Predicting Physical Activity and Sedentary Behaviors After Cardiac Rehabilitation: An Observational Study

Abstract

Background: A growing body of evidence suggests that low levels of physical activity (PA) and high levels of sedentary behavior (SB) are associated with an increased risk of adverse health outcomes in patients. Despite the objective of cardiovascular rehabilitation (CR) programs to increase PA and decrease SB levels, many patients continue to show low PA and high SB levels following their discharge from CR. The objective of the present study was to examined the levels of PA and SB following an outpatient CR program and to examine their motivational and emotional health-related correlates. PA and SB levels, along with motivational and health-related characteristics, were compared between outpatients and control participants who did not require care. Methods: The study included 119 participants: 68 CR patients (M_age 57.76±10.76; 86.76% males) and 51 control participants matched on age (M_age 57.35±6.33 years; 45.10% males). Accelerometers were used to assess PA and SB during the first week post-discharge for outpatients and during a typical week for controls. Validated scales were employed to measure motivational (i.e., perceived capabilities, affective and instrumental attitudes, intention, approach-avoidance tendencies) and emotional health-related (i.e., anxiety, depressive symptoms, fatigue, pain intensity) factors. Results: CR patients spent an average of 60.21 (±34.79) min of moderate-to-vigorous PA (MVPA), and 548.69 (±58.64) min of SB per day. They engaged in 18 more minutes of MVPA per day than controls (p =.038). Univariate and multivariate regressions indicated that positive affective attitudes were associated with higher MVPA (b = 10.32, R² = 0.07, p =.029). Additionally, males spent more time in SB than females (b = 40.54, R² = 0.09, p =.045). Univariate and multivariate logistic regressions showed that meeting the World Health Organization's weekly guidelines for MVPA was associated with higher perceived capabilities toward PA and more positive affective attitudes (OR = 1.17, p =.030; OR = 1.26, p <.001, respectively). Interaction tests showed no significant differences in these results between outpatients and controls. Conclusion: These findings underscore the importance of motivational factors in PA levels following a CR program.