Sense of coherence predicts post-myocardial infarction trajectory of leisure time physical activity: a prospective cohort study

We examined the predictive role of SOC in the long-term trajectory of leisure time physical activity (LTPA) after MI using a prospective cohort design.A cohort of 643 patients aged ≤ 65 years admitted to hospital in central Israel with incident MI between February 1992 and February 1993 were followed up for 13 years. Socioeconomic, clinical and psychological factors, including SOC, were assessed at baseline, and LTPA was self-reported on 5 separate occasions during follow-up. The predictive role of SOC in long-term trajectory of LTPA was assessed using generalized estimating equations.SOC was consistently associated with engagement in LTPA throughout follow-up. Patients in the lowest SOC tertile had almost twice the odds (odds ratio,1.99; 95% confidence interval,1.52-2.60) of decreasing their engagement in LTPA as those in the highest tertile. A strong association remained after controlling for disease severity, depression, sociodemographic and clinical factors.Our evidence suggests that SOC predicts LTPA trajectory post-MI. Assessment of SOC can help identify high-risk MI survivors, who may require additional help in following secondary prevention recommendations which can dramatically improve prognosis.Physical activity confers a survival advantage on post-myocardial infarction (MI) patients [1-4]. Regularly active MI survivors were shown to have approximately half the risk of dying compared with inactive patients, irrespective of pre-MI habits [5]. Despite this clear advantage, a minority of post-MI patients are regularly active [5,6]. It remains unclear what differentiates active from non-active post-MI patients.Sense of coherence (SOC), a central construct of the salutogenic model of health, has been associated with health outcomes. This model was designed to explain improvement in one's location on the health-disease continuum [7], with SOC representing a person's confidence that they have the resources to cope with problems and challenges [8]. Previous resear