Rationale:

The mortality/morbidity and quality of life benefits of exercise-based cardiac rehabilitation (CR) are well established, yet adherence to exercise can vary post discharge. Recent trials have attempted to enhance adherence to aerobic activities during transition from CR to home-based exercise. However, these trials have not addressed resistance training, which is also an integral part of many participants' CR exercise routines. Because accessibility to familiar training equipment (eg, weight machines) and instruction may be limited upon completion of CR, poor adherence to this essential form of exercise can result.

Objective:

The purpose of this study was to examine the effects of a brief intervention involving the provision of a motivation-enhancing instructional manual and elastic Thera-Bands(R) on self-efficacy for, and adherence to, upper body resistance exercise. It was hypothesized that participants receiving the intervention would report higher self-efficacy and greater adherence than those in a standard care control condition.

Methodology:

The study was a randomized controlled trial involving informed and consenting CR participants (N = 35; nmales = 28; Mage = 61 +/- 11.53). Participants in the intervention group (n = 17) received an orientation to home-based upper body resistance training, a theory-driven self-efficacy enhancing instructional manual, and Thera-Bands(R). The control group received an orientation to home-based upper body resistance training and standard care CR follow-up (n = 18). Participants completed baseline measures of resistance training self-efficacy one week prior to discharge from CR, and again at 4-weeks post-discharge and logged their sets of upper-body resistance exercises for the 4-week period.

Results:

There were no differences between groups on any of the study variables at baseline. Results of a 2X5 MANOVA on self-efficacy scores revealed a significant effect for condition at the 4-week follow-up, Wilks' Lambda = .65, F(5,29) = 3.72, [eta]2 = .35, P < .05. Self-efficacy for performing exercises safely and using proper form was higher (P < .05) in the intervention group for back, shoulder, and triceps exercises. MANOVA also showed a significant effect for condition on sets of resistance exercises, Wilks' Lambda = .44, F(6,28) = 5.92, [eta]2 = .56, P < .001. The intervention group performed more (P < .05) sets of all exercises except bicep curls. Interpreted as a composite, participants in the intervention group completed an average of 44.59 sets of resistance exercise/week compared to 22.36 sets in the control group; representing 99% more sets of resistance exercise among participants in the intervention group.

Conclusions:

Maintaining or increasing upper body strength is an important outcome of CR, as it relates to the performance of many activities of daily living. However, adherence to resistance exercises may be difficult upon completion of supervised, facility-based CR. This study illustrates that the provision of a motivation-enhancing instructional manual and low cost materials has a positive impact on self-efficacy and adherence to resistance training, and may help participants make a successful transition to home-based resistance exercise.

Section Description

For more information, contact Marilyn Thomas (204) 488-5854