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Freene N.1, del Pozo Cruz B.2, Davey R.3, McManus M.4, Mair T.5, Tan R.4
1University of Canberra, Physiotherapy, Bruce, Australia, 2University of Auckland, Department of Exercise Sciences, Auckland, New Zealand, 3University of Canberra, Centre for Research and Action in Public Health, Bruce, Australia, 4Canberra Hospital and Health Services, Department of Cardiology, Garran, Australia, 5Canberra Hospital and Health Services, Exercise Physiology, Garran, Australia
Background: There is little evidence of whether or not those who are attending cardiac rehabilitation (CR) are meeting the physical activity guidelines recommended for secondary prevention of cardiovascular disease. It has been shown that even if individuals are meeting the physical activity guidelines, the harmfulness of too much sedentary behaviour remains (active couch potato (ACP) phenomenon). Currently, there appears to be no evidence of the ACP phenomenon in those attending CR.
Purpose: The aim of the study is to examine the level of physical activity and sedentary behaviour in those with coronary heart disease (CHD) who are attending CR.
Methods: Using a prospective cohort study design, adults commencing a 6-week phase II hospital-based CR program with stable CHD and receiving optimal medical treatment +/- revascularisation were recruited. Outcomes included physical activity (Active Australia Survey, accelerometry), sedentary behaviour (Past-Day Adults Sedentary Time questionnaire, accelerometry), body mass index, waist-to-hip ratio, lipid profile, blood glucose level, quality-of-life (MacNew), anxiety and depression (Hospital Anxiety and Depression Scale), and exercise capacity (6-minute walk test).
Results: Seventy-four CR participants completed baseline measures. Participants were predominantly male, born in Australia, tertiary educated and in a relationship. Percutaneous coronary intervention was the main admission diagnosis, with half of the participants currently working. At baseline, mean self-reported sedentary time was less than accelerometer sedentary time (9.75 vs 12.05 hours per day). Accelerometry found that 14% of the participants were sufficiently active (150 minutes moderate-vigorous physical activity (MVPA) and 5 sessions per week) although, 73% of participants self-reported they were sufficiently active. Participants spent the majority of their day sitting or lying (87%), with 10.3 minutes per day spent in MVPA. Males completed significantly more MVPA minutes per day than females (p0.05). In linear regression modelling for males and females, some of the independent predictors of MVPA and sedentary behaviour were similar, while others differed.
Conclusion(s): Physical activity and sedentary behaviour may have independent effects on cardiovascular risk factors in people with CHD. If this is so, reducing sedentary behaviour may be a feasible first-line, additional and more achievable strategy to improve the health of those with CHD, alongside traditional recommendations to increase the time spent in MVPA.
Implications: Meeting the physical activity guidelines for patients soon after their cardiac event may be difficult to achieve. Initially CR programs should not only encourage participants to work towards achieving the physical activity guidelines but they should also encourage patients to sit less, which may be more achievable. In addition, consideration of different strategies to achieve this is indicated for males and females.
Funding acknowledgements: Funding for this project is provided by the University of Canberra and the ACT Health Chief Allied Health Office.
Topic: Cardiorespiratory
Ethics approval: This study was approved by the ACT Health Human Research Ethics Committee in August 2015 (ETH.5.15.076).
All authors, affiliations and abstracts have been published as submitted.
