Department of Exercise Science and Athletic Training, Springfield College, Springfield, USA.
Beth Israel Deaconess Medical Center, Boston, USA.
Int J Behav Med. 2024 Oct;31(5):659-668. doi: 10.1007/s12529-023-10207-9. Epub 2023 Aug 9.
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.
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.
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)).
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.
在参加心脏康复（CR）的患者中，运动恐惧和低运动自我效能感很常见。本研究测试了运动处方方法是否会影响运动恐惧和运动自我效能感。我们假设，与使用感觉用力评分（RPE）的标准运动处方相比，使用目标心率范围运动测试（GXT）进行运动处方会在 CR 期间更大程度地降低运动恐惧并增加自我效能感。
CR 中的患者（N=32）被随机分为使用 RPE 或目标心率范围的运动处方。在三个时间点使用问卷评估运动恐惧和自我效能感：基线；目标心率范围内 GXT 后的组；以及 RPE 组和 CR 完成时的第 6 次会议。项目采用五点李克特量表评分，得分越高表示对运动的恐惧越高，自我效能感越高。为了分析平均值差异，进行了混合效应分析。
从基线到 CR 出院，运动自我效能感没有明显变化；这些变化没有统计学意义（基线与结束时的平均差异为 0.63；结束时为 0.27（p=0.13））。同样，两组之间的恐惧也没有变化（基线为 0.30；结束时为 0.51（p=0.37））。
在 CR 期间，使用 RPE 和目标心率组的患者的运动自我效能感没有明显变化。与我们的假设相反，使用 GXT 和目标心率范围并没有降低恐惧，我们注意到基线恐惧较高的患者的运动恐惧持续或增加。似乎需要更有针对性的心理干预来降低 CR 中的运动恐惧和自我效能感。
