Physical Activity Level and Perspectives of Participants Transitioning from Onsite to Virtual Cardiac Rehabilitation during the Early COVID-19 Pandemic: A Mixed-Method Study.
Lais Manata Vanzella, Gabriela Lima de Melo Ghisi, Tracey Jacqueline Fitchett Colella, Jillian Larkin, Luiz Carlos Marques Vanderlei, Susan Marzolini, Scott Thomas, Paul Oh
Author Information
Lais Manata Vanzella: Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada.
Gabriela Lima de Melo Ghisi: Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada. ORCID
Tracey Jacqueline Fitchett Colella: Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada.
Jillian Larkin: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2W6, Canada.
Luiz Carlos Marques Vanderlei: School of Technology and Sciences, São Paulo State University, Presidente Prudente 19060-900, SP, Brazil. ORCID
Susan Marzolini: Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada. ORCID
Scott Thomas: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2W6, Canada.
Paul Oh: Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada.
This mixed-method study aimed to compare physical activity (PA) patterns of a cross-over cardiac rehabilitation (CR) cohort with a center-based CR cohort and to explore barriers and facilitators of participants transitioning and engaging in virtual CR. It included the retrospective self-reported PA of a cross-over CR cohort (n = 75) and a matched center-based CR cohort (n = 75). Some of the participants included in the cross-over cohort (n = 12) attended semi-structured focus group sessions and results were interpreted in the context of the PRECEDE-PROCEED model. Differences between groups were not observed (p > 0.05). The center-based CR cohort increased exercise frequency (p = 0.002), duration (p = 0.007), and MET/minutes (p = 0.007) over time. The cross-over cohort increased exercise duration (p = 0.04) with no significant change in any other parameters. Analysis from focus groups revealed six overarching themes classified under predisposing factors (knowledge), enabling factors (external support, COVID-19 restrictions, mental health, personal reasons/preferences), and reinforcing factors (recommendations). These findings suggest an improvement of the PA levels of center-based CR cohort participants pre-pandemic and mitigated improvement in those who transitioned to a virtual CR early in the pandemic. Improving patients’ exercise-related knowledge, provider endorsements, and the implementation of group videoconferencing sessions could help overcome barriers to participation in virtual CR.
