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Open Access Open Badges Research article

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

Vicki Myers1, Yaacov Drory2, Yariv Gerber1* and the Israel Study Group on First Acute Myocardial Infarction

Author Affiliations

1 Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Medical School, Tel Aviv University, Israel

2 Department of Rehabilitation, Sackler Medical School, Tel Aviv University, Israel

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BMC Public Health 2011, 11:708  doi:10.1186/1471-2458-11-708

Published: 19 September 2011



Physical activity confers a survival advantage after myocardial infarction (MI), yet the majority of post-MI patients are not regularly active. Since sense of coherence (SOC) has been associated with health outcomes and some health behaviours, we investigated whether it plays a role in post-MI physical activity.

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.

myocardial infarction; physical activity; secondary prevention; sense of coherence; psychosocial factors; cohort study