Saint Maurice

This research aims to understand neuropathic pain in children and adolescents who had limb amputations during childhood. It focuses on two types of neuropathic pain: phantom limb pain and residual limb pain. The study also looks at how these pain types affect quality of life and independence, and explores links between neuropathic pain, age at amputation, and daily functioning. The study is observational and uses a mixed retrospective and prospective design. Data are gathered from medical records and standardized questionnaires completed during routine follow-up visits at a specialized pediatric limb anomaly center. There is no intervention or change in usual care. The study distinguishes phantom limb pain from residual limb pain and assesses quality of life and functional autonomy using age-appropriate tools. Participants provide information through questionnaires during their regular visits. Researchers collect and analyze data on neuropathic pain presence, quality of life, independence, and age when the amputation occurred. The main outcome measure is the presence of neuropathic pain at study inclusion. The study aims to improve understanding and management of neuropathic pain and its impact on children with limb amputations.

Researchers are evaluating the diagnosis of infrapatellar fat pad (IFP) impingement syndrome, a common cause of anterior knee pain. This observational study aims to assess how well a group of five standardized clinical tests can detect IFP impingement compared to MRI, which is considered the gold standard. Additionally, the study seeks to identify clinical and subjective factors linked to IFP involvement confirmed by imaging. Fifty participants aged 18 to 70 years with anterior knee pain rated at least 3 out of 10 will be enrolled. Participants will undergo a clinical evaluation involving a series of five provocation tests targeting the IFP, performed in random order to reduce bias. These tests include provoked palpation, passive extension and flexion tests, Hoffa's test, and the gliding test. A test is positive if it reproduces the participant's typical knee pain at a level of 2 or higher on a 10-point pain scale. All participants will also complete a secure online questionnaire about their symptoms, pain areas, aggravating and relieving factors, and validated functional scales. Each participant must have a standardized knee MRI within two weeks of the clinical exam, interpreted blindly by an independent radiologist. During the study visit, trained physiotherapists and physicians will perform clinical assessments including skin temperature measurement, swelling evaluation, and range of motion testing. Data from clinical tests and MRI will be analyzed to determine diagnostic accuracy using statistical measures like sensitivity and specificity. The study lasts about 12 months with a 6-month recruitment period, and participation involves a single session during a regular consultation. All data will be anonymized and securely stored, aiming to improve clinical diagnosis of anterior knee pain related to IFP impingement.

In children population with obstetrical brachial plexus palsy (OBPP), shoulder musculoskeletal deformity is the main cause of morbidity, with a loss of range of shoulder motion, pain and a reduction in social participation. Some uncontrolled studies shows that early injections of botulinum toxin (BTI) in the internal shoulder rotator muscles (which cause the deformity) are one of the most promising treatment for the prevention of bony deformity. The main objective of this study will be the evaluation of the effectiveness of BTI in the internal shoulder rotator muscles at the age of 12 months in preventing an increase in posterior subluxation of the glenohumeral joint in babies with OBPP (evaluated at the ages of 11 months and 18 months), compared to the Sham group.

Schizophrenia is a condition affecting about 0.7% of people and often involves poor insight, which can lead to poor medication adherence, relapse, and rehospitalization, negatively impacting quality of life. Psychoeducation has shown potential to improve treatment compliance and the therapeutic relationship. This trial evaluates an individual early psychoeducation program called PEPITS, designed to support patients during the initial hospitalization phase to improve insight, medication adherence, and reduce relapse. The PEPITS program is delivered by nurses and consists of three main phases: an introduction phase, a pathology and care phase, and a recovery and "stepping stone" phase. Each phase involves several sessions that provide patients with information, key knowledge, and new skills related to their illness and recovery process. Participants in the study will either receive the PEPITS program alongside usual psychiatric care or just the usual care without PEPITS. Participants will be followed for one year after randomization. Researchers will assess changes in patients' insight over this period as the primary outcome. Throughout the study, patient progress, relapse, and medication adherence will be monitored to evaluate the program's impact. The total participation lasts up to one year, allowing detailed observation of the program's long-term effects.

Unilateral Spatial Neglect (USN) is a common neuropsychological condition following stroke, where patients have difficulty detecting, orienting, and recognizing events on one side of space opposite to a brain lesion. Current rehabilitation methods for USN have limited effectiveness, possibly because they focus on only certain sensory modalities and do not address the syndrome's complexity. Additionally, patient motivation can affect adherence to rehabilitation programs. This study aims to evaluate an immersive virtual reality rehabilitation approach based on musical practice, designed to improve spatial perception by incorporating new sensory modalities such as auditory stimuli, and to assess its impact on patients' daily lives and the role of mood and motivation in treatment benefits. Participants will be randomly assigned to one of two groups for a two-week period: one receiving conventional rehabilitation alone, and the other receiving both conventional rehabilitation and immersive virtual reality rehabilitation. The immersive protocol uses the "Piano Vision" application, which offers free or guided musical practice modes, while the conventional rehabilitation includes standard cognitive treatments like visual scanning exercises, sequence identification, scene descriptions, and pointing tasks. Throughout the study, patients will undergo assessments before and after the rehabilitation period. These include various tests such as the Bells Test, Mesulam cancellation Task, Bisection Test, and others evaluating spatial awareness and daily life activities. Virtual reality tasks and auditory localization exercises are also incorporated. Researchers will monitor patients' progress over eight weeks, focusing on improvements in spatial neglect symptoms and functional abilities, as well as the influence of mood and motivation on rehabilitation outcomes.

People with mental disorders tend to smoke more than the general population, which partly causes significant health differences and shorter life expectancy by 10 to 25 years. This gap is mainly due to heart and lung diseases, including bronchial cancers. Despite their motivation to quit, smoking is often overlooked or tolerated in psychiatric care, making quitting harder due to stronger withdrawal symptoms. This research evaluates a new intervention called "Tabapsy," designed with input from patients, mental health professionals, and general practitioners to support smoking cessation in adults receiving outpatient psychiatric care. The Tabapsy intervention includes a campaign to promote quitting smoking and a structured support program with multiple components: a general information meeting to boost motivation, an assessment workshop to personalize cessation plans, five thematic workshops covering treatments, emotional management, weight control, physical activity, and manual activities, plus peer support groups to encourage mutual help. A dedicated facilitator runs the program in psychiatric medical psychological centers (CMPs), supplemented by a website with resources. The study compares this intervention to usual care practices regarding smoking cessation in a cluster-randomized controlled trial involving psychiatric sectors in France. Participants are regular smokers aged 18 or older who receive outpatient psychiatric care at participating centers. They will complete questionnaires online at the start, and again at 3 and 6 months, covering smoking habits, nicotine dependence, motivation, use of quitting aids, mental and physical well-being, and knowledge about smoking. The main outcome is short-term smoking cessation lasting at least 7 days at 3 months. Secondary goals include assessing cost-effectiveness and how well the intervention is implemented. A total of 6,250 participants will be enrolled over 12 months across 22 sectors.

This research aims to understand the medical, social, and organizational factors that affect returning to work after an osteoarticular injury, especially limb fractures. These injuries often impact young working adults and can lead to long breaks from professional activities with significant social and economic effects. The study will observe how patients return to work within 12 months after their injury and examine factors such as injury severity, functional recovery, pain, professional characteristics, workplace accommodations, and administrative support like disability recognition. The study does not include treatments or interventions but focuses on collecting observational data. It will explore the timing of when return-to-work discussions begin during hospitalization, a critical but often overlooked period for planning professional reintegration. By identifying current practices and potential gaps, the study hopes to improve knowledge of return-to-work processes within the healthcare system and workplaces in France. Participants will be adults treated for osteoarticular trauma between June 2021 and June 2024 who were employed before their injury. Researchers will collect data on return-to-work rates, timing, and associated medical and social factors over a 12-month period after trauma. The study will assess workplace accommodations and administrative measures, aiming to provide valuable insights for improving early anticipation and coordination of professional reintegration.