Funaki Kuya, Adachi Takuji, Kameshima Masataka, Fujiyama Hiroaki, Iritani Naoki, Tanaka Chikako, Sakui Daisuke, Hara Yasutaka, Sugiura Hideshi, Yamada Sumio
Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, Nagoya,Japan.
Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya,Japan.
J Phys Act Health. 2023 Feb 22;20(4):279-291. doi: 10.1123/jpah.2022-0396. Print 2023 Apr 1.
This study aimed to clarify factors affecting changes in moderate to vigorous physical activity (MVPA) in patients 1 to 3 months after undergoing percutaneous coronary intervention (PCI).
In this prospective cohort study, we enrolled patients aged <75 years who underwent PCI. MVPA was objectively measured using an accelerometer at 1 and 3 months after hospital discharge. Factors associated with increased MVPA (≥150 min/wk at 3 mo) were analyzed in participants with MVPA < 150 minutes per week at 1 month. Univariate and multivariate logistic regression analyses were performed to explore variables potentially associated with increasing MVPA, using MVPA ≥ 150 minutes per week at 3 months as the dependent variable. Factors associated with decreased MVPA (<150 min/wk at 3 mo) were also analyzed in participants with MVPA ≥ 150 minutes per week at 1 month. Logistic regression analysis was performed to explore factors of declining MVPA, using MVPA < 150 minutes per week at 3 months as the dependent variable.
We analyzed 577 patients (median age 64 y, 13.5% female, and 20.6% acute coronary syndrome). Increased MVPA was significantly associated with participation in outpatient cardiac rehabilitation (odds ratio 3.67; 95% confidence interval, 1.22-11.0), left main trunk stenosis (13.0; 2.49-68.2), diabetes mellitus (0.42; 0.22-0.81), and hemoglobin (1.47, per 1 SD; 1.09-1.97). Decreased MVPA was significantly associated with depression (0.31; 0.14-0.74) and Self-Efficacy for Walking (0.92, per 1 point; 0.86-0.98).
Identifying patient factors associated with changes in MVPA may provide insight into behavioral changes and help with individualized PA promotion.
本研究旨在阐明经皮冠状动脉介入治疗（PCI）后1至3个月患者中影响中度至剧烈身体活动（MVPA）变化的因素。
在这项前瞻性队列研究中，我们纳入了年龄<75岁且接受PCI的患者。出院后1个月和3个月时使用加速度计客观测量MVPA。对1个月时MVPA<150分钟/周的参与者分析与MVPA增加（3个月时≥150分钟/周）相关的因素。以3个月时MVPA≥150分钟/周作为因变量，进行单因素和多因素逻辑回归分析，以探索可能与MVPA增加相关的变量。对1个月时MVPA≥150分钟/周的参与者也分析与MVPA减少（3个月时<150分钟/周）相关的因素。以3个月时MVPA<150分钟/周作为因变量，进行逻辑回归分析以探索MVPA下降的因素。
我们分析了577例患者（中位年龄64岁，女性占13.5%，急性冠状动脉综合征占20.6%）。MVPA增加与参与门诊心脏康复显著相关（比值比3.67；95%置信区间，1.22 - 11.0）、左主干狭窄（13.0；2.49 - 68.2）、糖尿病（0.42；0.22 - 0.81）和血红蛋白（每1个标准差为1.47；1.09 - 1.97）。MVPA减少与抑郁（0.31；0.14 - 0.74）和步行自我效能（每1分0.92；0.86 - 0.98）显著相关。
识别与MVPA变化相关的患者因素可能有助于深入了解行为变化，并有助于促进个性化的身体活动。
