Promoting self-regulatory efficacy to manage additional exercise among cardiac rehabilitation maintainers: A pilot feasibility study


Background: Supervised cardiac rehabilitation (CR) lowers cardiovascular risk and offers health benefits. However, maintained benefits post-CR are limited unless self-managed exercise (SMex) is performed in addition to structured maintenance exercise.  Adding SMex to structured maintenance is problematic as individuals may lack self-regulatory strategies required to independently exercise.  SMex has been effectively added to structured exercise for CR novices but motivational processes for CR maintainers remain unexamined.  Research indicates that confidence (self-regulatory efficacy; SRE) in cognitive behavioural skills is important in motivating future SMex (Bandura, 2004). Purpose: To examine changes in SRE for SMex among CR exercise therapy maintainers in both a theory-based group-mediated cognitive behavioral intervention (GMCB) and standard structured maintenance CR exercise.  Methods: 55 post-CR participants (Mage = 70.4 ± 7.2 years) maintaining structured exercise (> 6 mos) were recruited. CR sites were assigned to either standard maintenance attention-control ([AC], n = 23) or the GMCB (n = 32) in a quasi-experimental design. AC participants received cardiac health education. GMCB participants received group-motivated training in cognitive behavioural strategies to increase SRE for SMEx. Changes in SRE to [1] schedule, [2] overcome barriers, and [3] concurrently manage exercise with other goals were examined at baseline, post-intervention, and follow-up (12 weeks). Results: MANCOVA (CV = baseline SRE) revealed a multivariate group effect for SRE, ps < .05, model R2 range = .28-54. Univariate post hocs revealed significant group effects were maintained at follow-up (partial eta2 range = .08-.21).  Higher SRE for SMex favored the GMCB (e.g., SRE scheduling at follow-up: GMCB = 66.9± 17.9, AC = 43.1± 28.3). Conclusions: The GMCB group maintained their SRE for SMex at follow-up.  Findings are consistent with other GMCB RCTs which increased and sustained SRE for exercise among CR novices. This study is the first to sustain SRE for adherence-actions among maintenance CR participants. 

Acknowledgments: Canada Research Chair Training Funds