Adapted Physical Activities :
When sports and health go hand in hand
L’écho des seniors, Le Magazine des Seniors,
February 21, 2014
Still relatively
unknown by the public and yet promised to a great future, the profession of
teacher in Adapted Physical Activities (APA) keeps developping. We’ve met
Stéphane Dijoux, teaching that very subject, who takes it as a daily task to give
an adapted treatment to biological and psycho-social needs of disabled people, no
matter how old they are.
How did you discover
this activity?
Stéphane
Dijoux: After spending one year studying psychology at the university, I
discovered by chance (in 1999-2000), that the school of Sciences and Technics
for Physical and Sports Activities (STAPS) offered an option called
"Adapted Physical Activities". Fond of sports and sensitive to all sorts
of handicaps, I decided to register the following year.
What does
the training consist in?
Stéphane
Dijoux: We have to take a training program at the university about health, physical
and fitness activity and. It can be a three-years (bachelor), five-years or
even eight-years program for some of us... As far as I am concerned, a part of
my training took place in the Department of Readaption and After Effects Treatment (SSR) of Salins
Les Bains ; this training was provided by the general surgeon and teacher
of Adapted Physical Activities and Health (EAPA-S). I had the chance to be aware of the various approaches offered by
multidisciplinary teams: specialized educators, social assistants,
psychologists, APA-health professors, ergotherapists, psychomotor therapist,
physiotherapists, fitness
Coaches, etc…
What about
your professional path?
Stéphane
Dijoux: I became an APA-S teacher in 2005 in the local Loewel/Haslach Hospital polyvalent service of care and rehabilitation
(SSR) in Münster, Alsace. At the same time, I committed myself to the recognition of this profession, including becoming a member of the French Society of Professionals in Adapted Physical
Activities (SFP-APA) and by being part of several works begun by the
association. I participate in many thematic commissions organized by the
network (psychiatry, rules, breathing restoration, obesity and diabetes, cancer,
etc ...)
Faced with
the growing interest in physical
activity for seniors, the
SFP-APA also working on setting up a commission called "senior and the APA".
What does the
APA consist in ? What about its role?
Stéphane
Dijoux : The denomination of APA for Adapted Physical Activity was born in
Quebec in 1970. In France, the curicullum for STAPS APA was developed in the
1980’s, and the « APA » quote appeared in the title of the diploma in
1999. The APA bring together all the Physical and fitness Activities, adapted
to the person. They are taught to disabled, and/or aging people, suffering from
chronic disaseases, or from social handicaps, the goal is to work on the
prevention, reeducation and readaptation, reinsertion and education.
It,s during these
years at the university, that I really became aware of the APA role. I have seen the difficulties faced by people with
disabilities in their daily lives. Climb a curb, a slope or a simple staircase
when moving in wheelchairs for example, but also face the look of others (condescension, pity, ignorance,
fear, ...)
What are the
different organisations in which the APA teacher intervene?
Stéphane
Dijoux: The list is quite long, we intervene in many fields such as the
sanitary area (hospitals, clinics, after-effects and readaption services (SSR),
Fonctional Reeducation), the medico-educational area (Medico-Educational Institute
(EMI), specialized reception centers/houses (MAS), Therapy Edacation and
Instruction Institutes) not to mention the medico-social sector (mainly
retirement homes)
How is a
patient taken care of ?
Stéphane
Dijoux: During a stay in a reeducation / readaption departement, the APA-S treatment
starts with a consultation with the patient. After the abilities evaluation, we
offer a personalized program based on one or several physical activities. We
really take into account the patient’s feedback regarding the sessions and his
feelings. We are able then to analyse his care.
This occupation is rather new and
still little known. How can you explain this ?
Stéphane Dijoux:
The first Physical Education teachers working under the authority of the medical
corps and in favour of health already existed at the begining of the 19th
century : so I would not qualify it as a new field. Yet, after being
practiced until the 1960’s, the health sector was put aside little by
little by the physical and fitness
education, before being re-established in 1982, with the creation of the Adapted
Physical Activities diploma (APA), which became adapted Physical Activity and
Health in 2007 (APA-S).
Mainly, the ignorance
of this job is due to a lack of interest from public authorities in APA (for
health goal) ; but it is also due to a lack of scientific publications
(intervention based on proofs) to justify the intertest of Sports and Physical Activity.
Many
stereotypes remain though : just imagine all the obstacles the first
"APA-S teachers" encontered from some health professionals or
families, when they suggested to fragile ageing , sick or disabled people, to
start walking again, cycle again, practise fitness or even gymnastics !
Finally, we
still are rare in some structures and
the financial and material means are often scarce. Yet, since 2008, it
seems that a change is happening, thanks to a new interest in APA, which bring
a new momentum to this field.
Is the APA-S
teacher a fitness coach or a health professional?
Stéphane
Dijoux: both! We have to register at the local ministry of sports which
delivers a professional Sports coach licence. Therefore, I’d say « yes ».
We are professional in physical and fitness activity, but our job description,
beyond the simple teaching and sport management, also educates our patients to
health management. APA-S programs are introduced and implamented. For instance,
in the sanitary sector, where we intervene under medical prescriptions, we
commit ourselves in the care, as other health professionals would do.
Are only the
seniors concerned by the APA ?
Stéphane
Dijoux: The APA-Health deals with all the deficient and disabled people, those
at-risk or with health issues. Children, teenagers, adults, seniors and even
centenarians are concerned, and whatever their situations are (IME IMPRO, MAS, EHPAD,
retirement home, SSR), at school or at home.
You intervene
in multidisciplinary teams, how do you deal with the collaboration with other
professionals?
Stéphane
Dijoux: Despite tough beginings with some colleagues, collaborating with
different professionals (medical, paramedical, cares, technics, ...) is, as far
as I am concerned, rather good (I’d dare say very good). Working together with
the same goal but with different approaches, and a mutual respect, is the very
best for our patients.
Some
difficulties are sometimes linked to an ignorance of our skills. I would
compare that to the ergotherapist arrival in the reeducational world, which was
hard to cope with for some professionals. It was a time where, before learning
to work together, everyone would work seperate to avoid conflict. The APA-S grows :
training are more diverse and become multidisciplinary (for exemple, a joint
physio/APA-S training exists in Grenoble). These difficulties, will surely fade
away with time.
To conclude,
what are your profession needs nowadays?
Stéphane
Dijoux: The APA-S is a fascinating job, which developpment is obvious and
necessary. It needs a better acknowledgement.
I’ll quote Mrs
Valérie Fourneyron, our Sports Minister : "Practising
sports is better than having a long list of pills. Sports make hypertension
lower or it even decreases the need for insulin in our diabetic patients. This
idea has still to ffind it own way. Sports have a therapy role. It needs to be
said time and time again by physicians and health professionnal … « Special
needs » people deserve to get our attention: I think about seniors losing
their independance, people suffering from chronic pathologies, in other word everyone
who is in need for a very elaborated physical activity. "
Our
President, François Hollande, is fond on reminding people that the crisis does
not make sports less necessary, it makes it even more vital. Marisol Touraine
and I would agree with that. We intend to build on this inter-ministry shared ambition :
makings sports practice a major tool for our country public health. "We
can only hope that these speeches become consistent acts.
Interview by G.Gauthier February 21, 2014
To meet
professionals and get more information, visit the 1st Congress of APA
professionals
in April the 4th,
2014 in Bobigny.
Useful
links: www.cnp-apa.sfp-apa.fr; www.sfp-apa.fr; www.activites-physical-adaptees.fr;
www.apa-sante.fr
