A meta-analysis of psychoeduational programs for coronary heart disease patients.

In a meta-analysis of 37 studies, the effects of psychoeducational (health education and stress management) programs for coronary heart disease patients were examined. The results suggest that these programs yielded a 34% reduction in cardiac mortality; a 29% reduction in recurrence of myocardial infarction (MI); and significant (p < .025) positive effects on blood pressure, cholesterol, body weight, smoking behavior, physical exercise, and eating habits. No effects of psychoeducational programs were found in regard to coronary bypass surgery, anxiety, or depression. The results also suggest that cardiac rehabilitation programs that were successful on proximal targets (systolic blood pressure, smoking behavior, physical exercise, emotional distress) were more effective on distal targets (cardiac mortality and MI recurrences) than programs without success on proximal targets.     

Acute psychological benefits of aerobic exercise: a field study into the effects of exercise characteristics

Eighty volunteers were tested in their natural exercise environment consisting of a fitness centre they regularly attended. Half of the sample exercised on a stationary bicycle, the other half on a treadmill. All participants filled in the Exercise-Induced Feeling Inventory before and after their 20 min of exercise that was performed at self-selected workload. The results revealed that exercise intensity and the other parallel measures like heart rate, perceived exercise intensity and estimates of burned calories were higher in participants who ran in contrast to those who cycled. There were no differences in self-reports of enjoyment of the exercise sessions and in the psychological improvements from pre- to post-exercise between the groups. It is concluded that significant psychological improvements occur even after a 20-min bout of exercise and these changes are independent of the workload or exercise intensity.     

Regulation of exercise intensity using ratings of perceived exertion during passive visual distraction

The purpose of this investigation was to determine if passive visual distraction altered ability to regulate exercise intensity as, assessed by ratings of perceived exertion during a 30-min. treadmill run. 10 trained females (VO2max, 52.7 ml.kg-1.min.-1) performed a graded exercise test on a treadmill to assess maximal aerobic power and rating of perceived exertion, oxygen uptake (VO2), heart rate, and running velocity at the 2.5 mmol.L-1 blood lactate concentration. Subjects then used the target rating of perceived exertion to regulate exercise intensity during a control condition, and two treatment runs with passive visual distractions. During the treatment sessions, the subjects ran on a treadmill while viewing a high-action or a low-action video with no audio. The subjects were allowed to adjust the treadmill speed throughout the run to maintain the target rating of perceived exertion; however, subjects were not allowed to view the speed setting. There were no significant differences in blood lactate concentration among the conditions for the control, low action, high action, or graded exercise test (p < or = .05). No significant differences in VO2 or running velocity were found within or among the 30-min. treatment runs and the graded exercise test. Heart rate at 5 min. of exercise during control (158 +/- 3 b.min.-1), low action (158 +/- 3 b.min.-1), and high action (159 +/- 2 b.min.-1) was significantly lower than the graded exercise test (169 +/- 3 b.min.-1). Based on the data collected, visual passive distraction did not alter regulation of intensity using ratings of perceived exertion during a 30-min. treadmill run.     

Maintenance Cardiac Rehabilitation Exercise Adherence: Effects of Task and Self-Regulatory Self-Efficacy

The purpose of this study was to examine whether self-efficacy functions as a determinant and outcome of maintenance cardiac rehabilitation exercise adherence. Specifically, the purpose of this prospective observational study was to examine which types of self-efficacy–task or self-regulatory–predicted maintenance exercise attendance. In addition, the relative contribution of self-efficacy to the prediction of perceived exercise intensity was examined. Self-regulatory self-efficacy was operationalized as confidence to schedule and manage exercise sessions, while task self-efficacy concerned confidence to perform aspects of the exercise session and to walk for increasing durations. Sixty-four maintenance cardiac rehabilitation participants completed social cognitive measures and provided attendance data for 4 weeks prior to and 4 weeks following assessment. Results indicated that scheduling and walking self-efficacy significantly predicted cardiac rehabilitation exercise attendance. Task self-efficacy was the best predictor of perceived exercise intensity. Past exercise attendance significantly predicted all 3 dimensions of self-efficacy. Findings are discussed with respect to self-efficacy theory and applications to the maintenance of cardiac rehabilitation exercise adherence.     

The time course effect of moderate intensity exercise on response execution and response inhibition

This research aimed to investigate the time course effect of a moderate steady-state exercise session on response execution and response inhibition using a stop-task paradigm. Ten participants performed a stop-signal task whilst cycling at a carefully controlled workload intensity (40% of maximal aerobic power), immediately following exercise and 30 min after exercise cessation. Results showed that moderate exercise enhances a subjects’ ability to execute responses under time pressure (shorter Go reaction time, RT without a change in accuracy) but also enhances a subjects’ ability to withhold ongoing motor responses (shorter stop-signal RT). The present outcomes reveal that the beneficial effect of exercise is neither limited to motor response tasks, nor to cognitive tasks performed during exercise. Beneficial effects of exercise remain present on both response execution and response inhibition performance for up to 52 min after exercise cessation.     

Influence of acetaminophen consumption on perceived exertion at the lactate concentration threshold

The purpose of this investigation was to study effects of acetaminophen consumption on ratings of perceived exertion and estimated time limit responses at the lactate threshold. 98 young regional to national level athletes performed a graded exhausting exercise on an outdoor running track to estimate their maximal aerobic velocity and the velocity associated with their lactate concentration threshold. Urine (30 mL) was collected during this test and analysed for numerous substances. During urinary screening for doping substances, 9 acetaminophen consumers (9.2%) among the 98 included athletes were detected. These acetaminophen consumers have significantly lower perceived exertion at velocity corresponding to the lactate concentration threshold than nonconsumers (11.9 +/- 2.1 vs 13.6 +/- 2.1, respectively) although they were at the same relative exercise intensity. This result shows that acetaminophen consumption may have mediated the perceived exertion response at the lactate concentration threshold. This may then suggest that the pain induced by training load could be a factor in use of self-prescribed pain relievers. Such consumption must be taken into account by medical staff, trainers, or educators who have to give information on the use and adverse effects of this substance and to propose palliative methods to their athletes.     

Changes in pulmonary function response to a 10-week controlled exercise program in sedentary elderly adults

This randomized clinical trial was aimed to assess whether pulmonary function would change in sedentary elderly people after a controlled exercise program. 45 participants over 75 yr. of age (M age 83.7 +/- 3.0) were assigned randomly to a control and two aerobic exercise groups of moderate and high intensity. In 10 wk. the program sessions were 40 min. in duration 3 days per week. Forced vital capacity (FVC) and forced expiratory volume in 1 sec. (FEV1.0) were measured pre- and post-intervention. After the training, the Moderate intensity group experienced significant mean change in FVC. In the High intensity group, significant changes were observed in both FVC and FEV1.0, but no change was noted for the Control group. The 10-wk. aerobic training of moderate or high intensity showed positive effects on pulmonary function in these elderly individuals. These exercise-induced changes may be dose-related.     

Lactate threshold prediction by blood glucose and rating of perceived exertion in people with type 2 diabetes

The validity of rating of perceived exertion (RPE) in predicting lactate threshold during an incremental test was analyzed in 15 men with type 2 diabetes (M age = 53.4 yr., SD = 12.9). Blood glucose, lactate, and minute ventilation (VE)/VO2 responses identified the lactate, ventilatory, and glucose thresholds. Workloads (W) corresponding to RPEs 12, 13, 14, and 15 were determined. Second-order polynomials fit to VE/W and [lac]/W ratios corresponding to RPEs of 9-10, 12-13, and 16-17 also identified workloads above which there was an overproportional increase in VE and [lac]. These workload breakpoints did not differ, although at RPE 12 underestimated and at RPE 15 overestimated lactate threshold. RPE 13 and 14 and the responses of VE/W and [lac]/W to submaximal exercise accurately predicted lactate threshold.     

Varied intensities of training, predicted maximum oxygen uptake and the minimum threshold hypothesis

In this study, 24 sedentary first-year male university students aged 17 to 24 yr. were assigned to one of four groups. Three of the groups underwent a 6-wk. training program consisting of a 30-min. bicycle ergometer ride, three times per week. A fourth group acted as a control. The experimental groups trained at workload intensities corresponding to predetermined heart rates of 125, 140, and 155 bpm, respectively. Analysis of scores indicated that changes in aerobic capacity occurred only if the intensity of training exceeded a minimal level. Essentially, these results replicated data from other studies.     

Stress reactivity and exercise training in premenopausal and postmenopausal women.

Examined the influence of ovarian function on psychophysiological stress responses and determined if aerobic exercise reduced stress reactivity. Fifty premenopausal and postmenopausal women initially were subjected to a public speaking task and an ice-on-the-forehead procedure, during which time their blood pressure and heart rate were monitored and continuous blood samples were obtained. Subjects also underwent aerobic fitness evaluations with a maximum-exercise treadmill test. Subjects were then randomly assigned to a 12-week exercise program of either aerobic exercise (e.g., walking and jogging at a prescribed exercise intensity) or non-aerobic strength and flexibility training and were then reevaluated. Results indicated that postmenopausal women exhibited lower resting epinephrine levels but greater epinephrine reactivity to the speaking task compared to the premenopausal women. There were no differences between premenopausal and postmenopausal women with respect to cardiovascular or catecholamine responses during the cold challenge. Premenopausal and postmenopausal women also achieved comparable improvements in aerobic fitness. However, results of the mental stress testing were complex and provided only partial support for the role of aerobic exercise in reducing stress responses.     

Acute aerobic exercise improves memory across intensity and fitness levels

ABSTRACT

The present study was designed to examine the impact of exercise intensity and aerobic fitness on free recall, judgments of learning (JOLs), and metacognitive accuracy. In Experiment 1, 30 college students engaged in either (1) no exercise, (2) light exercise (55% of predicted maximal heart rate), or (3) moderate exercise (75% of predicted maximal heart rate) on three different days. In Experiment 2, 29 high-fit students (VO₂ max?≥?70th percentile) and 28 low-fit students (VO₂ max?≤?50th percentile) completed sedentary and light exercise conditions. In both experiments, free recall scores significantly increased in the exercise conditions compared with the sedentary condition, but JOL magnitude and metacognitive accuracy were largely unaffected. These results demonstrate that exercise can improve recall at both light and high intensities, and that the benefit can be obtained by individuals regardless of their fitness level.     

Common and specific process factors in cardiac rehabilitation: independent and interactive effects of the working alliance and self-efficacy.

OBJECTIVE: Therapeutic processes in cardiac rehabilitation programs are virtually unexamined. Models were tested by which changes in the working alliance between patient and staff (agreement on goals/tasks; emotional bond) may affect outcomes in conjunction with changes in patient self-efficacy to change their diets and increase exercise. DESIGN: Cardiac patients (n = 79) participated in a 12-week program, and completed assessments at early, mid, and late treatment. MAIN OUTCOME MEASURES: Changes in cardiac depression, physical health, perceived exertion during exercise, rate/pressure product at submaximal exercise tolerance, weight loss, return to work, total fat intake. RESULTS: Early-treatment changes in agreement on goals/tasks were related to changes in psychosocial factors and perceived exertion during exercise independent of effects of changes in self-efficacy. Early-treatment changes in goals/tasks and self-efficacy interacted to predict changes in cardiorespiratory fitness, weight loss, and return to work such that patients high on both goals/tasks and self-efficacy showed the most gains. CONCLUSION: Sound therapeutic relationships between patients and staff may play an important role in facilitating the achievement of a wide-range of salutary outcomes during cardiac rehabilitation.     

Current issues and new directions in Psychology and Health: The costs and benefits of self-regulation – a call for experimental research

Abstract

This study was designed to assess the effects of exercise on psychological functioning in healthy Type A men. Seventy-three middle-aged men (M=42.2 years) were randomly assigned either to an aerobic exercise (AE) training group or to a strength and flexibility (SF) training group. Subjects completed a comprehensive psychological assessment battery prior to beginning the 12-week exercise programs, and after completing the programs. The psychological test battery included measures of depression, anxiety and stress, as well as various psychiatric symptoms. In addition, subjects underwent graded exercise treadmill tests (ETT) at both times of measurement in order to document changes in cardiorespiratory fitness. Aerobic exercise training consisted of walking, jogging or stair-climbing at an intensity of at least 70% of initial measured maximal oxygen consumption (VO₂max determined during the treadmill test). Strength and flexibility training consisted of circuit Nautilus training with no aerobic exercise. Results at the conclusion of the 12-week programs indicated that [Vdot]O₂max for the AE group increased by 15%, while the SF group did not change. Both groups improved on measures of psychological well-being; however, there were no differential effects of the two exercise programs on measures of psychological functioning. These results suggest that improved cardiovascular fitness is not necessary for psychological improvement among exercise participants.     

Adherence to exercise prescriptions: effects of prescribing moderate versus higher levels of intensity and frequency.

Sedentary adults (N = 379) were randomly assigned in a 2 x 2 design to walk 30 min per day at a frequency of either 3-4 or 5-7 days per week, at an intensity of either 45%-55% or 65%-75% of maximum heart rate reserve. Analyses of exercise accumulated over 6 months showed greater amounts completed in the higher frequency (p = .0001) and moderate intensity (p = .021) conditions. Analyses of percentage of prescribed exercise completed showed greater adherence in the moderate intensity(p = .02) condition. Prescribing a higher frequency increased the accumulation of exercise without a decline in adherence, whereas prescribing a higher intensity decreased adherence and resulted in the completion of less exercise.     

Short-term effect of physical exercise at lactate threshold on choice reaction time

The duration of the enhancement of choice reaction task efficiency by physical exercise at lactate threshold was studied. After healthy male students completed the exercise or nonexercise (control) period for 10 min., they performed a three-choice reaction task for 20 min. The mean heart rate during the choice reaction task after the exercise was higher than that after the control period (p < .05). For average percentage of correct answers, there were no significant differences between the exercise and control conditions. The reaction time during the first 8 min. of the 20-min. choice reaction task after the exercise period was less than that after the control period and increased gradually thereafter. In conclusion, whereas the choice reaction time was improved by physical exercise at around lactate threshold, the positive effects were seen mainly in the early stages of the task.     

Dispositional Optimism as a Predictor of Health Changes among Cardiac Patients

We examined in a longitudinal study whether dispositional optimism (as measured by the Life Orientation Test) predicts success in making health changes associated with lower risk of coronary heart disease. Subjects were 22 patients participating in an 18 week cardiac rehabilitation program. As part of the program all patients were assigned goals (e.g., reduce weight by 20 lbs) designed to decrease the risk of a cardiac event. Optimism measured at the outset of the program was associated with greater success in achieving lower levels of saturated fat, body fat, and global coronary risk, and with greater success in increasing aerobic capacity by the end of the program. Moreover, these effects were significant after controlling for the magnitude of the goal, the number of health changes, and negative affect.     

Differentiated ratings of perceived exertion and physiological responses during aerobic dance steps by impact/type of arm movement

Overall ratings of perceived exertion, i.e., undifferentiated RPE, are often used as indicators of exercise intensity during walking, jogging, and cycling; however, conflicting results concerning RPE during aerobic dance exercise have been reported, and the use of differentiated RPE, i.e., local RPE and central RPE, has not been investigated. The purposes of this study were to assess local, central, and over-all RPE, and physiological responses [heart rate (HR); % HRmax; absolute and relative VO2;% VO2 max, ventilation (VE), ventilatory equivalent (VE.VO2(-1); and oxygen pulse] during aerobic dance exercise varied by Arm Movement (Static Arm vs Dynamic Arm) and Impact (High vs Low). Trained women (N = 25; max VO2 = 50.4 +/- 7.5 ml.kg-1.min.-1) completed four aerobic dance steps. No RPE were significantly correlated with heart rate or VO2; however, for all steps all RPE were significantly (r = .40-.62) correlated with VE.VO2(-1) or VE. No interactions were present for RPE or physiological variables, and main effects were noted for Impact and Arm Movement. All RPE were greater for High Impact and for Static Arm Movement. Because VE and VE.VO2(-1) were correlated with Overall RPE for all steps, this may suggest that participants "attended to" perceived changes in respiratory phenomena during aerobic dance exercise. It appears that during combined arm-and-leg aerobic dance exercise the use of Overall RPE is sufficient to assess perceptual sensations associated with the intensity of the exercise. Changes in Overall RPE were proportionate to objective measures of exercise intensity, i.e., HR and VO2; however, it is recommended that both HR and Overall RPE be used to assess fully a participant's objective and subjective responses during aerobic dance exercise.