title: Physical activity monitoring in patients with intermittent claudication.
abstract: OBJECTIVE
  Reduced physical activity (PA) is associated with a higher mortality rate and more rapid functional decline in patients with intermittent claudication (IC). The newest generation of accelerometers can assess both direction and intensity of activities three-dimensionally and may also adequately calculate energy expenditure in daily life. The aim of this study was to quantify daily PA level and energy expenditure of newly diagnosed patients with IC and healthy controls. PA outcomes are compared with contemporary public health physical activity guidelines.
  
  
  METHODS
  Before initiating treatment, 94 patients with newly diagnosed IC and 36 healthy controls were instructed to wear a tri-axial seismic accelerometer for 1 week. Daily PA levels (in metabolic equivalents, METs) were compared with the ACSM/AHA public health PA minimum recommendations (≥64 METs·min·day, in bouts of ≥10 minutes). A subgroup analysis assessed the effect of functional impairment on daily PA levels.
  
  
  RESULTS
  Data from 56 IC patients and 27 healthy controls were available for analysis. Patients with IC demonstrated significantly lower mean daily PA levels (±SD) than controls (387 ± 198 METs·min vs. 500 ± 156 METs·min, p = .02). This difference was solely attributable to a subgroup of IC patients with the largest functional impairment (WIQ-score < 0.4). Only 45% of IC patients met the public health physical activity guidelines compared with 74% of the healthy controls (p = .01).
  
  
  CONCLUSIONS
  More than half of patients with IC do not meet recommended standards of PA. Considering the serious health risks associated with low PA levels, these findings underscore the need for more awareness to improve physical exercise in patients with IC.
authors.affiliation: Catharina Hospital, Department of Vascular Surgery, Eindhoven, The Netherlands; CAPHRI Research School, Maastricht University, Maastricht, The Netherlands.
authors.forename: G J
authors.initials: GJ
authors.lastname: Lauret
authors.affiliation: Catharina Hospital, Department of Vascular Surgery, Eindhoven, The Netherlands; CAPHRI Research School, Maastricht University, Maastricht, The Netherlands.
authors.forename: H J P
authors.initials: HJ
authors.lastname: Fokkenrood
authors.affiliation: Catharina Hospital, Department of Vascular Surgery, Eindhoven, The Netherlands.
authors.forename: B L
authors.initials: BL
authors.lastname: Bendermacher
authors.affiliation: Maxima Medical Center, Department of Vascular Surgery, Veldhoven, The Netherlands; CARIM Research School, Maastricht University, Maastricht, The Netherlands.
authors.forename: M R M
authors.initials: MR
authors.lastname: Scheltinga
authors.affiliation: Catharina Hospital, Department of Vascular Surgery, Eindhoven, The Netherlands; CAPHRI Research School, Maastricht University, Maastricht, The Netherlands. Electronic address: joep.teijink@catharinaziekenhuis.nl.
authors.forename: J A W
authors.initials: JA
authors.lastname: Teijink
mesh_terms: D056044:Actigraphy / Q000295:instrumentation; D000203:Activities of Daily Living; D000368:Aged; D001364:Awareness; D016022:Case-Control Studies; D004867:Equipment Design; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010349:Patient Compliance; D011237:Predictive Value of Tests; D011446:Prospective Studies; D057185:Sedentary Behavior; D013997:Time Factors
keywords: Accelerometer; Energy expenditure; Exercise; Intermittent claudication; Physical activity