Reproducibility of the Veterans Physical Activity Questionnaire in an elderly population.

BACKGROUND: Quantifying lifetime physical activity using self-reported measures is challenging due to reliance on recall, especially in older populations. The purpose of this study was to determine the 1-year reproducibility of the Veterans Physical Activity Questionnaire (VAPAQ) in a cohort of patients with documented abdominal aortic aneurysm disease (AAA). METHODS: Subjects included men (n = 52) and women (n = 3) enrolled in AAA STOP, a randomized trial designed to test the ability of supervised exercise training to modify AAA biology and early disease progression. RESULTS: The overall correlation coefficient for lifetime recreational energy expenditure between the 2 examinations was 0.93 (P < .001), with an overall difference of 26 kcal/week, a typical error (standard deviation of the differences) of 171 kcals/week, and a coefficient of variation (CV) of 15.5%. CONCLUSIONS: The VAPAQ is a reproducible tool to quantify lifetime energy expenditure in older adults with documented vascular disease.

Agreement between activity-monitoring devices during home rehabilitation: a substudy of the AAA STOP trial.

As part of a home-based rehabilitation program, 24 older adult patients (71 ± 3 years) with abdominal aortic aneurysm (AAA) disease underwent 3 days (12 awake hr/day) of activity monitoring using an accelerometer (ACC), a pedometer, and a heart rate (HR) monitor, and recorded hourly activity logs. Subjects then underwent an interview to complete a 3-day activity recall questionnaire (3-DR). Mean energy expenditure (EE) in kcals/ day for HR, ACC, and 3-DR were 1,687 ± 458, 2,068 ± 529, and 1,974 ± 491, respectively. Differences in EE were not significant between 3-DR and ACC, but HR differed from both ACC (p < .001) and 3-DR (p < .01). ACC and 3-DR had the highest agreement, with a coefficient of variation of 7.9% and r = .86. Thus, ACC provided a reasonably accurate reflection of EE based the criterion measure, an activity recall questionnaire. ACC can be effectively used to monitor EE to achieve an appropriate training stimulus during home-based cardiac rehabilitation.

A randomized trial of exercise training in abdominal aortic aneurysm disease.

PURPOSE: Screening programs and greater public awareness have increased the recognition of early abdominal aortic aneurysm (AAA) disease. No medical therapy has proven effective in limiting AAA progression, and little is known regarding the safety and efficacy of exercise training in these patients. We evaluated the safety and efficacy of up to 3 yr of training in patients with early (≤5.5 cm) AAA disease. METHODS: One hundred and forty patients with small AAAs (72 ± 8 yr) were randomized to exercise training (n = 72) or usual care (n = 68). Exercise subjects participated in a combination of in-house and home training for up to 3 yr. Cardiopulmonary exercise testing (CPX) was performed at baseline and 3, 12, 24, and 36 months. Comparisons were made for AAA expansion, safety, CPX responses, and weekly energy expenditure. RESULTS: The average duration of participation was 23.4 ± 9.6 months; 81% of subjects completed ≥1 year. No adverse clinical events or excessive AAA growth rates related to training occurred. Exercise subjects expended a mean 1999 ± 1030 kcal·wk. Increases in peak exercise time and estimated METs occurred at the 3-month and 1-, 2-, and 3-yr evaluations (P < 0.01 between groups). A significant between-group interaction occurred for V˙O2 at the ventilatory threshold (P = 0.02), and submaximal heart rate was significantly reduced among exercise subjects. Neither exercise status nor level of fitness significantly influenced rate of AAA enlargement. CONCLUSIONS: These results support the safety and efficacy of training in patients with small AAA, a population for which few previous data are available. Despite advanced age and comorbidities, training up to 3 yr was well tolerated and sustainable in AAA patients. Training did not influence rate of AAA enlargement.