title: Association between mental health and physical activity in patients with chronic heart failure.
abstract: OBJECTIVE
  Poor mental health (MH) is common in chronic heart failure (CHF) patients. No studies have reported a relation between MH status and objectively measured physical activity (PA) in CHF patients. The study aim was to determine self-reported MH-related differences associated with PA and target values of PA for improved MH in CHF outpatients.
  
  
  METHODS
  We divided 243 CHF outpatients (mean age 57.1 years) into two groups according to MH assessed by Short Form-36 score: high-MH (≥68 points) group (n = 148) and poor-MH (<68 points) group (n = 95). Average step count (steps) and energy expenditure on PA (EE) (kcal) per day for 1 week of PA were assessed by an accelerometer and compared between groups. PA resulting in high MH was determined by the receiver-operating characteristic (ROC) analysis.
  
  
  RESULTS
  PA correlated positively with MH in all patients (steps: r = 0.46, p < 0.001; EE: r = 0.43, p < 0.001). After adjusting for patient characteristics, steps and EE were significantly lower in the poor-MH versus high-MH group (5020.1 ± 280.7 versus 7174.1 ± 221.5 steps, p < 0.001; 133.9 ± 10.8 versus 215.9 ± 8.4 kcal, p < 0.001). Cut-off values of 5590.8 steps and 141.1 kcal were determined as PA target values associated with improved MH.
  
  
  CONCLUSIONS
  Poor MH status may reduce PA. Attaining PA target values may improve MH status of CHF outpatients.
authors.affiliation: Department of Rehabilitation Medicine, St. Marianna University School of Medicine Hospital , Kanagawa , Japan .
authors.forename: Kazuhiro P
authors.initials: KP
authors.lastname: Izawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Watanabe
authors.forename: Koichiro
authors.initials: K
authors.lastname: Oka
authors.forename: Koji
authors.initials: K
authors.lastname: Hiraki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morio
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kasahara
authors.forename: Naohiko
authors.initials: N
authors.lastname: Osada
authors.forename: Kazuto
authors.initials: K
authors.lastname: Omiya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimizu
mesh_terms: D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D015444:Exercise; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009043:Motor Activity; D012372:ROC Curve