Abstract
BackgroundThe benefits of supervised physical activity programs in cardiac rehabilitation have been amply demonstrated, but the quantity of physical activity often declines quickly once supervision ends. This trial assesses the effectiveness of an experimental intervention drawing on habit formation theory to maintain physical activity.MethodsCardiovascular patients (N = 47) were randomly assigned to one of two groups. The first group participated in two supervised physical activity (SPA) sessions per week for 20 weeks. The second group was offered a progressively autonomous physical activity (PAPA) program as follows: the same supervised program as the SPA group for 10 weeks and then a further 10 weeks with one supervised session replaced by a strategy to build and sustain the habit of autonomous physical activity. The International Physical Activity Questionnaire (IPAQ; Craig et al. Med Sci Sports Exerc 35(8):1381–1395, 2003) was used to measure the quantity of physical activity, which was the primary outcome. The number of participants was limited, and we thus took multiple IPAQ measurements (at 0, 5, 7, 9 and 12 months after the start of the intervention) and used a mixed model for analysis. Physical condition, automaticity of the physical activity behavior, motivation, and quality of life were examined for changes.ResultsNo significant between-group differences were noted for physical activity behaviors after the program, physical condition, motivation, or behavioral automaticity. The PAPA group nevertheless completed more PA sessions during the intervention, and their quality of life was significantly higher than that of the SPA group at 12 months.ConclusionAlthough the number of supervised sessions was lower, the progressively autonomous PA program resulted in the same or even higher positive outcomes than the fully supervised PA program.Trial registrationCurrent Controlled Trials ISRCTN77313697, retrospectively registered on 20 November 2015.
Highlights
The benefits of supervised physical activity programs in cardiac rehabilitation have been amply demonstrated, but the quantity of physical activity often declines quickly once supervision ends
Physical activity The primary outcome was the level of physical activity (PA) according to the International Physical Activity Questionnaire (IPAQ) questionnaire
Because the data did not follow a normal distribution but presented strong right asymmetry, a generalized linear mixed model (GLMM) was used as this model is an extension of the LMM for distributions that are not normal
Summary
The benefits of supervised physical activity programs in cardiac rehabilitation have been amply demonstrated, but the quantity of physical activity often declines quickly once supervision ends. This trial assesses the effectiveness of an experimental intervention drawing on habit formation theory to maintain physical activity. In order to encourage the development and maintenance of healthy behaviors, CVD patients are usually offered a cardiac rehabilitation (CR) program, studies have shown that supervised PA programs for CVD patients improve the level of PA, they indicate that the patients tend to stop their PA practices once the supervised period is over [45]. All the programs used behavioral or cognitive methods to enhance PA maintenance, none of them
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