While rest has long been recommended to suffering people, things are changing. Studies show that sport is an effective treatment, like medications, for many pathologies. Of course, it’s not about running or jumping when you’re in pain and tired, but about moving every day and practicing physical activity adapted to your abilities. Already in 2008, an INSERM report indicated that “resuming appropriate regular physical activity is a major element in the treatment of the main chronic pathologies “. In 2012, the city of Strasbourg, a pioneer in “healthy sport”, set up a free physical activity program (swimming, cycling) for certain patients, with positive results. Four years later, finally, doctors were able to include physical activity on their prescriptions. And today, new provisions further expand the system.
Who is concerned ?
– At the beginning : the law to modernize our health system of 2016 introduced the possibility, for the attending physician, to prescribe adapted physical activity (APA) to people suffering from a long-term illness (ALD): diabetes, cancer, vascular accident cerebral, infarction, neurodegenerative disease, psychiatric disorders, multiple sclerosis… Goals : reduce risk factors and functional limitations. Nearly 10 million French people are affected.
– Which is new : the law aimed at “democratizing sport in France” and its implementing decree of March 2023 have expanded the beneficiaries of sport on prescription. From now on, people suffering from a chronic illness not classified as ALD (obesity, hypertension, etc.) and those losing their autonomy (elderly people, disabled people, etc.) are also concerned. “This makes 10 million more French people, or in total nearly 20 million who could be prescribed sport“indicates Dr Alexandre Feltz.
How to benefit from it?
– At the beginning : “The doctor ensures that the patient meets the criteria to benefit from the sports on prescriptionthat his state of health does not contraindicate the practice of physical activity for therapeutic purposes, then he prescribes physical activity adapted to his state of health for 3 or 6 months, explains Dr. Feltz. It can specify the sport, frequency, intensity. For my part, I believe that it is rather up to adapted physical activity (APA) professionals to judge..”
– Which is new : before, only the attending physician could prescribe appropriate physical activity. Since March 2023, all doctors involved in patient care (cardiologist, endocrinologist, psychiatrist, neurologist, etc.) can do so.. The patient must then contact an APA professional (physiotherapist, occupational therapist, psychomotor therapist, person with a diploma in adapted physical activity, etc.), who will make an assessment, will develop a program adapted to his pathology and his physical abilities, then provide a report to the prescribing doctor. To find an APA professional, you must contact your Regional Health Agency (ARS) or the Maison Sport Santé closest to you. There are now more than 500 in France.
What is the support?
At the beginning : the 2016 law does not provide for any specific organization or means of financing. As a result, the solutions come from local or private initiatives. “More and more cities, regional health agencies, regions, health insurance funds are covering all or part of the costssays Dr. Feltz. Likewise, some mutual offer partial financing.”
Which is new : last September, the government mentioned, as part of the 2024 Social Security financing bill, the possibility of reimbursement for adapted physical activity (APA). The decision and the terms of support should be known by the end of the year. “It is important to offer free activities, so that disadvantaged people, who are most affected by chronic diseases and often do not have the culture of sport, can benefit from its benefits”underlines the doctor.
Sport, a real medicine
The World Health Organization (WHO) and the National Health Security Agency (ANSES) make the promotion of physical activity and the fight against a sedentary lifestyle a priority. We move less and less (working at home, watching screens) and this inertia has dramatic repercussions on our health. “Physical activity is useful in primary prevention to reduce the risk of disease, and in secondary prevention to improve the quality and life expectancy of sick people.“, insists Dr. Feltz. It lowers blood pressure, strengthens bones and joints, maintains muscles, relieves stress, improves breathing, regulates blood sugar…”Against diabetes, 30 minutes of walking a day is as effective as the best medication. Practice regular physical activity reduces the risk of mortality in diabetics by 30 to 40%, women suffering from breast cancerpeople with chronic obstructive pulmonary disease (COPD)… and it’s like that for all diseases“, adds the doctor.
All disciplines can be practiced
“The prescribed physical activity is adapted to the abilities, but also to the tastes and constraints of each individual. This is most often 2 to 3 sessions of 30 to 60 minutes per week, for 3 to 6 months, renewable. Cycling, swimming pool and Nordic walking are popular. But all sports can be practiced as long as we adapt the rules, the equipment and the intensity. All sports federations (football, basketball, tennis, judo, etc.) now offer adapted physical activity.“
Thanks to Dr Alexandre Feltz, general practitioner and deputy mayor of Strasbourg, responsible for health, and author of Sport santé sur prescription published by Équateurs.
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