Patient education and physical training for patients with AF
445
Table I. Baseline characteristics of participants. All values are given as numbers unless otherwise stated in the table
Age, years, mean (SD) [range]
Female, n (%)
AF type, n (%)
Paroxysmal
Persistent
CHADS2VA2Sc score, n (%)
0
1
Control group (n = 24) Intervention group (n = 28) p-value for difference
60.2 (8.9) [42.7–73.4]
7 (29)
9 (38)
15 (63) 62.2 (10.0) [32.6–77.6)
11 (39)
16 (57)
12 (43) 0.447
0.562
0.177
0.673
9 (38)
8 (33) 6 (21)
11 (39)
5 (21)
2 (8) 7 (25)
4 (14)
2
3
Symptoms, n (%)
Fatigue
Dyspnoea
Palpitations
Dizziness
Syncope
Chest pain
Asymptomatic
Smoker, n (%) 11 (46)
9 (38)
10 (42)
6 (25)
1 (4)
10 (42)
3 (13)
1 (4) 12 (43)
11 (39)
14 (50)
11 (393)
3 (10)
7 (25)
5 (18)
1 (4) 1.000
1.000
0.588
0.376
0.615
2.450
0.711
1.000
BMI, kg/m 2 , mean (SD) [range]
Oxygen uptake, l/min/kg, mean (SD) [range]
Medical treatment, n (%)
Warfarin
Dabigatran
ASA
Beta blocker
Amiodarone
Flecainide 27.8 (3.9) [22.1–40.4]
31.7 (8.3) [15.4–50.1]
11 (46)
3 (13)
2 (8)
16 (67)
2 (8)
4 (17) 27.9 (5.1) [21.1–43.4]
29.0 (7.3) [16.5–42.0]
11 (39)
2 (7)
2 (7)
18 (64)
3 (11)
3 (11) 0.963
0.230
0.779
0.652
1.000
1.000
1.000
0.690
BMI: body mass index; AF: atrial fibrillation; SD: standard deviation; ASA: acetylsalicylic acid.
The PHQ9 and GAD questionnaires showed that
patients in both groups achieved a higher QoL after 6
months, but the increase was statistically significantly
higher in the intervention group. From 6 to 12 months
a lower QoL was found in both groups without statis-
tical significance at the end of the study (Table II and
Figs 2c and 2d).
A similar trend was found using the EQVAS,
with an initial not statistically significant in-
crease in QoL for the intervention group that de-
creased at the end of the study (Table II and Fig. 2e).
As shown in Fig. 3 and Table III, the participants in
the intervention group had a lower maximum exercise
capacity and oxygen (O 2 ) uptake and an inferior per-
formance in the 5RSS test at baseline than the control
group despite the electronic randomization. The control
group did not improve their exercise capacity and O 2
uptake during the study, whereas in the intervention
group, the maximum exercise capacity increased signi-
ficantly from baseline to 3 months and remained steady
Table II. Scores from quality of life (QoL) questionnaires at baseline and after 3, 6 and 12 months. The first column with p-values
stems from the unpaired comparison between treatment groups at baseline. Subsequent p-values stem from unpaired comparisons of
changes from baseline
Baseline
Questionnaire Mean (SD)
AF-QoL-18 52.2 (22.1)
48.4 (22.8)
66.3 (26.5)
67.5 (26.3)
3.6 (3.9)
5.3 (4.9)
4.3 (4.3)
5.8 (7.3)
76.2 (13.2)
71.0 (15.9)
AFEQT
GAD-7
PHQ-9
EQVAS
Physical training
Control
Intervention
Control
Intervention
Control
Intervention
Control
Intervention
Control
Intervention
3 months
p-value
0.555
0.841
0.092
0.251
0.184
Mean (SD)
57.3 (24.7)
63.2 (18.9)
78.2 (20.9)
86.4 (19.5)
2.4 (3.5)
2.7 (3.6)
4.2 (3.7)
3.3 (3.6)
73.4 (14.4)
75.4 (15.9)
6 months
p-value
0.014*
0.194
0.071
0.082
0.062
Mean (SD)
59.2 (27.28)
68.0 (15.21)
82.3 (18.7)
88.6 (15.1)
3.0 (3.1)
1.6 (2.1)
3.9 (3.5)
1.8 (2.5)
77.0 (12.1)
80.0 (11.0)
12 months
p-value
0.031*
0.822
0.003*
0.023*
0.099
Mean (SD)
58.0 (28.0)
59.1 (23.2)
83.4 (19.3)
86.7 (20.5)
3.3 (3.5)
3.2 (4.2)
4.8 (5.0)
3.4 (3.8)
77.8 (11.0)
76.2 (15.0)
p-value
0.359
0.812
0.074
0.028*
0.362
*p-values from analysis of variance (ANOVA) test of difference between groups from baseline to time-point
QoL: quality of life; SD: standard deviation; AFEQT: Atrial Fibrillation Effect on QualiTy of Life; GAD-7: Generalised Anxiety Disorder Assessment; PHQ-9: Patient
Health Questionnaire; EQ-5D: EuroQol 5D.
J Rehabil Med 51, 2019