Synergistic effects of intention and depression on action control: Longitudinal predictors of exercise after rehabilitation

ObjectivePhysical exercise is part of orthopedic and cardiac rehabilitation. Although intentions might be high, many patients fail to adopt or maintain exercise after discharge from rehabilitation because of self-regulatory failure. This might be due to depressive symptoms. Therefore, this study investigates whether depressive symptoms affect the translation of exercise intentions via action control into exercise.DesignAt the beginning of rehabilitation, intention, action control, depressive symptoms, and exercise behavior were assessed in 277 orthopedic and cardiac patients. Exercise was reassessed 6 weeks after discharge from rehabilitation.MethodsMediation and moderated mediation analyses were conducted. It was tested whether action control translates the effect of exercise intentions on subsequent behavior. In addition, it was examined whether this mediation was affected by levels of depressive symptoms.ResultsAction control worked as a mediator between exercise intentions and behavior. Moreover, levels of depressive symptoms moderated this mediation. The mediation effect only materialized within the subgroup of patients lower on depressive symptoms.ConclusionPatients with higher depressive symptoms may fail to use appropriate self-regulatory strategies for exercise. Future research should examine whether depressed individuals can benefit from action control interventions and identify which strategies are most beneficial for individuals with depressive symptoms.

Research highlights
► Moderated mediation analysis was conducted.
► Action control functioned as a mediator between exercise intentions and behavior.
► The mediation only materialized in patients with low depressive symptoms