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Concept

Soins ambulatoires

Résumé

Des soins ambulatoires sont des soins donnant lieu à une prise en charge médicale ou dans un service de santé d'un patient sans hospitalisation ou pour une durée de quelques heures. Par exemple, une prise en charge ambulatoire, à l'opposé d'une hospitalisation traditionnelle, permet de diagnostiquer, de traiter, de suivre un patient sans que celui-ci soit hospitalisé. Il peut ainsi dormir chez lui, garder ses habitudes et éventuellement continuer son travail. Une chirurgie ambulatoire est un geste chirurgical qui se fait dans la journée, et qui ne nécessite pas que le patient passe la nuit à l'hôpital (exemple : traitement de la cataracte). En psychiatrie, un suivi en ambulatoire signifie que le patient consulte le psychiatre à son cabinet en ville ou à l'hôpital, en dehors de tout cadre d'hospitalisation sous contrainte. Annexes Articles connexes

Association française de pédiatrie ambulatoire
Score de Chung

Liens externes *

Source officielle

https://fr.wikipedia.org/wiki/Soins_ambulatoires

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The physical activity in normal daily life is determined to a large extent by the functional ability of a subject. As a result, the measurement of the physical activity that a subject performs spontaneously could be a useful and objective measurement of disability, particularly in patients with disease-related functional impairment. The aim of this study is to provide an accurate method for the measurement and analysis of the physical activity under normal life conditions. Using three kinematical sensors strapped to the body, both the posture and the gait parameters can be assessed qualitatively and quantitatively. A detailed description of the algorithms used to analyse both the posture and the gait are presented in this paper. Two methods, based on different sensor configurations and signal processing, are proposed for the detection of sitting and standing postures (Methods P1 and P2). Two other methods are used for the quantitative assessment of walking (Methods W1 and W2). The performance of the algorithms (expressed in terms of sensitivity, specificity and error) is based on the comparison of data recorded simultaneously by a non-interfering observer (reference data) with the data provided by the recording system (21 patients, 61 h). Sensitivity and specificity are respectively 98.2% and 98.8% (P1), 97.8% and 98.1% (P2) for sitting; 98.0% and 98.5% (P1), 97.4% and 97.8% (P2) for standing; 97.1% and 97.9% (W1), 92.4% and 94.9% (W2) for walking; and finally, 99.2% and 98.6% for lying. Overall detection errors (as a percent of range) are as follows: 1.15% (P1) and 1.20% (P2) for sitting, 1.36% (P1) and 1.40% (P2) for standing, 1.20% (W1) and 1.60% (W2) for walking and 0.40% for lying. The error for the estimated walking distance and the speed is 6.8% and 9.6%, respectively. We conclude that both methods can be used for the accurate measurement of the basic physical activity in normal daily life. Measurements performed before and after the delivery of a treatment can therefore provide information of unprecedented accuracy and objectivity on the ability of a procedure, in this case spinal cord stimulation, to restore functional capabilities. (C) 2003 Elsevier B.V. All rights reserved.

2004

Chargement

There is a growing interest in the role played by attention and cognitive processing in the control of posture and gait, investigated by means of dual task methodology. The rationale for dual task testing is to assess whether the simultaneous performance of two (or more) attention- demanding tasks exceed the central information-processing capacity. Recently, we proposed a new ambulatory system for gait analysis (Physilog®) and validated its performances in studying normal and abnormal walking [1]. This system measures temporal and spatial parameters of gait during long period of walking and therefore provides stride-to- stride variability of these parameters. In this pilot study, we used the Physilog® system to assess, under both single and dual task conditions, gait changes in 6 elderly subjects after a ten- weeks balance training program. Our objective was to determine whether dual task testing would be more sensitive than single task testing in detecting gait improvement in these elderly persons

2003

Chargement

An ambulatory system for quantification of tremor and bradykinesia in patients with Parkinson's disease (PD) is presented. To record movements of the upper extremities, a sensing units which included miniature gyroscopes, has been fixed to each of the forearms. An algorithm to detect and quantify tremor and another algorithm to quantify bradykinesia have been proposed and validated. Two clinical studies have been performed. In the first study, 10 PD patients and 10 control subjects participated in a 45-min protocol of 17 typical daily activities. The algorithm for tremor detection showed an overall sensitivity of 99.5% and a specificity of 94.2% in comparison to a video reference. The estimated tremor amplitude showed a high correlation to the Unified Parkinson's Disease Rating Scale (UPDRS) tremor subscore (e.g.,

{rm r} = 0.87

{rm p} < 0.001

for the roll axis). There was a high and significant correlation between the estimated bradykinesia related parameters estimated for the whole period of measurement and respective UPDRS subscore (e.g.,

{rm r} =-0.83

{rm p} < 0.001

for the roll axis). In the second study, movements of upper extremities of 11 PD patients were recorded for periods of 35 hr. The patients were moving freely during the measurements. The effects of selection of window size used to calculate tremor and bradykinesia related parameters on the correlation between UPDRS and these parameters were studied. By selecting a window similar to the period of the first study, similar correlations were obtained. Moreover, one of the bradykinesia related parameters showed significant correlation (

{rm r} = -0.74

{rm p} < 0.01

) to UPDRS with window sizes as short as 5 min. Our study provides evidence that objective, accurate and simultaneous assessment of tremor and bradykinesia can be achieved in free moving PD patients during their daily activities.

2007

Chargement

, ,

2004

{rm r} = 0.87

{rm p} < 0.001

{rm r} =-0.83

{rm p} < 0.001

{rm r} = -0.74

{rm p} < 0.01

2007