HDR defense of Caroline Massot (SHV department)

• Pr Jacquin Courtois Sophie (Lyon) : rapporteur
• Pr Bertucci William (Reims) : rapporteur
• Pr Van Sint Jan Serge (Brussels) : rapporteur
• Pr Vukusic Sandra (Lyon) : examiner
• Pr Chèze Laurence (Lyon) : examiner
• Pr Hautecoeur Patrick (Lille): guest
• Pr Barbier Franck (Valenciennes): invited
• Pr Leteneur Sébastien (Valenciennes) : director
• Pr Simoneau Emilie (Valenciennes) : director

During my medical training in physical medicine and rehabilitation, I completed a PhD thesis in biomechanics at the Université Polytechnique Hauts-de-France, defended in 2021. This work has enabled me, with the position of Maitre de Conférences des Universités et Praticien Hospitalier and as an associate researcher in the Sciences de L'Homme et du Vivant (SHV) department of the Laboratoire d'Automatique, de Mécanique et d'Informatique industrielle et Humaine (LAMIH UMR-CNRS 8201), to develop my research activities.

In my clinical practice, I'm often confronted with issues expressed by patients, particularly those with Multiple Sclerosis (MS), but also by clinicians themselves.

In the context of a neurodegenerative pathology such as MS, certain symptoms such as locomotor disorders are not visible at the onset of the disease, even though they impact on patients' quality of life. Their management as a physical medicine and rehabilitation physician is therefore a priority.

The contribution of biomechanics is helping to remove many of the scientific barriers to addressing these clinical issues. It enables the screening, assessment and monitoring of invisible locomotor disorders to enable the implementation of adapted, personalized and early rehabilitation management for MS patients. I have made this my general research theme.

However, the use of biomechanics is restricted to the quantified movement analysis laboratory. Transposing the acquisition and use of biomechanics from the laboratory to the day-to-day clinic requires interconnection between the various academic research teams such as the CNRS and clinical.

This is why I have made it my general research theme.

However, the use of biomechanics is restricted to the quantified movement analysis laboratory.

The aim of this Habilitation à Diriger des Recherches is to propose an assessment of my research, teaching and clinical actions, and then to present my perspectives in these fields. The main thrust of my work is to demonstrate the value of biomechanical tools and analyses in detecting and characterizing locomotor disorders, ensuring objective follow-up and proposing early and specific rehabilitation treatment for MS patients. This manuscript is composed of 3 parts.

The first part presents my curriculum vitae and details my training and professional background as well as my various scientific, teaching and clinical activities. In particular, I detail my scientific production (19 articles published in international journals with an impact factor, 2 articles published in national journals, 26 oral communications at congresses and 22 poster communications), co-supervised theses (2 in progress), research projects (including 6 as principal investigator on 10 projects, responsible for the health data warehouse), teaching and clinical.

The first part presents my curriculum vitae and details my various scientific, teaching and clinical activities.

As part of this work and with the aim of fostering the link between academic researchers and clinical researchers, I worked on setting up the agreement between UPHF, the Groupement de l'Institut Catholique de Lille and the Faculté de Médecine, Maïeutique, Sciences et Santé. I also co-founded, with Pr Lenne, a Neurethic Lab mixed research team within the ETHICS laboratory of L'Université Catholique de Lille combining academic researchers and clinicians.

The second part of the manuscript aims to offer a synthesis of my research work across several themes:

• Characterization of biomechanical markers of the deterioration of locomotor disorders in MS patients and transfer to routine clinical practice
• Rehabilitation of locomotor and respiratory disorders in MS
• Health innovations: development of screening and management tools for locomotor disorders
• Comorbidities and MS: the importance of diagnosis and management

Each of these themes is based on issues exposed by patients or clinicians, enabling the setting up of a specific clinical research study.

The third part of the manuscript allows us to present research perspectives to improve the dissemination of knowledge and its application in routine clinical practice with the aim of improving patient care.

Firstly, it is necessary to develop technological innovations for the detection and rehabilitation of invisible locomotor disorders in MS patients.

Then, in a second step, I put forward the interest of a segmental approach as a complement to a whole-body approach. Indeed this would enable us to remove several clinical obstacles thanks to the contribution of biomechanics.

Finally, this manuscript presents various perspectives to ensure the dissemination of knowledge and practices to other clinical research centers and to patients.