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How physical activity level for patients with knee osteoarthritis. Epidemiological study on spa therapy
Annals of Physical and Rehabilitation Medicine 58S (2015) e99–e102
Available online at
ScienceDirect www.sciencedirect.com
Exercise and physical activity Oral communications Disclosure of interest The authors have not supplied their declaration of conflict of interest. CO25-001-e
http://dx.doi.org/10.1016/j.rehab.2015.07.227
Isokinetic adaptations of knee extensors and flexors after aerobic walk training in old sedentary women
CO25-002-e
P.L. Bernard (Dr)a,*, G. Tallon (Dr)a, G. Ninot (Prof)b, A. Jaussent c, O. Costes (Dr)d, S. Ramdani (Dr)a, M.C. Picot c, H. Blain (Prof)e a UFR APS. Euromov M2H, Montpellier, France b UFR APS, Epsylon c CHU de Montpellier, DIM d DRJSCS Montpellier e CHU de Montpellier, poˆle ge´rontologique A. Balmes *Corresponding author. E-mail address: [email protected] (P. L. Bernard) Introduction We examined the effects of active walk training 3 days per week, for 24 weeks on isokinetic peak torque (PT) and mean power (MP) of the knee extensors and flexors of osteopenic sedentary old women. Methods The population was composed by 121 women (65.5 4.2 years) with 5.3 ( 1.7) to the Physical Activity Scale for the Elderly (PASE) and 86% of the theoretical distance of the 6-minute walk test (6MWT). The women were eligible to participate if they had no medical contraindication and were not diagnosed with major motor and neurocognitive dysfunctions. The isokinetic performance of the knee extensors and flexors in both limbs was measured on Biodex System 3W in concentric/concentric condition on 808 range of motion. The experimental protocol consisted in 5 maximal effort performed at 608/sec, 60 second of rest interval and 5 maximal effort at 1808/sec. After 5 minutes of rest, identical paradigm was performed on contro-lateral side. Experimental group performed aerobic walk training: (1) between 60 and 80% of maximal heart rate; (2) with a distance between 1500 to 4500 meters at the end of the training; (3) with a total time effort between 25 to 45 minutes at the end of the training. Results Our results showed significant increase of PT of hamstring in dominant side at 1808/sec (p < 0.01). We observed significant differences in the experimental group for the hamstring at 608/sec for the dominant side (p < 0.02) and the no-dominant side (p < 0.01). For MP, no interaction was observed between groups and time. For the hamstring, we observed significant increase in the experimental group at 608/sec on the no-dominant side (p < 0.05). Discussion Our results indicate a moderate effects of the aerobic walk training performed during 6 months on the peak torque and the mean power of isokinetic knee extensors and flexors in old sedentary women.
1877-0657/
How physical activity level for patients with knee osteoarthritis. Epidemiological study on spa therapy C. Gay a,*, L. Gerbaud (Prof)b, C. Auclair b, C. Mourgues b, E. Coudeyre (Prof)c a CHU Clermont-Ferrand, universite´ d’Auvergne, Clermont-Ferrand, France b CHU, service de sante´ publique, Clermont-Ferrand c CHU, service de me´decine et de re´adaptation, universite´ d’Auvergne, Clermont-Ferrand *Corresponding author. E-mail address: [email protected] (C. Gay) Objective To describe the level and perception of the physical activity for patients with knee osteoarthritis in 9 spa resorts Method Five hundred and forty-eight patients (548) with knee osteoarthritis were interviewed by self-answered questionnaires. Physical activity level was evaluated by the International Physical Activity Questionnaire Short version (IPAQ) [1] and perception of physical activity by a new questionnaire (EPAP) based on a preliminary qualitative study. Re´sults The mean age of study population is 67.6 ( 7.9) years, whose 73.9% women and 30.9% are obese with a mean BMI of 28.2 ( 5.7). The subgroups analysis according to the 4 phenotypes described by the OARSI [2] shows that 92% patients are multi-joint osteoarthritis, 61% with comorbidities. Mean pain intensity on VAS is 4.5/10 and 67% of patients uses analgesics at least once a week. Only a third of patients receive a non-pharmacological treatment according to the latest guidelines [2]. According to the IPAQ, 42.6% of patients have a high level of activity, 38.6% moderate and 18.8% low. Obese patients have a significantly lower level of physical activity (p < 0.05). The facilitators are mainly biopsychosocial, cultural and environmental, while the barriers are mainly biomedical. Discussion Osteoarthritis spa resort patients are more active than the general population, despite a high level of pain. The literature shows that patient multidisciplinary care for knee osteoarthritis including self-care and exercise improves pain, physical function and contributes to weight reduction. This study can help adaptation of osteoarthritis management, taking into account the patient’s history, his psychology and his phenotype. This strategy could permit to offer tailored educational strategies regarding physical activity. Keywords Osteoarthritis; Knee; Physical Activity; Measurement; Epidemiology
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Exercise and physical activity / Annals of Physical and Rehabilitation Medicine 58S (2015) e99–e102
Disclosure of interest The authors have not supplied their declaration of conflict of interest. References [1] Craig, Cora L, et al. « International Physical Activity Questionnaire: 12-Country Reliability and Validity ». Med Sci Sports Exerc 2003;1381–95. [2] McAlindon T, et al. ‘‘OARSI Guidelines for the Non-Surgical Management of Knee Osteoarthritis.’’. Osteoarthritis Cartilage 2014;363–88. http://dx.doi.org/10.1016/j.rehab.2015.07.228 CO25-003-e
Facilitators and Barriers in physical activity engagement for knee osteoarthritis patients C. Gay a,*, B. Eschalier (Dr)b, C. Levyckyj (Dr)c, A. Chabaud (Dr)d, E. Coudeyre (Prof)e a CHU Clermont-Ferrand, universite´ d’Auvergne, Clermont-Ferrand, France b De´partement de me´decine ge´ne´rale, universite´ d’Auvergne, Clermont-Ferrand c Thermes de Royat d Service de me´decine physique et de re´adaptation, Clermont-Ferrand e Service de me´decine physique et de re´adaptation, universite´ d’Auvergne, Clermont-Ferrand *Corresponding author. E-mail address: [email protected] (C. Gay) Objective To identify facilitators and barriers of a regular physical activity practice for knee osteoarthritis patients. Method Qualitative, prospective study, based on semi-structured interviews and focus groups; stopping interviews leans on the principle of data saturation. Re´sults Twenty individual interviews and two focus groups were conducted with knee osteoarthritis patients (27 patients). The study population consisted of 18 women and 8 men, mean age 67 years old and BMI 29.2. They were mostly retired and lived in urban areas. The main facilitators are physical (physical well-being, reduction of pain, glance of other), personal (culture of physical activity, lifestyle, psychological well-being), societal (social link, lifestyle, glance of society) and environmental (living environment). They differ by sex, performance concept for men and others eyes for women. The barriers are psychological (fear of pain), physical (knee pain, asthenia) and related life events (depression and hospitalization). Discussion The study population has a positive representation on the relationship between physical activity and knee osteoarthritis management. The patients’ beliefs and knowledge agree with current recommendations [1,2]. Regular physical activity practice is a main part of the management of knee osteoarthritis. However, the implementation of these guidelines still remains moderate. There is a need to develop educational support taking into account progressivity and adaptation of physical exercise to every patient. Identification of facilitators and barriers can help improve adherence to these guidelines. Keywords Osteoarthritis; Knee; Physical Activity; Facilitators Barriers Qualitative study; Adherence Disclosure of interest The authors have not supplied their declaration of conflict of interest. References [1] Petursdottir. et al. « Facilitators and Barriers to Exercising among People with Osteoarthritis: A Phenomenological Study ». Physical Therapy 2010;90:1014–25. [2] Fernandes. et al. EULAR Recommendations for the NonPharmacological Core Management of Hip and Knee Osteoarthritis.’’. Annals of the Rheumatic Diseases 2013;72:1125–35. http://dx.doi.org/10.1016/j.rehab.2015.07.229
CO25-004-e
Effectiveness of a personalized rehabilitation-reconditioning program in brain tumors N. Khalil (Dr)a,*, L. Leyes-Bret a, D. Marcon (Dr)a, M.F. Ferry a, M. Blonski (Dr)b, M. Poussel (Dr)c, B. Chenuel (Prof)c, L. Taillandier (Prof)b, J. Paysant (Prof)a a Institut re´gional de re´adaptation de Nancy, Nancy, France b Service de neuro-oncologie, CHU de Nancy c Service d’e´preuves fonctionnelles respiratoires, CHU de Nancy *Corresponding author. E-mail address: [email protected] (N. Khalil) Objective Exercise behavior has shown its interest in cancers and may have a prognosis value in brain tumors [1]. The aim of this prospective study is to show the effectiveness of a guided personalized rehabilitation-reconditioning program in brain tumors. Patients Inclusion criteria: patients over 18; complain of fatigue and decrease or interruption of a physical activity; histological diagnosis of brain tumor; Karnofsky Performance Status > 60. Exclusion criteria: major neurological or cognitive impairment; cardiac or pulmonary contraindication; high risk of tumor progression. Methods Patients underwent an incremental, physician-supervised cardiopulmonary exercise test (CPET) before including the personalized rehabilitation reconditioning program. The program included 5 to 10 individualized sessions, supervised by a physiotherapist; from 30 to 45 minutes per session; 1 to 2 times per week; altered or continuous on walking treadmill or bicycle. The endurance phase was calculated depending on results of the CPET. The objectives of the sessions were personalized; the physical therapist gave the patient therapeutic advices to continue physical activity after the reconditioning program, with a written notebook of follow-up for self- sessions provided at home. The primary outcome was a 6-minute walk test (6MWT) [2]. Results Nineteen patients, mean aged of 53 years old (standard deviation 14.2) were proposed by the neurologist to follow the program; 11 had high-grade glioma and 8 of them low-grade glioma. Fourteen patients were included; 9 completed the program, 3 are currently following it. At follow up, all patients who had completed the program increased their walking speed from 1.68 m/sec (6 km/h) to 1.92 m/sec (6.9 km/h) (p = 0.022). Discussion Brain tumor survivors can improve walking function after a personalized and guided rehabilitation reconditioning program. This study is a preliminary study before a controlled study measuring the effects of such a program on quality of life and survey in glioblastoma. Keywords Cardiorespiratory rehabilitation; Brain tumour; Glioma; Physical activity; Walking speed Disclosure of interest The authors have not supplied their declaration of conflict of interest. References [1] Ruden E, et al. J Clin Oncol 2011. [2] Statement: ATS Guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002. http://dx.doi.org/10.1016/j.rehab.2015.07.230
Available online at
ScienceDirect www.sciencedirect.com
Exercise and physical activity Oral communications Disclosure of interest The authors have not supplied their declaration of conflict of interest. CO25-001-e
http://dx.doi.org/10.1016/j.rehab.2015.07.227
Isokinetic adaptations of knee extensors and flexors after aerobic walk training in old sedentary women
CO25-002-e
P.L. Bernard (Dr)a,*, G. Tallon (Dr)a, G. Ninot (Prof)b, A. Jaussent c, O. Costes (Dr)d, S. Ramdani (Dr)a, M.C. Picot c, H. Blain (Prof)e a UFR APS. Euromov M2H, Montpellier, France b UFR APS, Epsylon c CHU de Montpellier, DIM d DRJSCS Montpellier e CHU de Montpellier, poˆle ge´rontologique A. Balmes *Corresponding author. E-mail address: [email protected] (P. L. Bernard) Introduction We examined the effects of active walk training 3 days per week, for 24 weeks on isokinetic peak torque (PT) and mean power (MP) of the knee extensors and flexors of osteopenic sedentary old women. Methods The population was composed by 121 women (65.5 4.2 years) with 5.3 ( 1.7) to the Physical Activity Scale for the Elderly (PASE) and 86% of the theoretical distance of the 6-minute walk test (6MWT). The women were eligible to participate if they had no medical contraindication and were not diagnosed with major motor and neurocognitive dysfunctions. The isokinetic performance of the knee extensors and flexors in both limbs was measured on Biodex System 3W in concentric/concentric condition on 808 range of motion. The experimental protocol consisted in 5 maximal effort performed at 608/sec, 60 second of rest interval and 5 maximal effort at 1808/sec. After 5 minutes of rest, identical paradigm was performed on contro-lateral side. Experimental group performed aerobic walk training: (1) between 60 and 80% of maximal heart rate; (2) with a distance between 1500 to 4500 meters at the end of the training; (3) with a total time effort between 25 to 45 minutes at the end of the training. Results Our results showed significant increase of PT of hamstring in dominant side at 1808/sec (p < 0.01). We observed significant differences in the experimental group for the hamstring at 608/sec for the dominant side (p < 0.02) and the no-dominant side (p < 0.01). For MP, no interaction was observed between groups and time. For the hamstring, we observed significant increase in the experimental group at 608/sec on the no-dominant side (p < 0.05). Discussion Our results indicate a moderate effects of the aerobic walk training performed during 6 months on the peak torque and the mean power of isokinetic knee extensors and flexors in old sedentary women.
1877-0657/
How physical activity level for patients with knee osteoarthritis. Epidemiological study on spa therapy C. Gay a,*, L. Gerbaud (Prof)b, C. Auclair b, C. Mourgues b, E. Coudeyre (Prof)c a CHU Clermont-Ferrand, universite´ d’Auvergne, Clermont-Ferrand, France b CHU, service de sante´ publique, Clermont-Ferrand c CHU, service de me´decine et de re´adaptation, universite´ d’Auvergne, Clermont-Ferrand *Corresponding author. E-mail address: [email protected] (C. Gay) Objective To describe the level and perception of the physical activity for patients with knee osteoarthritis in 9 spa resorts Method Five hundred and forty-eight patients (548) with knee osteoarthritis were interviewed by self-answered questionnaires. Physical activity level was evaluated by the International Physical Activity Questionnaire Short version (IPAQ) [1] and perception of physical activity by a new questionnaire (EPAP) based on a preliminary qualitative study. Re´sults The mean age of study population is 67.6 ( 7.9) years, whose 73.9% women and 30.9% are obese with a mean BMI of 28.2 ( 5.7). The subgroups analysis according to the 4 phenotypes described by the OARSI [2] shows that 92% patients are multi-joint osteoarthritis, 61% with comorbidities. Mean pain intensity on VAS is 4.5/10 and 67% of patients uses analgesics at least once a week. Only a third of patients receive a non-pharmacological treatment according to the latest guidelines [2]. According to the IPAQ, 42.6% of patients have a high level of activity, 38.6% moderate and 18.8% low. Obese patients have a significantly lower level of physical activity (p < 0.05). The facilitators are mainly biopsychosocial, cultural and environmental, while the barriers are mainly biomedical. Discussion Osteoarthritis spa resort patients are more active than the general population, despite a high level of pain. The literature shows that patient multidisciplinary care for knee osteoarthritis including self-care and exercise improves pain, physical function and contributes to weight reduction. This study can help adaptation of osteoarthritis management, taking into account the patient’s history, his psychology and his phenotype. This strategy could permit to offer tailored educational strategies regarding physical activity. Keywords Osteoarthritis; Knee; Physical Activity; Measurement; Epidemiology
e100
Exercise and physical activity / Annals of Physical and Rehabilitation Medicine 58S (2015) e99–e102
Disclosure of interest The authors have not supplied their declaration of conflict of interest. References [1] Craig, Cora L, et al. « International Physical Activity Questionnaire: 12-Country Reliability and Validity ». Med Sci Sports Exerc 2003;1381–95. [2] McAlindon T, et al. ‘‘OARSI Guidelines for the Non-Surgical Management of Knee Osteoarthritis.’’. Osteoarthritis Cartilage 2014;363–88. http://dx.doi.org/10.1016/j.rehab.2015.07.228 CO25-003-e
Facilitators and Barriers in physical activity engagement for knee osteoarthritis patients C. Gay a,*, B. Eschalier (Dr)b, C. Levyckyj (Dr)c, A. Chabaud (Dr)d, E. Coudeyre (Prof)e a CHU Clermont-Ferrand, universite´ d’Auvergne, Clermont-Ferrand, France b De´partement de me´decine ge´ne´rale, universite´ d’Auvergne, Clermont-Ferrand c Thermes de Royat d Service de me´decine physique et de re´adaptation, Clermont-Ferrand e Service de me´decine physique et de re´adaptation, universite´ d’Auvergne, Clermont-Ferrand *Corresponding author. E-mail address: [email protected] (C. Gay) Objective To identify facilitators and barriers of a regular physical activity practice for knee osteoarthritis patients. Method Qualitative, prospective study, based on semi-structured interviews and focus groups; stopping interviews leans on the principle of data saturation. Re´sults Twenty individual interviews and two focus groups were conducted with knee osteoarthritis patients (27 patients). The study population consisted of 18 women and 8 men, mean age 67 years old and BMI 29.2. They were mostly retired and lived in urban areas. The main facilitators are physical (physical well-being, reduction of pain, glance of other), personal (culture of physical activity, lifestyle, psychological well-being), societal (social link, lifestyle, glance of society) and environmental (living environment). They differ by sex, performance concept for men and others eyes for women. The barriers are psychological (fear of pain), physical (knee pain, asthenia) and related life events (depression and hospitalization). Discussion The study population has a positive representation on the relationship between physical activity and knee osteoarthritis management. The patients’ beliefs and knowledge agree with current recommendations [1,2]. Regular physical activity practice is a main part of the management of knee osteoarthritis. However, the implementation of these guidelines still remains moderate. There is a need to develop educational support taking into account progressivity and adaptation of physical exercise to every patient. Identification of facilitators and barriers can help improve adherence to these guidelines. Keywords Osteoarthritis; Knee; Physical Activity; Facilitators Barriers Qualitative study; Adherence Disclosure of interest The authors have not supplied their declaration of conflict of interest. References [1] Petursdottir. et al. « Facilitators and Barriers to Exercising among People with Osteoarthritis: A Phenomenological Study ». Physical Therapy 2010;90:1014–25. [2] Fernandes. et al. EULAR Recommendations for the NonPharmacological Core Management of Hip and Knee Osteoarthritis.’’. Annals of the Rheumatic Diseases 2013;72:1125–35. http://dx.doi.org/10.1016/j.rehab.2015.07.229
CO25-004-e
Effectiveness of a personalized rehabilitation-reconditioning program in brain tumors N. Khalil (Dr)a,*, L. Leyes-Bret a, D. Marcon (Dr)a, M.F. Ferry a, M. Blonski (Dr)b, M. Poussel (Dr)c, B. Chenuel (Prof)c, L. Taillandier (Prof)b, J. Paysant (Prof)a a Institut re´gional de re´adaptation de Nancy, Nancy, France b Service de neuro-oncologie, CHU de Nancy c Service d’e´preuves fonctionnelles respiratoires, CHU de Nancy *Corresponding author. E-mail address: [email protected] (N. Khalil) Objective Exercise behavior has shown its interest in cancers and may have a prognosis value in brain tumors [1]. The aim of this prospective study is to show the effectiveness of a guided personalized rehabilitation-reconditioning program in brain tumors. Patients Inclusion criteria: patients over 18; complain of fatigue and decrease or interruption of a physical activity; histological diagnosis of brain tumor; Karnofsky Performance Status > 60. Exclusion criteria: major neurological or cognitive impairment; cardiac or pulmonary contraindication; high risk of tumor progression. Methods Patients underwent an incremental, physician-supervised cardiopulmonary exercise test (CPET) before including the personalized rehabilitation reconditioning program. The program included 5 to 10 individualized sessions, supervised by a physiotherapist; from 30 to 45 minutes per session; 1 to 2 times per week; altered or continuous on walking treadmill or bicycle. The endurance phase was calculated depending on results of the CPET. The objectives of the sessions were personalized; the physical therapist gave the patient therapeutic advices to continue physical activity after the reconditioning program, with a written notebook of follow-up for self- sessions provided at home. The primary outcome was a 6-minute walk test (6MWT) [2]. Results Nineteen patients, mean aged of 53 years old (standard deviation 14.2) were proposed by the neurologist to follow the program; 11 had high-grade glioma and 8 of them low-grade glioma. Fourteen patients were included; 9 completed the program, 3 are currently following it. At follow up, all patients who had completed the program increased their walking speed from 1.68 m/sec (6 km/h) to 1.92 m/sec (6.9 km/h) (p = 0.022). Discussion Brain tumor survivors can improve walking function after a personalized and guided rehabilitation reconditioning program. This study is a preliminary study before a controlled study measuring the effects of such a program on quality of life and survey in glioblastoma. Keywords Cardiorespiratory rehabilitation; Brain tumour; Glioma; Physical activity; Walking speed Disclosure of interest The authors have not supplied their declaration of conflict of interest. References [1] Ruden E, et al. J Clin Oncol 2011. [2] Statement: ATS Guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002. http://dx.doi.org/10.1016/j.rehab.2015.07.230