Motivation, psychological distress and exercise adherence following myocardial infarction

Fifty patients with myocardial infarction were recruited from a hospital based Cardiac Education and Assessment Program (CEAP) in Sydney, Australia. The Exercise Motivation Inventory-2 (EMI-2) and the Depression, Anxiety and Stress Scale (DASS) were administered prior to commencement in the program and re-administered by telephone interview at 5-month followup. Four exercise adherence measures were completed: attendance, exercise stress test, self-report ratings and a 7-day activity recall interview. There was a 46% adherence rate for MI patients during the hospital based CEAP. Of those individuals who completed CEAP, 91% obtained functional improvement on the exercise stress test. For the 38 patients who were followed-up by telephone interview at 5 months, 71% were exercising according to CEAP prescription. Higher levels of anxiety were associated with lower levels of self-reported exercise adherence. The 3 strongest motivations for exercise in this group of MI patients were all health related; wanting to be free from illness, maintaining good health and recovering from the effects of coronary heart disease. The discussion highlights the implications of these findings for cardiac rehabilitation programs and the need for empirically driven guidelines for measuring exercise adherence.