Health education helps increase physical activity among people with heart disease

Zhu L, Ho S, Wong TK  Effectiveness of health education programs on exercise behavior among patients with heart disease: A systematic review and meta-analysis  J Evid Based Med.  2013; 6: 265-301.

Review question

Can health education programs change exercise behaviour among individuals with heart disease?

Background

Heart disease is a leading cause of death worldwide. Regular exercise can benefit people with heart disease but many people find it challenging to do.  Health education can help encourage people to exercise more and may motivate people with heart disease to boost their physical activity.

How the review was done

This is a summary of 37 randomized controlled trials. The studies included 10 066 adults with heart disease. The average age of participants ranged from 53 to 79 years.

Participants took part in health education programs promoting exercise and physical activity.  These programs included teaching, counseling and behavior modification through face-to-face, telephone or printed materials. Other types of education programs such as online education were not included. The programs ranged in length from a few days (for patients in hospital) to 3 years; most were about 5 months long. The studies measured any change in participants’ exercise behaviour such as how often they exercised and for how long.

What the researchers found

In general, health education programs help motivate people with heart disease to exercise.  The programs helped to increase how long (minutes/week) and how often (sessions/week) participants spent exercising.  However, participants did not keep up these changes after the education programs ended and the programs did not appear to increase participants’ total energy output each week (eg. calories burned).   Because most studies relied on participants remembering and reporting their own exercise habits, future studies should also track exercise levels using monitors (such as pedometers).

Conclusion

Health education programs promoting exercise and physical activity help to motivate people with heart disease to exercise, but people may not continue after the programs end.