L’évolution croissante de l’obésité n’épargne pas les adolescents présentant une déficience intellectuelle. Nos travaux reposent sur le principe d’une « recherche- action » avec pour but l’amélioration de la prise en charge des personnes en situation de handicap mental. Réalisées dans 5 instituts médico-éducatifs, notre première étude montre que plus de 40% des adolescents déficients intellectuels présentent un excès de masse grasse. Plus de 30% des adolescents rapportent un faible niveau d’activité physique et seule la moitié pratiquerait suffisamment d’activité physique pour lutter contre le développement de l’obésité. De plus, les adolescents les plus actifs présentent moins de risques de développer un excès de masse grasse. Leur faible niveau de condition physique observé est un facteur de risque élevé pour la santé. Pour ces jeunes présentant un handicap mental, cela constitue un « sur-handicap » qui peut accentuer la restriction de participation sociale et altérer la qualité de vie. Etre actif au quotidien permettrait de limiter les risques pour la santé, notamment de limiter le développement de l’obésité. De ce fait, un programme d’Activité Physique Adaptée a été proposé aux jeunes repérés en situation de sur-adiposité. Celui-ci a permis d’augmenter les temps de pratique d’activité physique et de stabiliser l’évolution du poids, tout en diminuant la masse grasse et le tour de taille. L’approche interdisciplinaire de cette recherche nous a permis de considérer l’évolution du concept de soi chez ce public spécifique et de constater qu’il n’était pas altéré par cette prise en charge visant le contrôle du poids. / The growing evolution of obesity has not spared children and adolescents with intellectual disabilities. Ours studies based on "research-action", with the aim of improving care for people with mental disabilities. Conducted in 5 specialized schools, our first study shows that over 40% of adolescents with intellectual disabilities have an excess body fat. More than 30% of adolescents report a low physical activity level, and only half reaches enough physical activity to avoid an excess of body fat. Moreover, the most active adolescents are less likely to develop an excess body fat. Their low level of physical fitness is a high risk factor to health. For these adolescent with intellectual disabilities, this is an "extra-handicap" which may increase the restriction of social participation and impair quality of life. Being active daily would reduce the health risks, including limiting the obesity development. Thus, we proposed an Adapted Physical Activity program to over-fatness adolescents. This program has helped to increase level of physical activity and stabilize weight, while decreasing fat mass and waist circumference. The interdisciplinary approach of this research has allowed us to consider the evolution of self-concept and to note that it was not altered by this weight management program.

Contexte : Les tests de marche de 6 minutes (TM6) et de stepper de 6 minutes (TS6) permettent d’évaluer et de suivre en routine la tolérance à l’effort des patients porteurs pneumopathies interstitielles idiopathiques fibrosantes (PII-f). En général, les programmes de réhabilitation respiratoire (RR), améliorent la tolérance à l’effort et la performance à ces tests, la qualité de vie et les symptômes chez les patients atteints de PII-f, qu’ils soient réalisés en centre ou au domicile des patients. Peu d’études rapportent un maintien des bénéfices de la RR plusieurs mois après la fin de celle-ci chez les patients PII-f.Objectif : L’objectif général de la thèse était d’évaluer comparativement les adaptations cardioventilatoires au TM6 et TS6 chez les patients PII-f à différentes étapes de leur prise en charge en RR (pré et post-RR). Nous avions également pour objectif majeur d’évaluer la faisabilité et l’efficacité d’un programme de maintenance réalisé dans des structures proposant des activités physiques adaptées (APA) proches du domicile des patients PII-f sur le maintien des bénéfices à six mois post-RR.Matériel et méthodes : L’ensemble des patients atteints de PII-f ont réalisé un programme de RR au domicile de 8 semaines. Durant la période de suivi post-RR, les patients avaient le choix de bénéficier d’un suivi en APA dans une structure extérieure au domicile (groupe APA) ou de continuer la pratique d’une activité physique régulière en autonomie (groupe contrôle). Pré et post-RR, nous avons mesuré la tolérance à l’effort (TM6 et TS6) avec mesure des paramètres cardioventilatoires, les fonctions pulmonaires, la qualité de vie, la dyspnée, l’anxiété/dépression et la motivation des patients. Ces évaluations ont été réalisées aussi après 6 et 9 mois de suivi post-RR.Résultats : Parmi les 21 patients PII-f recrutés, 19 PII-f ont réalisé le programme de RR et sont revenus pour l’évaluation après 6 mois de suivi. Le TM6 et le TS6 induisent des adaptations cardioventilatoires différentes chez les patients atteints de PID, notamment une réponse ventilatoire supérieure au TS6 susceptible de jouer un rôle important sur la moindre désaturation en O2 observée comparé au TM6. A la suite d’un programme de RR, nous avons observé une amélioration des capacités physiques chez les patients PII-f. De manière individuelle, cependant, 58% des patients ne s’amélioraient pas post-RR, et 32% ne continuaient pas de pratiquer régulièrement les exercices physiques recommandés post-RR. La mise en place d’un programme de maintenance dans différentes structures locales proposant des APA proches du domicile chez des patients PII-f est réalisable et permet d’optimiser le maintien des bénéfices post-RR, qu’ils soient répondeurs ou non-répondeurs à la RR.Conclusion : Nos travaux ont souligné l’importance du choix du test d’effort, de la typologie de la PII-f et de la sévérité de l’hypoxémie sur les adaptations cardioventilatoires à l’effort, les adaptations physiologiques et l’évolution de la tolérance à l’effort post-RR. De plus, nous avons constaté que la réalisation de programmes de maintenance en APA, en s’appuyant sur des structures locales est réalisable et favorise un maintien des bénéfices à long terme chez les patients PII-f. Ainsi, l’évaluation des freins à l’activité physique chez un tiers des patients PII-f qui reste non-observant et arrête la pratique d’exercices physiques post-RR, est ainsi d’actualité. De plus, étudier plus précisément les différents profils de patients PII-f (répondeurs/non-répondeurs) pourrait être intéressant afin de comprendre les mécanismes potentiellement responsables de l’absence d’amélioration des capacités physiques post-RR chez les patients non-répondeurs, qu’elle soit liée à la pathologie, la médication ou une éventuelle pathologie musculaire associée. / Context: The 6-minute walk test (6MWT) and 6-minute stepper test (6MST) are routinely performed to measure and monitor exercise tolerance in patients with fibrosis interstitial idiopathic pneumonia (f-IIP). In those patients, exercise capacity, quality of life and symptoms are usually improved after a pulmonary rehabilitation (PR) program which can either be performed in a rehabilitation centre or at home.Aim: First, we aimed, to compare the cardio-pulmonary adaptations during a 6MWT and a 6MST in patients with f-IIP, before and after PR. We aimed to assess patients’ adhesion to physical activity maintenance programs which are offered and located near the f-IIP patient's homes. And their efficiency in maintaining benefits observed post-PR.Methods: All the f-IIP patients included followed a 8-week PR program at home. During the post-PR follow-up period, patients voluntarily chose to perform physical activity in a structure proposed by the investigator (APA group), or by themselves at home (control group). Before and after the PR program, we quantified the patient's exercise capacity (6MWT and 6MST) and measured cardiopulmonary parameters during both tests, pulmonary function at rest, quality of life, dyspnoea at rest and after each exercise, anxiety/depression and patients’ motivation. The same evaluations were repeated at 6 and 9 months post-PR.Results: Among the 21 recruited f-IIP patients, 19 finished the PR program and had an evaluation at 6 months post-PR. The 6MST was characterized by a higher minute ventilation compared with the 6MWT, and this may have contributed to the lower O2 desaturation also observed during the 6MST. Following the PR program, there was a mean improvement of exercise tolerance in f-IIP patients. However, among the patients, 58% showed no improvement in the 6MWT distance post-PR nor in the cardiorespiratory parameters during the test, and 32% did not continue to practise a regular physical activity post-PR. Finally, the individual support from the investigators for the patients to follow a maintenance program in local structures, near the f-IIP patient's home, probably contributed to their voluntary inscription in these programs, which allowed the patients to maintain the post-PR benefits, whether they patients initially responded to the PR program or not.Conclusion: Our works emphasized the importance of selecting an appropriate test, according to the fixed objective; of the f-IIP clinicopathological entities, and of the hypoxemia severity on exercise cardiorespiratory and physiological adaptations and changes of exercise tolerance post-PR. Moreover, we observed that patients from the APA group regularly attended the chosen physical maintenance program in local structures, which contributed to the maintenance the post-PR benefits in f-IIP. The evaluation of physical activity engagement barriers, that lead to the non-participation of a third of f-IIP patients to physical activities post-PR, remains to be conducted. Further studies should also focus on the explanation for the absence of improvement of exercise tolerance and cardiorespiratory parameters in about half of f-IIP patients post-RR, either due to their pathology, medication, or possible muscle disorders.

La littérature concernant l’obésité semble apporter de nombreuses connaissances quant à la mise en œuvre des dispositifs de lutte contre l’obésité mais également dans celle de la pratique d’activité physique (AP). Cependant, certains éléments comme les modalités de structuration de l’AP restent encore à approfondir. Ces travaux de recherche menés sous forme de recherche-action font appel à la fois aux données de terrain mais aussi à celles de la littérature. Complétés par un encadrement pluridisciplinaire en sciences de la vie et sciences humaines, pour répondre au caractère multidimensionnel de l’obésité, l’ensemble de cette organisation en fait son originalité.Cette recherche permet de mesurer les bénéfices d’un dispositif de terrain expérimental construit en ayant pris en compte à la fois les préconisations ou recommandations des politiques publiques (Programme National Nutrition Santé ou encore Plan Obésité) ainsi que celles émanant de la littérature. Nous nous sommes plus particulièrement intéressés aux bénéfices liés aux paramètres morphologiques des personnes puis nous avons aussi noté les changements opérés dans le profil d’activité physique et des comportements sédentaires. Enfin, nous avons tenté de comprendre les éléments semblant interférer ou au contraire aider le processus de perte de poids, à travers l'étude des interactions entre les variables d'activité physique, anthropométriques, de qualité de vie et de bien-être psychologique dans le cadre du programme d'AP proposé au long cours, mais aussi l'effet de la perte de poids et de la modification du profil d'activité sur la qualité de vie et le bien-être psychologique des participantes.Ces travaux de recherche ont permis d’apporter des éléments quant à la mise en œuvre pour la prise en charge de ce public atteint d’obésité en mettant à disposition des professionnels du secteur de nombreuses connaissances scientifiques et pratiques. Ils démontrent également l’intérêt et la complémentarité de la recherche de terrain / Literature about obesity seems to bring knowledge regarding the implementation of measures to fight obesity but also in physical practice. However, some elements like the conditions of structuration of the physical practice still should be examined further. This research studies conducted under in the form of action research rely on ground data but also on literature. What makes the organization different is the use of a multidisciplinary framework in life sciences and human sciences to answer the multidimensional nature of obesity. This research allows to see / gauge the profits of such a measure of experimental ground built on both recommendations of public policies - Programme National Nutrition Santé or Plan Obésité (National Program of Health and Nutrition or Plan on obesity) – and literature. We focused particularly on profits linked to the morphological aspect of people. Then we noted the changes operated in the physical activity pattern and in sedentary behaviors. Finally, we tried to understand the conditions that seem to interfere or on the contrary help the process of weight loss through the study of interactions between the variables of physical activity, anthropometrics, quality of life and well-being psychologic of the participants. Those research studies have allowed to provide conditions about the management of that public suffering from obesity by providing sector professionals of many scientific and practical knowledge. They demonstrate also the interest and the complementarity of field work

Outre la prescription d’un traitement médicamenteux, la pratique régulière d’une Activité Physique Adaptée (APA)est recommandée aux personnes atteintes d’un diabète de type 2 (DT2), au même titre qu’un nouvel équilibre alimentaire(HAS, 2006). Cette incitation à opérer des changements concrets dans son « style de vie » rencontre des résistances, qui sontaccentuées pour les malades n’ayant pas préalablement construit de dispositions à la pratique physique. Des dispositifsinnovants ont été imaginés dans certaines organisations de santé (réseau de santé, unité transversale d’éducation) pour rendrepossible cet engagement physique et lui permettre de se développer de manière autonome dans le cadre d’« une carrière depratiquant d’APA » au sens où la définit Becker (1985). L’objectif est d’étudier ce processus d’engagement dans ses relationsavec la « trajectoire de maladie » au sens où l’entend Strauss (1985), en rendant compte des différentes étapes de saconstruction. A l’interface de la sociologie de la santé et de la sociologie du sport, l’approche mobilise ainsi des conceptsinteractionnistes. La méthodologie articule une observation de terrain avec 52 récits d’expériences de personnes atteintes demaladie(s) chronique(s) (dont 39 de DT2) qui ont évolué dans deux dispositifs d’APA différents : l’un proposant des séancesthéoriques d’information/explication (n=17), l’autre mettant en place des séances pratiques dans un cycle éducatif en APA puisune orientation vers une association sportive de patients (n=35). L’analyse des récits utilise un logiciel de traitement dedonnées textuelles (Prospéro).Trois types d’engagement ont ainsi été repérés : Le premier s’inscrit dans la « trajectoire demaladie » mais suppose un rapport au corps renouvelé après une remise en question des représentations de l’AP du patient etde ses capacités. Le second ouvre une « carrière de pratiquant d’APA » et ajoute une sociabilité de l’entre-soi, initiée par lesdispositifs « à et via » l’APA. Le troisième consolide cette « carrière » dans une pratique davantage culturelle que médicale,en l’inscrivant dans une sociabilité plus ouverte. Ces trois formes d’engagement se succèdent selon un continuum au coursduquel s’affirment simultanément une recherche croissante d’autonomie par rapport aux prescriptions médicales, une attentiongrandissante au corps et un développement du réseau relationnel. / Alongside prescription medication, it is recommended that type 2 diabetes patients (T2D) carry out regular adaptedphysical activity (APA), in the same way that they should adopt a new dietary balance (HAS 2006). This incitement to bringabout concrete changes in lifestyle comes up against opposition which is compounded where the patient does not have ahistory of regular physical exercise. Some health organizations have devised innovative arrangements such as health networks,or inter-disciplinary patient education units, to make this engagement in physical activity possible, and to enable autonomousdevelopment within the framework of an “APA practitioner career” as defined by Becker (1985). The objective here is tostudy this process of engagement in relation to the “illness trajectory” as understood by Strauss (1985), taking into account thedifferent phases of its course. This approach brings into play the concept of Interactionism at the interface of health sociologyand sport sociology. The methodology used here links fieldwork with 52 personal narratives of people affected by chronicillness (39 of whom have T2D), which have developed through two different APA action plans, the first of which offers theorysessions providing information/explanation (n=17), and the second, the setting up of practical sessions which form a series ofAPA lessons followed by guidance towards a patients’ sports association (n=35). Textual data processing software is used toanalyse the patients’ narratives (Prospéro). Three types of engagement have thus been pinpointed: the first appears in the“illness trajectory” but assumes a new relationship with the body after challenging the patient’s pre-conceived ideas about PAand about his/her own capabilities. The second opens an “APA practitioner career” in the context of socialising with otherpeople like themselves, initiated via the apparatus of APA. The third consolidates this “career” into more of a cultural thanmedical practice, by making it part of a wider group activity. These three types of engagement progress along a continuum,over the course of which the following trends result simultaneously: a growing desire to decrease dependence on medicaladvice, an increase in physical self-awareness, and the development of a network of contacts.

Ce travail doctoral propose d’étudier les troubles de l’image du corps et les troubles psychologiques associés, chez des patientes anorexiques, comparées à des femmes sans trouble du comportement alimentaire (TCA), et d’examiner l’impact des facteurs socioculturels sur l’émergence de ces troubles, ainsi que l’influence d’un programme d’activés physiques adaptées (APA) sur leur régulation. L’étude 1 indique que l’insatisfaction corporelle des femmes sans TCA augmente significativement en fonction de l’âge et de la corpulence, démontrant de l’importance de l’image du corps sur la santé mentale des femmes dans nos sociétés occidentales. L’étude 2 montre que les patientes anorexiques ont une insatisfaction corporelle significativement plus importante, des scores d’anxiété physique sociale et de dépression significativement plus élevés, ainsi que des scores d’estime de soi globale et de soi physique globale significativement plus faibles que les femmes sans TCA, traduisant la coexistence de troubles psychologiques chez les patientes anorexiques. L’étude 3 révèle que les mécanismes de comparaison sociale et d’internalisation des messages sociaux sont significativement plus activés chez les anorexiques comparées aux femmes sans TCA. Toutefois, il apparaît qu’une amorce « idéal de minceur » n’a aucun effet significatif sur l’insatisfaction corporelle et la silhouette idéale, chez les deux groupes. Enfin, l’étude 4 montre que, même si le programme d’APA ne permet pas de réguler les troubles de l’image du corps et les troubles psychologiques, il n’interfère pas négativement dans le traitement thérapeutique de l’anorexie mentale. Ces différents résultats sont ensuite discutés, et des perspectives de recherche sont proposées. / The present doctoral research aims to investigate body image disturbances and associated psychological troubles, in patients with anorexia nervosa as compared to healthy controls, and to examine the impact of sociocultural factors on the emergence of the aforementioned troubles, as the effects of an adapted physical activity program (APA) on their regulation. Study 1 indicates that body dissatisfaction of women without eating disorders (ED) increases significantly according to age and shape, enlightening the role of body image in women’s health in Western societies. Study 2 shows that anorexics present significantly more body dissatisfaction and significantly higher scores of social physical anxiety and depression, but also a global self-esteem and a global physical self significantly lower, as compared to women without ED. Study 3 reveals that social comparison and social messages internalization are more relevant in anorexics than in women without ED. However, we observed no significant effect of thin ideal priming on body dissatisfaction and ideal body size in both groups. Finally, Study 4 shows that, even if APA program reveals no significant effect on body image disturbances and associated psychological troubles, it does not interfere negatively with the therapeutic treatment for anorexia nervosa. These results are then discussed and perspectives of research are presented.

Darbo tikslas: nustatyti, kokį poveikį daro taikomosios fizinės veiklos programa, nežymiai protiškai atsilikusių mokinių laikysenai. Tyrimo objektas ir metodai. Tyrime dalyvavo 45 Telšių ir Kauno miesto mokyklų 8 – 10 metų nežymiai protiškai atsilikę mokiniai, iš jų: 21 mergaitė ir 24 berniukai. Tyrime laikysena vertinta pagal W.W.K. Hoeger vizualinio laikysenos vertinimo sagitalioje ir frontalioje plokštumose metodiką. Pagal šią metodiką laikysena vertinama balais. Atskirų kūno dalių padėtys apžiūrimos frontalioje ir sagitalioje plokštumose. Atskiros kūno dalys vertinamos balais nuo 1 – 5 ir rezultatai sumuojami bei įvertinami pagal minėtą metodiką. Rezultatai. Nagrinėjant atliktų tyrimų duomenis nustatyta, kad net 61.9% tiriamųjų turėjo laikysenos sutrikimų. Kūno laikysenos sutrikimai dažnesni berniukams. Daugiausia laikysenos sutrikimų nustatyta vertinant pečių, stuburo, kaklo ir viršutinės stuburo dalies padėtis. Mažiausiai sutrikimų nustatyta vertinant kelių ir čiurnų, galvos padėtis. Berniukams mažiausiai nustatyta kelių ir čiurnų padėties sutrikimų (20.8%), mergaitėms liemens padėties sutrikimų (9.5%). Daugiausia sutrikimų nustatyta įvertinus pečių padėtį. Mergaitėms pečių padėties sutrikimų buvo 80.9%, o berniukams – 70.8%. Po taikomosios fizinės veiklos programos, nustatyta teigiami laikysenos pokyčiai: prieš taikomosios fizinės veiklos programą, laikysenos sutrikimų turėjo 33.3% berniukų ir 28.6% mergaičių, po taikomosios fizinės veiklos programos laikysenos... [toliau žr. visą tekstą] / Objective. To identify determine the impact of physical activity tests on the posture of pupils with mild mental retardation. Methods. 45 pupils between the ages of 8 - 10 (21 girls and 24 boys) from Telšiai and Kaunas secondary schools have been examined using W.W.K. Hoeger visual posture evaluation model in a frontal and sagittal plane. Testing was assessed according to a measuring scale from 1 to 5. Results. It was determined that even 61.9 % of participants had disorders in body posture and its segments: shoulder, spinal cord, neck and upper spinal cord positions. The disorders of posture were more frequent among boys. Least problematic body parts were knees, ankles and head. Among boys the best body segments proved to be knees and ankles, whilst among girls the investigators indicated the position of waist. Shoulder problems were more common in girls’ group (80.9%), in boys’ group these disorders were less significant (70.8%). The applied methods of adapted physical activity had a positive impact on the students’ posture. The study showed good results in students’ posture. Before adapted physical activity program posture impairment was determined to 33.3% of boys and 28.6% of girls. After the program the improvement was determined 20.8% and 19.1% accordingly. The maximum effect of adapted physical activity on the posture was noted after the evaluation of shoulder, lower part of spinal cord and abdomen in boys’ group, as well as neck and upper spinal cord positions in... [to full text]

Made available in DSpace on 2016-06-02T19:44:07Z (GMT). No. of bitstreams: 1 3343.pdf: 1537854 bytes, checksum: f0d9807bdf9c1de45608beb97ecd7455 (MD5) Previous issue date: 2010-11-05 / Whereas deepen the discussion about teacher training in the field of physical culture and how this training also includes people with disabilities, this study sought to identify and analyze the characteristics of the disciplines that comprise the field of Adapted Physical Activity, contained on curricular of Physical Education courses in Brazil. For this purpose, we sought information and reflections on the discipline that involves people with disabilities in Higher Education Institutions (IES). Thus it was taken as an object of study, data derived from a questionnaire answered by the course coordinators of Physical Education. The study included 114 IES, 101 undergraduate courses in physical education courses and 59 Bachelor of Physical Education. The collected material was analyzed by using as a guiding principle the contribution of the discipline devoted to people with disabilities to the professional training in physical education. The first stage of the study consisted of mapping the IES that offer the course in Physical Education (BA and BS) through the identification and location. The initial search of the IES was given by the electronic addresses of official bodies regulating the education and the statistical and evaluative at all levels and types of education and, through electronic lists that include data on the relationship of all education courses Physics of Brazil. In possession of electronic addresses of the IES, sailed on the pages of each IES to locate the e-mail the coordinators of Physical Education courses address or legal guardians of the IES. The procedure of sending the questionnaire, the second stage took place during the months of April and May 2009. The analysis was done by breaking the following variables: name given to the discipline, working hours, menu, title of professor, supervised training in the discipline, practice as a curriculum component in the training and extension projects aimed at people with disabilities. Research results indicated expertise in Adapted Physical Activity required for teacher performance / physical education professional, which were discussed drawing on the researcher's gaze and theoretical framework that supports the study, seeking to establish relations with the initial and emerging needs in society. Considering the presented problem and considering the knowledge that a physical educator must submit to engender a coherent teaching practice, it is recommended a restructuring of the curriculum in the discipline that involves people with disabilities in physical education courses. From this perspective, it must be emphasized in the speech that the task of this discipline is not only to train professionals in the inclusive perspective, but also exposed that there is still the exception, and seek solutions for teaching and pedagogical education with people with disabilities. It's up to these professionals to develop skills to enable the acceptance of diversity in their sphere of action. / Considerando ampliar as reflexões acerca da formação de professores no campo da Educação Física e como esta formação contempla também as pessoas com deficiência, o presente estudo buscou identificar e analisar as características das disciplinas que compõem a área da Atividade Física Adaptada, contidas nas matrizes curriculares dos cursos de Educação Física no Brasil. Com este propósito, explorou-se informações e reflexões sobre a disciplina que oferece conteúdos específicos acerca das pessoas com deficiência nas Instituições de Ensino Superior (IES). Desse modo, teve-se como objeto de estudo, dados oriundas de um questionário respondido pelos coordenadores dos cursos de Educação Física. Participaram do estudo 114 IES, sendo 101 cursos de Licenciatura em Educação Física e 59 cursos de Bacharelado em Educação Física. O material coletado foi analisado tendo como princípio norteador a contribuição das disciplinas voltadas ás pessoas com deficiências para a formação do profissional em Educação Física. A primeira etapa do estudo consistiu no mapeamento das IES que ofertam o curso de Educação Física (Licenciatura e Bacharelado) por meio de identificação e localização. A busca inicial das IES deu-se pelos endereços eletrônicos dos órgãos oficiais reguladores da educação e dos levantamentos estatísticos e avaliativos em todos os níveis e modalidades de ensino e; por meio de listas eletrônicas que abrangem dados referentes à relação de todos os cursos de Educação Física do Brasil. Em posse dos endereços eletrônicos das IES, navegou-se nas páginas de cada IES para localizar o endereço de e-mail dos coordenadores dos Cursos de Educação Física ou endereço dos responsáveis legais das IES. O procedimento de envio do questionário, a segunda etapa, realizou-se durante os meses de abril e maio de 2009. A análise foi efetuada partindo-se das seguintes variáveis: nome dado à disciplina, carga horária, ementa, titulação do docente, estágio supervisionado na disciplina, prática como componente curricular na disciplina e projetos de extensão voltados às pessoas com deficiência. Os resultados da investigação indicaram conhecimentos na área da Atividade Física Adaptada necessários à atuação do professor/profissional de Educação Física, os quais foram discutidos valendo-se do olhar do pesquisador e do referencial teórico que sustenta o estudo, buscando-se estabelecer as relações com a formação inicial e as necessidades emergentes na sociedade. Tendo em vista a problemática apresentada e considerando os conhecimentos que um profissional de Educação Física deve apresentar para engendrar uma prática pedagógica coerente, recomenda-se uma reestruturação curricular na disciplina que envolve as pessoas com deficiência nos cursos de Educação Física. Nesta perspectiva, é conveniente insistir no discurso de que a tarefa de tal da disciplina não é apenas a de formar profissionais na perspectiva inclusiva, mas também expor que ainda existe a exclusão, e buscar soluções didático-pedagógicas para o ensino junto a pessoas com deficiência. Caberá a estes profissionais desenvolverem competências que permitam a aceitação da diversidade em seus ambientes de atuação.

Orientador: Edison Duarte / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação Fisica / Made available in DSpace on 2018-08-14T18:32:27Z (GMT). No. of bitstreams: 1 Nazareth_ValberLazaro_D.pdf: 3706595 bytes, checksum: 6cad9a8835b5c3febdf3a3ad7619b5a0 (MD5) Previous issue date: 2009 / Resumo: A Esgrima em Cadeira de Rodas nasce por meio da adaptação das estruturas de equipamentos e organização da Esgrima Convencional, com o fim de viabilizar a prática da modalidade por pessoas com deficiência física. Apesar de se tratar de um novo. modelo de Esgrima em forma adaptada, a Esgrima em Cadeira de Rodas não se diferencia da Esgrima Convencional, no que concerne ao jogo das armas, no âmbito do duelo esportivo. No entanto, devido ao fato da pessoa com deficiência apresentar uma condição funcional diferenciada, isso terminou por criar algumas características particulares e exclusivas de realização do movimento técnico na Esgrima. Diante de tal fator, deduzimos que pensar o ensino da Esgrima para pessoa com deficiência física somente pela ótica dos métodos comuns a Esgrima Convencional, em certa medida, pode limitar as condições de aprendizado destes indivíduos, nessa modalidade. Daí a importância dos métodos de ensino na Esgrima em Cadeira de Rodas serem estruturados a partir das dimensões e realidade da própria modalidade adaptada e condição funcional do aluno com deficiência e não o inverso. Tendo em foco a pedagogia de ensino e desenvolvendo-se sob a perspectiva de um estudo do tipo qualitativo, a presente investigação teve por objetivo caracterizar a Esgrima em Cadeira de Rodas visando propor indicadores pedagógicos para intervenção de ensino, na modalidade. Para tanto, o corpo de discussão do estudo foi desenvolvido a partir de três focos: o primeiro, Esgrima em cadeira de rodas no Brasil (2002 a 2008), aborda o processo histórico de desenvolvimento desta modalidade no país, a partir de sua implantação no ano 2002. O segundo: Características da Esgrima em cadeira de rodas, busca delinear as particularidades de desenvolvimento dos equipamentos e jogos, bem como algumas características que definem o praticante com deficiência. O terceiro e último Capítulo: Pedagogia de ensino na Esgrima em cadeira de rodas, apresenta os fundamentos básicos da modalidade, com orientações pedagógicas para a iniciação do aluno com deficiência física. / Abstract: Wheelchair Fencing begins by the adaptation of the equipment structures and organization from Conventional Fencing in order to make viable the practice of the modality by handicapped people. Although it is a .new. model of Fencing in an adapted way, the Wheelchair Fencing is not different form Conventional Fencing regarding to the weapons game in the ambit of the sportive duel. But because of the fact of the handicapped person presents a differentiated functional condition, it ended by creating some particular and exclusive characteristics of the technical movement execution in Fencing. Facing this factor we deduce that thinking the Fencing teaching to handicapped person only by the models of the common methods of Conventional Fencing in a certain way it can limit the learning conditions of these individuals in this modality. There comes the importance of the methods of teaching Wheelchair Fencing are structured from the dimensions and reality from the own adapted modality and functional condition of the handicapped athlete and not the other way around. Having the focus in the teaching pedagogy and developing itself under the perspective of a qualitative study the present investigation had as its aim characterize the Wheelchair Fencing aiming for pedagogical indicators to the teaching intervention in the modality. In this way the corpus of the study discussion was developed from three foci: The first one, Fencing in Brazil (2002 to 2008) broaches the historical process of development of this modality in Brazil from its implantation in 2002. The second, Characteristics of wheelchair fencing searches for delineating the particularities of the development of the equipments and games, as well as some characteristics that define the handicapped practitioner. The third and last chapter Pedagogy of teaching in wheelchair fencing presents the basic bases of the modality with pedagogical orientations to initiate the handicapped student. / Doutorado / Atividade Fisica Adaptada / Doutor em Educação Física

L’insuffisance rénale chronique entraîne de nombreux effets secondaires indésirables sur le métabolisme et la santé dus à la dénutrition et à la sédentarité observées chez ces patients. Quatre-vingt pourcent du financement de cette maladie est dédié à la dialyse ; la greffe apparaît comme le traitement de choix. La prise en charge des patients est donc une problématique majeure tant au niveau médical, qu’humain, éthique et économique. Parmi les différents moyens mis en œuvre, nous nous sommes intéressés à l’aspect nutritionnel et à la pratique d’une activité physique adaptée de patients greffés du rein ou hémodialysés chroniques. Deux études ont été menées durant ma thèse. La première étude s’est intéressée aux effets du suivi nutritionnel chez des patients greffés du rein sous traitement de glucocorticoïdes. Les paramètres étudiés sont la composition corporelle, la qualité de vie et le comportement alimentaire. La deuxième étude s’est intéressée aux effets d’un programme de renforcement musculaire de 3 mois, ainsi qu’au déconditionnement physique 3 mois après la fin du programme chez des patients hémodialysés. Les paramètres étudiés sont la qualité de vie, la composition corporelle, certains paramètres biologiques, le sommeil, le comportement alimentaire et les capacités physiques. Le suivi nutritionnel comme l’activité physique adaptée montrent une amélioration significative ou des tendances à l’amélioration de plusieurs paramètres ce qui permettrait une meilleure prise en charge des patients. / Many sides effects occurs in chronic kidney disease due to malnutrition and inactivity. Dialysis represents eighty per cent of the disease cost; so kidney transplant is the most favourable treatment. Patients care is a major problem on medical, human, ethical and economic levels. Among the various means used for it, the nutritional aspect and the adapted physical activity on kidney transplant patients and chronic hemodialysis patients are interesting for us. In my thesis, two studies were conducted. The first study carried out the effects of a nutritional monitoring on kidney transplant patients with a glucocorticoid treatment. Body composition, quality of life and food behavior were observed. The second study carried out the effects of a three-month resistance training program and the physical deconditioning three months after the end of the program on hemodialysis patients. Quality of life, body composition, some biological parameters, sleep, food behavior and physical capacities were observed. Nutritional monitoring as well as adapted physical activity show a significant improvement or trend towards improving several parameters, which would allow better patient management.

La drépanocytose est une hémoglobinopathie génétique ayant pour conséquences une anémie hémolytique chronique et sévère et des crises vaso-occlusives itératives. Cette pathologie s’accompagne également d’une intolérance à l’effort et d’altérations de la fonction et du tissu musculaire. Récemment, nous avons pu montrer, par une étude contrôlée et randomisée, l’innocuité et les bénéfices fonctionnels d’un programme d’entrainement en endurance, d’intensité modérée, chez des patients drépanocytaires. L’objectif de ce travail doctoral a été d’évaluer les effets de ce programme d’entrainement sur les caractéristiques musculaires de quarante patients drépanocytaires homozygotes. L’analyse des biopsies musculaires rapporte des adaptations tissulaires chez les patients entrainés, illustrées par une augmentation de la surface des myocytes, une amélioration de leur capacité oxydative, une augmentation du nombre de microvaisseaux sans modification de leur tortuosité, laissant supposer une meilleure oxygénation musculaire. L’excellente tolérance de ce mode d’entrainement semble reposer sur une plus faible mobilisation des voies anaérobies comme en témoigne la stabilité des activités enzymatiques associées à la glycolyse lactique et l’absence de modification du contenu musculaire des protéines impliquées dans la régulation du pH. Par ailleurs, cet entrainement n’a pas engendré de dégradation tissulaire notable. Ainsi, cet entrainement a non seulement apporté des bénéfices fonctionnels, mais également réduit les dysfonctionnements tissulaires musculaires. Cette thérapie par l’exercice peut donc être considéré comme une stratégie adjuvante prometteuse pour les patients drépanocytaires. / Sickle cell disease is a genetic hemoglobinopathy resulting in chronic and severe hemolytic anemia and iterative vaso-occlusive crisis. This pathology is also accompanied by exercise intolerance and alterations in muscle function and tissue. Recently, we demonstrated, through a randomized controlled study, the safety and functional benefits of a moderate-intensity endurance exercise training program in sickle cell disease patients. The objective of this doctoral work was to evaluate the effects of this training program on the muscle characteristics of forty homozygous sickle cell disease patients. The analysis of muscle biopsies reported tissue adaptations in trained patients, illustrated by an increase in the surface area of myocytes, an improvement in their oxidative capacity, an increase in the number of microvessels without modification of their tortuosity, suggesting a better muscle oxygenation. The excellent tolerance of this training mode seems to be based on a lower mobilization of the anaerobic pathways, as shown by the stability of the enzymatic activities associated with lactic glycolysis and the lack of any modification of the muscle protein content involved in pH regulation. Moreover, this training did not result in any significant tissue degradation. Thus, this training provided functional benefits, but also reduced muscle tissue dysfunctions. This exercise therapy can therefore be considered a promising adjuvant strategy for sickle cell disease patients.