Physical activity readiness in patient withdrawals from cardiac rehabilitation

Rivett, Martin; Tsakirides, Costas; Pringle, Andrew; Carroll, Sean; Ingle, Lee; Dudfield, Mike

doi:10.12968/bjon.2009.18.3.39050

Cited by 12 publications

(13 citation statements)

References 27 publications

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“…It is important that future studies continue to explore this correlate because a lack of PA enjoyment may lead to withdrawal from CR programs and inactivity. 29 A stepwise linear regression identified the strongest model able to predict PA behavior among CR graduates. This model included established items (age and work status) and new items (PA enjoyment, CR staff support, and home location).…”

Section: Socioecological Correlates Of Physical Activitymentioning

confidence: 96%

Physical Activity Behavior Two to Six Years Following Cardiac Rehabilitation: A Socioecological Analysis

Bentley

Khan

et al. 2012

Clinical Cardiology

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Background: Cardiac rehabilitation (CR) promotes long-term positive health behaviours, such as physical activity (PA), in patients following a cardiovascular event. We have limited knowledge of long-term PA and its correlates. Therefore, this research examined both PA behaviour and socioecological correlates among elderly graduates 2-6 years following CR. Hypothesis: CR graduates will have a moderate PA level in the long term. Greater PA will be associated with various multilevel correlates.Methods: This was a retrospective, cross-sectional study which quantified PA using the Physical Activity Scale for the Elderly (PASE) and collected information about socioecological correlates at the intrapersonal, interpersonal and health service levels. Both univariate and multivariate analyses assessed PA and PA correlates. Results: The majority of the 584 participants were older (69.8 ± 9.8), male (80.3%), and well educated (75.4% ≥ some post-secondary). Average time since CR graduation was 41.5 ± 11.5 months. Seventy five percent of CR graduates reported current weekly PA levels that met, or exceeded, Canadian PA guidelines (>150 minutes of moderate-vigorous PA). Univariate analyses identified 13 PASE score correlates. Multivariate analyses identified age, PA enjoyment, current work status, CR staff support, location of primary residence, and perceived health as significantly associated with higher PASE scores (p < 0.001).Conclusions: Three and a half years post-CR graduates had high PA levels. Greater PA was associated with several modifiable multilevel correlates at all levels of influence. Understanding correlates of long-term PA behaviour among CR graduates will help identify groups at risk for nonadherence and assist with continued program development. IntroductionCompared to patients who only receive conventional inhospital care, patients who complete a cardiac rehabilitation (CR) program following a cardiac event experience a significant reduction in all-cause mortality 1 -3 by 20% to 25% within 3 years. 3 CR programs are traditionally short-term multifaceted interventions that include physical activity (PA) as a core element. 2,4,5 One of the overarching objectives of CR is to encourage patients to maintain PA at guidelinerecommended levels after program completion. Current Canadian PA guidelines for effective health advocate at least 150 minutes of moderate-vigorous PA per week. 6 There is some evidence that states that PA behavior among CR graduates in the short term (1 year post-CR) often fails toThe authors have no funding, financial relationships, or conflicts of interest to disclose. meet the recommendations. 7,8 There is very little evidence on PA behavior over the long term (2 or more years).Encouraging positive health behaviors among CR graduates is a complex process that involves many levels of influence. To examine these levels of influence, a comprehensive approach to health promotion must be employed, such as the socioecological model. 9 The socioecological model integrates intra-and interpersonal fa...

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Section: Socioecological Correlates Of Physical Activitymentioning

confidence: 96%

Physical Activity Behavior Two to Six Years Following Cardiac Rehabilitation: A Socioecological Analysis

Bentley

Khan

et al. 2012

Clinical Cardiology

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“…74 There exists a large variety of factors that may influence the individual adherence to long-term therapies including rehabilitation programmes. 75,76 Practicability and enjoyment may be regarded of special importance for a long-term maintenance of exercise training. [76][77][78][79][80] Individually tailored physical exercise therefore includes baseline assessment of a patient's fitness, the motivation to change lifestyle habits ('be active!…”

Section: Characteristics Of Pa and Exercise Training In Cadmentioning

confidence: 99%

“…75,76 Practicability and enjoyment may be regarded of special importance for a long-term maintenance of exercise training. [76][77][78][79][80] Individually tailored physical exercise therefore includes baseline assessment of a patient's fitness, the motivation to change lifestyle habits ('be active! '), the intensity of the exercise prescribed to reach the level of the target set, and finally a structured follow up, i.e.…”

Section: Characteristics Of Pa and Exercise Training In Cadmentioning

confidence: 99%

Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular disease (Part III)

Vanhees

Rauch

Piepoli

et al. 2012

Eur J Prev Cardiolog

183

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The beneficial effect of exercise training and exercise-based cardiac rehabilitation on symptom-free exercise capacity,cardiovascular and skeletal muscle function, quality of life, general healthy lifestyle, and reduction of depressive symptoms and psychosocial stress is nowadays well recognized. However, it remains largely obscure, which characteristics of physical activity (PA) and exercise training--frequency, intensity, time (duration), type (mode), and volume (dose: intensity x duration) of exercise--are the most effective. The present paper, therefore, will deal with these exercise characteristics in the management of individuals with cardiovascular disease, i.e. coronary artery disease and chronic heart failure patients, but also in patients with congenital or valvular heart disease. Based on the current literature, and if sufficient evidence is available, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding frequency, intensity, time and type of PA, and safety aspects during exercise inpatients with cardiovascular disease. This paper is the third in a series of three papers, all devoted to the same theme: the importance of the exercise characteristics in the management of cardiovascular health. Part I is directed to the general population and Part II to individuals with cardiovascular risk factors. In general, PA recommendations and exercise training programmes for patients with coronary artery disease or chronic heart failure need to be tailored to the individual's exercise capacity and risk profile, with the aim to reach and maintain the individually highest fitness level possible and to perform endurance exercise training 30–60 min daily (3–5 days per week) in combination with resistance training 2–3 times a week. Because of the frequently reported dose–response relationship between training effect and exercise intensity, one should seek sufficiently high training intensities, although more scientific evidence on effect sizes and safety is warranted. At present, there is insufficient data to give more specific recommendations on type, dosage, and intensity of exercise in some other cardiovascular diseases, such as congenital heart disease, valve disease, cardiomyopathies, channelopathies, and patients with implanted devices.

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“…For instance, the stages concept was validated with moderate and strenuous PA among children during PA (Haas & Nigg, 2009), college-age athletes during injury rehabilitation (Clement, 2008), adult high-risk employees (Faghri, Blozie, Gustavesen, & Kotejoshyer, 2008), and among older adults during cardiac rehabilitation (Rivett, et al, 2009) and PA program enrollment (Hildebrand & Neufeld, 2009). …”

Section: Constructs Of the Ttmmentioning

confidence: 99%

A research agenda to examine the efficacy and relevance of the Transtheoretical Model for physical activity behavior

Nigg

Geller

Motl

et al. 2011

Psychology of Sport and Exercise

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Regular physical activity (PA) decreases the risk of several chronic diseases including some cancers, type II diabetes, obesity, and cardiovascular disease; however, the majority of US adults are not meeting the recommended levels to experience these benefits. To address this public health concern, the underlying mechanisms for behavior change need to be understood, translated and disseminated into appropriately tailored interventions. The Transtheoretical Model (TTM) provides a framework for both the conceptualization and measurement of behavior change, as well as facilitating promotion strategies that are individualized and easily adapted. The purpose of this manuscript is to present the constructs of the TTM as they relate to PA behavior change. We begin with a brief synopsis of recent examinations of the TTM constructs and their application. Subsequent to its introduction, we specifically present the TTM within the PA context and discuss its application and usefulness to researchers and practitioners. Criticisms of the TTM are also noted and presented as opportunities for future research to enhance the valid application of the TTM. We offer general study design recommendations to appropriately test the hypothesized relationships within the model. With further examinations using appropriate study design and statistical analyses, we believe the TTM has the potential to advance the public health impact of future PA promotion interventions.

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Physical activity readiness in patient withdrawals from cardiac rehabilitation

Abstract: 66% of patients who had withdrawn from a phase IV CR programme remained in an advanced stage of PA readiness. Drop-out was due to a combination of financial, physical and lifestyle factors.

Cited by 12 publications

References 27 publications

Physical Activity Behavior Two to Six Years Following Cardiac Rehabilitation: A Socioecological Analysis

Physical Activity Behavior Two to Six Years Following Cardiac Rehabilitation: A Socioecological Analysis

Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular disease (Part III)

A research agenda to examine the efficacy and relevance of the Transtheoretical Model for physical activity behavior

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