Les objectifs de ce travail étaient de démontrer la faisabilité, l’acceptabilité et d’évaluer les bénéfices apportés par un programme d'APA multivarié à domicile pour des personnes âgées utilisant un système de visioconférence collectif. Quarante et un participants (67-80 ans) ont été recrutés et répartis en 3 groupes : un groupe témoin non entraîné, deux groupes entraînés en visioconférence et en face à face. Le programme d’APA a été dispensé sur 4 mois (2 séances d’1h par semaine). En vue d’améliorer la qualité de vie et les caractéristiques physiologiques des pratiquants, des exercices de résistance, d’équilibre et de travail aérobie étaient proposés à chaque séance. Afin d’évaluer les effets de ce programme, un protocole d’évaluation similaire en pré- et post-programme a été mis en place. La qualité de vie, la condition physique, l'équilibre, la marche simple et en situation de double tâche, la rythmicité biologique circadienne (température, somnolence et fatigue subjectives et cycle activité-repos) ont été évalués. Les principaux résultats ont montré une amélioration de la qualité de vie, de la puissance d’extension de la jambe, de la puissance maximale aérobie et du cycle activité-repos. L’entraînement n’a pas eu d’effet notable sur les capacités d’équilibration et de marche. Si des gains ont été obtenus, les effets sont globalement plus nombreux et semblent plus marqués suite à la diffusion classique par rapport à la diffusion en visioconférence. Les améliorations obtenues en visioconférence montrent cependant qu'il s'agit d'un outil pertinent et adapté au public âgé qui pourra être proposé en transition ou en complément des administrations traditionnelles. / The main goals of this thesis were to determine the feasibility, the acceptability, and to evaluate the benefits brought by a multivariate home based APA program for older adults using a videoconferencing system.Forty-one participants aged between 67 and 80 years old were recruited and separated into three groups: an untrained control group, and two groups trained by videoconferencing or face-to-face programs. The APA program was provided during 4 months, with two sessions of one hour per week. In order to improve the quality of life and the physiological characteristics of the participants, resistance, balance and aerobic exercises were conducted during each session. In order to evaluate the effects induced by this program, the evaluation protocol was similar for the pre- and post-program tests. Quality of life, physical condition, balance, simple and dual walking-tasks and circadian rhythmicity (temperature, subjective sleepiness and fatigue, rest-activity cycle) were evaluated.Main results showed improvement of quality of life, of the leg extension power, of the maximal aerobic power and of the rest-activity cycle. The training did not affect significantly balance and walking abilities of the participants.Although benefits have been obtained for both trained groups, effects are globally more important and seem larger when using the traditional face-to-face program in comparison to the use of the novel videoconferencing program. Nevertheless, the benefits observed using the video-conferencing program demonstrate its relevance in older adults. This program could thus be suitable as a complement or in transition of traditional methods (i.e. face-to-face).

Made available in DSpace on 2016-03-22T17:27:40Z (GMT). No. of bitstreams: 1 michele.pdf: 618985 bytes, checksum: 5aea5d3d30e1efe7646a8613ea316b46 (MD5) Previous issue date: 2006-12-19 / Background & objectives: To determine reference values for healthy adults subjects and to study the influence of determinants factors for handgrip strength. Methods: Three hundred subjects were studied, aged 18 to 90 years old. The handgrip strength (HS) was assessed by a hand dynamometer, as well as the adductor pollicis muscle (APM) thickness and other anthropometric variables. The results were analyzed by age group and gender. A multiple linear regression was performed to identify the significant determinant variables of handgrip strength. Results HS depends on gender significantly and decreases after 60 years old (p<0.001). Different reference values are presented to be used for each gender and age categories, for dominant and non-dominant hand. APM had a high correlation with HS (R2=0.71 e 0.70 for DHS and NDHS, respectively. After the adjustment for other variables as sex, age and body mass index, APM was still significantly associated to HS. Conclusion Reference values are necessary for using HS as a muscular function assessment tool and it should be stratified for gender and age group. The combined use of HS and APM may be useful as a nutritional assessment method / Justificativa e propósito - Determinar valores de referência para indivíduos adultos e saudáveis e estudar a influência de fatores determinantes para a força do aperto de mão (FAM). Métodos Foram estudados 300 voluntários, com idades de 18 a 90 anos, sendo avaliados a FAM com um dinamômetro de mão, a espessura do músculo adutor do polegar (MAP) e outras variáveis antropométricas. Os resultados foram analisados após estratificação por faixa etária e gênero. Foi realizada regressão linear múltipla para identificação das variáveis significativamente determinantes da FAM. Resultados A FAM depende significativamente do gênero e decresce após os 60 anos (p<0,001). Os diferentes valores de referência são apresentados para uso para cada gênero e categoria etária. O MAP teve alta correlação com a FAM (R2 = 0,71 e 0,70 para FAMD e FAMND, respectivamente). Após o ajuste para outras variáveis como gênero, idade e IMC, o MAP ainda é significativamente associado a FAM. Conclusão Os valores de referência são necessários para o uso da FAM na avaliação da função muscular e devem ser estratificados por gênero e idade. O uso associado da FAM e MAP pode ser útil como método de avaliação nutricional