Target step count for the secondary prevention of cardiovascular disease.

BACKGROUND: Obtaining an accurate measure of physical activity energy expenditure (PAEE) can be difficult, so the simple measurement of steps per day has become widely promoted and accepted in the general population. However, the relationship between PAEE and steps per day has not been evaluated in patients with cardiovascular disease. METHODS AND RESULTS: A total of 77 (53 men, 24 women) cardiac rehabilitation program participants aged between 46 and 88 years were enrolled. By means of an accelerometer the step count per day, amount of PAEE, as well as time per day spent in physical activity at light (<3 metabolic equivalents (METs)), moderate (3-6 METs) and vigorous (>6 METs) intensity were evaluated for each subject. The number of daily step counts strongly correlated with total PAEE (r=0.92, p<0.001) and time spent in moderate to vigorous intensity physical activity (r=0.85, p<0.001). The mean (95% confidence intervals) step counts associated with 214 and 314 kcal/day (ie, 1,500 and 2,200 kcal/week) were 6,470 and 8,496 steps/day, respectively. CONCLUSION: To achieve the total amount of PAEE generally recommended for the secondary prevention of cardiovascular disease, patients should be encouraged to accumulate 6,500-8,500 steps/day.

The physical activity patterns of cardiac rehabilitation program participants.

PURPOSE: This investigation aimed to examine the physical activity patterns of cardiac rehabilitation program (CRP) participants. METHODS: The investigation enrolled 53 male and 24 female CRP participants between 46 and 88 years of age. By means of a uniaxial accelerometer (Life-Corder), the amount of physical activity (in kilocalories) and the time spent in physical activity at light (<3 metabolic equivalents [METs]), moderate (3 to 6 METs), and vigorous (>6 METs) intensity were evaluated. In addition to these variables, the MET levels for the CRP and non-CRP periods were calculated. RESULTS: The weekly amount of physical activity energy expenditure averaged 1597 +/- 846 kcal/week, and the time spent in light, moderate, and vigorous physical activity averaged, respectively, 375.5 +/- 124.5 minutes, 125.2 +/- 109.4 minutes, and 5.7 +/- 12.8 minutes per week. These levels were significantly lower on non-CRP days than on CRP days: 177 +/- 113 versus 299 +/- 161 kcal/day and, respectively, 49.3 +/- 19.3 versus 59.7 +/- 19.8 minutes, 10.5 +/- 14.6 versus 26.4 +/- 20.4 minutes, and 0.4 +/- 1.7 versus 1.4 +/- 3.0 minutes per day. CONCLUSIONS: These results indicate that the amount of physical activity was generally adequate on CRP days, but failed to reach target levels on non-CRP days. Thus CRP participants, when it is medically appropriate, should be encouraged to incorporate lifestyle physical activity, additional exercise, or both on non-CRP days to supplement their caloric expenditure from CRP exercise sessions.

The metabolic demand of golf in patients with heart disease and in healthy adults.

PURPOSE: To evaluate the metabolic cost of golf, while pulling a cart, in a group of patients with heart disease (HD) and healthy adults with a wide range of functional capacities. METHODS: Twenty male golfers aged 49 to 78 years participated in this study. All participants underwent a graded exercise test (GXT) with expired gas analysis to determine functional capacity. Each patient with HD (n = 10) was matched with a healthy adult of similar age. Each pair completed 9 holes of golf while pulling a cart, during which oxygen consumption was monitored continuously via the Cosmed K4b2 portable unit. RESULTS: The average metabolic equivalent (MET) value (1 MET = 3.5 mL x kg(-1) x min(-1)) (mean +/- SEM) for 9 holes of golf in this group of men with HD (4.1 +/- 0.1 METs) was similar to that previously reported value of 4.3 METs. Whereas the average MET responses were similar between the groups, when expressed relative to peak oxygen consumption, on average, patients with HD worked at a significantly higher percentage of their functional capacity (57 +/- 2.7%) compared to the healthy adults (46 +/- 2.6%). Some patients with HD exceeded 100% of GXT MET level during golf. In contrast, some healthy adults failed to reach 60% of GXT MET level during golf. CONCLUSIONS: Based on these data, walking the golf course while pulling a cart appears to provide an adequate training stimulus for most patients with HD. However, some lower fit patients with HD (< 8 METs) are in danger of exceeding a safe level and should be encouraged to monitor intensity on the golf course and consider using a motorized cart. For most individuals who are more fit (functional capacity > or = 8 METs), golf does not appear to provide the stimulus generally associated with improvement in functional capacity.