ABC | Volume 113, Nº3, September 2019

Original Article Gerage et al. Physical activity in PAD patients Arq Bras Cardiol. 2019; 113(3):410-416 Figure 1 – Time spent in sedentary, low light, high light and moderate-to-vigorous (MVPA) physical activities (PA). 60 40 20 0 60 40 20 0 60 40 20 0 60 40 20 0 300 0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 0 10 20 30 40 50 60 70 80 90 350 450 400 500 600 700 800 900 850 750 650 550 300 350 450 400 500 600 700 800 900 850 750 650 550 Frequency (n) Frequency (n) Frequency (n) Frequency (n) Sedentary time (min/day) High-light PA (min/day) MVPA (min/day) Low-light PA (min/day) recommendations for the overall population; c) younger patients, regardless of clinical or physical factors, were more likely to meet the current physical activity recommendations for the overall population. The cutoff used in the present study considered, in addition to “sedentary” and “moderate-to-vigorous physical activity”, the “low-light” and “high-light” categories. 15 This decision was based on the following aspects: a) light physical activities are the physical activities most often performed by the elderly, especially those with functional capacity limitations (i.e. patients with PAD); b) light physical activity was broadly unspecified to account for all activity between sedentary and moderate-to-vigorous physical activity (100–1,951 counts/minute); c) the association between light physical activity and health parameters increases when those light physical activities with high energy expenditure (high-light physical activity), that are closer to the classification of moderate-to-vigorous physical activities than sedentary activities, are considered. 15 In the present study, our sample of PAD patients with intermittent claudication symptoms spent 640 min/day and 15 min/day in sedentary behavior and MVPA, respectively, which represents 66.7% and 1.5% of the waking hours of the day. This pattern is similar to that observed in patients with other cardiovascular diseases, including coronary heart disease, congestive heart failure, myocardial infarction 16 and stroke survivors. 17 In these populations, sedentary behavior ranged from 576 min/day 16 to 606 min/day, 16,17 while MVPA ranged from 8.6 min/day to 11.4 min/day. Interestingly, although pain symptoms (intermittent claudication) during exercise have been reported as a main barrier for physical activity practice in PAD patients, 9 their physical activity patterns seem to be similar to cardiac patients without walking impairment. The current physical activity recommendation for the overall population includes 150 min/day of MVPA in bouts of at least 10 min. The results of this study indicated that a very small percentage (3.4%) of our sample met the current physical activity recommendations. These values are lower than those of previous studies generally carried out with adults (~10%), 18 older adults (12%) 19 and osteoarthritis patients (13% men and 8% women) 20 who usually also have physical limitations. The reduced number of patients who met the physical activity recommendations could be explained by the difficulty of Table 2 – Total time spent in sedentary, high light or MVPA and MVPA bouts and sedentary breaks per week and per day in PAD patients (n = 174) Variable In a week (mean ± SD) In a day (mean ± SD) Total SED bouts 120.1 ± 32.6 17.2 ± 4.7 Total time in SED bouts (min) 2895.6 ± 1057.3 413.7 ± 151.1 Total SED breaks 118.7 ± 32.6 17.0 ± 4.7 Total time in SED breaks (min) 8543.9 ± 2518.0 174.4 ± 51.4 Total high light and MVPA bouts 5.7 ± 7.8 0.8 ± 1.1 Total time in high light and MVPA bouts (min) 84.01 ± 123.8 12.1 ± 17.7 Total MVPA bouts 1.5 ± 3.1 0.22 ± 0.44 Total time in MVPA (min) 22.7 ± 50.3 3.2 ± 7.2 SED: sedentary; MVPA: moderate/vigorous physical activity. 413