{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:56:28Z","timestamp":1783086988347,"version":"3.54.6"},"reference-count":61,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T00:00:00Z","timestamp":1660780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This mixed-method study aimed to compare physical activity (PA) patterns of a cross-over cardiac rehabilitation (CR) cohort with a center-based CR cohort and to explore barriers and facilitators of participants transitioning and engaging in virtual CR. It included the retrospective self-reported PA of a cross-over CR cohort (n = 75) and a matched center-based CR cohort (n = 75). Some of the participants included in the cross-over cohort (n = 12) attended semi-structured focus group sessions and results were interpreted in the context of the PRECEDE-PROCEED model. Differences between groups were not observed (p &gt; 0.05). The center-based CR cohort increased exercise frequency (p = 0.002), duration (p = 0.007), and MET\/minutes (p = 0.007) over time. The cross-over cohort increased exercise duration (p = 0.04) with no significant change in any other parameters. Analysis from focus groups revealed six overarching themes classified under predisposing factors (knowledge), enabling factors (external support, COVID-19 restrictions, mental health, personal reasons\/preferences), and reinforcing factors (recommendations). These findings suggest an improvement of the PA levels of center-based CR cohort participants pre-pandemic and mitigated improvement in those who transitioned to a virtual CR early in the pandemic. Improving patients\u2019 exercise-related knowledge, provider endorsements, and the implementation of group videoconferencing sessions could help overcome barriers to participation in virtual CR.<\/jats:p>","DOI":"10.3390\/jcm11164838","type":"journal-article","created":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T23:28:41Z","timestamp":1660865321000},"page":"4838","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Physical Activity Level and Perspectives of Participants Transitioning from Onsite to Virtual Cardiac Rehabilitation during the Early COVID-19 Pandemic: A Mixed-Method Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Lais Manata","family":"Vanzella","sequence":"first","affiliation":[{"name":"Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7946-3718","authenticated-orcid":false,"given":"Gabriela Lima de Melo","family":"Ghisi","sequence":"additional","affiliation":[{"name":"Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey Jacqueline Fitchett","family":"Colella","sequence":"additional","affiliation":[{"name":"Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada"},{"name":"Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian","family":"Larkin","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2W6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1891-3153","authenticated-orcid":false,"given":"Luiz Carlos Marques","family":"Vanderlei","sequence":"additional","affiliation":[{"name":"School of Technology and Sciences, S\u00e3o Paulo State University, Presidente Prudente 19060-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3186-400X","authenticated-orcid":false,"given":"Susan","family":"Marzolini","sequence":"additional","affiliation":[{"name":"Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada"},{"name":"Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2W6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Thomas","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5G 2W6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Oh","sequence":"additional","affiliation":[{"name":"Toronto Rehabilitation Institute, University Health Network, Toronto, ON M4G 2V6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,18]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2020). 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