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Master Thesis

L’examen postural améliore la prise en charge en soins premiers des douleurs d’origine musculo-squelettique et ostéo-articulaire. revue narrative de la littérature

Abstract : Introduction: musculoskeletal and osteoarticular pains constitute the most common reason for primary care consultations. These chronic pains, disabling, sometimes of unidentified aetiology, are particularly complex to manage. The interest of postural examination has been reviewed in this specific context. Objective: to identify and analyze the postural examination in the handling of musculoskeletal and osteoarticular pain in primary care, based on a narrative medical literature review. Method: based on PRISMA guidelines, narrative review of literature published between 1985 and 2017, available on following databases: PUBMED, COCHRANE, SUDOC, ScienceDirect, SPORTDiscus, EMC-Consulte, HAL, Revue Exercer, Revue Prescrire, BIUS, HAS, SFMG, INSERM, INPES, AMELI, Revue du praticien, grey literature. Results: 206 articles on postural analysis were included. 5 articles were devoted to general practice, 42 to neck pain, 60 to back pain and low back pain, 36 to arthralgia, 53 articles to temporomandibular joint pain and 10 articles to musculoskeletal disorders. The postural analysis of the various pains explored was systematic: classic anamnesis, use of validated and specialized questionnaires, a stabilometric analysis, associated with a photographic or radiographic analysis. It was occasionally completed by electromyography and a review of the podal and visual entrance. A relationship between postural abnormalities and explored pain has been found, making the postural examination complementary to conventional approaches. Conclusion: despite a limited degree of evidence proof in these studies, there is an overall agreement in favour of searching a postural disorder in patients with chronic common spinal pain, temporomandibular joint dysfunction, ankle sprains, or musculoskeletal disorders, since these patients presents common clinical characteristics. It’s also interesting to combine postural reeducation with conventional reeducation for osteoarticular and musculoskeletal pain in primary cares. The use of postural approach comes with a multidisciplinary organization. Clinical evaluation of postural examination must be carried on to specify its best indications.
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Master Thesis
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Caroline Boutin. L’examen postural améliore la prise en charge en soins premiers des douleurs d’origine musculo-squelettique et ostéo-articulaire. revue narrative de la littérature. Médecine humaine et pathologie. 2019. ⟨dumas-02586213⟩



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