Comparison of device-based physical activity and sedentary behaviour following percutaneous coronary intervention in a cohort from Sweden and Australia: a harmonised, exploratory study

Abstract

Background: Few studies have measured device-based physical activity and sedentary behaviour following a percutaneous coronary intervention (PCI), with no studies comparing these behaviours between countries using the same methods. The aim of the study was to compare device-based physical activity and sedentary behaviour, using a harmonised approach, following a PCI on-entry into centre-based cardiac rehabilitation in two countries. Methods: A cross-sectional study was conducted at two outpatient cardiac rehabilitation centres in Australia and Sweden. Participants were adults following a PCI and commencing cardiac rehabilitation (Australia n = 50, Sweden n = 133). Prior to discharge from hospital, Australian participants received brief physical activity advice (< 5 mins), while Swedish participants received physical activity counselling for 30 min. A triaxial accelerometer (Actigraph GT3X/ActiSleep) was used to objectively assess physical activity (light (LPA), moderate-to-vigorous (MVPA)) and sedentary behaviour. Outcomes included daily minutes of physical activity and sedentary behaviour, and the proportion and distribution of time spent in each behaviour. Results: There was no difference in age, gender or relationship status between countries. Swedish (S) participants commenced cardiac rehabilitation later than Australian (A) participants (days post-PCI A 16 vs S 22, p < 0.001). Proportionally, Swedish participants were significantly more physically active and less sedentary than Australian participants (LPA A 27% vs S 30%, p < 0.05; MVPA A 5% vs S 7%, p < 0.01; sedentary behaviour A 68% vs S 63%, p < 0.001). When adjusting for wear-time, Australian participants were doing less MVPA minutes (A 42 vs S 64, p < 0.001) and more sedentary behaviour minutes (A 573 vs S 571, p < 0.001) per day. Both Swedish and Australian participants spent a large part of the day sedentary, accumulating 9.5 h per day in sedentary behaviour.

Physical activity, inactivity and sleep in older patients with coronary artery disease following percutaneous coronary intervention: a longitudinal, observational study

“…In a recent systematic review and meta-analysis, moderate evidence supports that an association exists between attendance at cardiac rehabilitation and increases in physical activity regardless of monitoring method (subjective or objective) with more positive findings reported when high doses of cardiac rehabilitation were delivered [41]. Interestingly, differences have been reported between countries in patients’ physical activity levels and sedentary behaviour at the commencement of cardiac rehabilitation following PCI with patients from Sweden being significantly more active and less sedentary than their Australian counterparts at this stage of recovery [42]. We did not record details of patients who attended cardiac rehabilitation and cannot rule out the importance and benefit of this in increasing physical activity levels in this population over the 12-month study.…”

Activity counseling early postelective percutaneous coronary intervention (ACE‐PCI): Mixed‐methods pilot randomized controlled trial

“…25 Sedentary behavior was high in this cohort (>9 h/day) and did not change over 3 weeks, similar to previous studies within the first 30 days post-ACS event. 10,28 Device measured sedentary behavior greater than 7.5 h/day is associated with an increased risk of allcause mortality. 29 Additionally, participants self-reported they were watching television > 3.5 h/day on average over the last 12 months.…”

“…To identify best practices and factors that may influence outcomes, international comparisons are useful to provide a broader perspective of health and healthcare 9 . Using the same methods, device‐measured PA was compared in Australia and Sweden approximately 3‐weeks post‐PCI 10 . Swedish PCI participants completed more moderate‐to‐vigorous physical activity (MVPA) than Australian participants.…”

Very brief intervention for physical activity behaviour change in cardiac rehabilitation: protocol for the ‘Measure It!’ effectiveness–implementation hybrid trial

“…To measure sedentary behaviour, the vector magnitude cut-point will be used (<150 cpm), categorising light physical activity as 150–2689 cpm 33 34 36 38. These cut-points have not been validated in CHD participants, although they have been used in prior research in this population 33 34 39. Both cut-points have been validated in younger, generally healthy participants37 38 and currently no cut-points are available for people with CHD.…”