Publications by authors named "France Mourey"

43 Publications

Deterioration, Compensation and Motor Control Processes in Healthy Aging, Mild Cognitive Impairment and Alzheimer's Disease.

Geriatrics (Basel) 2021 Mar 23;6(1). Epub 2021 Mar 23.

INSERM U1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21000 Dijon, France.

Aging is associated with modifications of several brain structures and functions. These modifications then manifest as modified behaviors. It has been proposed that some brain function modifications may compensate for some other deteriorated ones, thus maintaining behavioral performance. Through the concept of compensation versus deterioration, this article reviews the literature on motor function in healthy and pathological aging. We first highlight mechanistic studies that used paradigms, allowing us to identify precise compensation mechanisms in healthy aging. Subsequently, we review studies investigating motor function in two often-associated neurological conditions, i.e., mild cognitive impairment and Alzheimer's disease. We point out the need to expand the knowledge gained from descriptive studies with studies targeting specific motor control processes. Teasing apart deteriorated versus compensating processes represents precious knowledge that could significantly improve the prevention and rehabilitation of age-related loss of mobility.
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http://dx.doi.org/10.3390/geriatrics6010033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006018PMC
March 2021

[Description of psychomotor disadaptation syndrome or frontal-subcortical dysfunction syndrome].

Soins Gerontol 2021 Jan-Feb;26(147):34-36. Epub 2020 Nov 5.

Institut national de la santé et de la recherche médicale U1093 Cognition, action et plasticité sensorimotrice, université de Bourgogne, BP 27877, 21078 Dijon cedex, France.

The psychomotor disadaptation syndrome (PDS) was first described 34 years ago by the geriatric research team from Dijon, France. This syndrome was initially called "psychomotor regression syndrome". It was renamed PDS in the 1990s following considerable advances in the understanding of its pathophysiology and management. Since the 2000s, a condition known as sub-cortical-frontal dysfunction (syndrome sous-cortico-frontal) has become synonymous with PDS. Effective management of PDS requires a multidisciplinary approach that includes physicians, physiotherapists, psychologists and the entire geriatrics healthcare team.
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http://dx.doi.org/10.1016/j.sger.2020.10.007DOI Listing
February 2021

Sensory reweighting in frail aged adults: Are the balance deficiencies mainly compensated by visual or podal dependences?

Neurosci Lett 2021 03 28;747:135670. Epub 2021 Jan 28.

Hôpital Nord Franche-Comté, Institut de Formation des Métiers de la Santé, Filière Kinésithérapie - Physiothérapie, 25200, Montbéliard, France; Laboratoire de Neurosciences intégratives et cliniques (EA 482), Université de Bourgogne Franche-Comté, 25000 Besançon, France. Electronic address:

Background: Postural control is based on the integration of different sensory inputs. The process of scaling the relative importance of these sensory cues (visual, vestibular and proprioceptive) depends on individuals and creates sensory preferences, leading to sensory dependences when one particular source is preponderant. In this context, the literature showed a frequent visual dependence (visual inputs weighting) in aged adults. However, the somaesthetic inputs can also be prioritised in a podal-dependent profile. In the frail aged adults, none study has shown the distribution of these two dependences.

Research Question: Which sensory orientation profile is preferentially adopted by frail aged males and females?

Methods: In this cross-sectional study, we compared 33 frail aged adults to 16 non frail aged adults during a static postural control task in three conditions on a force platform: i) a standard condition, ii) a no-vision condition and iii) a foam condition. An analysis with the factor sex was also performed in each group of participants.

Results: The analysis of stabilometric parameters (mean velocity and mean velocity variance) highlighted a significant difference in no-vision or foam conditions when compared to the standard condition in frail aged males and only in the foam condition when compared to the standard condition for females in the frail group. No significant difference was observed between conditions in the control group.

Significance: Our study showed the predominance of both visual and podal information in frail aged adults when controlling their posture. Considering the sex factor, frail males were more dependents to their visual cues than frail females. This result should be used when designing the rehabilitation programs in this population.
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http://dx.doi.org/10.1016/j.neulet.2021.135670DOI Listing
March 2021

Geriatric Rehabilitation and COVID-19: a Case Report.

SN Compr Clin Med 2020 Nov 9:1-9. Epub 2020 Nov 9.

Hôpital Nord Franche-Comté, Institut de Formation des Métiers de la Santé, Filière Kinésithérapie - Physiothérapie, 25200 Montbeliard, France.

The COVID-19 infection has particularly affected older adults. Clinical observations in this population highlight major respiratory impairment associated with the development or aggravation of the patient's frailty state. Mr. P is a 93-year-old frail patient, hospitalized after a COVID-19 infection. The assessment process of this patient has been supported by an innovative multi-systemic tool developed in view of the COVID-19 clinical consequences and a systemic evaluation of motor functions by the Frail'BESTest. This process allowed a mixed clinical picture associated with significant respiratory distress (linked with acute respiratory distress syndrome) and an evident motor frailty. The care plan was developed accordingly, and four assessments were done in the same manner until Mr. P returned home. This case report allows us to see a holistic COVID-19 clinical picture, showing the different axes of clinical reasoning to enhance the rehabilitation process. Furthermore, this case report illustrates the importance of rehabilitation in the COVID-19 context.
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http://dx.doi.org/10.1007/s42399-020-00613-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652377PMC
November 2020

Motor Planning of Vertical Arm Movements in Healthy Older Adults: Does Effort Minimization Persist With Aging?

Front Aging Neurosci 2020 25;12:37. Epub 2020 Feb 25.

INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, Dijon, France.

Several sensorimotor modifications are known to occur with aging, possibly leading to adverse outcomes such as falls. Recently, some of those modifications have been proposed to emerge from motor planning deteriorations. Motor planning of vertical movements is thought to engage an internal model of gravity to anticipate its mechanical effects on the body-limbs and thus to genuinely produce movements that minimize muscle effort. This is supported, amongst other results, by direction-dependent kinematics where relative durations to peak accelerations and peak velocity are shorter for upward than for downward movements. The present study compares the motor planning of fast and slow vertical arm reaching movements between 18 young (24 ± 3 years old) and 17 older adults (70 ± 5 years old). We found that older participants still exhibit strong directional asymmetries (i.e., differences between upward and downward movements), indicating that optimization processes during motor planning persist with healthy aging. However, the size of these differences was increased in older participants, indicating that gravity-related motor planning changes with age. We discuss this increase as the possible result of an overestimation of gravity torque or increased weight of the effort cost in the optimization process. Overall, these results support the hypothesis that feedforward processes and, more precisely, optimal motor planning, remain active with healthy aging.
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http://dx.doi.org/10.3389/fnagi.2020.00037DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052522PMC
February 2020

Physical and Psychological Effectiveness of Cardiac Rehabilitation: Age Is Not a Limiting Factor!

Can J Cardiol 2019 10;35(10):1353-1358

Service de Réadaptation Cardiaque, Clinique Les Rosiers, Dijon, France.

Background: There is little data regarding the impact of patient age on the physical and psychological effectiveness of cardiac rehabilitation (CR). The aim of the present study was therefore to compare the effects of an exercise-based CR program on physical and psychological parameters in young, old, and very old patients. We also aimed to identify the features that best predicted CR outcome.

Methods: A total of 733 patients were divided into 3 subgroups: YOUNG (< 65 years old), OLD (between 65 and 80 years old), and VERY OLD (≥ 80 years old). Physical variables such as peak workload and estimated peak VO as well as psychological variables such as scores of anxiety and depression were evaluated for all patients before and after CR.

Results: Performance in all tests and scores for all questionnaires were significantly improved in all patients (P < 0.05). Age was significantly correlated with all the initial values (P < 0.05) but not with post-CR values. In addition, lower initial values of peak workload were associated with larger post-CR improvements irrespective of age. However, higher pre-CR anxiety and depression scores were associated with greater post-CR increases in physical performance in YOUNG and OLD patients, respectively.

Conclusions: CR induced significant improvements of physical and psychological parameters for all patient groups. More interestingly, our results suggest that patients with the greatest physical impairments at baseline would benefit the most from CR, whatever their age. However, the value of initial mental state as a predictor of post-CR improvement depends on the age of the patient.
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http://dx.doi.org/10.1016/j.cjca.2019.05.038DOI Listing
October 2019

The use of motor imagery training to retain the performance improvement following physical practice in the elderly.

Exp Brain Res 2019 Jun 15;237(6):1375-1382. Epub 2019 Mar 15.

UFR des Sciences du Sport, INSERM UMR1093, UFR STAPS, Université de Bourgogne Franche-Comté, 21000, Dijon, France.

With physiological aging, appears a deterioration of the ability to retain motor skills newly acquired. In this study, we tested the beneficial role of motor imagery training to compensate this deterioration. We tested four groups: young control group (n = 10), elderly control group (n = 10), young mental-training group (n = 13) and elderly mental-training group (n = 13). In pre- and post-tests, the participants performed three trials on a dexterity manual task (the Nine Hole Peg Test), commonly used in clinic. We recorded the movement duration as a factor of performance. Each trial, including 36 arm movements, consisted in manipulating sticks as fast as possible. The control groups watched a non-emotional documentary for 30 min and the mental-training groups imagined the task (50 trials). First, we observed a speed improvement during the pre-test session for all groups. Immediately after viewing the movie (post-test 1), the young control group showed a preservation of motor performance in comparison to the performance measured before the break (pret-test 3), while the young mental-training group improved performance after motor imagery practice. For the elderly, the control group showed a deterioration of motor performance at post-test 1, attesting a deterioration of the ability to retain motor skills with aging. Interestingly, the elderly mental-training group showed a preservation of motor performance between the pre-test 3 and the post-test 1. The present findings demonstrate the beneficial role of mental training with motor imagery to retain the performance improvement following physical practice in the elderly. This method could be an alternative to prevent the deterioration of motor skills.
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http://dx.doi.org/10.1007/s00221-019-05514-1DOI Listing
June 2019

Shifts in Key Time Points and Strategies for a Multisegment Motor Task in Healthy Aging Subjects.

J Gerontol A Biol Sci Med Sci 2018 11;73(12):1609-1617

UFR-STAPS, INSERM U-1093, Cognition, Action and Sensorimotor Plasticity Université de Bourgogne, Campus Universitaire, Dijon, France.

In this study, we compared key temporal points in the whole body pointing movement of healthy aging and young subjects. During this movement, subject leans forward from a standing position to reach a target. As it involves forward inclination of the trunk, the movement creates a risk for falling. We examined two strategic time points during the task-first, the crossover point where the velocity of the center of mass (CoM) in the vertical dimension outstripped the velocity in the anteroposterior dimension and secondly, the time to peak of the CoM velocity profile. Transitions to stabilizing postures occur at these time points. They both occurred earlier in aging subjects. The crossover point also showed adjustments with target distance in aging subjects, while this was not observed in younger subjects. The shifts in these key time points could not be attributed to differences in movement duration between the two groups. Investigation with an optimal control model showed that the temporal adjustment as a function of target distance in the healthy aging subjects fits into a strategy that emphasized equilibrium maintenance rather than absolute work as a control strategy.
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http://dx.doi.org/10.1093/gerona/gly066DOI Listing
November 2018

Anticipatory Postural Adjustments and kinematic arm features when postural stability is manipulated.

PeerJ 2018 15;6:e4309. Epub 2018 Mar 15.

Núcleo de Medicina Tropical, Instituto de Ciencias Biológicas, Universidade Federal do Pará, Belém, Brazil.

Beyond the classical paradigm that presents the Anticipatory Postural Adjustments (APAs) as a manner to create forces that counteract disturbances arising from the moving segment during a pointing task, there is a controversial discussion about the role APAs to facilitate the movement and perform a task accurately. In addition, arm kinematics features are classically used to infer the content of motor planning for the execution and the control of arm movements. The present study aimed to disentangle the conflicting role of APAs during an arm-pointing task in which the subjects reach a central diode that suddenly turns on, while their postural stability was manipulated. Three postures were applied: Standing (Up), Sit without feet support (SitUnsup) and Sit with feet support (SitSup). We found that challenging postural stability induced an increase of the reaction time and movement duration (observed for the SitUnsup compared to SitSUp and Up) as well as modified the upper-limb velocity profile. Indeed, a greater max velocity and a shorter deceleration time were observed under the highest stability (SitSup). Thus, these Kinematics features reflect less challenging task and simple motor plan when the body is stabilized. Concerning the APAs, we observed the presence of them independently of the postural stability. Such a result strongly suggests that APAs act to facilitate the limb movement and to counteract perturbation forces. In conclusion, the degree of stability seems particularly tuned to the motor planning of the upper-limb during a pointing task whereas the postural chain (sitting vs. standing) was also determinant for APAs.
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http://dx.doi.org/10.7717/peerj.4309DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5857349PMC
March 2018

[Evaluation of the animal-assisted therapy in Alzheimer's disease].

Soins Gerontol 2017 May - Jun;22(125):35-38

Centre Georges Chevrier, UMR 7366 CNRS, Université de Bourgogne, 6 boulevard Gabriel, 21000 Dijon, France.

Animal-assisted therapy sessions have been set up in a protected unit for patients with a dementia-related syndrome. The aim is to measure the effects of animal-assisted therapy on behavioural disorders in daily life and care. The results obtained provided some interesting areas to explore and recommendations with a view to optimising the implementation of such a system.
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http://dx.doi.org/10.1016/j.sger.2017.03.008DOI Listing
October 2017

Advanced 3D movement analysis algorithms for robust functional capacity assessment.

Appl Clin Inform 2017 05 10;8(2):454-469. Epub 2017 May 10.

Asma Hassani, Université de Bourgogne, Laboratoire LE2I, Bâtiment I3M, 64 rue de Sully, 21000, Dijon., Tel.: +33 3 80 39 36 08, Fax: +33 3 80 39 59 10, Email:

Objectives: We developed a novel system for in home functional capacities assessment in frail older adults by analyzing the Timed Up and Go movements. This system aims to follow the older people evolution, potentially allowing a forward detection of motor decompensation in order to trigger the implementation of rehabilitation. However, the pre-experimentations conducted on the ground, in different environments, revealed some problems which were related to KinectTM operation. Hence, the aim of this actual study is to develop methods to resolve these problems.

Methods: Using the KinectTM sensor, we analyze the Timed Up and Go test movements by measuring nine spatio-temporal parameters, identified from the literature. We propose a video processing chain to improve the robustness of the analysis of the various test phases: automatic detection of the sitting posture, patient detection and three body joints extraction. We introduce a realistic database and a set of descriptors for sitting posture recognition. In addition, a new method for skin detection is implemented to facilitate the patient extraction and head detection. 94 experiments were conducted to assess the robustness of the sitting posture detection and the three joints extraction regarding condition changes.

Results: The results showed good performance of the proposed video processing chain: the global error of the sitting posture detection was 0.67%. The success rate of the trunk angle calculation was 96.42%. These results show the reliability of the proposed chain, which increases the robustness of the automatic analysis of the Timed Up and Go.

Conclusions: The system shows good measurements reliability and generates a note reflecting the patient functional level that showed a good correlation with 4 clinical tests commonly used. We suggest that it is interesting to use this system to detect impairment of motor planning processes.
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http://dx.doi.org/10.4338/ACI-2016-11-RA-0199DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241751PMC
May 2017

The Early Indicators of Functional Decrease in Mild Cognitive Impairment.

Front Aging Neurosci 2016 12;8:193. Epub 2016 Aug 12.

Unité 1093, Cognition, Action et Plasticité Sensorimotrice, Institut National de la Santé et de la Recherche MédicaleDijon, France; Unité de Formation et de Recherche (UFR), Santé, Université de Bourgogne Franche ComtéDijon, France.

Objectives: Motor deficiency is associated with cognitive frailty in patients with Mild Cognitive Impairments (MCI). In this study we aimed to test the integrity in muscle synergies involved in an arm-pointing movement in functionally unimpaired MCI patients. We hypothesized that early motor indicators exist in this population at a preclinical level.

Methods: Electromyographic signals were collected for 11 muscles in 3 groups: Young Adults (YA), Older Adults (OA), and MCI patients. The OA and MCI groups presented the same functional status. Each subject performed 20 arm-pointing movements from a standing position.

Results: The main differences were (1) an earlier activation of the left Obliquus internus in MCI compared with OA group, (2) an earlier activation for the MCI compared with both OA and YA. The temporal differences in muscle synergies between MCI and OA groups were linked with executive functions of MCI patients, assessed by the trail making test. Moreover, the results show a delayed activation of the right Biceps Femoris and the right Erector Spinae at l3 in MCI and OA compared with YA.

Interpretation: The motor program changes highlighted in our patient MCI group suggest that discrete modifications of the motor command seem to exist even in the absence of functional impairment. Instead of showing an indication of delayed muscle activation in the MCI patients, our results highlight some early activation of several trunk muscles.
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http://dx.doi.org/10.3389/fnagi.2016.00193DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4981593PMC
August 2016

Voluntary Imitation in Alzheimer's Disease Patients.

Front Aging Neurosci 2016 7;8:48. Epub 2016 Mar 7.

Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di TecnologiaGenoa, Italy; INSERM U1093 Cognition, Action et Plasticité Sensorimotrice, Université de Bourgogne Franche-ComtéDijon, France; Institut Universitaire de France, Université de Bourgogne Franche-ComtéDijon, France.

Although Alzheimer's disease (AD) primarily manifests as cognitive deficits, the implicit sensorimotor processes that underlie social interactions, such as automatic imitation, seem to be preserved in mild and moderate stages of the disease, as is the ability to communicate with other persons. Nevertheless, when AD patients face more challenging tasks, which do not rely on automatic processes but on explicit voluntary mechanisms and require the patient to pay attention to external events, the cognitive deficits resulting from the disease might negatively affect patients' behavior. The aim of the present study was to investigate whether voluntary motor imitation, i.e., a volitional mechanism that involves observing another person's action and translating this perception into one's own action, was affected in patients with AD. Further, we tested whether this ability was modulated by the nature of the observed stimulus by comparing the ability to reproduce the kinematic features of a human demonstrator with that of a computerized-stimulus. AD patients showed an intact ability to reproduce the velocity of the observed movements, particularly when the stimulus was a human agent. This result suggests that high-level cognitive processes involved in voluntary imitation might be preserved in mild and moderate stages of AD and that voluntary imitation abilities might benefit from the implicit interpersonal communication established between the patient and the human demonstrator.
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http://dx.doi.org/10.3389/fnagi.2016.00048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779892PMC
March 2016

Mental Rotation as an Indicator of Motor Representation in Patients with Mild Cognitive Impairment.

Front Aging Neurosci 2015 23;7:238. Epub 2015 Dec 23.

Institut National de la Santé et de la Recherche Médicale-U1093, Faculté des Sciences du SportDijon, France; Université Bourgogne Franche-Comté, Faculté des Sciences du SportDijon, France.

This internal representation of movement of part(s) of the body is involved during Implicit Motor Imagery tasks (IMI); the same representations are employed in the laterality judgment task. Few studies have looked at the consequences of aging, Alzheimer's disease (AD) and mild cognitive impairment (MCI) on the processes of motor preparation but none showed evidence of an alteration of action representation in patient with amnestic MCI. In the present study, the IMI task was used to assess the action representation abilities in MCI patients and healthy counterparts. A total of 24 elderly participants aged between 65 and 90 years old (12 women, 73.4 ± 6 years, mean ± S.D.) were recruited: 12 patients with MCI (MCI group) and 12 healthy aged adults (HAA group). The results showed that MCI patients have significantly a greater response time (RT) than HAA subjects only in IMI task and more precisely when performing their mental rotation at the challenging conditions. Furthermore, the IMI task related to the non-dominant hand induced a significant increase of RT only in MCI subjects. At the light of these results, we assume that MCI patients are able to engage themselves in IMI processes, still showing a compelling impairment of this mental ability across its complexity.
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http://dx.doi.org/10.3389/fnagi.2015.00238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688352PMC
January 2016

Balance control in aging: improvements in anticipatory postural adjustments and updating of internal models.

BMC Geriatr 2015 Dec 7;15:162. Epub 2015 Dec 7.

Institut National de la Santé et de la Recherche Médicale (INSERM), Unité 1093, Cognition, Action et Plasticité Sensorimotrice, Campus Universitaire, Université de Bourgogne, BP 27877, F-21078, Dijon, France.

Postural stability of older subjects can be estimated during orthostatic equilibrium. However, dynamic equilibrium is also important to investigate risks of fall. It implies different interpretations of measures given by force plates. Same dependant variables (e.g. center of pressure displacement) cannot be interpreted the same ways depending of the type of equilibrium that is investigated. In particular, sways increases during dynamic equilibrium and before movement execution may reflect an improvement of feedforward control.
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http://dx.doi.org/10.1186/s12877-015-0161-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672548PMC
December 2015

Kinematic analysis of motor strategies in frail aged adults during the Timed Up and Go: how to spot the motor frailty?

Clin Interv Aging 2015 26;10:505-13. Epub 2015 Feb 26.

Laboratoire LE2I CNRS 6306, Université de Bourgogne, Dijon, France.

Objective: The purpose of this work was to analyze and compare the movement kinematics of sit-to-stand (STS) and back-to-sit (BTS) transfers between frail aged adults and young subjects, as well as to determine the relationship between kinematic changes and functional capacities.

Methods: We analyzed the Timed Up and Go (TUG) movements by using a 3D movement analysis system for real-time balance assessment in frail elderly. Ten frail aged adults (frail group [FG]) and ten young subjects (young group [YG]) performed the TUG. Seven spatiotemporal parameters were extracted and compared between the two groups. Moreover, these parameters were plotted with TUG test duration.

Results: The experiments revealed that there were significant differences between FG and YG in trunk angle during both STS and BTS, and in TUG duration. The trunk angle of the young subjects was more than two times higher than that of the FG. As expected, the TUG duration was higher in the FG than in YG. Trunk angles during both transfers were the most different parameters between the groups. However, the BTS trunk angle and STS ratio were more linked to functional capacities.

Conclusion: There was a relationship between kinematic changes, representing the motor planning strategies, and physical frailty in these aged adults. These changes should be taken into account in clinical practice.
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http://dx.doi.org/10.2147/CIA.S74755DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345997PMC
November 2015

[Psychomotor disadaptation syndrome].

Geriatr Psychol Neuropsychiatr Vieil 2014 Mar;12(1):94-100

Inserm U1093, Motricité-plasticité : performance, dysfonctionnement, vieillissement et technologies d'optimisation, Université de Bourgogne, Dijon, France.

Psychomotor disadaptation syndrome (PDS) was first described in France by the Dijon geriatric school, 25 years ago, and named "psychomotor regression syndrome". The initial clinical description still remains without modifications. However, progress has been made both in understanding its physiopathology and management, and its name has been changed into PDS in the late 1990s. Since the early 2000s, it was also termed frontal-sub-cortical dysfunction syndrome. PDS results from decompensation of postural function, gait and psychomotor automatisms linked to posture and motor programming impairment related to fronto-sub-cortical lesions. PDS is characterized by retropulsion, non-specific gait disorders, neurological signs (including akinesia, reactional hypertonia, and impaired reactive postural responses and protective reactions) and psychological disorders (fear of standing and walking as an acute feature or cognitive processing retardation and anhedonia as a chronic feature). PDS occurrence is linked to three factors implicated in functional reserve impairment due to frontal-sub-cortical structures disturbances: aging, chronic affections (mainly of degenerative or vascular origin), and acute organic or functional factors which induce cerebral blood flow decrease. Multidisciplinary management, including medical motor physiotherapy and psychological approach, is required for patients with PDS care.
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http://dx.doi.org/10.1684/pnv.2014.0450DOI Listing
March 2014

[Comparative study of three methods of adapted physical activities].

Geriatr Psychol Neuropsychiatr Vieil 2014 Mar;12(1):34-42

Inserm U1093 cognition, action, et plasticité sensorimotrice, Université de Bourgogne, Dijon, France.

The goal of this study is to compare the efficiency of the adapted physical activity in three different manners (walking and balance exercises and muscles reinforcement) on elderly persons in rehabilitation to a traditional rehabilitation. The study was realized on 30 patients including 18 women and 12 men. The average age is 82 years old. At the beginning and the end of the training, the patients were tested using: gait speed, moving speed (Time up and go test), static and dynamic balance (Berg balance scale), strength of lower limbs (30-second chair-stand test) and functional independence. The group Walking shows a significant improvement on the whole test, between the pre-test and the post-test, two weeks later. The results show an significant effect of the practice of adapted physical activity, independently of the age of the patients, on the whole tests. The stagnation of the progress between two and four weeks, which concerns mainly the oldest (more than 85 years old), underlines the importance of the early care of the patient, and the necessity to emphasize the stresses during the two first weeks of the care to obtain more progress, especially with the walking course.
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http://dx.doi.org/10.1684/pnv.2014.0459DOI Listing
March 2014

Impact of ambulatory physiotherapy on motor abilities of elderly subjects with Alzheimer's disease.

Geriatr Gerontol Int 2014 Jan 25;14(1):167-75. Epub 2013 Apr 25.

Department of Geriatrics and Internal Medicine, Hospital of Champmaillot, University Hospital, Dijon, France; Inserm/U1093 Motricity-Plasticity, Dijon, France; Faculty of Medicine, University of Burgundy, Dijon, France.

Aim: We investigated the impact of ambulatory physiotherapy (AP) on motor abilities in elderly subjects with Alzheimer's disease (AD).

Methods: Subjects with mild to moderate AD were included and divided into "physiotherapy group" (PG) and "no physiotherapy group" (NPG) according to whether or not they received AP between inclusion (T0) and the second time of assessment, between 15 and 36 months after inclusion (T1). The follow-up duration, Mini-Mental State Examination, Tinetti and mini motor test (MMT) scores, Timed Up & Go test (TUG), gait speed (GS), one-leg balance (OLB), history of falls within the last 6 months (HF), ability to rise from the floor (RFF) and the use of a walking aid (UWA) were recorded at T0, and after at least 15 months of follow up (T1).

Results: A total of 50 subjects were included in the NPG and 20 in the PG. At baseline, these groups were not significantly different for all the parameters recorded. The anova showed a progression of cognitive disorders in the two groups between T0 and T1 (P < 0.001), which was similar in the two groups (P = 0.83). For each postural and motor quantitative test (Tinetti, MMT, TUG, GS) the anova showed a main effect of time of assessment (All P < 0.05) associated with a group × time of assessment interaction (All P < 0.05). The comparison between the two groups with regard to the evolution of qualitative parameters showed a significant difference for the OLB test only. No significant difference was found for RFF, HF and UWA.

Conclusions: There was a significant improvement or stability of motor abilities in the PG; while these abilities decreased in the NPG.
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http://dx.doi.org/10.1111/ggi.12075DOI Listing
January 2014

Do equilibrium constraints modulate postural reaction when viewing imbalance?

Brain Cogn 2012 Jul 30;79(2):89-95. Epub 2012 Mar 30.

INSERM U1093, Cognition, Action et Plasticité Sensorimotrice, Université de Bourgogne, Campus Universitaire, BP 27877, 21078 Dijon, France.

Action observation and action execution are tightly coupled on a neurophysiological and a behavioral level, such that visually perceiving an action can contaminate simultaneous and subsequent action execution. More specifically, observing a model in postural disequilibrium was shown to induce an increase in observers' body sway. Here we reciprocally questioned the role of observers' motor system in the contagion process by comparing participants' body sway when watching displays of antero-posterior vs. lateral imbalance. Indeed, during upright standing, biomechanical constraints differ along the antero-posterior (A-P) and medio-lateral (M-L) axes; hence an impact of observers' postural constraints on the contagion response would result in different reactions to both types of stimuli. In response to the displays, we recorded greater area of center of pressure (CoP) displacement when watching forward/backward compared to left/right imbalance. In addition, after normalizing A-P and M-L CoP displacements by a control condition (fixation cross), A-P CoP path length when viewing forward imbalance tended to be higher than M-L CoP path length when viewing imbalance to the left or right. These results indicate that postural contagion is promoted when the display is compatible with observers' motor stabilization strategy which is mainly oriented along the A-P axis. In terms of clinical application, this study brings new indications for adaptation of observational training devices in rehabilitation programs.
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http://dx.doi.org/10.1016/j.bandc.2012.02.008DOI Listing
July 2012

Delayed postural control during self-generated perturbations in the frail older adults.

Clin Interv Aging 2012 29;7:65-75. Epub 2012 Feb 29.

UFR STAPS, Université de Bourgogne, Dijon, France.

Purpose: The aim of this study was to investigate the coordination between posture and movement in pathological aging (frailty) in comparison with normal aging, with the hypothesis that in pathological aging, postural control evolves towards a more reactive mode for which the perturbation induced by the movement is not anticipated and leads to delayed and late postural adjustments.

Methods: Elderly subjects performed rapid focal arm-raising movements towards a target, from an upright standing position in two stimuli conditions: simple reaction time and choice reaction time (CRT). Hand and center of pressure (CoP) kinematics were compared between a control group and a frail group of the same age.

Results: In frail individuals, the entire movement was impaired and slowed down. In addition, postural adjustments that classically precede and accompany the focal arm movement were delayed and reduced, especially in the CRT condition in which the motor prediction is more limited. Finally, a correlation between the time to CoP maximal velocity and the timed up- and-go score was observed.

Conclusion: In these patients, it was concluded that the control of the CoP displacement evolved from a proactive mode in which the perturbation associated with the arm movement is anticipated toward a more reactive mode in which the perturbation is compensated by late and delayed adjustments.
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http://dx.doi.org/10.2147/CIA.S28352DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3302760PMC
June 2012

Practice-related improvements in postural control during rapid arm movement in older adults: a preliminary study.

J Gerontol A Biol Sci Med Sci 2012 Feb 23;67(2):196-203. Epub 2011 Sep 23.

UFR STAPS, Université de Bourgogne, Dijon, France.

Background: Postural control associated with self-paced movement is critical for balance in older adults. The present study aimed to investigate the effects of a virtual reality-based program on the postural control associated with rapid arm movement in this population.

Methods: From an upright standing position, participants performed rapid arm-raising movements toward a target. Practice-related changes were assessed by pre- and posttest comparisons of hand kinematics and center of pressure displacement parameters measured in a training group (mean age: 71.50 ± 2.67 years, n = 8) and a control group (mean age: 72.87 ± 3.09 years, n = 8). Training group participants took part in six sessions (35-40 minutes per session, three sessions per week). During the two test sessions, arm raising was analyzed under two conditions of stimuli: choice reaction time and simple reaction time.

Results: We observed improvements in the arm movement after training under both conditions of stimuli. The initial phase of the center of pressure displacement, especially the anticipatory postural adjustments, was improved in the choice reaction time condition.

Conclusions: Our short training program resulted in motor optimization of the postural control associated with rapid arm movements, and this implies central changes in motor programming.
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http://dx.doi.org/10.1093/gerona/glr148DOI Listing
February 2012

[Geriatric investigation in front of a balance disorders in the older elderly].

Rev Prat 2011 Jun;61(6):823-4

Service de médecine interne gériatrie, CHU de Dijon, hôpital de Champmaillot, 21079 Dijon Cedex.

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June 2011

Does observation of postural imbalance induce a postural reaction?

PLoS One 2011 Mar 15;6(3):e17799. Epub 2011 Mar 15.

INSERM U887, Motricité et Plasticité, Université de Bourgogne, Dijon, France.

Background: Several studies bring evidence that action observation elicits contagious responses during social interactions. However automatic imitative tendencies are generally inhibited and it remains unclear in which conditions mere action observation triggers motor behaviours. In this study, we addressed the question of contagious postural responses when observing human imbalance.

Methodology/principal Findings: We recorded participants' body sway while they observed a fixation cross (control condition), an upright point-light display of a gymnast balancing on a rope, and the same point-light display presented upside down. Our results showed that, when the upright stimulus was displayed prior to the inverted one, centre of pressure area and antero-posterior path length were significantly greater in the upright condition compared to the control and upside down conditions.

Conclusions/significance: These results demonstrate a contagious postural reaction suggesting a partial inefficiency of inhibitory processes. Further, kinematic information was sufficient to trigger this reaction. The difference recorded between the upright and upside down conditions indicates that the contagion effect was dependent on the integration of gravity constraints by body kinematics. Interestingly, the postural response was sensitive to habituation, and seemed to disappear when the observer was previously shown an inverted display. The motor contagion recorded here is consistent with previous work showing vegetative output during observation of an effortful movement and could indicate that lower level control facilitates contagion effects.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0017799PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057996PMC
March 2011

[Evaluation and care of the aged who often fall].

Authors:
France Mourey

Soins Gerontol 2010 May-Jun(83):23

Université de Bourgogne, Centre gériatrique de Champmaillot, CHU de Dijon.

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August 2010

[Walking and ageing].

Authors:
France Mourey

Soins Gerontol 2010 May-Jun(83):20-2

Université de Bourgogne, Gérontopôle, Centre gériatrique de Champmaillot, CHU de Dijon.

As we get older, our gait changes insidiously with a tendency for us to walk more slowly, to take shorter strides and to increase the time when both feet are on the ground. Four major factors are most often found interlinked in walking problems in the elderly. Being more aware of them enables healthcare teams to adapt the care provided to elderly patients.
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August 2010

Improvement of motor performance by observational training in elderly people.

Neurosci Lett 2010 Aug 12;480(2):138-42. Epub 2010 Jun 12.

Motricité et Plasticité, INSERM/U877, Université de Bourgogne, Campus Universitaire, B.P. 27877, 21078 Dijon, France.

Action observation influences action execution; this strong coupling is underlined by an overlap of cortical areas activated during observation and execution of action, and is dependent of specific motor experience. The goal of the present study was to verify if action observation can be used for rehabilitation of elderly people. We tested this question with a protocol of observational practice of 2 frequently used movements: walking and sit-to-stand/back-to-sit. Both tasks were performed at normal and maximal speed before and after training, by 8 elderly subjects. Observational practice led to an increase in walking velocity via an increase in step frequency, but without modification of step length. In addition, we noted a reduction in BTS duration, but no modification of STS duration. These results highlight the fact that observational practice induces a reactivation in mental representation of action, and may lead to better movement control. Overall, observational practice offers interesting perspectives for rehabilitation of elderly people.
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http://dx.doi.org/10.1016/j.neulet.2010.06.026DOI Listing
August 2010

Aging affects the mental simulation/planning of the "rising from the floor" sequence.

Arch Gerontol Geriatr 2010 Nov-Dec;51(3):e41-5. Epub 2009 Dec 9.

INSERM U887 Motricité-Plasticité, Université de Bourgogne, Campus Universitaire Montmuzard, BP 27 877, 21078 Dijon Cedex, France.

We investigated the effect of aging on the ability to mentally simulate/plan a complex sequential action of the whole body, namely "rising from the floor". Forty-four non-demented elderly people (mean age: 85.2±5.5 years) and 20 young people (mean age: 26.6±4.9 years) were included in the study. They were required to put in order six images representing the main movements necessary to get up from a sitting position on the floor. We showed that older subjects had poorer performance-both in terms of proportion of success and response time-than their younger counterparts. These results are in line with previous findings showing age-related alterations in action simulation/action planning processes, and highlight the fact that elderly people have particular difficulties when the action to mentally simulate is complex.
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http://dx.doi.org/10.1016/j.archger.2009.11.010DOI Listing
March 2011

Analysis of postural control in elderly subjects suffering from Psychomotor Disadaptation Syndrome (PDS).

Arch Gerontol Geriatr 2010 Jul-Aug;51(1):e19-23. Epub 2009 Aug 8.

INSERM/U887 Motricité-Plasticité: Performance, Dysfonctionnement, Vieillissement et Technologies d'optimisation, Université de Bourgogne, Faculté des Sciences du Sport, Dijon Cedex, France.

PDS is a geriatric affliction, described in 1999, characterized by postural impairments, including backward disequilibrium, freezing, a deterioration in the ability to anticipate postural adjustments, anxiety and fear of falling, inducing loss of autonomy. This study compared 10 subjects suffering from PDS, aged 87.3+/-4.9 years, with 10 control subjects, aged 85.4+/-7.9 years concerning postural control (body sway amplitude). In all participants, postural control was assessed using the SwayStar system in natural (spontaneous) and standardized stances, eyes open and eyes closed over a period of 40 s. It was found that: (1) with eyes open, subjects with PDS showed greater body sway amplitude than did controls whatever the position (natural or standardized) and the plane (sagittal or frontal) considered (F(1,16)=6.05; p=0.026), (2) with eyes closed, subjects with PDS showed greater body sway amplitude than did controls in the natural stance whatever the plane (F(1,18)=7.65; p=0.013). In conclusion, PDS has a negative effect on postural control. This data must be taken into account during the rehabilitation of patients with this syndrome.
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http://dx.doi.org/10.1016/j.archger.2009.07.003DOI Listing
September 2010