Relation of sedentary behaviour to physical function in phase I cardiac rehabilitation

Abstract

Increased sedentary behaviour (SB) is reportedly associated with mortality and morbidity in cardiovascular disease. However, its relation with physical function is not well understood in phase I cardiac rehabilitation (CR). This study aimed to investigate the rate of SB and the relation between SB and physical function among patients participating in phase I CR. This prospective multicentre cohort study enrolled patients participating in CR from October 2020 to July 2022. Patients with probable dementia and difficulty walking alone were excluded. We used sitting SB time as the index of SB and the Short Performance Physical Battery (SPPB) as the index of physical function at discharge. Patients were divided into the low SB group (< 480 min/day) or high SB group (≥ 480 min/day). We analysed and compared the two groups. The final analysis included 353 patients (mean age: 69.6 years, male: 75.6%), of whom 47.6% (168 of 353) were high SB patients. Total sitting SB time was higher in the high SB group versus the low SB group (733.6 ± 155.3 vs 246.4 ± 127.4 min/day, p < 0.001), and mean SPPB score was lower in the high SB group versus the low SB group (10.5 ± 2.4 vs 11.2 ± 1.6 points, p = 0.001). Multiple regression analysis identified SB as an explanatory variable for total SPPB score (p = 0.017). Patients with high SB had significantly lower SPPB scores than those with low SB. These findings underscore the importance of considering SB when improving physical function. Effective strategies to improve physical function can be developed that consider SB in phase I CR.

Sedentary behaviour may cause differences in physical outcomes and activities of daily living in older cardiovascular disease patients participating in phase I cardiac rehabilitation

“…This prospective multicentre cohort study (The Kobe-Cardiac Rehabilitation project for people around the World: K-CREW) included patients from four affiliated hospitals with 200 to 580 beds that conduct phase I CR 28 . Included patients were those admitted to the affiliated hospitals from October 2020 to September 2023, hospitalized for a period of more than 5 days, and participated in phase I CR.…”

“…Comprehensive phase I CR was conducted following the guidelines of the Japanese Circulation Society for rehabilitation of patients with CVD 1 , 2 . Phase I CR started no later than three days after admission and cardiac surgery 1 , 2 , 28 . Exercise was performed 5 to 7 days per each week of CR at an intensity ranging from 11 to 13 on the Borg scale or just below the patient’s anaerobic metabolism threshold.…”

“…Exercise was performed 5 to 7 days per each week of CR at an intensity ranging from 11 to 13 on the Borg scale or just below the patient’s anaerobic metabolism threshold. Exercise times included 10 to 20 min for upper and lower body stretching, < 25 min for aerobic exercise including warm-up, aerobics, and cool-down exercises, and 10 to 20 min for resistance training according to previous reports 1 , 2 , 6 , 16 , 28 . Exercise training was adjusted according to each patient’s condition.…”

“…The older CVD patients were instructed about their disease, lifestyle choices, nutrition improvement, medications, and exercise by a medical doctor, nurse, registered dietitian, pharmacist, and physical or occupational therapists, respectively 1 , 2 , 6 , 16 , 28 .…”

“…Because SB is a crucial target that may predict improvements in cardiac knowledge gained from patient education programs administered in phase I and II CR 20 , 26 – 28 , assessment of SB, especially in patients with high SB, is essential in both CR phases. This approach ensures that patients better comprehend and consider the educational content they receive during CR.…”