1. Johnston, M.

Article Content

Background and Aims: Little is known of the impact exercise based cardiac rehabilitation (CR) programs have on the subsequent physical activity (PA) patterns of elderly patients. Therefore the purpose of this study was to determine the influence of a CR program on exercise self efficacy (ESE) and the PA patterns of elderly cardiac patients.


Methods and Materials: Twenty patients recovering from an MI (9 female, 11 male; age 75+/-6.3 years) were studied. Patients were tested pre and post CR (20 sessions, 45 min/day; aerobic + strength training over 8-10 weeks). ESE was assessed using the multidimensional SE scale. This 9 item scale assessed three domains of SE; task, coping and scheduling. When responding to each item, patients were asked to think of exercises as "walking at a moderate intensity three times a week for about 30 minutes". All responses were scored on a 0-100% scale (no confidence to complete confidence). PA was determined using the SenseWear(TM) Pro Armband (SWA; Body Media, Pittsburgh, PA) which estimated daily energy expenditure (EE). The SWA was worn continuously for three consecutive days. EE was calculated using an algorithm which integrated data from a heat flux sensor, dual axial accelerometer, the galvanic skin response, skin temperature, near-body temperature and demographic characteristics. The SWA also provided information on steps/day (STEPS) and time spent in low (< 3 METs) or moderate (3-6 METs) daily PA. Self-reported PA was also measured using the Godin Leisure-Time Exercise Questionnaire, wherein patients record the frequency of mild, moderate and vigorous activity (in 15 minute bouts over 7 days).


Results: Post CR, ESE scores increased significantly, F(3,16)=4.21, p<.0.02, [eta]2=0.44. Significant improvements were also found for coping and scheduling SE ([eta]2=0.17, [eta]2= 0.17 respectively). Self-reported PA scores suggested that patients were more active post CR (45+/-41 vs. 16+/-13; p=0.005). However, post CR EE (2251+/-526 vs. 2150+/- 510 kcal) and STEPS (5697+/-2216 vs. 5227+/-2408) did not change. Furthermore, time spent in low (21+/-2.9 vs. 21+/-2.4 hours) and moderate (0.9+/-1.0 vs. 0.9+/-0.8 hours) PA did not change.


Conclusions: For these elderly patients while exercise self efficacy and self reported physical activity improved, the objective measures suggested that overall daily activity (i.e. EE) was not affected by prior participation in CR.