Membres ISSUL FBM

Gremeaux Vincent

Coordonnées Recherches Enseignements Publications

Axes de recherche

Analyse des résultat des injections de PRP dans la gonarthrose en fonction du taux de concentration plaquettaire
L'arthrose représente un enjeu médico-économique majeur compte tenu du handicap croissant qu'elle entraîne et de sa forte prévalence dans la population générale. Elle concerne des sujets âgés, mais aussi des personnes jeunes développant des atteintes post-traumatisme sportif, ou des sujets avançant en âge mais qui souhaite garder une activité physique ou sportive conséquente, qu'elle limite de façon importante. Actuellement, les thérapeutiques médicamenteuses restent purement symptomatiques, avec comme objectif de diminuer le retentissement fonctionnel et la douleur car aucune d'entre elles n'a réussi à démontrer des effets chondroprotecteurs cliniquement pertinents.

Les concentrés plasmatiques riches en plaquettes ou platelet-rich plasma (PRP) ont bénéficié ces dernières années d'un large essor dans le domaine musculo-squelettique, notamment en médecine du sport et en orthopédie. Il s'agit de concentrés autologues enrichis en plaquettes qui ont la capacité de libérer après activation exogène de très nombreux médiateurs et facteurs de croissance.

Dans la gonarthrose, la majorité des essais randomisés semblent en faveur d'un bénéfice symptomatique supérieur à la viscosupplémentation, surtout dans les stades précoces de la maladie et uniquement sur des données à moyen terme. Il reste cependant de nombreuses incertitudes sur le protocole d'injection à utiliser, probablement en raison de l'hétérogénéité des produits. Ce produit est en général obtenu après centrifugation, en utilisant des kits prêts à l'emploi commercialisé par des laboratoires pharmaceutiques, aboutissant à des taux de concentration variable en fonction du kit. Actuellement, le service de médecine du sport utilise un produit obtenu grâce au centre de production cellulaire, permettant une traçabilité à postériori du taux de concentration

Le but de ce projet est d'analyser les résultats cliniques de ces injections en fonction du taux de concentration plaquettaire mesuré chez les patients traités dans le service de médecine du sport



SMARTSWIM
Sports biomechanics is a rapidly progressing field, attracting more and more attention from coaches and both amateur and professional athletes. Swimming is considered as one of the best exercise to keep or improve health and fitness, thus drawing a growing attention. However, because of technical issues regarding the use of measure instruments in water, swimming remains poorly studied, and lots of unknown parameters are yet to be better depict for promoting the performance of swimmers, while promoting health. The main goal of this project is the design and implementation of an objective assessment wearable system (Smart Swim) to study swimming kinetic, kinematics and energy expenditure , helping both coaches and swimmers to promote faster and safer exercise. Wearable inertial measurement unit (IMU) is a powerful tool to monitor field performance of a person while practicing sports. Using these sensors, the final measurement package is going to be portable, waterproof and minimally obtrusiv e, and the measurements will be completely non-invasive. In order to develop the basic algorithms for this measurement system, we need to test a number of swimmers and extract their body segments motion signals using IMU sensors, while they are performing their usual sports activity and training. In the first phase, we will focus on automatic detection of different phases of swimming, including wall push-off, gliding, free-swimming and turn for all swimming styles. We will then go deep through each of these phases and extract meaningful parameters afterwards.



Indirect monitoring of autonomic regulation through heart rate variability: justification and clinical applications of a systemic approach
To perform, athletes must find the adequate balance between training, competitions and recovery, in addition to other life demands. Fatigue and recovery are assessed by physiological and psychological measures. A popular method for quantitative and qualitative recovery assessment is heart rate variability analysis (HRV), which provides an indirect evaluation of HR control by the autonomic nervous system (ANS). Monitoring vagal-derived indices of HRV brings key information on athletes fatigue status and permits to characterize different fatigue types. Support staff can propose different modalities to influence neurovegetative balance and thus recovery. This method is currently used in high-level athletes to monitor their fatigue status and optimize training schedule. Sports physicians have a key role in athletes' health/performance management plan and are mainly responsible of the methods implemented in athletes' monitoring daily routines. Consequently, investigating effects of different remediations on fatigue is important to better advise their athletes/patients. Purpose of the project is to anchor the method in a sport and exercise medicine unit. It first aims to analyze short-term HRV. Second aim is to analyze acute and chronic effects of different methods intended to modify people's cardiac autonomic state. Last aim is to present intellectual process of HRV monitoring in particular individuals. It would permit to argue for specific remediations proposal in real-life clinical cases. Pr Gremeaux is a PhD thesis co-director for sport scientist Cyril Besson (Msc sports sciences). Cyril Besson is working on heart rate recovery (HRV). Master projects are created to support current projects so as to allow students to familiarize themselves with various laboratory techniques, to carry out a study which will be of contribution to the current project and above all to learn how to approach a research project. The projects may be organized to pursue an MD-PhD.

Optimal training load estimation using personalized physical profile
Overtraining, an important risk factor for injuries

in athletes is the consequence of inappropriate and excessive

training load (TL).

The overarching goal of this project is to design a framework

to estimate optimal load for producing positive adaptation to

training and avoid overtraining. The implementation of this

framework will be based on the use of wearable sensors,

and development of algorithms to instrument functional tests,

estimate the quality of training and influence of fatigue on

it, monitor internal load from non-sport exercises, and predict

external load. Algorithm for instrumenting the sprint test have

been developed and tested, and work is underway on the

estimation of 'quality' through marathon measurements and

a systematic review on fatigue

Following key outcomes are expected from this work:

- Outlook and results from the systematic review on the

influence of fatigue on biosignals

- Development of a conceptual framework to measure the

quality of a training session and the influence of fatigue

- Instrumentation of a suite of functional tests, including

the T-test for agility, Sprint, Hop, and Y-balance tests

- Design and implementation of a wearable exercise

recognition system for monitoring training load

Development of a load estimation model based on the athlete's physical profile

Technologie de mesure de la transpiration portable pour un diagnostic personnalisé en temps réel et prévention
WeCare aims to provide a better understanding of sweat analysis for clinical diagnosis and preventive medicine.

WeCare will develop a new generation of non-invasive integrated wearable sweat biomonitoring platforms for personalized and preventive medicine, suitable for continuous assessment of an individual's health.

WeCare will focus primarily on fitness diagnosis of athletes, with a novel flexible-microfluidic system that provide information from the multiparametric measurements of a complete set of biosensors.

The development of such technology will permit significant advances to the basic understanding of the dynamics and significance of the biological information carried in sweat, and the development of inexpensive models for a personalized evaluation of human performance and health in sport. Beyond that, the knowledge gained in the project will allow physicians and patients to perform continuous health assessment with a non-invasive method and to prevent medical complications.

In order to achieve maximum impact, WeCare brings together the Institute of Neuroinformatics UZH, a worldwide famous group in Deep Neural Networks; EPFL-LMTS, an academic leader of printed and soft microsystems in Switzerland, and the Swiss Olympic Medical Center based in the Sports Medicine Center of the CHUV, the Instituto de Microelectrónica de Barcelona (IMB-CSIC), a reference European micro and nano-technology facility for the design, integration and characterization of biochemical smart systems.

The ultimate goal of WeCare is to construct truly personalized models of physiological states in sports practice in order to elaborate customized treatment and workout plans by use of the developed cognitive biomonitoring technology. To achieve this goal, Wecare will develop a new generation of cost-effective, cognitive and wearable devices for continuous biomonitoring of sweat.


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