de tests fonctionnels fiables. Le test d’inclinaison unilatérale du bassin propose une analyse dynamique du complexe lombo-pelvi-fémoral. Il n’existe cependant pas de description quantitative du mouvement attendu chez une population asymptomatique de triathlètes. Cette étude vise à identifier et à différencier des schémas de mouvement du complexe lombo-pelvi-fémoral lors du test et d’en fournir des premières valeurs normatives. Méthode: Vingt-deux triathlètes asymptomatiques ont reçu l’instruction d’effectuer le test d’inclinaison latérale du bassin de manière bilatérale. La cinématique 3D a été obtenue à partir d’un système d’analyse de mouvement à 24 caméras. Ceci a permis de modéliser via OpenSim l’amplitude articulaire du mouvement effectué par le tronc, le bassin, les hanches et les genoux. Une analyse de classe par latence a permis d’identifier les «classes» de mouvements possibles. Résultats : Quatre classes de mouvements possibles ont été identifiées. La mobilisation du genou était limitée au maximum en présence d’une limitation de l’inclinaison du bassin, puis de la rotation du bassin, et finalement de l’antéversion du bassin. Ces schémas étaient présents de manière différenciée entre le côté gauche et le côté droit chez 31.8% des participants. Discussion: Cette approche permet d’identifier des athlètes ayant des limitations de mobilité du complexe lombo-pelvifémoral. Conclusion: L’interprétation du mouvement fonctionnel polyarticulaire pourrait aider à identifier et comprendre différentes stratégies ou adaptations cinématiques expliquant la sur ou sous sollicitation de certaines articulations.

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

Article scientifique 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

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Tester la dysfonction sacro-iliaque :

Article scientifique 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

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Résumé:

Introduction: les tests sacro-iliaques sont fréquemment utilisés en thérapies manuelles pour poser le diagnostic de dysfonction sacro-iliaque (SIJD). Et ceci malgré le fait que la plupart des tests utilisés cliniquement ne semblent ne pas être reproductibles. Le test d’allongement-raccourcissement du membre inférieur (test de Downing) pourrait avoir un avantage sur les autres tests vu qu’il permet une analyse fonctionnelle de l’unité lombo-sacrée-coxo-fémorale. Cette étude vise à évaluer l’effet des manoeuvres du test de Downing sur la longueur fonctionnelle des membres inférieurs ainsi que la fiabilité intra-testeur et inter-testeur de ces mesures. Méthode: cette étude test-retest clinimétrique a inclus un échantillon de convenance de participants présentant un syndrome douloureux de l’articulation sacro-iliaque évalué par la présence d’au moins 3 sur 5 cinq tests de douleur positifs. Chaque articulation a ensuite été testée six fois par un ostéopathe pour évaluer la fiabilité intra-testeur et cinq fois par cinq ostéopathes pour évaluer la fiabilité inter-testeur des deux manoeuvres du test de Downing à l’aide de trois méthodes de mesure différentes : la longueur relative des membres inférieurs à la hauteur mi-mollets à l’aide d’un pied à coulisse, la distance entre l’épine iliaque antéro supérieure et la face externe de la malléole externe à l’aide d’un mètre souple, la hauteur relative de la plante des pieds à l’aide d’une table à pied à coulisses. Résultats : au total, 14 articulations ont été étudiées par 1’980 mesures. Nous n’avons remarqué aucune diminution des effets des manoeuvres sur les articulations présentant une douleur sacro-iliaque par rapport à celles ne la présentant pas (allongement : 6.9mm vs 5.2mm, p=0.004 ; raccourcissement : 3.9mm vs. 3.9mm, p=0.981). La fiabilité intra-testeur donna un coefficient de corrélation intraclasse (ICC) de 0.47 (IC=95% 0.23-0.74) pour le test d’allongement et 0.27 (IC=95% 0.08-0.58) pour le test de raccourcissement. La fiabilité inter-testeurs était moins bonne avec respectivement un ICC=0.15 (CI95% -0.04 – 0.48) et ICC=0.02 (CI95% -0.11 – 0.32). Les éventuels effets de la répétition de la manoeuvre n’ont pas été mis en cause. Discussion : cette étude nourrit le doute sur la validité et la fiabilité du test de Downing. Il semblerait que les effets des manoeuvres sur la longueur relative des membres inférieurs résulteraient davantage de la latéralisation du bassin qu’au jeu articulaire de la sacro-iliaque. Conclusion : rien ne justifie pour le moment l’utilisation clinique du test de Downing pour identifier une dysfonction de l’articulation sacro-iliaque.

2018

Soutenir les proches-aidants :

Article professionnel 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

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Résumé:

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

Conférence 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)

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Résumé:

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.

Réalisations

PEOPLE@HES-SO
Annuaire et Répertoire des compétences

Vaucher Paul

Intervenant externe

Compétences principales

Clinical predictive rules

Digital Transformation

Ambulatory care research

Musculoskeletal health

Psychosocial health

Interdisciplinary conversation

Active communication

Intervenant externe

PEOPLE@HES-SO Annuaire et Répertoire des compétences

Vaucher Paul

Intervenant externe

Compétences principales

Clinical predictive rules

Digital Transformation

Ambulatory care research

Musculoskeletal health

Psychosocial health

Interdisciplinary conversation

Active communication

Intervenant externe

PEOPLE@HES-SO
Annuaire et Répertoire des compétences