Promoting exercise maintenance: how interventions with booster sessions improve long-term rehabilitation outcomes

Follow-up intervention boosters are supposed to promote exercise maintenance beyond initial treatment. The current quasi-experimental study investigated the benefits of adding telephone-delivered intervention boosters to a self-management exercise intervention for rehabilitants. Psycho-social mechanisms by which the intervention boosters promote exercise maintenance were examined.

Between 2009 and 2011, individuals in cardiac and orthopedic rehabilitation (N = 1,166) were allocated to either a self-management exercise intervention or a control group (i.e., questionnaire only). In addition to standard rehabilitation, participants in the intervention group were offered a series of telephone-delivered intervention boosters after 6 weeks and again after 6 months. Self-efficacy, action planning, and satisfaction with previous exercise outcomes were reassessed 12 months after discharge. Habit strength and exercise were measured 18 months after rehabilitation.

The intervention with boosters promoted the maintenance of planning, self-efficacy, satisfaction, exercise, and habit strength. Changes in exercise were simultaneously mediated by changes in planning, self-efficacy, and satisfaction. Changes in habit strength were sequentially mediated by planning and exercise.

Interventions with boosters that focus on action planning, self-efficacy, and satisfaction help to maintain self-directed postrehabilitation exercise. Frequent exercise performance, in turn, can strengthen exercise habits.