Article

PURPOSE: To compare physical activity levels of patients in the first week after
myocardial infarction (MI) and stroke. METHOD:
We conducted an observational
study using behavioural mapping. MI patients were consecutively recruited from
Alfred Hospital, Melbourne.
Data for stroke patients
(Royal Perth Hospital or
Austin Hospital, Melbourne) were retrieved from an existing database. Patients
were observed for 1 min every 10 min from 8 am to 5 pm.
At each observation, the
patient's highest level of physical activity, location and people present were
recorded. Details of physiotherapy and occupational therapy sessions were
recorded by the therapists. RESULTS: Proportion of the day spent physically
inactive was lower in MI (n = 32, median 48%) than stroke (n = 125, median 59%)
patients, but this difference was not significant in univariate or multivariate
(adjusting for age, walking ability and days post-event) regression. Time spent
physically active was higher in MI (median 23%) than stroke (median 10%) patients
(p = 0.009), but this difference did not survive multivariate adjustment (p = 0.67). More stroke patients (78%) than MI patients (19%) participated in therapy.
CONCLUSIONS: This study provides the first objective data on physical activity
levels of acute MI patients. While they were more active than acute stroke
patients, the difference was largely attributable to walking ability.
Implications for rehabilitation In the first week after myocardial infarction,
patients spent about half the day physically inactive (even though 81% were able
to walk independently). Similar levels of inactivity were seen in a comparable
cohort of acute stroke patients, suggesting that environmental factors play an
important role. There appears to be wide scope for increasing levels of physical
rehabilitation after acute cardiovascular events, though optimal timing and dose
remain unclear.

Langue : ANGLAIS