Rural Versus Urban Comparison: Physical Activity and Functioning Following Coronary Artery Bypass Surgery

Abstract

Purpose

The purpose of this sub-analysis was to compare the early recovery of elderly patients following coronary artery bypass surgery (CABS) by geographic location (urban/rural) on physical functioning and physical activity.

Methods

The sample was 124 subjects who had been in the usual care group (or control group) of a randomized controlled trial.  Subjects were categorized into geographic locales using Rural Urban Commuting Area (RUCA) codes: urban n=35, large rural n=17, small rural n=23 and isolated rural n=33. Measures included the Medical Outcomes Study Short-Form 36 and the RT3® accelerometer. Mixed linear models were used to analyze the data.

Results

No significant differences were found for physical functioning by RUCA group. However, there was a statistically significant difference for physical activity, for average kcals/kg/ per day (F = 3.01, p < .05) and average daily activity counts (F = 3.95, p <.01), with the subjects in large rural communities having significantly (p < 0.05) more average kcals/kg per day than urban subjects (M = 29.04 and M = 27.25 respectively). Subjects in the large rural also had significantly (p < .005) more average daily activity counts than urban (M = 216635 and M = 161221 respectively).

Conclusions

This is the first study to compare early recovery functioning and activity outcomes of CABS subjects by rural/urban locations.  Additional study is warranted to evaluate why these differences exist and the potential need to tailor interventions for CABS based on geographic location.

Key Words Rural Urban Comparison; Cardiovascular Surgery; Physical Activity; Physical Functioning.