Article

Up until now, there has been little description of the test
exercises carried out in patients with neuromuscular diseases. However,
prescription of physical therapy by exercise requires rigorous individualized
assessment of the patient's physical endurance parameters. OBJECTIVE: To describe
exercise tolerance and external limitation factors in a sample group of adult
patients suffering from neuromuscular diseases. METHODS: A descriptive retrospective study of exercise tests realized at the Reims
university hospital for patients divided into three groups according to their
pathologies: CMT hereditary neuropathies, muscular dystrophies, metabolic
myopathies. RESULTS: Forty-four (44) tests were analyzed. Cessation was
occasioned on 63.6% of the cases by muscular symptomatology, with no possibility
of maintaining the cycling frequency in 29.5% of the overall population.
Insufficient lung volume recruitment was involved in 61.4% of the patients, final
oxygen pulse (VO2/heart rate) was 80% lower than the theoretical pulse in 50% of
the patients, and there existed an early first ventilatory threshold in 54.5% of
the cases. Peripheral deconditioning was highly severe in 18% of the population
and significantly greater in the subjects suffering from dystrophies (VT1 at 31%
of the maximum theoretical O2, P<0.001). DISCUSSION: The main limitation factor
in exercise tests is peripheral. Ventilatory and cardiovascular limitations can
nonetheless be added on; while they are absent when the patient is at rest, they
are unmasked in effort situations. Exercise tests could be of great interest in
screening and managing the relevant pathologies. Multicenter studies on
homogeneous populations could facilitate definition of the procedures specific to
exercise tests for patients suffuring from neuromuscular diseases.
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Langue : ANGLAIS ; FRANCAIS