University Health Network, Toronto rehabilitation institute, Rumsey Centre, 34, Rumsey road, Toronto, ON, Canada.
University Health Network, Toronto rehabilitation institute, Rumsey Centre, 34, Rumsey road, Toronto, ON, Canada.
Ann Phys Rehabil Med. 2018 Jul;61(4):207-214. doi: 10.1016/j.rehab.2017.06.003. Epub 2017 Oct 12.
Prolonged sedentary time is recognized as a distinct health risk, and mortality risks are expected to be greatest for individuals with low exercise levels. It is unknown whether participation in exercise-based cardiac rehabilitation (CR) programs influences sedentary behaviour particularly among those patients expected to be at greatest mortality risk. This study examined the influence of CR participation on sedentary behaviour and identified the proportion and characteristics (socio-demographic and clinical) of patients who do not meet exercise recommendations and have prolonged sedentary times.
A prospective study was conducted among patients of an exercise-based CR program and assessments performed at baseline and 3 months. Physical activity and sedentary behaviour information were collected by self-report, and convergent validity was examined on an accelerometer-wearing subsample.
Of 468 CR patients approached, 130 participants were recruited with an average sedentary time of 8hours/day. Sedentary behaviour remained consistent at follow-up (relative change= -2.4%, P=0.07) notwithstanding a greater proportion meeting exercise recommendations (relative change= 57.4%). 19.2% of participants were classified to have prolonged sedentary time and not meet exercise recommendations at baseline. No significant differences were found between the characteristics of high-risk individuals and lower risk subgroups. Findings were consistent among the accelerometer-derived subgroup and the overall sample despite poor to moderate convergent validity.
These results suggest that the exercise-focus of CR may not reduce sedentary behaviours. Future studies are needed to determine whether sedentary behaviour-specific reduction strategies are more effective than traditional exercise-based strategies and lead to meaningful improvements in clinical outcomes.
久坐时间过长已被确认为一种明显的健康风险，而运动水平较低的人预计面临的死亡风险最大。目前尚不清楚参加以运动为基础的心脏康复（CR）计划是否会影响久坐行为，尤其是对那些预计面临最大死亡风险的患者。本研究探讨了 CR 参与对久坐行为的影响，并确定了不符合运动建议且久坐时间过长的患者的比例和特征（社会人口统计学和临床）。
对一项以运动为基础的 CR 计划的患者进行前瞻性研究，并在基线和 3 个月时进行评估。通过自我报告收集身体活动和久坐行为信息，并在佩戴加速度计的亚组中进行了收敛效度检验。
在接触的 468 名 CR 患者中，有 130 名参与者被招募，平均每天久坐时间为 8 小时。尽管有更多的患者符合运动建议（相对变化=57.4%），但在随访时久坐行为仍然保持不变（相对变化=-2.4%，P=0.07）。基线时有 19.2%的参与者被归类为久坐时间过长且不符合运动建议。高危个体与低危亚组之间的特征无显著差异。尽管收敛效度较差，但在加速度计衍生的亚组和总体样本中均得出了一致的结果。
这些结果表明，CR 的运动重点可能不会减少久坐行为。需要进一步研究以确定针对久坐行为的特定减少策略是否比传统的以运动为基础的策略更有效，并导致临床结果的显著改善。
