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Estimation de la sollicitation énergétique des patients AVC en situation réelle de vie

Abstract : Measuring the physical activity levels of individuals with stroke requires objective and reliable tools to assess the link between physical activity and key health dimensions. The main methods of assessing physical activity are questionnaires, portable physical activity monitors, and physical activity logs that quantify physical activity levels by estimating energy expenditure. These methods have been developed and validated in healthy individuals. They are widely used in individuals with stroke sequelae, whereas individuals with stroke have an over-consumption of energy for physical activities and a very high interindividual variability in this energy consumption due to the variability of their impairments. These 2 specificities do not allow the use of calibration models and the development of methods to evaluate the physical activity level of healthy individuals because the risk would be to underestimate the physical activity level of stroke individuals and to neglect individual differences. The objective of our work was to assess the validity of the methods used to estimate energy expenditure in stroke individuals in real-life situations. We focused our work on physical activity monitors (pedometers, accelerometers, multi-sensors) and the physical activity compendium, which is the reference for calculating energy expenditure when using physical activity logs. Several studies have been carried out to analyse the consistency and accuracy of these tools in comparison with indirect calorimetry, which is recognised as the reference method for measuring energy expenditure. We have thus shown strong differences between the reference method and the methods tested, as well as a low level of agreement with the reference method. These results indicate that the methods currently used to measure the physical activity level of stroke individuals are not valid. We believe that the main reasons are the failure to take into account the specificities of variability and energy over-consumption when performing physical activities. We are considering several studies to confirm these results.
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Maxence Compagnat. Estimation de la sollicitation énergétique des patients AVC en situation réelle de vie. Médecine humaine et pathologie. Université de Limoges, 2020. Français. ⟨NNT : 2020LIMO0027⟩. ⟨tel-03159279⟩

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