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急性心肌梗死后患者出院后身体活动和久坐行为的迅速改善。

Rapid Improvements in Physical Activity and Sedentary Behavior in Patients With Acute Myocardial Infarction Immediately Following Hospital Discharge.

机构信息

Department of Physiology Radboud University Medical Center, Radboud Institute for Health Sciences Nijmegen the Netherlands.

Department of Cardiology, Radboud University Medical Center Radboud Institute for Health Sciences Nijmegen the Netherlands.

出版信息

J Am Heart Assoc. 2023 May 16;12(10):e028700. doi: 10.1161/JAHA.122.028700. Epub 2023 May 9.

Abstract

Background Little is known about changes in physical activity (PA) and sedentary behavior (SB) patterns in the acute phase of a myocardial infarction (MI). We objectively assessed PA and SB during hospitalization and the first week after discharge. Methods and Results Consecutively admitted patients hospitalized with an MI were approached to participate in this prospective cohort study. SB, light-intensity PA, and moderate-vigorous intensity PA were objectively assessed for 24 h/d during hospitalization and up to 7 days after discharge in 165 patients. Changes in PA and SB from the hospital to home phase were evaluated using mixed-model analyses, and outcomes were stratified for predefined subgroups based on patient characteristics. Patients (78% men) were aged 65±10 years and diagnosed with ST-segment-elevation MI (50%) or non-ST-segment-elevation MI (50%). Sedentary time was high during hospitalization (12.6 [95% CI, 11.8-13.7] h/d) but substantially decreased following transition to the home environment (-1.8 [95% CI, -2.4 to -1.3] h/d). Furthermore, the number of prolonged sedentary bouts (≥60 minutes) decreased between hospital and home (-1.6 [95% CI, -2.0 to -1.2] bouts/day). Light-intensity PA (1.1 [95% CI, 0.8-1.6] h/d) and moderate-vigorous intensity PA (0.2 [95% CI, 0.1-0.3] h/d) were low during hospitalization but significantly increased following transition to the home environment (light-intensity PA: 1.8 [95% CI, 1.4-2.3] h/d; moderate-vigorous intensity PA: 0.4 [95% CI, 0.3-0.5] h/d; both <0.001). Improvements in PA and SB were similar across groups, except for patients who underwent coronary artery bypass grafting and who did not improve their PA patterns after discharge. Conclusions Patients with MI demonstrate high levels of SB and low PA volumes during hospitalization, which immediately improved following discharge at the patient's home environment. Registration URL: trialsearch.who.int/; Unique identifier: NTR7646.

摘要

背景

对于心肌梗死(MI)急性期体力活动(PA)和久坐行为(SB)模式的变化知之甚少。我们客观评估了住院期间和出院后第一周的 PA 和 SB。

方法和结果

连续收治的 MI 住院患者被邀请参与这项前瞻性队列研究。在 165 名患者中,住院期间每天 24 小时进行 SB、低强度 PA 和中高强度 PA 的客观评估,出院后最多 7 天。使用混合模型分析评估从医院到家庭阶段的 PA 和 SB 的变化,并根据患者特征对预定义亚组的结果进行分层。患者(78%为男性)年龄 65±10 岁,诊断为 ST 段抬高型心肌梗死(50%)或非 ST 段抬高型心肌梗死(50%)。住院期间的久坐时间很高(12.6[95%CI,11.8-13.7]h/d),但在过渡到家庭环境后显著减少(-1.8[95%CI,-2.4 至-1.3]h/d)。此外,住院和家庭之间长时间久坐(≥60 分钟)的次数减少(-1.6[95%CI,-2.0 至-1.2]次/天)。住院期间低强度 PA(1.1[95%CI,0.8-1.6]h/d)和中高强度 PA(0.2[95%CI,0.1-0.3]h/d)较低,但在过渡到家庭环境后显著增加(低强度 PA:1.8[95%CI,1.4-2.3]h/d;中高强度 PA:0.4[95%CI,0.3-0.5]h/d;均<0.001)。PA 和 SB 的改善在各组之间相似,除了接受冠状动脉旁路移植术的患者和出院后未改善 PA 模式的患者。

结论

MI 患者在住院期间表现出高 SB 和低 PA 量,出院后在家环境中立即得到改善。

注册网址

trialsearch.who.int/;唯一标识符:NTR7646。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b700/10227295/bedd5e4d9071/JAH3-12-e028700-g001.jpg

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