Postural control at different anatomical levels: dependence upon sport practice

Control of equilibrium in upright posture is a multifactorial phenomenon influenced by the sensory modalities involved or by the characteristics of the environment. Or of the subjects. We have to specify how the practice of sports, especial1y judo or dance, could influence the role of the sensory information and t he postural strategies used. Practicers of Judo and dancers need to tram to control their equilibrium, in order for the judoka to maintain their own standing position while attempting to throw their opponents to the ground, or for the dancers to make the movements of the desired shape. Is this experience and skill generalized to the control of static equilibrium and which sensory aspects are trained the most (Crbmieux, Mesure, 1990, 1992), and does it change the postural strategies of the subjects? To answer these questions, an experiment was carried out with 60 young healthy adults: 2 groups of novice men and women, one group of men and one of women expert in Judo (black belt) and one group of women expert in classic dance ( 5years of practice). The subjects were tested in a sharpened Romberg position on either a hard or a soft surface within a vertical cylinder with vertical black and white stripes. Three type of illumination were used: normal or 2 Hz stroboscopic light, and darkness. Accelerometers were used to measure the subject's lateral (head and hips) or antero-posterior (ankles) body sway. A frequency power spectrum analysis shows a better static control in the expert men and women than in the beginners; but this improvement is not due to an aspecific increase in the use of visual, vestibular or proprioceptive cues for the three expert groups; rather it depends on the sport and sex of the subjects. They did not choose the same information for their own control. A study of the correlations between performances at the different anatomical levels show that the relation between motion of the different body levels are not the same for the five groups. To study the effect of sex and sport on this relative movements, we use .a new statistical determination of postural strategies (Amblard et al., 1992a. b) between two anatomical levels, by mean of a method based on the crosscorrelation functions between two simultaneous time series of accelerometric measurements. Results show that men and women, a as well as novices and experts have not the same relative body movements

A Comparison of Miltefosine and Sodium Stibogluconate for Treatment of Visceral Leishmaniasis in an Ethiopian Population with High Prevalence of HIV Infection.

BACKGROUND: Antimonials are the mainstay of visceral leishmaniasis (VL) treatment in Africa. The increasing incidence of human immunodeficiency virus (HIV) coinfection requires alternative safe and effective drug regimens. Oral miltefosine has been proven to be safe and effective in the treatment of Indian VL but has not been studied in Africa or in persons with HIV and VL coinfection. METHODS: We compared the efficacy of miltefosine and sodium stibogluconate (SSG) in the treatment of VL in persons in Ethiopia. A total of 580 men with parasitologically and/or serologically confirmed VL were randomized to receive either oral miltefosine (100 mg per day for 28 days) or intramuscular SSG (20 mg/kg per day for 30 days). RESULTS: The initial cure rate was 88% in both treatment groups. Mortality during treatment was 2% in the miltefosine group, compared with 10% in the SSG group. Initial treatment failure was 8% in the miltefosine group, compared with 1% in the SSG group. Among the 375 patients (65%) who agreed to HIV testing, HIV seroprevalence was 29%. Among patients not infected with HIV, initial cure, mortality, and initial treatment failure rates were not significantly different (94% vs. 95%, 1% vs. 3%, and 5% vs. 1% for the miltefosine and SSG groups, respectively). Initial treatment failure with miltefosine occurred in 18% of HIV-coinfected patients, compared with treatment failure in 5% of non-HIV-infected patients. At 6 months after treatment, 174 (60%) of the 290 miltefosine recipients and 189 (65%) of the 290 SSG recipients experienced cure; 30 (10%) of 290 in the miltefosine group and 7 (2%) of 290 in the SSG group experienced relapse, and the mortality rate was 6% in the miltefosine group, compared with 12% in the SSG group. HIV-infected patients had higher rates of relapse (16 [25%] of 63 patients), compared with non-HIV-infected patients (5 [5%] of 131). CONCLUSIONS: Treatment with miltefosine is equally effective as standard SSG treatment in non-HIV-infected men with VL. Among HIV-coinfected patients, miltefosine is safer but less effective than SSG

De l'élection de valeurs à l'adoption de normes

International audienc

REORGANIZATION OF EQUILIBRIUM AND MOVEMENT CONTROL STRATEGIES IN PATIENTS WITH KNEE ARTHRITIS

International audienc