Physical Activity Levels in Peripheral Artery Disease Patients

Abstract Background: Increases in daily physical activity levels is recommended for patients with peripheral artery disease (PAD). However, despite this recommendation, little is known about the physical activity patterns of PAD patients. Objective: To describe the physical activity patterns of patients with symptomatic peripheral artery (PAD) disease. Methods: This cross-sectional study included 174 PAD patients with intermittent claudication symptoms. Patients were submitted to clinical, hemodynamic and functional evaluations. Physical activity was objectively measured by an accelerometer, and the time spent in sedentary, low-light, high-light and moderate-vigorous physical activities (MVPA) were obtained. Descriptive analysis was performed to summarize patient data and binary logistic regression was used to test the crude and adjusted associations between adherence to physical activity recommendation and sociodemographic and clinical factors. For all the statistical analyses, significance was accepted at p < 0.05. Results: Patients spent in average of 640 ± 121 min/day, 269 ± 94 min/day, 36 ± 27 min/day and 15 ± 16 min/day in sedentary, low-light, high-light and MVPA, respectively. The prevalence of patients who achieved physical activity recommendations was 3.4%. After adjustment for confounders, a significant inverse association was observed between adherence to physical activity recommendation and age (OR = 0.925; p = 0.004), while time of disease, ankle brachial index and total walking distance were not associated with this adherence criteria (p > 0.05). Conclusion: The patterns of physical activity of PAD patients are characterized by a large amount of time spent in sedentary behaviors and a low engagement in MVPA. Younger patients, regardless of the clinical and functional factors, were more likely to meet the current physical activity recommendations.

研究背景：目前推荐外周动脉疾病（peripheral artery disease, PAD）患者提升日常体力活动水平。尽管有此类临床推荐，但学界对PAD患者的体力活动模式仍缺乏充分了解。研究目的：描述伴症状性外周动脉疾病（PAD）患者的体力活动模式。研究方法：本横断面研究纳入174名合并间歇性跛行症状的PAD患者，对所有受试者开展临床、血流动力学及功能评估。采用加速度计（accelerometer）客观测量患者的体力活动情况，获取其在久坐、轻强度、高强度及中高强度体力活动（moderate-vigorous physical activities, MVPA）中花费的时长。通过描述性分析汇总患者基线数据，并采用二元logistic回归检验体力活动推荐依从性与社会人口学及临床因素之间的粗关联与校正后关联。所有统计学分析均以p<0.05作为显著性判定阈值。结果：患者每日平均久坐、轻强度体力活动、高强度体力活动及中高强度体力活动的时长分别为640±121分钟、269±94分钟、36±27分钟及15±16分钟。符合体力活动推荐标准的患者占比为3.4%。在校正混杂因素后，体力活动推荐依从性与年龄呈显著负相关（优势比OR=0.925；p=0.004），而患病时长、踝肱指数（ankle brachial index）及总步行距离与该依从性标准无显著关联（p>0.05）。结论：PAD患者的体力活动模式以大量久坐行为与极低的中高强度体力活动参与度为典型特征。无论临床与功能状态如何，较年轻的患者更易达到当前的体力活动推荐标准。