Effets d'un programme d'incitation et d'éducation à l'activité physique à domicile chez des patients post-AVC en phase subaiguë sur la performance au test de marche de 6 minutes

Abstract : The aim of the study was to evaluate the effect of a home-based physical activity incentive program on the 6 minutes walking distance performance (6MWT) and its evolution, 6 months after the end of the program. This is a comparative, prospective, randomized, single-blind and monocentric clinical trial. Participants were 84 post-stroke patients (average age 61.7 ± 13.2 years, time since stroke 2.5 ± 1.5 months). Forty-two patients were randomly assigned to an experimental group (EG) and the other forty-two to a control group (CG). EG followed a home-based physical activity incentive program for 6 months. Three incentive methods have been used; an accelerometer (Armband Sensewear, Bodymedia), weekly telephone calls, and home visits every three weeks. In addition, educational session about physical activity and information about physical activity recommendations were conducted before the start of the protocol. CG received general information about physical activity benefits and post-stroke practicing activity recommendations. Other assessment criteria were functional ambulatory classification (FAC), barthel index (BI), motricity index (MI), quality of life (Euroqol-5D), body composition, the health care communication questionnaire (HCCQ), visual analog scale of pain (VAS), the hospital anxiety and depression scale (HADS), the multidimensional fatigue inventory 20 questionnaire (MFI-20). Patients were evaluated before intervention (T0), after intervention (T1) and 6 months after the end of the program (T2). Walking distance increased significantly in the EG between T0 and T1 (18%, p<0.001); however, there was not a significantly difference between EG and CG at T1 (p=0.30). The score of FAC increased significantly (+0.75, p=0.02) in EG at T1, but it was different between EG and CG (p=0.0013). Furthermore, MFI-20 score decreased significantly at T1 (-4.6, p<0.001) for the EG, it results was different between both groups (p<0.001). The program effects on walking distance (p=0.75), functional ability (p=0.17), and fatigue (p=0.74) at T2 were maintained. No significant effect of other variables was found. In addition, at the end of the program, the EG achieved the physical activity recommendation per day, step number (5955 ± 5475) and activity duration (105 ± 75 minutes).
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David Chaparro. Effets d'un programme d'incitation et d'éducation à l'activité physique à domicile chez des patients post-AVC en phase subaiguë sur la performance au test de marche de 6 minutes. Médecine humaine et pathologie. Université de Limoges, 2018. Français. ⟨NNT : 2018LIMO0074⟩. ⟨tel-02057708⟩

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