Cohesion and adherence in exercise groups of patients with chronic heart diseases - a prospective study

Objective: In cardiac rehabilitation, long-term adherence to exercise prescription is an important prerequisite to reduce mortality and the risk of recurrent cardiac events. Cohesion seems to be an important predictor of adherence when exercise is conducted in prevention settings, but in clinical settings, this relationship is currently unknown. To address this gap, the goal of this study was to determine the relationship between group cohesion and adherence in cardiac rehabilitation programs considering the duration of membership as a moderator.Design: The study was conducted with 474 participants (21.7% women), in three rehabilitation centres in North Rhine Westphalia, Germany, assessing cohesion, adherence and group membership in outpatient cardiac exercise groups.Main Outcome Measures: Cohesion was assessed using the KIT-FG and adherence was operationalized as the total number of sessions attended over a 7-week period.Results: Moderated hierarchical stepwise regression analyses revealed that perceptions of the social dimension of group cohesion significantly predicted adherence behaviour only for members with a rather long duration of membership.Conclusion: Our findings suggest that cohesion might have a differential effect on an individual's decision to regularly participate in exercise, depending on the duration of membership in the group.