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Interest of a physical activity program including Nordic walking in idiopathic Parkinson's disease
Physical activity and PRM / Annals of Physical and Rehabilitation Medicine 59S (2016) e51–e58
PO099
Impact of cardiac rehabilitation on the obstructive sleep apnoea in the coronary artery disease David Hupin 1,∗ , Vincent Pichot 1 , Cécile Lietar 2 , Erkan Poyraz 2 , Delphine Maudoux 1 , Emilia Sforza 1 , Jean-Claude Barthelemy 1 , Frédéric Roche 1 1 CHU de Saint-Étienne, physiologie clinique et de l’exercise, Saint-Priest-en-Jarez, France 2 Université Jean-Monnet, faculté de médecine Jacques-Lisfranc, Saint-Priest-en-Jarez, France ∗ Corresponding author. E-mail address: [email protected] (D. Hupin) Objective Obstructive sleep apnoea (OSA) syndrome is improved by physical activity in the general population. This has not been demonstrated in patients with coronary artery disease (CAD). We aimed to determine a correlation between cardiac rehabilitation and OSA syndrome in CAD patients. Material/patients and methods Forty-five CAD patients were included in cardiac rehabilitation programme of Saint-Étienne University Hospital. Patients were classified according to the severity of OSA syndrome. The number of events per hour was reported as the apnoea-hypopnoea index (AHI) measured from the Holter ECG and electrocardiogram-derived respiratory (EDR). An AHI less than 5 was considered normal. An AHI of 5–14 was mild, 15–29 was moderate and more than 30 events per hour characterized severe OSA. Cardiopulmonary exercise testing (CPET) and baroreflex (BRS) were performed to assess respectively VO2max and autonomic nervous system at the beginning and at the end of the cardiac rehabilitation. Results The reduction in AHI was significant in CAD patients with severe OSA syndrome (8.15 ± 12, P = 0.019). This correlation was even stronger than VO2max and BRS were improved (10.2 ± 8, P < 0.05 with a gain over 20% of VO2max and BRS) at the end of the rehabilitation. Discussion–conclusion Severe OSA syndrome is improved by cardiac rehabilitation among CAD patients. Autonomic nervous system regulation by physical activity might be key for alternative therapy for OSA syndrome. Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2016.07.131 PO0100
Interest of a physical activity program including Nordic walking in idiopathic Parkinson’s disease
Sarah Remisse ∗ , Francois Muller , Stéphanie Bannier , Sandrine Pujol , Sylvie Viollier-Fears , Patrick Dehail , Emmanuel Ellie Les Embruns, Juana, Bidart, France ∗ Corresponding author. E-mail address: [email protected] (S. Remisse) Objective Assess the efficiency of a program of physical activities including Nordic walking in patients with idiopathic Parkinson’s disease (PD). Material/patients and methods PD patients practiced Nordic walking sessions of 45 minutes supervised by a sports instructor twice a week for eight weeks. This activity was associated with physical therapy targeting work on posture, walking and balance. A qualitative and quantitative assessment of walking and balance were performed before and after the program. Participant’s satisfaction and the impact on their quality of life were also assessed. Results Twenty-nine patients participated in the study between January 2013 and September 2015. Involvement and tolerance was excellent since all the subjects except one have completed the entire program. Satisfaction was at least 8/10 for 76 % of them.
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The results show a significant improvement in the walking test of 2 minutes and the timed up and go test. It was not noted significant improvement in the quality of life of the PDQ-39. Discussion–conclusion Several recent studies have shown the interest of exercise in PD. Implementation of physical activities program including Nordic walking shows in PD patients motor performance improvement, a high level of satisfaction and good tolerance. Keywords Idiopathic Parkinson’s disease; Nordic walking; Physical activities Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2016.07.132 PO0101
Effects of brisk walking on autonomic nervous system reactivation in nursing home residents. Additional effects of transcutaneous vagus nerve stimulation Jérémy Raffin 1,∗ , Jean-Claude Barthelemy 2 , Philippe Terrat 1 , Marie-Christine Diana 1 , Emilie Achour 3 , Paul Calmels 4 , Mathieu Oriol 5 , Thierry Busso 6 , Lallia Hammadi 1 , Claude Montuy-Coquard 1 , Rémi Bouvier 1 , Rémi Poillerat 7 , Frédéric Roche 2 , David Hupin 2 1 Mutualité franc¸aise de la Loire, Saint-Étienne, France 2 CHU de Saint-Étienne, physiologie clinique et de l’exercice, Saint-Étienne, France 3 CHU de Saint-Étienne, gériatrie, Saint-Étienne, France 4 CHU de Saint-Étienne, MPR, Saint-Étienne, France 5 ICL, Centre Hygée, Saint-Priest-en-Jarez, France 6 Université Jean-Monnet, LIBM, Saint-Étienne, France 7 Fondation Paul-Bennetot, Groupe Matmut, Paris, France ∗ Corresponding author. E-mail address: jeremy.raffi[email protected] (J. Raffin) Objective It is well established that physical activity reduces the physiological effects of ageing. Among them, is the decrease of the autonomic nervous system (ANS) activity, which is associated with the increase of cardiovascular events and morbidities. It has been shown that high intensity cycle training can enhance the ANS activity by 30% in people with the age of 70. However, such trainings were done by old athletes, used to train at intensities that could not be tolerated by sedentary old people, such as nursing home residents. Furthermore, vagus nerve stimulation (VNS) is a novel technique that could potentialize the training effects on the ANS by reducing the parasympathetic activity decrease that occurs after an exhausting exercise. Therefore, we aim to compare the effects of a 9-month brisk walking training (1 time a week or 3 times a week) on the ANS of nursing home residents. Also, we wish to measure the effects of post exercise VNS stimulation on the ANS activity. Material/patients and methods One hundred and fifty 60-year-old subjects and older will be recruited within the ten nursing homes of La Mutualité franc¸aise de la Loire, France, and will be randomized into 5 groups: – G1: one brisk walking session a week; – G2: one brisk walking session a week + VNS; – G3: three brisk walking sessions a week; – G4: three brisk walking sessions a week + VNS; – G5: control group (no training or VNS). Testing procedure will occur at the inclusion and after 3 months, 6 months and 9 months of training. The primary outcome measure is the heart rate variability (SDNN value) measured by 24 hours Holter ECG and baroreflex. Expected results We expect an increase of the ANS activity, particularly of the parasympathetic arm, with a dose–response relationship through training. The increase would be higher for the
PO099
Impact of cardiac rehabilitation on the obstructive sleep apnoea in the coronary artery disease David Hupin 1,∗ , Vincent Pichot 1 , Cécile Lietar 2 , Erkan Poyraz 2 , Delphine Maudoux 1 , Emilia Sforza 1 , Jean-Claude Barthelemy 1 , Frédéric Roche 1 1 CHU de Saint-Étienne, physiologie clinique et de l’exercise, Saint-Priest-en-Jarez, France 2 Université Jean-Monnet, faculté de médecine Jacques-Lisfranc, Saint-Priest-en-Jarez, France ∗ Corresponding author. E-mail address: [email protected] (D. Hupin) Objective Obstructive sleep apnoea (OSA) syndrome is improved by physical activity in the general population. This has not been demonstrated in patients with coronary artery disease (CAD). We aimed to determine a correlation between cardiac rehabilitation and OSA syndrome in CAD patients. Material/patients and methods Forty-five CAD patients were included in cardiac rehabilitation programme of Saint-Étienne University Hospital. Patients were classified according to the severity of OSA syndrome. The number of events per hour was reported as the apnoea-hypopnoea index (AHI) measured from the Holter ECG and electrocardiogram-derived respiratory (EDR). An AHI less than 5 was considered normal. An AHI of 5–14 was mild, 15–29 was moderate and more than 30 events per hour characterized severe OSA. Cardiopulmonary exercise testing (CPET) and baroreflex (BRS) were performed to assess respectively VO2max and autonomic nervous system at the beginning and at the end of the cardiac rehabilitation. Results The reduction in AHI was significant in CAD patients with severe OSA syndrome (8.15 ± 12, P = 0.019). This correlation was even stronger than VO2max and BRS were improved (10.2 ± 8, P < 0.05 with a gain over 20% of VO2max and BRS) at the end of the rehabilitation. Discussion–conclusion Severe OSA syndrome is improved by cardiac rehabilitation among CAD patients. Autonomic nervous system regulation by physical activity might be key for alternative therapy for OSA syndrome. Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2016.07.131 PO0100
Interest of a physical activity program including Nordic walking in idiopathic Parkinson’s disease
Sarah Remisse ∗ , Francois Muller , Stéphanie Bannier , Sandrine Pujol , Sylvie Viollier-Fears , Patrick Dehail , Emmanuel Ellie Les Embruns, Juana, Bidart, France ∗ Corresponding author. E-mail address: [email protected] (S. Remisse) Objective Assess the efficiency of a program of physical activities including Nordic walking in patients with idiopathic Parkinson’s disease (PD). Material/patients and methods PD patients practiced Nordic walking sessions of 45 minutes supervised by a sports instructor twice a week for eight weeks. This activity was associated with physical therapy targeting work on posture, walking and balance. A qualitative and quantitative assessment of walking and balance were performed before and after the program. Participant’s satisfaction and the impact on their quality of life were also assessed. Results Twenty-nine patients participated in the study between January 2013 and September 2015. Involvement and tolerance was excellent since all the subjects except one have completed the entire program. Satisfaction was at least 8/10 for 76 % of them.
e57
The results show a significant improvement in the walking test of 2 minutes and the timed up and go test. It was not noted significant improvement in the quality of life of the PDQ-39. Discussion–conclusion Several recent studies have shown the interest of exercise in PD. Implementation of physical activities program including Nordic walking shows in PD patients motor performance improvement, a high level of satisfaction and good tolerance. Keywords Idiopathic Parkinson’s disease; Nordic walking; Physical activities Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.rehab.2016.07.132 PO0101
Effects of brisk walking on autonomic nervous system reactivation in nursing home residents. Additional effects of transcutaneous vagus nerve stimulation Jérémy Raffin 1,∗ , Jean-Claude Barthelemy 2 , Philippe Terrat 1 , Marie-Christine Diana 1 , Emilie Achour 3 , Paul Calmels 4 , Mathieu Oriol 5 , Thierry Busso 6 , Lallia Hammadi 1 , Claude Montuy-Coquard 1 , Rémi Bouvier 1 , Rémi Poillerat 7 , Frédéric Roche 2 , David Hupin 2 1 Mutualité franc¸aise de la Loire, Saint-Étienne, France 2 CHU de Saint-Étienne, physiologie clinique et de l’exercice, Saint-Étienne, France 3 CHU de Saint-Étienne, gériatrie, Saint-Étienne, France 4 CHU de Saint-Étienne, MPR, Saint-Étienne, France 5 ICL, Centre Hygée, Saint-Priest-en-Jarez, France 6 Université Jean-Monnet, LIBM, Saint-Étienne, France 7 Fondation Paul-Bennetot, Groupe Matmut, Paris, France ∗ Corresponding author. E-mail address: jeremy.raffi[email protected] (J. Raffin) Objective It is well established that physical activity reduces the physiological effects of ageing. Among them, is the decrease of the autonomic nervous system (ANS) activity, which is associated with the increase of cardiovascular events and morbidities. It has been shown that high intensity cycle training can enhance the ANS activity by 30% in people with the age of 70. However, such trainings were done by old athletes, used to train at intensities that could not be tolerated by sedentary old people, such as nursing home residents. Furthermore, vagus nerve stimulation (VNS) is a novel technique that could potentialize the training effects on the ANS by reducing the parasympathetic activity decrease that occurs after an exhausting exercise. Therefore, we aim to compare the effects of a 9-month brisk walking training (1 time a week or 3 times a week) on the ANS of nursing home residents. Also, we wish to measure the effects of post exercise VNS stimulation on the ANS activity. Material/patients and methods One hundred and fifty 60-year-old subjects and older will be recruited within the ten nursing homes of La Mutualité franc¸aise de la Loire, France, and will be randomized into 5 groups: – G1: one brisk walking session a week; – G2: one brisk walking session a week + VNS; – G3: three brisk walking sessions a week; – G4: three brisk walking sessions a week + VNS; – G5: control group (no training or VNS). Testing procedure will occur at the inclusion and after 3 months, 6 months and 9 months of training. The primary outcome measure is the heart rate variability (SDNN value) measured by 24 hours Holter ECG and baroreflex. Expected results We expect an increase of the ANS activity, particularly of the parasympathetic arm, with a dose–response relationship through training. The increase would be higher for the