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Comment optimiser l’alliance thérapeutique autour de l’activité physique dans les maladies cardiovasculaires ?

How to optimize the therapeutic alliance around physical activity in cardiovascular disease?

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La Lettre de médecine physique et de réadaptation

Résumé

La sédentarité reste un facteur de risque cardiovasculaire majeur. Les bénéfices de l’activité physique (AP) sont largement admis en prévention primaire et secondaire, et font l’objet de recommandations régulièrement remises à jour par les sociétés savantes internationales. Il persiste néanmoins quelques points de controverse, principalement concernant le type et l’intensité de l’AP. Les principales difficultés concernent les moyens de personnalisation de l’AP, dans le but de la rendre « ludique » et d’améliorer l’observance en suscitant des modifications de comportement durables. L’intégration de la promotion de l’AP dans une démarche d’éducation thérapeutique structurée peut permettre d’atteindre cet objectif. Après avoir rappelé la place centrale de l’AP dans le cadre du diagnostic éducatif (DE), nous présenterons une approche pratique du concept éducatif appliqué à l’AP dans les maladies cardiovasculaires en envisageant les outils utiles au DE ainsi qu’à la mise en place de l’intervention éducative, et enfin les éléments permettant la personnalisation des actions éducatives.

Abstract

Sedentary lifestyle remains a major cardiovascular risk factor. The benefits of physical activity (PA) are now clearly established, for both primary and secondary prevention, and recommendations are regularly updated by international scientific societies. However, there are still some controversial points, mainly concerning the type and intensity of PA. The main difficulty with these issues concern how to customize PA, in order to make it “enjoyable” and improve compliance, by creating lasting changes in health behavior. Integrating the promotion of PA in a structured therapeutic education approach can allow achieving this goal. After recalling the central role of PA in the educational diagnosis (ED), we present a practical approach of the educational concept applied to PA in cardiovascular diseases, the tools that can be used for ED as well as for the implementation of the educational intervention, and cues to customize the therapeutic education action for the PA to the patient.

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Correspondence to M. Labrunée.

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Satge, J., Gremeaux, V., Guiraud, T. et al. Comment optimiser l’alliance thérapeutique autour de l’activité physique dans les maladies cardiovasculaires ?. Lett Med Phys Readapt 29, 119–128 (2013). https://doi.org/10.1007/s11659-013-0362-3

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  • DOI: https://doi.org/10.1007/s11659-013-0362-3

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