Secondary Logo

Institutional members access full text with Ovid®

Medical and Psychosocial Factors Associated With Low Physical Activity and Increasing Exercise Level After a Coronary Event

Peersen, Kari, MSan; Otterstad, Jan Erik, MD, PhD; Sverre, Elise, MD; Perk, Joep, MD, PhD; Gullestad, Lars, MD, PhD; Moum, Torbjorn, PhD; Dammen, Toril, MD, PhD; Munkhaugen, John, MD, PhD

Journal of Cardiopulmonary Rehabilitation and Prevention: January 31, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/HCR.0000000000000399
Original Investigation: PDF Only

Purpose: The reasons why many coronary patients are inactive or have a low level of physical activity (PA) are not completely understood. We identified medical and psychosocial factors associated with PA status and increasing exercise level after a coronary event.

Methods: A cross-sectional study investigated the factors associated with PA in 1101 patients hospitalized with myocardial infarction (MI) and/or a revascularization procedure. Data were collected from hospital records, a self-report questionnaire, and a clinical examination. PA was categorized as inactivity, low activity, and adequate activity (≥ moderate intensity of 30 min ≥2-3 times/wk), an overall summary PA-index was measured as a continuous variable, and self-reported PA increase since the index event was measured on a 0- to 10-point Likert Scale.

Results: In all, 18% reported inactivity, 42% low, and 40% adequate activity at follow-up after median 16 mo. In multiadjusted linear regression analyses, low PA-index was significantly associated with smoking, obesity, unhealthy diet, depression, female, low education, MI as index diagnosis, and ≥1 previous coronary event. Motivation, risk and illness perceptions, and low reported need of help to increase PA were significantly associated with self-reported increasing PA level in adjusted continuous analyses.

Conclusions: Daily smoking, obesity, unhealthy diet, and depression were the major potentially modifiable factors associated with insufficient PA, whereas high motivation and risk and illness perceptions were associated with increasing PA level. Further research on the effect of interventions tailored to the reported significant factors of failure is needed to improve PA level in CHD patients.

Department of Cardiology, Vestfold Hospital Trust, Norway (Ms Peersen and Dr Otterstad); Department of Medicine, Drammen Hospital, Vestre Viken Trust, Norway (Drs Sverre and Munkhaugen); Department of Behavioural Sciences in Medicine (Drs Sverre, Moum, Dammen, and Munkhaugen) and Faculty of Medicine (Ms Peersen and Dr Gullestad), University of Oslo, Norway; Institute of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden (Dr Perk); and Department of Cardiology, Oslo University Hospital Rikshospitalet, Norway (Dr Gullestad).

Correspondence: Kari Peersen, MSan, Department of Cardiology, Vestfold Hospital Trust, 3103 Tønsberg, Norway (

The authors declare that there is no conflict of interest.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.