Mood Ratings and Physical Activity Among Patients in Cardiac Rehabilitation
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Date
2014-05
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Publisher
The Ohio State University
Abstract
(Introduction) Cardiac rehabilitation (CR) is an effective treatment strategy for patients with CVD, typically involving 36 sessions of aerobic exercise over the course of a 12-week period along with education regarding cardiac risk factors. Exercise has been shown to not only affect a person’s physical abilities, but have a psychological effect as well.
(Purpose) Previous studies have shown that exercise is often associated with enhanced mood and that positive mood ratings predict CR attendance. However, studies have not focused on ratings of perceived exertion and other physical symptoms in relation to mood and exercise performance. This study was designed to evaluate associations of symptom ratings with mood and exercise performance among patients in CR.
(Design) This is an observational study consisting of patient assessments at two time points approximately three months apart.
(Methods) Patients were recruited from the two outpatient CR programs at Ohio State University medical center. 38 patients (11 female) completed a questionnaire packet before and after CR that included the Hospital Anxiety and Depression Scale. The exercise testing consisted of a 60-foot walk test followed by a 6-minute walk test both before and after CR. Patients reported their ratings of dyspnea, fatigue, and perceived exertion before and after each walk test. Heart rate and oxygen saturation were also recorded before and after each walk test.
(Results) Participants reported a significant decrease in distress (11.23 to 8.87, p = .002, t(38) = 3.36). Participants also reported a significant decrease in anxiety (6.86 to 5.54, p = .018, t(35) = 2.49). Six minute walk test performance significantly improved between T1 and T2 (426.31 meters to 455.01 meters, p < .0001, t(38) = 4.76). Additionally, pre 60-foot walk test RPE decreased between T1 and T2 (7.23 to 6.39, p = .014, t(38) = 2.59), and pre 6-minute walk test RPE decreased from T1 to T2 (6.90 to 6.32, p = .026, t(38) = 2.33)Correlational analyses indicated that change in pre 60-foot walk test RPE from T1 to T2 was associated with T1 distress (r = .36, p = .027) and T1 depression (r = .33, p = .044), with a trend toward significance for anxiety (r = .31, p = .062)
(Conclusions/Importance) Results of this study provide evidence that there are many advantages to be gained from CR participation, including lower distress and anxiety levels, improved functional status, and decreased perceived exertion. However, the drop in RPE between assessment times was associated with elevated distress and depression before entering CR. Patients entering CR with elevated depression and distress tended to feel more exerted before CR began. The discovery of this relationship can allow CR programs to provide additional treatment for distress and depression upon entrance to the CR program so that patients may not feel so exerted when beginning the program, thus allowing them to provide a maximal effort and benefit from all the CR program has to offer.
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Keywords
Psychology, Rehabilitation, Cardiac, Exercise, Mood, Patients