[Preventing emotional disorders in the elderly with programs based on cognitive-behavioral therapies]. / Prévenir les troubles émotionnels des personnes âgées avec des programmes fondés sur les thérapies cognitivo-comportementales.

The cognitive-behavioral approach is particularly well-suited to older people who are looking for a short-term therapeutic solution to many emotional problems, without necessarily resorting to psychotropic drugs. One of the major advantages of this type of psychological treatment is that it helps seniors develop coping skills that can be beneficial in both the short and long term. However, some adjustments are sometimes necessary to achieve this goal.

[Techniques from EMDR Psychotherapy : a tool against disruptive psycho-behavioural disorders?] / Techniques issues de la psychothérapie EMDR : un outil contre les troubles psycho-comportementaux ?

Behavioural disorders in residential care facilities for dependent seniors are particularly common in residents with Alzheimer's and related diseases. Verbal agitation is one of the most disruptive behavioural disorders. The use of techniques from Eye Movement Desensitisation and Reprocessing therapy in gerontology, its applications and research perspectives may be illustrated.

Stochastic estimation of arm mechanical impedance during robotic stroke rehabilitation.

This paper presents a stochastic method to estimate the multijoint mechanical impedance of the human arm suitable for use in a clinical setting, e.g., with persons with stroke undergoing robotic rehabilitation for a paralyzed arm. In this context, special circumstances such as hypertonicity and tissue atrophy due to disuse of the hemiplegic limb must be considered. A low-impedance robot was used to bring the upper limb of a stroke patient to a test location, generate force perturbations, and measure the resulting motion. Methods were developed to compensate for input signal coupling at low frequencies apparently due to human-machine interaction dynamics. Data was analyzed by spectral procedures that make no assumption about model structure. The method was validated by measuring simple mechanical hardware and results from a patient's hemiplegic arm are presented.

Motions or muscles? Some behavioral factors underlying robotic assistance of motor recovery.

Robotics and related technologies have begun to realize their promise to improve the delivery of rehabilitation therapy. However, the mechanism by which they enhance recovery remains unclear. Ultimately, recovery depends on biology, yet the details of the recovery process remain largely unknown; a deeper understanding is important to accelerate refinements of robotic therapy or suggest new approaches. Fortunately, robots provide an excellent instrument platform from which to study recovery at the behavioral level. This article reviews some initial insights about the process of upper-limb behavioral recovery that have emerged from our work. Evidence to date suggests that the form of therapy may be more important than its intensity: muscle strengthening offers no advantage over movement training. Passive movement is insufficient; active participation is required. Progressive training based on measures of movement coordination yields substantially improved outcomes. Together these results indicate that movement coordination rather than muscle activation may be the most appropriate focus for robotic therapy.

Customized interactive robotic treatment for stroke: EMG-triggered therapy.

A system for electromyographic (EMG) triggering of robot-assisted therapy (dubbed the EMG game) for stroke patients is presented. The onset of a patient's attempt to move is detected by monitoring EMG in selected muscles, whereupon the robot assists her or him to perform point-to-point movements in a horizontal plane. Besides delivering customized robot-assisted therapy, the system can record signals that may be useful to better understand the process of recovery from stroke. Preliminary experiments aimed at testing the proposed system and gaining insight into the potential of EMG-triggered, robot-assisted therapy are reported.

[Methadone and sleep apnea syndrome]. / Méthadone et syndrome d'apnées du sommeil.

BACKGROUND: Sleep apnea syndrome occurs when, during sleep, breathing stops for 10 seconds or longer, with an index of 5 times or more an hour. It is clinically characterized by loud snoring at night, continuous or interrupted by pauses followed by loud breathing. Sleep is fitful, broken by arousals, and yields little rest. There is daytime excessive sleepiness with repeated involuntary falling asleep, often unknown by the subject. CLINICAL DESCRIPTION: In this article, we describe an observation of central sleep apnea syndrome in a female patient receiving an opiate replacement therapy. METHOD: An analysis of the before and after methadone withdrawal polysomnograhic tracing was done for this patient. RESULTS: This diagnosis etiology and physiopathology are critically approached. Clinicians should be careful in treating induced sleep disorders in such patients. CONCLUSION: Prescribing benzodiazepines during an opiate withdrawal of the methadone type is not recommended when central apnea occurs.