Abstract
Background: Exercise maintenance interventions are needed for cardiac rehabilitation (CR) graduates to maintain moderate and vigorous-intensity physical activity (MVPA). We tested an exercise facilitator intervention (EFI) to promote exercise maintenance compared with usual care (UC) separately in men and women. Methods: This was a 3-site, randomized (1:1), parallel-group, superiority trial (ECO-PCR). CR graduates were stratified by site and sex and randomly allocated (concealed). EFI participants received a face-to-face introductory session, 5 small-group counseling teleconferences, and 3 personal calls from a trained facilitator over 50 weeks. In-person assessments were undertaken at baseline and 26 and 52 weeks after randomization. The primary outcome was weekly minutes of MVPA, measured by accelerometer. Secondary outcomes were exercise capacity, risk factors, quality of life, and enrollment in community-based exercise programs. Effects were tested with the use of linear mixed models. Results: A total of 449 CR graduates (135 women, 314 men) were randomised (n = 226 EFI, n = 223 UC). In the intention-to-treat analysis for men and for women, there were no significant effects for treatment or time on MVPA. In a planned secondary analysis that considered only those adherent to EFI (completed ≥ 66% of sessions; per-protocol), bouted MVPA (ie, in sustained bouts of ≥ 10 min) was higher in women in the EFI group (mean = 132.6 ± 135.2 min/wk at 52 weeks) compared with UC (111.8 ± 113.1; P = 0.013). Regarding secondary outcomes, in women, a treatment group main effect was observed for blood pressure (P = 0.011) and exercise capacity (P = 0.019; both per-protocol) favouring EFI; no other differences were observed. Conclusions: In this trial of CR completers, an EFI showed promise for women, but was ineffective in men.
Original language | English |
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Pages (from-to) | 794-802 |
Number of pages | 9 |
Journal | Canadian Journal of Cardiology |
Volume | 37 |
Issue number | 5 |
DOIs | |
Publication status | Published - May 2021 |
Bibliographical note
Funding Information:This trial was supported by Heart and Stroke Foundation of Canada grant-in-aid no. G-14-0006126. SLG is supported in her work by the Toronto General and Toronto Western Hospital Foundation and the Peter Munk Cardiac Centre, University Health Network. The sponsor had no involvement in: the design of the study; the collection, analysis, and interpretation of the data; or in the decision to approve publication of the finished manuscript.
Publisher Copyright:
© 2020 The Authors
ASJC Scopus Subject Areas
- Cardiology and Cardiovascular Medicine
PubMed: MeSH publication types
- Journal Article
- Multicenter Study
- Randomized Controlled Trial
- Research Support, Non-U.S. Gov't