J F Mathé

L’Institut Régional de Médecine Physique et de Réadaptation, Nancy, Lorraine, France

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Publications (85)28.13 Total impact

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    Annals of Physical and Rehabilitation Medicine 10/2011; 54. DOI:10.1016/j.rehab.2011.07.842
  • Annals of Physical and Rehabilitation Medicine 10/2011; 54. DOI:10.1016/j.rehab.2011.07.852
  • Annals of Physical and Rehabilitation Medicine 10/2011; 54. DOI:10.1016/j.rehab.2011.07.858
  • Annals of Physical and Rehabilitation Medicine 10/2011; 54. DOI:10.1016/j.rehab.2011.07.860
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    Annals of Physical and Rehabilitation Medicine 10/2011; 54. DOI:10.1016/j.rehab.2011.07.849
  • Annals of Physical and Rehabilitation Medicine 10/2011; 54. DOI:10.1016/j.rehab.2011.07.499
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    Annals of Physical and Rehabilitation Medicine 10/2011; 54. DOI:10.1016/j.rehab.2011.07.845
  • Annals of Physical and Rehabilitation Medicine 10/2011; 54. DOI:10.1016/j.rehab.2011.07.506
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    ABSTRACT: IntroductionJusqu’à 40 % d’hommes et de femmes déclarent une altération de leur qualité de vie sexuelle au décours d’une fracture pelvienne [1]. Plusieurs facteurs en sont responsables, notamment une lésion neurologique, végétative et/ou somatique ou une lésion vasculaire. Les complications hémorragiques de ces traumatismes peuvent d’ailleurs être dramatiques à la phase initiale et l’embolisation artérielle hypogastrique peut constituer un geste salvateur en cas de constatation d’un hématome rétropéritonéal [2–4]. ObjetÀ partir d’un cas clinique complexe de fracture pelvienne, déterminer si l’embolisation hypogastrique est susceptible de favoriser des séquelles fonctionnelles pelvipérinéales à distance, notamment sexuelles. IntroductionUp to 40% of men and women complain of an alteration in the quality of their sex life during recovery from a pelvic fracture [1]. Several factors may be involved, including autonomic and/or somatic neurological lesions and the effects of a vascular lesion. Moreover, haemorrhagic complications of the trauma may be severe in the initial phase and embolisation of the internal iliac artery can be employed as a measure to halt further haemorrhage when retroperitoneal haematoma is detected [2–4]. ObjectiveTo describe a complex clinical case of pelvic fracture and to examine whether internal iliac embolisation is likely to lead to long-term pelvic and perineal consequences, particularly in sexual function. Mots clésFracture pelvienne-Artère hypogastrique-Embolisation-Dysfonction érectile KeywordsPelvic fracture-Hypogastric artery-Embolization-Erectile dysfunction
    Pelvi-périnéologie 06/2010; 5(2):105-109. DOI:10.1007/s11608-010-0305-2 · 0.03 Impact Factor
  • Pelvi-périnéologie 01/2010; 5(2):105-109. · 0.03 Impact Factor
  • Revue Neurologique 04/2007; 163(4):199-200. DOI:10.1016/S0035-3787(07)90886-3 · 0.60 Impact Factor
  • Journal de Réadaptation Médicale Pratique et Formation en Médecine Physique et de Réadaptation 06/2006; 26(s 1–2):22–28.
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    ABSTRACT: To evaluate of the effective use of gait orthosis in patients with spinal cord injuries. A total of 43 patients with complete paraplegia, level T3 to L1, who had a gait orthosis (hip-knee-ankle-foot orthosis, reciprocating gait orthosis, hybrid orthosis and functional electrical stimulation) answered a telephone questionnaire. Orthotic gait use was discontinued in 65% of patients who used the orthosis twice a week for 15 to 60 minutes. Two-thirds of the patients were able to fit the orthosis independently, 60% for standing and 25% for walking. The main reasons for discontinuing use were psychological reasons in 30% of patients, the lack of functional use and the necessity for human help or supervision. Presently available devices do not allow functional and independent use of gait orthoses. Their use is limited to physical training, and the only demonstrated physiological benefits are the effects of functional electrical stimulation on cardiovascular status. Prescription for gait orthosis appears justified only if requested by a motivated and well-informed patient or if it appears a useful step in the acceptation of the loss of the gait.
    Annales de Réadaptation et de Médecine Physique 07/2005; 48(5):240-7.
  • J.-F. Mathé, I. Richard, J. Rome
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    ABSTRACT: The management of persons with traumatic brain injury affects a large spectrum of interventions from acute phase to the hospital discharge and the return to community. The incidence of brain injuries on mortality and morbidity constitutes a serious problem in front of the Health Administration. The traffic accidents remain the main cause but the falls in elderly are increasing. In the both cases preventive measures can be efficiency. In France, each year, there are about 150,000 new cases, 8000 of them will be dead and 4000 with coma. It is likely that 30,000 persons are living to day with important sequela of a brain injury. The management requires various types of interventions, each of them with specific and specialized techniques. It is necessary to have an overview of the problem and to work together in a comprehensive network. So French Health Ministery has just published an official note to precise some directives and co-ordination of the different interventions.
    Annales Françaises d Anesthésie et de Réanimation 06/2005; 24(6):688-694. DOI:10.1016/j.annfar.2005.03.029 · 0.84 Impact Factor
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    ABSTRACT: The aim of this study is to determine, from the data available in the literature, the indications of tracheostomy in brain injured patients, the incidence and risk factors for complications and the follow-up required until decannulation. The incidence of tracheostomy is 10% in TBI and 50 to 70% in subpopulations with a Glasgow Coma Scale (GCS) below 9. Early complications are not specific. The most frequent late complication is laryngotracheal stenosis, which occurs in 15% and is more frequently observed in the most severe patients with major hypertonia. It is likely that tracheostomy, if needed, should be performed early and the prognosis as to whether it will be required, can be made at the end of the first week. The follow-up of these patients includes surveillance of multiresistant colonisations and systematic performance of fibroscopy before decannulation. Cuffless, small diameters, soft tracheostomy tubes, are preferred on the long-term unless the risk of aspiration remains high.
    Annales Françaises d Anesthésie et de Réanimation 06/2005; 24(6):659-662. DOI:10.1016/j.annfar.2005.03.010 · 0.84 Impact Factor
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    ABSTRACT: Objective. – To evaluate of the effective use of gait orthosis in patients with spinal cord injuries.Patients and methods. – A total of 43 patients with complete paraplegia, level T3 to L1, who had a gait orthosis (hip-knee-ankle-foot orthosis, reciprocating gait orthosis, hybrid orthosis and functional electrical stimulation) answered a telephone questionnaire.Results. – Orthotic gait use was discontinued in 65% of patients who used the orthosis twice a week for 15 to 60 minutes. Two-thirds of the patients were able to fit the orthosis independently, 60% for standing and 25% for walking. The main reasons for discontinuing use were psychological reasons in 30% of patients, the lack of functional use and the necessity for human help or supervision.Conclusion. – Presently available devices do not allow functional and independent use of gait orthoses. Their use is limited to physical training, and the only demonstrated physiological benefits are the effects of functional electrical stimulation on cardiovascular status. Prescription for gait orthosis appears justified only if requested by a motivated and well-informed patient or if it appears a useful step in the acceptation of the loss of the gait.
    Annales de Réadaptation et de Médecine Physique 06/2005; 48(5):240-247. DOI:10.1016/j.annrmp.2005.03.001
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    ABSTRACT: Case series of a consecutive sample. Retrospective audit. To analyze the long-term safety and efficacy of intrathecal baclofen (ITB), and technical incidents. Neurosurgical and Physical Medicine Departments of two university hospitals in western France. The medical records of 40 patients who underwent ITB pump placement for the treatment of severe chronic spasticity were reviewed. Patients were eligible independently of the origin of the spasticity (spinal cord origin 33, brain damage 8). They underwent a final assessment with clinical examination and questionnaire in 2001. Ashworth scale scores were assessed, patient satisfaction was rated on a visual analog scale (VAS), functional independence before and after treatment was classified as bed-ridden, wheelchair dependent or ambulant, and the frequency and nature of complications were noted. The average follow-up period was of 4 years. The average Ashworth score at the final assessment was 1.8+/-0.6. Average patients satisfaction was 7.4/10+/-2.21 on VAS. In all, 85% would have undergone the procedure again if they had to make the decision. In 85% of the cases the ambulation status was unchanged. Technical incidents occurred at least once in 37% of the patients (due to the catheter in 58% and to the pump in 42%). They included catheter disconnections (4), migration (4), kinks (3), obstruction (3), development of fibrosis (3), disconnection of pump reservoir (2), porosity of pump membrane (2), unexplained pump dysfunction (4) leakage, and subcutaneous collection (5). Severe pharmacological side effects requiring transfer to intensive care unit occurred in 12% of cases, 80% of which were directly related to pump refill procedures. ITB remained effective in the long term and patients were satisfied. Nevertheless, complications were frequent, involving mainly the catheters, which would require further technical improvements.
    Spinal Cord 01/2005; 42(12):686-93. DOI:10.1038/sj.sc.3101647 · 1.70 Impact Factor
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    ABSTRACT: Literature review of the data concerning pharmacologic treatment of post-traumatic behavioural disorders. This review is limited to the treatment of agitation, excitation, mood lability, hostility and agressivity as defined by the NRS and excludes pharmacologic treatment of mental slowness, cognitive disorders and depression. Medline interrogation using keywords Traumatic Brain Injury, Agitation, Agressivity, Behaviour, Pharmacology, Neuroleptics, Benzodiazepines, Carbamazepine, Valproate, Buspirone, SSRI, Propanolol, Methylphenidate and review of recent contents. The data finally includes 29 original studies. The overall level of evidence is quite low as the data mainly consist in open studies and case reports. These data and data from reviews or didactic articles suggest the efficiency of a variety of treatments. Mood-stabilizing antiepileptics, and specially carbamazepine constitute together with SSRI antidepressants the first choices. Some data suggest efficiency of buspirone, methylphenidate and atypic neuroleptics. Lithium requires close monitoring but is probably efficient. It is difficult to conclude concerning propanolol. The available data is in favour of the use of CBZ and SSRI antidepressants. Further studies are required. It is necessary to establish clear evidence of the efficiency of CBZ and assess the effects of methylphenidate, which is almost not prescribed in France.
    Annales de Réadaptation et de Médecine Physique 03/2003; 46(1):49-57.
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    ABSTRACT: Objective. – Literature review of the data concerning pharmacologic treatment of post-traumatic behavioural disorders. This review is limited to the treatment of agitation, excitation, mood lability, hostility and agressivity as defined by the NRS and excludes pharmacologic treatment of mental slowness, cognitive disorders and depression.Methods. – Medline interrogation using keywords Traumatic Brain Injury, Agitation, Agressivity, Behaviour, Pharmacology, Neuroleptics, Benzodiazepines, Carbamazepine, Valproate, Buspirone, SSRI, Propanolol, Methylphenidate and review of recent contents. The data finally includes 29 original studies.Results. – The overall level of evidence is quite low as the data mainly consist in open studies and case reports. These data and data from reviews or didactic articles suggest the efficiency of a variety of treatments. Mood-stabilizing antiepileptics, and specially carbamazepine constitute together with SSRI antidepressants the first choices. Some data suggest efficiency of buspirone, methylphenidate and atypic neuroleptics. Lithium requires close monitoring but is probably efficient. It is difficult to conclude concerning propanolol.Conclusion. – The available data is in favour of the use of CBZ and SSRI antidepressants. Further studies are required. It is necessary to establish clear evidence of the efficiency of CBZ and assess the effects of methylphenidate, which is almost not prescribed in France.
    Annales de Réadaptation et de Médecine Physique 01/2003; 46(1). DOI:10.1016/S0168-6054(02)00353-7
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    ABSTRACT: Spinal cord injuries often result in irreversible loss of motor and somatosensory functions below the lesion level. Treatment is limited to physiotherapy aimed at compensating disability. We previously showed that re-establishment of tissue continuity can be achieved in animal models through nerve autografts implanted between the rostral spinal ventral horn and the caudal ventral roots. Rostral motor neuron axons could thus reach peripheral targets, leading to some return of motor function. We used a similar approach in a paraplegic patient with stabilized clinical states three years after spinal cord traumatic damage at the T9 level. Three segments from autologous sural nerves were implanted into the right and left antero-lateral quadrant of the cord at T7-8 levels, then connected to homolateral L2-4 lumbar ventral roots, respectively. Eight months after surgery, voluntary contractions of bilateral adductors and of the left quadriceps were observed. Muscular activity was confirmed by motor unit potentials in response to attempted muscle contraction. Motor-evoked potentials from these muscles were recorded by transcranial magnetic stimulation. These data support the hypothesis that muscles have been re-connected to supra-spinal centers through motor neurons located in the rostral stump of the damaged cord. They suggest that delayed surgical reconstruction of motor pathways may contribute to partial functional recovery.
    Journal of Neurotrauma 09/2002; 19(8):909-16. DOI:10.1089/089771502320317069 · 3.97 Impact Factor