The relationship between heart failure and physical activity assessed by IPAQ questionnaire in patients included in cardiovascular rehabilitation programs

Introduction: Current treatment guidelines for heart failure recommend cardiovascular recovery through physical activity without individualizing the type of pa-tient. The notion of recovery includes not only physical activity but lifestyle change, modification of traditional and nontraditional risk factors. Close monitoring of adherence to recovery programs is very important in this category of patients; thereby, the IPAQ question-naire, a cheap but rigorous evaluation method, is used especially in patients in phase II and III of cardiovascu-lar recovery.

Objective: The aim of the study complements the gui-deline attempting to individualize the type of patient and recommended activity using the IPAQ question-naire. It allows quantitative and qualitative assessment of physical activity in patients included in recovery programs. It also aims to assess the cardiovascular risk categories as well as to adopt an individualized rehabi-litation program.

Methods: A 12-month comparative study was con-ducted involving 120 patients of both sexes aged 40-69 years, who were hospitalized in the Cardiovascular Rehabilitation Clinic of the Clinical Rehebilitation Ho-spital in Iasi. Among the inclusion criteria, we mention the presence of NYHA class II and III heart failure with at least two admissions. Patients were divided into two groups (control and study group), the latter being also divided into two subgroups: with preserved ejection fraction (PEF) and low ejection fraction (LEF).

Results: T he average age of patients enrolled in the study was 57.9 years. The gender ratio was balanced, with a 49.16% male gender. The results obtained by completing the IPAQ questionnaire revealed a per-centage of 79.2% of patients with physical activity of at least 1500 METs-minutes/week. The most important biological constants observed in the dynamics were: abdominal circumference, BMI (body mass index), fasting glucose and lipid fractions. The dynamic vari-ation of these parameters had a downward trend at the second admission to the first, except HDL-cholesterol, whose values increased by about 10 mg/dl. Multiple factors correlated with a high level of physical activity were identified during the study: age 40 to 50 years, weight status and abdominal circumference. Also, an important positive correlation between the intense physical activity monitored by the physician and the score obtained by completing the IPAQ questionnaire was demonstrated. Statistical analysis of the data did not reveal a significant association between exercise capacity (assessed on cyclogergometer) and physical activity. Also, there were no statistically significant di-fferences between physical activity and cardiovascular risk factors: alcohol consumption, diabetes mellitus and hypertension. Regarding the dynamic evolution of recorded parameters in effort test, the PEF groups had an upward trend in the number of METs made directly proportional to the number of watts. On the other hand, in the case of patients with LEF, the tendency to increase the number of MET is less pronounced, espe-cially for the control group.

Conclusions: The IPAQ questionnaire is an important step in what will be adopted in the new heart failure guidelines regarding the cardiovascular rehabilitation programs, both nationally and internationally. Sustai-ned physical activity is essential in secondary and ter-tiary prevention, according to the results of the latest trials.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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