Reallocating Time From Sedentary Behavior to Physical Activity in Patients With Peripheral Artery Disease: Analyzing the Effects on Walking Capacity Using Compositional Data Analysis

in Journal of Physical Activity and Health
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Background: To examine the associations between physical activity (PA) and sedentary behavior (SB) with walking capacity and the effects of reallocating time from SB to PA in patients with symptomatic peripheral artery disease (PAD) using compositional data analysis. Methods: This cross-sectional study included 178 patients (34% females, mean age = 66 [9] y, body mass index = 27.8 [5.0] kg/m2, and ankle-brachial index = 0.60 [0.18]). Walking capacity was assessed as the total walking distance (TWD) achieved in a 6-minute walk test, while SB, light-intensity PA, and moderate to vigorous-intensity PA (MVPA) were measured by a triaxial accelerometer and conceptualized as a time-use composition. Associations between time reallocation among wake-time behaviors and TWD were determined using compositional isotemporal substitution models. Results: A positive association of MVPA with TWD (relative to remaining behaviors) was found in men (β ilr = 66.9, SE = 21.4, P = .003) and women (β ilr = 56.5, SE = 19.8; P = .005). Reallocating 30 minutes per week from SB to MVPA was associated with higher TWD in men (6.7 m; 95% confidence interval, 2.6–10.9 m) and women (4.5 m; 95% confidence interval, 1.5–7.5 m). Conclusions: The findings highlight, using a compositional approach, the beneficial and independent association of MVPA with walking capacity in patients with symptomatic PAD, whereas SB and light-intensity PA were not associated.

Germano-Soares is with the Associated Graduate Program in Physical Education UPE/UFPB, University of Pernambuco, Recife, Pernambuco, Brazil. Tassitano and Farah are with the Physical Education Department, Federal Rural University of Pernambuco, Recife, Pernambuco, Brazil. Andrade-Lima is with the Department of Physical Education, Federal University of Sergipe, Sergipe, Brazil. Correia is with the Postgraduate Program in Medicine, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil. Gába and Štefelová are with the Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic. Puech-Leao is with the Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil. Wolosker is with the Hospital Israelita Albert Einstein, Sao Paulo, São Paulo, Brazil. Cucato is with Northumbria University, Newcastle Upon Tyne, England. Ritti-Dias is with the Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil.

Ritti-Dias (raphaelritti@gmail.com) is corresponding author.
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