Examining Factors Associated with Physical Activity During Cardiac Rehabilitation

Abstract

Recurrent myocardial infarctions (MIs) account for a third of the incident rate for all MIs. Physical activity (PA) is an important health behavior to prevent a recurrent MI. Fatigue, sleepiness, anxiety, and depression are all barriers to PA. The purpose of this pilot study was to examine how fatigue tolerance, sleep, depression, and anxiety influenced PA in those attending cardiac rehabilitation (CR) after an MI or coronary artery bypass surgery. Using a repeated measure design, we interviewed a pilot sample of 8 adults who were beginning CR. Each participant completed a demographic and health status form. A 100mm visual analog scale was used to determine fatigue tolerance. Sleep was measured using the Epworth Sleepiness Scale, the Patient Health Questionnaire-9 measured depression, and anxiety was measured using the Generalized Anxiety Disorder-7. Participants wore a Garmin activity tracker for one week and step data (PA) were calculated on full days of activity. All data were analyzed using Statistical Package for Social Sciences 25. Most of the participants (N = 8) were White (88%), women (62.5%), and had a mean age of 70.5 (SD = 10.5). All had high cholesterol, 88% high blood pressure, and 38% had a history of smoking. The mean depression score was 7 (SD = 4.3; range 1-15) indicating mild depression. Sleep (M = 7.1; SD = 6) and anxiety (M = 4.88; SD = 5) were in normal ranges. Average number of daily steps was 6000 (SD = 2517; range = 2863-9526). The average fatigue that they could tolerate (M = 59; SD = 26.7) and the average fatigue that slowed them down (M = 49.6; SD = 24.7) were lower than their perceived normal fatigue level for people similar to them (M = 70.4; SD = 24). Average daily steps were negatively associated with fatigue level that slows them down (r = -.78) but none of the other fatigue tolerability measures correlated with PA. Most are not reaching the amount of PA deemed to be cardioprotective. Because most indicated lower fatigue tolerance than what they perceived as normal, further study of fatigue tolerance and PA is warranted. A larger sample size is needed to determine the relationship of fatigue tolerance, sleep, depression and anxiety on PA.