title: Maintenance of exercise after phase II cardiac rehabilitation: a randomized controlled trial.
abstract: BACKGROUND
  Patients who have completed Phase II cardiac rehabilitation have low rates of maintenance of exercise after program completion, despite the importance of sustaining regular exercise to prevent future cardiac events.
  
  
  OBJECTIVE
  The efficacy of a home-based intervention to support exercise maintenance among patients who had completed Phase II cardiac rehabilitation versus contact control was evaluated.
  
  
  METHODS
  An RCT was used to evaluate the intervention. Data were collected in 2005-2010 and analyzed in 2010.
  
  
  METHODS
  One hundred thirty patients (mean age=63.6 years [SD=9.7], 20.8% female) were randomized to exercise counseling (Maintenance Counseling group, n=64) or contact control (Contact Control group, n=66).
  
  
  METHODS
  Maintenance Counseling group participants received a 6-month program of exercise counseling (based on the transtheoretical model and social cognitive theory) delivered via telephone, as well as print materials and feedback reports.
  
  
  METHODS
  Assessments of physical activity (7-Day Physical Activity Recall), motivational readiness for exercise, lipids, and physical functioning were conducted at baseline, 6 months, and 12 months. Objective accelerometer data were collected at the same time points. Fitness was assessed via maximal exercise stress tests at baseline and 6 months.
  
  
  RESULTS
  The Maintenance Counseling group reported significantly higher exercise participation than the Contact Control group at 12 months (difference of 80 minutes, 95% CI=22, 137). Group differences in exercise at 6 months were nonsignificant. The intervention significantly increased the probability of participants' exercising at or above physical activity guidelines and attenuated regression in motivational readiness versus the Contact Control Group at 6 and 12 months. Self-reported physical functioning was significantly higher in the Maintenance Counseling group at 12 months. No group differences were seen in fitness at 6 months or lipid measures at 6 and 12 months.
  
  
  CONCLUSIONS
  A telephone-based intervention can help maintain exercise, prevent regression in motivational readiness for exercise, and improve physical functioning in this patient population.
authors.affiliation: Centers for Behavioral and Preventive Medicine, Miriam Hospital, One Hoppin Street, Providence RI 02903, USA. bpinto@lifespan.org
authors.forename: Bernardine M
authors.initials: BM
authors.lastname: Pinto
authors.forename: Michael G
authors.initials: MG
authors.lastname: Goldstein
authors.forename: George D
authors.initials: GD
authors.lastname: Papandonatos
authors.forename: Nancy
authors.initials: N
authors.lastname: Farrell
authors.forename: Peter
authors.initials: P
authors.lastname: Tilkemeier
authors.forename: Bess H
authors.initials: BH
authors.lastname: Marcus
authors.forename: John F
authors.initials: JF
authors.lastname: Todaro
mesh_terms: D000368:Aged; D000072038:Cardiac Rehabilitation; D037001:Directive Counseling / Q000379:methods*; D015444:Exercise; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009043:Motor Activity; D013689:Telephone; D013997:Time Factors