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The Effect of Exercise-Based Cardiac Rehabilitation on Objectively Measured Physical Activity and Sedentary Behavior: A Systematic Review and Meta-analysis.

ABSTRACT: Objective: Adequate physical activity following cardiac rehabilitation (CR) is required to reduce secondary cardiovascular disease risk. The aim of this review and meta-analysis was to determine the effect of exercise-based CR on objectively measured physical activity (PA) and sedentary behavior (SB) comparing pre- to postintervention, pre- to postchange compared to a control group, and in a longer term follow-up. Methods: Five databases were searched (PubMed, MEDLINE [OVID], Scopus, SPORTDiscus, and CINAHL) from inception to January 2019. Two reviewers screened and selected 15 studies involving 1434 participants. Data were synthesized descriptively and by meta-analyses. Results: CR resulted in an improvement in activity behaviors compared with preintervention levels (standardized mean difference [SMD] 0.50, 95% CI 0.25-0.55, P < .0001). CR resulted in a greater improvement in activity behaviors in the intervention compared with the control group (SMD 0.25, 95% CI 0.02-0.49, P = .04). Increased PA was maintained (SMD 0.32, 95% CI 0.22-0.41, P < .0001). Eight out of 15 studies showed an improvement in PA outcomes while 7 reported that objectively measured PA did not change immediately following the intervention compared to preintervention levels and/or compared with the control group. Of the 7 studies that reported changes in SB, 4 observed a reduction following CR while 3 reported no change. Conclusion: Participation in exercise-based CR programs is effective in improving PA and SB. However, our descriptive synthesis indicates that only half the studies were successful in improving activity behaviors following exercise-based CR. Standard guidelines for the assessment of activity behaviors following CR would be valuable in understanding of the effects of CR on long-term activity participation.

SUBMITTER: Meiring RM

PROVIDER: S-EPMC7297483 | biostudies-literature | 2020 Jan-Dec

REPOSITORIES: biostudies-literature

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The Effect of Exercise-Based Cardiac Rehabilitation on Objectively Measured Physical Activity and Sedentary Behavior: A Systematic Review and Meta-analysis.

Meiring Rebecca Mary RM Tanimukai Kento K Bradnam Lynley L

Journal of primary care & community health 20200101

<b>Objective:</b> Adequate physical activity following cardiac rehabilitation (CR) is required to reduce secondary cardiovascular disease risk. The aim of this review and meta-analysis was to determine the effect of exercise-based CR on objectively measured physical activity (PA) and sedentary behavior (SB) comparing pre- to postintervention, pre- to postchange compared to a control group, and in a longer term follow-up. <b>Methods:</b> Five databases were searched (PubMed, MEDLINE [OVID], Scopu ...[more]

PMID: 32538312

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Project description:The recent prevalence of obesity in Japanese children is much higher compared to 1980. The present study compared daily sedentary behavior (SB) and physical activity (PA) between the school year and summer vacation in Japanese primary school children.Participants were 98 Japanese boys (8.9?±?1.8 years at baseline) and 111 girls (9.1?±?1.8 years). SB and PA were measured in May (school term) and July/August (summer vacation), 2011. SB and PA were assessed using a triaxial accelerometer (Active style Pro HJA-350IT, Omron Healthcare) for 7 consecutive days. The average number of minutes spent in SB (no more than 1.5 metabolic equivalents (METs)), light intensity activity (LPA; more than 1.5 to less than 3.0 METs) and moderate-to-vigorous physical activity (MVPA; 3.0 METs or more), and step counts were calculated for each individual. Moreover, the determinants/moderators of changes in SB and PA were examined.Daily SB was significantly higher in the summer vacation than in the school year for both boys and girls (p?<?0.05). Ambulatory and total LPA and MVPA, non-ambulatory LPA and step counts were lower in summer vacation in both genders (p?<?0.001). Moreover, non-ambulatory MVPA was significantly lower in the summer vacation than in the school year for girls (p?<?0.001). The decrease in non-ambulatory MVPA in boys and increase in SB in girls were significantly lower in those who participated in sports compared to those who did not (p?<?0.040 or p?<?0.033). The change in SB for boys was significantly associated with having a TV in the bedroom (p?<?0.022).These findings show that primary school children in Japan are less active in the summer vacation, as indicated by both higher SB and lower LPA and ambulatory MVPA in both genders. Moreover, the seasonal change in non-ambulatory MVPA for Japanese children was affected by gender. This study also suggests that sports participation and bedroom TV ownership may moderate seasonal changes in PA and SB. The results emphasize the need to take summer vacation into account when planning interventions aimed at decreasing SB or increasing PA in Japanese children.

Project description:ObjectiveThe aim of this study was to examine the associations between sedentary behavior and different intensities of physical activity with cardiometabolic risk, and to analyze the simultaneous effect of excess sedentary behavior and recommended levels of physical activity on cardiometabolic risk markers in older adults.MethodsWe conducted a population-based cross-sectional study on a sample of older adults (60+) living in Florianopolis, Brazil. The objectively measured predictors were sedentary time, light physical activity and moderate to vigorous physical activity, and the outcomes were markers of cardiometabolic risk. Data were considered valid when the participant had used the accelerometer for at least four days per week.ResultsThe sample included 425 older adults (59.8% women), with a mean age of 73.9 years (95%CI: 73.5-74.4). Sedentary behavior was associated with lower systolic blood pressure levels (? = -0.03; 95%CI: -0.05; -0.01) and lower HDL cholesterol (? = -0.02; 95%CI: -0.02; -0.01). Light physical activity was not associated with any cardiovascular risk markers after adjustment. Each minute spent in moderate to vigorous physical activity was associated with lower waist circumference (? = -0.15; 95%CI: -0.24; -0.05), systolic blood pressure (? = -0.18; 95%CI: -0.32; -0.04) and plasma glucose (? = -0.18; 95%CI: -0.33;-0.02), and with higher HDL cholesterol (? = 0.10; 95%CI: 0.01; 0.18). Moreover, physically inactive and sedentary individuals had a greater mean waist circumference and lower HDL cholesterol than physically active and non-sedentary subjects.ConclusionThe results suggest that moderate to vigorous physical activity have a positive impact on cardiometabolic risk markers in older adults. Light physical activity does not appear to have a beneficial effect on the cardiometabolic markers, and despite the benefits provided by the different intensities of physical activity, the simultaneous presence of sedentary behavior and low physical activity level was associated with poor cardiometabolic risk markers.

Project description:BACKGROUND:Sedentary behavior (SED) is a potential risk factor for poor pregnancy outcomes. We evaluated the validity of several common and one new method to assess SED across three trimesters of pregnancy. METHODS:This cohort study of pregnant women measured objective and self-reported SED each trimester via thigh-worn activPAL3 micro (criterion), waist-worn Actigraph GT3X, and self-report from the Pregnancy Physical Activity Questionnaire (PPAQ) and the de novo Sedentary Behavior Two Domain Questionnaire (SB2D). SED (hours per day) and percent time in SED (SED%) from activPAL were compared to GT3X, SB2D, and PPAQ using Pearson's r, ICC, Bland-Altman analysis, and comparison of criterion SED and SED% across tertiles of alternative methods. RESULTS:Fifty-eight women (mean age 31.5 ± 4.8 years; pre-pregnancy BMI 25.1 ± 5.6 kg/m2; 76% white) provided three trimesters of valid activPAL data. Compared to activPAL, GT3X had agreement ranging from r = 0.54-0.66 and ICC = 0.52-0.65. Bland-Altman plots revealed small mean differences and unpatterned errors, but wide limits of agreement (greater than ±2 h and ± 15%). The SB2D and PPAQ had r < 0.5 and ICC < 0.3 vs. activPAL SED, with lower agreement during the 2nd and 3rd trimesters, and performed poorly in Bland-Altman analyses. SED% from the modified SB2D performed best of the self-reported instruments with modest mean differences, r ranging from 0.55 to 0.60, and ICCs from 0.31-0.33; though, limits of agreement were greater than ±35%. Significant trends in activPAL SED were observed across increasing tertiles of SB2D SED in the 1st and 3rd trimesters (both p ≤ 0.001), but not the 2nd trimester (p = 0.425); and for PPAQ SED in the 1st and 2nd trimesters (both p < 0.05), but not the 3rd trimester (p = 0.158). AcitvPAL SED and SED% increased significantly across tertiles of GT3X SED and SED% as well as SB2D SED% (all p-for-trend ≤ 0.001). CONCLUSIONS:Compared to activPAL, waist-worn GT3X produced moderate agreement, though similar mean estimates of SED across pregnancy. Self-report questionnaires had large absolute error and wide limits of agreement for SED hr./day; SB2D measurement of SED% was the best self-report method. These data suggest activPAL be used to measure SED when possible, followed by GT3X, and - when necessary - SB2D assessing SED% in pregnancy. TRIAL REGISTRATION:www.clinicaltrials.gov NCT03084302 on 3/20/2017.

Project description:Patients after joint arthroplasty tend to be less physically active; however, studies measuring objective physical activity (PA) and sedentary behavior (SB) in these patients provide conflicting results. The aim of this meta-analysis was to assess objectively measured PA, SB and performance at periods up to and greater than 12 months after lower limb arthroplasty. Two electronic databases (PubMed and Medline) were searched to identify prospective and cross-sectional studies from 1 January 2000 to 31 December 2020. Studies including objectively measured SB, PA or specific performance tests in patients with knee or hip arthroplasty, were included in the analyses both pre- and post-operatively. The risk of bias was assessed using the Scottish Intercollegiate Guidelines Network (SIGN). After identification and exclusion, 35 studies were included. The data were analyzed using the inverse variance method with the random effects model and expressed as standardized mean difference and corresponding 95% confidence intervals. In total, we assessed 1943 subjects with a mean age of 64.9 (±5.85). Less than 3 months post-operative, studies showed no differences in PA, SB and performance. At 3 months post-operation, there was a significant increase in the 6 min walk test (6MWT) (SMD 0.65; CI: 0.48, 0.82). After 6 months, changes in moderate to vigorous physical activity (MVPA) (SMD 0.33; CI: 0.20, 0.46) and the number of steps (SMD 0.45; CI: 0.34, 0.54) with a large decrease in the timed-up-and-go test (SMD -0.61; CI: -0.94, -0.28) and increase in the 6MWT (SMD 0.62; CI: 0.26-0.98) were observed. Finally, a large increase in MVPA (SMD 0.70; CI: 0.53-0.87) and a moderate increase in step count (SMD 0.52; CI: 0.36, 0.69) were observed after 12 months. The comparison between patients and healthy individuals pre-operatively showed a very large difference in the number of steps (SMD -1.02; CI: -1.42, -0.62), but not at 12 months (SMD -0.75; -1.89, 0.38). Three to six months after knee or hip arthroplasty, functional performance already exceeded pre-operative levels, yet PA levels from this time period remained the same. Although PA and functional performance seemed to fully restore and exceed the pre-operation levels at six to nine months, SB did not. Moreover, PA remained lower compared to healthy individuals even longer than twelve months post-operation. Novel rehabilitation protocols and studies should focus on the effects of long-term behavioral changes (increasing PA and reducing SB) as soon as functional performance is restored.

Dataset Information

The Effect of Exercise-Based Cardiac Rehabilitation on Objectively Measured Physical Activity and Sedentary Behavior: A Systematic Review and Meta-analysis.

Publications

The Effect of Exercise-Based Cardiac Rehabilitation on Objectively Measured Physical Activity and Sedentary Behavior: A Systematic Review and Meta-analysis.

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