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Communication Dans Un Congrès Année : 2023

Eccentric resistance training and yoga program supervised by videoconferencing in adolescents with anorexia nervosa: the APAREXIM-Pilot randomized controlled clinical

Résumé

Introduction: Anorexia nervosa (AN) affects mainly adolescent girls and is characterized by strict and voluntary food deprivation. AN affects 4% of the population in Europe and is one of the most fatal psychiatric diseases. The treatment is multidisciplinary and remains long and complex due to the diversity of symptoms and lack of adherence to the treatment protocol (Treasure, 2020). Theoretical framework and methodology: AN involves multiple physical and psychological disorders requiring integration of various non-pharmacological interventions. Recently, the integration of Adapted Physical Activity (APA) has been progressively developed in order to improve adherence to care, to manage main symptoms of AN and associated disorders. However, interventional research in this area remains limited and sparse. Moreover, the literature does not report any evaluation of the acceptability and effectiveness of an APA intervention supervised by videoconference at home, which is nevertheless a relevant device to ensure good compliance and therapeutic continuity in outpatient care (Kuldavletova et al., 2021; Toutain et al., 2022). Primary objectives of this RCT study were to evaluate the feasibility and acceptability of a videoconferenced APA program (two one-hour sessions per week for 8 weeks of eccentric resistance training and yoga) and its effect on the main symptoms of AN. Secondary objectives were to assess its impact on mental health, physical condition, sleep and diurnal activity level. Fourteen adolescent girls from pediatric psychiatry service of the CHU of Caen were randomly assigned to the APA-group and to control group, and underwent an initial assessment (T1) at the COMETE laboratory (questionnaires, physical tests, sleep diary and actimetry) and a post-program assessment (T2). Results and discussion: There were no dropout and entire APA-group completed the program. The mean score on acceptability questionnaire was high and consistent (13.28/16±3.8). These results validated the feasibility and acceptability of APA via video-conferencing. Repeated-measures ANOVA and Tukey post-hoc analysis were performed to compare T1 and T2 results between groups and interaction effects. Significant (p<.05) decrease for both groups in main symptoms (EAT-26) revealed no deleterious effect due to APA. [PL1] [MT2] In the APA-group, a significant (p<.05) increase was observed in trunk endurance, elbow extension peak-torque and sleep efficiency. Significant decrease in interoceptive awareness trusting-subscale and increase in the 10 most active hours was found for the control group. These results revealed an improvement of physical condition and sleep quality for the APA-group, while the control group decreased interoceptive awareness and increased diurnal activity level. The latter is promising and suggest that control group may have reengaged in problematic exercise while the APA-group did not (or less). Thus, APA could help to regulate sleep disturbance and deleterious hyperactivity in AN (Achamrah et al., 2016). Conclusions and perspectives: Although sample size was small, primary objectives were met since APA by video-conferencing was well accepted and had no deleterious effects on patients' health. Concerning secondary objectives, sleep and physical health improved and diurnal activity was stabilized for the APA group. Nevertheless, these promising results need to be confirmed in a larger study sample to achieve a satisfactory level of evidence. References: Achamrah, N., Coëffier, M., & Déchelotte, P. (2016). Physical activity in patients with anorexia nervosa. Nutrition Reviews, 74(5), 301‑311. https://doi.org/10.1093/nutrit/nuw001 Kuldavletova, O., Pasquier, F., Bigot, L., Langeard, A., Gauthier, A., & Quarck, G. (2021). Videoconference-Based Adapted Physical Exercise Training Is a Good and Safe Option for Seniors. International Journal of Environmental Research and Public Health, 18(18), 9439. https://doi.org/10.3390/ijerph18189439 Toutain, M., Gauthier, A., & Leconte, P. (2022). Exercise therapy in the treatment of anorexia nervosa : Its effects depending on the type of physical exercise—A systematic review. Frontiers in Psychiatry, 13. https://www.frontiersin.org/articles/10.3389/fpsyt.2022.939856 Treasure, J. (2020). Eating disorders. Medicine, 48(11), 727‑731. https://doi.org/10.1016/j.mpmed.2020.08.001
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hal-04355496 , version 1 (20-12-2023)

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  • HAL Id : hal-04355496 , version 1

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Marc Toutain, Antoine Gauthier, Lucas Lalande, Marine Heude, Delphine Cuvillon-Nimal, et al.. Eccentric resistance training and yoga program supervised by videoconferencing in adolescents with anorexia nervosa: the APAREXIM-Pilot randomized controlled clinical. 20ème congrès international de l'ACAPS (Association des Chercheurs en Activité Physique et Sportive), Oct 2023, Reims, France. ⟨hal-04355496⟩
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