Abstract 18506: Cardiac Rehabilitation Extended With a Behavioral Group Intervention Improves Physical Activity and Physical Fitness in ACS Patients: The Opticare Randomized Controlled Trial
Introduction: Current standard cardiac rehabilitation (CR) is insufficient to achieve and maintain an active lifestyle.
Hypothesis: We hypothesize that CR extended with behavioral group sessions will achieve and maintain an active lifestyle and, consequently, maintain physical fitness in ACS patients.
Methods: In the OPTICARE RCT, 491 ACS patients (57 years; 80% men) were randomized into: 1) 3-months (M) standard CR (n=246); or 2) CR+counseling (n=245): standard CR with 3 additional active lifestyle group counseling sessions and a 9M follow-up program comprising 3 group sessions with fitness training and healthy lifestyle counseling. Measurements were performed at baseline, post-CR, 9M post-CR (end of follow-up program), and 15M post-CR. Physical activity was objectively measured with accelerometry and physical fitness with the 6-minute walk test. GEE analyses were performed using intention-to-treat principles.
Results: Participation in CR+counseling improved physical activity: post-CR daily 15.1 min of moderate-to-vigorous physical activity and 1504 steps were gained, whereas the standard CR group gained daily only 6.8 min and 723 steps (p=.015; p=.007). During the follow-up program, these improvements partly diminished, although there was still a trend for a higher improvement in daily step count in CR+counseling versus standard CR at 15-M post-CR (+863 vs +273 steps, p=.099) (Figure left). Furthermore, in contrast to standard CR, CR+counseling was more successful in improving physical fitness at 9M post-CR (p=.031), but not at 15M post-CR (Figure right).
Conclusions: CR extended with a behavioral group intervention was successful in improving physical activity during CR and maintaining fitness gains up to 9M post-CR in ACS patients. Although the program needs optimization for long-term benefits, we recommend to implement active lifestyle group counseling sessions as part of standard CR.
- Physical activity and exercise
- Cardiac rehabilitation
- Behavior change
- Acute coronary syndromes
- Sedentary behavior
Author Disclosures: N. ter Hoeve: None. M. Sunamura: None. M.L. Geleijnse: None. H.J. Stam: None. E. Boersma: None. R.T. van Domburg: None. R.J. van den Berg-Emons: None.
- © 2016 by American Heart Association, Inc.