[Behavioural strategies, activities, and pain : what you need to know]. / Stratégies comportementales, activités et douleur : ce qu'il est utile de savoir.

Pain has multiple consequences, forcing people to change the way they carry out their activities (domestic, work, leisure, social). Classically, three behavioural strategies have been described: avoidance, modulation, and persistence. Recent research suggests that the use of these strategies is more complex and subtle than previously imagined. Identifying behavioural activity strategies early in the management process with simple, precise, and concrete questions is particularly useful for adapting treatment plans. From a therapeutic point of view, the recommendations for promoting activity are both to choose activities that are valued by the patient in order to reinforce his or her commitment, and to encourage flexibility in the choice of behavioural strategies depending on the context.

La douleur a de multiples conséquences et oblige les personnes en souffrant à changer la manière de réaliser leurs activités (domestiques, travail, loisirs, sociales). Classiquement, trois stratégies comportementales ont été décrites : l'évitement, la modulation et la persistance. La recherche actuelle met en avant plus de complexité et de subtilités dans l'utilisation de ces stratégies. Repérer les stratégies d'activité tôt dans la prise en charge avec des questions simples, précises et concrètes est particulièrement utile pour adapter le traitement. Du point de vue thérapeutique, les recommandations pour favoriser l'activité sont à la fois de choisir celles étant valorisées par le patient pour renforcer son engagement et de favoriser la flexibilité dans le choix des stratégies comportementales selon les contextes.

Acute right opercular stroke-associated polyopic heautoscopy and hallucinations caused by disconnection to the inferior parietal lobule through the superior longitudinal fasciculus III: A single case study.

Illusory neuropsychiatric symptoms such as hallucinations or the feeling of a presence (FOP) can occur in diffuse brain lesion or dysfunction, in psychiatric diseases as well as in healthy individuals. Their occurrence due to focal brain lesions is rare, most probably due to underreporting, which limits progress in understanding their underlying mechanisms and anatomical determinants. In this single case study, an 86-year-old patient experienced, in the context of an acute right central opercular ischemic stroke, visual hallucinatory symptoms (including palinopsia), differently lateralized auditory hallucinations and FOP. This unusual clinical constellation could be precisely documented and illustrated while still present, allowing a realistic and immersive visual experience validated by the patient. The acute stroke appeared to be their most plausible cause (after exclusion of other etiologies). Furthermore, accurate analysis of tractographic data suggested that disruption in the posterior bundle of the superior longitudinal fasciculus connecting the stroke lesion to the inferior parietal lobule was the anatomical substrate explaining the FOP and, indirectly, also hallucinations through whiter matter involvement, in coherence with existing literature. We could finally elaborate on symptoms taxonomy and phenomenology (e.g., polyopic heautoscopy, hallucinatory FOP, etc), and on patient's remarkable distancing from them (with some therapeutic implications supported by plausibly engaged mechanisms). This case not only authentically enriched the description of such rare combination of heterogenous illusory symptoms through this novel visualization-based reporting approach, but disclosed an unrevealed anatomo-clinical link relating all of them to the acute stroke lesion through an association fiber, thereby contributing to the understanding of these intriguing symptoms and their determinants.

[Knee examination in practice: clinical relevance of author-named special tests]. / L'examen du genou en pratique : pertinence clinique des manœuvres à nom propre.

Special tests for clinical examination of the musculoskeletal system are numerous, many of them named after the author who described them. We have researched and listed the author-named tests available for knee examination, discussing their practical utility in sports medicine. For each structure, we recommend the combination of at least 2 tests, which increases the overall diagnostic performance of the clinical examination. At least one functional test must be included as part of a sports medicine consultation. The most useful author-named tests in this context and depending on the suspicion are the Lachman, Lelli, Smilie, McConnell, Arnold's cross-over, Godfrey, McIntosh pivot-shift, Slocum, McMurray, Apley, and Thessaly.

Les tests spéciaux pour l'examen clinique de l'appareil locomoteur sont nombreux, dont beaucoup portent le nom de l'auteur qui les a décrits. Nous avons recherché et listé les tests à nom propre disponibles pour l'examen du genou, en discutant leur utilité pratique en médecine du sport. Pour chaque structure, nous recommandons l'association d'au moins 2 tests, ce qui augmente la performance diagnostique globale de l'examen clinique. Au moins un test fonctionnel doit être inclus dans le cadre d'une consultation de médecine du sport. Les tests à nom propre les plus utiles dans ce contexte et selon la suspicion sont les Lachman, Lelli, Smilie, McConnell, cross-over d'Arnold, Godfrey, pivot-shift de McIntosh, Slocum, McMurray, Apley et Thessaly.