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Activité physique adaptée et cohérence cardiaque en soins de support : leurs effets sur la variabilité de la fréquence cardiaque et la qualité de vie en post-traitement d’une hémopathie maligne

Abstract : Introduction: Hematologic malignancies require aggressive treatment, including intensivechemotherapy and sometimes hematopoietic stem cell transplantation. The repercussions of cancer and its treatment is recognized for their significant long-term adverse effects on health-related quality of life. As a part of cancer treatment, physical exercise is known to improve mainly physical functioning and fatigue, but there are still questions regarding its impact on psychological and emotional functioning. Nonetheless, heart rate variability biofeedback (HRVB) is recognized for its positive effects on autonomic nervous system balance and emotional self-regulation. Recent research in neurocardiology has shown the benefits of Cardiac Coherence (CC) training on the autonomic balance and the psycho-emotional state. Method: The objectives of the research undertaken in this thesis are to evaluate the effects of a nonpharmacological intervention on quality of life in adult hematologic patients in post-treatment time. The recovery of physiological balance is indexed by the Heart Rate Variability (HRV), which is recognized as a window of the Autonomic Nervous System (ANS). We present four studies: an experimental study in healthy subjects to better understand the mechanisms of HRV during slow and deep breathing; a feasibility study on the implementation of an APA program in hematology; preliminary results of a randomized controlled trial evaluating the effects of a program associating APA and CC on HRV, quality of life, fatigue and anxiety-depression; and a qualitative study evaluating the program’s implementation and the effects of the both interventions. Results: Our results first show the feasibility of APA and CC in these patients. Although the results of the HRV analysis are inconclusive, they tend to confirm that CC intervention results in stimulation of vagal tone. Qualitative evaluation provides us with many important insights into the appropriateness of the interventions to the specific needs of the patients and their effectiveness in optimizing a return to the active daily life. Discussion: This research provides new experimental evidence in understanding the mechanisms of cardiac coherence and its applications in the clinical setting. Further experimentation is still needed to deepen our knowledge in the context of a psychophysiological approach in APA on cancer.
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Submitted on : Friday, September 11, 2020 - 2:28:08 PM
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Claire Fournié. Activité physique adaptée et cohérence cardiaque en soins de support : leurs effets sur la variabilité de la fréquence cardiaque et la qualité de vie en post-traitement d’une hémopathie maligne. Médecine humaine et pathologie. Université de la Réunion, 2020. Français. ⟨NNT : 2020LARE0009⟩. ⟨tel-02936594⟩

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