The locomotive cycle to move chom patients

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 building of Notre Dame Hospital, where patients lived together three or four in each room without access to a single bathroom.

“Maybe this was a trigger for people to want to get out of their room, go somewhere else, go to the cafeteria,” said Dr. Olivier Jacquin, stroke neurologist at CHUM.

Mais quand le service of neurology a emménagé dans ses nouveaux locaux du CHUM il ya quelques années, poursuit-il, un changement de comportement flagrant que youus observent s’est produit: “The patients ne sortent more de leur chambre, at-he says. They are more comfortable than they experienced in our old buildings. At CHUM, there are large single-glazed rooms overlooking the city center. “

He admitted that the specialists did not calculate the impact of this on the duration of hospitalization and on the rehabilitation of patients.

In order to address this particularly unexpected situation, the Parcours locomotive was created, a series of green dots pinned to the floor that direct patients to labels – sometimes humorous in flavor – that allow them to better understand stroke and its challenges, and that offer adaptive exercises. With the capabilities of the patients, tips are provided for improving living with and preventing stroke.

Originally from Switzerland, project director Dr Céline Audier took inspiration from the trails of nature offered to patients in her home to develop the Parcours locomotive with physiotherapist Marie-Andre Desjardins, researcher Line Beaudet, clinical nurse Judlène Joltéus and a few patient partners.

“We had the idea of ​​doing the exercises, and then maybe the training, anyway to get the patients moving in a slightly more structured way,” she said. We thought it could be a good way to get (the patients) out, get them moving, talk to other people and therefore also to stimulate them cognitively, it’s all a little bit down the road of the locomotive.”

It’s not uncommon during hospitalization, Dr. O’Dair said, to see a patient withdraw into themselves and become a little less active. Data 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 TV.

However, physical activity and the simple act of interacting with others are crucial to rehabilitation.

Parcours locomotive consists of four sections dealing with prevention; Stroke and its treatment. Rehabilitation; and possible repercussions of the disease.

Some of the exercises given to patients are illustrated with cartoons drawn by well-known animator Jean-Pierre Coullier. For example, we suggest pronouncing “simple words 100 times” and repeating them and conveying “everything that moves! 10 times 100 times a day +++”.

Other posters deal with sexual activity after a stroke, or the mood or cognitive disturbances 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 such tragedy.

“The difficult thing is that there is no prescription that works for everyone,” said Dr. O’Dair. “Everyone experiences stroke in their own way, with their own background, with their own emotions. We don’t have a magic phrase that will energize our patients. So we try to find ways to encourage them to discover the joy of exercise. We try.” Find the little spark.

She admits that it’s always difficult to scientifically document the benefits of physical activity after a stroke, because some patients come out of it more or less harmed than others. But in general, we see that movement has a positive effect not only on the body, but also on mood and memory.

Parcours locomotive had to stop at the station when the COVID-19 pandemic hit. This involuntary outage, Dr. Odier said, will at least allow the team to expand its website.

The locomotive track was “more actively” relaunched for a few months, and reached its top speed.

“The majority of patients thank us and are very satisfied,” said Dr. O’Dair. They find that it brings them things to do and information they didn’t have.

The project arouses the curiosity of other CHUM departments – such as cardiology, whose patients also need to transfer – and other health institutions.

“The idea is to give people a little spark so they can be active throughout their journey, so they don’t stay passive enjoying therapies,” concluded Dr. O’Dair. They must find out for themselves what works for them, what fuels them to continue their rehabilitation after a stroke. “

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Online:

https://www.chumontreal.qc.ca/repertoire/parcours-locomotive