What keeps them exercising? A qualitative exploration of exercise maintenance post-cardiac rehabilitation

Few individuals maintain their exercise levels post-cardiac rehabilitation. The objective of this study was to explore factors related to exercise maintenance post-cardiac rehabilitation. Participants were (a) 15 post-cardiac rehabilitation exercise maintainers and (b) 10 cardiac rehabilitation exercise professionals. Semi-structured interviews were conducted with participants in each group. The data were analysed abductively (combination of inductive and deductive) using content analysis to generate themes that linked to the Theoretical Domains Framework (TDF) and represented participants’ experiences and perceptions. Both the exercise maintainers and the exercise professionals identified seven common domains of the TDF relating to exercise maintenance post-cardiac rehabilitation: social influence, behavioural regulation, belief about capabilities, beliefs about consequences, reinforcements, emotions, and environment contexts and resources. Exercise maintainers also mentioned the domains of goals, optimism, social/professional role and identity, and memory/attention/decision process while the exercise professionals discussed the domain of knowledge about the benefits of exercise. In the inductive analysis, participants reported other themes (e.g. variety; cardiac rehabilitation improvements) not related to the TDF. Findings from this study highlighted similarities between both groups on seven theoretical domains and revealed insights (e.g. optimism and variety) that have rarely been examined with post-cardiac rehabilitation populations. This manuscript provides a greater understanding of the theoretical domains that could be fostered to facilitate long-term exercise participation among individuals completing a cardiac rehabilitation programme.