It is a sport:
Group classes with individual saber lessons supervised by trained fencing masters.
Adapted fencing practice is complementary to physiotherapy and is subject to medical approval.
A regular physical follow-up is assured within the association by a medical team.
The activity is aimed at women whether or not they are undergoing treatment.
Artistic fencing courses are offered after a few months of practice.
1) The fencing master(s) of the approved clubs will have undergone specific training provided by the IFFE or an approved training organization.
This training involves in particular the following professionals
Nurse for consultation of announcement
Referring fencing instructors
This program is adapted according to scientific medical and sports progress. It is coordinated by Dr. Dominique Hornus-Dragne, president of "SOLUTION R.I.P.O.S.T.E.".
2) The classes will be conducted exclusively by trained fencing masters. The fencing masters agree to follow the recommendations of the steering committee (fencing without touching during the months following the surgery, work on the fundamentals and adapted general muscular strengthening)
3) The sessions will be provided without financial compensation the first year of registration on the recommendations of the national league against cancer, given the financial difficulties encountered by patients during this period. The clubs can use this approval to obtain the necessary financing from public and private organizations.
4) The equipment will be reserved for this activity. It will be chosen and maintained with the aim of ensuring hygiene compatible with the infectious risk that can result from breast cancer treatments.
5) Every two years, the trained fencing masters will participate in a day of continuing education.
6) Club activity in this area will be reported to "SOLUTION R.I.P.O.S.T.E." annually.
7) All patients are licensed with the French Fencing Federation and insured by this license. Exceptions may be accepted after approval by " SOLUTION R.I.P.O.S.T.E. " under cover of an insurance for the practice of this activity
8) Licensed fencing clubs will endeavor to promote patient evaluation. Protocols are developed by the master training coordinator and this evaluation will be performed by local physicians and surgeons. Self-assessment questionnaires validated by the HAS will be systematically offered to fencers when medical evaluations are not possible. All results should be sent to the coordinator. This evaluation must allow us to measure the benefits of this practice and to make it evolve. A record of the results of these evaluations and any events that occur will be kept by the accrediting body. "SOLUTION R.I.P.O.S.T.E." may use these results for scientific communications or presentations to different audiences, including potential funders, in full respect of the anonymity of individuals and in accordance with the regulations of the CNIL.
9) As for any sport activity within the framework of sport-health, a medical certificate of absence of contraindication (CACI) will be required upon registration and will be renewed each year.
10) Any change of president or fencing master in a club approved by Solution R.I.P.O.S.T.E. must be reported to Solution R.I.P.O.S.T.E. and a new approval will be requested
11) The name, the sponsors and the logo of "SOLUTION R.I.P.O.S.T.E." can only be used within the approved clubs and only for the purpose of this approval. They are not separable. Communication means will be available to the fencing halls that wish to use them. They can be modified with the approval of Solution R.I.P.O.S.T.E.
Solution R.I.P.O.S.T.E. (for Reconstruction, Self-image, Posture, Oncology, Health, Fencing) is an association under the French law of 1901, created and chaired by an anesthesiologist from Toulouse and intended to provide an original response to a public health problem. Since 2008, numerous studies have demonstrated the benefits of sport after cancer, in particular breast cancer. These scientific studies have proven that "moving" combats cancer-induced fatigue, reduces the risk of recurrence, improves quality of life and reduces mortality. Encouraging her to practice sports is therefore a duty for her doctor. In 2011, a team of sports and health professionals adapted an Olympic sport, fencing, and offered these women this elegant and fun sports discovery. This first working group brought together Professor Daniel Rivière, a university professor of exercise physiology and sports medicine, Dr. Jean-Luc Manenc, a senological surgeon, Dr. Raymond Despax, an oncologist, Dr. Dominique Hornus-Dragne, an anesthesiologist and sports physician involved in fencing, Mr. Claude Lucas, a physical therapist, and Master Jean-Philippe Parade, a fencing instructor. Solution RIPOSTE was born in 2014, after confirming the absence of dangerousness of the practice by a precise evaluation of the first patients. In 2016, Solution RIPOSTE built a medical scientific committee to participate in the evolution of the concept, set up evaluation and clinical research work. This committee brings together doctors and surgeons from several regions of France, both academic and liberal. It is chaired by Professor Mathias Poussel. An Olympic fencing champion gave her support from the outset, quickly followed by other great champions. Breast cancer is the leading cause of cancer in women (1 in 8 women will be affected in their lifetime) and has become, through medical progress, a chronic disease. The treatments have side effects that alter the quality of life well beyond the treatment period.
The benefits of fencing are multiple:
The fencing outfit, identical for all and covering the whole body, spares the modesty of women marked by the tattooed points of radiotherapy and the port-à-cath (small subcutaneous box for chemotherapy) located in a part of the body uncovered in scalloped outfit.
The guard, an opening position, puts back in good position a shoulder often in fold after surgery and improves the posture always modified, especially after removal of a breast.
The precise target represented by the opponent, hit after an attack or a riposte, motivates the desire to fight and win.
The necessary coordination between the lower and upper limbs in walking and lungeing restores the awareness of a bust often denied after surgery.
The amplitude of the reflex gesture, educated by the fencing master, pushing the high parries further and further up, mobilizes a shoulder stiffened by scars and adhesions.
The acquisition of the gestures specific to fencing contributes to the fight against the concentration and memorization problems caused by chemotherapy treatments.
Coming to a fencing room fights against loneliness and desocialization contemporary to complementary treatments.
The elegance of fencing revalorizes a disturbed self-image and allows the discovery of a playful activity associated with a significant level of energy expenditure.
The specificity of this combat sport allows to evacuate the feeling of revolt, which is legitimate in the early stages of this disease and often expressed verbally.
The "fighters" practice on the operated side in order to have a maximum of beneficial effects and start the activity with muscle strengthening sessions involving all the muscles of the body, according to the recommendations of the National Cancer Institute (INCA).
No touching is given to the riposteuse until approved by the referring physician, i.e. at a sufficient distance from any surgery and treatment.
Since 2012, each year, fencing masters from France and abroad have followed, in partnership with the French Fencing Federation, a specific training on breast cancer, its treatments, their side effects, the psychology of these fragile women, the place of each professional and the recommendations of learned societies. The practice is learned in a fencing room with volunteer "riposteurs". The rules of adaptation of this sport are strict to avoid any danger. Refresher courses are mandatory every two years.
To date, 240 fencing masters have been trained and about 1000 women practice each year in France in 80 fencing rooms, in traditional or artistic fencing. Solution RIPOSTE, in Occitania, is committed to allowing the discovery of this unexpected sport within cancer leagues in order to motivate patients from the beginning of their treatments. Currently, more than 80 women are enrolled in this program in the region and this number continues to grow.
Several foreign countries have sent masters of arms to study this adaptation during initial training in Toulouse. Several fencing schools in Switzerland, Italy, Belgium and Canada offer this program. Two developing African countries have applied for the next training sessions and other countries showed their interest in the action during a world congress in London in July 2017.
A report by the National Cancer League in 2016 showed the significant cost borne by breast cancer patients. This is why the costs of fencing outfits, equipment, license and lessons are fully covered the year of treatment so that the cost can not be a brake on the practice during this period of loss of income. In Occitania, the association helps the various clubs to obtain specific, protective and adapted material. The Regional Committee of Fencing of Occitania takes care of the licenses. The clubs ensure the remuneration of the masters, some still remaining voluntary for this action. Some regions of France received the support of the ARS. The weapon rooms, approved by Solution RIPOSTE, meet precise specifications. An evaluation is required for each " riposteuse ". This evaluation, coordinated by Solution RIPOSTE, is carried out by a doctor or by self-evaluation grids and focuses on shoulder mobility, fatigue and quality of life. The results are the subject of theses and dissertations. Two theses have demonstrated the benefits of the practice on shoulder mobility and quality of life.
In 2014, its president was elected "woman of the year" by the magazine FEMINA and, in 2015, received the trophy for excellence from UNAPL (Union Nationale des Professions Libérales). This FEMINA award allowed her to set up this action for a year in a troubled neighborhood of Toulouse and to participate in women's discussion groups by talking about the importance of screening, physical activity and nutrition in the prevention and treatment of breast cancer. In 2018, she received the "sport and health" trophy at the Paris sport-health fair and, in 2019, the "sport and management" award at the national assembly.
In July 2019, a pink "caravan", which left Roanne, reached Toulouse for a meeting of sport and human sharing between "riposteuses" from Roanne and Toulouse. Several clubs in France have expressed the same desire to exchange with the Toulouse pioneers. A next gathering is planned in Occitania during the 2021-2022 sports year.
Since October 2020, Solution RIPOSTE took back its autonomy towards the French Federation of Fencing, the proposals emitted by the national medical commission having been judged not acceptable by several members of the scientific council. However, in order not to harm the action, to preserve its values and not to penalize the fencing masters invested in this action, Solution RIPOSTE chose to sign an agreement with the Training Institute of the F.F.E.
The initial and ongoing training of firearms masters will therefore take place according to the old formula, the initial training in Toulouse, the city of the practitioner-experts at the origin of the action, the ongoing training in the regions.
Some personalities have given their support to Solution RIPOSTE. The first is Mrs. Laura Flessel-Colovic, Olympic champion in epee and godmother of the association from the beginning, since 2011. The ministerial functions of Mrs. Laura Flessel did not allow her to ensure this function in 2017. To date, our godmothers are Mrs. Cecilia Hornus, actress of theater and television series "Plus belle la vie", Mrs. Cecilia Berder, world champion of saber. Mr Gaël Touya, Olympic sabre champion in Athens in 2004, actively participates in the life of the association.
The gestures of high parries in fencing, unconsciously mobilizing the shoulder, is an argument that adds to all the benefits of sport in general for this pathology. Solution RIPOSTE is an example of a beautiful synergy between the actors of sport and health for the victory of femininity and sport over cancer.
A few words from our first sponsor, Laura Flessel:
The action led by Dominique Hornus with Solution Riposte is a beautiful example of self-sacrifice.
The abnegation of a woman doctor towards a suffering population, that of women suffering from breast cancer.
The abnegation of a fencing enthusiast who, through her action, transmits the essential values of combat, self-respect and respect for others.
The abnegation is also that of all these women who participate in the Riposte course.
Courageous women who learn to fight, to find ways to overcome the hard knocks of life, to fight to overcome the disease.
Congratulations to all of you! Thank you Dominique!
Sabre fencing, an unexpected weapon to foster rehabilitation following breast cancer.
Dr Dominique Hornus-Dragne, Anaesthetist, Sports Doctor, National Federal Doctor for the French Fencing Federation, member of the medical commission of the French National Olympic and Sports Committee, Founding President of Solution RIPOSTE,
Pr Daniel Rivière, MD, PhD, University Professor, Head of the Sports Medicine department of Toulouse University Hospital,
Dr Jean-Luc Manenc, Breast Surgeon, Pasteur Hospital, Toulouse,
Dr Jérôme Farnarier, Breast Surgeon, Pasteur Hospital, Toulouse,
Jean-Philippe Parade, Fencing Master.
Numerous scientific studies have highlighted the positive effects of well-adapted physical activity after breast-cancer surgery - it is shown to reduce fatigability, posture problems and the risk of recurrence, hence to foster a better quality of life. Solution RIPOSTE, born inFrance in 2011, headed by a scientific committee made up of surgeons, oncologists, gynaecologists, sports doctors and physiotherapists, offers women with breast-cancer an adapted practice of fencing, devoid of hits, which improves shoulder mobility thanks to the reflexive gesture of high parry commonly made in sabre fencing, and also corrects posture anomalies thanks to the shoulder opening required by the en garde position. The body-covering fencing gear safeguards the intimacy of those women who bear the marks of port-a-cath and radiotherapy.Besides, the elegance of the sport helps to restore a feminine self- image which has been severely impaired. The fighting spirit it develops gives or restores the desire to oppose and overcome; it also makes it possible to give free vent to the anger often felt at the announcement or during the first stage of the treatments. Coming to a fencing hall means resuming social life, under the kind supervision of a fencing master. A medical thesis, based on validated scales, has highlighted improved shoulder mobility, reduced fatigue, and a better quality of life. Another study based on validated self-assessment questionnaires, is in the process of being finalised. All the fencing masters and instructors in charge of those vulnerable fencers must be specifically trained and regularly re-trained, so that they may acquire the specific skills to cater for that new kind of sportswomen, and be at the forefront of medical learned societies’ recommendations. In addition, we think that, with their oncologists’ backing, women with lumbar or sacrum metastases, for whom any sport involving stamping is strictly contraindicated, could also benefit from wheelchair fencing. Beyond the purely medical conclusions, the best testimony of the pleasure and well-being that such an adapted practice can bring is the ever-growing number of breast-cancer patients that go for it. Almost a hundred fencing halls in France, and some in other countries too, are already offering this activity. Adapted fencing can be a plus for the physical, social and psychological rehabilitation of thousands of women who have to contend with breast cancer every year.