ABC | Volume 113, Nº3, September 2019

Original Article Physical Activity Levels in Peripheral Artery Disease Patients Aline Mendes Gerage, 1 Marilia de Almeida Correia, 2 Paulo Mesquita Longano de Oliveira, 2 Aline Cabral Palmeira, 3 Wagner Jorge Ribeiro Domingues, 4 A ntônio Eduardo Zeratti, 5 Pedro Puech-Leão, 5 Nelson Wolosker, 3 Raphael Mendes Ritti-Dias, 2 Gabriel Grizzo Cucato 3 Universidade Federal de Santa Catarina - Departamento de Educação Física, 1 Florianópolis, SC – Brazil Universidade Nove de Julho, 2 São Paulo, SP – Brazil Hospital Israelita Albert Einstein, 3 São Paulo, SP – Brazil Universidade Federal do Amazonas, 4 Parintins, AM – Brazil Universidade de São Paulo Faculdade de Medicina Hospital das Clinicas, 5 São Paulo, SP – Brazil Mailing Address: Raphael Mendes Ritti-Dias • Universidade Nove de Julho - Programa de Pós-Graduação em Ciências da Reabilitação - Rua Vergueiro, 235. Postal Code 01504-000, São Paulo, SP – Brazil E-mail: raphaelritti@gmail.com Manuscript received October 16, 2018, revised manuscript December 09, 2018, accepted January 16, 2019 DOI: 10.5935/abc.20190142 Abstract Background: Increases in daily physical activity levels is recommended for patients with peripheral artery disease (PAD). However, despite this recommendation, little is known about the physical activity patterns of PAD patients. Objective: To describe the physical activity patterns of patients with symptomatic peripheral artery (PAD) disease. Methods: This cross-sectional study included 174 PAD patients with intermittent claudication symptoms. Patients were submitted to clinical, hemodynamic and functional evaluations. Physical activity was objectively measured by an accelerometer, and the time spent in sedentary, low-light, high-light and moderate-vigorous physical activities (MVPA) were obtained. Descriptive analysis was performed to summarize patient data and binary logistic regression was used to test the crude and adjusted associations between adherence to physical activity recommendation and sociodemographic and clinical factors. For all the statistical analyses, significance was accepted at p < 0.05. Results: Patients spent in average of 640 ± 121 min/day, 269 ± 94 min/day, 36 ± 27 min/day and 15 ± 16 min/day in sedentary, low-light, high-light and MVPA, respectively. The prevalence of patients who achieved physical activity recommendations was 3.4%. After adjustment for confounders, a significant inverse association was observed between adherence to physical activity recommendation and age (OR = 0.925; p = 0.004), while time of disease, ankle brachial index and total walking distance were not associated with this adherence criteria (p > 0.05). Conclusion: The patterns of physical activity of PAD patients are characterized by a large amount of time spent in sedentary behaviors and a low engagement in MVPA. Younger patients, regardless of the clinical and functional factors, were more likely to meet the current physical activity recommendations. (Arq Bras Cardiol. 2019; 113(3):410-416) Keywords: Motor Activity; Exercise; Waling; Peripheral Arterial Disease; Intermittent Claudication. Introduction Patients with peripheral artery disease (PAD) and symptoms of intermittent claudication have walking impairment, several comorbid conditions and increased cardiovascular risk, 1, 2 due to the disease characteristics and severity. Supervised exercise training has been considered a cornerstone in the clinical therapeutic approach in PAD patients, 3 as it improves several components of physical function and quality of life. 4-6 Similarly, positive effects of device-monitored, home-based exercise training programs to improve the walking capacity in these patients have also been reported. 7 However, these interventions are available for a restricted number of patients, limiting applicability in the public health context. Therefore, recommendations to increase physical activity levels remain the most often used approach in clinical practice. Current physical activity recommendations for the overall population, including PAD patients, consists of practicing at least 150 min of moderate or 75 min of vigorous physical activities or an equivalent combination of moderate-vigorous physical activities (MVPA) per week. 8 Furthermore, it has been recommended that MVPA should be performed in bouts with at least a 10-minute duration. 8 Surprisingly, there are no data indicating the number of symptomatic PAD patients who achieve these physical activity recommendations. Given that most of symptomatic PAD patients are older, have several comorbidities, and that symptoms of intermittent claudication are the main barrier for physical activity practice in these patients, 9 by limiting their walking and functional capacity, it is expected that only a small percentage of the patients would achieve the recommended physical activity levels. Thus, in this study we aimed to describe the physical activity pattern of Brazilian patients with PAD and symptoms 410