Changes in Physical Activity and Sedentary Behavior during Cardiac Rehabilitation

Publication date: Available online 13 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Nienke ter Hoeve, Madoka Sunamura, Myrna E. van Geffen, Malou H.J. Fanchamps, Herwin L.D. Horemans, Johannes B.J. Bussmann, Henk J. Stam, Ron T. van Domburg, Rita J.G. van den Berg-Emons
ObjectiveTo objectively measure changes in both moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) during and after standard cardiac rehabilitation (CR).DesignProspective cohort studySettingOutpatient CR centerParticipants135 patients with acute coronary syndrome (ACS) who completed CR.InterventionMulti-disciplinary CR according to current guidelinesMain outcome measuresThe proportion of time spent in MVPA and SB was objectively measured with an accelerometer. The distribution of time in MVPA and SB was also determined (e.g. average length of time periods spent in MVPA and SB). All measurements were obtained prior to CR, following CR and at one-year follow-up.ResultsPatients'time in MVPA during waking hours increased by 0.65% (≈5 min) during CR (p=0.002), and remained increased at one-year follow-up (p=0.037). The MVPA distribution did not change. During CR, time spent in SB decreased by 2.49% (≈22 min; p<0.001), and SB time became more fragmented with more breaks and shorter SB periods (p<0.001). These SB improvements were maintained at one-year follow-up (p<0.001).ConclusionsPatients with ACS achieved a small improvement in MVPA time during CR but MVPA distribution remained unchanged. More substantial improvements occurred for SB time and distribution. However, by the end of CR, patients still spent relatively little time in MVPA and a long time in SB, which is known to be detrimental to cardiovascular health. Although CR programs have the potential to improve physical behavior, our findings highlight the need to develop adjusted CR targets that address amount and distribution of MVPA and SB.



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