Sustained Post-Intervention Effects of Small Community Walking on Physical Activity, Well-Being, and Social Capital Among Older Patients With Cardiovascular Disease in the Chronic Phase　- A Follow-up Multicenter Randomized Controlled Trial.

Background: Because the sustained effects of physical activity (PA) and the positive psychological and social aspects during the chronic phase of cardiac rehabilitation (CR) have not been clarified, we examined the sustained post-intervention effects of small community walking (SCW) on PA, well-being, and individual-level social capital in older patients with cardiovascular disease (CVD) in the chronic phase and the influence of increased well-being and social capital on increased PA. Methods and Results: The subjects were 48 older patients with CVD who were randomly divided into SCW and walking-alone groups and were available for a 6-month follow-up survey after a 3 months' intervention by healthcare workers. We measured PA, well-being (subjective happiness scale), and social capital before, 3 months after the intervention, and 6 months after the intervention ended. At 6 months post-intervention, only the SCW group maintained significant increases from the pre-intervention values in PA and well-being (P<0.01). Furthermore, increased well-being was a predictor of increased PA in the SCW group (P<0.01). Conclusions: Our results suggest that SCW effectively maintains PA and well-being, even after the intervention ends, in older patients with CVD during the chronic phase. In addition, the effects of SCW are associated with PA and well-being. The relationship between PA and individual-level social capital should be further investigated.