Objectively measured preoperative physical activity and sedentary behaviour among Finnish patients scheduled for elective cardiac procedures: baseline results from randomized controlled trial

Abstract

Background We investigated preoperative physical activity (PA) and sedentary behaviour (SB) in patients scheduled for elective cardiac procedures and compared them with population-based sample of Finnish adults. Methods Cardiac patients (n = 139) undergoing cardiac operations carried a triaxial accelerometer for seven days during the month before the procedure. Patients were categorised into four groups according to the procedure: percutaneous coronary intervention or coronary angiography (PCI-CA), coronary artery bypass grafting (CABG), aortic valve replacement (AVR) and mitral valve surgery (MVS). The raw accelerometer data was analyzed with dedicated algorithms to determine metabolic equivalents (METs, 3.5 mL/kg/min of oxygen consumption) of PA. The intensity of PA was divided into two categories: light (LPA, 1.5–2.9 METs) and moderate-to-vigorous (MVPA, ≥ 3.0 METs), while SB represented intensity < 1.5 MET without movements. SB and PA were described as daily means and accumulation from different bout lengths. Daily standing, steps and mean and peak MET-values were calculated. The results were compared between the patient groups and against the reference group from a population-based study FinFit2017. Results Cardiac patients had fewer daily steps than the FinFit population (p = 0.01), and less SB accumulating from < 20 min bouts (p = 0.002) but more from 20 to 60 min bouts (p = 0.002). Particularly, CABG group had less daily MVPA (p = 0.002) and MVPA accumulating from > 10 min bouts (p < 0.001) than the FinFit population. Conclusions We found large differences in PA and SB between the patient groups and the FitFit population, CABG group having the worst activity profile. Also, the variation within the patient groups was wide, which should be considered to individualise the rehabilitation programs postoperatively. Trial registration clinicaltrials.gov (NCT03470246). Registered 19 March 2018, https://clinicaltrials.gov/ct2/show/NCT03470246.

Elective Cardiac Procedure Patients Have Low Preoperative Cardiorespiratory Fitness

“…Further, the cardiac patients accumulated more minutes of MVPA from bouts lasting < 5 min than from longer 5-10 min or > 10 min bouts [22]. These findings may indicate that the shortest bouts of MVPA are of crucial importance in cardiac patients [22]. Accordingly, only the most recent guidelines of PA have stated that also PA lasting < 10 min is associated with health benefits [37], while the previous recommendations used the threshold of 10 min for PA sessions beneficial for health [38].…”

“…In addition, correlations between 6MWT distance and different parameters of previously reported accelerometer-measured PA and SB of the patients were calculated for the first time in these cardiac patients using measured values of both fitness and activity with a great number of participants. [22]…”

“…Further, the cardiac patients accumulated more minutes of MVPA from bouts lasting <5 min than from longer 5-10 min or >10 min bouts. [22] These findings may indicate that the shortest This article is protected by copyright. All rights reserved.…”

“…bouts of MVPA are of crucial importance in cardiac patients. [22] Accordingly, only the most recent guidelines of PA have stated that also PA lasting <10 min is associated with health benefits [37], while the previous recommendations used the threshold of 10 min for PA sessions beneficial for health. [38] Another interesting finding was the surprisingly strong correlation of the mean daily accumulated time of SB bouts lasting 20-60 min with 6MWT compared to other SB bout lengths.…”

“…In a previous study of PACO trial, we found that regarding different SB bout lengths, 20-60 min was also the one with most variation between patient groups, even though <20 min bouts accumulated longer mean time of SB. [22] Therefore, especially these 20-60 min bouts of SB could be potentially targeted with interventions, which could have a positive effect on both cardiorespiratory fitness and even postoperative recovery.…”