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Psychosocial Outcomes of an Exercise Maintenance Intervention After Phase II Cardiac Rehabilitation

Pinto, Bernardine M. PhD; Dunsiger, Shira I. PhD; Farrell, Nancy MPH, CHES; Marcus, Bess H. PhD; Todaro, John F. PhD

Journal of Cardiopulmonary Rehabilitation and Prevention: March/April 2013 - Volume 33 - Issue 2 - p 91–98
doi: 10.1097/HCR.0b013e3182825531
Cardiac Rehabilitation

PURPOSE: Maintenance of exercise after completing phase II cardiac rehabilitation (CR) is challenging for many patients. We offered a telephone-based maintenance intervention and found improvement in exercise participation in the intervention group at 12 months post-CR discharge. We examined the effects of the intervention on psychosocial outcomes.

METHODS: The effects of a home-based exercise maintenance intervention on psychosocial outcomes among patients who had completed phase II CR versus contact control were evaluated in a randomized controlled trial. Data were collected in 2005 to 2010 and analyzed in 2011. One hundred thirty patients (mean age = 63.6 [SD = 9.7] years, 20.8% female) were randomized to exercise counseling (Maintenance Counseling group, n = 64) or contact control (Contact Control group, n = 66). Maintenance Counseling group participants received exercise counseling (based on the transtheoretical model and social-cognitive theory) delivered via telephone for 6 months, as well as print materials and feedback reports. Assessments of depression, quality of life, and mental health were conducted at baseline, 6 months, and 12 months.

RESULTS: The Maintenance Counseling group reported statistically significant higher quality of life than the Contact Control group at 6 months (b = 0.29, SE = 0.08, P < .001) and 12 months (b = 0.27, SE = 0.09, P = .002). Intervention effects on depressive symptoms were significant at 12 months (b = −6.42, SE = 2.43, P = .009). Effects on overall mental health were nonsignificant at both followups. No significant moderators of treatment effects were found.

CONCLUSION: A telephone-based intervention that helped maintain exercise showed statistically significant improvements in quality of life and reduced depressive symptoms in this patient population.

A 12-month randomized controlled trial was conducted to test the efficacy of a telephone-based intervention on exercise maintenance among 130 patients who had completed phase II cardiac rehabilitation. The intervention group showed statistically significant improvements in quality of life and reduced depressive symptoms compared with the control group.

Centers for Behavioral and Preventive Medicine, Miriam Hospital (Drs Pinto, Dunsiger, Marcus, and Todaro and Ms Farrell), W. Alpert Medical School of Brown University (Drs Pinto, Marcus, and Todaro), and Program in Public Health, Brown University (Dr Dunsiger), Providence, Rhode Island.

Correspondence: Bernardine M. Pinto, PhD, The Miriam Hospital, Coro Bldg, Ste 500, One Hoppin St, Providence, RI 02903 (

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.