Effects of Exercise Testing and Cardiac Rehabilitation in Patients with Coronary Heart Disease on Fear and Self-Efficacy of Exercise: A Pilot Study.

Publisher: Informa Healthcare Country of Publication: England NLM ID: 9421097 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-7558 (Electronic) Linking ISSN: 10705503 NLM ISO Abbreviation: Int J Behav Med Subsets: MEDLINE

Publication: London : Informa Healthcare
Original Publication: Hillsdale, NJ : Lawrence Erlbaum Associates, c1994-

Self Efficacy* ; Fear*/psychology ; Fear*/physiology ; Exercise Test*/methods ; Coronary Disease*/rehabilitation ; Coronary Disease*/psychology ; Exercise*/psychology ; Exercise*/physiology; Humans ; Male ; Female ; Pilot Projects ; Middle Aged ; Aged ; Exercise Therapy/methods ; Exercise Therapy/psychology ; Heart Rate/physiology ; Cardiac Rehabilitation/psychology ; Cardiac Rehabilitation/methods ; Surveys and Questionnaires

Background: Exercise 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.
Method: Patients 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.
Results: There 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)).
Conclusion: Patients 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.
(© 2023. International Society of Behavioral Medicine.)

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T32HL155020 United States NH NIH HHS; 1K23HL135440 NHLBI Division of Intramural Research; UL1RR025752 Tufts Medical Center; UL1TR000073 Tufts Medical Center; UL1TR001064 Tufts Medical Center; UL1TR002544 Tufts Medical Center; RPAP Baystate Health; T32HL155020 United States NH NIH HHS

Keywords: Cardiac rehabilitation; Exercise self-efficacy; Fear of exercise; Graded exercise testing; Rate of perceived exertion; Target heart rate range

Date Created: 20230809 Date Completed: 20241004 Latest Revision: 20241107

20241107

10.1007/s12529-023-10207-9

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