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"Exercise - psychology"
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Effects of Exercise Testing and Cardiac Rehabilitation in Patients with Coronary Heart Disease on Fear and Self-Efficacy of Exercise: A Pilot Study
BackgroundExercise fear and low exercise self-efficacy are common in patients attending cardiac rehabilitation (CR). This study tested whether exercise prescription methods influence exercise fear and exercise self-efficacy. We hypothesized that the use of graded exercise testing (GXT) with a target heart rate range exercise prescription, relative to standard exercise prescription using rating of perceived exertion (RPE), would produce greater reductions in exercise fear and increase self-efficacy during CR.MethodPatients in CR (N = 32) were randomized to an exercise prescription using either RPE or a target heart rate range. Exercise fear and self-efficacy were assessed with questionnaires at three time points: baseline; after the GXT in target heart rate range group; and at session 6 for the RPE group and CR completion. Items were scored on a five-point Likert-type scale with higher mean scores reflecting higher fear of exercise and higher self-efficacy. To analyze mean differences, a mixed effects analysis was run.ResultsThere were no significant changes in exercise self-efficacy between baseline and discharge from CR; these were not statistically significant (mean differences baseline − 0.63; end − 0.27 (p = 0.13)). Similarly, there was no change in fear between groups (baseline 0.30; end 0.51 (p = 0.37)).ConclusionPatients in the RPE and target heart rate groups had non-significant changes in exercise self-efficacy over the course of CR. Contrary to our hypothesis, the use of GXT and target heart rate range did not reduce fear, and we noted sustained or increases in fear of exercise among patients with elevated baseline fear. A more targeted psychological intervention seems warranted to reduce exercise fear and self-efficacy in CR.
Journal Article
Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial
Background
Exercise is an effective strategy to improve quality of life and physical fitness in breast cancer survivors; however, few studies have focused on the early survivorship period, minorities, physically inactive and obese women, or tested a combined exercise program and measured bone health. Here, we report the effects of a 16-week aerobic and resistance exercise intervention on patient-reported outcomes, physical fitness, and bone health in ethnically diverse, physically inactive, overweight or obese breast cancer survivors.
Methods
One hundred breast cancer survivors within 6 months of completing adjuvant treatment were assessed at baseline, post-intervention, and 3-month follow-up (exercise group only) for physical fitness, bone mineral density, serum concentrations of bone biomarkers, and quality of life. The exercise intervention consisted of moderate-vigorous (65–85% heart rate maximum) aerobic and resistance exercise thrice weekly for 16 weeks. Differences in mean changes for outcomes were evaluated using mixed-model repeated measure analysis.
Results
At post-intervention, the exercise group was superior to usual care for quality of life (between group difference: 14.7, 95% CI: 18.2, 9.7;
p
< 0.001), fatigue (p < 0.001), depression (p < 0.001), estimated VO
2max
(p < 0.001), muscular strength (p < 0.001), osteocalcin (
p
= 0.01), and BSAP (
p
= 0.001). At 3-month follow-up, all patient-reported outcomes and physical fitness variables remained significantly improved compared to baseline in the exercise group (
p
< 0.01).
Conclusions
A 16-week combined aerobic and resistance exercise program designed to address metabolic syndrome in ethnically-diverse overweight or obese breast cancer survivors also significantly improved quality of life and physical fitness. Our findings further support the inclusion of supervised clinical exercise programs into breast cancer treatment and care.
Trial registration
This trial is registered on ClinicalTrials.gov:
NCT01140282
as of June 9, 2010.
Journal Article
Self-monitoring and reminder text messages to increase physical activity in colorectal cancer survivors (Smart Pace): a pilot randomized controlled trial
Background
Over 1.3 million people live with colorectal cancer in the United States. Physical activity is associated with lower risk of colorectal cancer recurrence and mortality. Interventions are needed to increase physical activity in colorectal cancer survivors.
Methods
We conducted a 2-arm non-blinded pilot randomized controlled trial at the University of California, San Francisco among 42 individuals who had completed curative-intent treatment for colorectal cancer to determine the feasibility and acceptability of a 12-week (84 days) physical activity intervention using a Fitbit Flex™ and daily text messages. Participants were randomized 1:1 to receive the intervention with print educational materials or print educational materials alone. We explored the impact of the intervention versus usual care on physical activity using ActiGraph GT3X+ accelerometers pre−/post-intervention.
Results
We screened 406 individuals and randomized 42 to intervention (
n
= 21) or control (
n
= 21) groups. During the 12-week study, the intervention arm wore their Fitbits a median of 74 days [88% of days in study period, interquartile range: 23–83 days] and responded to a median of 34 (out of 46) text messages that asked for a reply (interquartile range: 13–38 text messages). Among the 16 intervention participants who completed the feedback survey, the majority (88%) reported that the intervention motivated them to exercise and that they were satisfied with their experience. No statistically significant difference in change in moderate-to-vigorous physical activity was found from baseline to 12 weeks between arms.
Conclusion
A 12-week physical activity intervention with a Fitbit and text messages was feasible and acceptable among colorectal cancer patients after curative treatment. Larger studies are needed to determine whether the intervention increases physical activity.
Trial registration
Clinicaltrials.gov
Identifier
NCT02966054
. Registered 17 November 2016, retrospectively registered.
Journal Article
The effect of education and supervised exercise on physical activity, pain, quality of life and self-efficacy - an intervention study with a reference group
Background
Individuals with knee and hip osteoarthritis (OA) are less physically active than people in general, and many of these individuals have adopted a sedentary lifestyle. In this study we evaluate the outcome of education and supervised exercise on the level of physical activity in individuals with knee or hip OA. We also evaluate the effect on pain, quality of life and self-efficacy.
Methods
Of the 264 included individuals with knee or hip OA, 195 were allocated to the intervention group. The intervention group received education and supervised exercise that comprised information delivered by a physiotherapist and individually adapted exercises. The reference group consisted of 69 individuals with knee or hip OA awaiting joint replacement and receiving standard care. The primary outcome was physical activity (as measured with an accelerometer). The secondary outcomes were pain (Visual Analog Scale), quality of life (EQ-5D), and self-efficacy (Arthritis Self-Efficacy Scale, pain and other symptoms subscales). Participants in both groups were evaluated at baseline and after 3 months. The intervention group was also evaluated after 12 months.
Results
No differences were found in the number of minutes spent in sedentary or in physical activity between the intervention and reference groups when comparing the baseline and 3 month follow-up. However, there was a significant difference in mean change (mean diff; 95% CI; significance) between the intervention group and reference group favoring the intervention group with regard to pain (13; 7 to 19;
p
< 0.001), quality of life (− 0.17; − 0.24 to − 0.10;
p
< 0.001), self-efficacy/other symptoms (− 5; − 10 to − 0.3;
p
< 0.04), and self-efficacy/pain (− 7; − 13 to − 2;
p
< 0.01). Improvements in pain and quality of life in the intervention group persisted at the 12-month follow-up.
Conclusions
Participation in an education and exercise program following the Swedish BOA program neither decreased the average amount of sedentary time nor increased the level of physical activity. However, participation in such a program resulted in decreased pain, increased quality of life, and increased self-efficacy.
Trial registration
The trial is registered with ClinicalTrials.gov. Registration number:
NCT02022566
. Retrospectively registered 12/18/2013.
Journal Article
Effects of neuromuscular versus stretching training performed during the warm-up on measures of physical fitness and mental well-being in highly-trained pubertal male soccer players
While there is ample evidence on the effects of neuromuscular training (NMT) and stretching training on selected measures of physical fitness in young athletes, less is known on the mental well-being effects. Here, we aimed to examine the effects of NMT versus stretching training (ST) performed during the warm-up and active control (CG) on selected physical fitness measures and mental well-being in highly-trained male pubertal soccer players. A secondary aim was to investigate associations between training-induced changes in physical fitness and mental well-being. Forty-six pubertal participants aged 12.2 ± 0.6 years were randomly allocated to NMT, ST, or CG. The eight-weeks NMT included balance, strength, plyometric, and change-of-direction (CoD) exercises. ST comprised four weeks of lower limbs static stretching followed by four weeks of dynamic stretching. The CG performed a soccer-specific warm-up. Training volumes were similar between groups. Pre-, and post-training, tests were scheduled to assess dynamic balance (Y-balance test), 15-m CoD speed, power (five-jump-test [FJT]), cognitive (CA), somatic anxiety (SA), and self-confidence (SC). Findings showed significant group-by-time interactions for all physical fitness measures (d = 1.00-3.23; p < 0.05) and mental well-being (d = 0.97-1.08; p < 0.05) tests. There were significant pre-post changes for all tested variables (d = 0.69-4.23; p < 0.05) in favor of NMT but not ST and CG. Pooled data indicated significant moderate correlations between training-induced performance changes in FJT and SA (r = −0.378, p < 0.05), FJT and SC (r = 0.360, p < 0.05) and 15-m CoD and SA (r = 0.393, p < 0.01). NMT but not ST or CG resulted in improved measures of physical fitness and mental well-being in highly-trained pubertal male soccer players. NMT performed during the warm-up is a safe and effective training method as it exerts positive effects on physical fitness and self-confidence as well as the coping of anxiety in highly-trained male pubertal soccer players.
Journal Article