Accelerometer as a tool to assess sedentarity and adherence to physical activity recommendations after cardiac rehabilitation program.

PURPOSE To objectively assess, in stable cardiac patients, the adherence to physical activity (PA) recommendations using an accelerometer at 2 or 12 months after the discharge of cardiac rehabilitation program (CRP). METHODS Eighty cardiac patients wore an accelerometer at 2 months (group 1, short-term adherence, n = 41) or one-year (group 2, long-term adherence, n = 39) after a CRP including therapeutic education about regular PA. PA was classified as "light" (1.8-2.9 Metabolic Equivalent of Task [METs]), "moderate" (3-5.9 METs), or "intense" (>6 METs). Energy expenditure (EE, in Kcal) and time (min) spent in these three different levels were measured during a one-week period with the MyWellness Key actimeter (MWK). Motivational readiness for change was also assessed at the end of CRP. Patients were considered as physically active when a minimum of 150 min of moderate PA during the one-week period was achieved. RESULTS Both groups were comparable, except for exercise capacity at the end of the CRP which was slightly higher in group 1 (167.5 ± 42.3 versus 140.7 ± 46.1 W, P < 0.01). The total weekly active EE averaged 676.7 ± 353.2 kcal and 609.5 ± 433.5 kcal in group 1 and 2, respectively. The time spent within the light-intensity range PA was 319.4 ± 170.9 and 310.9 ± 160.6 min, and the time spent within the moderate-intensity range averaged 157.4 ± 115.4 and 165 ± 77.2 min per week for group 1 and 2, respectively. Fifty-three percent and 41% of patients remained active in both groups respectively. CONCLUSION About half of the patients are non-adherent to PA after CRP and do not reach target levels recommended by physicians. The first 2 months following the discharge of CRP seem to be of outmost importance for lifestyle modifications maintenance, and further study monitoring more closely PA decrease could help to clarify the optimal follow-up options.

[1]  Henry S Miller,et al.  The physical activity patterns of cardiac rehabilitation program participants. , 2004, Journal of cardiopulmonary rehabilitation.

[2]  Fernando Costa,et al.  Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Ph , 2003, Circulation.

[3]  W. Kraus,et al.  Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. , 2009, JAMA.

[4]  Andreas Hoffmann,et al.  Comparative outcome one year after formal cardiac rehabilitation: the effects of a randomized intervention to improve exercise adherence , 2008, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[5]  Leonard A Kaminsky,et al.  An Assessment of the Total Amount of Physical Activity of Patients Participating in a Phase III Cardiac Rehabilitation Program , 2007, Journal of cardiopulmonary rehabilitation and prevention.

[6]  Various intensities of leisure time physical activity in patients with coronary artery disease: Effects on cardiorespiratory fitness and progression of coronary atherosclerotic lesions☆ , 1993 .

[7]  Gerasimos S Filippatos,et al.  Exercise training in heart failure: from theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation , 2011, European journal of heart failure.

[8]  M. Belyea,et al.  Barriers to physical activity maintenance after cardiac rehabilitation. , 2004, Journal of cardiopulmonary rehabilitation.

[9]  K. Courneya,et al.  Determinants of physical activity after hospitalization for coronary artery disease: the Tracking Exercise After Cardiac Hospitalization (TEACH) Study , 2006, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[10]  B. Riegel,et al.  Facilitators and barriers to heart failure self-care. , 2002, Patient education and counseling.

[11]  Victor F. Froelicher,et al.  Exercise and the Heart , 1993 .

[12]  G. Schuler,et al.  Various intensities of leisure time physical activity in patients with coronary artery disease: effects on cardiorespiratory fitness and progression of coronary atherosclerotic lesions. , 1993, Journal of the American College of Cardiology.

[13]  J. Ferrières,et al.  Specific profile and referral bias of rehabilitated patients after an acute coronary syndrome. , 2004, Journal of cardiopulmonary rehabilitation.

[14]  Vera Bittner,et al.  Core components of cardiac rehabilitation/secondary prevention programs: 2007 update. , 2007, The Journal of cardiovascular nursing.

[15]  I. Piña,et al.  Core components of cardiac rehabilitation/secondary prevention programs: A statement for healthcare professionals from the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation Writing Group. , 2000, Circulation.

[16]  Lisa Hartling,et al.  Meta-Analysis: Secondary Prevention Programs for Patients with Coronary Artery Disease , 2005, Annals of Internal Medicine.

[17]  J O Prochaska,et al.  Stages of change in the modification of problem behaviors. , 1992, Progress in behavior modification.

[18]  B. Ainsworth,et al.  Evaluation of the MyWellness Key accelerometer , 2009, British Journal of Sports Medicine.

[19]  Shirley M Moore,et al.  Women's and men's exercise adherence after a cardiac event. , 2010, Research in gerontological nursing.

[20]  S. Ebrahim,et al.  Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. , 2004, The American journal of medicine.

[21]  K. Kotseva,et al.  Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries , 2009, The Lancet.

[22]  Vera Bittner,et al.  Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Pr , 2007, Journal of cardiopulmonary rehabilitation and prevention.