EN SAVOIR PLUS SUR JOEL BARTHEJoël BARTHE is born in 1941
Studies of physiotherapy from 1961-1963 at Cours de Gymnastique Médicale et de Rééducation Fonctionnelle at l'Hôpital Necker Enfants Malades in Paris
Professional activity
•- in hospital.
« Hôpital Necker Enfants Malades » www.necker.fr
-1965: physiotherapist with Professeur Julien Marie and Professeur André Hennequet to take care of children affected by cystic fibrosis.
-1968: Creation of a department of physiotherapy respiratory pediatric.
-1970: Creation of a unit of physiotherapy respiratory independent for all hospitals.
•- Independently physiotherapists.
Office of physiotherapic specialized in respiratory physiotherapy in Paris
Research and developement.
The AFE (The Accelerated Exhalaison Flow)
40 years ago respiratory physiotherapy techniques, almost every where in the world were spread around by word of mouth. They were based upon intuitive compositions most of the time uncoordinated, even dangerous and without taking any account of progress within respiratory physiology.
According the merit of Joël Barthe who has searched for authors of different techniques within respiratory physiotherapy in order to understand their motivations and conclude to certain observations and contradictions.
The originality of Joël Barthe's techniques is based on the mathematical-physic comprehension of dynamic pressure of the fluids bronchic dynamic, appreciation of various flow (s) and of the rheology of bronchial secretions.
Each of these elements is based on indications, applications and limits.
The analysis of the different parameters led him to create a method called Increasing Respiratory Flow) The AFE was ratified by the meeting of consensus of Lyon 2000.
This should discredit archaic techniques like postural drainage, clapping and other different techniques.
The combination of these 3 elements mentioned above ( bronchial dynamic, the flows and the rheology of bronchial secretions) This clever techniques has allowed to adapt, according to the disability of every patient, to find the most adapted protocol for every ventilator cycle.
The main aim of this method is to find the air/liquid interface according to the
obstructed part, the flow and to find the distinction between laminar flow and turbulent flow (Number of Reynold).
With or without cooperation from his patient, the practitioner should find the compromise between
The bronchial dynamic until their collapsus.
The laminar or turbulent flows until zero.
The rheology of the bronchial secretions can be very thick when at the beginning of the séance and become much more fluid towards the end because of the released time which will make the secretions recover their initial viscosity.
The trigonometrically configuration of the thorax and his ventilatory muscles which are at the origin of the ventilation, but also of their tiredness. It's important to observe closely the tiredness of the ventilator muscles to avoid their exhaustion.
To permit the practitioner to validate his techniques there are certain elements.
As long as the patient expires he can be certain that a part of the bronchies is functional.
The noises transmitted to the mouth, by the passage of the air flow into the bronchies will make the practitioner able to find the optimal point where the secretions will be mobilized.
The technique of AFE, also called « Searching for the air liquid interface » has never been equivaled neither in conceptions nor in realizations. This technique, well understood and well applied, has allowed immediate improvement of obstructed patients, avoiding transfers to reanimation. Concerning bronchiolite the large diffusion of AFE has permitted the setting up of urgency networks in respiratory physiotherapy, avoiding unnecessary hospitalizations.
The Cystic fibrosis
An internal study at Necker Hospital in 1963 has showed that 32 children suffering from cystic fibrosis, diagnosed before the age of one year died before reaching the age of 5 years. After application of the AFE, in the 1990s treating children with cystic fibrosis, another study of 83 patients has showed a survival rate of 70% at 5 years with a life expectancy of 23 years.
Joël Barthe has conceived a "Barthebox" which explains the intrinsic lung mechanism mono and bi alveolar of the ..... (Box which explains the limits of the bronche dynamics function of external restraints (cough, l'AFE).
The observations, has permitted to follow a child suffering from cystic fibrosis who had been treated by chemotherapy for a cancer of the ischiojamb who has been healed. Joël Barthe has published this observation (The Lancet Vol 350 September 4, 1997 and XIII International Cystic Fibrosis Congress, Stockholm 4-8 Jun 2000).
Today we should (a therapy should be settled for the damages caused by chemotherapy.)
Concerning kidney transplants.
In absence of respiratory physiotherapy the risks of ventilation troubles are almost constantly accumns. The respiratory complications are avoided for this type of transplantations by instauring RP.
Giant omphalocele
A good understanding of the mechanisms of omphalocèles has allowed for the patients traited a recovery through surgery and physiotherapy in almost every case.
The associations
Fonder and Chairman of the Association Française pour l'Etude la Recherche et la Prévention en Kinésithérapie Respiratoire et Cardio-Vasculaire (AFERPKRCV) http://www.aferpkrcv.org/
Fonder and past chairman the Société Européenne de Kinésithérapie Respiratoire et Cardio-Vasculaire. (European Society of respiratory physiotherapy)
Member of the Cystic-Fibrosis International Group in Physiotherapy.
The professional training of french and foreign physical therapist (17 countries)
Creation of 2 university diplomas in continued formation of specialization in .
- Lung physiotherapy.
- Pediatric physiotherapy.
Creation of a department of continuing education within the AFERPKRCV
Congresses, Conferences
The french physiotherapy has been introduced all over the world by more than 200 communications
Communications
October 1986 « European Society of Respiratory and Cardiovascular physiotherapy » Stresa
(Italy): Indications and contraindications of chest physiotherapy techniques.
September 1985 "4th Congress Bronchitis and emphysema" Milano (Italia): Ventilatory
dynamics in the pulmonary disabled patient.
Induction by antitumoral drugs of proteins that functionally complement CFTR: a new
therapy for cystic fibrosis? The Lancet September 1997.
Juin 1991 « Congrès International de Pneumologie « Montréal (Canada) :- inquiry concerning
Respiratory assistance at home in France - approach of the reasons of the disparity of the results of the retraining at effort concerning chronical respiratory insuffiency
Educating the thracheomised patient to be able to do his own personnel physiotherapy.
June 2000 13 the International Cystic Fibrosis Congress. Stockholm: Discovery of a new
treatment for cystic fibrosis through physical therapy.
Insight into cystic fibrosis by structural modelling of CFTR first nucleotide binding fold .
Académie des Sciences Paris 1997.
Publications to come.
Differential diagnosis between asthma and "bronchiolite" by electronic measure of the maximal expiratory flow and the maximal expiratory volume which is called "Baby EFR"
Disposable nappies could cause perturbations of the lower part of oesophageal and lead to a reflux gastric and oseophageal.
œsophage et entraîneraient elles un Reflux Gastro Œsophagien ? (RGO)
Titres.
Responsible of the unit of respiratory physiotherapy at « Hospital Necker EM ».
Editor in chief of the « Cahiers de kinésithérapie »
Price winner of the « incitation of research »
Price winner of the « Grand Prix Editorial de la press medical »
Membre du grand jury d'attribution de la Main d'Or.
Editor in chief of many books of physiotherapy
Price winner of the « Grand Prix Editorial de la presse medicale »
Enseignement.
In France: In several physiotherapy schools in France and in Caribbean Islands.
In managerial schools physiotherapy
Consultant in Europe, Australia, Brazil, Canada, USA, Lebanon, Israel... for the creation and installation of many models applied in France for promotion of the respiratory physiotherapy.
Dans la même catégorie
EN SAVOIR PLUS SUR JOEL BARTHE
