Behaviour interventions in CR

Exercise consultation was developed in the UK setting. In the US, a similar procedure is termed physical activity counselling. A recent systematic review concluded that physical activity counselling was effective in increasing physical activity and fitness in the general population (Kahn, et al., 2002). Physical activity counselling is also based on the Transtheoretical Model and uses behaviour change strategies similar to those employed in the exercise consultation process. In addition, American CR guidelines recommend that physical activity counselling should be a core component of CR programmes to promote an active lifestyle for patients with CHD (Balady, et al., 2000).

This guideline recommends that physical activity counselling should include an evaluation of the individual's current physical activity level, stage of change for exercise behaviour, self-efficacy, barriers to increasing physical activity and social support in making positive changes. Interventions should include providing support, advice and counselling about physical activity needs, and setting goals to increase physical activity to 30 minutes per day of moderate physical activity on at least five days a week. In addition, patients' daily schedules should be explored in order to suggest how physical activity can be incorporated into their daily routine, e.g. parking further away than usual from entrances, walking up two or more flights of stairs and walking for 15 minutes during lunch breaks. In addition, the use of behaviour change interventions for structured exercise and other health behaviour is recommended in the UK (SIGN, 2002).

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