Ten thousand steps and more. The benefits of physical activity have long been known for cardiovascular diseases, for prevention but also as therapy. It is even in this area that its protective effects were observed for the first time, in the 1950s. And they are very significant: numerous studies show that an exercise retraining program reduces by 20% to 30 % relapses of coronary heart disease and 30% mortality of cardiovascular origin, according to the 2019 Inserm collective expertise “Physical activity: prevention and treatment of chronic diseases”. A challenge that is all the greater given that these pathologies are the main cause of death in the world.
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After a cardiovascular accident such as myocardial infarction, followed or not by an intervention (revascularization, bypass surgery, etc.), a rehabilitation program in a medical care and rehabilitation center (SMR) is recommended, including physical activity ( AP) is a key element. But, in fact, only “a quarter of eligible patients benefit from this stay”estimates Alain Fuch, president of the Azur Sport Santé association.
Specialists then recommend adapted physical activity (APA) sessions. In reality, it’s not that simple. “Either the patient considers himself cured and sees no benefit, or the offer is chargeable and/or insufficient”, notes Alain Fuch. Structures exist, such as those listed by the French Cardiology Federation, which brings together 269 heart and health clubs.
Progressive autonomy
The idea of creating a bridging offer, in the form of APA after rehabilitation, came from Stéphane Diagana, one of the co-founders of Azur Sport Santé, in 2015. “We wanted to study the impact on the health of these people, and also on the economic level”, explains the former athlete, very invested in sport-health. Forty-five people living in the Alpes-Maritimes, in a context of coronary heart disease, aged 63 on average, participated for five months.
“The study clearly demonstrated that a progressively independent physical activity program led to better participation in sessions at five months and better quality of life at twelve months of follow-up”indicates the article published in BMC Cardiovascular Disorders in 2018. On the economic level, a reduction of 30% (or almost 1,300 euros per year) in health expenses was noted for people who followed the program.
Certainly, “the weakness of the study is its small sample, recognizes Stéphane Diaganabut the extent of the drop in health spending encouraged us to initiate a second phase”. This program, called “Ace of hearts”, was secondarily introduced in the Social Security financing bill (PLFSS) of 2018, which makes it possible to experiment with innovative devices aimed at improving patient care.
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