A web-based adapted physical activity program (e-APA) versus health education program (e-HE) in patients with schizophrenia and healthy volunteers: study protocol for a randomized controlled trial (PEPSY V@Si).

Patients with schizophrenia (SZ) have a high level of cardiovascular morbidity and some clinical symptoms of illness remain resistant to pharmacological approaches. A large number of studies support the effectiveness of physical activity (PA) in SZ. The aims of this trial is to assess the effects of a remote, web-based adapted PA program (e-APA) compared to a health education program (e-HE) on brain plasticity in SZ and healthy volunteers (HV) and on psychiatric, neurocognitive, circadian and physical variables. The study is an interventional, multicenter, randomized open-label trial. Forty-two SZ will be randomized to either the active group (e-APA, N = 21) or nonactive group (e-HE, N = 21), and 21 HV will be matched to SZ according to age, gender, and level of PA in both e-APA and e-HE groups. Interventions will consist of 32 sessions (2 × 60 min/week, for 16 weeks) via supervised home-based videoconferencing. Cerebral magnetic resonance imaging, psychiatric symptoms, neurocognitive and circadian rhythms assessments as well as physical tests and biological analyses will be assessed at baseline and 16 weeks after the intervention. To our knowledge, this is the first study aiming to evaluate the efficacy of APA delivered by supervised home-based videoconferencing in SZ. Moreover, using multimodal MRI, this study could clarify the pathophysiological mechanisms underlying the efficacy of APA. Finally, this innovative approach might also increase participation in long-term PA since PA-based programs are known to have low adherence and early dropout. Trial registration: ClinicalTrials.gov identifier: NCT03261817. Registered on 16 August 2017.

Effect of adapted physical activity sessions in the hospital on health-related quality of life for children with cancer: a cross-over randomized trial.

BACKGROUND: To assess the efficacy of adapted physical activity (APA) on health-related quality of life (HRQoL) of hospitalized children and adolescents with cancer between 9 and 18 years of age. PROCEDURE: A two-sequence, four-period cross-over study, Activités Physiques en Oncologie Pédiatrique (APOP), compared hospital stay with APA sessions versus hospital stay without APA sessions on children's HRQoL. Children and parents completed the child and parent forms, respectively, of a HRQoL questionnaire, the Child Health Questionnaire, on the last day of hospitalization. We used mixed linear regression to determine the effect of treatment, of treatment order and whether response to previous treatment influenced HRQoL. RESULTS: Thirty children were included (mean age 13.6 ± 2.9 years; 18 males). Cross-over analysis revealed no effect of period or interaction between APA and period. HRQoL was higher when children practiced than did not practice APA during their hospitalization, as reported by both children and parents, for the dimensions physical functioning (P < 0.0001), role/social-physical (P = 0.001), self-esteem (P < 0.0001), and mental health (P < 0.0001). In addition, APA had a significant effect on the behavior dimension (P = 0.01), as reported by children, and on the bodily pain dimension (P = 0.0004), as reported by parents. The highest significant difference in scores between with and without APA was observed for the self-esteem dimension (P < 0.0001) for both children and parents. CONCLUSION: APA during hospitalization for children with cancer was associated with better HRQoL for most of the HRQoL psychological and physical dimensions. Whether this effect is specific for children with cancer should be explored.

C-Reactive Protein Level: A Key Predictive Marker of Cachexia in Lymphoma and Myeloma Patients.

BACKGROUND: Cachexia is defined as an involuntary loss of weight, characterized by a loss of skeletal muscle mass with or without fat mass loss. It increases mortality risk and decreases quality of life in patients with lymphoma or myeloma. Early markers of cachexia are not identified. The objective of this work was to identify risk factor of cachexia in a cohort of patients with hematological malignancies to develop strategies to prevent cachexia and its consequences. METHODS: Clinical and biological parameters were collected before and at the end of the treatment. Quantification of weight loss during cachexia was performed by the method of Martin. Clinical responses to treatment of patients with lymphoma or myeloma were monitored. RESULTS: Thirty-eight percent of the 145 patients enrolled were cachectic at the end of treatment. Classical prognostic disease scores at the time of diagnosis seemed to be not associated with cachexia observed at the end of treatment. Only C-reactive protein (CRP) > 54 mg/L seemed to be a risk factor of cachexia (P = 0.023, odds ratio (OR): 5.94 (1.55 - 39.14), confidence interval (CI): 1.55 - 39.14). Those results were confirmed by bootstrap analysis. CONCLUSION: This study highlights that high CRP level at diagnosis seems to be a risk factor for cachexia during treatment, permitting to identify patients at risk and in future to implement preventive strategies.

Effect of adapted physical activity on health-related quality of life among hospitalized children and adolescents (the ACTIV'HOP randomized controlled trial): design and methods.

INTRODUCTION: In promoting the health of chronically ill children, the hospital should help children cope both medically and psychosocially with their disease. The University Children's Hospital of Nancy proposes adapted physical activity for hospitalized children, but the practice during hospitalization is not well developed or understood. The ACTIV'HOP study aims to assess the effects of adapted physical activity sessions for hospitalized children in terms of 1) health-related quality of life (HRQoL) and 2) satisfaction with hospital care. RESEARCH DESIGN: ACTIV'HOP is an individual randomized controlled trial of patients admitted to the University Children's Hospital of Nancy. The inclusion criteria are 1) age 5 to 18 years, 2) hospitalized for at least 3 days, and 3) no medical contra-indication to practice adapted physical activity. HYPOTHESIS: Children and adolescents practicing adapted physical activity during hospitalization have a better HRQoL on hospital discharge and better satisfaction with care. OUTCOMES: HRQoL assessed by the Child Health Questionnaire on the first and last day of hospitalization, and satisfaction with care assessed by the Patients Judgment of Hospital Quality questionnaire were sent to the family home 11 to 15 days after hospital discharge. The French validated version of these questionnaires is used.