2023-06-03 18:46:08
MONTREAL — Doctors often have to work hard to convince their patients to start moving again after a stroke, which is crucial to their recovery.
The task was perhaps a little simpler in the old premises of Notre-Dame Hospital, where patients lived together three or four per room without access to an individual bathroom.
“It was probably a stimulus for people to want to get out of their room, to go somewhere else, to go to the cafeteria,” said Dr. Olivier Jacquin, a stroke neurologist at the CHUM.
But when the neurology department moved into its new premises at the CHUM a few years ago, he continues, a glaring change in behavior that everyone observes occurred: “Patients no longer leave their rooms, he said. -he says. They are much more comfortable than what they experienced in our old premises. At the CHUM, there are large single glazed rooms with a view of the city center.”
Specialists had not calculated the impact this could have on the duration of hospitalizations and on the rehabilitation of patients, he admitted.
It is in particular to remedy this unexpected situation that the Parcours locomotive was created, a series of green dots fixed to the ground which guide patients to posters ― sometimes humorous in flavor ― which allow them to better understand stroke and its challenges, which offer exercises adapted to the abilities of patients, and which put forward tips for better living with stroke and preventing it.
Originally from Switzerland, the project manager, Dr. Céline Odier, was inspired by nature trails that are offered to patients in her home to develop the Parcours locomotive with physiotherapist Marie-Andrée Desjardins, researcher Line Beaudet, the clinical nurse Judlène Joltéus and a few patient partners.
“We had this idea of doing exercises, then maybe training, in any case to make the patients move in a little more organized way, she said. We thought it could be a good way to get (the patients) out, to get them moving, to talk with other people and therefore also to stimulate them cognitively, then it’s all that a bit put together which led to the Locomotive Route.”
It is not unusual during a hospitalization to see a patient withdraw into himself and become a little less active, said Dr. Odier. Data even shows that up to 75% of patients are inactive ― both physically and cognitively ― after a stroke, even if they are in a rehabilitation center. Bedridden in their room, they wait for time to pass or watch television.
However, physical activity and the simple act of interacting with other people are crucial to rehabilitation.
The Parcours locomotive is made up of four sections dealing with prevention; stroke and its treatment; rehabilitation; and the possible repercussions of the disease.
Some of the exercises offered to patients are illustrated with caricatures drawn by well-known animator Jean-Pierre Coallier. For example, we propose to articulate and repeat “100 times simple words” and to move “everything that moves! 10 times 100 times a day +++”.
Other posters deal with sexuality after stroke, or mood or cognitive disorders that can accompany the disease. The course is therefore interesting not only for patients, but also for families who sometimes find themselves very helpless in the face of this tragedy.
“What is difficult, said Dr. Odier, is that there is no recipe that works for everyone. Everyone experiences stroke in their own way, with their background, with their own emotions. We don’t have a magic phrase that will activate our patients. So we try to find ways to encourage them to discover the pleasure of exercise. We try to find the little spark.
It is always difficult, she admits, to scientifically document the benefits of physical activity after a stroke, since some patients come out of it more or less damaged than others. But overall, we see that moving has a positive impact not only on the body, but also on mood and memory.
The Parcours locomotive had to stop at the station when the COVID-19 pandemic hit. This involuntary break, said Dr. Odier, will at least have allowed the team to expand its website.
Relaunched “more actively” for a few months, the Locomotive course is reaching its cruising speed.
“The majority of patients thank us and are very satisfied,” said Dr. Odier. They find that it brings them things to do and information that they had not had.
The project even arouses the curiosity of other CHUM departments ― such as cardiology, whose patients also need to move ― and other health establishments.
“The idea is to give people the little spark so that they become active throughout their journey, so that they don’t remain passive enjoying the therapies,” concluded Dr. Odier. They must themselves seek out what suits them, what nourishes them to take them further in their rehabilitation after the stroke.”
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On the Internet:
https://www.chumontreal.qc.ca/repertoire/parcours-locomotive
1685827866
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