Adoption of community-based cardiac rehabilitation programs and physical activity following phase III cardiac rehabilitation in Scotland: A prospective and predictive study

Little is known about levels of physical activity and attendance at phase IV community-based Cardiac Rehabilitation (CR) programs following completion of exercise-focussed, hospital-based phase III CR. This study aims to test, compare and combine the predictive utility of the Common-Sense Self-Regulation Model (CS-SRM) and the extended Theory of Planned Behaviour (TPB) with action planning for two rehabilitation behaviours: physical activity and phase IV CR attendance. Individuals diagnosed with coronary heart disease (n = 103) completed baseline measures of illness perceptions, intentions, perceived behavioural control (PBC), action planning and past physical activity in the last week of a phase III CR program, and 95 participants completed follow-up measures of physical activity and attended phase IV CR (objectively confirmed) 2 months later. Only one predictor (PBC/cyclical timeline) significantly predicted levels and change of physical activity. While illness perceptions were not predictive of phase IV CR attendance, the extended TPB model showed good predictive power with action planning and intention as the most powerful predictors. Amongst participants who planned when and where to attend phase IV CR at the end of phase III rehabilitation, 65.9% subsequently attended a phase IV CR program compared to only 18.5% of those who had not made a plan. This study adds to our understanding of cardiac rehabilitation behaviour after completion of health service delivered programs. Comparing theoretical models and rehabilitation behaviours contributes to the development of behaviour theory.     

Depression and heart rate variability in cardiac rehabilitation patients: exploring the roles of physical activity and fitness

Cardiac patients with depression have shown altered autonomic nervous system functioning, expressed as reduced heart rate variability. This may be associated with poorer physical fitness and less physical activity among depressed patients. These relationships were explored among patients enrolled in outpatient cardiac rehabilitation. 22 depressed and 22 nondepressed patients, matched for sex and age, were assessed at enrollment. The Beck Depression Inventory and structured interviews were used to measure depression. Patients completed ambulatory monitoring of ECG (i.e., Holter) and physical activity, as well as a treadmill stress test. Depression was associated with several measures of heart rate variability. Activity and fitness were lower among the depressed patients. Although exploratory, accounting for activity and fitness attenuated the relationship between depression and heart rate variability. This suggests that altered fitness and activity may help explain altered autonomic tone that characterizes patients with cardiovascular diseases who are psychologically depressed.     

Motivation for physical activity in young adults with physical disabilities during a rehabilitation stay: a longitudinal test of self‐determination theory

We tested a self‐determination theory (SDT) process model during a 3 week physical activity rehabilitation stay among young adults with a physical disability (N = 44, M_age = 24.7, SD = 5.1). As hypothesized, perceived autonomy support positively predicted needs satisfaction at the end of the stay (r = .38, p < .01). Further, needs satisfaction was positively linked to changes in autonomous motivation for physical activity (r = .47, p < .01). Both changes in autonomous motivation and self‐efficacy were associated with physical activity increases over the stay (r = .57, p < .01 and r = .47, p < .01, respectively). Bootstrapping results supported the SDT process model, indicating a support for a development toward more self‐determined motivation in rehabilitation.     

Coach autonomy support predicts autonomous motivation and daily moderate-to-vigorous physical activity and sedentary time in youth sport participants

ObjectiveGuided by self-determination theory (Deci & Ryan, 1987), this study tested a trans-contextual model linking perceptions of the social environment created by the youth sport coach to levels of autonomous and controlled motivation, and objectively measured daily moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) in young football players.DesignThe study employed a cross-sectional design, assessing physical activity using accelerometers.Method105 male youth sport footballers (M age = 12.79 ± 1.85 years) wore a GT3X accelerometer for 7 days. Measures of height and weight were recorded. Participants completed a multi-section questionnaire assessing perceptions of autonomy support and controlling coaching behaviours, and motivation toward their participation in sport and physically active games.ResultsPath analysis supported a model in which players’ perceptions of coach-provided autonomy support positively predicted autonomous motivation for sport engagement. In turn, autonomous motivation was positively associated with MVPA, and negatively related to ST (min/day). Controlling coach behaviours were positively linked to controlled motivation. However, controlled motivation for sport and physically active games was unrelated to daily MVPA and ST. Perceptions of coach-provided autonomy support had a significant positive indirect effect on daily MVPA, and a significant negative indirect effect on daily ST.ConclusionsResults suggest that autonomy supportive coach behaviours are related to daily physical activity patterns in young male footballers. Theory-based interventions that aim to encourage autonomy supportive coaching, and subsequently foster autonomous reasons for sport engagement, may enhance the potential of youth sport for increasing daily MVPA and reducing ST among children and adolescents active in this setting     

Impact of group rejections from a physical activity on physical self-esteem among university students

This study examined the effects of trait physical self-esteem (TPSE) and reasons for group rejections upon state physical self-esteem (SPSE) in a social psychology experiment. Two vignettes were prepared for students to imagine themselves being rejected from a group physical activity. In one vignette, students were rejected by chance, whereas in the other, due to physical incapability. The results indicated that SPSE did not change significantly after rejection by chance, but that SPSE decreased significantly after rejection due to physical incapability. When the sample was divided to subgroups, high TPSE students decreased SPSE to the same level as low TPSE students, and the magnitude of decrease in high TPSE students was even larger than that in low TPSE students after rejection due to physical incapability. The similar pattern was observed in the comparison between male and female students, whereas SPSE of Physical Education major students did not drop as much after rejection due to physical incapability. Contrary to previous research, high TPSE failed to protect the decline of SPSE after group rejections particularly due to physical incapability. The involvement of the importance theory, coping strategies, and sources of rejections needs to be investigated further. Educational implications of the findings are discussed.     

Motivation and physical activity levels in bariatric patients involved in a self-determination theory-based physical activity program

ObjectiveThis study examines the associations between pre-to post-intervention changes in motivation and physical activity (PA) levels of bariatric patients involved in a 6-month postoperative PA program based on self-determination theory (SDT). We also explore the extent to which patients’ perception of autonomy support and basic psychological need satisfaction during the program were associated with changes in their motivation to exercise.MethodForty patients were assigned to a motivational PA intervention (MPAI-G) or to a control group (CG). Both groups completed questionnaires assessing the variables of interest and wore GT3X accelerometers before surgery and after the program.ResultsThirty-two participants (78.1% female) completed all measures and were included in the present analyses. CG showed greater increases in integrated (d = −1.60, 95% CI [−2.40, −0.81]) and identified regulation (d = −0.75, 95% CI [−1.47, −0.03]) than MPAI-G. However, the MPAI-G experienced increases in introjected regulation (d = 1.95, 95% CI [1.11, 2.79]) and greater decreases in external regulation (d = −1.00, 95% CI [−1.74, −0.27]) than CG, which were associated with decreases in sedentary activity and increases in light and total PA. Oppositely to the CG, amotivation decreased in the MPAI-G (d = −2.98, 95% CI [−3.98, −1.97]) and it was related to increases in light and total PA. Changes in exercise motivation were associated with perceived autonomy support and basic psychological need satisfaction during the program.ConclusionThe SDT-based PA program gave rise to greater changes in controlled forms of motivation and amotivation than in autonomous motivation in post-bariatric surgery patients.     

Attributions for physical activity in very old adults: predicting everyday physical activity and mortality risk

Objectives: Although physical activity is recognised as a health-promoting behaviour for older adults, notable barriers exist that may reduce physical activity in this age group. Limited research has explored causal beliefs (attributions) as a barrier to physical activity. Our study assessed associations between older adults’ attributions about physical activity and objective health outcomes. Methods: We examined the role of attributions as a predictor of everyday physical activity (EPA) and subsequent mortality risk over a 10-year period (2006–2016) in a sample of older adults (M_age?=?87, N?=?261). Results: OLS and Cox proportional hazard regression analyses revealed older adults who endorsed more internal and uncontrollable attributions for limited activity (physical incapacity) when feeling unwell had lower subsequent EPA (β?=??0.18), and higher 10-year mortality risk (HR?=?1.46). Other attributions with different dimensional properties (e.g. internal and controllable) were not associated with EPA or mortality. Discussion: Findings suggest that causal beliefs older adults have about their physical activity can influence their future behaviour and longevity. Psychological treatments designed to discourage maladaptive attributional thinking for older populations who face barriers to physical activity may be an important avenue for future research.     

Self-determined motivation in physical education and its links to motivation for leisure-time physical activity, physical activity, and well-being in general

The present study tested a trans-contextual model based on self-determination theory of the relations between motivation in physical education, motivation in leisure-time physical activity, physical activity, and psychological well-being. Participants were 329 Norwegian upper secondary school students (M age = 16.5 yr., SD = 0.7). Students' perceptions of autonomy-supportive teachers in physical education were expected to be positively associated with students' psychological needs satisfaction in physical education, which was expected to be positively related to autonomous motivation for physical education participation. In turn, autonomous motivation for physical education was expected to be positively associated with perceived competence and autonomous motivation for leisure-time physical activity, which both were expected to be positively associated with leisure-time physical activity and psychological well-being in general. Structural equation models and bootstrapping supported the hypotheses and the indirect links between variables. Sex differences indicate that more research is needed on how to motivate girls to be more physically active in leisure time.     

The effects of exergaming on physical activity in a third-grade physical education class

We compared the effects of exergaming and traditional physical education on physical activity among 4 active children who were not overweight and who had experience with the exergaming activities prior to the study. Results showed that exergaming produced substantially higher percentages of physical activity and opportunity to engage in physical activity. In addition, an evaluation of the exergaming equipment showed that exergaming stations were associated with differential levels of physical activity across participants.     

Social-cognitive determinants of physical activity: the influence of social support, self-efficacy, outcome expectations, and self-regulation among participants in a church-based health promotion study.

A social-cognitive model of physical activity was tested, using structural equation analysis of data from 999 adults (21% African American; 66% female; 38% inactive) recruited from 14 southwestern Virginia churches participating in the baseline phase of a health promotion study. Within the model, age, race, social support, self-efficacy, and self-regulation contributed to participants' physical activity levels, but outcome expectations did not. Of the social-cognitive variables, self-regulation exerted the strongest effect on physical activity. Independent of self-regulation, self-efficacy had little effect. Social support influenced physical activity as a direct precursor to self-efficacy and self-regulation. The model provided a good fit to the data and explained 46% of the variance in physical activity among the diverse group of adults.     

Reciprocal effects of motivation in physical education and self-reported physical activity

ObjectivesThe present study tested whether self-reported school and leisure-time physical activity have a reciprocal relationship with Physical Education (PE)-based motivational regulations described by self-determination theory. Participants were 635 11- and 12-year-old school children from the United Kingdom.Design & MethodA cross-lagged longitudinal design over two time points was employed. Study hypotheses were analyzed using latent factor reciprocal effects models.ResultsFollowing temporal invariance tests, data revealed positive relationships between both types of physical activity and subsequent changes in autonomous motivation, but not the oft-stated reverse relationship. No relationships were observed involving introjected regulation. Theoretically aligned relationships between external regulation and changes in physical activity were observed, but no reverse relationships. Both types of physical activity behavior were negatively associated with changes in amotivation in PE, but surprisingly, amotivation in PE positively predicted changes in leisure-time physical activity.ConclusionsIn general, physical activity participation may help children internalize reasons for partaking in PE and foster self-determination. However, the widespread theory that self-determined PE motives can develop school and leisure-time physical activity participation was not compellingly demonstrated.     

Effect of university physical education courses on intention for physical activity adherence in Korea

Individuals' intentions of adopting physical activity as part of their lifestyle changed after university physical education courses in Korea. Male students (N = 264) taking physical education courses at a university in Korea were tested on the first and last day of a semester using a physical activity adherence questionnaire. The results showed that the intention to continue physical activity increased after taking the courses.     

Psychosocial mediators of a lifestyle physical activity intervention in women

ObjectivesA lifestyle physical activity intervention in women based on the transtheoretical model and social–cognitive theory effectively increased physical activity. The aim of the present study was to examine possible mediators (perceived benefits and barriers of physical activity, self-efficacy, processes of change, and social support) of these physical activity changes.MethodsMembers of four units of a women's organization followed a six-month minimal-contact physical activity program. The intervention program included one group meeting, a self-help booklet and five monthly reminder letters. Members of two other units served as control group. Physical activity (accelerometer counts), and psychosocial constructs (self-report questionnaires) were assessed at baseline (pretest) and directly after the intervention (posttest). Women who completed all measurements (n = 101) were included in the mediation analyses.ResultsParticipants in the intervention group reported significantly greater increases in the use of behavioral processes from pretest to posttest than participants in the control group. None of the proposed psychosocial constructs showed a mediating effect on changes in physical activity.ConclusionsThe mechanisms proposed by the transtheoretical model and social–cognitive theory could not explain the positive effect of the intervention on physical activity. Identifying the working components of an intervention remains a challenging and necessary step in the development of effective low-cost and high-reach physical activity interventions.     

Effects of cancer rehabilitation on problem-solving, anxiety and depression: a RCT comparing physical and cognitive-behavioural training versus physical training

We tested the effects on problem-solving, anxiety and depression of 12-week group-based self-management cancer rehabilitation, combining comprehensive physical training (PT) and cognitive-behavioural problem-solving training (CBT), compared with PT. We expected that PT + CBT would outperform PT in improvements in problem-solving (Social Problem-Solving Inventory-Revised (SPSI-R)), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), and that more anxious and/or depressed participants would benefit most from adding CBT to PT. Cancer survivors (aged 48.8 ± 10.9 years, all cancer types, medical treatment completed) were randomly assigned to PT + CBT (n = 76) or PT (n = 71). Measurement occasions were: before and post-rehabilitation (12 weeks), 3- and 9-month follow-up. A non-randomised usual care comparison group (UCC) (n = 62) was measured at baseline and after 12 weeks. Longitudinal intention-to-treat analyses showed no differential pattern in change between PT + CBT and PT. Post-rehabilitation, participants in PT and PT + CBT reported within-group improvements in problem-solving (negative problem orientation; p < 0.01), anxiety (p < 0.001) and depression (p < 0.001), which were maintained at 3- and 9-month follow-up (p < 0.05). Compared with UCC post-rehabilitation, PT and PT + CBT only improved in anxiety (p < 0.05). CBT did not add to the effects of PT and had no extra benefits for higher distressed participants. PT was feasible and sufficient for durably reducing cancer survivors' anxiety.     

Accuracy and repeatability of the Yale physical activity survey in assessing physical activity of older adults.

The purpose of this study was to extend the initial evaluation of the Yale Physical Activity Survey to assess physical activity in older adults. The survey yields three indicators of physical activity reflecting activities performed during a typical week of the previous month (Total Time, Total Energy Expenditure) and the past month (Total Activity Summary Index). Questionnaire validity was studied in 56 men and women, ages 56 to 86 years, by comparing the average of 3- or 7 day 24-hr. physical activity records (n=56), predicted maximal oxygen consumption (VO2 max) (n = 23) and the sum of three skinfold measurements. Two-week repeatability was estimated by calculating an intraclass coefficient using an analysis of variance with repeated measures. Spearman rhos were used to study questionnaire validity. Analysis showed the survey was easily administered and scored and exhibited moderate-to-good repeatability. For the first administration the Total Energy Expenditure Index was significantly associated with the physical activity diary (r = .27). On the second administration, correlations were significant for the physical activity diary with the Total Energy Expenditure Index (r = .30), the Total Activity Summary Index (r = .36), and the Total Time Index (r = .27), and for VO2 max and the Total Time Index (r = .49) and Total Activity Summary Index (r = .64). Relative to the criterion measures used in this study, some validity was evident for the second administration in this relatively active and healthy sample of older adults.     

The effects of exergaming on physical activity among inactive children in a physical education classroom

Childhood obesity, which is due in part to lack of physical activity, is a serious concern that requires the attention of the behavioral community. Although excessive video game play has been noted in the literature as a contributor to childhood obesity, newer video gaming technology, called exergaming, has been designed to capitalize on the reinforcing effects of video games to increase physical activity in children. This study evaluated the effects of exergaming on physical activity among 4 inactive children in a physical education (PE) classroom. Results showed that exergaming produced substantially more minutes of physical activity and more minutes of opportunity to engage in physical activity than did the standard PE program. In addition, exergaming was socially acceptable to both the students and the PE teacher. Exergaming appears to hold promise as a method for increasing physical activity among inactive children and might be a possible intervention for childhood obesity.     

Patient attributions for cardiac events: predictors of physical and psychological recovery

This study examined cardiac rehabilitation (CR) patients' causal attributions for their cardiac events, and used those attributions as predictors of cross‐sectional and prospective health status. Data were collected from 163 participants at the beginning and end of their CR programs. Results showed that patients' attributions can be categorized into controllable ones that are behavioral in nature, uncontrollable ones that are biological in nature, and a separate category for stress‐related causes. Findings showed that stress attributions at the beginning of CR were associated with engaging in healthy behaviors in the last month of CR, which, in turn, were positively associated with metabolic equivalence levels at the end of CR. Results imply a motivational component to believing that cardiac events are caused by stress.     

Determinants of physical activity and physical and sports activities in French school children

The influence of morphological, biological, sociological, psychological, and environmental factors on the practice of organized sports and the amount of moderate to vigorous physical activity was examined through a questionnaire and continuous heart-rate monitoring, for 80 schoolchildren, 11 to 16 years old. Sport-practicing boys had a lower percentage of fat mass. Sport-practicing girls had more frequently sport-practicing mothers and higher scores on achievement motivation than nonsport-practicing girls. Active boys had more frequently sport-practicing fathers than inactive boys. No statistically significant correlation was found between moderate to vigorous physical activity and organized sports. Those children who are the most involved in organized sports are thus not necessarily the most active ones.