scholarly journals Sustaining Physical Activity Following Cardiac Rehabilitation Discharge

2021 ◽  
Author(s):  
Kelly R. Evenson ◽  
Ty A. Ridenour ◽  
Jacqueline Bagwell ◽  
Robert D. Furberg
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Mixed Model ◽  
Final Report ◽  
Activity Tracking ◽  
Intervention Effect ◽  
Activity Tracker ◽  
History Information ◽  
Rigorous Study ◽  
Model Trajectory

Because many patients reduce exercise following outpatient cardiac rehabilitation (CR), we developed an intervention to assist with the transition and evaluated its feasibility and preliminary efficacy using a one-group pretest–posttest design. Five CR patients were enrolled ~1 month prior to CR discharge and provided an activity tracker. Each week during CR they received a summary of their physical activity and steps. Following CR discharge, participants received an individualized report that included their physical activity and step history, information on specific features of the activity tracker, and encouraging messages from former CR patients for each of the next 6 weeks. Mixed model trajectory analyses were used to test the intervention effect separately for active minutes and steps modeling three study phases: pre-intervention (day activity tracking began to CR discharge), intervention (day following CR discharge to day when final report sent), and maintenance (day following the final report to ~1 month later). Activity tracking was successfully deployed and, with weekly reports following CR, may offset the usual decline in physical activity. When weekly reports ceased, a decline in steps/day occurred. A scaled-up intervention with a more rigorous study design with sufficient sample size can evaluate this approach further.

The Impact of a 12-Month Activity Tracker Intervention on Activity Behavior Across Body Mass Index Subgroups Among Recent Retirees: Post Hoc Analysis of a Randomized Controlled Trial

2021 ◽  
pp. 1-7
Author(s):  
Miika Tuominen ◽  
Kristin Suorsa ◽  
Jaana Pentti ◽  
Pasi Koski ◽  
Sari Stenholm ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Body Mass ◽  
Intervention Group ◽  
Intervention Effect ◽  
Post Hoc Analysis ◽  
Activity Tracker ◽  
Activity Behavior ◽  
Post Hoc ◽  
The Impact

Background: This study examined the effectiveness of a 12-month activity tracker-based intervention on activity behavior among recent retirees (Enhancing physical ACTivity and healthy aging among recent REtirees [REACT]) in subgroups based on body mass index. Methods: REACT trial randomized 231 participants (mean age 65.2) into intervention and control groups. Main outcomes were accelerometer-measured moderate-to-vigorous (MVPA) and light physical activity (LPA) and sedentary time (SED) measured at baseline and 3-, 6-, and 12-month follow-ups. As a post hoc analysis, the intervention effect was examined among participants with normal weight (n = 77), overweight (n = 89), and obesity (n = 61). Results: An intervention effect was observed among participants with obesity in LPA (time × group P = .045) mirrored by a similar, albeit nonsignificant, effect in SED (P = .067), but not in MVPA (P = .92). A transient increase of 41 minutes per day (95% confidence interval, 14 to 68) in LPA was observed at 6 months among the intervention group, with a concomitant decrease of 42 minutes per day (−72 to −12) in SED. However, these changes were not maintained at 12 months. No between-group differences in changes over time were observed among participants with normal or overweight. Conclusions: Activity trackers may be particularly suitable for promoting changes in LPA and SED among older adults with obesity. However, their long-term effectiveness might be limited.

scholarly journals Measuring Daily Compliance with Physical Activity Tracking in Ambulatory Surgery Patients: Comparative Analysis of Five Compliance Criteria (Preprint)

2020 ◽  
Author(s):  
Ryan Kelly ◽  
Simon Jones ◽  
Blaine Price ◽  
Dmitri Katz ◽  
Ciaran McCormick ◽  
...  
Keyword(s):  
Physical Activity ◽  
Ambulatory Surgery ◽  
Time Windows ◽  
Perioperative Period ◽  
Activity Tracking ◽  
Activity Data ◽  
Temporary Reduction ◽  
Individual Level ◽  
Activity Tracker ◽  
Post Surgery

BACKGROUND Physical activity trackers such as the Fitbit can allow clinicians to monitor the recovery of their patients following surgery. An important issue when analysing activity tracker data is to determine patients’ daily compliance with wearing their assigned device, using an appropriate criterion to determine a valid day of wear. However, it is currently unclear as to how different criteria can affect the reported compliance of patients recovering from ambulatory surgery. Investigating this issue can help to inform the use of activity data by revealing factors that may impact compliance calculations. OBJECTIVE This study aimed to understand how using different criteria can affect the reported compliance with activity tracking in ambulatory surgery patients. It also aimed to investigate factors that explain variation between the outcomes of different compliance criteria. METHODS 62 patients who were scheduled to undergo total knee arthroplasty (TKA) volunteered to wear a commercial Fitbit Zip activity tracker over an 8-week perioperative period. Patients were asked to wear the Fitbit Zip daily, beginning 2 weeks prior to their surgery and ending 6 weeks post-surgery. Of the 62 patients who enrolled in the study, 20 provided Fitbit data and underwent successful surgery. The Fitbit data was analysed using five different daily compliance criteria, which consider patients as compliant with daily tracking if they either: register >0 steps in a day; register >500 steps in a day; register at least one step in 10 different hours of the day; register >0 steps in 3 distinct time windows; or register >0 steps in 3 out of 4 six-hour time windows. The criteria were compared in terms of compliance outcomes produced for each patient. Data was explored using heatmaps and line graphs. Linear mixed models were used to identify factors that lead to variation between compliance outcomes across the sample. RESULTS The five compliance criteria produce different outcomes when applied to the patients’ data, with an average 24% difference in reported compliance between the most lenient and strictest criteria. However, the extent to which each patient’s reported compliance was impacted by different criteria was not uniform. Some individuals were relatively unaffected, whereas others varied by up to 72%. Wearing the activity tracker as a clip-on device, rather than on the wrist, was associated with greater differences between compliance outcomes at the individual level (p = .004, r = 0.616). This effect was statistically significant in the first two weeks after surgery. There was also a small but significant main effect of age on compliance in the first two weeks after surgery. Gender and BMI were not associated with differences in individual compliance outcomes. Finally, the analysis revealed that surgery has an impact on patients’ compliance, with noticeable reductions in activity following surgery. These reductions affect compliance calculations by discarding greater amounts of data under strict criteria. CONCLUSIONS This study suggests that different compliance criteria cannot be used interchangeably to analyse activity data provided by TKA patients. Surgery leads to a temporary reduction in patients’ mobility, which affects their reported compliance when strict thresholds are used. Reductions in mobility suggest that the use of lenient compliance criteria, such as >0 Steps or windowed approaches, can avoid unnecessary data exclusion over the perioperative period. Encouraging patients to wear the device at their wrist may improve data quality by increasing the likelihood of patients wearing their tracker and ensuring that activity is registered in the two weeks after surgery. CLINICALTRIAL

Abstract P276: Activity Tracker Increases Daily Step Count Post-Cardiac Rehabilitation Compared to Placebo Device

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Erica Schorr ◽  
Hilton Dahl ◽  
Alicia Sarkinen ◽  
Rebecca Brown
Keyword(s):  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Intervention Group ◽  
Step Count ◽  
Daily Step ◽  
Activity Tracking ◽  
Activity Tracker ◽  
Daily Step Count ◽  
Tracking Devices

Introduction: Despite optimal levels of physical activity (PA) among patients immediately post-cardiac rehabilitation, little is known about PA levels long-term. Further, interventions to maintain recommended PA levels and functional capacity achieved during cardiac rehabilitation are lacking. Objective: To test the effect of wearing a Garmin vÍvofit for 3 months post-cardiac rehabilitation on PA levels and functional capacity compared to a placebo device. Methods: Change in daily step count and 6-minute walk test (6MWT) were assessed over 3 months using the vÍvofit activity tracker in 35 patients (mean age 62±8 years; 83% male; 94% Caucasian) post-cardiac rehabilitation. Goal was 10,000 steps for all participants. Patients were randomized into the control or intervention group with control devices displaying a digital clock. VÍvofit step data were recorded continuously; the 6MWT was conducted at 0, 9, 12, and 15 weeks. Comparisons between the 2 groups were made using test of proportions, t-test, and logistic and linear regression. Results: Control and intervention groups were balanced with respect to age, gender, education, baseline step count, and body composition. Although all participants exhibited above average daily step counts (>8,000 steps at 3, 9, and 15 weeks); step counts for intervention group participants were higher at 3, 9, and 15 weeks (by 2,537 steps, 2,022 steps, and 1,545 steps, respectively). Intervention group participants (N=17) increased the distance covered during the 6MWT by 138 feet (sd=28), compared to a 48 foot (sd=18) improvement among control group participants (p=0.500); although not statistically significant, but perhaps clinically relevant. Conclusion: These data provide preliminary support for using wrist-worn activity tracking devices to continuously monitor and maintain PA levels post-cardiac rehabilitation. There is a need for larger trials testing the effectiveness of these devices with a more diverse sample over a longer period of time. Wrist worn activity tracking devices should be coupled with other components known to support long-term behavior change (e.g., social support and text messaging) to develop effective interventions for secondary cardiovascular disease prevention.

scholarly journals Use of Wearable Activity Tracker in Patients With Cancer Undergoing Chemotherapy: Toward Evaluating Risk of Unplanned Health Care Encounters

2020 ◽  
pp. 839-853
Author(s):  
Tanachat Nilanon ◽  
Luciano P. Nocera ◽  
Alexander S. Martin ◽  
Anand Kolatkar ◽  
Marcella May ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Exploratory Analysis ◽  
Activity Tracking ◽  
Patients With Cancer ◽  
Activity Tracker ◽  
Activity Measurements ◽  
Health Care Encounters ◽  
Wearable Activity Tracker ◽  
Tracking Period

PURPOSE Unplanned health care encounters (UHEs) such as emergency room visits can occur commonly during cancer chemotherapy treatments. Patients at an increased risk of UHEs are typically identified by clinicians using performance status (PS) assessments based on a descriptive scale, such as the Eastern Cooperative Oncology Group (ECOG) scale. Such assessments can be bias prone, resulting in PS score disagreements between assessors. We therefore propose to evaluate PS using physical activity measurements (eg, energy expenditure) from wearable activity trackers. Specifically, we examined the feasibility of using a wristband (band) and a smartphone app for PS assessments. METHODS We conducted an observational study on a cohort of patients with solid tumor receiving highly emetogenic chemotherapy. Patients were instructed to wear the band for a 60-day activity-tracking period. During clinic visits, we obtained ECOG scores assessed by physicians, coordinators, and patients themselves. UHEs occurring during the activity-tracking period plus a 90-day follow-up period were later compiled. We defined our primary outcome as the percentage of patients adherent to band-wear ≥ 80% of 10 am to 8 pm for ≥ 80% of the activity-tracking period. In an exploratory analysis, we computed hourly metabolic equivalent of task (MET) and counted 10 am to 8 pm hours with > 1.5 METs as nonsedentary physical activity hours. RESULTS Forty-one patients completed the study (56.1% female; 61.0% age 40-60 years); 68% were adherent to band-wear. ECOG score disagreement between assessors ranged from 35.3% to 50.0%. In our exploratory analysis, lower average METs and nonsedentary hours, but not higher ECOG scores, were associated with higher 150-day UHEs. CONCLUSION The use of a wearable activity tracker is generally feasible in a similar population of patients with cancer. A larger randomized controlled trial should be conducted to confirm the association between lower nonsedentary hours and higher UHEs.

Barriers of physical activity (kinesiophobia) in patients subjected to cardiac rehabilitation

2014 ◽  
Vol 6 (4) ◽  
Author(s):  
Janusz Kocjan ◽  
Andrzej Knapik
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Short Form ◽  
Social Activity ◽  
Self Assessment ◽  
Rehabilitation Process ◽  
Sf 36 ◽  
Polish Version ◽  
High Level ◽  
The Relationship

AbstractBackground: Comprehensive cardiac rehabilitation (CR) is a process designed to restore full physical, psychological and social activity and to reduce cardiovascular risk factors. Fear of movement may contribute to the occurrence and intensification of hypokinesia, and consequently affect the effectiveness of therapy. The aim of the study was to determine the level of barriers of physical activity in patients undergoing cardiac rehabilitation. The relationship between selected determinants (age and health selfassessment) and the kinesiophobia level were also examined.Material/Methods: 115 people aged 40-84 years were examined: 50 females (x = 63.46; SD = 11.19) and 65 males (x = 64.65; SD = 10.59) - patients undergoing cardiac rehabilitation at the Upper-Silesian Medical Centre in Katowice. In the present study, the Polish version of questionnaires: Kinesiophobia Causes Scale (KCS) and Short Form Health Survey (SF-36) were used. Questionnaires were supplemented by authors’ short survey.Results: The patients presented an elevated level of kinesiophobia, both in general as well as in individual components. In women, the kinesiophobia level was higher than in men. The psychological domain was a greater barrier of physical activity than the biological one. Strong, negative correlations of psychological and biological domains of kinesiophobia to physical functioning (SF-36) were noted in women. In the case of men, correlations were weaker, but also statistically significant.Conclusions: 1. Sex differentiates patients in their kinesiophobia level 2. Poor self-assessment of health is associated with a greater intensification of kinesiophobia 3. A high level of kinesiophobia may negatively affect cardiac rehabilitation process

Effectiveness of mHealth Interventions on Physical Activity and Physical Fitness in Outpatient and Home-Based Cardiac Rehabilitation Programs: A Systematic Review (Preprint)

2019 ◽  
Author(s):  
Sheeba Nadarajah ◽  
Susan Buchholz ◽  
Kristen Dickins
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Physical Fitness ◽  
Cardiac Rehabilitation ◽  
Text Messaging ◽  
English Language ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
Mixed Effect ◽  
Home Based

BACKGROUND Globally, cardiovascular disease is the leading cause of death. Cardiovascular mortality can be decreased by participation in cardiac rehabilitation. Researchers are exploring the use of mHealth technology in cardiac rehabilitation. OBJECTIVE The aim of this systematic review is to examine the effectiveness of randomized controlled trials that use a mHealth intervention as a part of an outpatient and/or home-based cardiac rehabilitation program on improving physical activity and physical fitness outcomes. METHODS For this systematic review, mHealth interventions were limited to text messaging, mobile apps, and use of a mobile phone network for data transmission, used to deliver cardiac rehabilitation program. Using six databases, the search strategy included published English language studies through 2016. Data was extracted independently by two reviewers, and then synthesized. RESULTS The initial search yielded 149 articles, of which 15 articles that represented nine studies met inclusion criteria. Articles were published from 2010 to 2016 and came from two continents. The majority (84%) of participants were male. Generally, the participant mean age was late 50s to early 60s. Text messaging was the most frequently used intervention. The results of the physical activity and physical fitness findings were mixed. Effect sizes for intervention as measured by the 6-minute walk test ranged from 0.46 to 0.58 and peak VO2 ranged from 0.03 to 1.35. CONCLUSIONS Globally, use of mHealth in outpatient and/or home-based cardiac rehabilitation is being studied with greater attention. However, these studies are limited by geography, gender, and age. Therefore, further research in the area of cardiac rehabilitation and mHealth is recommended, especially in developing countries, among women, and older adults.

Efficacy of an activity tracker-and app intervention to increase physical activity in the entire family: Pilot single-arm intervention study (Preprint)

2019 ◽  
Author(s):  
Stephanie Schoeppe ◽  
Jo Salmon ◽  
Susan L. Williams ◽  
Deborah Power ◽  
Stephanie Alley ◽  
...  
Keyword(s):  
Physical Activity ◽  
Intervention Study ◽  
Post Intervention ◽  
Entire Family ◽  
Physical Activity Guidelines ◽  
Mothers And Fathers ◽  
Activity Tracker ◽  
Activity Trackers ◽  
Family Program ◽  
Intervention Efficacy

BACKGROUND Interventions using activity trackers and smartphone apps have demonstrated their ability to increase physical activity in children and adults. However, they have not been tested in entire families. Further, few family-centred interventions have actively involved both parents, and assessed intervention efficacy separately for children, mothers and fathers. OBJECTIVE This study aimed to examine the short-term efficacy of an activity tracker and app intervention to increase physical activity in the entire family (children, mothers and fathers). METHODS This was a pilot single-arm intervention study with pre-post measures. Between 2017-2018, 40 families (58 children aged 6-10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family program in Queensland, Australia. Using commercial activity trackers combined with apps (Garmin Vivofit Jr for children, Vivofit 3 for adults), the intervention included individual and family-level goal-setting, self-monitoring, performance feedback, family step challenges, family social support and modelling, weekly motivational text messages, and an introductory session delivered face-to-face or via telephone. Parent surveys were used to assess intervention efficacy measured as pre-post intervention changes in moderate-to-vigorous physical activity (MVPA) in children, mothers and fathers. RESULTS Thirty-eight families completed the post intervention survey (95% retention). At post intervention, MVPA had increased in children by 58 min/day (boys: 54 min/day, girls: 62 min/day; all P < .001). In mothers, MVPA increased by 27 min/day (P < .001), and in fathers, it increased by 31 min/day (P < .001). Furthermore, the percentage of children meeting Australia’s physical activity guidelines for children (≥60 MVPA min/day) increased from 34% to 89% (P < .001). The percentage of mothers and fathers meeting Australia’s physical activity guidelines for adults (≥150 MVPA min/week) increased from 8% to 57% (P < .001) in mothers, and from 21% to 68% (P < .001) in fathers. CONCLUSIONS Findings suggest that an activity tracker and app intervention is an efficacious approach to increasing physical activity in entire families to meet national physical activity guidelines. The Step it Up Family program warrants further testing in a larger, randomised controlled trial to determine its long-term impact. CLINICALTRIAL No trial registration as this is not an RCT. It is a pilot single-arm intervention study

Designing for Dissemination in Chronic Disease Prevention and Management

2017 ◽  
Author(s):  
Neville Owen ◽  
Ana Goode ◽  
Takemi Sugiyama ◽  
Mohammad Javad Koohsari ◽  
Genevieve Healy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Disease ◽  
Cost Effectiveness ◽  
Health Behavior Change ◽  
The Other ◽  
Research Quality ◽  
Policy Initiatives ◽  
Rigorous Study ◽  
Behavior Change Program

This chapter emphasizes the need for research that is designed and implemented explicitly with dissemination in mind. This is illustrated in relation to environmental and policy initiatives to influence physical activity through active transport, and through the example of initiatives to reduce workplace sitting. The other element of this chapter, the broad-reach intervention-dissemination case study of a health behavior-change program, highlights the need to maintain key elements of research quality in designing for dissemination, to the extent that is practically possible: a rigorous study design; the systematic tracking of implementation and related costs; and, the conduct of dose-response, maintenance and cost-effectiveness analyses. These examples of designing for dissemination illustrate not only the exciting opportunities for real-world dissemination research, but also the resourcefulness and commitment required for success.

scholarly journals Effectiveness of Text Messaging as an Incentive to Maintain Physical Activity after Cardiac Rehabilitation: A Randomized Controlled Pilot Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6645
Author(s):  
Giulia Foccardi ◽  
Marco Vecchiato ◽  
Daniel Neunhaeuserer ◽  
Michele Mezzaro ◽  
Giulia Quinto ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Exercise Testing ◽  
Text Messages ◽  
Control Group ◽  
Stand Test ◽  
Randomized Controlled ◽  
Sit To Stand ◽  
Significant Difference

Although the efficacy of cardiac rehabilitation (CR) is proven, the need to improve patients’ adherence has emerged. There are only a few studies that have investigated the effect of sending text messages after a CR period to stimulate subjects’ ongoing engagement in regular physical activity (PA). A randomized controlled pilot trial was conducted after CR, sending a daily PA text message reminder to an intervention group (IG), which was compared with a usual care control group (CG) during three months of follow-up. Thirty-two subjects were assessed pre- and post-study intervention with GPAQ, submaximal iso-watt exercise testing, a 30 s sit-to-stand test, a bilateral arm curl test, and a final survey on a seven-point Likert scale. A statistically significant difference in the increase of moderate PA time (Δ 244.7 (95% CI 189.1, 300.4) minutes, p < 0.001) and in the reduction of sedentary behavior time (Δ −77.5 (95% CI 104.9, −50.1) minutes, p = 0.004) was shown when the IG was compared with the CG. This was associated with an improvement in heart rate, blood pressure, and patients’ Borg rating on the category ratio scale 10 (CR10) in iso-watt exercise testing (all p < 0.05). Furthermore, only the IG did not show a worsening of the strength parameters in the follow-up leading to a change of the 30 s sit-to-stand test with a difference of +2.2 (95% CI 1.23, 3.17) repetitions compared to CG (p = 0.03). The telemedical intervention has been appreciated by the IG, whose willingness to continue with regular PA emerged to be superior compared to the CG. Text messages are an effective and inexpensive adjuvant after phase 2 CR that improves adherence to regular PA. Further studies are needed to confirm these results in a larger patient population and in the long term.

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