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Colas C, Le Berre Y, Fanget M, Savall A, Killian M, Goujon I, Labeix P, Bayle M, Féasson L, Roche F, Hupin D. Physical Activity in Long COVID: A Comparative Study of Exercise Rehabilitation Benefits in Patients with Long COVID, Coronary Artery Disease and Fibromyalgia. Int J Environ Res Public Health 2023; 20:6513. [PMID: 37569053 PMCID: PMC10418371 DOI: 10.3390/ijerph20156513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023]
Abstract
Exercise in long COVID is poorly studied. Nevertheless, exerciserehabilitation could improve cardiorespiratory, muscular and autonomic functions. We aimed to investigate improvement in physical and autonomic performances of long COVID patients (n = 38) after a 4-week exercise rehabilitation program (3 sessions/week) compared to two control groups composed of coronary artery disease (n = 38) and fibromyalgia patients (n = 38), two populations for whom exercise benefits are well known. Efficacy of exercise training was assessed by a cardiopulmonary exercise test, a handgrip force test, and a supine heart rate variability recording at rest before and after the rehabilitation program. Cardiorespiratory and muscular parameters were enhanced after exercise rehabilitation in the three groups (p < 0.001). No significant difference was observed for the autonomic variables. Through this comparative study with control groups, we confirm and reinforce the interest of caring for long COVID patients without post-exertional symptom exacerbation by exercise rehabilitation of both strength and endurance training, by personalizing the program to the patient and symptoms.
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Affiliation(s)
- Claire Colas
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, 42000 Saint-Etienne, France
- INSERM, U1059, DVH Team, SAINBIOSE, Jean Monnet University, 42000 Saint-Etienne, France
| | - Yann Le Berre
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, 42000 Saint-Etienne, France
- Jacques Lisfranc Medicine Faculty, Jean Monnet University, 42000 Saint-Etienne, France
| | - Marie Fanget
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, 42000 Saint-Etienne, France
- INSERM, U1059, DVH Team, SAINBIOSE, Jean Monnet University, 42000 Saint-Etienne, France
| | - Angélique Savall
- INSERM, U1059, DVH Team, SAINBIOSE, Jean Monnet University, 42000 Saint-Etienne, France
- Department of Education and Research in General Practice, Jean Monnet University, 42000 Saint-Etienne, France
| | - Martin Killian
- Department of Internal Medicine, University Hospital Center of Saint-Etienne, 42000 Saint-Etienne, France
- CIRI-Centre International de Recherche en Infectiologie, Team GIMAP, Jean Monnet University, Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR530, 42000 Saint-Etienne, France
- CIC 1408 Inserm, University Hospital Centre of Saint-Etienne, 42000 Saint-Etienne, France
| | - Ivan Goujon
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, 42000 Saint-Etienne, France
| | - Pierre Labeix
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, 42000 Saint-Etienne, France
- INSERM, U1059, DVH Team, SAINBIOSE, Jean Monnet University, 42000 Saint-Etienne, France
| | - Manon Bayle
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, 42000 Saint-Etienne, France
| | - Léonard Féasson
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, 42000 Saint-Etienne, France
- Inter-University Laboratory of Human Movement Biology, EA 7424, Jean Monnet University, 42000 Saint-Etienne, France
| | - Frederic Roche
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, 42000 Saint-Etienne, France
- INSERM, U1059, DVH Team, SAINBIOSE, Jean Monnet University, 42000 Saint-Etienne, France
| | - David Hupin
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, 42000 Saint-Etienne, France
- INSERM, U1059, DVH Team, SAINBIOSE, Jean Monnet University, 42000 Saint-Etienne, France
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2
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Labeix P, Court Fortune I, Muti D, Berger M, Chomette-Ballereau S, Barthelemy JC, Féasson L, Costes F. The effect of a pressure ventilatory support on quadriceps endurance is maintained after exercise training in severe COPD patients. A longitudinal randomized, cross over study. Front Physiol 2022; 13:1055023. [DOI: 10.3389/fphys.2022.1055023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose: In severe chronic obstructive pulmonary disease (COPD) patients, the application of an inspiratory pressure support (IPS) during exercise increases exercise tolerance and the benefit of exercise training during pulmonary rehabilitation (PR). Moreover, it improves quadriceps endurance after a session of cycling exercise suggesting a reduced muscle fatigue. We looked for the persistence of this effect after PR and sought an association between the improved quadriceps endurance with IPS and the training load during PR.Patients and methods: We studied 20 patients with severe COPD (6 in stage 3and 14 in stage 4 of GOLD) before and after PR. As part of a PR program, patients completed 16 cycling sessions over 6 weeks with the addition of IPS during exercise. As a surrogate of muscular fatigue, quadriceps endurance was measured at 70% of maximal strength in a control condition, after a constant work rate exercise test (CWR) with IPS (TlimQ IPS) or with a sham ventilation (TlimQsham), in a random order. These tests were repeated similarly at the end of PR.Results: PR was associated with a significant increase in maximal power output, cycling endurance, quadriceps strength and endurance. Session training load (power output x duration of the session) increased by 142% during the course of the program. Before PR, CWR duration increases with IPS compared to sham ventilation (Δtime = +244s, p = 0.001). Compared to control condition, post-exercise TlimQ reduction was lower with IPS at isotime than at the end of CWR or than with sham ventilation (−9 ± 21%, −18 ± 16% and −23 ± 18%, respectively, p = 0.09, p < 0.0001 and p < 0.0001). After PR, the post-exercise decrease of TlimQ was reduced after IPS compared to sham (−9 ± 18% vs. −21 ± 17%, respectively, p = 0.004). No relationship was found between the prevention of quadriceps fatigue and the training load.Conclusion: In severe COPD patients, the beneficial effect of a ventilator support on quadriceps endurance persisted after PR with IPS. However, it was not related to the increase in training load, and could not predict the training response to non-invasive ventilation during exercise.
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Colas C, Bayle M, Labeix P, Botelho-Nevers E, Gagneux-Brunon A, Cazorla C, Schein F, Breugnon E, Garcin A, Feasson L, Roche F, Hupin D. Management of Long COVID—The CoviMouv' Pilot Study: Importance of Adapted Physical Activity for Prolonged Symptoms Following SARS-CoV2 Infection. Front Sports Act Living 2022; 4:877188. [PMID: 35847457 PMCID: PMC9283867 DOI: 10.3389/fspor.2022.877188] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/01/2022] [Indexed: 12/03/2022] Open
Abstract
Context After a COVID-19 infection, some patients have persistent symptoms, the most common is fatigue. To prevent it from becoming chronic (post-COVID-19 syndrome), early management before 3 months could be useful. Exercise and education are recommended. Objective To assess fatigue in patients with prolonged symptoms after COVID-19 infection and who received a mixed program of remote adapted physical activity and therapeutic education. The secondary objective was to evaluate the efficacy and safety of this training method thanks to aerobic and anaerobic parameters. Methods “CoviMouv': From Coaching in Visual to Mouv in real” is a nonrandomized controlled pilot study. Patients in telerehabilitation followed 12 remote exercise sessions and 3 therapeutic education workshops. Patients on traditional rehabilitation followed their program with a community-based physiotherapist. Results Fatigue was reduced after the one-month intervention in both groups (p = 0.010). The majority of aerobic parameters were significantly improved, e.g., maximal oxygen uptake (p = 0.005), walking distance (p = 0.019) or hyperventilation values (p = 0.035). The anaerobic parameter was not improved (p = 0.400). No adverse event was declared. Discussion Telerehabilitation is a good alternative when a face-to-face program is not possible. This care at an early stage of the disease could help prevent the chronicity of post-COVID-19 symptoms and the installation of vicious circles of physical deconditioning. A larger study would be necessary.
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Affiliation(s)
- Claire Colas
- INSERM, U1059, SAINBIOSE, DVH, Lyon University, Jean Monnet University, Saint-Étienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
- Chaire Santé des Ainés, Presage Institute, Jean Monnet University, Lyon University, Saint-Étienne, France
- Chaire ActiFS, Presage Institute, Jean Monnet University, Lyon University, Saint-Étienne, France
- *Correspondence: Claire Colas
| | - Manon Bayle
- Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
| | - Pierre Labeix
- INSERM, U1059, SAINBIOSE, DVH, Lyon University, Jean Monnet University, Saint-Étienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
| | - Elisabeth Botelho-Nevers
- Department of Infectious Diseases, University Hospital Center, Saint-Étienne, France
- Chaire PreVacCI, Presage Institute, Lyon University, Jean Monnet University, Saint-Étienne, France
- CIRI, Team GIMAP, Univ Lyon, Université Jean Monnet, INSERM, U1111, CNRS, UMR530, Saint-Étienne, France
| | - Amandine Gagneux-Brunon
- Department of Infectious Diseases, University Hospital Center, Saint-Étienne, France
- Chaire PreVacCI, Presage Institute, Lyon University, Jean Monnet University, Saint-Étienne, France
- CIRI, Team GIMAP, Univ Lyon, Université Jean Monnet, INSERM, U1111, CNRS, UMR530, Saint-Étienne, France
| | - Céline Cazorla
- Department of Infectious Diseases, University Hospital Center, Saint-Étienne, France
| | - Flora Schein
- Department of Infectious Diseases, University Hospital Center, Saint-Étienne, France
| | - Emma Breugnon
- Department of Infectious Diseases, University Hospital Center, Saint-Étienne, France
| | - Arnauld Garcin
- INSERM, U1059, SAINBIOSE, DVH, Lyon University, Jean Monnet University, Saint-Étienne, France
- Innovation and Pharmacology Clinical Research Unit, University Hospital of Saint-Etienne, Saint-Étienne, France
| | - Léonard Feasson
- Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
- Chaire ActiFS, Presage Institute, Jean Monnet University, Lyon University, Saint-Étienne, France
- Interuniversity Laboratory of Human Movement Biology, EA 7424, Lyon University, Jean Monnet University, Saint-Étienne, France
| | - Frédéric Roche
- INSERM, U1059, SAINBIOSE, DVH, Lyon University, Jean Monnet University, Saint-Étienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
- Chaire Santé des Ainés, Presage Institute, Jean Monnet University, Lyon University, Saint-Étienne, France
| | - David Hupin
- INSERM, U1059, SAINBIOSE, DVH, Lyon University, Jean Monnet University, Saint-Étienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
- Chaire Santé des Ainés, Presage Institute, Jean Monnet University, Lyon University, Saint-Étienne, France
- Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden
- David Hupin
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Fanget M, Morin JB, Labeix P, Bayle M, Koral J, Peyrot N, Samozino P, Rossi J, Testa R, Busso T, Laukkanen JA, Roche F, Hupin D. An innovative cardiac rehabilitation based on the power-force-velocity profile to further improve cardiorespiratory capacities in coronary artery disease patients. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): Doctoral contract 2018-2022
Background
Several studies have shown the importance of the relationship between the power-force-velocity profile (PFVP) and sport performance in elite athletes through optimised exercise training.[1] Optimising the training programme is constantly sought in rehabilitation among patients always younger with coronary artery disease. Nowadays, it is well established that intermittent training should be offered to coronary patients during the rehabilitation cycle.[2] In this continuity, the assessment of the PFVP at the beginning of the cardiac rehabilitation (CR) would allow to better adapt the CR training programme for each patient.
Purpose
The aim of this study was to compare the effects of two exercise training programmes: a traditional CR versus a new CR relied on patient’s PFVP on cardiorespiratory, functional and autonomic systems in coronary patients.
Methods
This prospective randomized controlled trial was conducted from May 2020 to July 2021 in an university hospital. A total of 89 patients were randomly assigned (1:1) to test or control group. Before starting CR, participants performed two sprints of 8 s on a cycle ergometer to define the PFVP. The PFVP was analysed to determine whether the participant had a force or velocity deficit. Patients included in test group followed a specific cycling training programme based on their weak point (i.e., specific force training with high resistance and low pedalling frequency on the cycle if the PFVP was oriented in velocity and reversely). While control patients attended a conventional CR programme.
The 3-week training intervention consisted of 40 min of cycling, 30 min of walking on treadmill and 20 min of strength training (4/week).
Cardiopulmonary exercise test (VO2 at the first ventilatory threshold, SV1 and VO2 peak in ml/min/kg), functional assessments (distance of 6-min walk test, handgrip strength, 10 sit-to-stand repetitions, cholesterol levels, LDL-C and quality of life) and autonomic nervous system (heart rate variability and sensitivity baroreflex) were performed at the baseline and after CR.
A two-way ANOVA with one repeated measure (pre vs. post) and one independent factor (test vs. control) was realized.
Results
The mean age was 61.0 ± 9.6 years, 18% were women. A significant difference was observed in VO2 peak (test: +22.0 ± 19.1% vs. control: +10.2 ± 15.8%, p=0.003) and VO2 SV1 (test: +35.9 ± 33.9% vs. control: +11.9 ± 34.4%, p<0.001), LDL-C (p=0.016) and quality of life (p<0.001). No significant change between groups in other functional tests and autonomic activity occurred after CR programme.
Conclusion
Cardiopulmonary activity, cholesterol and quality of life were improved after 3-week exercise programme. The novel CR depending on initial PFVP showed greater cardiorespiratory benefits than a conventional CR. Therefore, the PFVP can be used in CR to adapt specifically the content of training sessions.
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Affiliation(s)
- M Fanget
- University of Saint-Etienne, Saint-Etienne, France
| | - JB Morin
- University of Saint-Etienne, Saint-Etienne, France
| | - P Labeix
- University Hospital of Saint-Etienne, Saint-Etienne, France
| | - M Bayle
- University Hospital of Saint-Etienne, Saint-Etienne, France
| | | | - N Peyrot
- Le Mans University, Le Mans, France
| | - P Samozino
- Savoie Mont Blanc University, Chambery, France
| | - J Rossi
- University of Saint-Etienne, Saint-Etienne, France
| | - R Testa
- University of Saint-Etienne, Saint-Etienne, France
| | - T Busso
- University of Saint-Etienne, Saint-Etienne, France
| | | | - F Roche
- University Hospital of Saint-Etienne, Saint-Etienne, France
| | - D Hupin
- University Hospital of Saint-Etienne, Saint-Etienne, France
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Fanget M, Bayle M, Labeix P, Roche F, Hupin D. Effects of Cardiac Telerehabilitation During COVID-19 on Cardiorespiratory Capacities in Patients With Coronary Artery Disease. Front Physiol 2022; 13:837482. [PMID: 35370786 PMCID: PMC8969221 DOI: 10.3389/fphys.2022.837482] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/07/2022] [Indexed: 12/27/2022] Open
Abstract
Background The COVID-19 pandemic led to the closure of most cardiac therapy centers. One of the solutions was to adapt the existing cardiac rehabilitation (CR) program in an institute to a remote approach offered by home-based telerehabilitation. The aim of this study was to measure the cardiorespiratory effects of telerehabilitation compared to conventional center-based CR. Methods Patients were assigned to two 3-week CR programs: telerehabilitation and conventional center-based CR. The telerehabilitation group wore a connected watch to monitor heart rate (HR) and gave their perception of effort according to a modified Borg scale. The exercise training (four sessions/week) consisted of 1-h aerobic endurance and strength training session at the target HR zone determined by results based on cardiopulmonary exercise test (CPET) and perception of effort, respectively. The exercise protocol was the same for conventional CR participants except the duration of session that lasted 2 h instead of one. The week before and after the training program, peak oxygen uptake (VO2 peak), oxygen uptake at first ventilatory threshold (VO2 at VT1), peak workload, percent of predicted maximum HR, and the absolute differences in HR and systolic blood pressure between maximum and recovery at 1 and 3 min were measured using a CPET. A two-way ANOVA with one repeated measure and one independent factor was performed. Results Fifty-four patients (mean age: 61.5 ± 8.6 years, 10 women) equally split in the two groups were included in this experiment. A significant increase was observed in both groups on VO2 peak (telerehabilitation: 8.1 ± 7.8% vs. conventional: 10.1 ± 9.7%, p < 0.001), VO2 at VT1 (telerehabilitation: 8.8 ± 4.4% vs. conventional: 7.3 ± 19.0%, p = 0.02) and peak workload (telerehabilitation: 16.6 ± 18.9% vs. conventional: 17.2 ± 7.0%, p < 0.001) after the 3-week telerehabilitation and conventional CR, respectively. No significant difference was noticed between both groups. Conclusion A 3-week exercise program improved patients’ cardiorespiratory fitness. Telerehabilitation was as effective and represents a safe alternative CR program during the COVID-19 period. In the future, this approach could facilitate the continuity of care for patients unable to participate in center-based CR.
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Affiliation(s)
- Marie Fanget
- INSERM, U1059, SAINBIOSE, DVH, University of Lyon, Jean Monnet University, Saint-Etienne, France
- *Correspondence: Marie Fanget,
| | - Manon Bayle
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
| | - Pierre Labeix
- INSERM, U1059, SAINBIOSE, DVH, University of Lyon, Jean Monnet University, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
| | - Frédéric Roche
- INSERM, U1059, SAINBIOSE, DVH, University of Lyon, Jean Monnet University, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
| | - David Hupin
- INSERM, U1059, SAINBIOSE, DVH, University of Lyon, Jean Monnet University, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France
- Department of Medicine, K2, Solna, Karolinska Institutet, Stockholm, Sweden
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Labeix P, Berger M, Zellag A, Garcin A, Barthelemy JC, Roche F, Hupin D. Resistance Training of Inspiratory Muscles After Coronary Artery Disease May Improve Obstructive Sleep Apnea in Outpatient Cardiac Rehabilitation: RICAOS Study. Front Physiol 2022; 13:846532. [PMID: 35360234 PMCID: PMC8961327 DOI: 10.3389/fphys.2022.846532] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/02/2022] [Indexed: 11/30/2022] Open
Abstract
Background Obstructive sleep apnea (OSA) affects 5% of the adult population and its prevalence is up to 13 times higher in coronary artery disease (CAD) patients. However, OSA in this population is less symptomatic, leading to lower adherence to positive airway pressure (CPAP). While oropharyngeal exercise showed a significant decrease in apnea-hypopnea index (AHI) in patients with moderate OSA, there have been no studies testing the impact of specific inspiratory muscle training (IMT) for these patients. The aim of our study was to assess the effectiveness of IMT on AHI reduction in CAD patients with moderate OSA. Methods We included patients with CAD involved in a cardiac rehabilitation program and presenting an AHI between 15 and 30. Patients were randomized in a 1:1 allocation to a control group (CTL – classic training) or an IMT group (classic training + IMT). IMT consisted in 60 deep inspirations a day, 6 days a week, into a resistive load device set at 70% of the maximum inspiratory pressure (MIP). After 6 weeks, we compared AHI, neck circumference, Epworth Sleepiness Scale, Pittsburgh Sleep Quality index, and quality of life with the 12-item Short Form Survey before and after rehabilitation. Results We studied 45 patient (60 ± 9 y, BMI = 27 ± 6 kg.m−2). The IMT group (n = 22) significantly improved MIP ( p < 0.05) and had a significant decrease in AHI by 25% (−6.5 ± 9.5, p = 0.02). In the CTL group (n = 23), AHI decreased only by 3.5% (−0.7 ± 13.1; p = 0.29). Between groups, we found a significant improvement in MIP ( p = 0.003) and neck circumference ( p = 0.01) in favor of the IMT group. However, we did not find any significant improvement of AHI in the IMT group compared to CTL ( p = 0.09). Conclusion A specific IMT during cardiac rehabilitation contributes to reduce significantly AHI in CAD patients with moderate OSA. Magnitude of the decrease in OSA severity could be enhanced according to implementation of specific IMT in this population.
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Affiliation(s)
- Pierre Labeix
- SAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Mathieu Berger
- SAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, France
- Center for Investigation and Research in Sleep, CHUV and UNIL, Lausanne, Switzerland
| | - Amandine Zellag
- SAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, France
- Infectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Arnauld Garcin
- SAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, France
- Innovation and Pharmacology Clinical Research Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Jean-Claude Barthelemy
- SAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, France
| | - Frederic Roche
- SAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - David Hupin
- SAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France
- *Correspondence: David Hupin,
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Berger M, Barthélémy JC, Garet M, Raffin J, Labeix P, Roche F, Hupin D. Longer-term effects of supervised physical activity on obstructive sleep apnea and subsequent health consequences. Scand J Med Sci Sports 2021; 31:1534-1544. [PMID: 33772900 DOI: 10.1111/sms.13961] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/12/2021] [Accepted: 03/23/2021] [Indexed: 11/29/2022]
Abstract
Although recent trials have shown promising benefits of exercise on obstructive sleep apnea (OSA) severity, the long-term effect of these interventions remains unknown. The aim of this study was to assess the effect of a 9-month community physical activity program on OSA severity one year later in free-living conditions. OSA patients, previously included in a 9-month randomized controlled trial (EXESAS study) evaluating the effects of supervised community physical activity on OSA severity, were invited to participate in an extra one-year observational study. Twenty-eight patients completed the study. Although OSA severity did not significantly worsen over the real-life period (9 to 21 months of follow-up), reductions in apnea-hypopnea index (AHI) and oxygen desaturation index were no longer significant after 21 months of follow-up compared to baseline (baseline AHI: 22.2 ± 6.3 /h; 9 months: 16.3 ± 6.4 /h; 21 months: 18.7 ± 8.9 /h). Benefits observed at 9 months on daytime sleepiness and mental health were preserved at 21 months, whereas cardiorespiratory fitness slightly decreased. Per-protocol analysis revealed that patients who stopped exercise at 9 months had worsened OSA severity compared to those who continued exercise during the real-life period (AHI: +9.0 ± 8.8 vs. -1.3 ± 5.3 /h; p < .01). In conclusion, our study suggested that improvements in OSA severity remain transient and is dependent on long-term adherence to regular physical activity practice.
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Affiliation(s)
- Mathieu Berger
- SNA-EPIS Laboratory, University of Lyon, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France.,IRAPS, French Federation for Physical Education and Voluntary Gymnastics (FFEPGV), Montreuil, France
| | - Jean-Claude Barthélémy
- SNA-EPIS Laboratory, University of Lyon, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France.,INSERM SAINBIOSE, U1059, Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne, France
| | - Martin Garet
- SNA-EPIS Laboratory, University of Lyon, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France.,INSERM SAINBIOSE, U1059, Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne, France
| | - Jérémy Raffin
- SNA-EPIS Laboratory, University of Lyon, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Pierre Labeix
- SNA-EPIS Laboratory, University of Lyon, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France.,INSERM SAINBIOSE, U1059, Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne, France
| | - Frédéric Roche
- SNA-EPIS Laboratory, University of Lyon, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France.,INSERM SAINBIOSE, U1059, Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne, France
| | - David Hupin
- SNA-EPIS Laboratory, University of Lyon, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France.,INSERM SAINBIOSE, U1059, Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, Saint-Etienne, France
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8
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Labeix P, Berger M, Court Fortune I, Feasson L, Verges S, Costes F. Quadriceps Endurance Increases Following Cycling Exercise With Non-Invasive Ventilation In Moderate-To-Severe COPD Patients. A Non-Randomized Controlled Study. Int J Chron Obstruct Pulmon Dis 2019; 14:2461-2468. [PMID: 31806955 PMCID: PMC6842274 DOI: 10.2147/copd.s216347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 09/23/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Application of non-invasive ventilation (NIV) during exercise improves exercise tolerance in severe COPD patients; however, the underlying mechanism is only partially unraveled. As part of its known effect to unload the respiratory muscles, we looked for the influence of NIV on post-exercise quadriceps muscle endurance. Patients and methods We included 25 severe COPD patients entering an outpatient pulmonary rehabilitation program. They performed, on successive days, three quadriceps endurance tests at 70% of the maximal strength (1RM) to task failure (TlimQ); 1) control condition; 2) following constant load cycling exercise to exhaustion without Inspiratory Pressure Support (TlimQ IPS-); 3) following the same cycling exercise with IPS (TlmQ IPS+). Results Dyspnea Borg score was significantly reduced at the end of the constant load cycling exercise with IPS+ compared to IPS- (3.5±2.6 to 4.3±2.3, p<0.05). Compared to controlled condition, TlimQ was reduced from 78.9±22.7 s to 64.7±22.1 s (p<0.01) with IPS+ and to 48.9±13.7 s (p<0.001) with IPS-. Sensitive analysis revealed a positive effect of NIV on TlimQ in only 15 of the 25 included patients (60%) and was unpredictable from exercise tolerance or maximal quadriceps strength. Conclusion Using a simple muscle endurance test, we showed the protective effect of NIV on the exercise-induced quadriceps dysfunction. This beneficial effect is inconstant in our small series of patients and could not be predicted by exercise capacity or endurance to exercise. However, measuring quadriceps muscle endurance following a session of exercise could determine in which patient NIV would improve the benefit of pulmonary rehabilitation.
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Affiliation(s)
- Pierre Labeix
- Centre VISAS, Service de Physiologie Clinique et de l'Exercice, CHU St Etienne, France.,Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Saint-Etienne F-42023, France
| | - Mathieu Berger
- Univ Lyon, UJM Saint-Etienne, laboratoire SNA-EPIS, EA4607, Saint-Etienne, France
| | | | - Léonard Feasson
- Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Saint-Etienne F-42023, France.,Unité de Myologie, CHU St Etienne, France
| | - Samuel Verges
- Université Grenoble Alpes, Inserm, Laboratoire HP2, Grenoble, France
| | - Frédéric Costes
- Université Clermont Auvergne, INRA, UNH Clermont Ferrand, France.,Service de Médecine du Sport et des Explorations Fonctionnelles, CHU Clermont Ferrand, France
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Berger M, Raffin J, Pichot V, Hupin D, Garet M, Labeix P, Costes F, Barthélémy JC, Roche F. Effect of exercise training on heart rate variability in patients with obstructive sleep apnea: A randomized controlled trial. Scand J Med Sci Sports 2019; 29:1254-1262. [PMID: 31050034 DOI: 10.1111/sms.13447] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 03/22/2019] [Accepted: 04/24/2019] [Indexed: 12/16/2022]
Abstract
While obstructive sleep apnea (OSA) increases chemoreflex, leading to an autonomic dysfunction in the long term, no studies have yet assessed the potential benefit of exercise on cardiac autonomic activity in these patients. The aim of this study was to evaluate potential improvement in cardiac autonomic function (CAF) measured through heart rate variability (HRV) after a 9-month physical activity program in patients with OSA. Seventy-four patients with moderate OSA, aged 40-80 years, were randomly assigned to an exercise group (n = 36, 3 × 1 h/wk) or a control group (n = 38) during 9 months. Linear and nonlinear HRV parameters were measured during night using a Holter ECG. After 9 months, mean R-R intervals increased in the exercise group without any changes in HRV parameters, while controls decreased global (standard deviation of normal-to-normal intervals, total power) and parasympathetic (root mean square successive difference of N-Ns, very low frequency, high frequency, and standard deviation of the instantaneous beat-to-beat variability) indices of HRV (P < 0.05 for all). Significant correlations with moderate effect size were found between changes in apnea severity and changes in R-R intervals (P < 0.05). Improvement in moderate-to-vigorous physical activity was also correlated to improvement in nocturnal oxygen parameters (P < 0.05). In conclusion, supervised community physical activity may prevent a decline in nighttime CAF observed in nontreated community-dwelling patients with moderate OSA over a 9-month period. Thus, beyond apnea-hypopnea index improvement, exercise may be cardioprotective in OSA patients through bradycardia, CAF preservation, and VO2peak increase.
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Affiliation(s)
- Mathieu Berger
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France.,IRAPS, Fédération Française d'Éducation Physique et de Gymnastique Volontaire (FFEPGV), Montreuil, France
| | - Jérémy Raffin
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Vincent Pichot
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - David Hupin
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Martin Garet
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Pierre Labeix
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Frédéric Costes
- Service de Physiologie de l'Exercice, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - Jean-Claude Barthélémy
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Frédéric Roche
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
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Berger M, Barthélémy JC, Hupin D, Raffin J, Dupré C, Labeix P, Costes F, Gaspoz JM, Roche F. Benefits of supervised community physical activity in obstructive sleep apnoea. Eur Respir J 2018; 52:13993003.01592-2018. [DOI: 10.1183/13993003.01592-2018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 09/05/2018] [Indexed: 11/05/2022]
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Hupin D, Pichot V, Berger M, Raffin J, Labeix P, Maudoux D, Barthélémy J, Roche F. Obstructive sleep apnea syndrome in cardiac rehabilitation patients. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Saint Martin M, Labeix P, Garet M, Thomas T, Barthélémy JC, Collet P, Roche F, Sforza E. Does Subjective Sleep Affect Bone Mineral Density in Older People with Minimal Health Disorders? The PROOF Cohort. J Clin Sleep Med 2016; 12:1461-1469. [PMID: 27655463 PMCID: PMC5078700 DOI: 10.5664/jcsm.6266] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 06/30/2016] [Indexed: 01/04/2023]
Abstract
STUDY OBJECTIVES Clinical and epidemiological studies suggest a relation between bone mineral density (BMD) and self-assessment of sleep with an effect on bone formation and osteoporosis (OS) risk in short and long sleepers. This study explores this association in a large sample of older subjects. METHODS We examined 500 participants without insomnia complaints aged 65.7 ± 0.8 y. Each participant had a full evaluation including anthropometric measurement, clinical examination and measurements of BMD at the lumbar spine and femoral sites by dual-energy X-ray absorptiometry. The daily energy expenditure (DEE) was measured by the Population Physical Activity Questionnaire. Sleep duration and quality were evaluated by the Pittsburgh Sleep Quality Index. The subjects were stratified into three groups according to sleep duration, i.e., short (< 6 h), normal (6-8 h), and long (≥ 8 h) sleepers. RESULTS Osteopenia was found in 40% of the subjects at the femoral level and 43% at the vertebral level. The prevalence of OS was lower both at femoral (8%) and vertebral (12%) levels. Short, normal, and long sleepers accounted for 29%, 40%, and 31% of subjects, respectively. After adjustments for metabolic, anthropometric, and DEE, multinomial logistic regression analysis indicated that long sleepers were more likely to have femoral neck OS with a slight effect of DEE at vertebral spine. CONCLUSIONS In a sample of older subjects, self-reported long sleep was the best predictor of OS risk at the femoral level. This finding suggests an association between OS and self-reported sleep duration in older subjects. CLINICAL TRIAL REGISTRATION NCT 00759304 and NCT 00766584.
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Affiliation(s)
- Magali Saint Martin
- Service de Physiologie Clinique et de l'Exercice, CHU Nord, Saint-Etienne, Faculté de Médecine Jacques Lisfranc, PRES de Lyon, Université Jean Monnet, Saint-Etienne, France
- Service de Neurologie, réhabilitation cognitive, centre Hélio Marin, Hyères, France
| | - Pierre Labeix
- Service de Physiologie Clinique et de l'Exercice, CHU Nord, Saint-Etienne, Faculté de Médecine Jacques Lisfranc, PRES de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - Martin Garet
- Service de Physiologie Clinique et de l'Exercice, CHU Nord, Saint-Etienne, Faculté de Médecine Jacques Lisfranc, PRES de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - Thierry Thomas
- Service de Rhumatologie, CHU Saint-Etienne, Faculté de Médecine Jacques Lisfranc, Inserm U1059 LBTO, UJM, PRES de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - Jean-Claude Barthélémy
- Service de Physiologie Clinique et de l'Exercice, CHU Nord, Saint-Etienne, Faculté de Médecine Jacques Lisfranc, PRES de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - Philippe Collet
- Service de Rhumatologie, CHU Saint-Etienne, Faculté de Médecine Jacques Lisfranc, Inserm U1059 LBTO, UJM, PRES de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - Frédéric Roche
- Service de Physiologie Clinique et de l'Exercice, CHU Nord, Saint-Etienne, Faculté de Médecine Jacques Lisfranc, PRES de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - Emilia Sforza
- Service de Physiologie Clinique et de l'Exercice, CHU Nord, Saint-Etienne, Faculté de Médecine Jacques Lisfranc, PRES de Lyon, Université Jean Monnet, Saint-Etienne, France
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Labeix P, Duperrey R, Januel B, Costes F. Poster 11. Rev Mal Respir 2008. [DOI: 10.1016/s0761-8425(08)71634-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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