Device-based 24-hour movement behaviours in adult phase III cardiac rehabilitation service-users during the COVID-19 pandemic: a mixed-methods prospective observational study
Creators: name: Meredith, S. J.
name: Shepherd, A. I.
name: Saynor, Z. L.
name: Scott, A.
name: Gorczynski, P.
name: Perrisiou, M.
name: Horne, M.
name: McNarry, M. A.
name: Mackintosh, K. A.
name: Witcher, C. S. G.
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Biophysics
subject: Medicine
subject: Molecular Biology
subject: Physiology
subject: FOS: Biological sciences
subject: Pharmacology
subject: Biotechnology
subject: Environmental Sciences not elsewhere classified
subject: Sociology
subject: FOS: Sociology
subject: Biological Sciences not elsewhere classified

description: To examine changes in device-based 24-hour movement behaviours (MB), and facilitators and barriers to physical activity (PA) and exercise, during remotely-delivered cardiac rehabilitation (RDCR). This prospective observational study used wrist-worn GENEActiv accelerometers to assess MB of 10 service-users (63 ± 10 years) at the start, middle, and end of three-months of RDCR. Barriers and facilitators to PA and exercise were explored through self-report diaries and analysed using content analysis. At start, service-users were sedentary for 12.6 ± 0.7 h · day<sup>−1</sup> and accumulated most PA at a light-intensity (133.52 ± 28.57 min · day<sup>−1</sup>) – neither changed significantly during RDCR. Sleep efficiency significantly reduced from start (88.80 ± 4.2%) to the end (86.1 ± 4.76%) of CR, with values meeting health-based recommendations (≥85%). Barriers to RDCR exercise included exertional discomfort and cardiac symptoms, and reduced confidence when exercising alone. Setting meaningful PA goals, self-monitoring health targets, and having social support, facilitated PA and exercise during RDCR. Our RDCR programme failed to elicit significant changes in MB or sleep. To increase the likelihood of successful RDCR, it is important to promote a variety of exercise and PA options, target sedentary time, and apply theory to RDCR design, delivery, and support strategies. Practitioners should work with service-users to understand how best to support them to maximise the benefit(s) of remotely/hybrid delivered services.Facilitating easy (and regular) access to health professionals during remotely/hybrid delivered cardiac rehabilitation (CR) will support the development of service-users’ physical activity (PA) and exercise self-efficacy (i.e., confidence).Remotely/hybrid delivered CR should be informed by theory and/or behaviour change techniques to support increased PA, reduced sedentary time and improved sleep during and after CR.It is important to include strategies to reduce sedentary time in addition to targeting PA and exercise in remotely-delivered CR. Practitioners should work with service-users to understand how best to support them to maximise the benefit(s) of remotely/hybrid delivered services. Facilitating easy (and regular) access to health professionals during remotely/hybrid delivered cardiac rehabilitation (CR) will support the development of service-users’ physical activity (PA) and exercise self-efficacy (i.e., confidence). Remotely/hybrid delivered CR should be informed by theory and/or behaviour change techniques to support increased PA, reduced sedentary time and improved sleep during and after CR. It is important to include strategies to reduce sedentary time in addition to targeting PA and exercise in remotely-delivered CR.