Clinique de Saint-Orens, Centre de rééducation cardiovasculaire et pulmonaire, 12, avenue de Revel, 31650 Saint-Orens de Gameville, France.
Ann Phys Rehabil Med. 2012 Jul;55(5):312-21. doi: 10.1016/j.rehab.2012.05.002. Epub 2012 Jun 12.
To objectively assess, in stable cardiac patients, the adherence to physical activity (PA) recommendations using an accelerometer at 2 or 12 months after the discharge of cardiac rehabilitation program (CRP).
Eighty cardiac patients wore an accelerometer at 2 months (group 1, short-term adherence, n = 41) or one-year (group 2, long-term adherence, n = 39) after a CRP including therapeutic education about regular PA. PA was classified as "light" (1.8-2.9 Metabolic Equivalent of Task [METs]), "moderate" (3-5.9 METs), or "intense" (>6 METs). Energy expenditure (EE, in Kcal) and time (min) spent in these three different levels were measured during a one-week period with the MyWellness Key actimeter (MWK). Motivational readiness for change was also assessed at the end of CRP. Patients were considered as physically active when a minimum of 150 min of moderate PA during the one-week period was achieved.
Both groups were comparable, except for exercise capacity at the end of the CRP which was slightly higher in group 1 (167.5 ± 42.3 versus 140.7 ± 46.1 W, P < 0.01). The total weekly active EE averaged 676.7 ± 353.2 kcal and 609.5 ± 433.5 kcal in group 1 and 2, respectively. The time spent within the light-intensity range PA was 319.4 ± 170.9 and 310.9 ± 160.6 min, and the time spent within the moderate-intensity range averaged 157.4 ± 115.4 and 165 ± 77.2 min per week for group 1 and 2, respectively. Fifty-three percent and 41% of patients remained active in both groups respectively.
About half of the patients are non-adherent to PA after CRP and do not reach target levels recommended by physicians. The first 2 months following the discharge of CRP seem to be of outmost importance for lifestyle modifications maintenance, and further study monitoring more closely PA decrease could help to clarify the optimal follow-up options.
使用加速度计在心脏康复计划（CRP）出院后 2 或 12 个月客观评估稳定型心脏病患者对体力活动（PA）建议的依从性。
80 例心脏病患者在 CRP 后 2 个月（第 1 组，短期依从，n = 41）或 1 年（第 2 组，长期依从，n = 39）佩戴加速度计，其中包括关于常规 PA 的治疗性教育。PA 分为“轻度”（1.8-2.9 代谢当量 [MET]）、“中度”（3-5.9 METs）或“剧烈”（>6 METs）。在一周的时间内，使用 MyWellness Key 计步器（MWK）测量这三个不同水平的能量消耗（EE，以卡路里为单位）和时间（分钟）。CRP 结束时还评估了改变的动机准备程度。当在一周内至少完成 150 分钟中等强度 PA 时，患者被认为是活跃的。
两组患者无差异，除了 CRP 结束时的运动能力，第 1 组稍高（167.5 ± 42.3 与 140.7 ± 46.1 W，P < 0.01）。第 1 组和第 2 组的每周总主动 EE 平均为 676.7 ± 353.2 卡路里和 609.5 ± 433.5 卡路里，第 1 组和第 2 组的轻强度 PA 时间分别为 319.4 ± 170.9 和 310.9 ± 160.6 分钟，中等强度 PA 时间平均每周分别为 157.4 ± 115.4 和 165 ± 77.2 分钟。两组各有 53%和 41%的患者仍然活跃。
大约一半的患者在 CRP 后不遵守 PA 建议，未达到医生推荐的目标水平。CRP 出院后的头 2 个月对于维持生活方式的改变似乎至关重要，进一步的研究更密切地监测 PA 减少情况可以帮助阐明最佳随访方案。
