Anthony Gelis

• MD, PhD
• MD PhD at Université de Montpellier

Introduction Tetraplegia causes extensive sensorimotor deficits affecting activity, participation and quality of life. People with C6-C7 tetraplegia can learn to grasp objects by performing wrist extension movement (ie, tenodesis grasp), and motor imagery (MI) added to rehabilitation significantly improved tenodesis grasp. We hypothesise that this...

Introduction: Most people with a spinal cord injury are concerned by pressure injuries (Pri). since dynamic activities may involve distributions of forces over time that are different from static and given the significant impact of Pris on healthcare costs, it is, important to study these sitting forces. We aim to investigate sitting forces (overal...

Current microbiome investigations of patients with pressure ulcers (PU) are mainly based on wound swabs and/or biopsy sequencing, leaving the coloniza-tion scenario unclear. Urinary microbiota has been never studied. As a part of the prospective ESCAFLOR study, we studied urinary microbiota of spinal cord injury (SCI) patients with PU without any u...

Background: Poliomyelitis is a global disabling disease affecting 12-20 million of people. Post poliomyelitis syndrome (PPS) may affect up to 80% of polio survivors: increased muscle weakness, pain, fatigue, functional decline. It relies on aging of an impaired neuro-muscular system with ongoing denervation processes. A late involvement of humoral...

Background Early Mobilization in Intensive Care Units (ICUs) enhances patients’ evolution, but has been rarely studied in neurological ICUs. The aim of this study was to assess gait training with body-weight support (BWS) in neuroICU, and to report on its safety, feasibility and on delays before walking with and without BWS. Methods This study was...

Context: Spinal-cord injury (SCI) induces bone loss and dramatically increases the risk of fracture. Objectives: Determine the effects of whole-body vibration (WBV) on areal bone mineral density (aBMD), whole body composition and bone biological parameters in individuals with chronic-state SCI. Design: Randomized study. Setting: Centre Neuro...

Background Current microbiome investigations of patients with pressure ulcers (PU) are mainly based on wound swabs and/or biopsy sequencing, leaving the colonization scenario unclear. Urinary microbiota has been never studied. Methods As part of the prospective ESCAFLOR study, we studied urinary microbiota of spinal cord injury (SCI) patients with...

Background: The increasing number of wheelchair users and their risk of medical complications such as pressure ulcers (PU) make it important to have a better understanding of their seating characteristics. However, while most studies tackling this issue are based on static measurements, wheelchair users are active in their wheelchairs when perform...

Spinal cord injury (SCI) induces severe losses of trabecular and cortical volumetric bone mineral density (vBMD), which cannot be discriminated with conventional dual-energy X-ray absorptiometry (DXA) analysis. The objectives were to: (i) determine the effects of SCI on areal BMD (aBMD) and vBMD determined by advanced 3D-DXA-based methods at variou...

Aim: We report the comparative results of functional upper extremity surgery plans in patients with tetraplegia, including restoration of elbow extension and construction of a key grip in a "one-stage" or "two-stage" operation. Materials and methods: A series of 36 patients with tetraplegia, with a total of 45 operated upper limbs, was analyzed ret...

Background. Early Mobilization in Intensive Care Units (ICUs) enhances patients’ evolution, but its benefits and practical implementation have rarely been studied in neurological ICUs. To report on tolerance, feasibility and benefits of walking with a specific body-weight support (BWS) device for patients admitted to a neurological intensive care u...

Résumé Introduction Les transferts répétés et la propulsion d’un fauteuil roulant chez les patients avec déficit neurologique des membres inférieurs conduisent à une surcharge mécanique majeure des membres supérieurs et particulièrement des épaules, devenant locomotrices. Dans ces conditions, une arthroplastie est soumise à des contraintes importa...

Two percent of the general population are wheelchair-dependent. The shoulder takes on the weight-bearing locomotor function, and tends with age to develop degenerative pathologies, notably in the rotator cuff. The association between weight-bearing shoulder and rotator cuff tear raises several questions.What are the mechanisms by which wheelchair p...

Citation: Fayolle, M.; Morsli, M.; Gelis, A.; Chateauraynaud, M.; Yahiaoui-Martinez, A.; Sotto, A.; Lavigne, J.-P.; Dunyach-Remy, C. The Persistence of Staphylococcus aureus in Pressure Ulcers: A Colonising Role. Abstract: Decubitus pressure ulcers (PU) are a major complication of immobilised patients. Staphylococcus aureus is one of the most frequ...

Purpose To adapt the Moorong Self-Efficacy Scale (MSES) in the French language and determine its psychometric proprieties. Materials and methods After a back-translation process, an expert committee was solicited to develop the French Self Efficacy Scale, thanks to a Delphi method, regarding theoretical framework and concepts explored. A total of...

Introduction: Repeated transfers and wheelchair propulsion in patients with a neurological deficit of the lower limbs overloads the upper limbs mechanically, particularly the shoulders, which become weight-bearing. Under these conditions, arthroplasty implants are subjected to large stresses, even though this indication is controversial in such a c...

This poster explain the process developped to adapt and translate the MSES to the French culture and langage. The psychometrics characteristics of the MSES-Fr are good.

Bacterial species and their role in delaying the healing of pressure ulcers (PU) in spinal cord injury (SCI) patients have not been well described. This pilot study aimed to characterise the evolution of the cutaneous microbiota of PU in SCI cohort. Twenty-four patients with SCI from a French neurological rehabilitation centre were prospectively in...

Background Pressure ulcers are a risk for bedridden patients and various supports exist to prevent them. The Pressure Relief Index (PRI) evaluates pressure relief of dynamic mattresses over time. This study compared the PRI of the SUMMIT mattress (AKS-France) and the NIMBUS 3 (HNE Medical). Methods In this non-blinded, randomized, crossover, non-i...

Résumé Les patients en fauteuil représentent 2 % de la population générale. Dans cette population, l’épaule assure la fonction locomotrice et présente, avec l’âge, des pathologies dégénératives, notamment de la coiffe des rotateurs (CDR). L’association épaule locomotrice et rupture de la CDR pose plusieurs questions : par quels mécanismes la propul...

Background Visual and molecular changes occurring upon aging are rather well characterized. Still, aging signs show great significant inter-individual variations, and little is known concerning the link between perceived age and cutaneous microcirculation. Materials and Methods To investigate this point, we recruited Caucasian women in their mid-5...

The aim of our study is to describe the assessment of the upper limb in tetraplegic patients to follow his (her) neurological progression and to define the medical or surgical treatment program. We selected upper limb assessment tools and scales for tetraplegic patients described in the medical literature through a PubMed search over the last four...

Background Flap surgery for deep pelvic pressure ulcers has already shown its effectiveness. Most studies relating to the postoperative period assessed complications rates and associated risk factors, but none focused on delayed wound healing. The objective of this study was to describe wound healing delay after primary flap surgery in patients wit...

BACKGROUND The clinical evaluation of a pressure ulcer is based on a quantitative and qualitative evaluation. In clinical practice, the technique of reference to measure wound surface is the use of acetate tracing, however it is difficult to use in daily practice (availability of the material, data storage issues, time needed to calculate the surfa...

Background Clinical evaluation of a pressure ulcer is based on quantitative and qualitative evaluation. In clinical practice, acetate tracing is the standard technique used to measure wound surface area; however, it is difficult to use in daily practice (because of material availability, data storage issues, and time needed to calculate the surface...

Objectives Explore the perceptions and beliefs related to pressure ulcers (PU), their prevention and treatment strategies, in order to discuss potential learning objectives for PU-related therapeutic education in persons with spinal cord injury (SCI). Design Qualitative study, using grounded theory for the analysis of data collected via a question...

Background: The benefit of an intradiscal injection of corticosteroids for low back pain with active discopathy is not totally resolved. Objective: The objective of this study was to estimate the clinical efficacy of an intradiscal injection of glucocorticoids versus lidocaine in patients with low back pain and active discopathy (Modic 1 changes...

Background: We hypothesized that a selective neural electrical stimulation of radial and median nerves enables the activation of functional movements in the paralyzed hand of individuals with tetraplegia. Compared to previous approaches for which up to 12 muscles were targeted through individual muscular stimulations, we focused on minimizing the...

Statement: Peer role-play (PRP) is a simulation-based training method (SBTM) in which medical students alternately play the patient's and clinician's role. This review aimed to assess the effectiveness of PRP for improving the communication skills of medical students. A systematic search was conducted in the MedLine, PsycInfo, and ERIC databases....

Background: Few rehabilitation methods have proven their efficacy in increasing sensori-motor recovery and/or function of the upper limb (UL) after stroke. Video games (VGs) are promising tools in this indication. Objective: To compare UL rehabilitation by using VGs and conventional rehabilitation (CR) in patients with sub-acute stroke. Design:...

Individuals who sustained a spinal cord injury often lose important motor skills, and cannot perform basic daily living activities. Several assistive technologies, including robotic assistance and functional electrical stimulation, have been developed to restore lost functions. However, designing reliable interfaces to control assistive devices for...

Abstract: The Personal Self-Efficacy correspond to the personal feeling of confidence and belief in one’s abilities, in situations of challenge or stress. This feeling is very important in rehabilitation center because it can influate the different thoughts and representations that the person has of herself: ● It is strongly associated with optimis...

Background: In individuals with spinal cord injury (SCI) and sleep apnea (SA), adherence to continuous positive airway pressure (CPAP) therapy seems unsatisfactory despite technical and educational support implemented when starting treatment. Objective: We aimed to design comprehensive model of adherence to CPAP therapy in individuals with SCI a...

Background: Spinal cord injury (SCI) induces an acute alteration in bone metabolism. Although the aetiology of the bone disturbances is not precisely known, immobilisation reduces mechanical loading and the morphology of osteocytes, which are the primary mechanosensors. Periostin and sclerostin are secreted mostly by osteocytes and are involved in...

Objectives: There is currently a low level of evidence for the impact of patient education on the management of patients with chronic neurological disease at risk of developing pressure ulcers. The objective of this study was to assess the impact of a patient education programme on pressure ulcer prevention in patients with chronic spinal cord inj...

Background: Functional Electrical Stimulation (FES) is used for decades in rehabilitation centers. For patients with a spinal cord injury (SCI), FES can prevent muscular atrophy, reduce spasticity and/or restore limb movements. To this last aim, FES external devices can be used, but elicit imprecise movements. FES implanted devices used neuromuscul...

Nous rapportons les résultats de la comparaison d’un programme de chirurgie fonctionnelle du membre supérieur chez des patients tétraplégiques comprenant une réanimation de l’extension du coude et la construction d’une key grip en « un seul temps » opératoire ou en « deux temps » opératoires. Une série de 36 patients tétraplégiques avec 45 membres...

Background: . Flap surgery for deep pelvic pressure ulcers (PPUs) has been found effective, but the recurrence rate remains high and few risk factors have been identified. Objective: We evaluated risk factors for PU recurrence after primary flap surgery in people with spinal cord injury (SCI). Patients and methods: This observational retrospec...

Background: . There is little evidence regarding the best way to treat adhesive capsulitis. Physical therapy can reduce pain and improve function and range of motion. However, we lack clear indications on the regimen, techniques or intensity of physical therapy to achieve better results. Intensive physical therapy seems to be confined to the later...

Introduction/Background We conducted a study measuring the impact of a program of therapeutic education concerning the prevention of risk of pressure ulcers for persons with a medullar lesion, during the chronic phase. Material and method This study concerns each person older than 18 with a medullar lesion, no matter the cause, having had pressure...

Introduction/Background Pressure ulcers are frequent complications in PMR wards. A lot of patients arrive from intensive care units. French national society for pressure ulcer conducts several national studies in France and a study in intensive care units in 2017. We analyse PU prevalence and Acquired PU prevalence, for patients with neurological d...

Introduction/Background In France, many people with disabilities have difficulties with primary care access, particularly dental and gynecological consultations. These difficulties are various: inaccessibility of the premises, maladapted materials, and insufficient time of consultation, communication difficulties or patients’ behaviors. Among the p...

Introduction/Background Bacterial species and their role in delaying the healing of pressure ulcers (PU) in spinal cord injury (SCI) patients have not been well described. The aim of this study was to characterize temporal evolution of superficial and deep microbiota of PU in SCI population. Material and method Patients treated for PU between 05/2...

Introduction/Background Pressure ulcers are frequent complications in PMR wards. Some patients arrive with PU, prevalence is 12% in national survey conducted by French society for PU (PERSE - prevention, education, research, care of PU). Some patients are Spinal cord injured (SCI) and require surgery. French society for PU provide guidelines: in 20...

Spinal cord injury (SCI), stroke and other nervous system conditions can result in partial or total paralysis of individual's limbs. Numerous technologies have been proposed to assist neurorehabilitation or movement restoration, e.g. robotics or neuroprosthesis. However, individuals with tetraplegia often find difficult to pilot these devices. We d...

Study design: Cross-sectional psychometrics study. Objectives: To determine the construct validity and internal consistency of the revised Skin Management Needs Assessment Checklist (revised SMnac). Setting: Six spinal cord rehabilitation centers. Methods: One-hundred and thirty-two community-dwelling individuals with spinal cord injury (SCI...

Functional electrical stimulation (FES) is a neuroprosthetic technique to help restore motor function of spinal cord-injured (SCI) patients. Through delivery of electrical pulses to muscles of motor-impaired subjects, FES is able to artificially induce their muscle contractions. Evoked electromyography (eEMG) is used to record such FES-induced elec...

Objective Sleep apnea is a frequent issue for the general population, with a prevalence between 2 and 4%. It is 2 to 5 times more frequent for the spinal cord-injured population. The night ventilation by positive pressure is the reference treatment but the compliance is still an issue. Its determinants are well studied in the general population, bu...

This article introduces a new human-machine interface for individuals with tetraplegia. We investigated the feasibility of piloting an assistive device by processing supra-lesional muscle responses online. The ability to voluntarily contract a set of selected muscles was assessed in five spinal cord-injured subjects through electromyographic (EMG)...

Opinion/Feedback Surgical indication is recommended for specific locations (pelvic stage 3 and 4 pressure ulcers) and if medical treatment is impossible: – global patient assessment is recommended before surgical indication with benefits and risks analysis; – analysis is conducted on several stages; – risk factors analysis and control level; – effi...

This article introduces a new approach of selective neural electrical stimulation of the upper limb nerves. Median and radial nerves of individuals with tetraplegia are stimulated via a multipolar cuff electrode to elicit movements of wrist and hand in acute conditions during a surgical intervention. Various configurations corresponding to various...

As a neuroprosthetic technique, functional electrical stimulation (FES) can restore lost motor performance of impaired patients. Through delivering electrical pulses to target muscles, the joint movement can be eventually elicited. This work presents a real-time FES system which is able to deal with two neuroprosthetic missions: one is estimating F...

Study design: Cross-sectional study. Objectives: To compare quality of life (QoL) in patients with spinal cord injury (SCI) who underwent overactive detrusor treatment by botulinum toxin (BT) versus augmentation cystoplasty (AC). Setting: France. Methods: Prospective and descriptive study: Patients with a refractory overactive bladder due to...

The Région Languedoc Roussillon is the umbrella organisation for an interconnected and integrated project on active and healthy ageing (AHA). It covers the 3 pillars of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA): (A) Prevention and health promotion, (B) Care and cure, (C) and (D) Active and independent living of e...

Groupe d’étude MACVIA-LR intégral :Jean Bousquet, Rodolphe Bourret , Thierry Camuzat , Philippe Augé , Philippe Domy, Jacques Bringer , Nicolas Best, Olivier Jonquet, Jean-Emmanuel de la Coussaye, Michel Noguès, Jean-Marie Robine, Antoine Avignon, Hubert Blain, Bernard Combe, Gérard Dray, Vincent Dufour, Mireille Fouletier, Nicolas Giraudeau, Didie...

Background This article is a prospective review of patients with spinal cord injury who underwent multidisciplinary consultation from January 2005 to September 2013 for pain in one or both shoulders. Methods We performed clinical, functional, and lesion evaluations of 38 patients with paraplegia and quadriplegia presenting with rotator cuff pathol...

This article is a prospective review of patients with spinal cord injury who underwent multidisciplinary consultation from January 2005 to September 2013 for pain in one or both shoulders. We performed clinical, functional, and lesion evaluations of 38 patients with paraplegia and quadriplegia presenting with rotator cuff pathologies. Surgery was i...

Dans le cadre d’un projet d’élaboration d’un référentiel d’éducation thérapeutique sur la prise en charge de l’escarre chez le lésé médullaire (REFESCAR), une enquête sur les pratiques éducatives a été réalisée fin 2012. Ce travail représente la synthèse des expériences éducatives de huit équipes référentes dans le suivi des personnes blessées médu...

La chirurgia funzionale dell’arto o degli arti superiori nel soggetto tetraplegico è oggi una chirurgia ben codificata con procedure e protocolli. Essa è il frutto di un’esperienza di più di 30 anni, che permette di offrire alla grande maggioranza dei soggetti tetraplegici delle prospettive di miglioramento delle loro capacità di prensione. Mira a...

Le fauteuil roulant électrique (FRE) est d’abord un dispositif d’aide au déplacement, qui peut s’imposer au sujet lésé médullaire, pour répondre à d’autres problématiques que celle de la locomotion. Les exigences fonctionnelles, la diminution de l’endurance à l’effort, la sursollicitation de l’appareil musculosquelettique sont autant de facteurs qu...

La cirugía funcional del miembro superior en la persona tetrapléjica está bien codificada con procedimientos y protocolos. Una experiencia de más de 30 años permite ofrecer a la mayoría de las personas tetrapléjicas perspectivas de mejoría en sus capacidades de prensión. El objetivo es recuperar, en función de las necesidades y los recursos muscula...

INTRODUCTION: Pressure ulcer (PU) is a common complication in chronic affection, especially neurological disorders and diseases commonly diagnosed in the elderly. For a long period of time, the prevention of skin lesions was taught only in an empirical manner. The development of therapeutic patient education (TPE) sheds a new light on care manageme...

Methods.– Ten young subjects (18.8 ± 1.8 years, mean ± SD) and 18 old subjects (74.1 ± 7.2 years) were recruited from community. Subjects stood barefoot on a force platform and were asked to sway as little as possible. The task was executed in four experimental sessions: before, just after (post0), after 2 minutes (post2) and after 4 minutes (post4...