Keeping bodies in motion: Cardiac rehabilitation specialists' views on exercise maintenance


Cardiac rehabilitation has been shown to increase exercise levels and prevent subsequent cardiac events; however, people do not maintain this change post-program. The purpose of this study was to help identify what factors are important for cardiac rehabilitation participants to maintain their exercise levels post-program. Ten cardiac rehabilitation exercise specialists were recruited from Canadian cardiac rehabilitation programs and interviewed over the telephone using a semi-structured interview guide. Interviews lasted on average between 25-35 minutes. An inductive qualitative thematic analysis was conducted on the transcripts, which were transcribed verbatim. Two coders conducted the analysis separately. Three dominant themes emerged from the data. First, participants identified the importance of specific motivational factors including the fear of another cardiac event, beliefs in the importance of maintained health, and presence of a strong social support system. The second theme focused on necessary improvements needed in cardiac rehabilitation programs to enhance exercise maintenance. Specifically, participants felt that tailoring sessions, tracking progress during and post program, having highly trained and educated staff, and conducting an exit meeting before discharge would assist with maintenance. The final theme centered on improvements for the continuation of care after the program. Participants suggested that increasing the availability of staff and access to facilities, increasing collaboration with different organizations such as community fitness centers, including a follow up protocol, and designing a program that facilitates the transition from end program to daily life would be beneficial. These findings offer a unique detailed viewpoint from exercise specialists on exercise maintenance. Given that exercise specialists work directly with patients, these findings can help inform future theory-based interventions to inform practice and enhance exercise maintenance among this population.