Objectively measured preoperative physical activity and sedentary behaviour among patients scheduled for elective cardiac procedures

Abstract

Preoperative physical activity (PA) and sedentary behaviour (SB) were investigated in patients scheduled for elective cardiac procedure and compared with population-based sample of Finnish adults. Cardiac patients (n=139) undergoing cardiac operation carried a triaxial acceletometer for seven days during the month prior to the procedure. Patients were categorised into four groups according to the procedure: percutaneous coronary intervention or coronary angiography (PCI-CA), coronary artery bypass grafting (CABG), aortic valve replacement (AVR) and mitral valve surgery (MVS). The raw accelerometer data was analyzed with specific algorithms to determine metabolic equivalents (METs, 3.5 mL/kg/min of oxygen consumption) and further divide the intensity of PA into two categories: light (LPA, 1.5-2.9 METs) and moderate-to-vigorous (MVPA, ≥3.0 METs). SB and PA were determined as daily means and accumulation from different bout lengths. Daily standing, steps and mean and peak MET-values were calculated. The results were compared between the patient groups and against the control group from a population-based study FinFit2017. Cardiac patients had fewer steps daily than the control population (p=0.01), and less SB accumulating from <20 min bouts (p=0.002) but more from 20-60 min bouts (p=0.002). Particularly, CABG group had less daily MVPA (p=0.002) and MVPA accumulating from >10 min bouts (p<0.001) than the control population. There were large differences in PA and SB between the patient groups and the control group, CABG group having the worst activity profile. Also, the variation within the patient groups was wide, which should be considered to individualise the rehabilitation program postoperatively.