Education thérapeutique et activité physique adaptée dans la maladie veineuse chronique

Titre original : 
Systematic review of adapted physical activity and therapeutic education of patients with chronic venous disease.
Titre en français : 
Revue systémique de l'activité physique adaptée et de l'éducation thérapeutique chez les patients atteints d'une pathologie veineuse chronique.
Auteurs : 
Thibert, A., Briche, N., Vernizeau, B. D., Mougin-Guillaume, F., Béliard S.
Revue : 
Journal of Vascular Surgery: Venous and Lymphatic Disorders, Volume 10, Issue 6, November 2022, Pages 1385-1400




Résumé : 

BACKGROUND

Chronic venous disease (CVD), comprising impaired lower limb venous return, will lead to chronic distal venous pressure overload manifested by various clinical signs and symptoms and resulting in diminished quality of life. The CEAP (Clinical, Etiology, Anatomy, and Pathophysiology) classification of CVD distinguishes six stages (C0-C6) using clinical, etiologic, anatomic, and pathophysiologic parameters. In the present study, we analyzed the effects of adapted physical activity (APA) and patient-oriented therapeutic education (PTE) programs on the clinical signs, symptoms, and quality of life of patients with CVD.

 

METHODS

Our analysis, in accordance with the PRISMA (preferred reporting items for systematic reviews and meta-analyses) recommendations, included a search of PubMed, CINAHL and LiSSa databases, using a single search equation.

 

RESULTS

A total of 21 studies were selected for analysis. The analysis revealed first, that patients at stage C0 to C5 had had access to an APA program. This therapy alleviated the clinical signs and symptoms and improved the patients’ quality of life. The beneficial effects of APA were greater in the programs that had included aquatic activities than in the program that were exclusively dry-land programs. Second, patients at stage C6 had predominantly followed a PTE program. This therapy showed beneficial effects on the clinical signs and symptoms. However, the quality of life had rarely been assessed.

 

CONCLUSIONS

At present, APA and PTE programs comprise useful and complementary therapeutic options for the care of patients with CVD. Two of the studies included in our review had evaluated the effects of combining these two approaches, notably in the context of balneotherapy, and reported promising results.