Motivational interviewing can support physical activity in elderly patients with diastolic heart failure: results from a pilot study

Abstract

Aims Patients suffering from heart failure with preserved ejection fraction (HFpEF) report similar symptoms and reduction in quality of life to those with reduced ejection fraction but remain largely untreated. We conducted a preliminary evaluation of the acceptance, feasibility, and efficacy of a motivational interviewing (MI) intervention to support elderly patients suffering from HFpEF in maintaining or starting physical activity. Methods and results At the conclusion of the exercise training in diastolic heart failure parent trial that examined the effects of supervised exercise, patients with HFpEF were offered participation in a two‐group pilot study. Based on their preference, consenting patients were assigned to either a 6 month MI intervention group (n = 19) or their physicians' usual care (n = 20). To support participants in increasing and/or maintaining their physical activity, counsellors delivered a mean of 6.5 MI sessions (face to face and via telephone) and also provided a physical activity diary as self‐management tool. At baseline and 6 months, we assessed participants' physical activity motivation (Sportbezogene Selbstkonkordanz Scale) and their physical improvements with the 6 min walk test and a cardiopulmonary exercise test. Of the entire sample (N = 39), 46% were female, their mean age was 73, 90% were in New York Heart Association Class II, and the mean ejection fraction was 61.4%. The majority of MI participants rated the intervention as acceptable, 90% perceived MI as helpful in setting specific exercise goals and overcoming barriers concerning physical activity, and 58% considered the physical activity diary as very helpful. Three‐quarters of MI participants (79%) reported an increase in their physical activity compared with the previous year. Intervention participants showed a greater increase in median peak VO2 from baseline to 6 months (baseline: 18.4 mL/kg/min; 6 months: 20.4 mL/kg/min) compared with the control group (baseline: 20.0 mL/kg/min; 6 months: 19.2 mL/kg/min; P = 0.015). There was no significant change in motivation on the Sportbezogene Selbstkonkordanz Scale for either group (MI: 1.7 vs. 3, P = 0.55; control: 4.7 vs. 4, P = 0.26) nor did patients show any significant improvements in the 6 min walk test (MI: 549 vs. 540 m, P = 0.80; control: 572 vs. 580 m, P = 0.37). Counsellors rated the implementation of the MI intervention as feasible. Conclusions The results from this pilot study suggest that our MI intervention was well accepted by participants and deemed feasible. It also appears to be an effective treatment to increase and maintain physical activity and exercise capacity in patients suffering from HFpEF. Our findings need to be confirmed in a randomized clinical trial with larger and unselected patient cohorts.

Efficacy of a physical activity programme combining individualized aerobic exercise and coaching to improve physical fitness in neuromuscular diseases (I’M FINE): study protocol of a randomized controlled trial

“…However, few studies on exercise interventions among NMD have focused on the sustainability of acquired results of exercise programmes [23]. Based on other studies of chronic health conditions such as obesity [24] and heart failure [25], motivational interviewing (MI) seems to be a promising basis for implementation of a coaching programme in interventions to increase physical activity within the NMD population [26][27][28][29].…”

The Impact of Motivational Interviewing on Self-care and Health-Related Quality of Life in Patients With Chronic Heart Failure

“…14,15 On the basis of a set of techniques aimed at facilitating the development and maintenance of certain behaviors, MI is delivered in the form of semistructured patient-centered visits during which patients examine and resolve attitudes of possible ambivalence and resistance to change. 11,15,16 Relatively few study authors have evaluated the effectiveness of MI in patients with HF, measured in terms of physical exercise, [16][17][18] hospital readmissions, 19 self-care, 11,17,[20][21][22][23] and HRQoL. 20,24 Furthermore, those studies have reported mixed results, partially explained by design limitations such as small samples and short follow-ups (<6 months).…”

Mini-Review of Studies Testing the Cardiorespiratory Hypothesis With Near-Infrared Spectroscopy (NIRS): Overview and Perspectives

“…Indeed, patients with high self-efficacy, expectancy and self-determination are those who are more likely to be involved in a physical activity program and to maintain physical activity ( Sweet et al, 2011 ). However, when dealing with unmotivated patients, the use of a motivational intervention would be appropriate to induce engagement in the physical activity program ( Schertz et al, 2019 ).…”