Mediators of Exercise Maintenance After Cardiac Rehabilitation

Abstract

PURPOSE Exercise maintenance after completing Phase II cardiac rehabilitation (CR) is challenging for many patients. A telephone-based maintenance intervention improved exercise participation compared to a control group at 12 months post-CR discharge. We examined the 6-month mediators of intervention effects on exercise. METHODS In a randomized controlled trial, 130 patients who had completed CR (mean age: 63.6 years [SD=9.7], 20.8% female) were randomized to Maintenance Counseling (n=64) or contact control (n=66). Putative mediators examined included: self-efficacy, behavioral processes of change, decisional balance index, social support for exercise, and enjoyment of exercise. RESULTS Multiple mediation analyses showed that the intervention significantly increased social support from friends at 6 months but not the other constructs. Decreasing support from friends mediated greater exercise participation in Maintenance Counseling vs. Contact Control at 12 months. CONCLUSIONS Social support from friends functioned as a suppressor mediator for exercise maintenance among cardiac patients.

Effectiveness of telehealth interventions as a part of secondary prevention in coronary artery disease: a systematic review and meta‐analysis

“…In total, 11 studies about lipid changes , 11 studies about blood pressure , eight studies about smoking cessation , 13 studies about physical activity , eight studies about medication adherence and four studies about waist circumference were eventually included (summary of study characteristics) (Fig. ).…”

“…Fourteen studies were published between 2015 and 2017, and ten studies between 2003 and 2014. Four studies were conducted in Australia , four in the United States , three in Canada , two each in New Zealand , Sweden and Norway , and one in each of the following countries: Belgium , Italy , Malaysia , Netherlands , Germany , Korea and Iceland .…”

“…When the types of intervention were examined, it was found that four types of intervention were used in the studies: text messages, telephone calls, telephone calls in combination with messages and telemonitoring. It was determined that telephone calls were the most commonly used intervention in 11 studies and text messages came second intervention with seven studies . It was found that telephone calls in combination with messages were used in four studies and telemonitoring was used in two studies (Table ).…”

“…Some of the studies measured outcomes at different time points using several instruments or indicators. The follow‐ups ranged in length from 30 days to 18 months, and seven of the studies had more than one follow‐up . We selected the outcomes at the end point of each of the studies and the follow‐up at 6 or 12 months when the maximum was 12–18 months, where the most commonly reported follow‐up period was 6 months.…”

“…We selected the outcomes at the end point of each of the studies and the follow‐up at 6 or 12 months when the maximum was 12–18 months, where the most commonly reported follow‐up period was 6 months. Six studies had a 1‐year follow‐up period and two a follow‐up period of 18 months . Nine studies had a 6‐month follow‐up period , and seven studies had a follow‐up of less than 6 months: 18 weeks , 12 weeks , 6 weeks , 8 weeks and 30 days .…”