Physical activity maintenance, motivation and self-efficacy after cardiac rehabilitation with the Life Plus watch as motivational device: a pilot observational study (Preprint)

BACKGROUND As physical activity is recognized as key in cardiovascular disease management, maintenance of physical activity following the completion of a supervised cardiac rehabilitation program remains a challenge for many patients. Wearable devices such as the Life Plus connected watch may help patients maintain physical activity through self-monitoring, goal setting and motivational features. OBJECTIVE To assess physical activity maintenance with the Life Plus connected watch (version 2.3.100) after of a supervised center-based cardiac rehabilitation program, motivation and key factors of behavior change maintenance. METHODS Forty-three participants wore a Life Plus connected watch at the wrist for 8 weeks (2 last weeks of the supervised center-based cardiac rehabilitation program and 6 weeks after the end of the cardiac rehabilitation program). Physical activity parameters (number of global steps, number of active walking steps, activity duration) were retrieved at the end of the 8-week intervention. Motivation, states of change and quality of life were assessed pre intervention and post intervention through three scales (echelle de Motivation à la pratique d’une Activité Physique à des fins de Santé,self-efficacy scale for physical activity, state of change)and one questionnaire (quality of life Short-Form 12 items). Acceptability and perceived usefulness were assessed through oral discussion. RESULTS No significant difference was found for total number of steps P=.88 ; 95% CI (-523.04; 448.41)), number of active steps (P=.39; CI 95% (-609.48; 243.92)) and mean active duration (P=.26; CI 95% (-8.18; 2.23)) between the 2 last weeks of the supervised center-based cardiac rehabilitation program and the 6 weeks following the end of the supervised center-based cardiac rehabilitation program. No significant difference was found for total number of steps, number of active steps and activity duration for each 8 weeks of intervention. Physical activity was maintained through the 8 weeks at the same level. Self-efficacy toward exercise (P=.04), self-determined motivation (P<.01) and physical quality of life (P=.002) were significantly enhanced at the end of the intervention. Patients moved from a state of readiness and action to a state of maintenance of change for physical activity and expressed perceived usefulness. CONCLUSIONS Using a tool such as the Life Plus watch version 2.3.100 could help physical activity maintenance after a supervised center-based cardiac rehabilitation program and help improving self-efficacy and self-determined motivation as well as moving from action states to maintenance state of change for physical activity. This is important as the Life Plus watch was used as the only tool to help the maintenance of physical activity and didn’t involve any health care personal as it is often the case in other studies. CLINICALTRIAL This study was approved by the ethics committee of the University Hospital of Saint-Etienne in January 2023 (IRBN1072022/CHUSTE).