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van Bakel, BMA, Kroesen, SH, Bakker, EA, van Miltenburg, RV, Günal, A, Scheepmaker, A, Aengevaeren, WRM, Willems, FF, Wondergem, R, Pisters, MF, de Bruin, M, Hopman, MTE, Thijssen, DHJ and Eijsvogels, TMH (2023) Effectiveness of an intervention to reduce sedentary behaviour as a personalised secondary prevention strategy for patients with coronary artery disease: main outcomes of the SIT LESS randomised clinical trial. International Journal of Behavioral Nutrition and Physical Activity, 20 (1). ISSN 1479-5868
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Abstract
Background: A high sedentary time is associated with increased mortality risk. Previous studies indicate that replacement of sedentary time with light- and moderate-to-vigorous physical activity attenuates the risk for adverse outcomes and improves cardiovascular risk factors. Patients with cardiovascular disease are more sedentary compared to the general population, while daily time spent sedentary remains high following contemporary cardiac rehabilitation programmes. This clinical trial investigated the effectiveness of a sedentary behaviour intervention as a personalised secondary prevention strategy (SIT LESS) on changes in sedentary time among patients with coronary artery disease participating in cardiac rehabilitation.
Methods: Patients were randomised to usual care (n = 104) or SIT LESS (n = 108). Both groups received a comprehensive 12-week centre-based cardiac rehabilitation programme with face-to-face consultations and supervised exercise sessions, whereas SIT LESS participants additionally received a 12-week, nurse-delivered, hybrid behaviour change intervention in combination with a pocket-worn activity tracker connected to a smartphone application to continuously monitor sedentary time. Primary outcome was the change in device-based sedentary time between pre- to post-rehabilitation. Changes in sedentary time characteristics (prevalence of prolonged sedentary bouts and proportion of patients with sedentary time ≥ 9.5 h/day); time spent in light-intensity and moderate-to-vigorous physical activity; step count; quality of life; competencies for self-management; and cardiovascular risk score were assessed as secondary outcomes.
Results: Patients (77% male) were 63 ± 10 years and primarily diagnosed with myocardial infarction (78%). Sedentary time decreased in SIT LESS (- 1.6 [- 2.1 to - 1.1] hours/day) and controls (- 1.2 [ ─1.7 to - 0.8]), but between group differences did not reach statistical significance (─0.4 [─1.0 to 0.3]) hours/day). The post-rehabilitation proportion of patients with a sedentary time above the upper limit of normal (≥ 9.5 h/day) was significantly lower in SIT LESS versus controls (48% versus 72%, baseline-adjusted odds-ratio 0.4 (0.2-0.8)). No differences were observed in the other predefined secondary outcomes.
Conclusions: Among patients with coronary artery disease participating in cardiac rehabilitation, SIT LESS did not induce significantly greater reductions in sedentary time compared to controls, but delivery was feasible and a reduced odds of a sedentary time ≥ 9.5 h/day was observed.
| Item Type: | Article |
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| Uncontrolled Keywords: | Humans; Myocardial Infarction; Quality of Life; Female; Male; Coronary Artery Disease; Secondary Prevention; Sedentary Behavior; Cardiac rehabilitation; Cardiovascular disease; Physical activity; Prevention; Sedentary lifestyle; e-Health; Humans; Male; Female; Coronary Artery Disease; Sedentary Behavior; Secondary Prevention; Quality of Life; Myocardial Infarction; 11 Medical and Health Sciences; 13 Education; Public Health |
| Subjects: | R Medicine > R Medicine (General) R Medicine > RC Internal medicine > RC1200 Sports Medicine |
| Divisions: | Sport & Exercise Sciences |
| Publisher: | BIOMED CENTRAL LTD |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 02 Mar 2023 11:21 |
| Last Modified: | 02 Mar 2023 11:30 |
| DOI or ID number: | 10.1186/s12966-023-01419-z |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/18991 |
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