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Adherence in the Training Levels Comparison Trial

LEE, JEANNETTE Y.; JENSEN, BETSY E.; OBERMAN, ALBERT; FLETCHER, GERALD F.; FLETCHER, BARBARA J.; RACZYNSKI, JAMES M.

Medicine & Science in Sports & Exercise: January 1996 - Volume 28 - Issue 1 - pp 47-52
Clinical Sciences: Clinical Investigations

In the Training Levels Comparison Trial, 197 male coronary heart disease patients were randomized to low or high intensity training with target heart rates, which corresponded to 50% and 85% of the ˙VO2max achieved on the previous exercise test, respectively. Patients were to exercise at their assigned intensity level at three 1-h long supervised sessions per week for 2 yr. This paper reports on two components of adherence: attendance at exercise sessions and achievement of heart rates in the target range. During the first year of training, the average percent of exercise sessions attended (mean± SE) for the low intensity group (64.0% ± 2.5%) was significantly higher than for the high intensity group (55.5% ± 2.7%). At the end of 1 yr of training, 54% and 37% of the low and high intensity patients, respectively, achieved heart rates within 5 beats·min-1 of their target heart rates. Although the low intensity program was preferable to achieve maximum attendance, attenders on the high intensity program achieved higher heart rates. These results suggest that to maximize the achieved heart rate, it would be optimal to motivate a cardiac rehabilitation patient to train at the high intensity level for a prolonged period of time.

Biostatistics Unit, Comprehensive Cancer Center, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294-3300; and; Emory Health Enhancement Program, Center for Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA 30322

Submitted for publication February 1995.

Accepted for publication September 1995.

Supported by a grant from the National Heart, Lung, and Blood Institute(R01 HL37597-03)

Address correspondence to: Jeannette Y. Lee, Biostatistics Unit, Comprehensive Cancer Center, University of Alabama at Birmingham, 1824 Sixth Avenue South, Birmingham, AL 35294-3300; E-mail:GCRC002@UABDPO.DPO.UAB.EDU.

©1996The American College of Sports Medicine