Hyeres

Context Polyhandicap as a chronic complex disability condition, lead to a combination of profound intellectual disability and serious motor deficit, resulting in the extreme restriction of autonomy and communication. Due to the improvement of preventive actions and supportive care, the life expectancy of these persons is increased In order to assess the issues associated with the aging of people with polyhandicap (an emerging and underexplored phenomenon), life experiences, social representations, specific needs and expectations of familial caregivers (parents and siblings) need to be explored. It is essential to better understand these phenomenon in order to better support and assist these families. The PolyAGE project relies on an interdisciplinary approach, based on social and human sciences (social psychology of health) and public health. PolyAGE is based on a solid network including engaged and volunteer actors. Objectives The general objective of PolyAGE is to explore the life experience of familial caregivers of aging persons with polyhandicap (\>= 35 years). The investigators will question parents (objective 1) and siblings (objective 2) about the experiences, the social representations, the needs and the expectations, as well as the mechanisms associated with their choices about their children with polyhandicap. The objective 3 is to co-analyze parents' and siblings' experiences regarding the aging of their relatives with polyhandicap. Methods PolyAGE relies on the EVAL-PLH cohort, initiated in 2015, including persons with polyhandicap, familial and institutional caregivers. Eight teams are involved in PolyAGE: 2 specialized reeducation centers (Hendaye et San Salvadour), the J. Bost Foundation, the Groupe Polyhandicap France (family association), 3 university teams (CeReSS and LPS of Aix Marseille university and SantESiH of Montpellier university), 1 epidemiology team (AP-HM).The investigators propose a pluri-methodological mixt approach combining quantitative and qualitative approaches in a socio-contextual and comprehensive perspective: 1. Quantitative approach: * Evaluations using standardized self-reported questionnaires: quality of life, coping, emotional intelligence, burden. * Parents: data already available (EVAL-PLH cohort: 2 evaluation times 20151-6 and 2020-21). * Siblings: data to be collected (phone, mail). 2. Qualitative approach: * Evaluations based on interviews (parents and siblings; 1 confounding factor: participant's sex); * Combination of interviews content and interpretative phenomenological analysis. 3. Methodological triangulation: * Crossing and confrontation of quantitative and qualitative findings. Perspectives * Improvement of knowledge and identification of the specific needs/expectations of family caregivers of aging persons with polyhandicap. * Understanding the underlying reasons behind the choices made by families in terms of support for aging persons with polyhandicap in order to support the transitions related to the joint aging of persons with polyhandicap and their relatives. * Better supporting families in the aging transition (health professionals, health-decision makers).

As secondary objectives, the study aims to: 1. compare and evaluate the impact of this intensive care of rehabilitation of psychomotor vs. the standard care on: * result of evaluation with Vineland Scale of adaptive behaviour at 6 months after randomization; * result of evaluation with Brunet-Lézine Scale of developement at 12 months after randomization; * the pain evaluation at 12 months after randomization; * the durability of acquired cognitive-motor improvement at 6 months after the end of intervention (18 months after randomization); * the quality of life of the patients' family or relatives at 12 months after randomization; * the clinical global impressions and the quality of life for work for the long-term professional caregivers at 12 months after randomization. 2. evaluate the tolerance of intensive care in psychomotor rehabilitation at 6 and 12 months after randomization. 3. study the concordance between the Vineland scale and the Brunet-Lézine scale.

Two main objectives will be assessed simultaneously: * To compare the effect of SIMEOX, combined with remote Physiotherapy, with enhanced SoC (SoC + Remote Physiotherapy), on the quality of life related to the respiratory problems of patients at mid term. * To compare the effect of SIMEOX, combined with remote Physiotherapy with enhanced SoC (SoC + Remote Physiotherapy) on the rate of respiratory exacerbations at long term.

Sport addiction (or exercise addiction) has been recognized as a pathology by the World Health Organization since 2011. However, it is still relatively under-researched. It is one of the so-called behavioral addictions and has long-term negative consequences for physical, psychological and social health, such as : isolation ; frequent injuries; co-addiction with or as a result of sports'. The study is aimed in particular at military physicians and will target a population where sport is an integral part of the job and where sporting performance is valued: military personnel. The aim of this study is to explain and try to understand this pathology through the experiences of those who suffer from it. Therefore, investigators have chosen to conduct a qualitative study inspired by the embedded theory. Semi-structured individual interviews will be conducted using an interview guide. This guide, consisting of 5 or 6 open-ended questions, will help to set the general direction of the interview without preventing the participant from deviating. The interview guide may evolve as the interviews progress, enriched by any new ideas or themes that emerge.

Cystic fibrosis (CF) is characterized by various extrapulmonary manifestations, including altered skeletal muscle function, with both quantitative (e.g. reduced muscle mass) and qualitative (e.g. impaired oxidative function) impairments that may have a negative impact on exercise tolerance and quality of life. These abnormalities have traditionally been related to disease (e.g. systemic inflammation) or behavioral factors (e.g. increased physical inactivity). However, most of the studies that observed these abnormalities and tried to shed light on the underlying factors were either small or conducted before the widespread of CFTR (Cystic fibrosis transmembrane conductance regulator) modulators that have profound impact on the trajectory of the disease. While several studies suggested that the major recent improvements in therapeutics, including highly effective CFTR modulators, may have positive effects on skeletal muscle function, either directly (e.g. improved mitochondrial function) or indirectly (e.g. reduction in physical inactivity), no studies to date have thoroughly investigated this issue in a representative sample of people with CF. The absence of recent data on muscle function and physical activity levels casts doubt on the relevance of recommendations on exercise training in this population that were published before the widespread use of highly effective CFTR modulators. This study aims to compare muscle function, measured according to the latest recommendations of the European Cystic Fibrosis Society (Saynor et al., 2023), and physical activity of children and adults with CF under CFTR modulators, compared to age- and sex-matched healthy individuals. We hypothesize that the strength, endurance, muscle power, and physical activity levels of individuals with cystic fibrosis, treated with CFTR modulators, remain reduced compared to healthy individuals.

This observational study aims to assess the perception of advanced rehabilitation technologies among three key groups involved in stroke recovery: post-stroke patients, physicians specialized in Physical and Rehabilitation Medicine, and allied health professionals. The study is conducted at HCL - Renée Sabran Hospital , specifically within the Kermes 2 department. Participants are selected using a non-probability sampling method, based on predefined inclusion and exclusion criteria. Data will be collected using a structured, author-developed questionnaire designed to evaluate attitudes, perceived usefulness, ease of use, and intention to adopt technologies such as exoskeletons, social robots, wearable interactive devices, and biofeedback systems. The questionnaire is applied at a single time point after obtaining informed consent. This research responds to the growing integration of technology in neurorehabilitation and seeks to identify potential barriers or facilitators to its adoption in clinical practice. The hypothesis is that there is a significant difference in perception and acceptance of advanced rehabilitation technologies between the three groups, influenced by their respective roles, experience, and level of exposure to such technologies.

Initial assessments will be conducted preoperatively. The follow-up examination will take place during the first 7 days following surgery and then at 21 days (D21), 45 days (D45), and 5 months postoperatively.