Telephone Support Oriented by Accelerometric Measurements Enhances Adherence to Physical Activity Recommendations in Noncompliant Patients After a Cardiac Rehabilitation Program


      Guiraud T, Granger R, Gremeaux V, Bousquet M, Richard L, Soukarié L, Babin T, Labrunée M, Sanguignol F, Bosquet L, Golay A, Pathak A. Telephone support oriented by accelerometric measurements enhances adherence to physical activity recommendations in noncompliant patients after a cardiac rehabilitation program.


      To assess the efficacy of a strategy, based on telephone support oriented by accelerometer measurements, on the adherence to physical activity (PA) recommendations in cardiac patients not achieving PA recommendations.


      Prospective and randomized study.


      A cardiac rehabilitation program (CRP) at a clinic.


      Stable, noncompliant cardiac (coronary artery disease, heart failure, post–cardiovascular surgery) patients (weekly moderate-intensity PA <150min) were randomly assigned to an intervention group (n=19) or a control group (n=10).


      The intervention group wore an accelerometer for 8 weeks. Every 15 days, feedback and support were provided by telephone. The control group wore the accelerometer during the 8th week of the intervention only.

      Main Outcome Measures

      Active energy expenditure (EE) (in kilocalories) and the time spent doing light, moderate, or intense PA (minutes per week).


      In the intervention group, the time spent at moderate-intensity PA increased from 95.6±80.7 to 137.2±87.5min/wk between the 1st and 8th week (P=.002), with 36.8% of the sample achieving the target amount of moderate-intensity PA. During the 8th week, the EE averaged 543.7±144.1kcal and 266.7±107.4kcal in the intervention group and control group, respectively (P=.004).


      Telephone support based on accelerometer recordings appeared to be an effective strategy to improve adherence to PA in noncompliant patients. This intervention could be implemented after a CRP as an inexpensive, modern, and easy-to-use strategy.

      Key Words

      List of Abbreviations:

      ANOVA (analysis of variance), CRP (cardiac rehabilitation program), EE (energy expenditure), MET (metabolic equivalent), PA (physical activity)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Balady G.J.
        • Williams M.A.
        • Ades P.A.
        • et al.
        Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation.
        Circulation. 2007; 115: 2675-2682
        • Piepoli M.F.
        • Conraads V.
        • Corra U.
        • et al.
        Exercise training in heart failure: from theory to practice.
        Eur J Heart Fail. 2011; 13: 347-357
        • Guiraud T.
        • Granger R.
        • Gremeaux V.
        • et al.
        Accelerometer as a tool to assess sedentarity and adherence to physical activity recommendations after cardiac rehabilitation program.
        Ann Phys Rehabil Med. 2012; 55: 312-321
        • Reid R.D.
        • Morrin L.I.
        • Pipe A.L.
        • et al.
        Determinants of physical activity after hospitalization for coronary artery disease: the Tracking Exercise After Cardiac Hospitalization (Teach) Study.
        Eur J Cardiovasc Prev Rehabil. 2006; 13: 529-537
        • Burke L.E.
        • Dunbar-Jacob J.M.
        • Hill M.N.
        Compliance with cardiovascular disease prevention strategies: a review of the research.
        Ann Behav Med. 1997; 19: 239-263
        • Gillespie R.
        Manufacturing knowledge: a history of the Hawthorne experiments.
        Cambridge University Pr, New York1991
        • Herrmann S.D.
        • Hart T.L.
        • Lee C.D.
        • Ainsworth B.E.
        Evaluation of the MyWellness Key accelerometer.
        Br J Sports Med. 2011; 45: 109-113
        • Thompson P.D.
        • Buchner D.
        • Pina I.L.
        • et al.
        Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity).
        Circulation. 2003; 107: 3109-3116
        • Kotseva K.
        • Wood D.
        • De Backer G.
        • et al.
        EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries.
        Eur J Cardiovasc Prev Rehabil. 2009; 16: 121-137
        • Leon A.S.
        • Franklin B.A.
        • Costa F.
        • et al.
        Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American Association of Cardiovascular and Pulmonary Rehabilitation.
        Circulation. 2005; 111: 369-376
        • Conroy M.B.
        • Yang K.
        • Elci O.U.
        • et al.
        Physical activity self-monitoring and weight loss: 6-month results of the smart trial.
        Med Sci Sports Exerc. 2011; 43: 1568-1574
        • Pinto B.M.
        • Goldstein M.G.
        • Papandonatos G.D.
        • et al.
        Maintenance of exercise after phase II cardiac rehabilitation: a randomized controlled trial.
        Am J Prev Med. 2011; 41: 274-283
        • Butler L.
        • Furber S.
        • Phongsavan P.
        • Mark A.
        • Bauman A.
        Effects of a pedometer-based intervention on physical activity levels after cardiac rehabilitation: a randomized controlled trial.
        J Cardiopulm Rehabil Prev. 2009; 29: 105-114
        • Houle J.
        • Doyon O.
        • Vadeboncoeur N.
        • Turbide G.
        • Diaz A.
        • Poirier P.
        Innovative program to increase physical activity following an acute coronary syndrome: randomized controlled trial.
        Patient Educ Couns. 2011; 85: e237-e244
        • Moore S.M.
        • Charvat J.M.
        • Gordon N.H.
        • et al.
        Effects of a change intervention to increase exercise maintenance following cardiac events.
        Ann Behav Med. 2006; 31: 53-62
        • Hughes A.R.
        • Mutrie N.
        • Macintyre P.D.
        Effect of an exercise consultation on maintenance of physical activity after completion of phase III exercise-based cardiac rehabilitation.
        Eur J Cardiovasc Prev Rehabil. 2007; 14: 114-121
        • Sofi F.
        • Capalbo A.
        • Marcucci R.
        • et al.
        Leisure time but not occupational physical activity significantly affects cardiovascular risk factors in an adult population.
        Eur J Clin Invest. 2007; 37: 947-953
        • Cottin Y.
        • Cambou J.P.
        • Casillas J.M.
        • Ferrieres J.
        • Cantet C.
        • Danchin N.
        Specific profile and referral bias of rehabilitated patients after an acute coronary syndrome.
        J Cardiopulm Rehabil. 2004; 24: 38-44