Walking activity during ambulant cardiac rehabilitation is related to maximum working capacity, age, and smoking behavior

Abstract

BackgroundA total of 6,500 to 8,000 steps per day are recommended for cardiovascular secondary prevention. The aim of this research was to examine how many steps per day patients achieve during ambulant cardiac rehabilitation (CR), and if there is a correlation between the number of steps and physical and cardiological parameters.MethodsIn all, 192 stable CR patients were included and advised for sealed pedometry. The assessed parameters included maximum working capacity and heart rate, body mass index (BMI), New York Heart Association (NYHA) class, ejection fraction (EF), coronary artery disease status, beta-blocker medication, age, sex, smoking behavior, and laboratory parameters. A regularized regression approach called least absolute shrinkage and selection operator (LASSO) was used to detect a small set of explanatory variables associated with the response for steps per day. Based on these selected covariates, a sparse additive regression model was fitted.ResultsThe model noted that steps per day had a strong positive correlation with maximum working capacity (P=0.001), a significant negative correlation with higher age (P=0.01) and smoking (smoker: P<0.05; ex-smoker: P=0.01), a positive correlation with high-density lipoprotein (HDL), and a negative correlation with beta-blockers. Correlation between BMI and walking activity was nonlinear (BMI 18.5–24: 7,427±2,730 steps per day; BMI 25–29: 6,448±2,393 steps/day; BMI 30–34: 6,751±2,393 steps per day; BMI 35–39: 5,163±2,574; BMI >40: 6,077±1,567).ConclusionWalking activity during CR is reduced in patients who are unfit, older, smoke, or used to smoke. In addition to training recommendations, estimated steps per day during CR could be seen as a baseline orientation that helps patients to stay generally active or even to increase activity after CR.

Power walking based outpatient cardiac rehabilitation in patients with post‐coronary angioplasty: Randomized control trial

“…(2011) reported 34% improvement in LVEF after 12 weeks CR where additional threshold for improvement brought by long intervention and unpreserved ejection fraction. Similar to our results, the use of pedometers and nordic walking similar to power walking had enhanced the clinical outcomes in ambulant CR (Al Najem et al., 2018; Nagyova et al., 2020).…”

“…Cardiac patients feel motivated, self‐directed while using pedometer and positive correlation between number of steps and improved work capacity (WC) were also reported (Thorup, Gronkjær, et al., 2016; Al Najem et al., 2018). It was evident that standard CR with additional walking significantly improved HQoL, FEC, peak VO 2 and maximal power output as compared to standard programs in patients with heart surgery (Eder et al., 2010).…”