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A randomized trial of an exercise maintenance intervention after cardiac rehabilitation

Session Poster Session 2

Speaker Robert Reid

Congress : ESC Preventive Cardiology (Formerly EuroPrevent) 2019

  • Topic : preventive cardiology
  • Sub-topic : Secondary Prevention
  • Session type : Poster Session
  • FP Number : P521

Authors : E Wooding (Ottawa,CA), SL Grace (Toronto,CA), C Blanchard (Halifax,CA), M Moghei (Toronto,CA), J Harris (Ottawa,CA), GA Proulx (Ottawa,CA), SA Prince (Ottawa,CA), KA Mullen (Ottawa,CA), D Manual (Ottawa,CA), M Krahn (Toronto,CA), G Ghisi (Toronto,CA), A Mark (Ottawa,CA), AL Pipe (Ottawa,CA), C Chessex (Toronto,CA), RD Reid (Ottawa,CA)

Authors:
E Wooding1 , SL Grace2 , C Blanchard3 , M Moghei4 , J Harris1 , GA Proulx1 , SA Prince1 , KA Mullen1 , D Manual5 , M Krahn4 , G Ghisi2 , A Mark1 , AL Pipe1 , C Chessex2 , RD Reid1 , 1University of Ottawa Heart Institute - Ottawa - Canada , 2University Health Network - Toronto - Canada , 3Dalhousie University - Halifax - Canada , 4University of Toronto - Toronto - Canada , 5The Ottawa Hospital - Ottawa - Canada ,

Citation:

Background: Cardiac rehabilitation (CR) help patients initiate exercise, but exercise maintenance is problematic.

Purpose: Compare effects of exercise maintenance treatment (EMT) to usual care (UC) on moderate and vigorous physical activity (MVPA) after CR.

Methods: 449 patients (135 women, 314 men) completing CR were stratified by sex and randomly allocated to EMT (n=226) or UC (n=223). EMT participants received 1 face-to-face session, 5 group counseling teleconferences, and 3 personal telephone calls from an exercise facilitator over 50 weeks. UC participants received information about exercise maintenance. MVPA in bouts of =10 minutes, was measured by accelerometer at 26 and 52 weeks. Exercise capacity was a secondary outcome. Treatment effects were tested with mixed models.

Results: See Table. In main analysis, there were no significant effects for treatment or time on MVPA for women. In secondary analysis considering only women adherent to EMT (= 66% of sessions), MVPA was higher with EMT vs. UC (P=0.034). In main analysis of men, MVPA declined over time; there was no treatment effect. Results were similar considering men adherent to EMT. In women, exercise capacity showed better improvement with EMT vs. UC. In men, EMT had no effect on exercise capacity.

Conclusion: In CR completers, exercise maintenance treatment showed promise for women but not men.

Sex/Outcome Baseline 26 weeks 52 weeks

Group effect

P-value

Time effect

P-value

Women
MVPA (min/wk)
EMT 132.7 (138.3) 158.2 (188.3) 132.6 (135.2) .121 .836
UC 129.2 (117.8) 108.3 (116.7) 110.8 (113.7)
Exercise Capacity (ml/kg/min)
EMT 18.09 (5.04) 22.95 (4.86) .009 .024
UC 17.03 *5.25) 20.33 (5.06)
Men
MVPA (min/wk)
EMT 178.1 (149.1) 176.8 (157.9) 148.4 (149.5) .791 .052
UC 188.1 (136.9) 152.2 (146.3) 153.2 (148.5)
Exercise Capacity (ml/kg/min)
EMT 22.80 (5.24) 25.20 (6.20) .970 .017
UC 24.2 (5.88) 27.4 (8.10)
MVPA = Moderate and vigorous intensity physical activity; EMT = exercise maintenance treatment; UC = usual care

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