We found no added value of tDCS combined with GMI treatments for reducing pain in patients with chronic CRPS. However, given that GMI+sham tDCS induced no significant change, further studies comparing GMI+tDCS and tDCS alone are needed to further document tDCS's effect in CRPS.
Background: Transcranial magnetic stimulation (TMS) is a non-invasive technique that can be used to evaluate cortical function and corticospinal pathway in normal and pathological aging. Yet, the metrologic properties of TMS-related measurements is still limited in the aging population.Objectives: The aim of this cross-sectional study was to document the reliability and smallest detectable change of TMS measurements among community-dwelling seniors. A secondary objective was to test if TMS measurements differ between elders based on lifestyle, medical and socio-demographic factors.Methods: Motor evoked potentials (MEPs) elicited by single-pulse TMS were recorded in the first dorsal interosseous (FDI) in 26 elderly individuals (mean age = 70 ± 3.8 years). Resting motor threshold (rMT), MEP amplitudes and contralateral silent period (cSP) were measured on two separate occasions (1-week interval), and the standard error of the measurement (SEMeas), intraclass correlation coefficient (ICC), and smallest detectable change in an individual (SDCindv) were calculated. Lifestyle, medical and socio-demographic factors were collected using questionnaires. TMS-related outcomes were compared using independent sample t-test based on the presence of chronic health diseases, chronic medication intake, obesity, history of smoking, physical activity levels, gender, and level of education.Results: rMT and cSP measures were the most reliable outcomes, with the lowest SEMeas and highest ICCs, whereas MEP amplitude-related measures were less reliable. SDCindv levels were generally high, even for rMT (7.29 %MSO) and cSP (43.16–50.84 ms) measures. Although not systematically significant, results pointed toward a higher corticospinal excitability in elderly individuals who were regularly active, who had no chronic medical conditions and who did not take any medication.Conclusion: Even though SDCindv levels were relatively high, these results show that rMT and cSP are the most reliable outcomes to investigate age-related changes in the corticomotor system and suggest that the influence of factors such as lifestyle habits and medications on TMS measures should be investigated further.
Le Plan d’action en santé mentale 2015-2020, du ministère de la Santé et des
services sociaux du Québec, comprend des mesures « favorisant le plein exercice de la
citoyenneté ». Il mise sur la mobilisation de tous les partenaires. Participation aux
instances et citoyenneté vont de pair, mais jusqu’à récemment il n’existait pas de mesure de
la citoyenneté qui aurait permis d’observer empiriquement d’éventuelles avancées en cette
matière. Nous avons utilisé les résultats d’une nouvelle mesure de la citoyenneté validée
pour structurer des groupes de discussion avec 18 usagers de services de santé mentale
québécois ; ils ont ainsi commenté les résultats à la mesure administrée auprès de 800
autres répondants. Pour mener l’évaluation, deux types de données ont été mis à contribution
de manière croisée, soit dans le cadre d’une méthode mixte. En effet, des données
quantitatives ont été générées à partir des résultats à la mesure de la citoyenneté, tandis
que des entrevues de groupe ont permis de produire des données qualitatives ici présentées
sous forme d’extraits de ces entrevues. Avec 57,9 %, c’est pour la dimension « implication
dans la communauté » que le résultat est le plus faible. Les participants aux entrevues de
groupe ont commenté ce résultat en suggérant que l’implication dans la communauté se
manifeste souvent d’abord par l’exercice d’un travail ; c’est d’ailleurs pour la question
« Vous avez accès à du travail » que le score est le plus faible d’entre tous les 23 items,
à égalité avec la possibilité d’influencer la communauté (50,3 %). D’autre part, le fait que
ce soit pour l’item « Vous êtes traités avec dignité et respect » que le résultat soit le
plus élevé s’explique peut-être par la possibilité que, en prenant davantage conscience de
l’influence des déterminants sociaux (ce n’est donc pas volontairement que nous serions
malades ou sans-emploi), les participants se regardent eux-mêmes avec plus de dignité et de
respect. Ils sentent que le système public les considère davantage comme citoyens à part
entière puisqu’il sollicite leur participation. La mesure de la citoyenneté s’est avérée
pertinente pour soulever de tels enjeux.Objectives The Global Model of Public Mental Health is “global”
not only in the sense of having an international perspective, but in regarding service users
as actors at all levels of public mental health exerting collective and organized influence
on the social determinants of health, in addition to being recipients of care. Having access
to appropriate health and mental health care when needed is a fundamental human right.
Having a say over the manner in which care is provided, including partnership in decision
making in care planning and ongoing care, has gained increasing support among recipients and
providers of care. Over the past ...
The current results suggest that adjustment of pulse amplitude during TENS application does not provide greater hypoalgesia in individuals with chronic low-back pain. Future studies are needed to confirm these findings in other pain populations.
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