Physical activity, a therapeutic treatment in its own right – Prevention

L'activité physique adaptée

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The Haute Autorité de santé has just published a guide and advice sheets for doctors who can prescribe a physical activity adapted to the physiology and psychology of the patient. She thus recalls all the benefits of this practice on health.

Physical activity

Since the entry into force of the health system modernization law of 2016, general practitioners can prescribe the practice of physical activity by prescription people who suffer from a long-term condition (diabetes, obesity, Alzheimer’s disease, etc.). The law of March 2, 2022, which aims to democratize sport in France and to develop sport-health, reiterates this possibility and extends it to all doctors. She devotes physical activity as a therapeutic treatment fully fledged.

In this dynamic, the High Authority for Health (HAS) has just published a guide for consultation and medical prescription of physical activity in adults and sourced advice sheets for doctors, physiotherapists and teachers of adapted physical activity. These publications aim to better inform them and support the medical profession in its care procedures.

By physical activity, we do not only mean sport, as Professor Martine Duclos, endocrinologist and physiologist, head of the sports medicine department at Clermont-Ferrand University Hospital, points out. “It is any bodily movement produced by the muscles that requires an expenditure of energy greater than the expenditure of rest. In other words, are concerned walking, cycling, using the stairs instead of the elevator to go upstairs or even gardening or cleaning at home.

How to exercise when working seated?

The fight against physical inactivity and a sedentary lifestyle is a public health priority. Recent studies have revealed that at age 7, a child spends 51% of their time sitting. This time is 74% for a 15-year-old teenager. Adults are not left out. They pass sit twelve hours a day, when they work. Brought to nine when they are at rest.

Telecommuting has not helped matters. ” The chair is our new addiction “, laments Professor François Carré, cardiologist and sports doctor at the University Hospital of Rennes.

Professor Martine Duclos, endocrinologist and physiologist, head of the sports medicine department at Clermont-Ferrand University Hospital, therefore advises get up from your seat every hour and “move for at least one to three minutes “. It can be taking the stairs to get a drink, like doing stretches or doing small movements on the floor. “You clear your head and after that, you’re much more focused.”

Physical activity facilitates disease prevention and management

To date, although the law stipulates it, few prescriptions for physical activity are issued by doctors. If the brakes remain, it is above all a lack of knowledge. Yet there is proven evidence of the health benefits of its daily practice. “Things need to change and my sisters and brothers need to be trained in the prescription of physical activity, raises Professor François Carré, cardiologist and sports doctor at the University Hospital of Rennes. The training of professionals is essential both at the university level and throughout professional life. »

In addition, many patients feel apprehensive about indulging in physical activity because of inactivity well established in their daily lives, their advanced age or their declining or affected health. Physical activity is a medically and scientifically recognized therapeutic treatment, whether performed alone or accompanied by other medicinal or non-drug treatments. ” For instance, it reduces the risk of diabetes by 30 to 50% and reduces the possible recurrence of certain breast cancers observes Professor Duclos.

Regular physical activity facilitates the prevention and management of non-communicable pathologies. She contributes to prevent hypertension, the risk of depression and cardiovascular disease among other things, to maintain a correct body weight. It affects general well-being, including mental health, and quality of life. It must be regular and continued throughout life.

A physical activity adapted in its duration and intensity

The doctor must adapt the prescribed physical activity, from its duration to its intensity, taking into account the patient’s physiological and psychological state of health. The tastes of the latter must also be taken into account. Thus, as indicated in the reference sheets of the HAS, the prescription will be oriented towards endurance and resistance activities, such as jogging or dancing, for asthmatic patients.

With regard to Parkinson’s disease, endurance physical activities, such as yoga or Nordic walking, have shown a positive effect on physical health, balance, walking speed, risk of falls, etc.

Regular, moderate-intensity physical activity is also recommended for patients with schizophrenic disorders. She constitutes a complementary therapy to antipsychotic treatments without side effects. Time spent in sedentary activities should be reduced. On the other hand, that devoted to daily physical activities (housework, walking, etc.) and adapted, prescribed by the doctor, must be greater.

“At one time, we tended to say that we had to economize,” recognizes Professor Martine Duclos. “This is the case for pregnant women who were put to rest when they must continue physical activity if their state of health allows it. This prevents, among other things, weight gain, reduces labor time during delivery, recourse to caesarean section…”.

Supervision by a “sport-health” professional

Physical activity must be supervised by a professional. This can be in one of the Sport-Santé centers* spread across France, with a physiotherapist or a sports health educator specialist**.

The prescription of physical activity is not reimbursed by Social Security, although this option is being studied for patients with chronic diseases (cancer, heart disease, diabetes, etc.). But already some complementary health offer partial or total support.

The HAS will soon make available to users “patient sheets” providing information on the effects of physical activity on sixteen different pathologies and health states. A consultation and physical activity prescription guide for children will also soon be published for doctors.

*The Sport-Santé houses bring together health and sports professionals. They are intended for people in good health who wish to (re)take up physical and sporting activity with specific support and for people suffering from chronic illnesses requiring, on prescription, adapted physical activity.

**That is to say a qualified professional STAPS – Adapted physical activity and health, or trained by a device proposed by the Ministry of Sports or by a sports federation which provides “sport-health” training.

  • Photo credit: Getty Images
Article author

Patricia Guipponi

generalist journalist specializing in particular in social and health.

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