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Izawa KP, Kasahara Y, Watanabe S, Oka K, Brubaker PH, Kida K, Akashi YJ. Association of objectively measured daily physical activity and health utility to disease severity in chronic heart failure patients: A cross-sectional study. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2021; 10:100051. [PMID: 38560645 PMCID: PMC10978131 DOI: 10.1016/j.ahjo.2021.100051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 04/04/2024]
Abstract
Background and aims Physical activity (PA) levels are related to mortality and morbidity in patients with chronic heart failure (CHF). Health utility (HU), a very important cost-effectiveness analysis for health care and health status, is measured by several preference-based utility measures. This study aimed to evaluate the relation between PA and HU and the effect of disease severity on PA and HU in patients with CHF. Methods We enrolled 226 consecutive outpatients with CHF (mean age, 57.5 years; males, 79.6%) in this retrospective cross-sectional study. Patients were divided into three groups by NYHA class for classification of disease severity. Patient characteristics, average step count in steps/day, PA energy expenditure (PAEE) in kcal/day for 7 days as assessed by accelerometer, and HU assessed by Short Form-6D were compared between the groups. Results Average step count (r = 0.37, P < 0.01) and average PAEE (r = 0.36, P < 0.01) correlated positively with HU in all patients. Patients were classified into three groups by NYHA class: class I (n = 92), class II (n = 97), and class III (n = 37). Average step counts (7618.58, 6452.51, and 4225.63 steps/day, P < 0.001), average PAEE (244.65, 176.88, and 103.72 kcal/day, P < 0.001), and HU (0.68, 0.63, and 0.57, P < 0.001) respectively decreased with the increase in NYHA class (P < 0.001). Conclusion This study showed a significant relationship of daily PA and HU to disease severity in patients with CHF. Although causation cannot be determined from this study, these results suggest that PA and HU may provide important information related to the severity of disease in patients with CHF.
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Affiliation(s)
- Kazuhiro P. Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Yusuke Kasahara
- Department of Rehabilitation Medicine, St. Marianna University Yokohama-city Seibu Hospital, Yokohama, Japan
| | - Satoshi Watanabe
- Department of Rehabilitation Center, St. Marianna University School of Medicine Hospital, Kawasaki, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Peter H. Brubaker
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Keisuke Kida
- Department of Pharmacology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoshihiro J. Akashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
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Hashimoto K, Hirashiki A, Kawamura K, Sugioka J, Mizuno Y, Tanioku S, Sato K, Ueda I, Itoh N, Nomoto K, Kokubo M, Shimizu A, Kondo I. Short physical performance battery score and driving a car are independent factors associated with life-space activities in older adults with cardiovascular disease. Geriatr Gerontol Int 2021; 21:900-906. [PMID: 34363304 DOI: 10.1111/ggi.14254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 06/26/2021] [Accepted: 07/16/2021] [Indexed: 12/24/2022]
Abstract
AIM Decreased use of life spaces, as reflected in decreased Life-Space Assessment (LSA) scores, is associated with poor prognosis in older adults. The purpose of this study was to examine factors affecting the extent of life-space activities in older adults with cardiovascular disease. METHODS We carried out a prospective observational study in 98 older adults (minimum age 65 years; mean age 79.5 ± 7.4 years) who were admitted to our hospital due to cardiovascular disease. Once their medical condition was stable, they underwent cardiopulmonary exercise testing, echocardiography and physical evaluation, and completed questionnaires. RESULTS The LSA score was significantly associated with the ability to drive a car (driving 95.1 ± 21.1 points, not driving 60.4 ± 30.3 points, P < 0.001). In addition, LSA was significantly correlated with age; peak VO2 ; brain natriuretic peptide; and Short Physical Performance Battery, Geriatric Depression Scale and Mini-Mental State Examination scores. In a multiple regression analysis, Short Physical Performance Battery and driving a car were significantly associated with LSA (β = 0.28, β = 0.37, respectively). CONCLUSION Assessment of motor function and social factors in addition to clinical cardiac function might be important to understand the complete context of life-space activity in older adults with cardiovascular disease. Geriatr Gerontol Int 2021; ••: ••-••.
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Affiliation(s)
- Kakeru Hashimoto
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Akihiro Hirashiki
- Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Koki Kawamura
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Junpei Sugioka
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yumi Mizuno
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Shunya Tanioku
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Sato
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ikue Ueda
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Naoki Itoh
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenichiro Nomoto
- Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Manabu Kokubo
- Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Atsuya Shimizu
- Department of Cardiology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Izumi Kondo
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
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O'Donnell J, Smith-Byrne K, Velardo C, Conrad N, Salimi-Khorshidi G, Doherty A, Dwyer T, Tarassenko L, Rahimi K. Self-reported and objectively measured physical activity in people with and without chronic heart failure: UK Biobank analysis. Open Heart 2020; 7:e001099. [PMID: 32153787 PMCID: PMC7046950 DOI: 10.1136/openhrt-2019-001099] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/18/2019] [Accepted: 11/27/2019] [Indexed: 01/06/2023] Open
Abstract
Objective The impact of heart failure (HF) on perceived and objectively measured levels of physical activity (PA) can inform risk stratification and treatment recommendation. We aimed to compare self-reported and objectively measured PA levels in a large sample of participants with and without HF. Methods A validated PA questionnaire was used to estimate self-reported weekly PA among 1600 participants with HF and 387 580 participants without HF. Accelerometer data were studied in 596 participants with HF and 96 105 participants without HF for a period of 7 days. Using multivariable linear regression models, we compared the PA levels between participants with HF and without HF, focusing on both the average daily PA levels and the intensity of PAs throughout the day. Results PA levels were significantly lower in participants with HF using both self-report (excess metabolic equivalent of task hours per week of 26.5 (95% CI 24.7 to 28.4) vs 34.7 (95% CI 34.5 to 34.9), respectively (p<0.001)) and accelerometer measures (mean accelerations of 23.7 milligravity (95% CI 23.1 to 24.4) vs 28.1 milligravity (95% CI 28.0 to 28.1), respectively (p<0.001)). Findings were consistent across different PA intensities. Hour-by-hour comparisons showed that accelerometer-derived PA levels of patients with HF were reduced throughout the day. Conclusion Perceived and objectively recorded PA levels of patients with chronic HF are significantly lower than those of individuals without HF. This difference is continuous throughout the different hours of the day, with individuals with HF being on average 16% less active than individuals without HF. In patients with HF, increases in everyday activity may be a potential alternative to structured exercise programmes.
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Affiliation(s)
- Johanna O'Donnell
- George Institute for Global Health, University of Oxford, Oxford, Oxfordshire, UK.,Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Karl Smith-Byrne
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Carmelo Velardo
- Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Nathalie Conrad
- George Institute for Global Health, University of Oxford, Oxford, Oxfordshire, UK
| | | | - Aiden Doherty
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Terence Dwyer
- George Institute for Global Health, University of Oxford, Oxford, Oxfordshire, UK
| | - Lionel Tarassenko
- Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Kazem Rahimi
- George Institute for Global Health, University of Oxford, Oxford, Oxfordshire, UK
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Boekhout JM, Peels DA, Berendsen BA, Bolman CA, Lechner L. An eHealth Intervention to Promote Physical Activity and Social Network of Single, Chronically Impaired Older Adults: Adaptation of an Existing Intervention Using Intervention Mapping. JMIR Res Protoc 2017; 6:e230. [PMID: 29170146 PMCID: PMC5721211 DOI: 10.2196/resprot.8093] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/29/2017] [Accepted: 10/30/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Especially for single older adults with chronic diseases, physical inactivity and a poor social network are regarded as serious threats to their health and independence. The Active Plus intervention is an automated computer-tailored eHealth intervention that has been proven effective to promote physical activity (PA) in the general population of adults older than 50 years. OBJECTIVE The aim of this study was to report on the methods and results of the systematic adaptation of Active Plus to the wishes and needs of the subgroup of single people older than 65 years who have one or more chronic diseases, as this specific target population may encounter specific challenges regarding PA and social network. METHODS The Intervention Mapping (IM) protocol was used to systematically adapt the existing intervention to optimally suit this specific target population. A literature study was performed, and quantitative as well as qualitative data were derived from health care professionals (by questionnaires, n=10) and the target population (by focus group interviews, n=14), which were then systematically integrated into the adapted intervention. RESULTS As the health problems and the targeted behavior are largely the same in the original and adapted intervention, the outcome of the needs assessment was that the performance objectives remained the same. As found in the literature study and in data derived from health professionals and focus groups, the relative importance and operationalization of the relevant psychosocial determinants related to these objectives are different from the original intervention, resulting in a refinement of the change objectives to optimally fit the specific target population. This refinement also resulted in changes in the practical applications, program components, intervention materials, and the evaluation and implementation strategy for the subgroup of single, chronically impaired older adults. CONCLUSIONS This study demonstrates that the adaptation of an existing intervention is an intensive process in which adopting the IM protocol is an invaluable tool. The study provides a broad insight in adapting interventions aimed at single older adults with a chronic disease. It is concluded that even when the new target population is a sizable segment of the original target population, the adapted intervention still needs considerable changes to optimally fit the needs and situational differences of the narrower target population.
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Affiliation(s)
- Janet M Boekhout
- Faculty of Psychology and Educational Science, Open University of the Netherlands, Heerlen, Netherlands
| | - Denise A Peels
- Faculty of Psychology and Educational Science, Open University of the Netherlands, Heerlen, Netherlands
| | - Brenda Aj Berendsen
- Faculty of Psychology and Educational Science, Open University of the Netherlands, Heerlen, Netherlands
| | - Catherine Aw Bolman
- Faculty of Psychology and Educational Science, Open University of the Netherlands, Heerlen, Netherlands
| | - Lilian Lechner
- Faculty of Psychology and Educational Science, Open University of the Netherlands, Heerlen, Netherlands
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Leisure-time physical activity over four seasons in chronic heart failure patients. Int J Cardiol 2014; 177:651-3. [DOI: 10.1016/j.ijcard.2014.09.176] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 09/27/2014] [Indexed: 11/22/2022]
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Izawa KP, Watanabe S, Hiraki K, Morio Y, Kasahara Y, Takeichi N, Oka K, Osada N, Omiya K. Determination of the Effectiveness of Accelerometer Use in the Promotion of Physical Activity in Cardiac Patients: A Randomized Controlled Trial. Arch Phys Med Rehabil 2012; 93:1896-902. [DOI: 10.1016/j.apmr.2012.06.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 06/19/2012] [Accepted: 06/19/2012] [Indexed: 10/28/2022]
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