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Examining the Steps-Per-Day Trajectories of Cardiac Rehabilitation Patients: A LATENT CLASS GROWTH ANALYSIS PERSPECTIVE

Blanchard, Chris M. PhD; Giacomantonio, Nicholas MD; Lyons, Renee PhD; Cyr, Cleo RN; Rhodes, Ryan E. PhD; Reid, Robert D. PhD; Spence, J. C. PhD; McGannon, Kerry R. PhD

Journal of Cardiopulmonary Rehabilitation and Prevention: March/April 2014 - Volume 34 - Issue 2 - p 106–113
doi: 10.1097/HCR.0000000000000031
Cardiac Rehabilitation

PURPOSE: Research suggests that cardiac rehabilitation (CR) patients need to engage in at least 6500 steps per day to obtain health benefits. Unfortunately, very little is known about the steps-per-day trajectories of these patients and whether the demographic, clinical, and CR program characteristics are similar for these trajectories.

METHODS: Patients (n = 235) completed a questionnaire assessing demographic and clinical variables upon entry to CR and subsequently wore a pedometer for 7 days at the end of CR, and 3, 6, and 9 months after completing CR.

RESULTS: Latent class growth analyses showed that 3 classes of patients emerged that were termed nonadherers (averaged ∼3112 steps per day at the end of CR and remained stable up to 9 months after CR), significant decliners (averaged ∼7010 steps per day at the end of CR and steadily declined after CR), and optimal adherers (averaged ∼10 700 steps per day and remained stable after CR). Logistic regressions showed that nonadherers were more likely to be obese, have at least 1 comorbidity, and a lower exercise capacity compared with the significant decliners/optimal adherers.

CONCLUSIONS: Distinct steps-per-day trajectories exist for CR patients that are partially distinguished by demographic and clinical variables.

Little is known about the steps-per-day trajectories of cardiac rehabilitation patients. Latent class growth analyses on 235 patients showed that distinct steps-per-day trajectories exist that are partially distinguished by demographic and clinical variables.

Department of Medicine, Division of Cardiology (Drs Blanchard and Giacomantonio), Dalhousie University, Halifax, Nova Scotia, Canada; Bridgepoint Health, Toronto, Ontario, Canada (Dr Lyons); New Brunswick Heart Centre, Saint John, New Brunswick, Canada (Ms Cyr); Behavioral Medicine Laboratory, Faculty of Education, University of Victoria, Victoria, British Columbia, Canada (Dr Rhodes); Minto Prevention and Rehabilitation Centre, Ottawa Heart Institute, Ottawa, Ontario, Canada (Dr Reid); Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada (Dr Spence); and School of Human Kinetics, Laurentian University, Sudbury, Ontario, Canada (Dr McGannon).

Correspondence: Chris M. Blanchard, PhD, Centre for Clinical Research, Dalhousie University, Room 205, 5790 University Ave, Halifax, NS B3H 1V7, Canada (

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins