The effectiveness of a transtheoretical model-based multidisciplinary collaboration on cardiac rehabilitation outcomes in patients with acute myocardial infarction：a quasi-randomized study

Background Cardiac rehabilitation (CR) has been shown to reduce morbidity and mortality in patients with acute myocardial infarction (AMI), however, the proportion of patients participating in and benefiting from cardiac rehabilitation (CR) remains low in China. This study aims to explore the effects of a trans-theoretical model (TTM)- based multidisciplinary CR program (TTMCR) on behavior change and CR outcomes in AMI patients. Methods This was a pragmatic, nonrandomized trial of 84 patients with AMI, who were enrolled in TTMCR program (TTMCR group, n = 43 ) or standard nursing care and in-hospital CR (control group, n = 41). The primary study outcome was 3-month change in CR outcomes assessed by cardiopulmonary exercise test (CPET) and subjective measures including the Exercise Self-Efficacy Scale (ESES), and the Exercise Social Support Scale (ESSS). The secondary study outcome was 3-month behavior change evaluated by weekly exercise frequency and the Stages of Exercise Behavior Change Scale. Results Characteristics of the 43 patients in TTMCR group and 41 patients in the control group were similar. As compared to the control group, patients in the TTMCR groups achieved greater 3-month gains in ventilation oxygen at the anaerobic threshold per kilogram (AT-VO ₂ /kg) (p < 0.001), peak ventilation oxygen per kilogram (VO ₂ Peak/kg) (p < 0.001), ESES cores (p < 0.001) and ESSS scores (p < 0.001). 3 months post discharge, the proportion of patients achieving successful behavior change was higher in the TTMCR group, with significantly increased weekly exercise frequency (p < 0.001). Conclusions Patients enrolled in the TTMCR group achieved greater 3-month improvement in CR outcomes and behavior change than those in the control group. Our data suggest the novel TTMCR program is promising in improving CR outcomes in AMI patients during the early post-discharge period. Trial registration: Clinicaltrials.gov, NCT07045220 (Data assigned: 22/6/2025). Retrospectively registered.