Exercise maintenance after rehabilitation: How experience can make a difference

Objectives: Rehabilitation treatment includes physical exercise to enable patients to decrease limitations and facilitate post-treatment exercise performance. However, many patients fail to maintain an active lifestyle after their discharge from rehabilitation. It is assumed that their experience with exercise during rehabilitation treatment, their satisfaction with it, and their self-regulatory goal pursuit may be sufficient for long-term exercise maintenance. Therefore, the present study aims to examine the psychological mechanisms that might contribute to exercise maintenance after rehabilitation. Design: At the beginning and at the end of cardiac and orthopedic rehabilitation, 248 patients filled in a computer-based questionnaire assessing exercise experiences, satisfaction, planning, and behavior. Physical exercise was reassessed 6 weeks after discharge. Methods: Multiple mediation analysis was conducted to unveil working mechanisms of exercise experiences. It was tested whether the impact of exercise experiences during rehabilitation had an effect on behavior after discharge and whether satisfaction and planning would mediate this process, controlling for past behavior and patient group (cardiac vs. orthopedic). Results: Analyses revealed that experiences exert its influence on subsequent behavior via two independent social-cognitive pathways: satisfaction and planning (full mediation). Conclusions: Findings suggest that focusing on individuals' experiences during rehabilitation may promote exercise maintenance indirectly by increasing satisfaction levels and planning skills. Standard rehabilitation care may be complemented by psychological interventions that promote positive experiences, improve satisfaction, and teach self-regulatory skills such as planning.