Correction de l’hypoxémie d’exercice chez le BPCO : variabilité des réponses, enjeux et problèmes posés dans le cadre de la réhabilitation respiratoire

Aim

To define in chronic obstructive pulmonary disease patients (COPD) moderately hypoxemic in resting conditions, if controlled acute oxygen supplementation was always able to increase exercise tolerance when partial oxygen saturation SpO₂ was corrected.

Results

In hyperoxia, endurance time (T_LIM) was significantly and consistently increased in 14 COPD (+68%) and decreased in seven others (–36%). These two subgroups exhibited no difference in resting values or in their disease severity. COPD with a decreased T_LIM under hyperoxic conditions had an abnormal response to O₂: unchanged cardiac output and ventilation, increased breathing frequency.

Conclusion

This work shows that acute O₂ supplementation responses in COPD are not univocal, either on exercise tolerance or cardio-respiratory variables typically affected by hyperoxia.     

Cinétique de la consommation d’oxygène chez le cycliste amateur

Aims

Study was to analyze the relationship between oxygen uptake and power output in amateur cyclists before and after threshold corresponding to a blood lactate concentration of 4 mmol/l.

Methods

We evaluated 109 subjects and they were divided according to age, cycling speciality, level and period. Each subject performed an incremental exercise test (50 W per 3 min) until exhaustion on an electromagnetically braked cycloergometer. Gas exchange data were continuously analyzed and recorded using an automated breath by breath system. Mean values of oxygen uptake were taken during the last minute of each stage in order to build and calculate the regression equations.

Results

The total sample presents an oxygen–kinetic deflection after lactate threshold, with the slope before threshold significantly higher (P < 0.001) than the slope after threshold. This indicates an absence of linearity. Considering the level, the slope and intercept before threshold of the national group presented significantly lower values than regional cyclists. For speciality, the slope before threshold is significantly lower in mountain bike group compared to road. Slope's analyse before and after lactate threshold could present complementary criteria for a good discrimination in comparison with classic concepts used during an incremental exhaustive test.     

La technique de Didier Patte dans les luxations récidivantes de l’épaule : notre expérience à propos de 35 cas avec un suivi d’une dizaine d’années

Aims

Authors report their personal experience on the surgical treatment of repeated anterior shoulder dislocations, using an anterior bone block in accordance with the procedure suggested by Didier Patte.

Results

From the year 1988 and during 10 years, 35 patients suffering from repeated anterior shoulder dislocations were surgically treated by this procedure. It was appropriate to retrospectively review the clinical and functional outcomes after Patte repair for recurrent anterior glenohumeral instability. The mean follow-up was approximately 10 years, with a mean percentage of 75% for the observance. There was no recurrence after surgery. Moreover, 88% of patients had good outcomes, according to the scale suggested by Butel et al., with total resumption of work and physical activities. The occurrence of chronic complication such as osteoathrosis was scarce (only one case for the series), while 20% of subjects showed apprehension during some specific shoulder movements.

Conclusion

In order to expect best functional outcomes, the choice of the surgical procedure should take into account the extent of initial injury. Considering these ground requirements, the Patte procedure seems to provide very satisfactory long-term functional outcomes.     

Activité physique adaptée et qualité de vie liée à la santé lors d’un séjour hospitalier chez des enfants atteints d’un cancer : APOP, un essai randomisé en cross-over

Introduction

The objective was to assess the efficacy of adapted physical activity on quality of life of hospitalized children and adolescents with cancer.

Facts

Thirty children were included in the APOP study (mean age 13.6 ± 2.9 years; 18 males). Cross-over analysis revealed no effect of period or interaction between physical activity and period. Quality of life was higher when children practiced than when they did not practice physical activity during their hospitalization, as reported by both children and parents, for the dimensions of physical functioning (P < 0.0001), role/social-physical limitations (P = 0.001), self-esteem (P < 0.0001) and mental health (P < 0.0001). Physical activity had a significant effect on the general behavior dimension (P = 0.01), as reported by children, and on the bodily pain dimension (P = 0.0004), as reported by parents.

Conclusion

Physical activity practiced during hospitalization for children with cancer was associated with better health-related quality of life.