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Steps for Improving Physical Activity Orientation Among Health-care Providers of Older Cardiovascular Patients

  • Cardiovascular Disease in the Elderly (DE Forman, Section Editor)
  • Published:
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Abstract

Attaining appropriate levels of physical activity can have many potential physiological and psychological benefits in older adults with cardiovascular disease. However, these individuals often report low levels of physical activity and high levels of sedentary behavior. Older adults encounter many potential “barriers” to physical activity, but numerous studies have demonstrated the ability to positively influence this important health behavior using well-established behavior change theories and models. The information provided in this review is directed at health-care providers who have the potential to impact physical activity behaviors during regular, often brief, clinical interactions. In addition to providing the latest physical activity recommendations, this update will provide a brief summary of some of the more widely used behavioral skills and strategies for promoting physical activity in older adults with cardiovascular disease.

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References

  1. Thompson PD, Buchner D, Pina IL, et al. Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). American Heart Association Council on Clinical Cardiology Subcommittee on Exercise, Rehabilitation, and Prevention; American Heart Association Council on Nutrition, Physical Activity, and Metabolism Subcommittee on Physical Activity. Circulation. 2003;107(24):3109–16.

    Article  PubMed  Google Scholar 

  2. Haskell WL, Lee IM, Pate RR, Powell KL, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1423–34.

    Article  PubMed  Google Scholar 

  3. Artinian NT, Fletcher GF, Mozaffarian D, et al. Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: a scientific statement from the American Heart Association. American Heart Association Prevention Committee of the Council on Cardiovascular Nursing. Circulation. 2010;122(4):406–41. This scientific statement provides evidence-based recommendations on implementing PA and dietary interventions among adult individuals. The most efficacious and effective strategies are summarized into practice.

    Article  PubMed  Google Scholar 

  4. Pollock M, Franklin B, Balady G, et al. AHA Science Advisory. Resistance exercise in individuals with and without cardiovascular disease: benefits, rationale, safety, and prescription: an advisory from the Committee on Exercise, Rehabilitation, and Prevention, Council on Clinical Cardiology, American Heart Association; Position paper endorsed by the American College of Sports Medicine. Circulation. 2000;101:828–33.

    Article  CAS  PubMed  Google Scholar 

  5. Thompson P, Buchner D, Pina I, et al. Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). Circulation. 2003;107:3109–16.

    Article  PubMed  Google Scholar 

  6. American Geriatric Society, British Geriatric Society, and American Academy of Orthopedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001;49:664–72.

    Article  Google Scholar 

  7. Chobanian A, Bakris B, Black H, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–72.

    Article  CAS  PubMed  Google Scholar 

  8. McDermott M, Liu K, Ferrucci L, et al. Physical performance in peripheral arterial disease: a slower rate of decline in patients who walk more. Ann Intern Med. 2006;144:10–20.

    Article  PubMed  Google Scholar 

  9. Sigal R, Kenny G, Wasserman D, Casteneda-Sceppa D. Physical activity/exercise and type 2 diabetes. Diabetes Care. 2004;27:2518–39.

    Article  PubMed  Google Scholar 

  10. Preventive US. Service Task Force. Screening for obesity in adults: recommendations and rationale. Ann Intern Med. 2003;139:930–2.

    Article  Google Scholar 

  11. Geliebter A, Mahar M, Gerace L, Gutin B, Heysmfield S, Hashim S. Effects of strength or aerobic training on body composition, resting metabolic rate, and peak oxygen consump- tion in obese dieting subjects. Am J Clin Nutr. 1997;66:557–63.

    CAS  PubMed  Google Scholar 

  12. Going S, Lohman T, Houtkooper L, et al. Effects of exercise on bone mineral density in calcium-replete postmenopausal women with and without hormone replacement therapy. Osteoporos Int. 2003;14(8):637–43.

    Article  CAS  PubMed  Google Scholar 

  13. US Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General, Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, 2004.

  14. American College of Rheumatology. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum. 2000;43:1905–15.

    Article  Google Scholar 

  15. American Geriatric Society. Exercise prescription for older adults with osteoarthritis pain: consensus practice recommendations. A supplement to the AGS Clinical Practice Guidelines on the management of chronic pain in older adults. J Am Geriatr Soc. 2001;49:808–23.

    Article  Google Scholar 

  16. Stewart K, Hiatt W, Regensteiner J, Hirsch A. Exercise training for claudication. N Engl J Med. 2002;347:1941–51.

    Article  PubMed  Google Scholar 

  17. Pauwells RA, Buist RA, Calverley PM, Jenkins CR, Hurd SS. GOLD Scientific Committee. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med. 2001;163:1256–76.

    Article  Google Scholar 

  18. American College of Sports Medicine. Position Stand. Exercise and hypertension. Med Sci Sports Exerc. 2004;36:533–53.

    Article  Google Scholar 

  19. Kesaneimi Y, Danforth E, Jensen M, Kopelman P, Lefebreve P, Reeder B. Dose–response issues concerning physical activity and health: an evidence-based symposium. Med Sci Sports Exerc. 2001;33(6 Suppl):S351–8.

    Google Scholar 

  20. Study LIFE. Investigators. Effects of a physical activity intervention on measures of physical performance: results of the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) Study. J Gerontol A Biol Sci Med Sci. 2006;61:1157–65.

    Article  Google Scholar 

  21. Nelson M, Layne J, Bernstein M, et al. The effects of multi-dimensional home-based exercise on functional performance in elderly people. J Gerontol A Biol Sci Med Sci. 2004;59:154–60.

    Article  PubMed  Google Scholar 

  22. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2014;129(3):e28–e292. An important update that provides the most current evidence relating to the low PA participation and adherence rates in older CVD patients.

    Article  PubMed  Google Scholar 

  23. Pescatello LS, editor. ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed. Baltimore: Lippincott Williams & Wilkins; 2013.

    Google Scholar 

  24. Smith Jr SC, Benjamin EJ, Bonow RO, et al. AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. World Heart Federation and the Preventive Cardiovascular Nurses Association. Circulation. 2011;124(22):2458–73. These updated guidelines combine other guideline statements and new evidence from clinical trials to further supports and broadens the merits of intensive risk-reduction therapies for patients with established coronary and other atherosclerotic vascular disease.

    Article  PubMed  Google Scholar 

  25. US Department of Health and Human Services. 2008 physical activity guidelines for Americans. http://www.health.gov/paguidelines/guidelines/default.aspx

  26. Nelson M, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, et al. Physical Activity and Public Health in Older Adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):1435–45.

    Article  PubMed  Google Scholar 

  27. Health Canada. Canada’s Physical Activity Guide to Healthy Active Living for Older Adults. Ottawa, Ontario, Canada, 1999.

  28. Tseng B, Marsh D, Hamilton M, Booth F. Strength and aerobic training attenuate muscle wasting and improve resistance to the development of disability with aging. J Gerontol A Biol Sci Med Sci. 1995;50:113–9.

    PubMed  Google Scholar 

  29. Singh N, Clements K, Fiatorone M. A randomized controlled trial of the effect of exercise on sleep. Sleep. 1997;20:95–101.

    CAS  PubMed  Google Scholar 

  30. Latham M, Anderson C, Bennett D, Stretton C. Progressive resistance strength training for physical disability in older people. Cochrane Database Syst Rev. 2003;2, CD002759.

    PubMed  Google Scholar 

  31. US Department of Health and Human Services. Strength training among adults aged >65 years - United States 2001. MMWR. 2004;53:25–8.

    Google Scholar 

  32. Kahn E, Ramsey L, Brownson R, et al. The effectiveness of interventions to increase physical activity. A systematic review. Am J Prev Med. 2002;22(4 Suppl):73–107.

    Article  PubMed  Google Scholar 

  33. Hootman J, Macera C, Ainsworth B, Addy C, Martin M, Blair S. Epidemiology of musculoskeletal injuries among sedentary and physically active adults. Med Sci Sports Exerc. 2002;34:838–44.

    Article  PubMed  Google Scholar 

  34. Sallis JF, Hovell MF. Determinants of exercise behavior. Exerc Sport Sci Rev. 1990;18:307–30.

    CAS  PubMed  Google Scholar 

  35. ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription 7th Edition. 2013 Editor Swain, Chp. 45 Principles of behavior change: skill building to promote physical activity. Pages 745–760.

  36. Strath SJ, Kaminsky LA, Ainsworth BE, et al. Guide to the assessment of physical activity: Clinical and research applications: a scientific statement from the American Heart Association. American Heart Association Physical Activity Committee of the Council on Lifestyle and Cardiometabolic Health and Cardiovascular, Exercise, Cardiac Rehabilitation and Prevention Committee of the Council on Clinical Cardiology, and Council. Circulation. 2013;128(20):2259–79. This review provides very useful information, including a decision matrix and table, to allow professionals to make a goal-specific selection of a meaningful physical activity assessment method.

    Article  PubMed  Google Scholar 

  37. Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R, et al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA. 2007;298(19):2296–304.

    Article  CAS  PubMed  Google Scholar 

  38. Izawa KP, Watanabe S, Omiya K, Hirano Y, Oka K, Osada N, et al. Effect of the self-monitoring approach on exercise maintenance during cardiac rehabilitation: a randomized, controlled trial. Am J Phys Med Rehabil. 2005;84(5):313–21.

    Article  PubMed  Google Scholar 

  39. Butler L, Furber S, Phongsavan P, Mark A, Bauman A. Effects of a pedometer-based intervention on physical activity levels after cardiac rehabilitation: a randomized controlled trial. J Cardiopulm Rehabil Prev. 2009;29(2):105–14.

    Article  PubMed  Google Scholar 

  40. Ayabe M, Brubaker PH. Self-Monitoring Moderate-Vigorous Physical Activity Versus Steps/Day Is More Effective in Chronic Disease Exercise Programs. J Cardiopulm Rehabil Prev. 2010;30(2):111–5. A small but important intervention study demonstrated that self-monitoring PA with accelerometers leads to a greater increase in mod-vig. PA than self-monitoring with pedometers in chronic disease patients.

    Article  PubMed  Google Scholar 

  41. Martin JE, Dubbert PM, Katell AD, et al. Behavioral control of exercise in sedentary adults: studies 1 through 6. J Consult Clin Psychol. 1984;52(5):795–811.

    Article  CAS  PubMed  Google Scholar 

  42. Stanford FC, Durkin MW, Stallworth JR, Powell CK, Poston MB, Blair SN. Factors that influence physicians' and medical students' confidence in counseling patients about physical activity. J Prim Prev. 2014;35(3):193–201. Through the use of questionnaires, this study found after adjusting for BMI, that physicians and medical students who met USDHHS guidelines for vigorous activity were more than twice as likely to provide exercise counseling than physicians who did not meet these guidelines.

    Article  PubMed  Google Scholar 

  43. Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38–48.

    Article  CAS  PubMed  Google Scholar 

  44. Pinto BM, Goldstein MG, Marcus BH. Activity counseling by primary care physicians. Prev Med. 1998;27(4):306–13.

    Article  Google Scholar 

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Peter H. Brubaker declares that he has no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Peter H. Brubaker.

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Brubaker, P.H. Steps for Improving Physical Activity Orientation Among Health-care Providers of Older Cardiovascular Patients. Curr Geri Rep 3, 291–298 (2014). https://doi.org/10.1007/s13670-014-0104-7

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  • DOI: https://doi.org/10.1007/s13670-014-0104-7

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