Sustainability of the Effects of an Adapted Physical Activity Program on Physical Fitness and Psycho-behavioral Factors in Patients With Chronic Diseases

• Health and Fitness Program (Other): Common Practices at MSS In the standard setting of MSS La Musse, participants are referred by their primary care physician, a specialist involved in prescribing physical activity programs. Each participant undergoes an individual pre-test guided by the protocols of the National Observatory of Physical and Sports Activities (ONAPS), which assesses various parameters of physical fitness as well as certain psychological aspects (see Appendix - ONAPS protocol). These assessments serve as the basis for referral to a personalized physical activity plan (PPAP), developed jointly with a physical activity instructor. These assessments serve as the basis for referral to a personalized physical activity plan (PPAP), developed jointly with a physical activity instructor. This PPAP defines weekly goals centered on independent physical activity (gentle mobility, self-directed exercises at home), combating a sedentary lifestyle (reducing time spent resting), and participation in supervised sessions (

Primary outcomes

• Improvements in physical fitness and anthropometric parameters [At the start of the program, 3 months after the first assessment, and then 6 months, 12 months, and 18 months]: Several tests will be conducted: The TDM6, which assesses cardiorespiratory fitness by measuring the distance (in meters) covered while walking at a brisk pace for six minutes; The 30-second "Sit to Stand" test, which measures quadriceps muscle endurance as well as physical capacity; The handgrip test, which assesses upper limb muscle strength; The "Sit and Reach" test, which assesses lower limb flexibility and the range of motion of the posterior chain; The "Timed Up and Go" test, which assesses overall functional mobility through a sequence of movements (standing up from a chair, walking three meters, turning around, returning, and sitting down); Body Mass Index (BMI) will be calculated using body weight (in kilograms) divided by height squared (in meters); Body weight will be measured using a calibrated electronic scale, with the participant fully clothed and barefoot; Waist circumference will be measured using a non-stretchable anthropometric tape measuring tape, placed midway bet

Secondary outcomes

• The Health-Related Physical Activity Motivation Scale [At the start of the program, and then 3 months, 6 months, 12 months, and 18 months after the first assessment]: The Health-Related Physical Activity Motivation Scale (EMAPS) measures the various forms of motivation described by self-determination theory. It consists of 18 items rated on a seven-point scale and includes six dimensions (intrinsic motivation, integrated regulation, identified regulation, introjected regulation, external regulation, and amotivation).
• The Exercise Confidence Survey (ECS) [At the start of the program, and then 3 months, 6 months, 12 months, and 18 months after the first assessment.]: The Exercise Confidence Survey (ECS) is a questionnaire designed to measure perceived self-efficacy in the regular practice of physical activity. It consists of 12 items organized into two dimensions: adherence to PA, which assesses confidence in maintaining physical activity despite various obstacles (fatigue, stress, lack of support, obligations), and time management, which focuses on the ability to organize one's schedule to incorporate PA. Responses are rated on a five-point scale ranging from "I know I can't" to "I know I can."
• The International Physical Activity Questionnaire [At the start of the program, and then 3 months, 6 months, 12 months, and 18 months after the first assessment.]: The International Physical Activity Questionnaire - Short Form (IPAQ-SF, 7-day) is used to assess self-reported physical activity over the previous week. It includes questions on the frequency and duration of vigorous and moderate-intensity activities, walking, as well as time spent sitting. Responses are converted into MET-minutes per week, allowing individuals to be classified into three levels of physical activity: low, moderate, or high. An official French version is available and widely used, although psychometric validation of the short form remains limited.
• The meCUE [At the start of the program, and then 3 months, 6 months, 12 months, and 18 months after the first assessment.]: The meCUE (Modular Evaluation of Key Components of the User Experience) scale is a standardized questionnaire used to evaluate the key components of the user experience, whether instrumental (utility, usability) or non-instrumental (aesthetics, status, engagement).

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Patients over the age of 18
* French-speaking patients
* Patients with a chronic condition diagnosed by a doctor
* Patients with a doctor's prescription for APA
* Patients capable of understanding instructions
* Patients enrolled in the Social Security system
* Patients referred to Maison Sport Santé La Musse by a doctor for the first time

Non inclusion Criteria :

* Medical contraindications to physical exertion
* Pregnant women
* Individuals under legal guardianship, conservatorship, or judicial protection.
* Severe cognitive or motor impairment
* Lack of proficiency in French
* Patients in the acute phase requiring specialized care
* Patients simultaneously participating in another interventional research study
* Inability to attend sessions regularly or adhere to the schedule of evaluations.
* Patients who have already completed a program at the Maison Sport Santé

Exclusion Criteria:

* Completion of fewer than 16 APA sessions (less than 70% of sessions)
* Acute exacerbation of a chronic condition during follow-up
* For groups without smartwatches, the use of a digital tool such as a physical activity tracker by participants would constitute an exclusion criterion
* Completion of a patient therapeutic education program