Heart disease patients in France prescribed free sports classes

Doctors should be able to prescribe physical activity to patients “of all ages”, sports minister Amélie Oudéa-Castéra proposed in September.

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However, an experiment is already underway to evaluate the benefits of prescribed, reimbursed physical activity in managing chronic illnesses.

Over five months, almost 500 people who recently suffered from serious heart problems have been taking part in two sports classes per week.

The classes follow on from the three-week cardiac rehabilitation patients already receive.

Nine health centres from five regions were chosen to participate in the experiment, dubbed ‘As du Coeur’, which began in October last year.

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Exercise program shown to reduce healthcare costs by 30%

It follows a 2015 study in which 45 people suffering from cardiovascular disease followed a five-month exercise programme, resulting in a €1,300, or 30%, reduction in healthcare costs per patient on average.

“This is a country where medicine is more curative than preventative,” said Dr Alain Fuch, president of Azur Sport Santé, the association leading the project.

Since 2016, doctors have been able to prescribe physical activity to those suffering from chronic illnesses, though this is not currently reimbursed.

Just 30% of doctors prescribed physical activity in 2018, according to the Haute autorité de santé, which recently published a guide for doctors to help them understand when and why to prescribe exercise.

“It was revolutionary to consider physical activity as a treatment like any other, but to see the full effects, it needs to be funded,” Dr Fuch said.

“Before, when patients finished rehab, doctors would tell them to continue exercising, but once home, 99% stopped and resumed their normal lives.”

Free sport classes could go nation-wide

The goal of the study is to show that free sports classes help patients and could be introduced around the country.

“As well as the health benefits, there is a financial benefit. So there is no longer any argument for not funding it.”

If successful, the programme could be extended to all heart patients undergoing rehab, as well as other chronic illnesses.

Classes typically feature Nordic walking, with poles, to increase endurance, and circuit training to rebuild muscle.

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Thibault Le Pallec, director of Clinique Saint Yves in Rennes, one of the nine participating establishments, said: “Heart disease is often chronic and linked to an unhealthy lifestyle or a lack of physical activity.

“Lots of studies have shown that relapse is common.”

Céline Chouhan, in charge of rehabilitation at the clinic, said three weeks of physical activity is insufficient. “Our brain needs 10 weeks to change its habits.”

The programme also includes an educational component, to understand the patient’s motivations and teach them to take responsibility for their own treatment.

Patients at Saint Yves completed the trial in August and the clinic is now focusing on getting the habit to stick.

Mr Le Pallec recognises the importance of giving patients a leg-up to start living a healthier lifestyle, but he believes it would be unrealistic for public health insurance to fund the classes in the long term.

“The state cannot be responsible for individual behaviours.”

Health authorities say 53% of French women and 70% of men attain the WHO’s recommendations of 30 minutes of daily physical activity.

As well as managing heart disease, physical activity can reduce the risk of diabetes and of breast cancer recurring, and can be used to treat other disorders, such as depression.

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