Background and Aims: Physical activity (PA) constitutes an essential component of a cardiac rehabilitation (CR) process. Literature demonstrates that persons with coronary heart disease (CHD) had a poor adherence regarding this behavior. Counseling associated with pedometer-based activity program have been identified as a potential motivational aid for increasing PA, but their efficacy has not been demonstrated among persons with CHD. Furthermore, assessment and individualization of treatment plan for risk factors modification and psychosocial status are recommended to improve efficacy of a CR program. The aims of this study were to evaluate the effect of intervention by a clinical nurse specialist (CNS) on PA behavior at 3, 6, 9 and 12 months after a cardiac event and to verify the impact of this intervention on the management of lipid profile, systemic blood pressure, fasting glucose and waist circumference.
Methods and Materials: This is a randomized controlled trial. Subjects in the experimental group (n = 32) received an intervention from CNS who use the McGill conceptual model and a pedometer (SW-200) with a log book to improve perception of self-efficacy. The control group (n = 33) received usual care. The PA was measured by another pedometer (NL-2000) blinded to the participant and a log book. Risk factors were measured during clinical visits. Student's t test and repeated measures ANOVA tests were performed.
Results: At baseline, PA was similar for the two groups (experimental group = 6116 +/- 2985 steps/day; control group = 6020 +/- 3325 steps/day; P = .767). Preliminary results demonstrate that the two groups increased significantly PA at 3 month after hospitalization (experimental group = 9285 +/- 3359 steps/day; control group 8447 +/- 3974 steps/day). At 6 months, the experimental group maintained PA behavior (+109 steps/day); whereas the control group decreased PA (-1501 steps/day) versus 3 months after hospitalization. Furthermore, the changes in LDL-C, CT/HDL-C, waist circumference and systemic blood pressure were significantly different between the two groups (P < .001).
Conclusions: Those preliminary results demonstrate that the use of a counseling and pedometer based PA program led by a CNS improves and maintain PA 6 months after CHD. Behavior of PA measured by a pedometer and a log book shows a positive effect on risk factors of CHD and constitutes an addition to CR.