A modified cardiac rehabilitation protocol emphasizing independent exercise increased self-efficacy for independent exercise without continuous ECG monitoring compared to a traditional protocol (P<.05).
RCT (n=80)
Randomized
Does a modified cardiac rehabilitation protocol improve self-efficacy and exercise behavior compared to a traditional protocol in low- to moderate-risk cardiac patients?
A modified cardiac rehabilitation program emphasizing independent exercise improves self-efficacy, which is a significant predictor of exercise behavior over 6 months in low- to moderate-risk cardiac patients.
p-value: p=<.05
BACKGROUND: Self-efficacy and social support are established determinants of exercise adherence and have potential usefulness for tailoring independent exercise regimens for cardiac patients. Highly supervised traditional cardiac rehabilitation programs may be a barrier for independent exercise self-efficacy in low - and moderate-risk patients. PURPOSE: The authors evaluated changes in psychosocial measures including self-efficacy and social support in 80 cardiac patients with low to moderate risk randomized to a traditional cardiac rehabilitation protocol (TP) or modified protocol (MP). These measures also were assessed for their potential to predict subsequent exercise behavior. METHODS: The TP (n = 38) emphasized a supervised exercise regimen and included continuous electrocardiogram (ECG) monitoring for 3 months. The lower cost MP (n = 42) emphasized independent exercise and included group education/support meetings, and gradually weaned patients from continuous ECG monitoring and direct medical supervision. RESULTS: Repeated measures analyses of variance indicated that MP patients had higher levels of self-efficacy for independent exercise without continuous ECG monitoring (P < .05). No other protocol differences were found. Multiple regression analyses using the pooled sample (excluding dropouts) indicated that self-efficacy for independent exercise was the only significant predictor of exercise over 6 months (R2=.28 [adjusted R2= .221 P < .01). In contrast to previous reports, social support for exercise was not a significant predictor of exercise behavior. CONCLUSIONS: These findings suggest cardiac rehabilitation programs for low- and moderate-risk patients should emphasize educational and patient monitoring methods that promote patient self-efficacy for independent exercise. Programs that emphasize highly supervised exercise including longer term use of continuous ECG monitoring may impair self-efficacy for independent exercise. Longer-term studies are needed to fully determine the value of using psychosocial measures for designing individualized exercise programs and predicting long-term exercise behavior in cardiac patients.
Carlson et al. (Thu,) conducted a rct in Cardiac patients with low to moderate risk (n=80). Modified cardiac rehabilitation protocol (MP) vs. Traditional cardiac rehabilitation protocol (TP) was evaluated on Changes in psychosocial measures including self-efficacy and social support (p=<.05). A modified cardiac rehabilitation protocol emphasizing independent exercise increased self-efficacy for independent exercise without continuous ECG monitoring compared to a traditional protocol (P<.05).