| Summary: | <h4>Background</h4> Exercise-based cardiac rehabilitation (CR) is an essential contributor to a successful recovery for elderly cardiac patients. The motivation for physical activity is a psychological parameter seldom described in secondary prevention, and it is plausible that motivation contributes to the differential effect of CR. <h4>Purpose</h4> To investigate if motivation, measured using the behavioural regulation in an exercise questionnaire (BREQ-2), predicts VO2peak in elderly cardiac patients before and after CR. <h4>Methods</h4> A prospective cohort study of elderly ischemic cardiac patients and patients with valvular disease participating in cardiac rehabilitation was used. Motivation was measured using BREQ-2, which measures five constructs of motivation and a summed score—the relative autonomy index (RAI). VO2peak was measured before and after CR using a cardiopulmonary exercise test (CPET). <h4>Results</h4> Two hundred and three patients performed the baseline tests and initiated CR. One hundred and eighty-two completed CR and comprised the follow-up group. The mean VO2peak was 18 ml/kg/min (SD±5.1). VO2peak increased significantly with increasing motivation, 1.02 (.41–1.62) ml/kg/min pr. SD. Mean improvement from CR was 2.3 ml/kg/min (SD±4.3), the equivalent of a 12% increase. A change in VO2peak after CR was likewise positively associated with increased motivation, .74 (.31–1.17) pr. SD. <h4>Conclusion</h4> The level of motivation predicts VO2peak before CR, and is also able to predict changes in VO2peak following CR. Motivation measured with the BREQ-2 questionnaire can be applied as a screening tool for elderly cardiac patients before they initiate CR to identify patients with need of specific attention.
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