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Monika Slovinec D’Angelo, Robert D. Reid, and Luc G. Pelletier

Despite the known benefits of habitual exercise in patients with heart disease, less than half of these patients exercise regularly and many of those who initiate programs fail to maintain physical activity routines over the long term. The aim of this research was to examine processes related to short- and long-term regulation of exercise to gain a clearer understanding of why people might fail to maintain intended behavioral changes. We modeled intention formation and plan formulation to investigate the distinct roles of self-efficacy and motivation (self-determination) in different phases of behavior change. Our results showed self-efficacy to be more relevant to exercise intentions and motivation to exercise planning. This research provides evidence supporting the proposition that the psychological processes related to short- and long-term regulation of behavior change differ and suggests that people might fail to continue regulating intended behavior owing to a lack of self-determined motivation.

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Stephanie Dunn, Sally Lark, and Stephen Fallows

Background:

Cardiac Rehabilitation (CR) programs are the most cost-effective measure for reducing morbidity associated with Coronary Vascular Disease (CVD). To be more effective there is a need to understand what influences the maintenance of healthy behaviors. This study identifies similar and different influences in CR of the United Kingdom (UK) and New Zealand (NZ).

Methods:

A retrospective study. Participants had previously been discharged from CR for 6 to 12+ months within the UK (n = 22) and NZ (n = 21). Participant’s attended a focus group. Discussions were digitally recorded, transcribed then thematically analyzed. The CR programs were observed over 2 months to enable comment on findings relating to ‘theory in practice.’

Results:

Similar positive patient experiences influencing behavior between groups and countries were; support, education, positive attitude, and motivation. Companionship and exercising alongside people with similar health problems was the major determinant for positive exercise behavior. Barriers to maintaining exercise included; physical disabilities, time constraints, and weather conditions. NZ participants were more affected by external factors (eg, opportunity, access, and time).

Conclusion:

Both CR programs were successful in facilitating the maintenance of healthy lifestyles. Exercising with other cardiac patients for support in a structured environment was the strongest influence in maintaining healthy lifestyles beyond CR programs.

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Urte Scholz, Falko F. Sniehotta, and Ralf Schwarzer

During the process of health behavior change, individuals pass different phases characterized by different demands and challenges that have to be mastered. To overcome these demands successfully, phase-specific self-efficacy beliefs are important. The present study distinguishes between task self-efficacy, maintenance self-efficacy, and recovery self-efficacy. These phase-specific beliefs were studied in a sample of 484 cardiac patients during rehabilitation treatment and at follow-up 2 and 4 months after discharge to predict physical exercise at 4 and 12 months follow-up. The three phase-specific self-efficacies showed sufficient discriminant validity and allowed for differential predictions of intentions and behavior. Persons in the maintenance phase benefited more from maintenance self-efficacy in terms of physical exercise than persons not in the maintenance phase. Those who had to resume their physical exercise after a health related break profited more from recovery self-efficacy in terms of physical exercise than persons who were continuously active. Implications for possible interventions are discussed.

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Llion A. Roberts, Johnpaul Caia, Lachlan P. James, Tannath J. Scott, and Vincent G. Kelly

Purpose: External counterpulsation (ECP) has previously been used to treat cardiac patients via compression of the lower extremities during diastole to increase venous return and coronary perfusion. However, the effects of ECP on exercise performance and markers of recovery in elite athletes are largely unknown. Methods: On 2 separate occasions, 48 h apart, 7 elite National Rugby League players performed an identical 60-min field-based conditioning session followed by a 30-min period of either regular ECP treatment or placebo. Power measures during repeated cycle bouts and countermovement jump height and contraction time derivatives were measured at rest and 5 h postexercise. Saliva samples and venous blood samples were taken at rest, postexercise, and 5 h postexercise to assess stress, inflammation, and muscle damage. Results: After ECP treatment, cycling peak power output (P = .028; 11%) and accumulated peak power (P = .027; 14%) increased compared with the placebo condition. Postexercise plasma interleukin 1 receptor antagonist only increased after ECP (P = .024; 84%), and concentrations of plasma interleukin 1 receptor antagonist tended to be higher (P = .093; 76%) 5 h postexercise. Furthermore, testosterone-to-cortisol ratio was increased above baseline and placebo 5 h postexercise (P = .017–.029; 24–77%). The ratio of postexercise salivary α-amylase to immunoglobulin A decreased after treatment (P = .013; 50%) compared with the placebo control. Conclusions: Exercise performance and hormonal indicators of stress were improved and inflammation markers were reduced following acute ECP.

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Mollie G. DeLozier, Richard G. Israel, Kevin F. O’Brien, Robert A. Shaw, and Walter J. Pories

This investigation quantified body composition and aerobic capacity and examined the interrelationships of these measures in 20 morbidly obese females (M age = 34.6 yrs) prior to gastric bypass surgery. Fifteen subjects were hydrostatically weighed at residual lung volume in order to determine body composition. Eighteen subjects performed a maximal modified progressive treadmill test to determine aerobic capacity. Results indicated that the 15 subjects who were weighed hydrostatically were heavier (M wt = 132.34 kg) and fatter (M % fat = 53.18) than any previously described individuals. Relative weight, which is used as a criterion to determine surgery eligibility, was not significantly (p > .05) correlated to percent body fat. Mean aerobic capacity (V̇O2 = 14.99 ml • kg-1 mir-1) was comparable to Class III cardiac patients and was limited by the individuals’ extreme body weight. Since relative weight was shown to be an insensitive measure of obesity, it is recommended that percent fat be measured and used as a means to determine eligibility for gastric bypass surgery. Further study of these individuals is warranted in order to determine what effects large weight loss following surgery will have on parameters of body composition and aerobic capacity. Understanding how large weight loss affects these parameters will aid in designing effective postsurgical exercise rehabilitative programs for future patients.

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Kym Joanne Price, Brett Ashley Gordon, Kim Gray, Kerri Gergely, Stephen Richard Bird, and Amanda Clare Benson

from the validated Medical Outcomes Study 36-item Short Form Questionnaire (SF-36; Brown, 2003 ; Stewart, Hays, & Ware, 1988 ) was used to establish self-reported physical function. The Ewart self-efficacy scale, developed in cardiac patients ( Ewart, Stewart, Gillilan, & Keleman, 1986 ; Ewart

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Guy El Hajj Boutros, José A. Morais, and Antony D. Karelis

week). Therefore, this HIIT program may be used by older adults in order to be more time efficient. Safety is an important factor for the successful implementation of any exercise intervention program. Accordingly, several studies have noted no adverse events during HIIT in older cardiac patients

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Carl Foster, Daniel Boullosa, Michael McGuigan, Andrea Fusco, Cristina Cortis, Blaine E. Arney, Bo Orton, Christopher Dodge, Salvador Jaime, Kim Radtke, Teun van Erp, Jos J. de Koning, Daniel Bok, Jose A. Rodriguez-Marroyo, and John P. Porcari

( 1 ): 57 – 69 . PubMed ID: 16430682 doi:10.1111/j.1600-0838.2005.00448.x 10.1111/j.1600-0838.2005.00448.x 10. Pollock ML , Foster C , Rod JL , Wible G . Comparison of methods for determining exercise training intensity for cardiac patients and healthy adults . Adv Cardiol . 1982 ; 31

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José Machado Filho, Carlos Leonardo Figueiredo Machado, Hirofumi Tanaka, and Rodrigo Ferrari

Borne , P. ( 2005 ). The effect of different intensity modalities of resistance training on beat-to-beat blood pressure in cardiac patients . European Journal of Cardiovascular Prevention & Rehabilitation, 12 ( 1 ), 12 – 17 . PubMed ID: 15703501 doi:10.1177/204748730501200103 10

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Kim Gammage, Lori Dithurbide, Alison Ede, Blair Evans, Sean Locke, Eric Martin, Desi McEwan, and Kathleen Wilson

, this paper is worth a read. Who knows, you may be persuaded to use MOST. Huffman, J.C., Millstein, R.A., Celano, C.M., Healy, B.C., Park, E.R., & Collins, L.M. (2020). Developing a psychological–behavioral intervention in cardiac patients using the multiphase optimization strategy: Lessons learned from