Physical activity in hypertrophic cardiomyopathy: prevalence of inactivity and perceived barriers

Abstract

Objectives: This study aimed to determine the prevalence of physical inactivity and perceived barriers to physical activity among individuals with hypertrophic cardiomyopathy (HCM), and to determine potential demographic, clinical and health-related factors influencing likelihood of meeting physical activity guidelines.

Methods: This was a cross-sectional study of consecutive patients (n=198) with HCM attending a specialist HCM centre from July 2014 to November 2015. The primary outcome measure was physical activity (minutes per day), as measured by self-report (International Physical Activity Questionnaire (IPAQ)) and objective means (ActiGraph accelerometer). For both, participants were classified as meeting guidelines if they did at least 150 min per week of physical activity. Quality of life (Short Form-36 V.2, SF-36v2), barriers to exercise and clinical-demographic data were also collected.

Results: In total, 54.8% of participants did not meet physical activity recommendations based on IPAQ, and 12.7% did not meet guidelines based on accelerometer data. The most commonly identified barriers to exercise were 'pain interferes with my exercise' (33%) and 'I have an injury/disability that stops me' (29%). Independent factors associated with meeting guidelines included older age (OR 0.66, 95% CI 0.51 to 0.85, p=0.002), higher education level (OR 2.31, 95% CI 1.08 to 4.93, p=0.03), better physical quality of life (OR 1.05, 95% CI 1.0 to 1.09, p=0.05) and more reported barriers (OR 0.71, 95% CI 0.56 to 0.91, p=0.01).

Conclusions: More than half of the patients with HCM did not meet minimum physical activity recommendations. Several barriers to exercise among individuals with HCM exist, and provide the basis for targeted interventions to promote physical activity and improve overall health in patients with HCM.

Keywords: Physical Activity; exercise.

Figure 1

Study recruitment flow chart. HCM, hypertrophic cardiomyopathy.

Figure 2

Distribution of physical activity (min/week) across 30 min increments. MVPA, moderate–vigorous physical activity.

Figure 3

Spider plot of the unstandardised SF-36v2 subscales, comparing our HCM population with the mean for the general population (aged 45–54 years). Patients with HCM scored significantly lower than the age-matched general AUS population norms on the following subscales (marked with an asterisk); PF (p<0.001), RP (p=0.004), GH (p<0.001), VT (p=0.01), RE (p=0.01) and MH (p<0.001). BP and SF were non-significant. AUS, Australian; BP, bodily pain; GH, general health; HCM, hypertrophic cardiomyopathy; MH, mental health; PF, physical functioning; RE, role emotional; RP, role physical; SF, social function; SF-36v2, Short Form-36 V.2; VT, vitality. *p<0.05.

Figure 4

Barriers to exercise identified by our HCM population. HCM, hypertrophic cardiomyopathy.