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Sahu PK, Goodstadt N, Ramakrishnan A, Silfies SP. Test-retest reliability and concurrent validity of knee extensor strength measured by a novel device incorporated into a weight stack machine vs. handheld and isokinetic dynamometry. PLoS One 2024; 19:e0301872. [PMID: 38776288 PMCID: PMC11111025 DOI: 10.1371/journal.pone.0301872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/22/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND The current clinical gold standard for assessing isometric quadriceps muscle strength is an isokinetic dynamometer (IKD). However, in clinics without an IKD, clinicians default to using handheld dynamometers (HHD), which are less reliable and accurate than the IKD, particularly for large muscle groups. A novel device (ND) was developed that locks the weight stack of weight machines, and measures forces applied to the machine, turning this equipment into an isometric dynamometer. The objectives of this study were to characterize the test-retest reliability of the ND, determine the within-day and between-days inter-rater reliability and concurrent validity compared with that of the HHD, in healthy volunteers (HV) and individuals with knee osteoarthritis (OA) for measuring knee extensors isometric muscle force. MATERIALS AND METHODS 29 healthy (age = 28.4 ± 7.4 years) and 15 knee OA (age = 37.6 ± 13.4 years) participants completed three maximum force isometric strength testing trials on dominant side knee extensor muscles on three devices (ND, HHD, and IKD) in two separate sessions by two raters. The maximum force (Fmax) produced, and the force-time series were recorded. Reliability and validity were assessed using Intraclass Correlation Coefficient (ICC), Bland-Altman Plots, Pearson's r, and cross-correlations. RESULTS The ND demonstrated excellent test-retest reliability (ICC2,3 = 0.97). The within-day (ICC2,3 = 0.88) and between-day inter-rater reliability (ICC2,3 = 0.87) was good for HHD. The ND showed excellent within-day (ICC2,3 = 0.93) and good between-day (ICC2,3 = 0.89) inter-rater reliability. The Bland-Altman analysis revealed HHD systematic bias and underestimation of force particularly with quadriceps force values exceeding 450 N. Mean differences were found in maximum force between HHD vs. IKD (MDabs = 58 N, p < .001) but not the HHD vs. ND (MDabs = 24 N, p = .267) or ND vs. IKD (MDabs = 34 N, p = .051). The concurrent validity of Fmax (r = 0.81) and force-time curve correlation (0.96 ± 0.05) were the highest between the ND and IKD. CONCLUSIONS The ND's test-retest reliability and concurrent validity make it a potential strength assessment tool with utility in physical therapy and fitness settings for large muscle groups such as the knee extensors.
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Affiliation(s)
- Pradeep K. Sahu
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Noel Goodstadt
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Arun Ramakrishnan
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Sheri P. Silfies
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
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Duan FX, Wu Q, Zuo YF, Yang HX, Dai F, Wang L. Effects of mind-body exercise on cardiopulmonary function, blood pressure, and quality of life in CHD patients: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25042. [PMID: 33655981 PMCID: PMC7939156 DOI: 10.1097/md.0000000000025042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/12/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronary heart disease (CHD) is one of the highest mortality diseases in the world, which seriously threatens human health and quality of life (QOL). The purpose of this study is to systematically analyze the effects of mind-body exercise on cardiopulmonary function, blood pressure and QOL in CHD patients, and to provide scientific evidence-based exercise prescription for patients with coronary heart disease. METHODS This research review will include the following electronic databases from its establishment to December 2020: PubMed, EMBASE, Web of Science, Cochrane Library, the Chinese National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database, and Wanfang. Objective to search randomized controlled trials (RCTs) about the effects of mind-body exercise on cardiopulmonary function, blood pressure and QOL in patients with coronary heart disease. CONCLUSION This systematic review and meta-analysis will provide strong evidence for the efficacy and safety of mind-body exercise in patients with coronary heart disease. SYSTEMATIC REVIEW REGISTRATION INPLASY202120016. ETHICS AND DISSEMINATION Ethical approval will not be necessary since this systematic review and meta-analysis will not contain any private information of participants or violate their human rights.
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Affiliation(s)
- Fei-xing Duan
- Department of Physical Education, Wuhan University of Technology, Wuhan
| | - Qi Wu
- Department of Physical Education, Wuhan University of Technology, Wuhan
| | - Yi-fan Zuo
- Department of Physical Education, Wuhan University of Technology, Wuhan
| | - Hui-xin Yang
- Traditional Sport Institute, Harbin Sport University, Harbin
| | - Fei Dai
- Institute of Physical Education, Wuchang Institute of Technology, Wuhan, China
| | - Lin Wang
- Department of Physical Education, Wuhan University of Technology, Wuhan
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3
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Bácsné Bába É, Ráthonyi G, Müller A, Ráthonyi-Odor K, Balogh P, Ádány R, Bács Z. Physical Activity of the Population of the Most Obese Country in Europe, Hungary. Front Public Health 2020; 8:203. [PMID: 32582609 PMCID: PMC7280479 DOI: 10.3389/fpubh.2020.00203] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 05/05/2020] [Indexed: 01/26/2023] Open
Abstract
Introduction: Physical activity is inversely proportional to mortality, so it has an important role in disease prevention. The aim of our study was to characterize the physical activity of Hungarians, the most obese population in Europe. Materials and methods: In a cross-sectional study the physical activity of the Hungarian population was characterized in a sample (n = 1,295) which was representative of the sex, age and geographical location of the adult population aged 18 years and above by using the long form of the International Physical Activity Questionnaires (IPAQ) as an instrument. Based on the metabolic equivalent (MET) rates three categories of physical activity (low, moderate, and high) were defined. Two-step cluster analysis was used to explore physical activity characteristics of participants using sex, age, settlement type and BMI categories as categorical variables, and MET values related to the Work, Transportation, Domestic and Garden, and Leisure Time domains of physical activity as continuous variables. Results: The study showed that 63.39% of the adult Hungarian population took part in high, and 24.78% in moderate activity, and only 11.73% of the sample belonged to the category of low physical activity. By cluster analysis six clusters of people with typical lifestyles could be identified in the Hungarian adult population. In all the six groups participants achieved moderate or high activity levels through work and housework. Physical activity in relation to transportation is very low, similarly to leisure-time sporting activities. In the case of elder people, severe overweight/obesity problems can be detected in married city-dwellers. Discussion: Although Hungary has the highest obesity rate in Europe our research has proved that Hungarians lead physically active lives. The dominant forms of their physical activity are linked to work and housework. Our findings draw attention to the need to examine other risk factors in addition to physical inactivity. Our findings also suggest that the type of physical activity should be more severely considered when defining factors protective against obesity.
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Affiliation(s)
- Éva Bácsné Bába
- Institute of Sport Management, University of Debrecen, Debrecen, Hungary
| | - Gergely Ráthonyi
- Institute of Applied Informatics and Logistics, University of Debrecen, Debrecen, Hungary
| | - Anetta Müller
- Institute of Sport Management, University of Debrecen, Debrecen, Hungary
| | | | - Péter Balogh
- Institute of Sectoral Economics and Methodology, University of Debrecen, Debrecen, Hungary
| | - Róza Ádány
- MTA-DE Public Health Research Group, Public Health Research Institute, University of Debrecen, Debrecen, Hungary
| | - Zoltán Bács
- Department of Accounting, Institute of Accounting and Finance, University of Debrecen, Debrecen, Hungary
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Tulppo MP, Kiviniemi AM, Lahtinen M, Ukkola O, Toukola T, Perkiömäki J, Junttila MJ, Huikuri HV. Physical Activity and the Risk for Sudden Cardiac Death in Patients With Coronary Artery Disease. Circ Arrhythm Electrophysiol 2020; 13:e007908. [PMID: 32433894 DOI: 10.1161/circep.119.007908] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The association between leisure-time physical activity (LTPA) and the risk of sudden cardiac death (SCD) in coronary artery disease patients is not well known. We aim to assess whether there is an association between LTPA and the risk of SCD and non-SCD in patients with coronary artery disease. METHODS Patients with angiographically verified coronary artery disease (n=1946) underwent a clinical evaluation, including filling in an LTPA questionnaire and extensive risk profiling at the baseline. The patients were classified into 4 groups according to LTPA: (1) inactive; (2) irregularly active; (3) active, exercise regularly 2× to 3× weekly; (4) highly active, exercise regularly ≥4× weekly. Age, sex, body mass index, left ventricular ejection fraction, type 2 diabetes mellitus, history of myocardial infarction, Canadian Cardiovascular Society grading of angina pectoris class, and exercise capacity were used as covariates in the multivariate Cox regression analysis. RESULTS During follow-up (median 6.3 years), 52 SCDs and 49 non-SCDs occurred. Inactive patients had increased risk for SCD compared with active patients (hazard ratio, 2.45 [95% CI, 1.01-5.98]; P<0.05). A significant LTPA×Canadian Cardiovascular Society grading of angina pectoris class interaction was observed in SCD risk (P=0.019 in highly active patients). LTPA was not associated with SCD in patients with Canadian Cardiovascular Society grading of angina pectoris class 1 (n=1107, 18 events). Among patients with Canadian Cardiovascular Society grading of angina pectoris class 2 or higher (n=839, 34 events), increased risk for SCD was encountered in highly active patients (hazard ratio, 7.46 [95% CI, 2.32-23.9]; P<0.001) and inactive patients (hazard ratio, 3.64 [95% CI, 1.16-11.5]; P<0.05) as compared to active patients. A linear association was observed between LTPA and non-SCD; those with high LTPA had the lowest risk for non-SCD. CONCLUSIONS Inactive coronary artery disease patients had increased risk for SCD. In subgroup analysis among symptomatic patients, the risk of SCD was increased in highly active and inactive patients compared with active patients. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01426685.
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Affiliation(s)
- Mikko P Tulppo
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Finland
| | - Antti M Kiviniemi
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Finland
| | - Minna Lahtinen
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Finland
| | - Olavi Ukkola
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Finland
| | - Tomi Toukola
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Finland
| | - Juha Perkiömäki
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Finland
| | - M Juhani Junttila
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Finland
| | - Heikki V Huikuri
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Finland
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Freene N, Borg S, McManus M, Mair T, Tan R, Davey R, Öberg B, Bäck M. Comparison of device-based physical activity and sedentary behaviour following percutaneous coronary intervention in a cohort from Sweden and Australia: a harmonised, exploratory study. BMC Sports Sci Med Rehabil 2020; 12:17. [PMID: 32419950 PMCID: PMC7210676 DOI: 10.1186/s13102-020-00164-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/20/2020] [Indexed: 11/18/2022]
Abstract
Background Few studies have measured device-based physical activity and sedentary behaviour following a percutaneous coronary intervention (PCI), with no studies comparing these behaviours between countries using the same methods. The aim of the study was to compare device-based physical activity and sedentary behaviour, using a harmonised approach, following a PCI on-entry into centre-based cardiac rehabilitation in two countries. Methods A cross-sectional study was conducted at two outpatient cardiac rehabilitation centres in Australia and Sweden. Participants were adults following a PCI and commencing cardiac rehabilitation (Australia n = 50, Sweden n = 133). Prior to discharge from hospital, Australian participants received brief physical activity advice (< 5 mins), while Swedish participants received physical activity counselling for 30 min. A triaxial accelerometer (Actigraph GT3X/ActiSleep) was used to objectively assess physical activity (light (LPA), moderate-to-vigorous (MVPA)) and sedentary behaviour. Outcomes included daily minutes of physical activity and sedentary behaviour, and the proportion and distribution of time spent in each behaviour. Results There was no difference in age, gender or relationship status between countries. Swedish (S) participants commenced cardiac rehabilitation later than Australian (A) participants (days post-PCI A 16 vs S 22, p < 0.001). Proportionally, Swedish participants were significantly more physically active and less sedentary than Australian participants (LPA A 27% vs S 30%, p < 0.05; MVPA A 5% vs S 7%, p < 0.01; sedentary behaviour A 68% vs S 63%, p < 0.001). When adjusting for wear-time, Australian participants were doing less MVPA minutes (A 42 vs S 64, p < 0.001) and more sedentary behaviour minutes (A 573 vs S 571, p < 0.001) per day. Both Swedish and Australian participants spent a large part of the day sedentary, accumulating 9.5 h per day in sedentary behaviour. Conclusion Swedish PCI participants when commencing cardiac rehabilitation are more physically active than Australian participants. Potential explanatory factors are differences in post-PCI in-hospital physical activity education between countries and pre-existing physical activity levels. Despite this, sedentary behaviour is high in both countries. Internationally, interventions to address sedentary behaviour are indicated post-PCI, in both the acute setting and cardiac rehabilitation, in addition to traditional physical activity and cardiac rehabilitation recommendations. Trial registrations Australia: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12615000995572. Registered 22 September 2015, Sweden: World Health Organization Trial Registration Data Set: NCT02895451.
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Affiliation(s)
- Nicole Freene
- 1Physiotherapy, Faculty of Health, University of Canberra, Bruce, ACT 2617 Australia.,2Health Research Institute, University of Canberra, Bruce, ACT Australia
| | - Sabina Borg
- 3Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden.,4Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | | | - Tarryn Mair
- Exercise Physiology, Canberra Health Services, Garran, ACT Australia
| | - Ren Tan
- Cardiology, Canberra Health Services, Garran, ACT Australia
| | - Rachel Davey
- 2Health Research Institute, University of Canberra, Bruce, ACT Australia.,7Centre for Research and Action in Public Health, University of Canberra, Bruce, ACT Australia
| | - Birgitta Öberg
- 3Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
| | - Maria Bäck
- 3Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden.,8Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
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Gerber M, Börjesson M, Jonsdottir IH, Lindwall M. Association of change in physical activity associated with change in sleep complaints: results from a six-year longitudinal study with Swedish health care workers. Sleep Med 2020; 69:189-197. [DOI: 10.1016/j.sleep.2019.01.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 12/09/2018] [Accepted: 01/08/2019] [Indexed: 01/26/2023]
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7
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Bouisset F, Ruidavets JB, Bongard V, Taraszkiewicz D, Bérard E, Galinier M, Carrié D, Elbaz M, Ferrières J. Long-term Prognostic Impact of Physical Activity in Patients With Stable Coronary Heart Disease. Am J Cardiol 2020; 125:176-181. [PMID: 31740022 DOI: 10.1016/j.amjcard.2019.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/01/2019] [Accepted: 10/03/2019] [Indexed: 11/17/2022]
Abstract
Stable coronary heart disease (CHD) patients are advised to practice regular physical activity (PA). However, data on very long-term prognosis impact of regular exercise remain scarce. We aimed to evaluate the impact of physical activity level on mortality at long term in stable CHD patients. We analyzed 822 patients with stable CHD. They answered questionnaires on medical history, underwent a standardized clinical examination, and provided a fasting blood sample. PA was evaluated by the MOSPA questionnaire. Three tertiles of patients were individualized according to PA level: 0.0-9 Metabolic Equivalent of Task (METs) hour per week (n = 267); 10-39.9 METs hour per week (n = 279); and ≥40 METs hour per week (n = 276). After a median follow-up of 14.6 years, 324 patients had died. In a multivariate analysis adjusted for age, dyslipidemia, smoking status, diabetes, high blood pressure, waist circumference, left ventricular ejection fraction, Gensini score, heart rate, ankle-brachial index and duration of disease, physical activity was significantly and independently associated with all-cause mortality. Compared to the lowest PA tertile, both the median and the highest PA tertiles, were associated to a reduction of all-cause mortality risk with hazard ratios at 0.79 (95%confidence interval [0.61:1.03], P = 0.08) and 0.71 ([0.53:0.96], P = 0.025) respectively; P for trend = 0.02. Adjusted hazard ratios for an increase of 10 METs hour per week was 0.95 [0.92 to 0.98], (P <0.002). In conclusion, our study demonstrates an independent association between PA and long term vital prognosis with a 5% total mortality decrease for an increase of 10 METs hour per week.
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Affiliation(s)
- Frédéric Bouisset
- Department of Cardiology, Rangueil University Hospital, Toulouse, France; Department of epidemiology, INSERM UMR 1027, Toulouse, France.
| | | | - Vanina Bongard
- Department of Cardiology, Rangueil University Hospital, Toulouse, France; Department of epidemiology, INSERM UMR 1027, Toulouse, France
| | | | - Emilie Bérard
- Department of epidemiology, INSERM UMR 1027, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Meyer Elbaz
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Jean Ferrières
- Department of Cardiology, Rangueil University Hospital, Toulouse, France; Department of epidemiology, INSERM UMR 1027, Toulouse, France
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8
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Ozyemisci-Taskiran O, Demirsoy N, Atan T, Yuksel S, Coskun O, Aytur YK, Tur BS, Karakas M, Turak O, Topal S. Development and Validation of a Scale to Measure Fear of Activity in Patients With Coronary Artery Disease (Fact-CAD). Arch Phys Med Rehabil 2019; 101:479-486. [PMID: 31562874 DOI: 10.1016/j.apmr.2019.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/25/2019] [Accepted: 09/06/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To develop and validate a scale to measure fear of activity in patients with coronary artery disease. DESIGN Psychometric study. SETTING Outpatient cardiology clinics. PARTICIPANTS The scale was applied to patients who had myocardial infarction, coronary artery bypass grafting, or percutaneous coronary intervention within the last 12 months (N=250). INTERVENTIONS A scale for fear of activity in patients with coronary artery disease (Fact-CAD) was created through semistructured focus group interviews with patients. Face and content validity of Fact-CAD was verified. MAIN OUTCOME MEASURES Psychometric analysis included model fit, unidimensionality, reliability, local dependency, differential item functioning, and external construct validity. Analyses were performed using the Rasch Analysis Model. RESULTS Fact-CAD scale was a reliable (high Person Separation Index of 0.89) and valid (unidimensional, no misfit, local independency supported, no residual correlations) measure of fear of activity. Three items showed differential item functioning according to employment status, marital status, and angina pectoris, which were not assigned as real item bias by experts and remained in the model. CONCLUSION Fact-CAD was supported by Rasch analysis as a psychometrically valid scale to evaluate fear of activity in patients with coronary artery disease.
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Affiliation(s)
| | - Nesrin Demirsoy
- Gazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ankara
| | - Tugba Atan
- Hitit University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Corum.
| | - Selcen Yuksel
- Yildirim Beyazit University Faculty of Medicine, Department of Biostatistics, Ankara
| | - Ozlem Coskun
- Gazi University Faculty of Medicine, Department of Medical Education, Ankara
| | - Yesim Kurtais Aytur
- Ankara University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ankara
| | - Birkan Sonel Tur
- Ankara University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ankara
| | - Merve Karakas
- Ankara University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ankara
| | - Osman Turak
- Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara
| | - Salih Topal
- Gazi University Faculty of Medicine, Department of Cardiology, Ankara, Turkey
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Farrell SW, Barlow CE, Willis BL, Leonard D, Pavlovic A, DeFina LF, Haskell WL. Cardiorespiratory Fitness, Different Measures of Adiposity, and Cardiovascular Disease Mortality Risk in Women. J Womens Health (Larchmt) 2019; 29:319-326. [PMID: 31532335 DOI: 10.1089/jwh.2019.7793] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Associations among cardiorespiratory fitness (CRF), different adiposity exposures, and cardiovascular disease (CVD) mortality in women are not well defined. Materials and Methods: A total of 19,838 women completed a baseline examination between 1971 and 2013. Measures included body mass index (BMI), waist circumference (WC), waist-to-height (W:HT) ratio, skinfold-derived percent body fat (% Fat), and CRF estimated from a maximal treadmill test. CRF categories were low (quintile 1), moderate (quintiles 2-3), and high (quintiles 4-5); standard cut points were used for adiposity exposures. Hazard ratios (HRs) were estimated using Cox regression. Results: During a mean follow-up period of 19.2 ± 10.3 years, 391 cardiovascular deaths occurred. HRs (95% confidence interval) for CVD in moderate and low CRF groups, using high CRF as the referent, were 1.87 (1.46-2.38) and 2.54 (1.93-3.35), respectively (p trend <0.001). HRs of obese women within each adiposity exposure were higher when compared with normal-weight women (p ≤ 0.03). Joint associations of CRF × adiposity showed a positive trend in CVD mortality across decreasing categories of CRF within each category of W:HT and % Fat, as well as within the normal and overweight BMI categories and the normal WC category (p ≤ 0.03 for each). Conclusion: Higher levels of CRF are associated with lower CVD mortality risk in women, and predict lower risk of CVD mortality in normal-weight women and in obese women. Using different measures of adiposity to predict CVD mortality risk in women may be misleading unless CRF is taken into account. These results support the American Heart Association (AHA) recommendation for including CRF as a clinical vital sign.
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Affiliation(s)
| | | | | | - David Leonard
- Research Division, The Cooper Institute, Dallas, Texas
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10
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Mediano MFF, Leifer ES, Cooper LS, Keteyian SJ, Kraus WE, Mentz RJ, Fleg JL. Influence of Baseline Physical Activity Level on Exercise Training Response and Clinical Outcomes in Heart Failure: The HF-ACTION Trial. JACC. HEART FAILURE 2018; 6:1011-1019. [PMID: 30497641 PMCID: PMC6317714 DOI: 10.1016/j.jchf.2018.09.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/11/2018] [Accepted: 09/20/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study sought to evaluate the influence of baseline physical activity (PA) on responses to aerobic exercise training and clinical events in outpatients with chronic systolic heart failure (HF) from the multicenter HF-ACTION (Exercise Training Program to Improve Clinical Outcomes in Individuals With Congestive Heart Failure) trial. BACKGROUND The influence of baseline PA on exercise capacity, responses to exercise training and clinical outcomes in patients with chronic HF is unclear. METHODS Of 2,130 participants who provided consent for this analysis, 1,494 patients (64%) had complete baseline PA data, using a modified version of the International Physical Activity Questionnaire-Short Form questionnaire and were included in the analysis; 742 received usual care and 752 were allocated to the exercise training group. Changes in exercise capacity, all-cause mortality and hospitalization, cardiovascular (CV) mortality and hospitalization, and CV mortality and HF hospitalization were evaluated as a function of baseline PA tertile. RESULTS At baseline, the highest PA tertile showed greater peak oxygen uptake, cardiopulmonary exercise test duration, and 6-min walk test distance than the other 2 PA tertiles, as well as lower New York Heart Association functional class, lower Beck depression score, and lower atrial fibrillation prevalence than the lowest PA tertile. Compared to the lowest PA tertile, the middle tertile had 18% lower risk of CV death/CV hospitalizations, and the upper tertile showed 23% lower risk of CV death/HF hospitalizations. Exercise capacity and clinical outcome responses to training were similar and largely nonsignificant across baseline PA tertiles with significant benefit of training on exercise test duration for all tertiles. CONCLUSIONS In patients with chronic systolic HF, aerobic exercise training significantly improves exercise test duration to a similar extent across baseline PA tertiles. Although higher baseline PA was associated with lower risk of clinical events, no significant differences in event rates within each PA tertile were seen between subgroups randomized to exercise training versus usual care. (Exercise Training Program to Improve Clinical Outcomes in Individuals With Congestive Heart Failure [HF-ACTION]; NCT00047437).
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Affiliation(s)
- Mauro F F Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Manguinhos, Rio de Janeiro, Brazil
| | - Eric S Leifer
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Lawton S Cooper
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | | | | | | | - Jerome L Fleg
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
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11
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Tiainen S, Kiviniemi A, Hautala A, Huikuri H, Ukkola O, Tokola K, Tulppo M, Vasankari T. Effects of a Two-Year Home-Based Exercise Training Program on Oxidized LDL and HDL Lipids in Coronary Artery Disease Patients with and without Type-2 Diabetes. Antioxidants (Basel) 2018; 7:antiox7100144. [PMID: 30332828 PMCID: PMC6211047 DOI: 10.3390/antiox7100144] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 09/18/2018] [Accepted: 10/12/2018] [Indexed: 01/14/2023] Open
Abstract
We investigated the effect of two-year home-based exercise training program on oxidized low-density lipoprotein LDL (ox-LDL) and high-density lipoprotein HDL (ox-HDL) lipids in patients with coronary artery disease (CAD), both with and without type-2 diabetes (T2D). Analysis of lipoprotein-oxidized lipids was based on the determination of baseline conjugated dienes in lipoprotein lipids. In order to study the effect of an exercise load on ox-LDL and ox-HDL lipids patients in both CAD and CAD + T2D intervention, groups were divided in three based on exercise load (high, medium, and low). During the two-year home-based exercise training program, the study showed that only higher training volume resulted in a decreased concentration of ox-LDL, while the two groups with lower training volumes showed no change. This result indicates that the training load needs to be sufficiently high in order to decrease the concentration of atherogenic ox-LDL lipids in patients with CAD and CAD + T2D. Interestingly, the concentration of ox-HDL did not change in any of the subgroups. This could indicate that the lipid peroxide-transporting capacity of HDL, suggested by results from exercise training studies in healthy adults, may not function similarly in CAD patients with or without T2D. Moreover, the lipid-lowering medication used may have had an influence on these results.
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Affiliation(s)
- Sanna Tiainen
- Sports Institute of Finland, 19100 Vierumäki, Finland.
- Department of Health and Exercise and Paavo Nurmi Center, University of Turku, 20540 Turku, Finland.
| | - Antti Kiviniemi
- Research of Internal Medicine, Medical Research Center Oulu, Oulu University, Hospital and University of Oulu, 90220 Oulu, Finland.
| | - Arto Hautala
- Cardiovascular Research Group, Division of Cardiology, Oulu University Hospital, University of Oulu, 90220 Oulu, Finland.
| | - Heikki Huikuri
- Research of Internal Medicine, Medical Research Center Oulu, Oulu University, Hospital and University of Oulu, 90220 Oulu, Finland.
| | - Olavi Ukkola
- Research of Internal Medicine, Medical Research Center Oulu, Oulu University, Hospital and University of Oulu, 90220 Oulu, Finland.
| | - Kari Tokola
- The UKK Institute for Health Promotion Research, 33500 Tampere, Finland.
| | - Mikko Tulppo
- Research of Internal Medicine, Medical Research Center Oulu, Oulu University, Hospital and University of Oulu, 90220 Oulu, Finland.
| | - Tommi Vasankari
- The UKK Institute for Health Promotion Research, 33500 Tampere, Finland.
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12
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Cheng W, Zhang Z, Cheng W, Yang C, Diao L, Liu W. Associations of leisure-time physical activity with cardiovascular mortality: A systematic review and meta-analysis of 44 prospective cohort studies. Eur J Prev Cardiol 2018; 25:1864-1872. [PMID: 30157685 DOI: 10.1177/2047487318795194] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Many cohort studies within the past few decades have shown the protective effect of leisure-time physical activity on cardiovascular mortality. To summarise the evidence from prospective cohort studies on the relationship between the amount of leisure-time physical activity and the risk of cardiovascular mortality, a dose–response meta-analysis was conducted in this study. Methods and results Electronic databases, including PubMed and Embase databases, Scopus and Cochrane Library, were systemically retrieved by two investigators from inception to 14 June 2018 for related studies. The maximum adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, and a dose–response analysis was conducted using the restricted cubic splines. Finally, a total of 44 studies comprising 1,584,181 participants was enrolled into this meta-analysis. The HRs of cardiovascular mortality for moderate and high leisure-time physical activity were 0.77 (95% CI 0.74–0.81) and 0.73 (95% CI 0.69–0.77), respectively. Among these 44 studies, 19 were eligible for the dose–response meta-analysis, which suggested a linear negative correlation of leisure-time physical activity with cardiovascular mortality, regardless of age, gender and the presence of underlying cardiovascular disease or not. Conclusions Leisure-time physical activity shows a linear negative correlation with the risk of cardiovascular mortality regardless of age, gender and the presence of cardiovascular disease or not. However, the cardiovascular benefits of leisure-time physical activity is decreased for those aged over 65 years or those with a history of cardiovascular disease. Moreover, leisure-time physical activity displays more cardiovascular benefits to people followed up for over 10 years than to those followed up for less than 10 years. Besides, high-intensity leisure-time physical activity has more obvious cardiovascular benefits than those of moderate-intensity leisure-time physical activity.
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Affiliation(s)
- Wenke Cheng
- Department of Cardiology, Affiliated Hospital of Qinghai University, China
| | - Zhen Zhang
- Department of Oncology, Affiliated Hospital of Qinghai University, China
| | - Wensi Cheng
- School of Nursing, Heze Medical College, China
| | - Chong Yang
- Department of Obstetrics, Zaozhuang Municipal Hospital, China
| | - Linlin Diao
- Department of Cardiology, Zaozhuang Municipal Hospital, China
| | - Weijun Liu
- Department of Cardiology, Affiliated Hospital of Qinghai University, China
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13
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Ku PW, Chen LJ, Fox KR, Chen YH, Liao Y, Lin CH. Leisure-Time, Domestic, and Work-Related Physical Activity and Their Prospective Associations With All-Cause Mortality in Patients With Cardiovascular Disease. Am J Cardiol 2018; 121:177-181. [PMID: 29132648 DOI: 10.1016/j.amjcard.2017.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 12/26/2022]
Abstract
This study aimed to examine the prospective associations between total physical activity, leisure-time physical activity (LTPA), and domestic and work-related physical activity (DWPA) involving heavy physical labor, with all-cause mortality in patients with cardiovascular disease (CVD). A 7-year follow-up cohort design was used based on the data from the Taiwan 2005 National Health Interview Survey, which was linked to the 2005 to 2012 Taiwan National Health Insurance claims data. Multivariable Cox proportional hazard models were utilized to assess the associations between physical activity and all-cause mortality in 2,370 patients with CVD. Participants who achieved a volume of all physical activities of ≥1,000 kcal/week experienced lower risks of all-cause mortality than those who achieved less. Additionally, an inverse relation between LTPA and all-cause mortality was observed. Furthermore, participants who reported exertions (1 to 999 kcal/week) in DWPA had the lowest risk of all-cause mortality. This study provides evidence that patients with CVD who achieve at least a moderate volume of physical activity reduce their mortality risk. It also reveals that both LTPA and DWPA may be important contributors to the reduced risk of premature death among this clinical population.
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14
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Lahtinen M, Toukola T, Junttila MJ, Piira OP, Lepojärvi S, Kääriäinen M, Huikuri HV, Tulppo MP, Kiviniemi AM. Effect of Changes in Physical Activity on Risk for Cardiac Death in Patients With Coronary Artery Disease. Am J Cardiol 2018; 121:143-148. [PMID: 29126583 DOI: 10.1016/j.amjcard.2017.10.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 11/29/2022]
Abstract
Leisure-time physical activity (LTPA) is associated with longevity in patients with coronary artery disease (CAD). However, less is known about prognostic significance of longitudinally assessed LTPA in patients with stable CAD. The present study assessed the relationship between changes in LTPA and cardiac mortality in patients with CAD. Patients with angiographically documented CAD (n = 1,746) underwent clinical examination and echocardiography at the baseline. Lifestyle factors, including LTPA (inactive, irregularly active, active, highly active), were surveyed at baseline and after 2 years' follow-up. Thereafter, the patients entered the follow-up (median: 4.5 years; first to third quartile: 3.4 to 5.8 years) during which cardiac deaths were registered (n = 68, 3.9%). The patients who remained inactive (n = 114, 18 events, 16%) and became inactive (n = 228, 18 events, 8%) had 7.6- (95% confidence interval [CI] 4.2 to 13.6) and 3.7-fold (95% CI 2.1 to 6.7) univariate risk for cardiac death compared with those who remained at least irregularly active (n = 1,351, 30 events, 2%), respectively. After adjustment for age, gender, body mass index, diabetes, previous myocardial infarction, left ventricular ejection fraction, angina pectoris grading, cardiovascular event during initial 2-year follow-up, smoking and alcohol consumption, the patients who remained inactive and became inactive still had 4.9- (95% CI 2.4 to 9.8, p <0.001) and 2.4-fold (95% CI 1.3 to 4.5, p <0.01) risk for cardiac death, respectively, compared with patients remaining at least irregularly active. In conclusion, LTPA has important prognostic value for cardiac death in patients with stable CAD. Even minor changes in LTPA over 2 years were related to the subsequent risk for cardiac death.
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Affiliation(s)
- Minna Lahtinen
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tomi Toukola
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - M Juhani Junttila
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Olli-Pekka Piira
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Samuli Lepojärvi
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Heikki V Huikuri
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mikko P Tulppo
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Antti M Kiviniemi
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
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15
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Farrell SW, Finley CE, Barlow CE, Willis BL, DeFina LF, Haskell WL, Vega GL. Moderate to High Levels of Cardiorespiratory Fitness Attenuate the Effects of Triglyceride to High-Density Lipoprotein Cholesterol Ratio on Coronary Heart Disease Mortality in Men. Mayo Clin Proc 2017; 92:1763-1771. [PMID: 29157534 DOI: 10.1016/j.mayocp.2017.08.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/18/2017] [Accepted: 08/23/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the prospective relationships among cardiorespiratory fitness (CRF), fasting blood triglyceride to high density lipoprotein cholesterol ratio (TG:HDL-C), and coronary heart disease (CHD) mortality in men. METHODS A total of 40,269 men received a comprehensive baseline clinical examination between January 1, 1978, and December 31, 2010. Their CRF was determined from a maximal treadmill exercise test. Participants were divided into CRF categories of low, moderate, and high fit by age group and by TG:HDL-C quartiles. Hazard ratios for CHD mortality were computed using Cox regression analysis. RESULTS A total of 556 deaths due to CHD occurred during a mean ± SD of 16.6±9.7 years (669,678 man-years) of follow-up. A significant positive trend in adjusted CHD mortality was shown across decreasing CRF categories (P for trend<.01). Adjusted hazard ratios were significantly higher across increasing TG:HDL-C quartiles as well (P for trend<.01). When grouped by CRF category and TG:HDL-C quartile, there was a significant positive trend (P=.04) in CHD mortality across decreasing CRF categories in each TG:HDL-C quartile. CONCLUSION Both CRF and TG:HDL-C are significantly associated with CHD mortality in men. The risk of CHD mortality in each TG:HDL-C quartile was significantly attenuated in men with moderate to high CRF compared with men with low CRF. These results suggest that assessment of CRF and TG:HDL-C should be included for routine CHD mortality risk assessment and risk management.
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Affiliation(s)
| | | | | | | | | | | | - Gloria L Vega
- Center for Human Nutrition/Department of Clinical Nutrition, University of Texas Southwestern Medical Center, Dallas
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16
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Kayser JW, Cossette S, Côté J, Bourbonnais A, Purden M, Juneau M, Tanguay JF, Simard MJ, Dupuis J, Diodati JG, Tremblay JF, Maheu-Cadotte MA, Cournoyer D. Evaluation of a Web-Based Tailored Nursing Intervention (TAVIE en m@rche) Aimed at Increasing Walking After an Acute Coronary Syndrome: A Multicenter Randomized Controlled Trial Protocol. JMIR Res Protoc 2017; 6:e64. [PMID: 28450272 PMCID: PMC5427251 DOI: 10.2196/resprot.6430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 02/01/2017] [Accepted: 02/22/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the health benefits of increasing physical activity in the secondary prevention of acute coronary syndrome (ACS), up to 60% of ACS patients are insufficiently active. Evidence supporting the effect of Web-based interventions on increasing physical activity outcomes in ACS patients is growing. However, randomized controlled trials (RCTs) using Web-based technologies that measured objective physical activity outcomes are sparse. OBJECTIVE Our aim is to evaluate in insufficiently active ACS patients, the effect of a fully automated, Web-based tailored nursing intervention (TAVIE en m@rche) on increasing steps per day. METHODS A parallel two-group multicenter RCT (target N=148) is being conducted in four major teaching hospitals in Montréal, Canada. An experimental group receiving the 4-week TAVIE en m@rche intervention plus a brief "booster" at 8 weeks, is compared with the control group receiving hyperlinks to publicly available websites. TAVIE en m@rche is based on the Strengths-Based Nursing Care orientation to nursing practice and the Self-Determination Theory of human motivation. The intervention is centered on videos of a nurse who delivers the content tailored to baseline levels of self-reported autonomous motivation, perceived competence, and walking behavior. Participants are recruited in hospital and are eligible if they report access to a computer and report less than recommended physical activity levels 6 months before hospitalization. Most outcome data are collected online at baseline, and 5 and 12 weeks postrandomization. The primary outcome is change in accelerometer-measured steps per day between randomization and 12 weeks. The secondary outcomes include change in steps per day between randomization and 5 weeks, and change in self-reported energy expenditure for walking and moderate to vigorous physical activity between randomization, and 5 and 12 weeks. Theoretical outcomes are the mediating role of self-reported perceived autonomy support, autonomous and controlled motivations, perceived competence, and barrier self-efficacy on steps per day. Clinical outcomes are quality of life, smoking, medication adherence, secondary prevention program attendance, health care utilization, and angina frequency. The potential moderating role of sex will also be explored. Analysis of covariance models will be used with covariates such as sex, age, fatigue, and depression symptoms. Allocation sequence is concealed, and blinding will be implemented during data analysis. RESULTS Recruitment started March 30, 2016. Data analysis is planned for November 2017. CONCLUSIONS Finding alternative interventions aimed at increasing the adoption of health behavior changes such as physical activity in the secondary prevention of ACS is clearly needed. Our RCT is expected to help support the potential efficacy of a fully automated, Web-based tailored nursing intervention on the objective outcome of steps per day in an ACS population. If this RCT is successful, and after its implementation as part of usual care, TAVIE en m@rche could help improve the health of ACS patients at large. TRIAL REGISTRATION ClinicalTrials.gov NCT02617641; https://clinicaltrials.gov/ct2/show/NCT02617641 (Archived by WebCite at http://www.webcitation.org/6pNNGndRa).
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Affiliation(s)
- John William Kayser
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - Sylvie Cossette
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - José Côté
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Anne Bourbonnais
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Research Center of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Margaret Purden
- McGill University, Ingram School of Nursing, Montréal, QC, Canada.,Jewish General Hospital Centre for Nursing Research, Montréal, QC, Canada
| | - Martin Juneau
- Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - Jean-Francois Tanguay
- Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - Marie-Josée Simard
- Integrated Health and Social Services Centres, l'Est de l'Île de Montréal, Montréal, QC, Canada
| | - Jocelyn Dupuis
- Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | | | | | - Marc-André Maheu-Cadotte
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - Daniel Cournoyer
- Montreal Health Innovations Coordinating Center, Montréal, QC, Canada
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17
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Dhana K, Koolhaas CM, Berghout MA, Peeters A, Ikram MA, Tiemeier H, Hofman A, Nusselder W, Franco OH. Physical activity types and life expectancy with and without cardiovascular disease: the Rotterdam Study. J Public Health (Oxf) 2016; 39:e209-e218. [DOI: 10.1093/pubmed/fdw110] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 09/01/2016] [Indexed: 11/12/2022] Open
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18
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Sangster J, Furber S, Phongsavan P, Redfern J, Mark A, Bauman A. Effects of a Pedometer-Based Telephone Coaching Intervention on Physical Activity Among People with Cardiac Disease in Urban, Rural and Semi-Rural Settings: A Replication Study. Heart Lung Circ 2016; 26:354-361. [PMID: 27622895 DOI: 10.1016/j.hlc.2016.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 06/08/2016] [Accepted: 07/07/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to determine the replicability of a pedometer-based telephone coaching intervention by comparing the outcomes of a study conducted in rural and urban settings to a study that previously found the same intervention effective in a semi-rural setting. METHODS Replication studies are conducted to assess whether an efficacious intervention is effective in multiple different settings. This study compared the outcomes of a pedometer-based coaching intervention implemented in urban and rural settings (replication study) with the same intervention implemented in a semi-rural setting (reference study) on physical activity levels. RESULTS Improvements in total weekly physical activity time in the replication study were significant from baseline to six weeks (p<0.001 urban, p=0.006 rural) and remained significant at six months (p=0.029 urban, p=0.005 rural). These increases were comparable to those achieved in the original efficacy trial conducted in a semi-rural setting. CONCLUSIONS The pedometer-based telephone coaching intervention increases physical activity levels of people with cardiac disease referred to a CR program in diverse settings. This replication study indicates the suitability of this minimal contact, low-cost intervention for further scaling-up to address unmet need in community-dwelling cardiac patients.
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Affiliation(s)
- Janice Sangster
- School of Dentistry and Health Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.
| | - Susan Furber
- Health Promotion Service, Illawarra and Shoalhaven Local Health District, Warrawong, NSW, Australia; School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Julie Redfern
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Andrew Mark
- National Heart Foundation of Australia (Illawarra Shoalhaven Region NSW)
| | - Adrian Bauman
- School of Public Health, University of Sydney, Sydney, NSW, Australia
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19
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Lindegård A, Jonsdottir IH, Börjesson M, Lindwall M, Gerber M. Changes in mental health in compliers and non-compliers with physical activity recommendations in patients with stress-related exhaustion. BMC Psychiatry 2015; 15:272. [PMID: 26530329 PMCID: PMC4632342 DOI: 10.1186/s12888-015-0642-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 10/08/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND There is a lack of research regarding the long-lasting effects of a more physically active lifestyle in patients with mental disorders. In the present study, clinical data were analysed to examine if initially physically inactive patients, clinically diagnosed with stress-related exhaustion, taking part in 12-month multimodal treatment (MMT), differ at the 18-month follow-up regarding mental health, depending on whether they did or did not comply with the physical activity (PA) recommendations resembling those of the American College of Sports Medicine. METHODS The study population consisted of 69 patients (65% women) who were referred to a stress clinic due to stress-related exhaustion. All patients received MMT. A major goal was to increase patients' PA levels. The patients received general comprehensive instructions including personal advice regarding the positive effects of PA on mental health and could self-select for an 18-week coached exercise program. Changes in mental health symptoms over an 18-month period were compared between non-compliers (n = 26), mild compliers (n = 22) and strong compliers (n = 21) with the PA recommendations included in the MMT. RESULTS Non-compliers, mild and strong compliers did not differ regarding burnout, depression and anxiety at baseline. Although substantial improvements occurred in all groups, mild and strong compliers reported significantly lower burnout and depression levels at the 18-month follow-up than the non-complying group (p < .05). The general pattern of findings was corroborated, if standard cut-off criteria for clinical burnout were used. CONCLUSIONS Compliance with PA recommendations is associated with decreased levels of burnout and depression in patients with stress-related exhaustion. Thus, the promotion of a more active lifestyle among patients with stress-related exhaustion should be implemented as a part of MMT, to achieve a more sustainable decrease of symptoms of burnout and depression. TRIAL REGISTRATION This is not a clinical trial.
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Affiliation(s)
- Agneta Lindegård
- Institute of Stress Medicine, Carl Skottsbergs gata 22B, Gothenburg, SE-41319, Sweden.
| | - Ingibjörg H. Jonsdottir
- Institute of Stress Medicine, Carl Skottsbergs gata 22B, Gothenburg, SE-41319 Sweden ,Department of Food and Nutrition, and Sport Science, University of Gothenburg, PO Box 300, Gothenburg, SE-40530 Sweden
| | - Mats Börjesson
- The Swedish School of Sport and Health Sciences, University of Stockholm, Lidingövägen 1, Stockholm 1, SE-11433, Sweden. .,Department of Cardiology, Karolinska University Hospital, Stockholm, SE-17176, Sweden.
| | - Magnus Lindwall
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, PO Box 300, Gothenburg, SE-40530, Sweden. .,Department of Psychology, University of Gothenburg, PO Box 500, Gothenburg, SE-40530, Sweden.
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320B, Basel, CH-4052, Switzerland.
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20
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Ekblom Ö, Ekblom-Bak E, Bolam KA, Ekblom B, Schmidt C, Söderberg S, Bergström G, Börjesson M. Concurrent and predictive validity of physical activity measurement items commonly used in clinical settings--data from SCAPIS pilot study. BMC Public Health 2015; 15:978. [PMID: 26415512 PMCID: PMC4587776 DOI: 10.1186/s12889-015-2316-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 09/22/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND As the understanding of how different aspects of the physical activity (PA) pattern relate to health and disease, proper assessment is increasingly important. In clinical care, self-reports are the most commonly used assessment technique. However, systematic comparisons between questions regarding concurrent or criterion validity are rare, as are measures of predictive validity. The aim of the study was to examine the concurrent (using accelerometry as reference) and predictive validity (for metabolic syndrome) of five PA questions. METHODS A sample of 948 middle-aged Swedish men and women reported their PA patterns via five different questions and wore an accelerometer (Actigraph GT3X) for a minimum of 4 days. Concurrent validity was assessed as correlations and ROC-analyses. Predictive validity was assessed using logistic regression, controlling for potential confounders. RESULTS Concurrent validity was low-to-moderate (r <0.35 and ROC AUC <0.7) with large misclassifications regarding time spent sitting/sedentary and in moderate-to vigorous PA. The predictive validity of the questions was good, and one question (PHAS) showed an 80 % decreased odds-ratio of having metabolic syndrome, after taking potential confounders into consideration. DISCUSSION In this mixed sample of adults, both concurrent and predictive validity vaired between items and between measures of the physical activity pattern. The PHAS and WALK items are proposed for assessment of adherence to PA recommendations. CONCLUSION Assessing PA patterns using self-report measures results in methodological problems when trying to predict individual risk for the metabolic syndrome, as the concurrent validity generally was low. However, several of the investigated questions may be useful for assessing risk at a group level, showing better predictive validity.
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Affiliation(s)
- Örjan Ekblom
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
| | - Elin Ekblom-Bak
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
| | - Kate A Bolam
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden. .,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - Björn Ekblom
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
| | - Caroline Schmidt
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden. .,Sahlgrenska Centre for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Medicine and Heart Centre, Umeå University, Umeå, Sweden.
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden. .,Sahlgrenska Centre for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Mats Börjesson
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden. .,Karolinska University Hospital, Stockholm, Sweden.
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21
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Bergström G, Börjesson M, Schmidt C. Self-efficacy regarding physical activity is superior to self-assessed activity level, in long-term prediction of cardiovascular events in middle-aged men. BMC Public Health 2015; 15:820. [PMID: 26303077 PMCID: PMC4548687 DOI: 10.1186/s12889-015-2140-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 08/11/2015] [Indexed: 01/22/2023] Open
Abstract
Background Self-efficacy has been determined to be a strong predictor of who will engage in physical activity. We aimed to evaluate the associations between self-efficacy to perform physical activity, self-reported leisure-time physical activity and cardiovascular events in a population-based cohort of middle-aged Swedish men with no previous cardiovascular disease, or treatment with cardiovascular drugs. Methods Analyses are based on 377 men randomly selected and stratified for weight and insulin sensitivity from a population sample of 58-year-old men (n = 1728) and who had answered a question about their competence to perform exercise (as an assessment of physical self-efficacy). The Saltin-Grimby Physical Activity Level Scale was used to assess self-reported levels of leisure-time physical activity. Cardiovascular events were recorded during 13-years of follow-up. Results The group with poor self-efficacy to perform physical activity had a significantly higher incidence of cardiovascular events compared with the group with good physical self-efficacy (32.1 % vs 17.1 %, p < 0.01). Multivariate analyses showed that poor physical self-efficacy was associated with an increased relative risk of 2.0 (95 % CI 1.2 to 3.0), of having a cardiovascular event during follow-up also after adjustments for co-variates such as waist to hip ratio, heart rate, fasting plasma glucose, serum triglycerides, systolic blood pressure, apoB/apoA-I ratio and leisure-time physical activity. Conclusion Self-efficacy to perform physical activity was strongly and independently associated with cardiovascular events and was superior to self-assessed physical activity in predicting cardiovascular events during 13-years of follow-up in a group of middle-aged men, without known CVD or treatment with cardiovascular drugs.
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Affiliation(s)
- Göran Bergström
- Wallenberg Laboratory for Cardiovascular Research, Institution of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy at University of Gothenburg, Göteborg, S-413 45, Sweden.
| | - Mats Börjesson
- Swedish School of Sports and Health Sciences and Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research, Institution of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy at University of Gothenburg, Göteborg, S-413 45, Sweden.
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Gerber M, Jonsdottir IH, Arvidson E, Lindwall M, Lindegård A. Promoting graded exercise as a part of multimodal treatment in patients diagnosed with stress-related exhaustion. J Clin Nurs 2015; 24:1904-15. [PMID: 25939917 DOI: 10.1111/jocn.12820] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2015] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this study was to examine, by using patient cohort data, the changes in exercise habits during a 12-month multimodal treatment period, in patients seeking specialist care for stress-related exhaustion. BACKGROUND Randomised controlled trials have greatly contributed to the fact that both physicians and patients regard regular exercise participation as a highly valuable and effective treatment for mental health disorders. Nevertheless, little is known about the adherence to physical activity recommendations for patients with stress-related mental problems in a clinical setting. Knowledge about what can be achieved within the clinical context, and how current treatments can be improved, is crucial for clinicians, researchers, educators, managers and policy makers involved in nursing practice. DESIGN Longitudinal analysis of patient cohort data. METHODS The sample consisted of 169 patients (79% women; mean age = 42·7 years) who were referred to a stress clinic due to stress-related exhaustion. All patients received multimodal treatment with similar components. Two different approaches to promote exercise were used in the clinical work (general comprehensive instruction either with or without an 18-week coached exercise programme). The self-reported overall exercise level was assessed at baseline and at three, six and 12 months after the first visit. Group by time effects were examined with repeated measures analyses of variance. RESULTS The frequency, duration and intensity of exercise increased substantially during the first three months of multimodal treatment. Although exercise levels tended to decrease thereafter, there was still a significant time effect at the 12-month follow-up showing that follow-up exercise levels were higher than at baseline. CONCLUSION Both general exercise instructions and coached exercise were effective in promoting exercise involvement. RELEVANCE TO CLINICAL PRACTICE Exercise can be successfully promoted as a part of multimodal treatment in patients with stress-related exhaustion.
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Affiliation(s)
- Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Gothenburg, Sweden.,Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | | | - Magnus Lindwall
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.,Department of Psychology, University of Gothenburg, Gothenburg, Sweden
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Karjalainen JJ, Kiviniemi AM, Hautala AJ, Piira OP, Lepojärvi ES, Perkiömäki JS, Junttila MJ, Huikuri HV, Tulppo MP. Effects of physical activity and exercise training on cardiovascular risk in coronary artery disease patients with and without type 2 diabetes. Diabetes Care 2015; 38:706-15. [PMID: 25592198 DOI: 10.2337/dc14-2216] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Leisure-time physical activity (LTPA) and exercise training are essential parts of current guidelines for patients with coronary artery disease (CAD). However, the contributions of LTPA and exercise training to cardiovascular (CV) risk in CAD patients with type 2 diabetes (T2D) are not well established. RESEARCH DESIGN AND METHODS We examined the effects of LTPA (n = 539 and n = 507; with and without T2D, respectively) and 2-year controlled, home-based exercise training (n = 63 plus 64 control subjects with T2D and n = 72 plus 68 control subjects without T2D) on the CV risk profile and composite end point among CAD patients. RESULTS During the 2-year follow-up, patients with reduced LTPA at baseline had an increased risk of CV events (adjusted hazard ratio 2.3 [95% CI 1.1-5.1; P = 0.033], 2.1 [1.1-4.2; P = 0.027], and 2.0 [1.0-3.9; P = 0.044] for no LTPA, LTPA irregularly, and LTPA two to three times weekly, respectively) compared with those with LTPA more than three times weekly. Among patients who completed the 2-year exercise intervention, exercise training resulted in favorable changes in exercise capacity both in CAD patients with T2D (+0.2 ± 0.8 vs. -0.1 ± 0.8 MET, P = 0.030) and without T2D (+0.3 ± 0.7 vs. -0.1 ± 0.5 MET, P = 0.002) as compared with the control group but did not have any significant effects on major metabolic or autonomic nervous system risk factors in CAD patients with or without T2D. CONCLUSIONS There is an inverse association between habitual LTPA and short-term CV outcome, but controlled, home-based exercise training has only minor effects on the CV risk profile in CAD patients with T2D.
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Affiliation(s)
- Jaana J Karjalainen
- Department of Exercise and Medical Physiology, Verve Research, Oulu, Finland Medical Research Center, University of Oulu and University Central Hospital, Oulu, Finland
| | - Antti M Kiviniemi
- Department of Exercise and Medical Physiology, Verve Research, Oulu, Finland
| | - Arto J Hautala
- Department of Exercise and Medical Physiology, Verve Research, Oulu, Finland
| | - Olli-Pekka Piira
- Medical Research Center, University of Oulu and University Central Hospital, Oulu, Finland
| | - E Samuli Lepojärvi
- Medical Research Center, University of Oulu and University Central Hospital, Oulu, Finland
| | - Juha S Perkiömäki
- Medical Research Center, University of Oulu and University Central Hospital, Oulu, Finland
| | - M Juhani Junttila
- Medical Research Center, University of Oulu and University Central Hospital, Oulu, Finland
| | - Heikki V Huikuri
- Medical Research Center, University of Oulu and University Central Hospital, Oulu, Finland
| | - Mikko P Tulppo
- Department of Exercise and Medical Physiology, Verve Research, Oulu, Finland Medical Research Center, University of Oulu and University Central Hospital, Oulu, Finland Department of Applied Sciences, London South Bank University, London, U.K.
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Hållmarker U, Michaëlsson K, Ärnlöv J, Hellberg D, Lagerqvist B, Lindbäck J, James S. Risk of recurrent ischaemic events after myocardial infarction in long-distance ski race participants. Eur J Prev Cardiol 2015; 23:282-90. [DOI: 10.1177/2047487315578664] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/03/2015] [Indexed: 01/03/2023]
Affiliation(s)
- Ulf Hållmarker
- Department of Medical Sciences, Uppsala University, Sweden
- Department of Internal Medicine, Mora Hospital, Sweden
| | - Karl Michaëlsson
- Department of Medical Sciences, Uppsala University, Sweden
- Department of Surgical Sciences, Uppsala University, Sweden
| | - Johan Ärnlöv
- Department of Medical Sciences, Uppsala University, Sweden
- School of Health and Social Studies, Dalarna University, Sweden
| | - Dan Hellberg
- Department of Women’s and Children’s Health, Uppsala University, Sweden
| | - Bo Lagerqvist
- Department of Medical Sciences, Uppsala University, Sweden
- Uppsala Clinical Research Center, Sweden
| | | | - Stefan James
- Department of Medical Sciences, Uppsala University, Sweden
- Uppsala Clinical Research Center, Sweden
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Physical activity enhances metabolic fitness independently of cardiorespiratory fitness in marathon runners. DISEASE MARKERS 2015; 2015:806418. [PMID: 25821340 PMCID: PMC4363791 DOI: 10.1155/2015/806418] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 02/12/2015] [Indexed: 01/09/2023]
Abstract
High levels of cardiovascular fitness (CRF) and physical activity (PA) are associated with decreased mortality and risk to develop metabolic diseases. The independent contributions of CRF and PA to metabolic disease risk factors are unknown. We tested the hypothesis that runners who run consistently >50 km/wk and/or >2 marathons/yr for the last 5 years have superior metabolic fitness compared to matched sedentary subjects (CRF, age, gender, and BMI). Case-control recruitment of 31 pairs of runner-sedentary subjects identified 10 matched pairs with similar VO2max (mL/min/kg) (similar-VO2max). The similar-VO2max group was compared with a group of age, gender, and BMI matched pairs who had the largest difference in VO2max (different-VO2max). Primary outcomes that defined metabolic fitness including insulin response to an oral glucose tolerance test, fasting lipids, and fasting insulin were superior in runners versus sedentary controls despite similar VO2max. Furthermore, performance (velocity at VO2max, running economy), improved exercise metabolism (lactate threshold), and skeletal muscle levels of mitochondrial proteins were superior in runners versus sedentary controls with similar VO2max. In conclusion subjects with a high amount of PA have more positive metabolic health parameters independent of CRF. PA is thus a good marker against metabolic diseases.
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Leisure-time physical inactivity and risk of myocardial infarction and all-cause mortality: A case–control study. Int J Cardiol 2014; 177:599-600. [DOI: 10.1016/j.ijcard.2014.08.137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 08/26/2014] [Indexed: 11/19/2022]
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Mons U, Hahmann H, Brenner H. A reverse J-shaped association of leisure time physical activity with prognosis in patients with stable coronary heart disease: evidence from a large cohort with repeated measurements. Heart 2014; 100:1043-9. [PMID: 24829374 DOI: 10.1136/heartjnl-2013-305242] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To study the association of self-reported physical activity level with prognosis in a cohort of patients with coronary heart disease (CHD), with a special focus on the dose-response relationship with different levels of physical activity. METHODS Data were drawn from a prospective cohort of 1038 subjects with stable CHD in which frequency of strenuous leisure time physical activity was assessed repeatedly over 10 years of follow-up. Multiple Cox proportional hazards regression models were used to assess the association of physical activity level with different outcomes of prognosis (major cardiovascular events, cardiovascular mortality, all-cause mortality), with different sets of adjustments for potential confounders and taking into account time-dependence of frequency of physical activity. RESULTS A decline in engagement in physical activity over follow-up was observed. For all outcomes, the highest hazards were consistently found in the least active patient group, with a roughly twofold risk for major cardiovascular events and a roughly fourfold risk for both cardiovascular and all-cause mortality in comparison to the reference group of moderately frequent active patients. Furthermore, when taking time-dependence of physical activity into account, our data indicated reverse J-shaped associations of physical activity level with cardiovascular mortality, with the most frequently active patients also having increased hazards (2.36, 95% CI 1.05 to 5.34). CONCLUSIONS This study substantiated previous findings on the increased risks for adverse outcomes in physically inactive CHD patients. In addition, we also found evidence of increased cardiovascular mortality in patients with daily strenuous physical activity, which warrants further investigation.
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Affiliation(s)
- Ute Mons
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
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28
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Nolan RP, Payne AY, Ross H, White M, D'Antono B, Chan S, Barr SI, Gwadry-Sridhar F, Nigam A, Perreault S, Farkouh M, McDonald M, Goodman J, Thomas S, Zieroth S, Isaac D, Oh P, Rajda M, Chen M, Eysenbach G, Liu S, Zbib A. An Internet-Based Counseling Intervention With Email Reminders that Promotes Self-Care in Adults With Chronic Heart Failure: Randomized Controlled Trial Protocol. JMIR Res Protoc 2014; 3:e5. [PMID: 24480783 PMCID: PMC3936276 DOI: 10.2196/resprot.2957] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 11/18/2013] [Accepted: 11/22/2013] [Indexed: 01/03/2023] Open
Abstract
Background Chronic heart failure (CHF) is a public health priority. Its age-standardized prevalence has increased over the past decade. A major challenge for the management of CHF is to promote long-term adherence to self-care behaviors without overtaxing available health care resources. Counseling by multidisciplinary health care teams helps to improve adherence to self-care behaviors and to reduce the rate of death and hospitalization. In the absence of intervention, adherence to self-care is below recommended standards. Objective This trial aims to establish and evaluate a Canadian e-platform that will provide a core, standardized protocol of behavioral counseling and education to facilitate long-term adherence to self-care among patients with CHF. Methods Canadian e-Platform to Promote Behavioral Self-Management in Chronic Heart Failure (CHF-CePPORT) is a multi-site, double blind, randomized controlled trial with a 2 parallel-group (e-Counseling + Usual Care vs e-Info Control + Usual Care) by 3 assessments (baseline, 4-, and 12-month) design. We will identify subjects with New York Heart Association Class II or III systolic heart failure from collaborating CHF clinics and then recruit them (n=278) by phone. Subjects will be randomized in blocks within each site (Toronto, Montreal, and Vancouver). The primary outcome will be improved quality of life, defined as an increased number of subjects with an improvement of ≥5 points on the summary score of the Kansas City Cardiomyopathy Questionnaire. We will also assess the following secondary outcomes: (1) diet habits, depression, anxiety, smoking history, stress level, and readiness for change using self-report questionnaires, (2) physical activity level, current smoking status, and vagal-heart rate modulation by physiological tests, and (3) exercise capacity, prognostic indicators of cardiovascular functioning, and medication adherence through medical chart review. The primary outcome will be analyzed using generalized estimation equations with repeated measures on an intention-to-treat basis. Secondary outcomes will be analyzed using repeated-measures linear mixed models with a random effects intercept. All significant main effects or interactions in the statistical models will be followed up with post hoc contrasts using a Bonferroni correction with a 2-sided statistical significance criterion of P<.05. Results This 3.5-year, proof-of-principle trial will establish the e-infrastructure for a pan-Canadian e-platform for CHF that is comprised of a standardized, evidence-based protocol of e-Counseling. Conclusions CHF-CePPORT is designed to improve long-term adherence to self-care behaviors and quality of life among patients with CHF. It will demonstrate a distinct Canadian initiative to build capacity for preventive eHealth services for patients with CHF. Trial Registration ClinicalTrials.gov NCT01864369; http://clinicaltrials.gov/ct2/show/NCT01864369 (Archived by WebCite at http://www.webcitation.org/6Iiv6so7E).
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Affiliation(s)
- Robert P Nolan
- Behavioral Cardiology Research Unit, University Health Network, Toronto, ON, Canada.
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Beatty AL, Fukuoka Y, Whooley MA. Using mobile technology for cardiac rehabilitation: a review and framework for development and evaluation. J Am Heart Assoc 2013; 2:e000568. [PMID: 24185949 PMCID: PMC3886753 DOI: 10.1161/jaha.113.000568] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alexis L. Beatty
- Department of Medicine, University of California, San Francisco, CA (A.L.B., M.A.W.)
| | - Yoshimi Fukuoka
- Institute for Health and Aging, Department of Social and Behavioral Sciences, University of California, San Francisco, CA (Y.F.)
| | - Mary A. Whooley
- Department of Medicine, University of California, San Francisco, CA (A.L.B., M.A.W.)
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (M.A.W.)
- Veterans Affairs Medical Center, San Francisco, CA (M.A.W.)
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30
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Arvidson E, Börjesson M, Ahlborg G, Lindegård A, Jonsdottir IH. The level of leisure time physical activity is associated with work ability-a cross sectional and prospective study of health care workers. BMC Public Health 2013; 13:855. [PMID: 24044699 PMCID: PMC3848003 DOI: 10.1186/1471-2458-13-855] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 08/20/2013] [Indexed: 12/30/2022] Open
Abstract
Background With increasing age, physical capacity decreases, while the need and time for recovery increases. At the same time, the demands of work usually do not change with age. In the near future, an aging and physically changing workforce risks reduced work ability. Therefore, the impact of different factors, such as physical activity, on work ability is of interest. Thus, the aim of this study was to evaluate the association between physical activity and work ability using both cross sectional and prospective analyses. Methods This study was based on an extensive questionnaire survey. The number of participants included in the analysis at baseline in 2004 was 2.783, of whom 2.597 were also included in the follow-up in 2006. The primary outcome measure was the Work Ability Index (WAI), and the level of physical activity was measured using a single-item question. In the cross-sectional analysis we calculated the level of physical activity and the prevalence of poor or moderate work ability as reported by the participants. In the prospective analysis we calculated different levels of physical activity and the prevalence of positive changes in WAI-category from baseline to follow-up. In both the cross sectional and the prospective analyses the prevalence ratio was calculated using Generalized Linear Models. Results The cross-sectional analysis showed that with an increased level of physical activity, the reporting of poor or moderate work ability decreased. In the prospective analysis, participants reporting a higher level of physical activity were more likely to have made an improvement in WAI from 2004 to 2006. Conclusions The level of physical activity seems to be related to work ability. Assessment of physical activity may also be useful as a predictive tool, potentially making it possible to prevent poor work ability and improve future work ability. For employers, the main implications of this study are the importance of promoting and facilitating the employees’ engagement in physical activity, and the importance of the employees’ maintaining a physically active lifestyle.
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Affiliation(s)
- Elin Arvidson
- The Institute of Stress Medicine, Carl Skottbergs gata 22 B, 413 19 Gothenburg, Sweden.
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Farrell SW, Finley CE, Radford NB, Haskell WL. Cardiorespiratory Fitness, Body Mass Index, and Heart Failure Mortality in Men. Circ Heart Fail 2013; 6:898-905. [DOI: 10.1161/circheartfailure.112.000088] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Stephen W. Farrell
- From the Education Department (S.W.F.), and Research Department (C.E.F.), The Cooper Institute, Dallas, TX; Cardiovascular Medicine Department, The Cooper Clinic, Dallas, TX (N.B.R.); and Department of Medicine, Stanford University, Palo Alto, CA (W.L.H.)
| | - Carrie E. Finley
- From the Education Department (S.W.F.), and Research Department (C.E.F.), The Cooper Institute, Dallas, TX; Cardiovascular Medicine Department, The Cooper Clinic, Dallas, TX (N.B.R.); and Department of Medicine, Stanford University, Palo Alto, CA (W.L.H.)
| | - Nina B. Radford
- From the Education Department (S.W.F.), and Research Department (C.E.F.), The Cooper Institute, Dallas, TX; Cardiovascular Medicine Department, The Cooper Clinic, Dallas, TX (N.B.R.); and Department of Medicine, Stanford University, Palo Alto, CA (W.L.H.)
| | - William L. Haskell
- From the Education Department (S.W.F.), and Research Department (C.E.F.), The Cooper Institute, Dallas, TX; Cardiovascular Medicine Department, The Cooper Clinic, Dallas, TX (N.B.R.); and Department of Medicine, Stanford University, Palo Alto, CA (W.L.H.)
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Dalusung-Angosta A. CHD knowledge and risk factors among Filipino-Americans connected to primary care services. J Am Assoc Nurse Pract 2013; 25:503-12. [PMID: 24170655 DOI: 10.1002/2327-6924.12039] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE To examine the baseline knowledge and risk factors of coronary heart disease (CHD) among Filipino-Americans (FAs), and to identify the predictors of CHD knowledge. DATA SOURCES A convenience sample of 120 FAs recruited from three primary care clinics in Las Vegas, Nevada between May and July, 2010. Participants were asked about their demographic data and presence of CHD risk factors using the Demographics questionnaire. CHD knowledge was examined using the Heart Disease Fact questionnaire. CONCLUSIONS FAs connected to primary care services are knowledgeable about CHD. Predictors of CHD knowledge include: gender and education. CHD risk factors common to FAs include: hypertension, diabetes mellitus type 2, dyslipidemia, abdominal adiposity, overweight, lack of exercise, and smoking. IMPLICATIONS FOR PRACTICE Knowledge on CHD alone may not help prevent heart disease among FAs. Behavioral and cultural factors may play a major role in the development of CHD and CHD risk factors among FAs. NPs and other health care providers serve a vital role on health promotion, disease prevention, and management of patients. The use of the Neuman's systems model can serve as a guide when caring for FAs because of its emphasis in primary and secondary prevention interventions. Nurse practitioners must provide holistic and culturally sensitive care when managing their FA patients.
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Gremeaux V, Gayda M, Lepers R, Sosner P, Juneau M, Nigam A. Exercise and longevity. Maturitas 2012; 73:312-7. [PMID: 23063021 DOI: 10.1016/j.maturitas.2012.09.012] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 09/12/2012] [Accepted: 09/13/2012] [Indexed: 10/27/2022]
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FARRELL STEPHENW, FINLEY CARRIEE, GRUNDY SCOTTM. Cardiorespiratory Fitness, LDL Cholesterol, and CHD Mortality in Men. Med Sci Sports Exerc 2012; 44:2132-7. [DOI: 10.1249/mss.0b013e31826524be] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Physical activity in relation to cardiac risk markers in secondary prevention of coronary artery disease. Int J Cardiol 2012; 168:478-83. [PMID: 23041099 DOI: 10.1016/j.ijcard.2012.09.117] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Revised: 09/17/2012] [Accepted: 09/22/2012] [Indexed: 12/27/2022]
Abstract
BACKGROUND The relationship between physical activity and cardiac risk markers in secondary prevention for patients with coronary artery disease (CAD) is uncertain. The aims of the study were therefore to examine the level of physical activity in patients with CAD, and to investigate the association between physical activity and cardiac risk markers. METHODS In total, 332 patients, mean age, 65 ± 9.1 years, diagnosed with CAD at a university hospital were included in the study 6 months after their cardiac event. Physical activity was measured with a pedometer (steps/day) and two questionnaires. Investigation of cardiac risk markers included serum lipids, oral glucose-tolerance test, twenty-four hour blood pressure and heart rate monitoring, smoking, body-mass index (BMI), waist-hip ratio, and muscle endurance. The study had a cross-sectional design. RESULTS The patients performed a median of 7,027 steps/day. After adjustment for confounders, statistically significant correlations between steps/day and risk markers were found with regard to; high-density lipoprotein cholesterol (HDL-C) (r=0.19, p<0.001), muscle endurance measures (r ranging from 0.19 to 0.25, p=0.001 or less) triglycerides (r=-0.19, p<0.001), glucose-tolerance (r=-0.23, p<0.001), BMI (r=-0.21, p<0.001), 24-h heart rate recording during night (r=-0.17, p=0.004), and average 24-h heart rate (r=-0.13, p=0.02). CONCLUSIONS A relatively high level of physical activity was found among patients with CAD. There was a weak, but significant, association between pedometer steps/day and HDL-C, muscle endurance, triglycerides, glucose-tolerance, BMI and 24-h heart rate, indicating potential positive effects of physical activity on these parameters. However, before clinical implications can be formed, more confirmatory data are needed.
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Rödjer L, Jonsdottir IH, Rosengren A, Björck L, Grimby G, Thelle DS, Lappas G, Börjesson M. Self-reported leisure time physical activity: a useful assessment tool in everyday health care. BMC Public Health 2012; 12:693. [PMID: 22920914 PMCID: PMC3519710 DOI: 10.1186/1471-2458-12-693] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 08/20/2012] [Indexed: 01/17/2023] Open
Abstract
Background The individual physical activity level is an independent risk factor for cardiovascular disease and death, as well as a possible target for improving health outcome. However, today´s widely adopted risk score charts, typically do not include the level of physical activity. There is a need for a simple risk assessment tool, which includes a reliable assessment of the level of physical activity. The aim of this study was therefore, to analyse the association between the self-reported levels of physical activity, according to the Saltin-Grimby Physical Activity Level Scale (SGPALS) question, and cardiovascular risk factors, specifically focusing on the group of individuals with the lowest level of self-reported PA. Methods We used cross sectional data from the Intergene study, a random sample of inhabitants from the western part of Sweden, totalling 3588 (1685 men and 1903 women, mean age 52 and 51). Metabolic measurements, including serum-cholesterol, serum-triglycerides, fasting plasma-glucose, waist circumference, blood pressure and resting heart rate, as well as smoking and self-reported stress were related to the self-reported physical activity level, according to the modernized version of the SGPALS 4-level scale. Results There was a strong negative association between the self-reported physical activity level, and smoking, weight, waist circumference, resting heart rate, as well as to the levels of fasting plasma-glucose, serum-triglycerides, low-density lipoproteins (LDL), and self-reported stress and a positive association with the levels of high-density lipoproteins (HDL). The individuals reporting the lowest level of PA (SGPALS, level 1) had the highest odds-ratios (OR) for having pre-defined levels of abnormal risk factors, such as being overweight (men OR 2.19, 95% CI: 1.51-3.19; women OR 2.57, 95 % CI: 1.78-3.73), having an increased waist circumference (men OR 3.76, 95 % CI: 2.61-5.43; women OR 2.91, 95% CI: 1.94-4.35) and for reporting stress (men OR 3.59, 95 % CI: 2.34-5.49; women OR 1.25, 95% CI: 0.79-1.98), compared to the most active individuals, but also showed increased OR for most other risk factors analyzed above. Conclusion The self-reported PA-level according to the modernized Saltin-Grimby Physical Activity Level Scale, SGPALS, is associated with the presence of many cardiovascular risk factors, with the most inactive individuals having the highest risk factor profile, including self-reported stress. We propose that the present SGPALS may be used as an additional, simple tool in a routine risk assessment in e.g. primary care, to identify inactive individuals, with a higher risk profile.
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Affiliation(s)
- Lars Rödjer
- Department of Emergency and Cardiovascular Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Hamer M, Ingle L, Carroll S, Stamatakis E. Physical activity and cardiovascular mortality risk: possible protective mechanisms? Med Sci Sports Exerc 2012; 44:84-8. [PMID: 21659902 DOI: 10.1249/mss.0b013e3182251077] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The biological mechanisms through which increased physical activity or structured exercise training lowers the risk of recurrent cardiac events are incompletely understood. We examined the extent to which modification of primary risk markers explains the association between physical activity and cardiovascular death in participants with diagnosed cardiovascular disease (CVD). METHODS AND RESULTS In a prospective study of 1429 participants with physician-diagnosed CVD living in England and Scotland (age = 66.5 ± 11.1 yr (mean ± SD), 54.2% men), we measured physical activity and several risk markers (body mass index, total-to-HDL cholesterol ratio, diagnosed diabetes, systolic blood pressure, resting heart rate, C-reactive protein) at baseline. The main outcome was CVD death. There were a total of 446 all-cause deaths during an average of 7.0 ± 3.1 yr of follow-up, of which 213 were attributed to cardiovascular causes. Participation in moderate to vigorous physical activity at least three sessions per week was associated with lower risk of CVD death (hazard ratio = 0.61, 95% confidence interval = 0.38-0.98). Physically active participants demonstrated significantly lower levels of body mass index, diabetes, and inflammatory risk (C-reactive protein). Metabolic (body mass index, total-to-HDL cholesterol ratio, and physician-diagnosed diabetes) and inflammatory risk factors explained an estimated 12.8% and 15.4%, respectively, of the association between physical activity and CVD death. CONCLUSIONS Physical activity may reduce the risk of secondary CVD events, in part, by improving metabolic and inflammatory risk markers.
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Affiliation(s)
- Mark Hamer
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Kim J, Han HR. Physical activity, abdominal obesity and the risk of coronary heart disease: a Korean national sample study. Public Health 2012; 126:410-6. [PMID: 22445715 DOI: 10.1016/j.puhe.2012.01.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2010] [Revised: 09/29/2011] [Accepted: 01/25/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To examine the interaction between physical activity and abdominal obesity in relation to the Framingham Risk Score (FRS) for predicting the 10-year risk of coronary heart disease (CHD) using a representative sample of Korean adults. STUDY DESIGN Cross-sectional study. METHODS Drawing from the 2007 Korean National Health and Nutrition Examination Survey (NHANES IV-1), data from 2112 adults aged 30-74 years were analysed. The risk of CHD was calculated according to the FRS, and odds ratios (ORs) were analysed for the at-risk group (probability > 10%) with multivariate logistic regression. RESULTS Compared with physically active men with a normal waist circumference (WC), inactive men with a large WC had an OR for CHD risk of 2.91 [95% confidence interval (CI) 1.63-5.22]. Compared with active women with a normal WC, inactive women with a large WC had an OR of 6.37 (95% CI 3.44-11.80). Among women with a normal WC, inactive women were at increased risk of CHD compared with active women (OR 2.16, 95% CI 1.19-3.93). Among active individuals, both men and women with large WCs were at increased risk of CHD compared with those with normal WCs. CONCLUSIONS Abdominal obesity was associated with risk of CHD regardless of the level of physical activity. The 10-year risk of CHD associated with physical inactivity and abdominal obesity was much stronger in Korean women than in Korean men. While the importance of obesity control and physical activity is clear, future interventions should incorporate more targeted abdominal obesity prevention and control efforts, especially for women.
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Affiliation(s)
- J Kim
- Department of Nursing, Gachon University, Seongnam, South Korea
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Sense of coherence predicts post-myocardial infarction trajectory of leisure time physical activity: a prospective cohort study. BMC Public Health 2011; 11:708. [PMID: 21929805 PMCID: PMC3182936 DOI: 10.1186/1471-2458-11-708] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 09/19/2011] [Indexed: 11/10/2022] Open
Abstract
Background Physical activity confers a survival advantage after myocardial infarction (MI), yet the majority of post-MI patients are not regularly active. Since sense of coherence (SOC) has been associated with health outcomes and some health behaviours, we investigated whether it plays a role in post-MI physical activity. We examined the predictive role of SOC in the long-term trajectory of leisure time physical activity (LTPA) after MI using a prospective cohort design. Methods A cohort of 643 patients aged ≤ 65 years admitted to hospital in central Israel with incident MI between February 1992 and February 1993 were followed up for 13 years. Socioeconomic, clinical and psychological factors, including SOC, were assessed at baseline, and LTPA was self-reported on 5 separate occasions during follow-up. The predictive role of SOC in long-term trajectory of LTPA was assessed using generalized estimating equations. Results SOC was consistently associated with engagement in LTPA throughout follow-up. Patients in the lowest SOC tertile had almost twice the odds (odds ratio,1.99; 95% confidence interval,1.52-2.60) of decreasing their engagement in LTPA as those in the highest tertile. A strong association remained after controlling for disease severity, depression, sociodemographic and clinical factors. Conclusion Our evidence suggests that SOC predicts LTPA trajectory post-MI. Assessment of SOC can help identify high-risk MI survivors, who may require additional help in following secondary prevention recommendations which can dramatically improve prognosis.
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Reid RD, Morrin LI, Beaton LJ, Papadakis S, Kocourek J, McDonnell L, D'Angelo MES, Tulloch H, Suskin N, Unsworth K, Blanchard C, Pipe AL. Randomized trial of an internet-based computer-tailored expert system for physical activity in patients with heart disease. Eur J Prev Cardiol 2011; 19:1357-64. [PMID: 21903744 DOI: 10.1177/1741826711422988] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Robert D Reid
- University of Ottawa Heart Institute, Ottawa, Canada
| | | | - Louise J Beaton
- North Bay Parry Sound District Health Unit, North Bay, Canada
| | | | - Jana Kocourek
- University of Ottawa Heart Institute, Ottawa, Canada
| | | | | | | | | | | | | | - Andrew L Pipe
- University of Ottawa Heart Institute, Ottawa, Canada
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Healthcare workers' participation in a healthy-lifestyle-promotion project in western Sweden. BMC Public Health 2011; 11:448. [PMID: 21651762 PMCID: PMC3118251 DOI: 10.1186/1471-2458-11-448] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 06/08/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare professionals play a central role in health promotion and lifestyle information towards patients as well as towards the general population, and it has been shown that own lifestyle habits can influence attitudes and counselling practice towards patients. The purpose of this study was to explore the participation of healthcare workers (HCWs) in a worksite health promotion (WHP) programme. We also aimed to find out whether HCWs with poorer lifestyle-related health engage in health-promotion activities to a larger extent than employees reporting healthier lifestyles. METHOD A biennial questionnaire survey was used in this study, and it was originally posted to employees in the public healthcare sector in western Sweden, one year before the onset of the WHP programme. The response rate was 61% (n = 3207). In the four-year follow-up, a question regarding participation in a three-year-long WHP programme was included, and those responding to this question were included in the final analysis (n = 1859). The WHP programme used a broad all-inclusive approach, relying on the individual's decision to participate in activities related to four different themes: physical activity, nutrition, sleep, and happiness/enjoyment. RESULTS The participation rate was around 21%, the most popular theme being physical activity. Indicators of lifestyle-related health/behaviour for each theme were used, and regression analysis showed that individuals who were sedentary prior to the programme were less likely to participate in the programme's physical activities than the more active individuals. Participation in the other three themes was not significantly predicted by the indicators of the lifestyle-related health, (body mass index, sleep disturbances, or depressive mood). CONCLUSION Our results indicate that HCWs are not more prone to participate in WHP programmes compared to what has been reported for other working populations, and despite a supposedly good knowledge of health-related issues, HCWs reporting relatively unfavourable lifestyles are not more motivated to participate. As HCWs are key actors in promoting healthy lifestyles to other groups (such as patients), it is of utmost importance to find strategies to engage this professional group in activities that promote their own health.
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Dalusung-Angosta A. The impact of Tai Chi exercise on coronary heart disease: a systematic review. ACTA ACUST UNITED AC 2011; 23:376-81. [PMID: 21696487 DOI: 10.1111/j.1745-7599.2011.00597.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE (a) To explore current studies on Tai Chi and its impact on coronary heart disease (CHD), (b) provide critique of existing studies, and (c) provide recommendations for clinical practice and future research. DATA SOURCES Comprehensive review of literature. CONCLUSIONS Tai Chi is a safe alternative exercise for patients who are at risk of CHD or with existing CHD. Implementing Tai Chi exercise may improve serum lipids, blood pressure, and heart rate. IMPLICATIONS FOR PRACTICE Nurse practitioners (NPs) are in an ideal position to facilitate health promotion and disease prevention. NPs may prescribe Tai Chi as an alternative exercise therapy for their patients who are at risk for developing CHD and even for those with existing CHD. Tai Chi exercise may help prevent and even reverse the progression of cardiac disease.
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Reid RD, Morrin LI, Higginson LAJ, Wielgosz A, Blanchard C, Beaton LJ, Nelson C, McDonnell L, Oldridge N, Wells GA, Pipe AL. Motivational counselling for physical activity in patients with coronary artery disease not participating in cardiac rehabilitation. Eur J Prev Cardiol 2011; 19:161-6. [PMID: 21450579 DOI: 10.1177/1741826711400519] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many patients with coronary artery disease (CAD) fail to attend cardiac rehabilitation following acute coronary events because they lack motivation to exercise. Theory-based approaches to promote physical activity among non-participants in cardiac rehabilitation are required. DESIGN A randomized trial comparing physical activity levels at baseline, 6, and 12 months between a motivational counselling (MC) intervention group and a usual care (UC) control group. METHOD One hundred and forty-one participants hospitalized with acute coronary syndromes not planning to attend cardiac rehabilitation were recruited at a single centre and randomized to either MC (n = 69) or UC (n = 72). The MC intervention, designed from an ecological perspective, included one face-to-face contact and eight telephone contacts with a trained physiotherapist over a 52-week period. The UC group received written information about starting a walking programme and brief physical activity advice from their attending cardiologist. Physical activity was measured by: 7-day physical activity recall interview; self-report questionnaire; and pedometer at baseline, 6, and 12 months after randomization. RESULTS Latent growth curve analyses, which combined all three outcome measures into a single latent construct, showed that physical activity increased more over time in the MC versus the UC group (µ(add) = 0.69, p < 0.05). CONCLUSION Patients with CAD not participating in cardiac rehabilitation receiving a theory-based motivational counselling intervention were more physically active at follow-up than those receiving usual care. This intervention may extend the reach of cardiac rehabilitation by increasing physical activity in those disinclined to participate in structured programmes.
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Affiliation(s)
- Robert D Reid
- Minto Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada.
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Oerkild B, Frederiksen M, Hansen JF, Prescott E. Self-reported physical inactivity predicts survival after hospitalization for heart disease. ACTA ACUST UNITED AC 2011; 18:475-80. [DOI: 10.1177/1741826710389379] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Bodil Oerkild
- Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
| | | | | | - Eva Prescott
- Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
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Gerber Y, Myers V, Goldbourt U, Benyamini Y, Scheinowitz M, Drory Y. Long-term trajectory of leisure time physical activity and survival after first myocardial infarction: a population-based cohort study. Eur J Epidemiol 2010; 26:109-16. [PMID: 21116840 DOI: 10.1007/s10654-010-9523-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Accepted: 11/16/2010] [Indexed: 11/30/2022]
Abstract
The benefits of leisure time physical activity (LTPA) in cardiovascular prevention are well established. While cardiac rehabilitation programmes have been demonstrated as improving myocardial infarction (MI) prognosis, the strength of the association between LTPA and post-MI survival has yet to be quantified. We evaluated long-term survival after MI of inactive, irregularly active, and regularly active patients and examined trajectories of LTPA and their relationship to mortality risk. Consecutive patients aged ≤65 years (n = 1,521), discharged from 8 hospitals in central Israel after first MI in 1992-1993, were followed through 2005. Extensive clinical and sociodemographic data, including self-reported LTPA habits, were obtained at baseline and at 4 subsequent interviews. Pre-MI inactive patients (54%) had lower socioeconomic status, higher prevalence of risk factors and comorbidities and more severe MI. The point prevalence rate of regular LTPA at all follow-up interviews was approximately 40% and 18% were regularly active throughout the entire follow-up. Over a median follow-up of 13.2 years, 427 deaths occurred. After multivariable adjustment, no association was observed between pre-MI LTPA and death. However, with LTPA categories modelled as time-dependent variables, providing an estimation of cumulative assessment and accounting for changes in LTPA post-MI, a strong inverse graded association was revealed (multivariable-adjusted hazard ratios, 0.56 [95% CI: 0.42-0.74] for regular and 0.71 [95% CI: 0.54-0.95] for irregular activity vs. none). Similar estimates were obtained among pre-MI sedentary patients. In summary, after MI, regularly active patients had about half the risk of dying compared with inactive patients, irrespective of pre-MI habits.
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Affiliation(s)
- Yariv Gerber
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Medical School, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel.
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Jonsdottir IH, Rödjer L, Hadzibajramovic E, Börjesson M, Ahlborg G. A prospective study of leisure-time physical activity and mental health in Swedish health care workers and social insurance officers. Prev Med 2010; 51:373-7. [PMID: 20691721 DOI: 10.1016/j.ypmed.2010.07.019] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 07/09/2010] [Accepted: 07/24/2010] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study analyzes longitudinal associations between self-reported leisure-time physical activity (PA) and perceived stress, burnout and symptoms of depression and anxiety. METHOD Cohort data collected in 2004 and 2006 from health care and social insurance workers in western Sweden (2694 women; 420 men) were analyzed. Cox regression was conducted to examine associations between baseline levels of PA and mental health (MH) problems 2 years later. RESULTS Cross-sectional analysis show that individuals reporting either light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) were less likely to report high levels of perceived stress, burnout and symptoms of depression and anxiety, as compared to individuals reporting a sedentary lifestyle. The risks of symptoms of depression, burnout, and high stress levels at follow-up were significantly lower for those reporting LPA or MVPA at baseline. For symptoms of anxiety, an activity level corresponding to MVPA was required. CONCLUSION Participation in PA appeared to lower the risk of developing MH problems two years later. This relationship involved LPA and MVPA regarding feelings of depression, burnout and perceived stress, and exclusively MVPA regarding feelings of anxiety. The implications of these findings are important, as preventive strategies for psychosocial stress and mental health problems are needed.
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Affiliation(s)
- Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
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Shagoury PB, Currier M, Fetter JC. A motivational interviewing group to manage cardiometabolic risk on an inpatient psychiatry unit. PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2010; 12. [PMID: 20944779 DOI: 10.4088/pcc.09l00886blu] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Paul B Shagoury
- Department of Psychology , Department of Recreational Therapy , and Departments of Psychiatry and Internal Medicine , New Hampshire Hospital, Dartmouth Medical School, Concord
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Abstract
Physical activity is an essential lifestyle intervention for the patient with existing cardiovascular disease. National guidelines describe the importance of and define the minimal doses of daily physical activity including walking 10,000 steps a day (equivalent to 5 miles) or performing 30 minutes of moderate-intensity aerobic activity most days of the week in 10- to 15-minute bouts. However, cardiac patients are often fearful that increasing physical activity would be detrimental and cause chest pain or myocardial infarction. Research has shown that cardiac patients can perform a walking program safely. Patient education; development of a realistic plan; measurement of the frequency, intensity, duration, and type of physical activity attained; and consistent follow-up over time are key strategies. This article provides important information for healthcare providers to plan a safe and efficacious walking plan to increase physical activity in the cardiac patient.
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Fletcher GF. Central obesity--more weight in cardiovascular disease prevention. Am J Cardiol 2009; 103:1408-10. [PMID: 19427437 DOI: 10.1016/j.amjcard.2009.01.350] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 01/23/2009] [Accepted: 01/23/2009] [Indexed: 11/24/2022]
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