ORCID Profile
0000-0002-2179-0481
Current Organisations
Université Laval
,
CHU de Québec-Université Laval
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Publisher: Walter de Gruyter GmbH
Date: 07-2016
DOI: 10.1016/J.SJPAIN.2016.03.005
Abstract: Isometric activation (ISOM) of deep multifidi muscles (MF) can influence postural adjustments and primary motor cortex (M1) function in chronic low back pain (CLBP). In order to better understand how ISOM impacts on CLBP condition, the present study contrasted ISOM aftereffects on Ml function, MF postural activation and pain with another training, the global activation of paravertebral muscles (GLOB, hip extension). The main objective of this study was to compare the effects of ISOM and GLOB (3-week training each) on MF postural activation and Ml function in a CLBP population. Twenty-four people with CLBP were randomly allocated to ISOM and GLOB groups for a 3- week daily practice. Pre ost-training after-effects were assessed by the onset of superficial MF (MF-S) activation during ballistic limb movements (bilateral shoulder flexion in standing unilateral hip extension in prine lying), MF-S corticomotor control tested by transcranial magnetic stimulation of M1, and assessment of pain, kinesiophobia and disability by standardized questionnaires. Both ISOM and GLOB improved pain and disability. However, only ISOM influenced Ml function (decreased corticospinal excitability and increased intracortical inhibition), fastened MF-S postural activation and decreased kinesiophobia. Changes of corticospinal excitability and of MF-S postural adjustments suggest that ISOM better influenced brain plasticity. Future studies should further test whether our novel findings relate to an influence of the exercises on the lumbopelvic control of different muscles and on cognitive function. Clinically, in idual’s evaluation remains warranted before prescribing one or the other of these two conventional exercises for reducing pain. This original study presents how motor control exercises can influence brain plasticity and postural control in chronic low back pain. This knowledge will impact on the decision of clinicians to prescribe specific exercises with a view of improving motor control in this musculoskeletal condition.
Publisher: Medical Journals Sweden AB
Date: 2013
Abstract: To conduct a systematic review using validated critical appraisal scales to analyze both the quality and content of the psychometric evidence of spasticity measurement tools in cerebral palsy children and adolescents. The literature search was performed in 3 databases (Pubmed, CINAHL, Embase) up to March 2012. To be retained for detailed review, studies had to report on at least one psychometric property of one or many spasticity assessment tool(s) used to evaluate cerebral palsy children and adolescents. Two raters independently reviewed admissible articles using a critical appraisal scale and a structured data extraction form. A total of 19 studies examining 17 spasticity assessment tools in cerebral palsy children and adolescents were reviewed. None of the reviewed tools demonstrated satisfactory results for all psychometric properties evaluated, and a major lack of evidence concerning responsiveness was emphasized. However, neurophysiological tools demonstrated the most promising results in terms of reliability and discriminating validity. This systematic review revealed insufficient psychometric evidence for a single spasticity assessment tool to be recommended over the others in pediatric and adolescent populations.
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.JELEKIN.2016.02.004
Abstract: Chronic low back pain (CLBP) and fear of movement (kinesiophobia) are associated with an overactivation of paravertebral muscles during forward bending. This impairs spine motor control and contributes to pain perpetuation. However, the abdominal muscles activation is engaged too in spine stabilization but its modulation with kinesiophobia remains unknown. Our study tested whether CLBP and kinesiophobia affected the activation pattern of abdominal muscles during trunk flexion/extension. Surface electromyographical recordings of the internal oblique/transversus abdominis (IO/TrA) and external oblique (EO) muscles were analyzed in 12 people with CLBP and 13 pain-free subjects during low-velocity forward bending back and forth from erected posture. T a Scale of Kinesiophobia was also administrated. IO/TrA activation, but not EO, was modulated across the phases of movement in both groups, i.e. maximal at onset of flexion and end of extension, and minimal at full flexion. In CLBP group only, IO/TrA activation was increased near to full trunk flexion and in correlation with kinesiophobia. The phase-dependence of IO/TrA activation during trunk flexion/extension in standing may have a role in spine motor control. The influence of kinesiophobia in CLBP should be further investigated as an important target in CLBP management.
Publisher: Informa UK Limited
Date: 02-01-2020
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.CLINPH.2017.04.021
Abstract: To investigate the ability of transcranial magnetic stimulation (TMS) outcomes in the chronic stroke population to (i) track in idual plastic changes and (ii) detect differences between in iduals. To this end, intrarater "test-retest" reliability (relative and absolute) was tested for the ipsilesional and contralesional hemispheres. Thirteen participants with a unilateral stroke (≥6months ago) and sensorimotor impairments were enrolled. Single and paired-pulse TMS outcomes were obtained from the primary motor cortex (M1) representation of the tibialis anterior muscle in both hemispheres and at two sessions separated by one week. The standard error of the measurement (SEM Active motor threshold and latency of motor evoked potentials provided the lowest SEM Our study provided supporting evidence of good to excellent intrarater reliability for a few TMS outcomes and proposed recommendations on the interpretation and the use of that knowledge in future work. Psychometric properties of TMS measures should be further addressed in order to better understand how to refine their use in clinical settings.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2013
Publisher: Wiley
Date: 17-09-2017
DOI: 10.1002/HBM.23816
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.JNS.2013.12.038
Abstract: This study explored the relationships between motor cortical control of ankle dorsiflexors and clinical impairments of volitional ankle dorsiflexion in people with chronic stroke. Eighteen persons with stroke and 14 controls were evaluated. Clinical tools were used to assess ankle dorsiflexion litude and isometric strength. Transcranial magnetic stimulation (TMS) of the primary motor cortex (M1) tested the functional integrity of cortical circuits controlling the tibialis anterior (TA). All clinical scores and most TMS outcomes were impaired in people with chronic stroke. The lower clinical scores were related to the reduction of the strength of corticospinal projections onto spinal motoneurons. Concurrent TMS and clinical testing in chronic stroke provided original data demonstrating relationships between the integrity of cortical and corticospinal components of TA motor control and volitional ankle tasks. Our study proposes that volitional ankle mobilization in chronic stroke may be explained by the residual abnormal M1 circuits which may be responsive for rehabilitation intervention. This should be confirmed in longitudinal studies with larger s les to determine whether TMS outcomes associated with lower limb muscles are predictive of clinical changes or vice versa.
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1016/J.NEUCLI.2011.03.004
Abstract: Chronic recurrent pain results in brain reorganization for cortical sensory and motor representation of muscles. This review supports the hypothesis that maladaptive plasticity in chronic low back pain patients could be associated with disorders of volitional activation of trunk elvis muscles and alterations of their anticipatory motor patterns for postural control. This is actually observed for the transversus abdominis muscle, an abdominal muscle that stabilizes the lumbosacral spine against external and internal postural perturbations. Indeed, voluntary activation of this muscle is more difficult in low back pain and a posterolateral translation of its cortical motor representation is observed in association with a delay of its anticipatory activation (usually observed in any focal limb movement). During physiotherapy, low back pain patients are trained to hollowing for contracting the transversus abdominis muscle, which normalizes both activation delays and cortical motor representation. This motor rehabilitation could be potentiated by peripheral repetitive magnetic stimulation directly over the nerves/muscles. This review introduces the magnetic stimulation technique and proposes to combine peripheral theta-burst stimulation to conventional therapy for increasing the functional gain. This may facilitate the activation of sensory afferents and modulate cortical plasticity to improve (or even re-activate) the sensorimotor control and possibly influence pain. Peripheral magnetic stimulation as an ancillary treatment adjuvant for promoting motor control in low back pain might also be relevant in any other neurological or musculoskeletal disorder with underlying maladaptive brain reorganization.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.BRS.2016.12.008
Abstract: Transcranial magnetic stimulation (TMS) is used worldwide for noninvasively testing human motor systems but its psychometric properties remain unclear. This work systematically reviewed studies on the reliability of TMS outcome measures of primary motor cortex (M1) excitability in healthy humans, with an emphasis on retrieving minimal detectable changes (MDC). The literature search was performed in three databases (Pubmed, CINAHL, Embase) up to June 2016 and additional studies were identified through hand-searching. French and English-written studies had to report the reliability of at least one TMS outcome of M1 in healthy humans. Two independent raters assessed the eligibility of potential studies, and eligible articles were reviewed using a structured data extraction form and two critical appraisal scales. A total of 34 articles met the selection criteria, which tested the intra- and inter-rater reliability (relative and absolute subtypes) of several TMS outcomes. However, our critical appraisal of studies raised concerns on the applicability and generalization of results because of methodological and statistical pitfalls. Importantly, MDC were generally large and likely affected by various factors, especially time elapsed between sessions and number of stimuli delivered. This systematic review underlined that the evidence about the reliability of TMS outcomes is scarce and affected by several methodological and statistical problems. Data and knowledge of the review provided however relevant insights on the ability of TMS outcomes to track plastic changes within an in idual or within a group, and recommendations were made to level up the quality of future work in the field.
Publisher: Wiley
Date: 17-07-2012
DOI: 10.1111/J.1651-2227.2012.02770.X
Abstract: Given that prematurity has deleterious effects on brain networking development beyond childhood, the study explored whether an early intervention such as Kangaroo Mother Care (KMC) in very preterm preemies could have influenced brain motor function up to adolescence. Transcranial magnetic stimulation (TMS) was applied over the primary motor cortex (M1) of 39 adolescents born very prematurely ( 37 weeks' gestational age, >2500 g) to assess the functional integrity of motor circuits in each hemisphere (motor planning) and between hemispheres (callosal function). All TMS outcomes were similar between KMC and term adolescents, with typical values as in healthy adults, and better than in Controls. KMC adolescents presented faster conduction times revealing more efficient M1 cell synchronization (p < 0.05) and interhemispheric transfer time (p < 0.0001), more frequent inhibitory processes with a better control between hemispheres (p < 0.0001). The enhanced synchronization, conduction times and connectivity of cerebral motor pathways in the KMC group suggests that the Kangaroo Mother Care positively influenced the premature brain networks and synaptic efficacy up to adolescence.
Publisher: Elsevier BV
Date: 02-2018
Publisher: Springer Science and Business Media LLC
Date: 05-02-2012
DOI: 10.1007/S00221-012-3008-9
Abstract: Contralateral transversus abdominis muscle (cTrA) is known to be anticipatory to rapid focal movement. The activation of ipsilateral TrA (iTrA) follows cTrA, but their anticipatory interaction in healthy subjects seems to be delayed in low back pain (LBP) patients. TrA delay in LBP is linked with reorganization of the primary motor cortex (M1), thus supporting that cortical changes underlie the altered postural control. Our study tested whether differences in postural adjustments were present in LBP for TrA onsets and co-activation, and whether these differences were paralleled by cortical motor changes. Thirteen chronic LBP patients and 9 healthy Controls were enrolled. Surface recordings of cTrA/internal oblique (IO) and iTrA/IO were collected during a rapid shoulder flexion task while standing. Transcranial magnetic stimulation of M1 tested TrA/IO corticospinal excitability, active motor threshold and short-interval intracortical inhibition (SICI). In LBP compared to Controls, iTrA/IO activation was delayed, co-activation was absent, timing between TrA/IO onsets was impaired, and SICI was missing. Between-outcomes correlations observed in one group were not significant in the other. Delay of iTrA/IO and the lacking co-activation were not explained by between-group differences of transcranial magnetic stimulation outcomes. TrA/IO co-activation is present during rapid focal movement in healthy subjects only. LBP patients displayed an important alteration of the control of spine stability that can be explained by altered mechanisms of M1 motor programming.
Publisher: Springer Science and Business Media LLC
Date: 26-12-2015
DOI: 10.1007/S00221-015-4528-X
Abstract: Chronic low back pain (CLBP) is often associated with impaired control of deep trunk muscles and reorganization of the primary motor areas (M1). Precisely, functional changes of the lumbar multifidus muscles (MF) involved in spine stability may be of special interest in rehabilitation. Therefore, we tested MF corticomotor control using double transcranial magnetic stimulation (TMS) paradigms for the first time in this muscle and examined its link with MF volitional activation. Eleven in iduals with lateralized CLBP and 13 pain-free participants were recruited. Ultrasound imaging enabled measurement of MF volitional isometric contraction in prone lying. TMS of MF M1 area was used to test hemispheric excitability and mechanisms in relation to motor programming, i.e., active motor threshold (AMT), litude of motor-evoked potentials and short-interval intracortical inhibition (SICI) and facilitation (SICF). In CLBP, SICI level was lower in the left hemisphere and MF volitional contraction was not related to AMT (M1 excitability), conversely to what was observed in the pain-free group. No other between-group difference was detected. These original findings support a plasticity of cortical maps controlling paravertebral muscles and likely including a different motor strategy for the control of MF. Changes of M1 function may thus underlie impaired motor control of lumbopelvic spine and pain persistence in CLBP.
Publisher: Public Library of Science (PLoS)
Date: 10-08-2016
Publisher: Wiley
Date: 17-11-2018
DOI: 10.1002/HBM.24471
Publisher: Informa UK Limited
Date: 28-01-2015
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.GAITPOST.2014.11.006
Abstract: Cross-sectional study of lumbopelvic muscle activation during rapid limb movements in chronic low back pain (CLBP) patients and healthy controls. Controversy exists over whether bilateral anticipatory activation of the deep abdominal muscles represents a normal motor control strategy prior to all rapid limb movements, or if this is simply a task-specific strategy appropriate for only certain movement conditions. To assess the onset timing of the transversus abdominis/internal oblique muscles (TrA/IO) during two rapid limb movement tasks with different postural demands - bilateral shoulder flexion in standing, unilateral hip extension in prone lying - as well as differences between CLBP and controls. Twelve CLBP and 13 controls performed the two tasks in response to an auditory cue. Surface EMG was acquired bilaterally from five muscles, including TrA/IO. In both groups, 50% of bilateral shoulder flexion trials showed bilateral anticipatory TrA/IO activation. This was rare, however, in unilateral hip extension for which only the TrA/IO contralateral to the moving leg showed anticipatory activation. The only significant difference in lumbo-pelvic muscle onset timing between CLBP and controls was a delay in semitendinosus activation during bilateral shoulder flexion in standing. Our data suggest that bilateral anticipatory TrA/IO activation is a task-specific motor control strategy, appropriate for only certain rapid limb movement conditions. Furthermore, the presence of altered semitendinosus onset timing in the CLBP group during bilateral shoulder flexion may be reflective of other possible lumbo-pelvic motor control alterations among this population.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.CLINPH.2016.12.020
Abstract: The study tested whether combining repetitive peripheral magnetic stimulation (RPMS) and motor training of the superficial multifidus muscle (MF) better improved the corticomotor control of spine than training alone in chronic low back pain (CLBP). Twenty-one participants with CLBP were randomly allocated to [RPMS+training] and [Sham+training] groups for three sessions (S1-S3) over a week where MF was stimulated before training (volitional contraction). Training was also home-practiced twice a day. Changes were tested at S1 and S3 for anticipatory postural adjustments (APAs) of MF and semi-tendinosus (ST), MF EMG activation, cortical motor plasticity (transcranial magnetic stimulation) and pain/disability. The RPMS group showed immediate decrease of pain at S1, then improvement of MF activation, ST APA, M1 facilitation, and pain/disability at S3. Changes were larger when brain excitability was lower at baseline. Disability index remained improved one month later. Combining RPMS with training of MF in CLBP impacted motor planning, MF and lumbopelvic spine motor control and pain/disability one week after the onset of protocol. Brain plasticity might have favoured motor learning and improved daily lumbopelvic spine control without pain generation. Clinically, RPMS impacted the function by improving the gains beyond those reached by training alone in CLBP.
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.NEUCLI.2017.02.003
Abstract: This study tested the after-effects of neuromuscular electrical stimulation (NMES), repetitive peripheral magnetic stimulation (rPMS) and muscle tendon vibration (VIB) on brain plasticity and sensorimotor impairments in chronic stroke to investigate whether different results could depend on the nature of afferents recruited by each technique. Fifteen people with chronic stroke participated in five sessions (one per week). Baseline measures were collected in session one, then, each participant received 4 randomly ordered interventions (NMES, rPMS, VIB and a 'control' intervention of exercises). Interventions were applied to the paretic ankle muscles and parameters of application were matched as closely as possible. Standardized clinical measures of the ankle function on the paretic side and transcranial magnetic stimulation (TMS) outcomes of both primary motor cortices (M1) were collected at pre- and post-application of each intervention. The ankle muscle strength was significantly improved by rPMS and VIB (P≤0.02). rPMS influenced M1 excitability (increase in the contralesional hemisphere, P=0.03) and inhibition (decrease in both hemispheres, P≤0.04). The group mean of a few clinical outcomes improved across sessions, i.e. independently of the order of interventions. Some TMS outcomes at baseline could predict the responsiveness to rPMS and VIB. This original study suggests that rPMS and VIB were efficient to drive M1 plasticity and sensorimotor improvements, likely via massive inflows of 'pure' proprioceptive information generated. Usefulness of some TMS outcomes to predict which intervention a patient could be more responsive to should be further tested in future studies.
Publisher: Springer Science and Business Media LLC
Date: 15-11-2016
DOI: 10.1007/S00221-016-4834-Y
Abstract: Hemispheric lateralization of pain processing was reported with overactivation of the right frontal lobe. Specifically in chronic low back pain (CLBP), functional changes in the left primary motor cortex (M1) with impaired anticipatory postural activation (APA) of trunk muscles have been observed. Given the connections between frontal and M1 areas for motor planning, it is hypothesized that the pain side could differently influence M1 function and APA of paravertebral multifidus (MF) muscles. This study aimed at testing whether people with right- versus left-sided CLBP showed different M1 excitability and APA. Thirty-five in iduals with lateralized CLBP (19 right-sided and 16 left-sided) and 13 pain-free subjects (normative values) were tested for the excitability of MF M1 area (active motor threshold-AMT) with transcranial magnetic stimulation and for the latency of MF APA during bilateral shoulder flexion and during unilateral hip extension in prone lying. In the right-sided CLBP group, the AMT of both M1 areas was lower than in the left-sided group and the pain-free subjects the latency of MF APA was shorter in bilateral shoulder flexion and in the left hip extension tasks as compared to the left-sided group. In CLBP, an earlier MF APA was correlated with lower AMT in both tasks. People with right-sided CLBP presented with increased M1 excitability in both hemispheres and earlier MF APA. These results likely rely on cortical motor adaptation related to the tasks and axial muscles tested. Future studies should investigate whether CLBP side-related differences have a clinical impact, e.g. in diagnosis and intervention.
Publisher: MDPI AG
Date: 08-09-2016
DOI: 10.3390/HEALTHCARE4030067
Abstract: Chronic low back pain (CLBP) is a recurrent debilitating condition that costs billions to society. Refractoriness to conventional treatment, lack of improvement, and associated movement disorders could be related to the extensive brain plasticity present in this condition, especially in the sensorimotor cortices. This narrative review on corticomotor plasticity in CLBP will try to delineate how interventions such as training and neuromodulation can improve the condition. The review recommends subgrouping classification in CLBP owing to brain plasticity markers with a view of better understanding and treating this complex condition.
No related grants have been discovered for Cyril Schneider.