Abstract
BackgroundAlthough the benefits of supervised physical activity programs in cardiac rehabilitation have been well documented, the amount of physical activity often drops quickly after the end of the supervised period. This trial (registered as ISRCTN77313697) will evaluate the effectiveness of an experimental intervention based on habit formation theory applied to physical activity maintenance.Methods/DesignCardiovascular patients (N = 56) will be individually randomized into two groups. Two supervised physical activity (SPA) sessions per week will be offered to the first group for 20 weeks. Progressively autonomous physical activity (PAPA) will be offered to the second group as follows: 10 weeks of the same supervised program as the SPA group followed by 10 more weeks in which one supervised session will be replaced by a strategy to build and sustain the habit of autonomous practice of physical activity. The primary outcome is the amount of physical activity measured by the International Physical Activity Questionnaire (IPAQ; Craig et al., Med Sci Sport Exercises 35(8):1381–95, 2003). To compensate for the limited capacity to recruit subjects, multiple IPAQ measurements will be made (at T0, T5, T7, T9 and T12 months after the start of the intervention) and analyzed using the mixed model approach. We will also assess changes in physical and physiological indicators, automaticity of the physical activity behavior, motivation and quality of life. Last, we will assess the cost-effectiveness for each type of program.DiscussionIf proven to be effective, the PAPA intervention, which requires fewer supervised sessions, should provide a cost-effective solution to the problem of physical activity maintenance in cardiac rehabilitation.
Highlights
The benefits of supervised physical activity programs in cardiac rehabilitation have been well documented, the amount of physical activity often drops quickly after the end of the supervised period
Based on the linear trend in the physical activity (PA) measures made in the months following the end of the intervention, we expect to find a decline in PA post-intervention only for the supervised physical activity (SPA) group
We expect that patients of the Progressively autonomous physical activity (PAPA) group will either maintain the same level or even increase their PA in the months following the end of the intervention
Summary
Cardiovascular patients are generally willing to take part in CR, but they do not systematically have the opportunity to do so (80 % of our sample). We will carry out exploratory analyses to test whether the PAPA intervention leads to greater automaticity and motivation for PA, higher quality of life and better physical condition compared with the SPA intervention Another limitation of the study can be the used of the sport motivation scale to assess participant’s motivation in the context of PA as motivation for sport and physical activity can differ. As this study will show whether the PAPA intervention promotes physical activity maintenance in people with CVD, it has potentially significant implications for the management of cardiovascular patients If successful, it will increase PA behaviors and reduce medical costs and enhance the quality of life of people with CVD over the long term. Abbreviations CR, cardiac rehabilitation; CVD, cardiovascular disease; PA, physical activity; PAPA, progressive autonomy; SPG, supervised physical activity
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