[Practical advice for exercise-induced asthma in children: experience of the exercise training centre of Necker-Enfants malades hospital]. / Conseils pratiques pour l'asthme de l'enfant déclenché par l'exercice physique: expérience du centre de réentraînement à l'effort de l'hôpital Necker-Enfants-malades .

Now, to care exercise-induced asthma is not only to prescribe drugs. It is a global and interdisciplinary approach: the pulmonary rehabilitation, matching a therapeutic education and a physical training, with the goal of promoting a regular physical activity in the asthmatic child, achieving physiological benefits and improvement of quality of life. Getting from the experience of Necker-Enfants Malades Hospital's Training Centre, a few advises encourage the physical practice of the asthmatic child, and decrease risks of exercise-induced asthma: optimisation of treatments;progressive beginning and end of exercises; use of the diaphragmatic breathing, keeping up with the exercise; use of the ventilatory threshold (or dysponea threshold) as intensity of the aerobic training; practice of different activities promoting play and conviviality in sports and allowing the integration of sports in the daily life of the asthmatic child.

Factor analysis of quality of life, dyspnea, and physiologic variables in patients with chronic obstructive pulmonary disease before and after rehabilitation.

OBJECTIVE: To identify the relationships between quality of life (QOL) and the clinical state using factor analysis pre- and postrehabilitation. Patients with chronic obstructive pulmonary disease (COPD) suffer from a significant physiologic impairment associated with an altered QOL. Comprehensive rehabilitative programs, including exercise training, have beneficial effects on exercise tolerance and QOL for these patients. DESIGN: Factor analysis (n = 6) was conducted using the data of 32 patients with COPD. Patients had been evaluated for QOL using the Nottingham Health Profile (NHP), spirometric values, dyspnea, and the variables assessed by an incremental exercise test at three levels of activity. All measurements were obtained pre- and postrehabilitation. RESULTS: Factor analysis showed that the following two factors characterize the pathophysiologic condition of patients with COPD: (1) the specific cardiorespiratory responses to incremental exercise test and the spirometric values; and (2) the QOL results. The factor analysis results differed with the testing time (pre, post) and the level of activity. CONCLUSIONS: QOL, as evaluated by a generic questionnaire and the clinical state of patients with COPD, was independent; this independence characterized the pathophysiologic condition of our patients. Our results reinforce the usefulness of different types of evaluation, especially pre- and postrehabilitation, because they reflect independent benefits used to understand the success and follow-up of rehabilitative programs.

Quality of life and exercise tolerance in chronic obstructive pulmonary disease: effects of a short and intensive inpatient rehabilitation program.

The quality of life and the exercise endurance of patients with chronic obstructive pulmonary disease are impaired. The aim of our study was to determine the impact of a 3-wk intensive inpatient rehabilitation program on the quality of life of patients with chronic obstructive pulmonary disease and to examine the correlation between quality-of-life measures and physiologic measures throughout rehabilitation. Thirty-two patients with chronic obstructive pulmonary disease (20 men, 12 women) were evaluated by spirometry and maximal exercise testing for exercise endurance and by the French version of the Nottingham Health Profile for quality of life. Rehabilitation components were individualized exercise at ventilatory threshold (4 hr/day), health education, and physical therapy and relaxation for 3 wk. Our results showed an improvement in the quality of life (especially in physical mobility, energy, and social isolation) and exercise endurance (increase of 14% of maximal power and symptom-limited oxygen uptake). In contrast, no significant correlations were found between the quality of life and physiologic parameters (gas exchange, cardiovascular and lung function parameters) throughout rehabilitation. Changes in the quality of life seem to be independent of the physiologic results during the course of a short and intensive inpatient rehabilitation program. Quality of life should, therefore, be more systematically evaluated to determine the psychosocial benefits, which, although subjective, are important for encouraging patients' compliance with rehabilitation programs.