NEWS RELEASE
For immediate release: November 13, 2002
BEHAVORIAL COUNSELING BENEFITS OLDER ADULTS IN CARDIAC REHABILITATION
PROGRAMS
Study shows men with least fitness capacity benefit most in
small group settings and demonstrate greater exercise adherence
INDIANAPOLIS - The American College of Sports Medicine (ACSM) has
published a study comparing the effects of two different approaches to
cardiac rehabilitation on performance and self-reported physical
function in older adults. Data from the study suggest that patients with
the most compromised physical function can achieve the greatest benefit
from physical activity when it is coupled with behavioral counseling
targeted for the promotion of an independent lifestyle. The results also
suggest that the benefits of physical activity in the prevention of
physical disability can be enhanced with behavioral counseling in small
group settings that target specific goals for each individual
participant.
As many as half of all individuals enrolled in exercise therapy drop
out within the first six months, a trend that may be even more
significant in women and older adults. These findings may contribute to
future solutions to prevent poor adherence and non-compliance that
undermine the potential benefits of exercise programs prescribed as
rehabilitation for patients with, or at risk of, cardiac disease. The
results of the investigation have been published in the November 2002
issue of Medicine and Science in Sports and Exercise .
"For most patients, traditional exercise therapy provides neither the
motivation nor the instruction and practice needed to make a successful
transition from structured center-based exercise to independent
maintenance of physical activity," said Jack Rejeski, Ph.D., lead author
of the study. The Cardiovascular Health and Activity Maintenance Program
(CHAMP) is a 12-month randomized clinical trial being conducted at Wake
Forest University. Researchers looked at the first three months of the
trial in which a traditional rehabilitation program (including warm-up,
walking, upper body strength training, cool-down and stretching
exercises three days a week) is compared to a similar regimen of
physical activity that is designed to gradually wean patients from
supervised exercise and to use group counseling as a means of promoting
an independent, physically-active lifestyle. The transition was
facilitated by homework assignments and small-group counseling sessions.
Participants discussed physical and psychological challenges of
disability, exercise, and physical functioning in the counseling
session. Social problem solving was a key principle of the group
activity, participants were taught various self-regulatory skills, and
lessons were augmented by behaviorally-oriented "homework"
assignments.
Regardless of treatment, the 129 participants who completed the
investigation (average age, 65) significantly improved their performance
on two types of exercise tests. In addition, participants reported a
higher level of physical function and greater satisfaction with their
ability to perform daily tasks.
Although, as predicted, retention rates at three months did not
differ between the two types of rehabilitation programs, there were
important differences on the outcomes of interest as a function of both
initial levels of physical function and assignment to either the
traditional or group-mediated behavioral treatment arms of the study.
For example, men with the lowest initial levels of physical function
experienced the greatest improvements in performance when behavioral
counseling was included in the treatment program. Also, men showed
greater adherence to exercise than women and those in the group-mediated
behavioral counseling condition had better rates of adherence than those
in the traditional arm of the study. Independent of gender, participants
in the group-mediated treatment who had the lowest baseline levels of
self-reported function made the most improvement in self-reported
difficulty with various daily tasks.
The American College of Sports Medicine is the largest sports
medicine and exercise science organization in the world. More than
18,000 International, National and Regional members are dedicated to
promoting and integrating scientific research education and practical
applications of sports medicine and exercise science to maintain and
enhance physical performance, fitness, health and quality of life.
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NOTE: Medicine & Science in Sports & Exercise® is the
official journal of the American College of Sports Medicine, and is
available from Lippincott, Williams & Wilkins at 1-800-638-6423. For
a complete copy of the research paper (Vol. 34, No. 11, pages 1705 -
1713) or to speak with a leading sports medicine expert on the topic,
contact the Communications and Public Information Department at
317-637-9200. Visit ACSM online at www.acsm.org.
The conclusions outlined in this news release are those of the
researchers only, and should not be construed as an official statement
of the American College of Sports Medicine.
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message may not be read. Please contact the ACSM Communications and
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117.
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