Larsson Lena, Johansson Bengt, Wadell Karin, Thilén Ulf, Sandberg Camilla
Department of Public Health and Clinical Medicine, Umeå University, Sweden.
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Sweden.
Int J Cardiol Heart Vasc. 2018 Nov 17;22:13-17. doi: 10.1016/j.ijcha.2018.11.005. eCollection 2019 Mar.
Physical activity reduces the risk of acquired cardiovascular disease, which is of great importance in patients with congenital heart disease (CHD). There are diverging data whether physical activity level (PAL) differs between patients with CHD and controls. Furthermore, it is unknown if PAL can be reliably assessed in patients with CHD using self-reported instruments.
Seventy-five patients with CHD (mean age 37.5 ± 15.5 years, women = 29 [38.7%]) and 42 age and sex matched controls completed the International Physical Activity Questionnaire (IPAQ) and carried the activity monitor Actiheart over 4 days. Time spent at ≥3 METS ≥21.4 min/day, i.e. reaching the WHO recommendation for PAL to promote health, was used as the outcome measure. Data on PAL obtained from IPAQ were compared with Actiheart.
The proportion of individuals reaching target PAL according to IPAQ was similar in patients with CHD and controls (70.7%vs.76.2%, = 0.52) as well as between patients with simple and complex lesions. There was an overall difference between IPAQ and Actiheart in detecting recommended PAL (72.6%vs.51.3%, < 0.001). In a subgroup analysis, this difference was also detected in patients but was borderline for controls. The negative predictive value for IPAQ in detecting insufficient PAL was higher in patients than in controls (73%vs.40%).
The proportion of persons reaching sufficient PAL to promote health was similar in patients and controls. The self-reported instrument overestimated PAL in relation to objective measurements. However, with a high negative predictive value, IPAQ is a potentially useful tool for detecting patients with insufficient PAL.
体育活动可降低后天性心血管疾病的风险，这对先天性心脏病（CHD）患者极为重要。关于CHD患者与对照组的身体活动水平（PAL）是否存在差异，现有数据存在分歧。此外，尚不清楚使用自我报告工具能否在CHD患者中可靠地评估PAL。
75例CHD患者（平均年龄37.5±15.5岁，女性29例[38.7%]）以及42例年龄和性别匹配的对照组完成了国际体力活动问卷（IPAQ），并佩戴活动监测仪Actiheart 4天。以每天至少21.4分钟达到≥3代谢当量（METS），即达到世界卫生组织促进健康的PAL推荐值的时间作为结局指标。将IPAQ获得的PAL数据与Actiheart进行比较。
根据IPAQ达到目标PAL的个体比例在CHD患者和对照组中相似（70.7%对76.2%，P=0.52），简单病变和复杂病变患者之间也是如此。在检测推荐的PAL方面，IPAQ和Actiheart总体上存在差异（72.6%对51.3%，P<0.001）。在亚组分析中，患者中也检测到了这种差异，但对照组接近临界值。IPAQ检测不足PAL的阴性预测值在患者中高于对照组（73%对40%）。
患者和对照组中达到促进健康的足够PAL的人群比例相似。与客观测量相比，自我报告工具高估了PAL。然而，由于具有较高的阴性预测值，IPAQ是检测PAL不足患者的潜在有用工具。
