Tripartite prehabilitation of patients with acute myeloid leukaemia and high-risk myelodysplastic syndromes during intensive chemotherapy before allogeneic haematopoietic stem cell transplantation (COHABILIT): protocol for an innovating prospective multicentre study.

OBJECTIVES: Acute myeloid leukaemia (AML) and high-risk myelodysplastic syndromes (MDS) are often treated with intensive chemotherapy followed by allogeneic haematopoietic stem cell transplantation (allo-HSCT). The pretransplant treatment results in a general deterioration of the patient's health and quality of life. Furthermore, allo-HSCT can be responsible for significant toxicity with risks of graft-versus-host disease (GvHD). Developing strategies to prevent physical deconditioning, undernutrition and psychological distress could help maintain a satisfactory general state of health before transplantation and thus limit these deleterious effects. This protocol evaluates the feasibility and adherence to a personalised prehabilitation programme, which can be modulated and assisted by connected objects, provided from the diagnosis to the allo-HSCT. METHODS AND ANALYSIS: This multicentre interventional study will include 50 patients treated for AML or high-risk MDS with intensive chemotherapy and eligible for allo-HSCT. The intervention consists of a coached, supervised or self-directed physical activity programme, organised during the hospitalisation phases and periods at home. At the same time, patients will receive a weekly dietary follow-up. The whole intervention is controlled and modulated through the use of a dedicated application and connected objects allowing adaptation and individualisation. The rate of participation in the prescribed physical activity sessions will assess the feasibility of this study. In addition, the evolution of physical capacities (Short Physical Performance Battery, grip and quadriceps strengths), psychosocial parameters (Functional Assessment of Cancer Therapy - Leukaemia, Functional Assessment of Cancer Therapy - Fatigue, subjective well-being, Hospital Anxiety and Depression Scale, self-efficacy, Coach-Athlete Relationship Questionnaire, interviews) and clinical status (weight, lean body mass, survival rate, number of infections, days of hospitalisation, GvHD) will be evaluated. ETHICS AND DISSEMINATION: The study procedures have been approved by the National Ethics Committee (21.00223.000003). Consent is given in person by each participant. The information collected on the participants contains only a non-identifiable study identifier. The results of this protocol will be published in a scientific paper and communicated to the medical staff of the medical centre. TRIAL REGISTRATION NUMBER: NCT03595787.

A study of elite sport-inspired coaching for patients after allogeneic hematopoietic stem cell transplantation.

A need for social support is often expressed after hospitalization post HSCT. Emotional support and positive psychological constructs play an important role in post-HSCT recovery. Interventions generating positive affect can influence the health and well-being of transplant patients. It has been established that coaching in elite sport area leads to performance by playing a decisive role in maintaining the athlete's feelings of hope and autonomy in order to enable him or her to achieve their goals. In this single-center, prospective, one-arm study, we evaluated, in 32 post-HSCT patients, the acceptability of a coaching program inspired by elite sport coaching. Benefits were evaluated by questionnaires and semi-structured interviews. The coaching program was accepted by 97% of the patients. Analysis of the scores on the "Means" sub-dimension of Hope showed a significant increase over time (p = 0.0249 < 0.05) for every patient. Qualitative analysis of patient's satisfaction pointed out that this support facilitated the transition to a life without illness in particular in the non-hospital context of coaching sessions. Our results show that a "sport-inspired coaching" may offer an innovative approach supporting psychological and social recovery after HSCT and helping to start and/or maintain the processes leading to psychological well-being.

[Sport coaching for psychological and social recovery after hematological cancer: An innovative perspective]. / Le coaching sportif pour un rétablissement psychologique et social : une perspective innovante.

This study is a first step towards the transfer of knowledge and practices between psychological support and performance in elite sport and a patient's "social recovery" in oncology. This proposal brings together people engaged in a variety of healthcare and relationship support roles, and aims to set up a support system beyond the hospital context. It questions the ability of elite sport management and its main actors, the "Great Coaches", to contribute to the support of patients in cancer remission through an onco-coaching approach. This innovative proposal is initiated by a life coaching pilot study designed for hematologic cancer patients in remission after a hematopoietic stem cell transplantation.

Interference effects in bimanual coordination are independent of movement type.

Simultaneously executed limb movements interfere with each other. Whereas the interference between discrete movements is examined mostly from a cognitive perspective, that between rhythmic movements is studied mainly from a dynamical systems perspective. As the tools and concepts developed by both communities are limited in their applicability to the other domain, it remains unclear if a common cause underlies motor interference in both domains. We investigated the interference between simultaneously executed discrete and rhythmic wrist movements. The discrete movements' reaction time and movement time decreased with increasing rhythmic movement frequency. The discrete movements accelerated or decelerated the rhythmic movements in a manner that depended on movement frequency and the discrete movement's initiation phase. The acceleration/deceleration profile was bimodal at low frequencies and unimodal at high frequencies, mimicking the hallmark feature of rhythmic-rhythmic coordination, thus suggesting that interference between movements may be invariant across different movement types.

Muscular proprioception contributes to the control of interceptive actions.

The authors proposed a model of the control of interceptive action over a ground plane (Chardenon, Montagne, Laurent, & Bootsma, 2004). This model is based on the cancellation of the rate of change of the angle between the current position of the target and the direction of displacement (i.e., the bearing angle). While several sources of visual information specify this angle, the contribution of proprioceptive information has not been directly tested. In this study, the authors used a virtual reality setup to study the role of proprioception when intercepting a moving target. In a series of experiments, the authors manipulated proprioceptive information by using the tendon vibration paradigm. The results revealed that proprioception is crucial not only to locate a moving target with respect to the body but also, and more importantly, to produce online displacement velocity changes to intercept a moving target. These findings emphasize the importance of proprioception in the control of interceptive action and illustrate the relevance of our model to account for the regulations produced by the participants.

Transcranial magnetic stimulation of the sensorimotor cortex alters kinaesthesia.

Tendon vibration is known to evoke perception of illusory movements, together with motor responses in the muscles antagonistic to those vibrated. In the present study, we assessed the perceptual and motor effects of transcranial magnetic stimulation of the sensorimotor cortex during illusions of hand movements evoked by vibration of wrist muscle tendons. The results showed that transcranial magnetic stimulation could accelerate or decelerate the illusory movements, depending on the site and intensity of magnetic stimulation. Whenever transcranial magnetic stimulation decelerated illusory movements, motor responses decreased, whereas whenever it accelerated illusory movements, motor responses increased. We conclude that motor responses associated with movement illusions have a cortical stage, because they are affected by experimentally induced disruption of activity in intracortical networks.

Stabilization and destabilization of perception--action patterns influence the self-organized recruitment of degrees of freedom.

The recruitment of an additional biomechanical degree of freedom in a unimanual rhythmic task was explored. Subjects were asked to synchronize adduction or abduction of their right index finger with a metronome, the frequency of which was increased systematically. In addition, haptic contact on or off the metronome beat was provided. Results showed that the pattern exhibiting the highest intrinsic stability recruited the vertical plane more than did the less stable one. Moreover, presence and location of haptic contact modulated coordination stability and therefore induced changes in the recruitment of the vertical plane. Thus, a trade-off was shown between coordination stability on the horizontal plane and recruitment of the vertical one. These findings suggest that recruitment of degrees of freedom is governed by general principles of coordination dynamics.