Clinical trials

This study aims to describe the medical, social, and organizational determinants of returning to work after an osteoarticular injury, particularly limb fractures. Using observational data, the study will evaluate the modalities of returning to work within 12 months of the injury and analyze the factors influencing professional reintegration, including the severity of the injury, functional recovery, pain, professional characteristics, workplace accommodations, and administrative support measures such as recognition of disabled worker status. The study will also explore the point at which the issue of returning to work is first raised with the patient during hospitalization, a period during which professional reintegration is often insufficiently anticipated. By identifying current practices and breaking points, this study aims to improve understanding of the pathways to returning to work in the context of the healthcare system and the world of work in France.

This observational study aims to assess the presence of neuropathic pain in children and adolescents who underwent limb amputation during childhood. The study focuses on two types of neuropathic pain: phantom limb pain and residual limb pain. It also evaluates quality of life and functional autonomy in this population and explores potential associations between neuropathic pain, autonomy, quality of life, and age at amputation. Using a mixed retrospective and prospective design, data are collected from medical records and standardized questionnaires administered during routine follow-up visits at a specialized pediatric limb anomaly center. The study seeks to improve understanding of neuropathic pain after pediatric amputation and its impact on daily functioning.

The ETICHOFFA study is a clinical research project aiming to improve the diagnosis of Infrapatellar fat pad impingement syndrome, a common source of anterior knee pain. Although MRI remains the gold standard for diagnosis, clinical testing strategies lack validation. This observational study has two main objectives: to assess the diagnostic accuracy of a cluster of standardized clinical provocation tests for IFP impingement compared to MRI findings, and to identify clinical and subjective characteristics associated with IFP involvement confirmed by imaging. This observational study will recruit 50 patients aged 18 to 70 years with anterior knee pain rated at least 3 out of 10 in intensity. Participants will complete a secure online questionnaire documenting symptoms, pain distribution, aggravating and relieving factors, and pain intensity at rest, during activity, and daily life. They will also complete three validated scales: the Anterior Knee Pain Scale (AKPS), the Knee injury and Osteoarthritis Outcome Score (KOOS), and the Tampa Scale for Kinesiophobia (TSK). A standardized clinical examination will be performed, including subpatellar skin temperature measurement, knee swelling assessment, passive range of motion testing, and a series of provocation tests targeting Hoffa's fat pad. Tests will be randomized to reduce bias and considered positive if they reproduce the patient's typical pain with an intensity of at least 2/10. Each participant must also undergo a standardized MRI of the knee within two weeks of the clinical assessment, interpreted blindly by an independent musculoskeletal radiologist. All data will be anonymized, stored securely, and analyzed using SPSS software. Diagnostic accuracy of clinical tests will be evaluated through sensitivity, specificity, predictive values, and likelihood ratios. Functional outcomes related to taping will also be analyzed. The study has received ethical approval and adheres to GDPR standards for data protection. Participation is voluntary, with the right to withdraw at any time. The ETICHOFFA study is expected to enhance clinical diagnostic pathways for anterior knee pain associated with Infrapatellar fat pad involvement.

The management of patients with longitudinal ulnar deficiency is a clinical challenge due to the rarity of this condition and the wide variety of its manifestations. In particular, there is no consensus in the literature on the indications for surgery. The aim of this research is to improve understanding and management of this malformation by analyzing existing data from patient medical follow-up. No new clinical evaluations or occupational therapy assessments will be performed specifically for this study. The analysis will be based on previous medical and paramedical data (consultation reports, imaging, occupational therapy assessments, etc.) in order to better describe the functional evolution of patients and identify the decision-making criteria that guide surgical management. Parents will also receive standardized questionnaires (PROMIS and ABILHAND-Kids-CP) to gather their perceptions of their child's quality of life and independence. The results will be used to propose recommendations for a more consistent and multidisciplinary assessment of longitudinal ulnar deficit in the future.

The goal of this replicated single case experimental study using a randomized multiple baseline design across participants and goals is to enable children/adolescents (aged 8-16 years) with developmental coordination disorders and/or executive function deficits following an acquired or congenital brain injury, to achieve their occupational goals. The aim is to make them more independents and autonomous in their daily lives. To achieve this, we're going to offer them an intensive group CO-OP (Cognitive Orientation to daily Occupational Performance Approach) rehabilitation training, and actively involving the parents. The main questions it aims to answer are: * To evaluate the improvement in occupational performance\* (and its maintenance over time) following intervention using the CO-OP Approach. \*Occupational performance is a person's ability to choose, organize and engage in meaningful occupations that give them satisfaction. These occupations, determined by culture and corresponding to their age group, enable them to take care of themselves, have fun and contribute to the social and economic fabric of the community. * To gather parents' experiences of supporting their child during the CO-OP intervention and its follow-up phase. Participants will be asked to identify 3 goals that they would like to achieve with the CO-OP Approach. The CO-OP intervention will take the form of two half-days a week for 5 weeks, with 1 hour 30 minutes of individual CO-OP sessions and 1 hour 30 minutes of group sessions.

Unilateral Spatial Neglect (USN) is a relatively common neuropsychological syndrome following stroke. It is characterized by difficulties in detecting, orienting and identifying events located in the hemispace contralateral to a brain lesion, unrelated to a primary motor or sensory disorder. Numerous methods have been developed for the rehabilitation of this syndrome. However, limitations in terms of efficacy are highlighted. These limitations may be linked to the fact that these methods are restricted to certain sensory modalities, thus failing to take into account the heterogeneity of the syndrome. Moreover, some patients' adherence to rehabilitation programs can also be complicated by motivational difficulties. Immersive Virtual Reality could help overcome these limitations. Indeed, it enables the introduction of new sensory modalities, notably auditory, to support a better apprehension of space. The main objective of this study is to determine the efficacy of an immersive virtual reality rehabilitation protocol based on musical practice in patients suffering from USN. This study also aims to explore the benefits of this rehabilitation protocol on patients' daily lives, as well as to explore the influence of patients' mood and motivation on the benefits of the immersive virtual reality rehabilitation protocol. To achieve these goals, patients will benefit from immersive virtual reality rehabilitation based on music practice. This rehabilitation will be compared to conventional USN rehabilitation. To this end, patients will be divided into two groups: classical rehabilitation only or classical rehabilitation and immersive virtual reality in parallel. Each patient will be randomly assigned to one of the two groups for a period of 2 weeks. Pre- and post-rehabilitation assessments will be provided.