Cabinet de Kinésithérapie De Nève Julien

03/03/2026

🦶 𝗛𝗼𝘄 𝗖𝗵𝗿𝗼𝗻𝗶𝗰 𝗔𝗻𝗸𝗹𝗲 𝗜𝗻𝘀𝘁𝗮𝗯𝗶𝗹𝗶𝘁𝘆 𝗖𝗵𝗮𝗻𝗴𝗲𝘀 𝘁𝗵𝗲 𝗪𝗮𝘆 𝗪𝗲 𝗦𝘁𝗮𝗿𝘁 𝗪𝗮𝗹𝗸𝗶𝗻𝗴: 𝗔 𝗗𝗲𝗲𝗽 𝗗𝗶𝘃𝗲

⬛ Lateral ankle sprains are among the most common musculoskeletal injuries. While many people recover quickly, up to 40% of injured individuals develop Chronic Ankle Instability (CAI), a condition characterized by recurrent sprains, residual pain, weakness, and a lingering sensation of the ankle "giving way".
⬛ But does this instability affect the simple, everyday act of taking your first step?
⬛ A 2023 systematic review by Yousefi et al. explored precisely this question, investigating how CAI alters the biomechanical organization of gait initiation. By screening 878 articles and analyzing the 6 that met their strict inclusion criteria, the researchers uncovered fascinating insights into the ways our bodies compensate for chronic ankle issues.

🚶‍♂️ 𝗧𝗵𝗲 𝗠𝗲𝗰𝗵𝗮𝗻𝗶𝗰𝘀 𝗼𝗳 𝗧𝗮𝗸𝗶𝗻𝗴 𝗮 𝗦𝘁𝗲𝗽

⬛ To understand the impact of CAI, we first need to understand gait initiation (GI), which is the transition from a quiet stance to steady-state walking.
⬛ This transition relies heavily on Anticipatory Postural Adjustments (APAs). These are centrally initiated, subconscious dynamic movements that occur before you actually move your foot.
⬛ During a normal APA, your center of pressure (COP) shifts backward and laterally toward the stepping foot to propel your center of mass forward and keep you balanced.

⚙️ 𝗛𝗼𝘄 𝗖𝗔𝗜 𝗔𝗹𝘁𝗲𝗿𝘀 𝗚𝗮𝗶𝘁 𝗜𝗻𝗶𝘁𝗶𝗮𝘁𝗶𝗼𝗻

⬛ The systematic review identified several major biomechanical changes in individuals with CAI compared to healthy controls.
⏱️ 𝗗𝗲𝗹𝗮𝘆𝗲𝗱 𝗥𝗲𝗮𝗰𝘁𝗶𝗼𝗻 𝗧𝗶𝗺𝗲𝘀 & 𝗦𝗵𝗼𝗿𝘁𝗲𝗿 𝗔𝗣𝗔𝘀
⬛ Individuals with CAI exhibit a significantly longer reaction time (the delay between a trigger signal and the start of the APA).
⬛ However, once the APA begins, its duration is actually shorter in those with CAI.
📍 𝗔𝗹𝘁𝗲𝗿𝗲𝗱 𝗖𝗲𝗻𝘁𝗲𝗿 𝗼𝗳 𝗣𝗿𝗲𝘀𝘀𝘂𝗿𝗲 (𝗖𝗢𝗣) 𝗦𝗵𝗶𝗳𝘁𝘀
⬛ The magnitude of the lateral COP shift during the APA phase is notably decreased in individuals with CAI.
⬛ Interestingly, the anteroposterior (forward-to-backward) COP shift remains completely unchanged.
⬛ This means CAI patients are still able to generate the forward velocity needed to walk, but their side-to-side balance preparation is impaired.
💪 𝗣𝗿𝗲𝗺𝗮𝘁𝘂𝗿𝗲 𝗠𝘂𝘀𝗰𝗹𝗲 𝗔𝗰𝘁𝗶𝘃𝗮𝘁𝗶𝗼𝗻
⬛ A healthy ankle relies on a complex synergy of muscle activation and deactivation, including the silencing of the soleus muscle.
⬛ In individuals with CAI, the soleus muscle of the injured leg activates earlier than normal, indicating a shortened period of muscle inhibition.
🔄 𝗜𝗻𝗰𝗿𝗲𝗮𝘀𝗲𝗱 𝗥𝗲𝗮𝗿𝗳𝗼𝗼𝘁 𝗜𝗻𝘃𝗲𝗿𝘀𝗶𝗼𝗻
⬛ During the actual step ex*****on phase, individuals with CAI demonstrate increased rearfoot inversion (the ankle rolling inward) from the time the heel strikes to when the foot lifts off.

🧠 𝗪𝗵𝘆 𝗧𝗵𝗶𝘀 𝗠𝗮𝘁𝘁𝗲𝗿𝘀: 𝗔 "𝗚𝗹𝗼𝗯𝗮𝗹" 𝗡𝗲𝘂𝗿𝗼𝗺𝘂𝘀𝗰𝘂𝗹𝗮𝗿 𝗜𝘀𝘀𝘂𝗲

⬛ Perhaps the most significant takeaway from this review is that these biomechanical alterations occur regardless of which leg takes the first step.
⬛ The changes are bilateral, meaning that even if a patient only has unilateral CAI (instability in one ankle), their postural adjustments are altered on both sides.
⬛ This strongly supports the hypothesis that CAI is not just a localized, mechanical joint problem, but a global condition that impairs supraspinal (central nervous system) motor control mechanisms.
⬛ Because the lateral COP shift during the APA is essential for preventing lateral instability and falls, a reduction in this shift suggests patients might be subconsciously adopting a "safety strategy" to minimize anticipatory postural forces and reduce the risk of rolling their ankle.

🎯 𝗧𝗵𝗲 𝗣𝗮𝘁𝗵 𝗙𝗼𝗿𝘄𝗮𝗿𝗱 𝗳𝗼𝗿 𝗥𝗲𝗵𝗮𝗯𝗶𝗹𝗶𝘁𝗮𝘁𝗶𝗼𝗻

⬛ Because CAI affects all levels of the neuromuscular control system, physical therapy must go beyond simply strengthening the ankle.
⬛ The authors suggest that rehabilitation programs should incorporate APA-focused training to restore normal neuromuscular control and central movement patterns.
⬛ Doing so could significantly improve balance, restore safe movement control, and reduce the risk of future sprains.

⚠️ 𝗡𝗼𝘁𝗲 𝗼𝗻 𝗟𝗶𝗺𝗶𝘁𝗮𝘁𝗶𝗼𝗻𝘀

⬛ The researchers noted that while the overall consensus of the literature is strong, the pool of eligible studies was relatively small (6 studies) and all studies were retrospective, meaning it is difficult to determine if these motor control changes existed before the initial sprain or developed as a result of it.

21/01/2026

Bonjour à toutes et tous,

Comme chaque année, je dois m'absenter une petite semaine pour préparer ma saison cycliste 2026.

Le cabinet sera donc fermé du 23 janvier au 30 janvier inclus.

Je vous souhaite une excellente semaine et on se retrouve dès le 02 février.

Merci.

19/12/2025

Joyeuses fêtes de fin d'année 2025 🥳.

Le cabinet sera fermé du 24/12 à partir de 16h jusqu'au 04 janvier inclus.

Je vous souhaite mes meilleurs vœux!

Julien

05/12/2025

🚨 Alerte - News 🚨

Le grand saint Nicolas est passé au cabinet, dès aujourd'hui les traitements par ondes de chocs sont de nouveau disponibles.

Vous étiez nombreux à me l'avoir demandé, il est bien arrivé.

Bonne journée à tous et à bientôt.

Julien

05/11/2025

📣 NEW Consensus Statement 📄

🔍 Critical evidence synthesis on rehabilitation following arthroscopic shoulder stabilisation surgery for traumatic anterior instability

Consensus recommendations for clinical practice and research – commissioned by the British Elbow & Shoulder Society 💪

Article ➡️ https://bit.ly/4oDXSN6

03/10/2025

🥳 🇱🇺🇱🇺🇱🇺

🇱🇺 A historic moment in Luxembourg! 👑

From 3 to 5 October, the country celebrates the “Trounwiessel”, the accession of H.R.H. the Crown Prince Guillaume to the throne, following the abdication of H.R.H. the Grand Duke Henri. 📜

The Grand Duke is Luxembourg’s Head of State, a symbol of continuity, unity, and the country’s values both at home and abroad. 🌍

Here’s what’s on the programme:

– Official ceremonies in Luxembourg City (Friday)

– Public celebrations across the country (Saturday)

– A solemn Te Deum at Notre-Dame Cathedral (Sunday), broadcast on TV and online ⛪📺

A heartfelt thank you to TT.RR.HH. the Grand Duke Henri and the Grand Duchess Maria Teresa for their decades of dedication.

And our warmest wishes to TT.RR.HH. the Grand Duke Guillaume and the Grand Duchess Stéphanie as they begin this new chapter. ✨

👉 Which moment of the are you most looking forward to? 👇

🇱🇺 Moment historique au Luxembourg! 🇱🇺

Du 3 au 5 octobre, le pays vit le « Trounwiessel », l’accession de S.A.R. le Grand-Duc Héritier Guillaume au trône, après l’abdication de S.A.R. le Grand-Duc Henri. 📜

Le Grand-Duc est le chef d’État du Luxembourg, garant de la continuité, de l’unité et des valeurs du pays, tant au Luxembourg qu’à l’international. 🌍

Au programme :

– Cérémonies officielles à Luxembourg-Ville (vendredi)

– Grandes festivités publiques dans tout le pays (samedi)

– Te Deum solennel à la Cathédrale Notre-Dame (dimanche), retransmis à la télévision et en ligne. ⛪📺

Un grand merci à LL.AA.RR. le Grand-Duc Henri et la Grande-Duchesse Maria Teresa pour leurs décennies d’engagement.

Nos vœux les plus chaleureux accompagnent LL.AA.RR. le Grand-Duc Guillaume et la Grande-Duchesse Stéphanie à l’aube de ce nouveau chapitre. ✨

👉 Quel moment du attendez-vous le plus ? 👇



luxembourg.lu - the Grand Duchy's portal, Cour Grand-Ducale, Visit Luxembourg

📸: © Maison du Grand-Duc | Kary Barthelmey and Christian Aschman

03/10/2025

https://www.facebook.com/share/p/17Ay8jqt5Y/

Six Clinically Recognizable Pain Distribution Patterns in Lumbar Spinal Stenosis

■ 🧩 Overview

Based on a study of 2,379 patients with lumbar spinal stenosis (LSS) presenting to a secondary spine center in Denmark, six clinically recognizable pain distribution patterns were identified using digital pain diagrams.

These findings highlight that heterogeneous pain presentations are common in people with LSS and that pain distribution is often more complex than the "textbook" presentations of central or lateral stenosis.

■ 🔹 Class 1: Bilateral posterior leg pain

This pattern was present in 11.4% of the patients (n=272).

It represents pain located in the back of both legs.

This distribution is often considered a "textbook" LSS pain pattern associated with central canal stenosis, where multiple nerve roots are involved.

■ 🔹 Class 2: Bilateral posterior and anterior leg pain

This pattern was identified in 8.7% of patients (n=207).

It involves pain in both the front and back of both legs.

The presence of anterior leg pain in a bilateral pattern illustrates a more complex pain presentation than is typically described.

■ 🔹 Class 3: Unilateral posterior leg pain

This was the most common pattern, found in 26.1% of the patients (n=620).

This class describes pain in the back of a single leg and is often associated with lateral stenosis affecting a single nerve root.

The researchers specifically distinguished this class from Class 4 to highlight the difference between unilateral posterior leg pain with and without a focus on low back pain.

■ 🔹 Class 4: Unilateral posterior leg pain with low back pain

This pattern accounted for 21.0% of the patient sample (n=499).

While other classes also included patients with back pain, this class was named to specifically highlight the combination of unilateral posterior leg pain and low back pain.

Patients in this group reported slightly lower mean leg pain scores compared to the other classes.

■ 🔹 Class 5: Unilateral anterior and posterior leg pain

This pattern was identified in 22.9% of patients (n=545).

It describes pain in both the front and back of a single leg.

The study notes that the proportion of patients with this pattern was greater than the combined proportion of patients with both types of bilateral leg pain (Class 1 and Class 2), underscoring the significant heterogeneity in LSS pain presentations.

■ 🔹 Class 6: Multisite pain

This pattern was found in 9.9% of patients (n=236).

This class had a higher proportion of females (58.9%) than other groups.

Patients in this group also reported slightly greater social isolation scores and were more likely to have experienced pain for more than 12 months.

The identification of this pattern may help clinicians differentiate LSS from other conditions, such as multi-joint osteoarthritis.

■ 🩺 Clinical Relevance

These identified pain distribution patterns may represent clinical LSS phenotypes that could help improve diagnosis, patient-clinician communication, and treatment decisions.

-----------------

⚠️Disclaimer: Sharing a study or a part of it is NOT an endorsement. Please read the original article and evaluate critically.⚠️

Link to Article 👇

03/09/2025

😍 Great illustration of the neurological examination of the upper extremity according to Miller & Thompson

📘 Reference: Thompson, Stephen R., and Mark D. Miller, eds.
Miller's Review of Orthopaedics E-Book. Elsevier Health Sciences, 2025, https://www.eu.elsevierhealth.com/millers-review-of-orthopaedics-9780443112140.html

02/07/2025

Bonjour à toutes et tous,

‼️Le cabinet de kinésithérapie De Nève Julien sera fermé du 28/07 au 11/08 inclus.‼️

Je vous souhaite d'ores et déjà de bonne vacance 2025. ⛱☀️

En ce jour de canicule, n'hésitez pas à bien vous hydrater. 🍹🧉

Julien

23/06/2025

🇱🇺 Joyeuse fête nationale à toutes et tous 🥳🇱🇺

29/05/2025

⚠️Article du Républicain Lorrain du 29/05/25 sur la pratique de la microkinésithérapie⚠️

Bien que largement répandue dans notre région, la microkinésithérapie n'a pas de lien direct avec notre profession !

D'une manière générale, toute pratique ne faisant pas partie de notre décret de compétences ne peut être mise au compte de l'assurance maladie dans le cadre d'une séance de rééducation.

L'information précise donnée au patient (acte non remboursable...) et son consentement clair sur toutes ces techniques hors nomenclatures sont primordiaux pour vous prémunir de poursuites.

12/05/2025

Hot off the Press 🔥

An International Consensus on the Etiology, Risk Factors, Diagnosis, and Management for Individuals with Frozen Shoulder: A Delphi Study 📑

Background and Objective: 🌟

Frozen shoulder (FS) is frequently characterized by chronic inflammation and fibrosis of the glenohumeral joint (https://pubmed.ncbi.nlm.nih.gov/17673588/). The term ‘FS’ was first introduced by Earnest Codman in 1934 to emphasize the debilitating loss of shoulder range of motion (ROM) in patients afflicted with this condition. Codman described this condition as ‘difficult to define, difficult to treat and difficult to explain from the point of view of pathology’ (https://pubmed.ncbi.nlm.nih.gov/2182257/).

Much of Codman’s sentiments around FS remain true today. Frozen shoulders are classified as primary or secondary, where primary FS is idiopathic and secondary FS is associated with a systemic disease such as diabetes (secondary systemic FS), following breast surgery or ipsilateral clavicular, humeral or scapular fracture (secondary extrinsic),or history of surgery (secondary iatrogenic FS).

📘 A brand-new Delphi study by aimed to establish an international, multiprofessional consensus on the etiology, risk factors, diagnosis, and management of FS to guide clinical practice and future research. 🩺 (https://pubmed.ncbi.nlm.nih.gov/40042389/)

Methods: 🔍

The study employed a three-round Delphi process (January to March 2024) involving 14 international experts (12 physiotherapists, 1 orthopedic surgeon, 1 physiatrist) from five countries. 🌐 A steering committee developed survey questions based on recent literature, covering etiology, risk factors (biophysical and psychosocial), diagnosis, and management. 📝 Consensus was set at ≥80% agreement, with 79% considered due to near-threshold responses. Surveys used a Likert scale and open-ended feedback, with 117, 101, and 59 questions in rounds 1, 2, and 3, respectively.

The study adhered to ACCORD guidelines for Delphi reporting. ✅

Results: 🎉

Consensus was reached on 101 items across four key areas:

Etiology (9 items): 🧬

Secondary FS is associated with diabetes mellitus, trauma, shoulder arthroscopy, thyroid disease, prolonged immobilization, adrenocorticotropic hormone deficiency, metabolic syndrome, connective tissue disorders, and hyperlipidemia. 🩺

Risk Factors (40 items): ⚠️

💡Biophysical factors (e.g., diabetes, thyroid disease, female s*x, menopause, contralateral FS history, hyperlipidemia, metabolic syndrome) were deemed more influential than psychosocial factors in FS development.

Biophysical factors like diabetes, thyroid disease, ipsilateral FS, and Parkinson’s disease impact management and outcomes. 🧠

Psychosocial factors (e.g., depression, anxiety, fear-avoidance, cultural views, self-efficacy, mental stress) influence management and outcomes but not FS development. 😔

Diagnosis (19 items): 🩻

FS diagnosis requires ruling out competing conditions (e.g., osteoarthritis, muscle guarding) but not necessarily rotator cuff tears or bursitis. 🚫

Key signs/symptoms include night pain, pain with rapid movements, discomfort lying on the affected shoulder, pain at end-range, age >35 years, global loss of active/passive range of motion (ROM), and reduced external rotation (decreased passive external rotation greater than active and decreased external rotation with increasing abduction). 😖

Management (33 items): 💉

FS does not resolve equally without treatment. 🚫

Early phase (pain > stiffness): Effective interventions include corticosteroid injections, patient education, and reassurance. 👍 Ineffective treatments include massage, surgery, immobilization, heat, ice, electrical stimulation, ultrasound, hydrodilatation, and manual therapy. 🙅‍♂️

Later phase (stiffness > pain): Effective treatments include surgery (capsular lysis/manipulation under anesthesia), hydrodilatation, manual therapy, and education/reassurance. 🙌 Ineffective treatments include massage, acupuncture, immobilization, ice, electrical stimulation, and ultrasound. 🚫

General recovery aids include provider education, initial evaluation, exercise plans, medication, hydrodilatation, follow-up ability, and reassurance of no sinister pathology. 🥳

Imaging is not effective for recovery. 📷🚫

Discussion: 🗣️

The study aligns with existing literature, confirming diabetes, trauma, and metabolic conditions as key secondary FS etiologies.

📚 Biophysical risk factors dominate FS development, while psychosocial factors influence management and outcomes.

Diagnosis relies on clinical examination, with specific signs/symptoms guiding identification.

🩺 Management varies by FS stage, with tailored interventions improving outcomes.

The consensus highlights the lack of recent, high-quality CPGs, with only two outdated guidelines available. 😕

Strengths and Limitations: 💪❓

Strengths: High response rate (100% after round 1), international expert input, and relevance due to outdated CPGs. 🌟

Limitations: Predominance of physiotherapists may bias results, and findings reflect expert opinion, not direct evidence of intervention effectiveness. 🤔

Conclusion: 🎯

This consensus provides a foundation for understanding FS etiology, risk factors, diagnosis, and stage-specific management, addressing gaps in current CPGs. 🏗️ It emphasizes biophysical factors, clinical diagnosis, and tailored interventions. Future research should explore precision-based approaches to optimize FS management. 🚀