[Hemiplegia and a hiking tour of Mont Blanc: from hope to reality].
BACKGROUND
At the end of an endurance training program for stroke patients with hemiplegia, we offered a hiking tour around the Mont Blanc Pedestrian Tour. We found no publication describing a similar experience and no scientific data in the literature to determine the physiological characteristics required for this performance, particularly regarding cardiac and vascular capacities, level of impairment, and functional abilities.


OBJECTIVE
To complete a part of the Mont Blanc Pedestrian Tour over six days, with a group of adults with hemiparesis and aphasia due to stroke.


METHODS
Seven of 20 subjects with right hemiparesis and aphasia were selected on the basis of results of physiological tests, after an endurance training program and two tests hikes at medium altitude. Mean age was 51.71 +/- 7.13 years, mean VO(2max) 19.76 +/- 3.46 ml.g(-1).mm(-1), mean P(max) 90 +/- 22.68 and mean walking speed 3.60 +/- 1.30 km/hour.


METHODS
Organization involved setting up the itinerary, recruiting accompanying personnel (9 people), and arranging security. No specific adaptations for accessibility were available, and no specific equipment was used, except for standard walking sticks.


RESULTS
During this pedestrian tour, the subjects demonstrated strong motivation, as well as exceptional physical and functional performance, despite significant changes in elevation (up to 1500 m per day) and long walking times (from 5 to 9 hours per day).


CONCLUSIONS
This experience has enriched our reflection about the medical, functional, and psychological conditions required for this type of physical effort, both from patients and accompanying personnel. In the absence of reports on similar experiences with this patient population, we thought it interesting, six months after this challenge, to present our observations as well as the patients' point of view. This may encourage other rehabilitation teams to offer intensive walking activities for stroke patients.
Calmels
P
P
Service de médecine physique et de réadaptation, centre hospitalier universitaire de Saint-Etienne, France. paul.calmels@chu-st-etienne.fr
Degache
F
F
Fayolle-Minon
I
I
Condemine
A
A
Courbon
A
A
Ramas
J
J
Richard
R
R
Roche
F
F
Degache
A
A
Girardin
N
N
Gautheron
V
V
Devillard
X
X
D001037:Aphasia / Q000503:physiopathology / Q000523:psychology; D005602:France; D006429:Hemiplegia / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009051:Mountaineering / Q000502:physiology / Q000523:psychology*; D020521:Stroke / Q000503:physiopathology / Q000523:psychology*