Body Mass Index and Chronic Health Conditions as Predictors of Exercise Fear-Avoidance Beliefs

Brooks Wingo,Monica Baskin,Renee Desmond,Retta Evans,Jamy Ard,Jane Roy

doi:10.5171/2013.793181

Abstract

Obese adults often experience heightened physical responses to exercise, and some may interpret this response as a sign that they are in danger of harm or injury. This fear of harm, or fearavoidance beliefs (FAB), leads some individuals to avoid exercise, leading to increased sedentary behavior and further difficulty maintaining weight. Evidence indicates that body mass index (BMI) is predictive of FAB, but no research has considered the impact of medical conditions on FAB in obese adults. The purpose of this study was to assess the impact of cardiorespiratory and musculoskeletal conditions on FAB. Participants (n=155) completed the Exercise Fear Avoidance Scale (EFAS), a checklist of medical conditions, and the Pain Disability Index. We calculated differences in EFAS scores between groups with and without each condition using t-tests. We used linear regression to calculate the amount of variance in EFAS scores accounted for by BMI, age, pain and condition. Individuals reporting a cardiorespiratory or musculoskeletal condition had significantly higher EFAS scores than those who did not (7.4 points, P<.001; 4.4 points, P=.001, respectively). BMI, pain and age explained significant portions of the variance in EFAS scores (P=.003; P<.001; P=.001, respectively). When added to the regression equations, no condition significantly added to the variance in EFAS scores. While those with cardiorespiratory and musculoskeletal conditions may have higher FAB than those without, BMI appears to contribute to this fear even in individuals without these conditions. Practitioners should consider FAB when discussing exercise recommendations with obese individuals regardless of cardiorespiratory or musculoskeletal history.

Highlights

Physical activity is a key component of behavioral interventions for obesity, but exercise can be a difficult behavior for individuals who are overweight or obese to initiate
Evidence indicates that body mass index (BMI) is predictive of fearavoidance beliefs (FAB), but no research has considered the impact of medical conditions on FAB in obese adults
This study assessed the differences in exercise fear avoidance beliefs in adults who had various chronic medical conditions

Summary

Introduction

Physical activity is a key component of behavioral interventions for obesity, but exercise can be a difficult behavior for individuals who are overweight or obese to initiate. Discomfort may be due to increased daily pain associated with obesity, as well as heightened physical response to exertion experienced by obese individuals compared to normal weight adults (Ekkekakis & Lind, 2006; Nevitt & Lane,1999; Tukker, Visscher & Picavet, 2009) This increased response may be in the form of joint pain, which can be made worse by the additional force exerted on joints as a result of higher body weight in obese individuals (Nevitt & Lane, 1999; Tukker, et al, 2009). Overweight and obese individuals have been found to experience increased symptoms of cardiovascular exertion including increased perceived exertion and oxygen consumption compared to sedentary individuals of normal weight when performing an equal amount of work This may result in a higher rate of perceived exertion and decreased enjoyment of activity (Ekkekakis & Lind, 2006)

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