Effect of the self-monitoring approach on exercise maintenance during cardiac rehabilitation: A randomized, controlled trial

Kazuhiro P. Izawa*, Satoshi Watanabe, Kazuto Omiya, Yasuyuki Hirano, Koichiro Oka, Naohiko Osada, Setsu Iijima

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

95 Citations (Scopus)


Objective: To evaluate the effect of the self-monitoring approach (SMA) on self-efficacy for physical activity (SEPA), exercise maintenance, and objective physical activity level over a 6-mo period after a supervised 6-mo cardiac rehabilitation (CR) program. Design: We conducted a randomized, controlled trial with 45 myocardial infarction patients (38 men, seven women; mean age, 64.2 yrs) recruited after completion of an acute-phase, exercise-based CR program. Patients were randomly assigned to an SMA group (n=24) or control group (n=21). Along with CR, the subjects in the SMA group self-monitored their weight and physical activity for 6 mos. The SMA used in this study was based on Bandura's self-efficacy theory and was designed to enhance confidence for exercise maintenance. The control group participated in CR only. All patients were evaluated with the SEPA assessment tool. Exercise maintenance, SEPA scores, and objective physical activity (average steps per week) as a caloric expenditure were assessed at baseline and during a 6-mo period after the supervised CR program. Results: Mean period from myocardial infarction onset did not differ significantly between the SMA and control groups (12.1 ± 1.3 vs. 12.2 ± 1.2 mos, P = 0.692). All patients maintained their exercise routine in the SMA group. Mean SEPA score (90.5 vs. 72.7 points, P < 0.001) and mean objective physical activity (10,458.7 vs. 6922.5 steps/wk, P < 0.001) at 12 mos after myocardial infarction onset were significantly higher in the SMA than control group. SEPA showed significant positive correlation with objective physical activity (r = 0.642, P < 0.001). Conclusions: SMA during supervised CR may effectively increase exercise maintenance, SEPA, and objective physical activity at 12 mos after myocardial infarction onset.

Original languageEnglish
Pages (from-to)313-321
Number of pages9
JournalAmerican Journal of Physical Medicine and Rehabilitation
Issue number5
Publication statusPublished - 2005 May
Externally publishedYes


  • Cardiac Rehabilitation
  • Exercise Maintenance
  • Objective Physical Activity
  • Self-Efficacy for Physical Activity

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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