Maintaining physical activity in cardiac rehabilitation: Exercise Leadership in Cardiac Rehabilitation: An Evidence-Based Approach

This chapter describes an intervention that has been used to encourage individuals to remain regularly physically active in exercise-based CR in phases III and IV.The principles of this intervention are also appropriate for allphases of CR.This intervention, called the exercise consultation (EC), is based on the Transtheoretical Model of behaviour change and Relapse Prevention Model (pp.197-205), and uses cognitive and behavioural strategies to increaseand maintain physical activity (Loughlan and Mutrie,1995,1997). The strategies used in this EC include: assessing stage of change, decisional balance, overcoming barriers to activity, social support, goal setting, self-monitoring and relapse prevention. It involves a client-centred, one-to-one counselling approach and encourages individuals to develop an activity plan, tailored to their needs, readiness to change and lifestyle. The EC aims to encourage accumulated physical activity accumulating at least 30 minutes ofmoderate intensity activity on five days per week (Pate, et al., 1995, stage one, as discussed in Chapter 4). In addition, this level of physical activity may be easier for cardiac patients to incorporate into their daily routine and to sustainin the long term. Thus, the exercise consultation encourages individuals to integrate moderate intensity activity into their daily lives. In addition, EC can help maintain involvement in structured exercise in phases III and IV (SIGN, 2002).