Clinical Predictors of Adherence to Exercise Training Among Individuals With Heart Failure: THE HF-ACTION STUDY.
Clinical Predictors of Adherence to Exercise Training Among Individuals With Heart Failure: THE HF-ACTION STUDY.
复制标题
心力衰竭患者坚持运动训练的临床预测因素：HF-ACTION 研究。
DOI：
10.1097/hcr.0000000000000757
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发表时间：
2023
影响因子：
3.8
通讯作者：
HF-ACTIONInvestigators
中科院分区：
文献类型：
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作者：
Collins,KatherineA;Reeves,GordonR;Miller,NancyHouston;Whellan,DavidJ;O'Connor,ChristopherM;Marcus,BessH;Kitzman,DalaneW;Kraus,WilliamE;HF-ACTIONInvestigators
目的：依从性不佳是实现运动干预益处的主要限制，而我们预测和提高依从性的能力是有限的。本分析的目的是确定预测 HF-ACTION 研究队列中运动训练依从性的基线临床和人口特征。方法：对随机接受 HF-ACTION 运动干预的 1159 名参与者评估运动训练的依从性，即运动总持续时间（分钟/周）。在开发 1-3 个月（监督训练）和 10-12 个月（家庭训练）的分钟/周终点模型时考虑了 50 多个临床、人口统计和运动测试变量。结果：在 1-3 个月的多变量模型中，年龄较小、收入较低、二尖瓣关闭不全较严重、6 分钟步行测试距离较短、运动能力较低以及黑人或非裔美国人种族与较差的运动干预依从性相关。没有变量占方差> 2%，最终模型的调整后的 R 2 为 0.14。 10-12 个月的依从性预测同样受到限制。结论：运动训练开始时可用的临床和人口统计学变量为识别有运动干预依从性差风险的心力衰竭患者提供了非常有限的信息。
Purpose:Suboptimal adherence is a major limitation to achieving the benefits of exercise interventions, and our ability to predict and improve adherence is limited. The purpose of this analysis was to identify baseline clinical and demographic characteristics predicting exercise training adherence in the HF-ACTION study cohort.Methods:Adherence to exercise training, defined by the total duration of exercise performed (min/wk), was evaluated in 1159 participants randomized to the HF-ACTION exercise intervention. More than 50 clinical, demographic, and exercise testing variables were considered in developing a model of the min/wk end point for 1-3 mo (supervised training) and 10-12 mo (home-based training).Results:In the multivariable model for 1-3 mo, younger age, lower income, more severe mitral regurgitation, shorter 6-min walk test distance, lower exercise capacity, and Black or African American race were associated with poorer exercise intervention adherence. No variable accounted for> 2% of the variance and the adjusted R 2 for the final model was 0.14. Prediction of adherence was similarly limited for 10-12 mo.Conclusions:Clinical and demographic variables available at the initiation of exercise training provide very limited information for identifying patients with heart failure who are at risk for poor adherence to exercise interventions.