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Practising sports and physical activity with chronic illness in older age

Claire Perrin & Nathalie BarthCenter of Research and Innovation about Sport, EA 647University Claude Bernard Lyon 1

Financial Support of the French Institute of Prevention and Health Education

13 April 2015 Glasgow Caledonian University

+Therapeutic treatment of

type 2 diabetes

� Medication

� Balanced nutrition

� Regular Physical Activity (PA)

Patient education as a new fundamental component of

treating chronic illnesses

+� analyse the process of commitment to physical activity (PA),

� by looking at 22 subjects diagnosed with type 2 diabetes, who

engage in physical activity firstly via a therapeutic education

plan based upon Physical Activity (APA), either through a

hospital or health network, and thereafter via patient group

activities.

Physical education for health

Recommanding PA for health

Exercise

for the

organism

Autonomy as compliance

Information

Recommendations /

way of life Bio

méd

ical

ap

pro

ach

to

PA

Cu

ltu

ral

app

roac

h t

o P

A

Information

Promoting an active

lifestyle

Physical,

sports and

leisure

activities

Physical exercise,

programmes

Conceptions of

PA and

Autonomy

+1. Entry into an Adapted

Physical Activity follower career

� “When I was admitted to hospital, the doctors and

management talked to me about physical activity.

They told me it was a good thing to do but I didn’t

feel it was something for me”

(Eliane, 54, no occupation, hypertension, T2D

(1999), obese, intensive APA).

+1. Entry into an Adapted Physical Activity follower career

� “At first it was hard [to come], and then I’d never

been in gym shoes before. It was an amazing

exploit for me”

(Sylvianne, 64, retired cleaner, hypertension, T2D

(2003), depression (2004-2005), occasional APA).

� “I didn’t want to be with people who don’t have

health problems, no I wouldn’t have liked that, I

needed something adapted for me”

(Maryse, 72, retired postwoman, T2D (1990), period

of depression, regular APA).

+2. Perception of the effects of APA

� “I had a lot of aches and pains, I could feel that my

body was reacting. That was something new for me

(…). Doing sport first taught me to pay attention to my

body, the way I felt” (Paul, 61, retired bus driver, T2D

since 1984, regular activity).

� “(…) I realize that in the course of the sessions there

were things I couldn’t do at the start and that I can do

now” (Nathalie , age 54, unemployed former

ambulance driver, multiple pathology, regular APA).

� “Those 20 sessions showed me I could still achieve

something (in PA) and that I could move one from one

thing to another” (Christian, 79, retired accountant,

cardiac problem (2004), intensive APA).

+ 3. Constructing a taste for the

effects of activity

� “It’s like a drug now, I can’t live without coming here and

doing some physical exercise, it’s impossible” (Philippe,

57, retired from France Télécom, longstanding T2D,

cardiac problem (2005), obese, intensive APA).

� “I was in a state where I didn’t want to take care of my

body, I’ve never liked my body. (…) My body just

accumulated, and that’s what happened when I had my

depression. (…). My face, my eyes, I look after everything

that is more or less passable, I need to do it because it’s an

important part of my relation to others, and now I use

lotions, not out of vanity or to mask my age, I just need it to

have an image of myself that isn’t any more devalued”

(Ghislaine, 58, retired teacher, T2D (1997), depression

(1997) and obesity, regular APA).

+4. The impact of the APA-follower

career on the illness trajectory

� enables the patient to gain autonomy relative to the

illness trajectory, is the one from which patients

become able, in certain conditions, to have a

personal PA outside the medical world.

+Conclusion

� Diabetes networks unanimous about the goal of patient

autonomy

� A long term process

� Importance of the social experience of physical activity

� A professional specialized in Adapted Physical Activity

whose approach to teaching meets participants’ needs,

corresponds to their abilities and is meaningful to them

� The question is reversed : Physical Activity with chronic

illness could become Adapted Sport in certain conditions

� Practices of the Masters couldn`t be an example for

sedentary people affected by chronic illness

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Thank you for your attention