1. LOCATION, MODALITY AND DEGREE OF EXERCISE OVER
18 MONTHS IN CARDIAC REHABILITATION GRADUATES
Clinicaltrials.gov Registration Number: NCT
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Sabrina Gallant, B.Sc3, Robert Reid, Ph.D2, Jennifer Harris, B.ScPT2, Sherry L. Grace, Ph.D1, 3.
1 Cardiovascular Prevention and Rehabilitation Program, University Health Network, Toronto, Canada.2 University of Ottawa Heart Institute, Ottawa, Canada. 3School of Kinesiology and Health Science, York University, Toronto, Canada. .
INTRODUCTION
Patients who participate in cardiac rehabilitation (CR) significantly increase their physical activity.
However, exercise adherence is known to decay post-program, leading to poorer long-term prognosis
Some community exercise facilities have been identified as “heart wise” for CR graduates (
The CR graduates are informed about these locations to support their continued exercise
OBJECTIVES
To describe where patients exercise over the 18 months post- CR, and whether they are using HWE facilities.
METHODS
This study presents secondary analysis of an ongoing randomized controlled trial (ECO-PCR) investigating a post-CR exercise facilitation intervention.
Design: observational and prospective.
Supervised CR graduates were recruited from 3 programs in Ontario.
Participants completed a questionnaire at 4 time points: at CR discharge, and 6, 12, and 18- months post-CR
Surveys assessed intensity, frequency, and location of exercise
RESULTS
At 6 months post-CR discharge:
Of community-based exercisers, 37 (17.1%) reported exercising at a CR- recommended facility, 17 (7.8%) at a HWE program, 2 (5.5%) at a maintenance program associated with their CR program, and 83 (38.4%) exercised at another location
52 (23.4%) participants reported engaging in group activities, of which 47 (21.6%) were land-based and 14 (6.4%) were water-based
Most participants engaged in exercise at home (Figure 1), and individual fitness activities were most common (Figure 2)
Table 1. Participant Characteristics at Baseline / CR Exit, n=304.
Patient Characteristics
n (%)
Sociodemographic
Gender, male
224 (75.7)
Age
63.42+/- 9.67
Clinical
BMI
28.24+/-4.78
BMI >30
83 (28.0)
Hypertension
121 (41.0)
Dyslipidemia
130 (44.1)
Referral Indications
CAD
292 (98.6)
PCI
189 (63.9) MI
149 (50.5)
CABG
76 (25.8)
Diabetes (Type I and II)
56 (19.2)
ACS
19 (6.4)
Angina
14 (5.2)
At 18 months post-CR discharge:
Of those that reported community exercise 11 (16.2%) exercised at a facility recommended by their CR program, 6 (8.8%) exercised at a HWE program, and 1 (1.5%) exercised at a CR-associated maintenance program
Were patients meeting current guidelines of 150 mins of MVPA (moderate-vigorous physical activity) per week?
135 (60.2%) met guidelines at 6 months (mean / ), 92 (50%) at 12 months (mean / ), and 49 (48%) at 18 months (mean /-148.5).
Other locations included at work, recreational sports, golf course, etc.
LIMITATIONS
Retention bias, social desirability bias – very few reported no exercise
Due to the nature of the intervention, exercise is likely higher than what would be observed in the population of CR graduates more generally
Generalizability limited to CR graduates
CONCLUSIONS
CR graduates most often exercised at home, followed by a community facility.
HWE programs were not frequently attended, which may be due to the newness of the program in the area.
Efforts to improve awareness are now underway.
RETENTION:
224 (73.7%) participants were retained 6 months post- CR,
184 (60.5%) at 12 months, and
102 (33.5%) were retained 18 months post-CR to date.
Figure 2. Types of Individual Exercise Engaged in by CR Graduates