06.11.2024

The benefits of Adapted Physical Activity (APA) for rehabilitation

Interview with Charlotte Brun

Charlotte Brun is a sports instructor in Adapted Physical Activity (APA) at the Clinique Valmont. She tells us more about this little-known discipline, which is nonetheless essential to the orthopaedic and neurological rehabilitation process. The aim is to re-train patients by giving them back a taste for movement through tailored, individualised sports activities that are practical, beneficial and enjoyable.

What is Adapted Physical Activity (APA)?

Adapted Physical Activity (APA) involves physical and sporting activities that are modified to best suit the physical abilities, expectations, needs and psychological state of each individual. The aim is to re-train patients by giving them back a taste for movement through tailored, individualised sports activities that are practical, beneficial and enjoyable. This can involve both analytical exercises and sporting activities to improve mobility, strength, endurance, balance and coordination.

At Clinique Valmont, what do you offer patients who have undergone knee replacement surgery?

Following the fitting of a prosthesis, patients generally experience a lack of mobility in the joint and a loss of muscle strength in the operated limb, and are often afraid to put any weight on it. We therefore suggest activities such as cycling to improve the amplitude of the joint, pure muscle strengthening exercises and adapted sports activities. In the case of a knee prosthesis, we don't ask patients to take part in a volleyball match, but rather to perform a series of cuffs, the famous movement for catching a ball. This involves bending and extending the knee to lift the ball upwards. By linking this movement together, patients indirectly work on the range of movement of their knee joints and the strength of their leg muscles. To encourage patients to put weight on their operated leg, we often suggest bowling. The idea is not to build up momentum before the throw, or even to play with a large, heavy bowling ball, but to adapt the practice to facilitate the movement. The run-up will be very short, even limited to a single step forward, and the bowling ball will be replaced by a simple ball that knocks over light pins.

What about hip prosthesis?

In this case, football is a sport that we often suggest. The aim is not to chase a ball, dribble or even shoot at a goal, but simply to make a few short passes while standing still. Receiving and blocking a ball rolling along the ground requires hip flexion and work on the hip flexor muscle, known as the psoas. To encourage the patient to put weight on the side of the operated limb, darts are an ideal activity, as to reach the target, the patient has to propel himself forward and then stop his momentum by loading his front leg.

The clinic also specialises in neurological rehabilitation. As an APA sports instructor, do you also work in this field?

Yes, of course. In patients suffering from neurodegenerative pathologies – such as Parkinson's disease and multiple sclerosis – or stroke victims, it is necessary to work on overall mobility, cardiorespiratory endurance and whole-body strength. Following orthopaedic surgery, we use equipment such as a bicycle, rowing machine or treadmill, as well as machines and accessories. However, with these patients, the main problem often remains balance, which we also have to train through sporting activity.

Our expert

Clinique Valmont

Charlotte Brun

Specialisation
Adapted physical activity, Alter G, Global reconditioning, Parkinson View more

And precisely how do you find sporting activities that keep patients safe despite balance problems?

Practising a sporting activity while maintaining balance is very often a complex task for these patients, because it involves a double task. As you said, safety is paramount in this case. So our role is to adapt the practice or the practice environment to enable safe working. To do this, we will, for example, place the patient in a corner of the room, giving them two fixed points of reference on which they can rest if they become unbalanced. In terms of activities, we often adapt Frisbee, using flying plastic cups, and badminton, where the shuttlecock is replaced by a balloon. This reduces the speed of the game and the need for patients to react quickly. Ping-pong is also an interesting exercise for training balance and coordination, as the patient has to analyse the situation quickly in order to catch the ball and return it to the other side of the net. This analysis and interpretation part has to be done quickly, without forgetting the main task of maintaining balance.

Many other sporting disciplines are also available at the clinic, including archery, basketball, tennis, boxing, pétanque, croquet and group gymnastics classes.