Physical activity on prescription: recos HAS

At the end of these evaluations, an APA can be prescribed in the form of a structured program delivered by an APA professional, under the conditions provided for by decree (art. L. 1172-1 of the CSP); here again: the programs depend on the pathology (more details in the HAS guidelines, see box). The prescription can go beyond the APA, by also providing advice on physical activity which can be carried out independently or unsupervised, if the situation and the patient’s capacities allow it, and by including advice for reducing the time spent in a sedentary lifestyle. For more details, see the HAS summary “Adapted physical activity prescription (APA)”.

APA professionals are: either health professionals (masseur-kinesitherapist, occupational therapist, psychomotor therapist), or APA-S teachers holders of at least a license mention STAPS “adapted physical activity and health”.

APA program typically consists of 2 to 3 sessions per week (at least 1 day of rest between sessions) from 45 mins to 60 minsover a period of 3 months, possibly renewable. Each session combines aerobic endurance and muscle strengthening PAs. Depending on the pathology or the targeted state of health, other types of exercises can be combined: balance, coordination, stretching or breathing exercises (see HAS sheets by pathology).

It is the APA professional who best adapts the program to the pathology(ies), to the patient’s functional capacities and activity limits, as well as to his degree of autonomy and his risks to the practice of the activity. In addition, he regularly sends a report to the prescribing doctor (procedure, effects on the patient’s physical condition and functional state, degree of autonomy) and gives a copy to the patient (art. D. 1172-5 of the CSP). Finally, the APA professional, throughout the program, accompanies the person towards a practice of AP in autonomy and in the long term ensures the relay towards ordinary AP.

A 3-month APA program can be renewed, in particular if the disease, its evolution or the general state of health of the patient does not allow him to switch to a practice of ordinary AP; and if the resumption or continuation of an APA allows a stabilization or a favorable evolution of his pathology or his state of health.

He is stopped when the person is able to practice AP independently and safely, or if he expresses his refusal to follow this therapy. If the disease is destabilized or if the patient has a contraindication, the program can also be suspended, or if necessary relayed by a rehabilitation/rehabilitation program.

It remains to be seen, finally, when these activities will be reimbursed. : the law of March 2, 2022 provides “a report on the coverage by health insurance of APA sessions prescribed “, which should be presented to the National Assembly in the fall.

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