Paul Vaucher

University of Applied Sciences and Arts Western Switzerland · School of Health Sciences Fribourg

In geriatrics, driving cessation is addressed within the biopsychosocial model. This has broadened the scope of practitioners, not only in terms of assessing fitness to drive, but also by helping to maintain social engagements and provide support for transport transition. Causes can be addressed at different levels by adapting medication, improving...

Background Mental disorders, common in primary care, are often associated with physical complaints. While exposure to psychosocial stressors and development or presence of principal mental disorders (i.e. depression, anxiety and somatoform disorders defined as multisomatoforme disorders) is commonly correlated, temporal association remains unproven...

Advances in biopsychosocial science have underlined the importance of taking social history and life course perspective into consideration in primary care. For both clinical and research purposes, this study aims to develop and validate a standardised instrument measuring both material and social deprivation at an individual level. We identified re...

When facing age-related cerebral decline, older adults are unequally affected by cognitive impairment without us knowing why. To explore underlying mechanisms and find possible solutions to maintain life-space mobility, there is a need for a standardized behavioral test that relates to behaviors in natural environments. The aim of the project descr...

In many countries, primary care physicians determine whether or not older drivers are fit to drive. Little, however, is known regarding the effects of cognitive decline on driving performance and the means to detect it. This study explores to what extent the trail making test (TMT) can provide indications to clinicians about their older patients' o...

Background Observing how individuals actively adapt to their environment may provide additional insights into traditional clinical tests. Rather than using tests that only identify joint mobility limitations, it seems relevant to use clinical motion tests that assess global biomechanical functions more generally and identify functional behaviours....

Osteopaths are expected to keep up to date with research evidence relevant to their clinical practice and to integrate this knowledge with their own experience and their patients' values and preferences. One of the potential challenges when engaging with research is to make sense of it, to decide if it is trustworthy, and if it is applicable to the...

Contexte : Avec l’émergence de la pratique éclairée, les cliniciens s’engagent à donner du sens à la recherche, de décider si elle est digne de confiance et si elle est appli‐ cable à la nature complexe de leur pratique clinique. Ceci est rendu plus difficile par l’exposition croissante à la désin‐ formation (délibérée ou non) et aux extrapolations...

Bruxism is a common disorder often associated with other musculoskeletal disorders. Osteopaths offer functional assessments and management for a range of health-related disorders including bruxism and neck pain. New instruments and methodologies are now available to quantify ROM data in a clinical context. This study explores the value of using mot...

Objectives: To review the dynamic analytical elements used in the functional assessment of the stomatognathic system, summarize the available scientific evidence, and consider interrelations with body posture and cognition. Method and materials: A thorough literature search was conducted using PubMed, the Cochrane Library database, and Google Sc...

Objectives: To review the elements of static analysis in the functional assessment of the stomatognathic system, as promoted for more than a century by gnathologists, and summarize the available scientific evidence, including anthropologic observations. Method and materials: A thorough search was conducted using PubMed, the Cochrane Library data...

Background Assessing fitness to drive and predicting driving cessation remains a challenge for primary care physicians using standard screening procedures. The objective of this study was to prospectively evaluate the properties of neuropsychological screening tests, including the Trail Making Test (TMT), Clock Drawing Test (CDT), Montreal Cognitiv...

Introduction This study explores the interest of using motion analysis to evaluate cervical and jaw ROM on students with or without bruxism when comparing Osteopathic manipulative treatment (OMT) to sham in school settings. Methods A feasibility study was run with 48 volunteer students from an osteopathic training institution. Random sequence for...

Explorer de nouvelles dimensions à l’interprétation des tests cliniques traditionnels ouvre des perspectives innovantes pour l’évaluation des pratiques professionnelles en thérapie manuelle. Plutôt que de recourir à des tests qui visent uniquement à identifier des limitations de mobilité articulaires, l’enjeu serait de recourir à des tests qui éval...

Osteopathy became recently regulated as a healthcare profession in Italy. The Italian legislation classifies osteopathy as a healthcare profession, which focuses on health prevention and maintenance with a role in rehabilitation and functional psychosocial recovery. The legislative framework also lays down the osteopathic professional profile. Oste...

Osteopathy became recently regulated as a healthcare profession in Italy. The Italian legislation classifies osteopathy as a healthcare profession, which focuses on health prevention and maintenance with a role in rehabilitation and functional psychosocial recovery. The legislative framework also lays down the osteopathic professional profile. Oste...

The trusted role and professional standing that osteopaths have with their patients and within their wider communities requires that the information and messages they communicate are informed by and congruent with current evidence, public health guidance and scientific consensus. This expectation is even more critical during the covid-19 pandemic,...

The value of incorporating research evidence into clinical practice is in part, to help acknowledge, accept and manage uncertainties. The urgency related to the Covid-19 pandemic has changed usual publication process and information sharing. The rapid knowledge exchange between theory, research and clinical recommendation has occurred with the hope...

Bruxism is a common disorder often associated with other musculoskeletal disorders. 1,2 Bruxism is a common disorder often associated with other musculoskeletal disorders (i.e. neck pain, headache, tinnitus, temporomandibular pain etc.). Recent studies have highlighted interrelations between cervical spine and jaw musculoskeletal functions. Osteopa...

Bruxism is a common disorder often associated with other musculoskeletal disorders (i.e. neck pain, headache, tinnitus, temporomandibular pain etc.). Recent studies have highlighted interrelations between cervical spine and jaw musculoskeletal functions. Osteopaths offer functional assessments, diagnosis and management for a range of health-related...

Background Infants who excessively cry, are distressed and unsettled can have a marked impact on family life. One form of support is manual therapy and osteopathic care. There is, however, limited research and debate about the effectiveness of manual therapy and osteopathic care for these infants. Aim To evaluate the effectiveness of osteopathic l...

Objective The on-road assessment is the gold standard because of its ecological validity. Yet existing instruments are heterogeneous and little is known about their psychometric properties. This study identified existing on-road assessment instruments and extracted data on psychometric properties and usability in clinical settings. Method A system...

The digitalization of humanitarian supply chains allows overcoming one of the greatest difficulties faced by NGOs and governments in managing health equipment in crisis situations: the visibility of stocks and consumption at the end of the chain. This paper presents the design process of the health equipment inventory management system developed to...

Cas clinique: Une mère se présente en consultation ostéopathique pour son nourrisson de sept semaines présentant des pleurs incessants depuis une semaine avec des signes évoquant des coliques. Les pleurs incessants du nourrisson représentent un syndrome bénin courant pouvant entrainer des sentiments d'impuissance, d'épuisement et de frustration che...

This training load increases the risk of injuries in lower back and the lower limb (Gosling et al. 2008). Despite an abundant literature, the evaluation of the risk of low back pain remains complex as it lacks evidence-based recommendations and reliable functional test. Several functional movement tools are suggested to evaluate this risk in assess...

The mechanics by which osteopathic treatment may produce an increased joint range of motion remains unclear. The aim of this blind pilot study was to measure the immediate effect of OMT on range of motion (ROM) of the sacro-lumbar joint and the pelvis spatial orientations during the one-sided tilt test.

One important shared vision of osteopathic principles among osteopathic professionals is the link between structure and function. Advances in neuroscience, behavioural therapy, imaging and 3D analysis has changed the way we perceive and understand these links in biomechanics. This workshop will develop the concept of applied integrated biomechanics...

The evaluation of the risk of low back pain remains complex as it lacks evidence-based recommendations and a reliable functional test. The one-sided tilt test can provide additional information on the dynamics of the lum-bo-pelvic complex. However, little is known about the expected movement. This study aims to identify different patterns of movem...

The aim of this pilot study was to use a musculoskeletal modelling approach to propose a functional screening approach of lumbar-pelvic-femoral complex range of motion during the one-sided tilt test

The aim of this blind pilot study was to measure the immediate effect of OMT on range of motion (ROM) of the sacro-lumbar joint and the pelvis spatial orientations during the one-sided tilt test.

Le développement des collaborations entre cliniciens et biomécaniciens est un véritable enjeu médical et scientifique. Dans ce sens, en France, depuis l’article n° 2014/11, la biomécanique est entrée officiellement dans la formation des étudiants en ostéopathie comme une unité d’enseignement propre. Au-delà des connaissances fondamentales apportées...

À ce jour, les études expérimentales menées sur l’évaluation des tests utilisés en ostéopathie ont montré qu’ils sont peu reproductibles mis à part certains tests liés à la reproduction de la douleur. Le test de la commère, décrit classiquement en ostéopathie, permet d’accéder aux mobilités articulaires du complexe lombo-pelvien et les nouvelles mé...

Introduction: sacroiliac joint tests are commonly used for the diagnosis of sacroiliac joint dysfunction (SIJD) despite the fact that most dynamic and structural palpation tests appear to be unreliable. The aim of this study was to differentiate the effects of a quantitative dynamic test of the sacroiliac joint, known as Downing's test, applied to...

Objectives This study investigated the beliefs and attitudes of UK registered osteopaths towards chronic pain and the management of chronic pain sufferers. Methods A cross-sectional questionnaire based survey of UK registered osteopaths was performed to test the hypothesis that osteopaths have a more biopsychosocial approach to treating and manag...

Objective: We aimed to assess how often and for what reasons general practitioners (GPs) consider older drivers medically unfit to drive. Methods: All GPs certified to carry out fitness-to-drive assessments in Geneva (medical assessors, n = 69), as well as a random sample of 500 GPs practising in Vaud, Neuchatel and Jura, were asked to complete...

Objective:: Cardiovascular diseases (CVD) are the main cause of death worldwide and despite a higher prevalence in men, mortality from CVD is higher among women. Few studies have assessed sex differences in chest pain management in ambulatory care. The objective of this post hoc analysis of data from a prospective cohort study was to assess sex di...

Objectives The aim of this study was to describe osteopathic activity and scope of practice to understand the current and future role of osteopathy in the Swiss healthcare system. Design A questionnaire survey that included a patient record-based retrospective clinical audit. Setting/population Osteopaths with a national diploma (n=1086) were inv...

Objective: We aimed to explore the extent to which general practitioners (GPs) in Western Switzerland adhere to Swiss recommendations when assessing fitness-to-drive in the elderly. Methods: A random sample of 500 GPs practicing in Vaud, Neuchatel and Jura, and all GPs certified to conduct fitness-to-drive assessments in Geneva ("experts", n = 6...

OBJECTIVE We aimed to explore the extent to which general practitioners (GPs) in Western Switzerland adhere to Swiss recommendations when assessing fitness-to-drive in the elderly. METHODS A random sample of 500 GPs practicing in Vaud, Neuchatel and Jura, and all GPs certified to conduct fitness-to-drive assessments in Geneva (“experts”, n = 69) we...

This report describes scope of practice for osteopathic care in Switzerland. It is the result of a practice review run with over 500 osteopaths who reported their management for 4 of their patients in 2016 using their patient record.

Syndrome du côlon irritable, troubles fonctionnels intestinaux, thérapies manuelles, revue systématique Background : irritable bowel Syndrome (IBS) is a functional disorder that affects approximately 11 % of the population. Often, medication only partially improves symptoms and does not resolve the problem. Some patients seek alternative treatments...

Objectives The aim of this study is to quantify the importance of loss of contrast sensitivity (CS) and its relationship to loss of visual acuity (VA), driving restrictions and daytime, on-road driving evaluations in drivers aged 70+. Design A predictive cross-sectional study. Setting Volunteer participants to a drivers’ refresher course for adul...

Introduction: Postmortem CT angiography is the method of choice for the postmortem imaging investigations of the cardiovascular (CV) system. However, autopsy still remains the gold standard for CV measurement. Nevertheless, there are not any studies on CV measurements on the multi-phase postmortem angiography (MPMCTA) which includes comparisons wi...

Studies are available that assess the risk of malaria in accordance to the body's iron store and the systematic iron supplementation of preschool children. However, only a few studies evaluated the temporal association between hemoglobin and malaria and their results are opposing. A total of 1,650 3-month-old Papua New Guinean infants were enrolled...

Les notions de fiabilité sont essentielles pour mieux décider de la place que l’on veut accorder aux tests cliniques. En théra- pies manuelles, les observations empiriques semblent suggé- rer que la plupart des tests cliniques sont bien plus complexes que ce que l’on croyait. Ils ne répondent apparemment pas à un modèle dichotomique définissant la...

Embrasser l’incertitude pour l’intégrer dans son quotidien; un point que se partage les cliniciens et les scientifiques. Cet article survole les principes de base de la valeur-p et sa place dans le raisonnement scientifique. Un accent particulier est mis sur l’im- portance de la rigueur méthodologique et le devoir du scien- tifique de tout faire po...

The role of osteopathic tests within the decision process has been questioned by research during the last 25 years. The two most important challenges we are facing are their lack of reliability when taken out of their context and our dif cul- ties in nding gold standards to test them against. This has questioned the basis of the osteopathic diagnos...

- BACKGROUND: Three-dimensional (3D) printed models of the human skull and parts of it are being increasingly used for surgical education and customized preoperative planning. - OBJECTIVE: This study, using the calvaria as a model, provides a methodologic analysis with regard to future investigations aimed at evaluating patient-specific skull repli...

Background and objectives: Hepcidin is the main hormone that regulates iron balance. Its lowering favours digestive iron absorption in cases of iron deficiency or enhanced erythropoiesis. The careful dosage of this small peptide promises new diagnostic and therapeutic strategies. Its measurement is progressively being validated and now its clinica...

Introduction Occupational therapists could play an important role in facilitating driving cessation for ageing drivers. This, however, requires an easy-to-learn, standardised on-road evaluation method. This study therefore investigates whether use of ‘P-drive’ could be reliably taught to occupational therapists via a short half-day training session...

Although the performance of the Swiss health system is high, one out of ten patients in general practitioner's (GP) office declares having foregone care in the previous twelve months for economic reasons. Reasons for foregoing care are several and include a lack of knowledge of existing social aids in getting health insurance, unavailability of GPs...

Introduction: By 2075, over 50% of the population in Europe will be aged over 60 years with a three fold increase of those aged 80 years or more compared to now. Our society needs to anticipate this demographic change and help older adults conserve their autonomy for as long as possible. Non-pathological or normal ageing is accompanied by brain alt...

Growing social inequities have made it important for general practitioners to verify if patients can afford treatment and procedures. Incorporating social conditions into clinical decision-making allows general practitioners to address mismatches between patients' health-care needs and financial resources. Identify a screening question to, indirect...

To identify which physician and patient characteristics are associated with physicians' estimation of their patient social status. Cross-sectional multicentric survey. Fourty-seven primary care private offices in Western Switzerland. Random sample of 2030 patients ≥16, who encountered a general practitioner (GP) between September 2010 and February...

Restless legs syndrome (RLS) is a frequent condition with a prevalence of 5-15% in the general population. Clinical and genetic observations have shown that iron deficiency, highly prevalent among blood donors, can be related to RLS. The objective of this study was to assess the prevalence of RLS in female blood donors 1 week after blood donation....

Background Current guidelines underline the limitations of existing instruments to assess fitness to drive and the poor adaptability of batteries of neuropsychological tests in primary care settings. Aims To provide a free, reliable, transparent computer based instrument capable of detecting effects of age or drugs on visual processing and cognitiv...

Background Primary care physicians are often requested to assess their patients’ fitness to drive. Little is however known on their needs to help them in this task. Aims The aim of this study is to develop theories on needs, expectations, and barriers for clinical instruments helping physicians assess fitness to drive in primary care. Methods This...

Background and purpose: Multi-phase postmortem CT angiography (MPMCTA) is increasingly being recognized as a valuable adjunct medicolegal tool to explore the vascular system. Adequate interpretation, however, requires knowledge about the most common technique-related artefacts. The purpose of this study was to identify and index the possible artef...

Iron deficiency is generally investigated when faced with anemia, or with symptoms that could be related to iron deficiency without anemia. This simple disorder is easy to treat, provided that the diagnosis is correct. Several biological tests are available, but their interpretation is oftentimes problematic. Pre-analytical factors can interfere wi...

Purpose: Postmortem computed tomography angiography (PMCTA) was introduced into forensic investigations a few years ago. It provides reliable images that can be consulted at any time. Conventional autopsy remains the reference standard for defining the cause of death, but provides only limited possibility of a second examination. This study compar...