Effectiveness of a home-based music-paced physical activity programme on exercise-related outcomes after cardiac rehabilitation: a randomized controlled trial.

AIMS: A randomized controlled trial was conducted to examine the effects of a home-based music-paced physical activity programme guided by Information-Motivation-Strategy (IMS) model and Self-determination theory on exercise-related outcomes for patients with coronary heart disease (CHD) after cardiac rehabilitation (CR). METHODS AND RESULTS: A total of 130 patients with CHD from a regional CR centre in Hong Kong were recruited and randomly allocated into intervention (n = 65) or control groups (n = 65). The intervention group received theory-guided practical sessions on performing prescribed home-based physical activity with individualized synchronized music, and follow-up telephone calls. The primary outcome was exercise capacity. Secondary outcomes included exercise self-efficacy, physical activity level, and exercise self-determination. Data were collected at baseline, 3 months, and 6 months after study entry. The generalized estimating equations model was used to assess the intervention effects. Patients with CHD in the intervention group demonstrated significantly greater improvements in exercise capacity at 3 months [ß = 35.68, 95% confidence interval (CI) 2.69-68.68, P = 0.034] and significantly improved exercise self-efficacy at 6 months (ß = 3.72, 95% CI 0.11-7.32, P = 0.043) when compared with the control group. However, no significant group differences were found in physical activity level and exercise self-determination. CONCLUSION: The study findings provide evidence on an innovation on improving the exercise capacity and exercise self-efficacy of patients with CHD. The music-paced physical activity guided by the IMS model and Self-determination theory requires further investigation on its long-term effects in future studies. CLINICAL TRIAL REGISTRATION: ChiCTR-IOR-17011015.

Exercise capacity and its determinants among postcardiac rehabilitation patients with coronary heart disease.

AIM: To investigate the determinants of exercise capacity in postcardiac rehabilitation patients with coronary heart disease (CHD). DESIGN: A cross-sectional design was used. METHODS: This study analysed the cross-sectional data from the baseline assessment of 130 CHD patients who participated in a longitudinal randomized controlled trial of music-paced physical activity intervention for CHD patients (ChiCTR-IOR-17011015) (September 2017 to February 2019). Exercise capacity was measured by using the 10-metre incremental shuttle-walk test. The amount of physical activity, exercise self-determination and exercise self-efficacy were measured by validated instruments. Participants' anthropometric parameters (body mass index, body fat mass percentage and waist circumference) were measured. Hierarchical regression analyses were used to identify the factors influencing exercise capacity. RESULTS: The mean incremental shuttle-walk test distance was 493.00 ± 180.04 m. The factors significantly associated with exercise capacity were age (ß = -.42), female (ß = -.35), body mass index (ß = -.25) and exercise self-efficacy (ß = -.20). These factors accounted for 56.5% of the total variance of exercise capacity.

Vasomotor symptoms, cardiovascular risk factors, and cardiovascular disease risk among Chinese postmenopausal women in Hong Kong.

Vasomotor symptoms are frequently reported by postmenopausal women and linked with unfavorable changes in cardiovascular risk factors, suggesting a likely association with cardiovascular disease (CVD) risk. This study aimed to investigate the characteristics of and associations between vasomotor symptoms, cardiovascular risk factors, and CVD risk among Chinese postmenopausal women. From March 2018 to August 2019, a convenience sample of 288 postmenopausal women who experienced natural menopause for ≥12 months were recruited from district centers of women associations in Hong Kong. We assessed vasomotor symptoms, cardiovascular risk factors, and CVD risk using questionnaires, anthropometric measures, and laboratory testing of fasting blood samples. Data were analyzed using bivariate correlation analyses and linear regression analyses. Over half of the participants experienced vasomotor symptoms (50.3 percent), and 23.3 percent had a high 10-year CVD risk. After adjusting for sociodemographic and clinical variables, flashing (ß = 0.270, P = .002) and sweating (ß = > -0.206, P = .018) were significantly associated with low-density lipoprotein cholesterol and flashing (ß = 0.229, P = .007) were significantly associated with total cholesterol. No statistically significant association was observed between vasomotor symptoms and CVD risk. Vasomotor symptoms were common and associated with several cardiovascular risk factors in Chinese postmenopausal women.

Relationship between sleep quality and cardiovascular disease risk in Chinese post-menopausal women.

BACKGROUND: Menopause is an inevitable stage affecting every middle-aged woman. China has a large and increasing group of post-menopausal women. Most post-menopausal women suffer from increased risks for cardiovascular diseases (CVD) and sleep problems. Previous studies have demonstrated the associations between sleep disorders and increased CVD risks in general population. The current study is to examine the relationship between sleep quality and CVD risks among Chinese post-menopausal women. METHODS: This study was a sub-study nested in a cross-sectional study that investigated the sleep quality of community-dwelling adults in Xian, Shaanxi Province, China. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and the Framingham 10-year risk score (FRS) were used to measure sleep quality and CVD risk among 154 Chinese post-menopausal women. Multivariate regression and logistic regression were used to determine the association between sleep quality and CVD risk. RESULTS: The participants (age: 63.65 ± 4.47 years) experienced poor sleep quality (mean score of global PSQI = 8.58) and a 10-year risk of CVD of 12.54%. The CVD risk was significantly associated with sleep duration (ß = - 0.18, p = 0.04) and sleep disturbance (ß = 0.33, p < 0.001). Women with good sleep quality (PSQI ≤5) were less likely to be at high risk for CVD (FRS > 10%) (odds ratio = 0.51, p = 0.04). CONCLUSIONS: Poor sleep quality might increase the CVD risk in post-menopausal women. Interventions to promote the cardiovascular health of Chinese post-menopausal women may need to include sleep promotion strategies.

Effects of Lifestyle Intervention on Physiological Outcomes in Chinese Adults With, or at High Risk of, Metabolic Syndrome.

BACKGROUND: Metabolic syndrome (MS) increases the risk of cardiovascular events and the development of diabetes. This article reports the effects of lifestyle intervention on the physiological outcomes of people with or at high risk of MS in the community setting of Hong Kong. METHODS: Chinese adults with 2 or more MS components were recruited from 13 community centers, which were cluster-randomized to the intervention or control group. The intervention group received a low-intensity lifestyle intervention program for people with MS consisting of group sessions, individual counseling, and telephone follow-ups over 3 months. The control group received standard care plus an attention placebo. The primary outcomes were body weight and waist circumference, whereas the secondary outcomes included blood pressure, lipids, glucose, and number of MS components. Linear mixed-effects models were used to compare the effects of the program between the 2 groups. RESULTS: The final sample consisted of 183 adults (19.1% male) with a mean (SD) age of 54.0 (7.8) years. At 3 months, overall MS prevalence was reduced to 13.8%. Compared with the control group, subjects in the intervention group exhibited a reduced waist circumference (ß = -.146, P = .008) when the interaction effects of time and group were considered simultaneously. However, no significant differences were found for changes in the other measured outcomes. CONCLUSION: A low-intensity lifestyle intervention program for people with MS can reduce central obesity among people with or at high risk for MS. Further research is necessary to confirm the long-term physiological effects of the intervention.

Factors associated with health-promoting behavior of people with or at high risk of metabolic syndrome: Based on the health belief model.

PURPOSE: The purpose of this study is to identify the associations between self-efficacy and the various factors in the Health Belief Model (HBM), and the health-promoting behaviors of people with, or at high risk of, Metabolic Syndrome (MS). METHODS: 132 adults with two or more MS components were included in this cross-sectional study. Health-promoting behavior, self-efficacy and the four-constructs of HBM (perceived threat, cues, benefits, and barriers) were measured using validated tools. The contributions of each HBM factor towards the respective behavior were identified using a three-step hierarchical regression approach. RESULTS: After controlling for age, gender, education level, income and knowledge of MS, HBM factors accounted for 11% of the total variance in health-promoting behaviors. Beliefs about barriers were found to be a significant predictor of exercise (ß=-.28, p<.01) and diet management (ß=-.24, p=<.01), suggesting that a higher level of perceived barrier was associated with a lower frequency of health-promoting behaviors. In the final model, self-efficacy explained an additional 31% of the variance in exercise behavior and 13% in diet management behavior. CONCLUSIONS: Self-efficacy and perceived barriers made independent contributions to health-promoting behavior among people with, or at high risk of, MS. Community health program targeting this particular group should tailor strategies that can enhance individuals' self-efficacy and address barriers perceived.