Department of Cardiology, Vestfold Hospital Trust, Norway (Ms Peersen and Dr Otterstad); Department of Medicine, Drammen Hospital, Vestre Viken Trust, Norway (Drs Sverre and Munkhaugen); Department of Behavioural Sciences in Medicine (Drs Sverre, Moum, Dammen, and Munkhaugen) and Faculty of Medicine (Ms Peersen and Dr Gullestad), University of Oslo, Norway; Institute of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden (Dr Perk); and Department of Cardiology, Oslo University Hospital Rikshospitalet, Norway (Dr Gullestad).
J Cardiopulm Rehabil Prev. 2020 Jan;40(1):35-40. doi: 10.1097/HCR.0000000000000399.
The reasons why many coronary patients are inactive or have a low level of physical activity (PA) are not completely understood. We identified medical and psychosocial factors associated with PA status and increasing exercise level after a coronary event.
A cross-sectional study investigated the factors associated with PA in 1101 patients hospitalized with myocardial infarction (MI) and/or a revascularization procedure. Data were collected from hospital records, a self-report questionnaire, and a clinical examination. PA was categorized as inactivity, low activity, and adequate activity (≥ moderate intensity of 30 min ≥2-3 times/wk), an overall summary PA-index was measured as a continuous variable, and self-reported PA increase since the index event was measured on a 0- to 10-point Likert Scale.
In all, 18% reported inactivity, 42% low, and 40% adequate activity at follow-up after median 16 mo. In multiadjusted linear regression analyses, low PA-index was significantly associated with smoking, obesity, unhealthy diet, depression, female, low education, MI as index diagnosis, and ≥1 previous coronary event. Motivation, risk and illness perceptions, and low reported need of help to increase PA were significantly associated with self-reported increasing PA level in adjusted continuous analyses.
Daily smoking, obesity, unhealthy diet, and depression were the major potentially modifiable factors associated with insufficient PA, whereas high motivation and risk and illness perceptions were associated with increasing PA level. Further research on the effect of interventions tailored to the reported significant factors of failure is needed to improve PA level in CHD patients.
许多冠心病患者不活动或体力活动(PA)水平较低的原因尚不完全清楚。我们确定了与 PA 状态以及冠心病事件后运动水平增加相关的医学和心理社会因素。
一项横断面研究调查了 1101 例因心肌梗死(MI)和/或血运重建术住院的患者的 PA 相关因素。数据来自医院记录、自我报告问卷和临床检查。PA 分为不活动、低活动和足够活动(≥中等强度 30 分钟≥2-3 次/周),总体 PA 指数作为连续变量进行测量,自指数事件以来的自我报告 PA 增加情况则以 0 到 10 点李克特量表进行测量。
在所有患者中,18%在随访 16 个月后报告不活动,42%报告低活动,40%报告足够活动。在多因素线性回归分析中,低 PA 指数与吸烟、肥胖、不健康饮食、抑郁、女性、低教育程度、MI 作为指数诊断以及≥1 次先前的冠心病事件显著相关。在调整后的连续分析中,动机、风险和疾病感知以及低报告增加 PA 的需求与自我报告的 PA 水平增加显著相关。
每日吸烟、肥胖、不健康饮食和抑郁是与 PA 不足相关的主要潜在可改变因素,而高动机、风险和疾病感知与 PA 水平增加相关。需要进一步研究针对报告的失败相关因素的个体化干预措施对改善 CHD 患者 PA 水平的效果。