Annika Bay1, Mikael Dellborg2, Malin Berghammer3, Camilla Sandberg4, Gunnar Engström5, Philip Moons6, Bengt Johansson7. 1. Department of Public Health and Clinical Medicine, Umeå University, Sweden; Department of Nursing, Umeå University, Sweden. Electronic address: annika.bay@umu.se. 2. Institute of Medicine, The Sahlgrenska Academy, Gothenburg University, Sweden. 3. Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden; Department of Health Science, University West, Trollhättan, Sweden. 4. Department of Public Health and Clinical Medicine, Umeå University, Sweden; Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Sweden. 5. Department of Surgical and Perioperative Science, Cardiothoracic Surgery Division, Umeå University. 6. KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Belgium; Institute of Health and Care Sciences, University of Gothenburg, Sweden. 7. Department of Public Health and Clinical Medicine, Umeå University, Sweden.
Abstract
BACKGROUND: In general, adults with congenital heart disease (CHD) have impaired exercise capacity, and approximately 50% do not reach current recommendations on physical activity. Herein we analysed factors associated with physical activity level (PAL) in adults with CHD by using patient-reported outcomes (PRO). METHODS: Patients with CHD (n=471) were randomly selected from the national register on CHD and categorized according to complexity of lesions - simple (n=172, 39.1±14.6years), moderate (n=212, 39±14.1years), and severe (n=87, 31.7±10.7years). Participants completed a standardized questionnaire measuring PRO-domains including PAL. Variables associated with PAL were tested in multivariate logistic regression. RESULTS: PAL was categorized into high (≥3 METs ≥2.5h/week, n=192) and low (≥3 METs <2.5h/week, n=279). Patients with low PAL were older (42.6 vs. 35.8years, p≤0.001), had more prescribed medications (51% vs. 39%, p=0.009), more symptoms (25% vs. 16%, p=0.02) and comorbidity (45% vs. 34% p=0.02). Patients with low PAL rated a lower quality of life (76.6 vs. 83.4, p<0.001), satisfaction with life (25.6 vs. 27.3, p=0.003), a lower Physical Component Summary score (PCS) (78.1 vs. 90.5, p<0.001) and Mental Component Summary score (MCS) (73.5 vs. 79.5, p<0.001). Complexity of heart lesion was not associated with PAL. The included PROs - separately tested in the model, together with age were associated with PAL. CONCLUSIONS: PCS and MCS are stronger associated with PAL than age and medical factors. The use of these PROs could therefore provide valuable information of benefit for individualized advice regarding physical activity to patients with CHD.
BACKGROUND: In general, adults with congenital heart disease (CHD) have impaired exercise capacity, and approximately 50% do not reach current recommendations on physical activity. Herein we analysed factors associated with physical activity level (PAL) in adults with CHD by using patient-reported outcomes (PRO). METHODS:Patients with CHD (n=471) were randomly selected from the national register on CHD and categorized according to complexity of lesions - simple (n=172, 39.1±14.6years), moderate (n=212, 39±14.1years), and severe (n=87, 31.7±10.7years). Participants completed a standardized questionnaire measuring PRO-domains including PAL. Variables associated with PAL were tested in multivariate logistic regression. RESULTS: PAL was categorized into high (≥3 METs ≥2.5h/week, n=192) and low (≥3 METs <2.5h/week, n=279). Patients with low PAL were older (42.6 vs. 35.8years, p≤0.001), had more prescribed medications (51% vs. 39%, p=0.009), more symptoms (25% vs. 16%, p=0.02) and comorbidity (45% vs. 34% p=0.02). Patients with low PAL rated a lower quality of life (76.6 vs. 83.4, p<0.001), satisfaction with life (25.6 vs. 27.3, p=0.003), a lower Physical Component Summary score (PCS) (78.1 vs. 90.5, p<0.001) and Mental Component Summary score (MCS) (73.5 vs. 79.5, p<0.001). Complexity of heart lesion was not associated with PAL. The included PROs - separately tested in the model, together with age were associated with PAL. CONCLUSIONS: PCS and MCS are stronger associated with PAL than age and medical factors. The use of these PROs could therefore provide valuable information of benefit for individualized advice regarding physical activity to patients with CHD.
Authors: Lena Larsson; Bengt Johansson; Camilla Sandberg; Silke Apers; Adrienne H Kovacs; Koen Luyckx; Corina Thomet; Werner Budts; Junko Enomoto; Maayke A Sluman; Jou-Kou Wang; Jamie L Jackson; Paul Khairy; Stephen C Cook; Luis Alday; Katrine Eriksen; Mikael Dellborg; Malin Berghammer; Gwen Rempel; Samuel Menahem; Maryanne Caruana; Martha Tomlin; Alexandra Soufi; Susan M Fernandes; Kamila White; Edward Callus; Shelby Kutty; Philip Moons Journal: Int J Cardiol Heart Vasc Date: 2018-11-22