Maintaining Exercise after Cardiac Rehabilitation

描述（由申请人提供）：在已完成心脏康复的患者中保持运动参与是冠状动脉事件和心脏再住院的二级预防的组成部分。II期心脏康复计划中的患者，大多数是老年人，在计划期间参加定期监督锻炼;然而，长期坚持锻炼的情况很差，只有30%的患者在12个月随访时报告定期锻炼。为了促进运动的维护完成12周的第二阶段康复计划后，我们建议提供一个理论为基础的干预，我们已经成功地用于促进老年人，初级保健患者的运动。该计划（维持咨询）包括心脏康复病例经理在第二阶段计划出院时提供的简短建议，然后是基于行为改变和社会认知理论的跨理论模型的电话咨询。健康教育工作者将在6个月内提供基于电话的干预。采用随机对照设计，将180例患者分配至维持咨询组或简要建议加接触控制组。结果评估将包括运动耐量试验（基线/康复后和6个月）、自我报告的运动参与、运动动机准备以及基线、6、12和18个月时的客观活动监测。这些数据将有助于确定是否基于电话的运动咨询是一个有效的策略，维持定期运动和健身的心脏康复患者，从而有助于二级预防冠心病。

DESCRIPTION (provided by applicant): Maintaining exercise participation among patients who have completed cardiac rehabilitation is integral to secondary prevention of coronary events and cardiac re-hospitalization. Patients in Phase II cardiac rehabilitation programs, a majority being older adults, participate in regular supervised exercise during the program; however, long-term adherence to exercise is poor, with only 30% reporting regular exercise at 12 month follow-ups. To promote exercise maintenance after completion of a 12 week Phase II rehabilitation program, we propose to offer a theoretically-based intervention that we have used successfully to promote exercise among older, primary-care patients. This program (Maintenance Counseling) includes brief advice from the Cardiac Rehabilitation case manager at Phase II program discharge followed by telephone counseling based on the Transtheoretical Model of Behavior Change and Social Cognitive Theory. Health educators will provide the telephone-based intervention over 6 months. Using a randomized controlled design, 180 patients will be assigned to Maintenance Counseling or Brief Advice plus Contact Control. Outcome assessments will include an exercise tolerance test (baseline/post-rehabilitation and 6 months), self reported exercise participation, motivational readiness for exercise, and objective activity monitoring at baseline, 6, 12 and 18 months. These data will help to identify whether telephone-based exercise counseling is an effective strategy for sustaining regular exercise and fitness among cardiac rehabilitation patients thereby contributing to secondary prevention of coronary heart disease.