https://orcid.org/0000-0001-8612-583X
Abstract
Purpose
Despite beneficial effects, adherence to exercise-based cardiac rehabilitation (exCR) is low in patients with coronary artery disease (CAD). The aim of this study was to investigate adherence to and the effects of a behavioral medicine intervention in physiotherapy (BMIP) added to routine exCR care on the primary outcome of physical fitness compared with routine exCR care.
Patients and Methods
In a randomized, controlled trial, 170 patients with CAD (136 men), mean age 62.3 (7.9) years, were included at a Swedish university hospital. Patients were randomized 1:1 to routine exCR care (RC) or to a BMIP added to routine exCR care for four months, with a long-term follow-up at 12 months. The outcome assessment included submaximal aerobic exercise capacity, muscle endurance and self-reported physical activity and physical capacity.
Results
The four-month follow-up showed improvements in all outcomes for both groups, but changes did not differ significantly between the groups. Patients in the BMIP group were more adherent to exCR recommendations compared with the RC group (31% vs 19%) and a non-significant tendency towards the maintenance of submaximal aerobic exercise capacity over time was seen in the BMIP group, whereas patients in the RC group appeared to deteriorate.
Conclusion
Both groups improved significantly at the four-month follow-up, while the 12-month follow-up showed a non-significant tendency towards better long-term effects on submaximal aerobic exercise capacity and exercise adherence for a BMIP compared with RC. In spite of this, a better understanding of the role of a BMIP in enhancing adherence is needed.
Abbreviations
BHW PA, the Swedish National Board of Health and Welfare physical activity; BMIP, behavioral medicine intervention in physiotherapy; CAD, coronary artery disease; CT, control theory; exCR, exercise-based cardiac rehabilitation; PCI, percutaneous coronary intervention; RC, routine exercise-based cardiac rehabilitation care; SD, standard deviation; VAS, visual analogue scale.
Data Sharing Statement
The data generated and analysed during the present study are not publicly available but can be obtained from the corresponding author in response to a reasonable request.
Acknowledgments
The authors wish to thank the physiotherapists at the coronary care unit at which the study took place for their practical support with enrolment and the testing procedure.
Disclosure
The authors report no conflicts of interest in this work.