Savage Patrick D, Ades Philip A
Cardiac Rehabilitation and Prevention, Division of Cardiology, University of Vermont College of Medicine, Burlington, VT, USA.
J Cardiopulm Rehabil Prev. 2008 Nov-Dec;28(6):370-7; quiz 378-9. doi: 10.1097/HCR.0b013e31818c3b6d.
Walking exercise favorably affects cardiac risk factors (CRF) and reduces total and cardiovascular disease-related mortality. The purpose of this study was to describe walking levels, prospectively measured by pedometer, in individuals commencing phase II cardiac rehabilitation (CR) and to correlate step counts with CRF.
Participants (n = 107) wore a pedometer for 7 consecutive days starting the day after their first formal phase II CR exercise training session. Primary outcome was total steps taken, with CR and non-CR days analyzed separately. We examined the relationship between daily step counts and CRF.
Participants achieved significantly higher step counts on CR versus non-CR days (7,387 +/- 3,387 vs 5,315 +/- 3,336, P < .0001). Total daily step count correlated significantly, in descending order, with peak oxygen uptake, the number of days since the index cardiac event, diagnosis of diabetes mellitus, physical function score, waist circumference, body mass index, age, and high-density lipoprotein cholesterol (HDL-C). By multivariate analysis, peak oxygen uptake, HDL-C, and the diagnosis of diabetes mellitus independently correlated with daily non-CR step count (cumulative total r = 0.62, adjusted R2 = 0.35, P < .0001). Regression analysis, using step counts on CR days, produced similar results.
Daily steps taken by patients during the first week of phase II CR are quite low. Despite the low step counts, significant correlations between steps taken and CRF were found including fitness, centrally distributed adiposity, and HDL-C. Our results suggest that, even early after a coronary event, higher levels of walking are favorably related to CRF.
步行锻炼对心脏危险因素（CRF）有积极影响，并可降低全因死亡率和心血管疾病相关死亡率。本研究的目的是描述开始心脏康复（CR）二期的个体通过计步器前瞻性测量的步行水平，并将步数与心脏危险因素相关联。
参与者（n = 107）从首次正式的CR二期运动训练课程后的第二天开始，连续7天佩戴计步器。主要结局是总步数，分别分析CR日和非CR日。我们研究了每日步数与心脏危险因素之间的关系。
与非CR日相比，参与者在CR日的步数显著更高（7,387±3,387对5,315±3,336，P <.0001）。每日总步数与峰值摄氧量、自心脏指数事件以来的天数、糖尿病诊断、身体功能评分、腰围、体重指数、年龄和高密度脂蛋白胆固醇（HDL-C）呈显著相关，顺序递减。通过多变量分析，峰值摄氧量、HDL-C和糖尿病诊断与每日非CR步数独立相关（累积总r = 0.62，调整后R2 = 0.35，P <.0001）。使用CR日步数进行的回归分析产生了类似的结果。
CR二期第一周患者的每日步数相当低。尽管步数较低，但发现步数与心脏危险因素之间存在显著相关性，包括体能、中心性肥胖和HDL-C。我们的结果表明，即使在冠状动脉事件后早期，较高水平的步行与心脏危险因素也呈正相关。
