Effectiveness of an education intervention associated with an exercise program in improving disease-related knowledge and health behaviours among diabetes patients.

OBJECTIVE: to assess the effectiveness of an education intervention associated with an exercise program in improving knowledge and health behaviours among diabetes patients. METHODS: Diabetes and prediabetes patients were exposed to an evidence- and theoretically-based comprehensive education intervention over 24 weeks. Patients completed surveys assessing knowledge, physical activity, food intake, self-efficacy, and health literacy. Functional capacity was measured by oxygen uptake. All outcomes were assessed pre- and post-CR. Satisfaction about the education provided was assessed at post-CR. Paired t-tests, Pearson correlation coefficients, and linear regression models were computed to investigate the effectiveness of this intervention. RESULTS: 84 patients consented to participate, of which 47(56.0%) completed post-CR assessments. There was a significant improvement in patients' overall knowledge pre- to post-CR, as well as in physical activity, food intake, self-efficacy, and health literacy (p < 0.05). Peak VO2 has clinically significant improved. Results showed a low significant positive correlation was between post-CR knowledge and food intake(r = 0.297;p = 0.04). Linear regression analysis revealed that age(B=-0.051; p = 0.01) was influential in changing post-CR knowledge. CONCLUSION: The benefits of an education intervention designed for diabetes and prediabetes patients associated with an exercise program have been supported. PRACTICE IMPLICATIONS: This work shows one effective education strategy taken in place that can be replicated in different settings.

Antecedent rest may not be necessary for automated office blood pressure at lower treatment targets.

In SPRINT (Systolic Blood Pressure Intervention Trial), use of the Omron 907XL blood pressure (BP) monitor set at 5 minutes of antecedent rest to record BP produced an automated office BP value 7/6 mm Hg lower than awake ambulatory BP at 27 months. The authors studied the impact on automated office BP of setting the Omron 907XL to 0 minutes instead of 5 minutes of rest in patients with readings in the lower normal BP range, similar to on-treatment BP in the SPRINT intensive therapy group. Patients (n = 100) in cardiac rehabilitation were randomized to three BP readings at 1-minute intervals using an Omron 907XL BP device set for 5 or 0 minutes of antecedent rest. Mean (±standard deviation) automated office BP (mm Hg) after 5 minutes of rest (120.2 ± 14.6/66.9 ± 8.6 mm Hg) was lower (P < .001/P < .01) than without rest (124.2 ± 16.4/67.9 ± 9.1 mm Hg). When target BP is in the lower normal range, automated office BP recorded without antecedent rest using an Omron 907XL device should be higher and closer to the awake ambulatory BP, compared with readings taken after 5 minutes of rest.

Validation of the Fitbit Flex in an Acute Post-Cardiac Surgery Patient Population.

Purpose: This study examined the validity of the Fitbit Flex activity monitor for step count and distance walked among post-cardiac surgery patients. Method: Participants (n=20) from a major urban cardiac surgery centre were recruited 1-2 days before hospital discharge. The Fitbit Flex step count and distance walked outputs and video recording of each participant performing the 6-minute walk test were collected. Fitbit Flex output was compared with criterion measures of manual step count obtained from the video recording and manual measurement of distance walked. Statistical analysis compared the output and criterion measures using paired sample t-tests, Pearson correlation coefficients, Lin's concordance correlations, and Bland-Altman plots. Sub-analysis compared slower walking (<0.8 m/s; n=11) and faster walking (≥0.8 m/s; n=8) group speeds (1 participant was excluded from analysis). Results: Steps counted and distance walked were significantly different between the Fitbit Flex outputs and criterion measures (p<0.05). The Fitbit Flex steps counted and distance walked showed moderate association with manual measure steps counted (r=0.67) and distance walked (r=0.45). Lin's concordance coefficients revealed a lack of agreement between the Fitbit Flex and the criterion measurement of both steps counted (concordance correlation coefficient [CCC]=0.43) and distance walked (CCC=0.36). The percentage of relative error was -18.6 (SD 22.7) for steps counted and 25.4 (SD 45.8) for distance walked. Conclusions: The Fitbit Flex activity monitor was not a valid measure of step count and distance walked in this sample of post-cardiac surgery patients. The lack of agreement between outputs and criterion measures suggests the Fitbit Flex alone would not be an acceptable clinical outcome measure for monitoring walking progression in the early postoperative period.

Objectif : examiner la validité du moniteur d'activité Fitbit Flex pour calculer le compte des pas et la distance parcourue chez des patients après une chirurgie cardiaque. Méthodologie : les chercheurs ont recruté les participants (n=20) dans un grand centre de chirurgie cardiaque urbain un ou deux jours avant leur congé de l'hôpital. Ils ont recueilli les résultats du compte de pas et la distance parcourue à l'aide du moniteur Fitbit Flex et l'enregistrement vidéo de chaque participant qui effectue le texte de marche de six minutes (TM6M). Ils ont comparé les résultats du moniteur Fitbit Flex aux critères du compte manuel des pas obtenus par l'enregistrement vidéo et la mesure manuelle de la distance parcourue. Par l'analyse statistique, ils ont comparé les résultats et les critères à l'aide d'échantillons de tests de Student appariés, du coefficient de corrélation de Pearson, de la corrélation de concordance de Lin et du graphique de Bland-Altman. Ils ont effectué la sous-analyse en comparant la vitesse de marche plus lente (<0,8 m/s; n=11) et plus rapide (≥0,8 m/s; n=8) des groupes (un participant a été exclu de l'analyse). Résultats : le compte de pas et la distance parcourue différaient considérablement entre les résultats du moniteur Fitbit Flex et des critères (p<0,05). Le compte de pas et la distance parcourue calculés à l'aide du moniteur Fitbit Flex ont révélé une association modérée avec la mesure manuelle du compte de pas (r =0,67) et la distance parcourue (r=0,45). Les coefficients de concordance de Lin ont révélé une absence de concordance entre le moniteur Fitbit Flex et les critères pour ce qui est du compte de pas (CCC=0,43) et de la distance parcourue (CCC=0,36). L'erreur relative du compte de pas était de −18,6 (ÉT 22,7) et celle de la distance parcourue, de 25,4 (ÉT 45,8). Conclusions : le moniteur d'activité Fitbit Flex n'est pas une mesure valide du nombre de pas et de la distance parcourue dans cet échantillon de patients après une chirurgie cardiaque. Selon l'absence de concordance entre les résultats et les critères, le moniteur Fitbit Flex ne serait pas une mesure de résultat clinique acceptable pour surveiller la progression de la marche au début de la période postopératoire.