Clinical ResearchVolume and Patterns of Physical Activity Across the Health and Heart Failure Continuum
Section snippets
Study design
This was a cross-sectional observational study. The sample size was determined on the basis of a power of 0.80, and an α of 0.05 using Cohen d of 0.867 (f = 0.4335) for daily energy expenditure (EE) between patients with HF and healthy control participants.12 A total sample size of 55 was calculated. However, because this was a substudy of the larger Alberta Heart Failure Etiology and Analysis Research Team (HEART) research program,13 (a prospective observational cohort study aimed to define
Results
One hundred fifty-one participants (median age 72 [IQR, 64-78] years, 46% female) were recruited. Data from 6 participants were removed from analysis because of their inability to comply with the minimum required SWA recording time. Participants wore the SWA for a median 4 [IQR, 3-4] days and median 23.8 [IQR, 23.4-23.9] h/d. Age, sex, BMI, and sleeping time were significantly different across groups (Table 1) and therefore considered as covariates to be controlled in the model. Because LVEF is
Discussion
To the best of our knowledge this is the first study to compare PA in healthy, at risk for HF, and patients with HFREF and HFPEF. The major new findings are: (1) steps per day was the most robust activity outcome to evaluate daily PA in this population; (2) patients with HFPEF completed the lowest volume of daily PA defined as time in light and MVPA; (3) the only significant difference between HFPEF and HFREF was the time spent at bouts of MVPA.
Step count is a common method to assess PA in
Conclusions
In the present study step count was the most robust outcome in evaluating daily PA. By monitoring daily PA we determined that patients with HF appear to be habitually sedentary, and those with HFPEF did virtually no continuous MVPA. Although PA guidelines for HF patients typically recommend at least 30 minutes of moderate-intensity PA on most days of the week, our findings suggest that a more realistic initial goal for patient with HF would be to focus on reducing sedentary time and encouraging
Funding Sources
Milad Yavari received a Supporting Training Encompassing All in Diastolic Heart Failure (STEADI HF) award and Alberta Innovates Health Solutions (AIHS) has funded Alberta HEART.
Disclosures
The authors have no conflicts of interest to disclose.
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Cited by (16)
Accelerometer-assessed physical behavior and the association with clinical outcomes in implantable cardioverter-defibrillator recipients: A systematic review
2022, Cardiovascular Digital Health JournalCitation Excerpt :Compared to HF patients, ICD carriers walked more steps per day and reached a higher peak performance (a daily average of the highest step rate values).47 Apart from the study by Witham and colleagues,48 there was a significant difference in daily total step count and time spent in moderate-to-vigorous physical activity (MVPA) across NYHA class groups49–51 and a correlation between step count and LVEF was seen.52 Five studies demonstrated that sleep behavior and PA were associated with patient-reported physical function, quality of life, and cognitive function.49,52–55
Dynamic factor analysis of seasonal variation in daily physical activity in individuals with heart failure and implanted cardiac devices
2021, Heart and LungCitation Excerpt :In individuals with heart failure (HF), daily physical activity (PA) is associated with many important clinical endpoints including actual and predicted mortality risk,1–4 aerobic capacity,1 health-related quality of life,5–7 sympathetic nervous system activity,8,9 hospitalization10–13 and ability to participate in activities of daily living.5–7
Physical Functioning in Heart Failure With Preserved Ejection Fraction
2021, Journal of Cardiac FailureCitation Excerpt :As such, more studies are needed to assess the variables that affect PA and its reproducibility. Compared with healthy controls, patients with HFpEF have decreased accelerometer-assessed daily PA, and differences may also exist compared with HFrEF.60 One potential explanation, as mentioned elsewhere in this article, relates to relative challenges with the HFpEF diagnosis as compared with HFrEF.61,62
Physical activity for patients with heart failure: Position paper from the heart failure (GICC) and cardiac rehabilitation (GERS-P) Working Groups of the French Society of Cardiology
2019, Archives of Cardiovascular DiseasesCitation Excerpt :This highlights the need for patient-centred ET programmes, and the importance of encouraging adherence [30,31]. The beneficial effects of ET are present regardless of the level of left ventricular ejection fraction [1,32–37], and are correlated with patient compliance [13,38] and ET intensity [39]. Adherence is essential, as the beneficial effects of ET disappear a few weeks after stopping the training [40].
Failing at Heart Failure Therapies: Are Health Behaviours to Blame?
2017, Canadian Journal of Cardiology
See editorial by Stone et al., pages 1462–1464 of this issue.
See page 1470 for disclosure information.
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Jason R.B. Dyck, PhD is a member of the Alberta Heart Failure Etiology and Analysis Research Team, Alberta Innovates Health Solutions Interdisciplinary Team, Alberta, Canada.