Is the Theory of Planned Behavior a Useful Framework for Understanding Exercise Adherence During Phase II Cardiac Rehabilitation? (original) (raw)

Recent evidence suggests that exercise capacity, compared with other known cardiovascular risk factors, is the strongest predictor of mortality in patients with cardiovascular disease . 1 Research in phase II cardiac rehabilitation (CR) consistently shows that patients experience significant increases in exercise capacity after completing a phase II CR program. This increase in exercise capacity may be one of the factors contributing to the 20% reduction in mortality during the first 3 years after a cardiac event. 6 Despite these promising findings, however, adherence to such programs remains problematic. In fact, previous research shows that dropout rates have ranged from 10% to 36%. 5,9,10 Furthermore, even when patients do not drop out of phase II CR, exercise adherence has ranged from 47% to 81% 7,8,11 and many patients' exercise adherence levels decline even further once they complete their program. More specifically, Moore et al 12 showed that only 30% of their sample were engaging in regular exercise 3 months after phase II CR, whereas Hellman 13 showed similar results (ie, 30% were regular exercisers) at 12 to 18 months after phase II CR. Together, these results suggest the importance of identifying key determinants of exercise during phase II CR as a stepping stone toward developing effective exercise interventions.