The Added Value of a Behavioral Medicine Intervention in Physiotherapy on Adherence and Physical Fitness in Exercise-Based Cardiac Rehabilitation (ECRA): A Randomised, Controlled Trial

Borg, Sabina; Öberg, Birgitta; Nilsson, Lennart; Söderlund, Anne; Bäck, Maria

doi:10.2147/ppa.s285905

Cited by 4 publications

(3 citation statements)

References 41 publications

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“…While supervised aerobic exercise programmes have been associated with reductions in blood pressure following a TIA [ 9 ], such interventions are relatively time and resource intensive, and may not be feasible or cost effective in current healthcare system settings. Poor uptake and attendance, particularly among some groups, including older adults, can also limit their efficacy [ 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Development of a Digital Lifestyle Modification Intervention for Use after Transient Ischaemic Attack or Minor Stroke: A Person-Based Approach

Heron

O’Connor

Kee

et al. 2021

IJERPH

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This paper describes the development of the ‘Brain-Fit’ app, a digital secondary prevention intervention designed for use in the early phase after transient ischaemic attack (TIA) or minor stroke. The aim of the study was to explore perceptions on usability and relevance of the app in order to maximise user engagement and sustainability. Using the theory- and evidence-informed person-based approach, initial planning included a scoping review of qualitative evidence to identify barriers and facilitators to use of digital interventions in people with cardiovascular conditions and two focus groups exploring experiences and support needs of people (N = 32) with a history of TIA or minor stroke. The scoping review and focus group data were analysed thematically and findings were used to produce guiding principles, a behavioural analysis and explanatory logic model for the intervention. Optimisation included an additional focus group (N = 12) and individual think-aloud interviews (N = 8) to explore perspectives on content and usability of a prototype app. Overall, thematic analysis highlighted uncertainty about increasing physical activity and concerns that fatigue might limit participation. Realistic goals and progressive increases in activity were seen as important to improving self-confidence and personal control. The app was seen as a useful and flexible resource. Participant feedback from the optimisation phase was used to make modifications to the app to maximise engagement, including simplification of the goal setting and daily data entry sections. Further studies are required to examine efficacy and cost-effectiveness of this novel digital intervention.

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Section: Introductionmentioning

confidence: 99%

Development of a Digital Lifestyle Modification Intervention for Use after Transient Ischaemic Attack or Minor Stroke: A Person-Based Approach

Heron

O’Connor

Kee

et al. 2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…Exercise habits and changes in peak VO 2 during and after the CR program are shown in Table 2. The number of CR attendances during the 3-month CR program was higher in women (14 [11][12][13][14][15][16][17][18][19][20][21][22][23][24] sessions vs. 10 [3-15] sessions, p = 0.00020). There was no sex difference in exercise habits that The percentage trend of the predicted peak VO 2 is shown in Figure 2.…”

Section: Resultsmentioning

confidence: 99%

“…A previous study reported the influence of subjective factors on the reasons for CR non-participation 18) . Furthermore, a randomized controlled trial revealed that the addition of a behavioral medicine intervention in physiotherapy to a conventional CR program contributed to the maintenance of exercise capacity in patients with CAD 19) . Therefore, it is necessary to further examine strategies to instill exercise habits.…”

Section: Discussionmentioning

confidence: 99%

Sex-related Differences in Exercise Capacity Trends and Determinants after Cardiac Rehabilitation in Patients with Acute Myocardial Infarction

et al. 2022

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This study aimed to investigate whether longitudinal changes in exercise capacity in patients with acute myocardial infarction (AMI) differ by sex and clarified what contributed to these differences. Methods: We retrospectively examined the differences in each variable between men and women in 156 patients with AMI (mean age: 65 ± 12 years; 82.0% male) who participated in a 3-month cardiac rehabilitation (CR) program and could be followed-up for exercise capacity 12-months after AMI onset. Sex-related differences in the change in peak oxygen uptake (peak VO 2 ) at baseline, 3-months, and 12-months after AMI were analyzed. Results: Male patients with AMI were younger and had higher body mass index and employment rate than women. The attendance of the CR program was higher in women (men vs. women; 10 [3-15] vs. 14 [11-24] sessions, p = 0.0002). Women showed a significant lower %change in peak VO 2 after 12 months (men vs. women; 7.8% [-0.49% to 14.6%] vs. 1. 3% [-5.7% to 7.5%], p = 0.013). In multiple linear regression analysis, age (β = -0.76, 95% confidence interval [CI] = -1.0 to -0.50, p <0.0001) and female sex (β = -6.3, 95% CI = -9.1 to -3.5, p <0.0001) were negative independent predictors of change in peak VO 2 over 12 months, while CR attendance (β = 0.21, 95% CI = 0.0032-0.42, p = 0.047) and recommended exercise habit after the CR program (β = 2.1, 95% CI = 0.095-4.1, p = 0.040) were positive independent predictors of change in peak VO 2 over 12 months. Conclusion: In female patients, exercise capacity improved during the CR program but decreased to AMI onset levels after 12 months.

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Effectiveness of a behavioral medicine intervention in physical therapy on secondary psychological outcomes and health-related quality of life in exercise-based cardiac rehabilitation: a randomized, controlled trial

Borg

Öberg

Nilsson

et al. 2023

BMC Sports Sci Med Rehabil

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Background Interventions promoting adherence to exercise-based cardiac rehabilitation (exCR) are important to achieve positive physical and psychological outcomes, but knowledge of the added value of behavioral medicine interventions for these measures is limited. The aim of the study was to investigate the added value of a behavioral medicine intervention in physical therapy (BMIP) in routine exCR on psychological outcomes and health-related quality of life (HRQoL) versus routine exCR alone (RC). Methods A total of 170 patients with coronary artery disease (136 men), mean age 62.3 ± 7.9 years, were randomized at a Swedish university hospital to a BMIP plus routine exCR or to RC for four months. The outcome assessments included HRQoL (SF-36, EQ-5D), anxiety and depression (HADS), patient enablement and self-efficacy and was performed at baseline, four and 12 months. Between-group differences were tested with an independent samples t-test and, for comparisons within groups, a paired t-test was used. An intention-to-treat and a per-protocol analysis were performed. Results No significant differences in outcomes between the groups were shown between baseline and four months or between four and 12 months. Both groups improved in most SF-36 domains, EQ-VAS and HADS anxiety at the four-month follow-up and sufficient enablement remained at the 12-months follow-up. Conclusion A BMIP added to routine exCR care had no significant effect on psychological outcomes and HRQoL compared with RC, but significant improvements in several measures were shown in both groups at the four-month follow-up. Since recruited participants showed a better psychological profile than the general coronary artery disease population, further studies on BMIP in exCR, tailored to meet individual needs in broader patient groups, are needed. Trial registration number NCT02895451, 09/09/2016, retrospectively registered.

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The Added Value of a Behavioral Medicine Intervention in Physiotherapy on Adherence and Physical Fitness in Exercise-Based Cardiac Rehabilitation (ECRA): A Randomised, Controlled Trial

Cited by 4 publications

References 41 publications

Development of a Digital Lifestyle Modification Intervention for Use after Transient Ischaemic Attack or Minor Stroke: A Person-Based Approach

Development of a Digital Lifestyle Modification Intervention for Use after Transient Ischaemic Attack or Minor Stroke: A Person-Based Approach

Sex-related Differences in Exercise Capacity Trends and Determinants after Cardiac Rehabilitation in Patients with Acute Myocardial Infarction

Effectiveness of a behavioral medicine intervention in physical therapy on secondary psychological outcomes and health-related quality of life in exercise-based cardiac rehabilitation: a randomized, controlled trial

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