S. Mandigout

Physical training increases heart rate variability in healthy prepubertal children

Background The aim of the present study was to evaluate the effect of an endurance training program on heart rate variability (HRV) in prepubertal healthy children and to determine the relationships between HRV components and training‐induced cardiac adaptations.

Physical Factors Associated With Fatigue After Stroke: An Exploratory Study

Abstract Objective: To look for a relationship between physical fatigue and physical parameters in patients at least 3 months post stroke. Methods: We conducted a prospective cross-sectional study of 32 poststroke patients (average duration of stroke 40 months) who were recruited among in- and outpatients followed by the Department of Physical and Rehabilitation Medicine of a university hospital. Fatigue was defined as a Fatigue Severity Scale (FSS) score of 4 or more. The parameters studied were age, sex, time since stroke, Demeurisse Motor Index, Barthel Index score, new Functional Ambulation Category, Berg Balance Scale, 10-meter walk test, 6-minute walk test, Dijon Physical Activity Score, Montgomery and Asberg Depression Rating Scale, Epworth Sleepiness Scale, presence of pain, and length and area of the center of pressure displacement obtained posturographically. Results: Two-thirds of patients (65.6%) were fatigued. The mean FSS score was 4.3 ± 1.8. Fatigue was not associated with the physical parameters studied; notably, there was no correlation with motor impairment, autonomy and walking capacity, or balance and physical activity. However, after multivariate analysis, we found an association between physical fatigue and time since the occurrence of stroke (P = .05). Conclusions: Our study revealed a relationship between pain and physical fatigue, as reported by 2 other studies. Poststroke fatigue management should include appropriate pain management. Further studies are necessary to determine the causes of physical fatigue after stroke.

Longitudinal follow-up of biochemical markers of fatigue throughout a sporting season in young elite rugby players.

Abstract Alaphilippe, A, Mandigout, S, Ratel, S, Bonis, J, Courteix, D and Duclos, M. Longitudinal follow-up of biochemical markers of fatigue throughout a sporting season in young elite rugby players. J Strength Cond Res 26(12): 3376–3384, 2012—The aims of this study were to evaluate links between biochemical markers and competition and training conditions, overtraining questionnaire scores, and anthropometric characteristics of young elite rugby players and to identify evolving profiles of fatigue during the sports season. Twelve elite rugby players were included in the study. The tests were carried out every 15 days over the course of one sporting season from July until March, including the interseason. Changes in body composition parameters, blood biochemistry, and scores on various questionnaires were examined. The majority of the biochemical parameters and subjective variables showed significant variations over time. There were significant positive correlations between overtraining scores and alanine amino transferase (ALAT; r = 0.24, p < 0.05) and creatine phosphokinase (CK; r = 0.3, p < 0.01) levels. In addition, game time was significantly correlated with changes in CK (r = 0.46, p < 0.01), whereas difficult training sessions were significantly correlated with changes in both CK (r = 0.27, p < 0.05) and ALAT (r = 0.33, p < 0.01). We suggest that regular monitoring of these biochemical parameters may provide important information for the coach on the fatigue of rugby players and their perceived difficulty of training.

Physical Activity Level Among Stroke Patients Hospitalized in a Rehabilitation Unit

The current literature contains little information about the level of physical activity of hospitalized patients who have had a stroke. Improving knowledge in the area could help optimize rehabilitation.

Can energy expenditure be accurately assessed using accelerometry-based wearable motion detectors for physical activity monitoring in post-stroke patients in the subacute phase?

Background In the subacute stroke phase, the monitoring of ambulatory activity and activities of daily life with wearable sensors may have relevant clinical applications. Do current commercially available wearable activity trackers allow us to objectively assess the energy expenditure of these activities? The objective of the present study was to compare the energy expenditure evaluated by indirect calorimetry during the course of a scenario consisting of everyday activities while estimating the energy expenditure using several commercialised wearable sensors in post-stroke patients (less than six months since stroke). Method Twenty-four patients (age 68.2 ± 13.9; post-stroke delay 34 ± 25 days) voluntarily participated in this study. Each patient underwent a scenario of various everyday tasks (transfer, walking, etc.). During the implementation, patients wore 14 wearable sensors (Armband, Actigraph GT3X, Actical, pedometer) to obtain an estimate of the energy expenditure. The actual energy expenditure was concurrently determined by indirect calorimetry. Results Except for the Armband worn on the non-plegic side, the results of our study show a significant difference between the energy expenditure values estimated by the various sensors and the actual energy expenditure when the scenario is considered as a whole. Conclusion The present results suggest that, for a series of everyday tasks, the wearable sensors underestimate the actual energy expenditure values in post-stroke patients in the subacute phase and are therefore not accurate. Several factors are likely to confound the results: types of activity, prediction equations, the position of the sensor and the hemiplegia side.

Effects of a Multicomponent Exercise Program on Spatiotemporal Gait Parameters, Risk of Falling and Physical Activity in Dementia Patients

Background: Exercise programs are presumed to rehabilitate gait disorders and to reduce the risk of falling in dementia patients. This study aimed to analyze the specific effects of multicomponent exercise on gait disorders and to determine the association between gait impairments and the risk of falling in dementia patients before and after intervention. Methods: We conducted an 8-week multicomponent exercise program in 16 dementia patients (age 86.7 ± 5.4 years). All participants were assessed several times for gait analysis (Locométrix®), Tinetti score and physical activity (Body Media SenseWear® Pro armband). Results: After 8 weeks of the exercise program, the mean gait speed was 0.12 m/s faster than before the intervention (0.55 ± 0.17 vs. 0.67 ± 0.14 m/s). The multicomponent exercise program improved gait performance and Tinetti score (p < 0.05). Gait performance (gait speed, stride length) was correlated with the Tinetti score (p < 0.05). Conclusion: Analysis of spatiotemporal gait parameters using an accelerometer method provided a quick and easy tool to estimate the benefits of an exercise program and the risk of falling.

Rating of perceived exertion with Borg scale in stroke over two common activities of the daily living

Abstract Background The Borg Scale for the rating of perceived exertion (RPE) is recommended to measure the intensity of physical exercise during stroke rehabilitation, but its reliability in activities of daily living is not explored. Objective To evaluate the correlation between the RPE using the Borg Scale (6–20) and the intensity of effort as measured by the Total Energy Expenditure per minute (TEE.min−1) in a post-stroke population for two tasks: walking at spontaneous comfortable speed and walking up and down stairs. Methods A cross-sectional study has been conducted. Any post-stroke subjects able to walk without being helped were recruited. Subjects were asked to walk at their spontaneous comfortable walking speed for 6 min and then to walk up and down stairs with a portable gas analyzer to measure the TEE.min−1. The RPE was evaluated by the Borg scale (6–20). The correlation between the RPE and the TEE.min−1 for each subject’s walking task and stairs task was calculated with the Pearson coefficient. Results Twenty subjects were included. TEE.min−1 averaged at 5.6 (±1.2 kcal.min−1) for the walking task and 9.58 (±4.3 kcal.min−1) for the stairs task. The median RPE was 11 (min 6; max 15) for the walking task and 11 (min 6; max 16) for the stairs task. The correlation coefficient between the RPE and TEE.min−1 was r = 0.12 (p = 0.25). Conclusion Our work has not determined a correlation between the RPE and TEE.min−1 for two common activities of daily living in post-stroke subjects.

Prediction of the oxygen cost of walking in hemiparetic stroke patients

OBJECTIVE To verify the relation between spontaneous walking speed (Sfree) and oxygen cost of walking at Sfree (Cwfree) in post-stroke hemiparetic patients and to test the validity of a prediction model to estimate Cwfree based on Sfree. DESIGN We included 26 participants (mean age 65.1 years [SD 15.7]) with mild to moderate disability after stroke who walked at Sfree using mobility aids if necessary for 6min. The Cwfree was measured at a stabilized metabolic rate by indirect calorimetry with the Metamax 3B spiroergometry device. The relation between Sfree and Cwfree was analyzed by the correlation coefficient (r) and coefficient of determination (R2). The Cwfree prediction model was developed from a regression equation, then tested on a second population of 29 patients (mean age 62.1 years [SD 13.4]) with the same inclusion and exclusion criteria. RESULTS For the 26 participants, the Sfree and Cwfree were highly correlated (r=-0.94 and R2=0.97), which allowed for formulating a regression equation and developing the Cwfree prediction model based on Sfree. The prediction model tests yielded accurate results (mean bias -0.02mL.kg-1.m-1; 95% limits of agreement -0.31 to 0.26mL.kg-1.m-1). The relation between Cwfree estimated by the model and measured by Metamax was high (R2=0.98). CONCLUSION Cwfree was strongly correlated with Sfree, which allowed for the development of a valid Cwfree prediction model. A practitioner could estimate the energy expenditure of walking for a patient without using an indirect calorimeter.

Impact de différentes situations de double tâche sur la qualité de marche de personnes atteintes de démence

Résultats.– L’analyse révèle une absence systématique de différence significative entre les trois séries de mesure pour les paramètres cinématiques. L’analyse des paramètres non-linéaires montre des différences significatives pour les paramètres de CTM dans le plan antéro-postérieur (p < 0,002), de déterminisme de la RQA dans le plan médiolatéral (ML) (p < 0,0001) et d’entropie de la RQA en ML (p < 0,004). Discussion.– Il est satisfaisant d’observer qu’un exercice de marche n’induit pas une fatigue significativement perturbatrice de la réponse posturale chez ce public. De plus, il apparaît que les méthodes non-linaires constitueraient des méthodes pertinentes à la caractérisation des capacités d’adaptation posturales.

Communication brèveÉvolution des paramètres physique et anthropométrique de jeunes rugbymen de haut niveau sur une saison sportivePhysical and anthropometric parameters evolution of the young elite of French rugby players

Introduction The objective of the study is to measure the evolution of the anthropometric and physical parameters in young elite rugby players during one rugby league season.