Accidents vasculaires Cérébraux

Le 16/10/2021 de 09:00 à 11:00

Président(s): Alain Yelnik (Paris);

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Intensité cardiovasculaire en kinésithérapie post AVC : La sollicitation est-elle suffisante ?

Benjamin Thoreux (Rennes, France), Thibault Lefebvre (Rennes, France), Claire Amiot (Rennes, France), Charles Guignans (Rennes, France), Mélanie Cogne (Rennes, France), Simon Butet (Rennes, France), Isabelle Bonan (Rennes, France)

Objective : Poor cardiovascular adaptation to exercise is a major limiting factor after stroke. It is therefore necessary to offer exercises improving the capacity of effort for patients suffering from subacute or chronic stroke. Those exercises must reach at least 55% of the theoretical maximum heart frequency (TMF) in order to achieve sufficient exercise training intensity to improve physical parameters.  The aim of our work was to monitor the level of cardiovascular stress registered during usual physical therapy sessions (PT) in order to assess their cardiovascular intensity in participants with a chronic stroke.

Material / Patients and Methods : We conducted a bicentric, longitudinal study with a heart rate monitoring during PT 30 min-sessions on a sample of 25 patients with ischemic or hemorrhagic stroke >3 months who participated in an outpatient stroke rehabilitation. Primary outcome was the time (min) spent in the target heart rate zone, i.e cardiac frequency > 55-100% of the theoretical maximum frequency of the patient. The physiotherapists were blinded during the monitoring.

Results : Based on intermediate statistical analyses on 19 participants, the average time spent in the target heart zone (FMT>55%) was very low (9min+/-9,88). Only 11 of the 63 sessions monitored during PT achieved the length (20 minutes) recommended by the French National Authority for Health (HAS).

Discussion - Conclusion : This study demonstrates that cardiovascular intensity during classical PT sessions is insufficient to induce cardiovascular adaptation to exercise. The implementation of supplementary specific sessions dedicated to exercise training after stroke seems crucial to improve patient autonomy and reduce activity limitations

Keywords : stroke, exercise training, rehabilitation, cardiovascular intensity, physiotherapy, aerobic work, adapted physical activity, autonomy