Exercise Beliefs Research Articles

Striving for success or addiction? Exercise dependence among elite Australian athletes

Exercise dependence is a condition that involves a preoccupation and involvement with training and exercise, and has serious health and performance consequences for athletes. We examined the validity of a biopsychosocial model to explain the development and maintenance of exercise dependence among elite Australian athletes. Participants were 234 elite Australian athletes recruited from institutes and academies of sport. Thirty-four percent of elite athletes were classified as having exercise dependence based on high scores on the measure of exercise dependence. These athletes had a higher body mass index, and more extreme and maladaptive exercise beliefs compared to non-dependent athletes. They also reported higher pressure from coaches and teammates, and lower social support, compared to athletes who were not exercise dependent. These results support the utility of a biopsychosocial model of exercise dependence in understanding the aetiology of exercise dependence among elite athletes. Limitations of the study and future research directions are highlighted.

The effect of exercise absence on affect and body dissatisfaction as moderated by obligatory exercise beliefs and eating disordered beliefs and behaviors

AimResearch suggests that exercise absence is frequently associated with greater guilt and negative affect, particularly when obligatory exercise beliefs and eating disordered psychopathology are considered. Two separate studies used ecological momentary assessment (EMA) to examine differences in mood on exercise and non-exercise days and the moderating impact of obligatory exercise beliefs and eating disordered beliefs and behaviors. MethodBoth studies recruited female university students who endorsed frequent exercise behavior and study two also recruited based on level of eating disordered psychopathology. Participants completed the Obligatory Exercise Questionnaire at baseline and EMA measures of affect and exercise behavior for approximately one week. Study two participants also completed measures of body dissatisfaction and cognitions. ResultsResults of study one suggest that obligation to exercise appears to have a greater impact on general level of affect than does exercise absence or the interaction of these two. In addition, in study two, eating disorder symptomatology was significantly associated with affect and cognition while exercise absence and obligatory exercise beliefs were not. ConclusionsThe present studies suggest that the absence of exercise is not associated with significant changes in affect or cognitions. However, obligation to exercise and eating disorder symptomatology do impact affect and cognitions.

Exercise promotion: An integration of exercise self-identity, beliefs, intention, and behaviour

We explored the role of exercise self-identity within the framework of the theory of planned behaviour (TPB). Participants were 538 undergraduate students who completed measures of exercise self-identity, exercise behaviour, TPB items, and behavioural and control beliefs. Regression analysis showed that self-identity was the second strongest predictor of exercise behaviour and interacted with exercise intention. Follow-up analysis showed that the intention–exercise relationship was more than three times stronger at high than at low levels of exercise self-identity. Results also showed that only a marginal part of the sample with strong exercise identities had a weak exercise intention, whereas a large part of the sample with a strong exercise intention also reported a strong exercise identity. Nevertheless, only a quarter of the sample that reported strong exercise identity and intention were sufficiently active. The results underline the notion that exercise self-identity may be a useful component for the theory of planned behaviour.

Stroke: Physical Fitness, Exercise, and Fatigue

Stroke: Physical Fitness, Exercise, and Fatigue

Boosting Exercise Beliefs and Motivation Through a Psychological Intervention Designed for Poststroke Populations

Background: The effect of patient education on reducing stroke has had mixed effects, raising questions about how to achieve optimal benefit. Because past evaluations have typically lacked an appropriate theoretical base, the design of past research may have missed important effects. Method: This study used a social cognitive framework to identify variables that might change in response to education. A mixed design was used to evaluate 2 approaches to an intervention, both of which included education. Twenty-six seniors completed a measure of stroke knowledge and beliefs twice: before and after an intervention that was either “standard” (educational brochure plus activities that were not about stroke) or “enhanced” (educational brochure plus activities designed to enhance beliefs about stroke). Outcome measures were health beliefs, intention to exercise to reduce stroke, and stroke knowledge. Results: Selected beliefs changed significantly over time but not differentially across conditions. Beliefs that changed were (1) perceived susceptibility to stroke, and (2) perceived benefit of exercise to reduce risk. Benefit beliefs, in particular, were strongly and positively associated with intention to exercise. Conclusion: Findings suggest that basic approaches to patient education may influence health beliefs. More effective stroke prevention programs may result from continued consideration of the role of health beliefs in such programs.

Exercise Programming and Counseling Preferences of Breast Cancer Survivors During or After Radiation Therapy

To explore exercise programming and counseling preferences and exercise-related beliefs in breast cancer survivors during and after radiation therapy, and to compare differences based on treatment and insurance status. Cross-sectional survey. Ambulatory cancer center in a rural community in eastern North Carolina. 91 breast cancer survivors during or after radiation therapy. The researchers administered the questionnaire to participants. Exercise programming and counseling preferences and exercise beliefs moderated by treatment status (on-treatment, early, and late survivors) and insurance status (Medicaid, non-Medicaid). Chi-square analyses indicated that fewer Medicaid users were physically active and reported health benefits as an advantage of exercise compared to non-Medicaid users (p < 0.05). In addition, more Medicaid users preferred exercise programming at their cancer center compared to non-Medicaid users (p < 0.05). More on-treatment and early survivors listed health benefits as advantages to exercise, but fewer indicated weight control as an advantage compared to late survivors (p < 0.05). Early survivors were more likely than on-treatment survivors to indicate that accessible facilities would make exercising easier for them (p < 0.05). Medicaid users are less active, less likely to identify health benefits as an advantage for exercising, and more likely to prefer cancer center-based exercise programming compared to non-Medicaid users. In addition, on-treatment and early survivors are more likely to list health benefits and less likely to indicate weight control as advantages of exercising compared to late survivors. The low activity levels of Medicaid users may be best targeted by providing cancer center-based exercise programming. Exercise interventions may be most effective if tailored to the unique needs of treatment status.

Activity Increase Despite Arthritis (AÏDA): phase II randomised controlled trial of an active management booklet for hip and knee osteoarthritis in primary care

The Hip & Knee Book: Helping you cope with osteoarthritis was developed to change disadvantageous beliefs and encourage physical activity in people with hip or knee osteoarthritis. To assess the feasibility of conducting a definitive randomised controlled trial (RCT) of this evidence-based booklet in people with hip or knee osteoarthritis. Phase II feasibility randomised controlled trial (RCT). Computerised searches of patients' record databases identified people with osteoarthritis of the hip or knee, who were invited to participate in the RCT comparing the new booklet with a control booklet. Outcomes were measured at baseline, 1 month, and 3 months, and included: beliefs about hip and knee pain, exercise, and fear avoidance; level of physical activity; and health service use. The trial methods were feasible in terms of recruitment, randomisation, and follow-up, but most participants recruited had longstanding established symptoms. After one and 3 months, there was a small relative improvement in illness, exercise, and fear-avoidance beliefs and physical activity level in The Hip & Knee Book group (n = 59) compared with the control group (n = 60), which provides some proof of principle for using these outcomes in future trials. This feasibility study provided proof of principle for testing The Hip & Knee Book in a larger definitive RCT.

Beliefs about excessive exercise in eating disorders: The role of obsessions and compulsions

This study aimed to develop an understanding of excessive exercise in eating disorders by exploring the role of exercise beliefs, obsessive beliefs and obsessive-compulsive behaviours. Sixty-four women were recruited from eating disorder services and 75 non-clinical women were recruited from a university. Exercise beliefs and behaviours, obsessive beliefs and behaviours and eating disorder psychopathology were assessed using self-report questionnaires. There was an association between exercise beliefs, obsessive beliefs and obsessive-compulsive behaviours in the eating-disordered group, but not in the non-eating-disordered group. In the eating-disordered group obsessive beliefs and obsessive-compulsive behaviours were associated with a significant proportion of variance in exercise beliefs after controlling for eating disorder psychopathology and BMI. In the non-eating-disordered group obsessive beliefs and behaviours were associated with beliefs about exercise as a method of affect regulation after controlling for BMI. The results are compatible with a model in which obsessive beliefs and exercise beliefs could maintain exercise in eating disorders. This has implications for the assessment and treatment of excessive exercise. Further research is necessary to determine the causality of these relationships.

The lifestyle behaviours and exercise beliefs of undergraduate student nurses

PurposeOnly limited published research is available exploring the lifestyle practices of student nurses. The purpose of this paper is to explore the lifestyle behaviours and exercise beliefs of Irish student nurses.Design/methodology/approachA descriptive survey design was used. First‐year and third‐year undergraduate student nurses (n=182) studying at one Irish university participated. Data were collected by administering self‐report questionnaires.FindingsA total of 20 per cent of the students smoked, 95 per cent consumed alcohol and 19 per cent of the females reported that they exceeded the recommended weekly safe level for alcohol consumption. In total, 73 per cent of the students reported exercising two to five times per week, and walking was the most popular exercise undertaken. The male students reported significantly higher fitness levels and exercised more on a weekly basis than the females. The students identified a range of benefits of and barriers to exercising.Research limitations/implicationsThere are a number of study limitations, including: only one university setting was used; a descriptive survey approach was employed; and data were collected using self‐report questionnaires. Further studies need to be conducted with additional data collection methods to explore students' lifestyle and physical activity behaviours.Practical implicationsThe university, as a setting for health promotion, must increase awareness, facilitate and encourage student nurses to engage in healthy lifestyle behaviours.Originality/valueThis survey revealed the lifestyle and exercise behaviours of Irish student nurses. Lower levels of smoking and higher levels of physical activity were found amongst these student nurses than those reported elsewhere in the literature.

The effectiveness of a health‐based message on pregnant women’s intentions to exercise postpartum

Background: The benefits of physical activity in the general population are established and research suggests regular physical activity following childbirth is linked with improved health outcomes. However, many women do not resume pre‐pregnancy exercise levels. Objective: The present research used the Theory of Planned Behaviour (TPB) framework to examine whether information about the health benefits of postpartum exercise presented during pregnancy can serve as a meaningful source of exercise motivation. Method: Pregnant women (n = 89) were randomly assigned into one of two conditions: experimental (read a brochure about the health benefits of postpartum exercise) and control (no information). After the intervention, all participants completed measures of attitude, subjective norms (SN), perceived behavioural control (PBC) and intention to exercise postpartum. Results: Independent group t‐tests showed that compared to the control group, participants who received the persuasive message reported significantly more positive attitudes, stronger SN, PBC, and greater intention to exercise (all p’s < .05). Attitudes, SN, and PBC accounted for 51% of the variance in intention. Conclusion: This study demonstrates that exposure to information about the health benefits of exercise during the postpartum period grounded in the TPB can influence pregnant women’s exercise beliefs and intentions.

Influence of Psychosocial Work Environment on Adherence to Workplace Exercise

Physical exercise can reduce the prevalence of musculoskeletal disorders, but adherence to exercise is challenging for many employees. This study determines prognostic factors for adherence to workplace exercise. In Copenhagen, 132 office workers with neck/shoulder pain were randomized to 2 or 12 minutes of exercise five days a week. Low, medium, and high adherence was defined as performing less than 10, 10-30, or more than 30 exercise sessions during the subsequent 10 weeks. Odds ratios (OR) for adherence were modeled by logistic regression. Lower adherence to the 10-week exercise program was predicted by poorer psychosocial work environment and lower exercise self-efficacy. A longer exercise program was not associated with lower adherence. Concurrent strategies to improve psychosocial work environment and individual exercise beliefs should be considered when implementing exercise at the workplace.

Theory Guiding Communication Campaign Praxis: A Qualitative Elicitation Study Comparing Exercise Beliefs of Overweight and Healthy Weight College Students

College students are at great risk of obesity and overweight, and campaigns encouraging exercise may mitigate associated health risks. Although some factors influential in college student exercise behavior have been reported, important in communication targeting, few have studied differences between overweight and normal weight students. Body mass index influences exercise behavior; thus, cognitive factors may be different in these subpopulations, necessitating different messaging approaches. This study aims to address this gap through theory-based qualitative elicitation work. Results indicate that overweight and normal weight college students differ in their perceived facilitators to regular exercise. Implications for exercise messages are discussed.

The relationship of self-determination theory variables to exercise identity

Objectives The aim of the present study was to examine the patterns of association of self-determination theory variables with exercise role identity and exercise beliefs as parts of exercise identity among men and women. Design A cross-sectional study in which perceived autonomy support by the exercise instructor, basic psychological needs, behavioral regulations, and exercise identity were assessed among 733 exercise participants aged 18–64 yrs. Results Hierarchical regression analyses revealed that all types of behavioral regulations and the fulfillment of the need for competence were associated with the exercise role identity part of exercise identity whereas introjected regulation, identified regulation, intrinsic motivation and the needs for competence and relatedness were associated with the exercise beliefs part of exercise identity. Conclusions The findings revealed meaningful associations between self-determination theory variables and exercise identity supporting the relevance of self-determination theory in better understanding the processes related to the adoption and maintenance of an exercise identity.

Colon cancer information as a source of exercise motivation for relatives of patients with colon cancer

Using a Protection Motivation Theory (PMT) framework, this study examined whether factual colon cancer information is a meaningful source of exercise motivation for relatives of patients with colon cancer. One hundred sixty-six inactive relatives were randomly assigned to one of two treatment conditions: PMT group (intervention); and non-PMT group (attention control). At baseline (T1) participants completed demographic information, a questionnaire designed to assess their beliefs toward exercise and colon cancer as well as their exercise intentions. At T2 (one week following T1) participants watched one of two DVD videos that were created for the study. The intervention DVD contained exercise and colon cancer information that was yoked within the four major components of PMT: perceived vulnerability (PV); perceived severity (PS); response efficacy (RE); and self-efficacy (SE), while the attention control DVD contained general diet and cancer information. Immediately following watching the DVD, participants completed the same measures as in T1. Participants assigned to the PMT intervention group showed significant improvement in PV, RE, SE and exercise intentions, whereas participants assigned to the attention control group showed significant improvement only in RE. RE, SE, and PS made significant and unique contributions to prediction of exercise intention. Overall, the results of the present study demonstrate that a single exposure media intervention grounded in a PMT framework can change individuals' exercise and colon cancer beliefs, as well as change their exercise intentions. Implications of these findings and direction for future research are discussed.

‘Exercise is medicine’: Understanding the exercise beliefs and practices of older Chinese women immigrants in British Columbia, Canada

In this paper we examine how Western biomedical beliefs around exercise and related health practices compare and contrast with traditional Chinese medicine's (TCM) conceptions of health and exercise in a globalizing society, and how these narratives about health and physical activity are understood and taken up by 15 aging Chinese immigrant women (aged 65+) living in the multicultural city of Vancouver. Drawing upon theoretical work around the body and society to guide our analysis (including the ideas of Bourdieu and Foucault), we outline how the participants in our project take a pragmatic approach to their use of medicine, combining TCM with Western biomedicine in creative ways. However, understandings of the body are underpinned, we argue, by Eastern narratives of the ‘oneness’ of mind–body and the need for ‘balance’ in order to achieve health. Towards this end, we found that many of the participants view (and use) traditional Chinese body practices as an extension of TCM, a technique to help them achieve balance. We conclude that the neoliberal narrative of personal responsibility for health does not fuel the exercise practices of many of the participants, but rather that they perceive exercise as a pleasurable activity that improves their levels of happiness (and balance) and enhances their lives.

Patient Education Based on Principles of Cognitive Behavioral Therapy for a Patient With Persistent Low Back Pain: A Case Report

Case report. Cognitive behavioral therapy (CBT) is an effective intervention for patients with persistent pain. Recent research indicates that physical therapists self-perceive a lack of knowledge, skills, and time to provide this intervention. The purpose of this case report is to describe how specific CBT strategies can be integrated with multimodal physical therapist management of a patient with persistent low back pain. The patient was a 70-year-old female with activity limitations of walking, standing, and forward bending. Oswestry Disability Questionnaire score was 19/50 and Fear-Avoidance Belief Questionnaire physical activity subscale was 23/24. The Low Back Activity Confidence Scale revealed 19%, 100%, and 84% for function, symptom self-regulation, and exercise, respectively. CBT-based patient education was provided in combination with manual therapy and exercise. CBT techniques included cognitive restructuring, goal setting, activity pacing, problem-solving strategies, graded exposure, encouraging exposure to pleasant experiences, and maintenance strategies. The patient was discharged after 7 visits distributed over 21 weeks. Her Oswestry Disability Questionnaire score was reduced 10% and Fear-Avoidance Belief Questionnaire physical activity subscale score reduced 48%. On the Low Back Activity Confidence Scale the patient's scores were 19%, 87%, and 94% for function, symptom self-regulation, and exercise, respectively. This case report describes the use of CBT techniques during patient education by a physical therapist. The patient demonstrated clinically measurable and significant improvements in disability. Improvements in both self-efficacy beliefs related to exercise and activity avoidance beliefs were associated with improvement in disability. Additional research is needed to determine best practices for CBT-based patient education by physical therapists. Therapy, level 4.

Dog Obesity: Can Dog Caregivers' (Owners') Feeding and Exercise Intentions and Behaviors Be Predicted From Attitudes?

Dog obesity is a common nutritional disorder affecting up to 40% of the companion animal (pet) dog population in Australia and other developed nations. A clear understanding of factors determining relevant caregiver (owner) behaviors underpins effective treatment for this disorder. The theory of planned behavior can be used to understand factors contributing to human behavior. This article describes research informed by this theory. The research examined relationships between owners' behavioral beliefs and barriers, normative beliefs and perceptions of control, owners' feeding and exercise behaviors toward their dogs, and the body condition scores (BCSs) of dogs. The study recruited a sample of 182 dog and owner dyads. The researcher independently assessed BCSs. Owners completed a questionnaire measuring relevant feeding and exercise beliefs and behaviors. This revealed significant correlations between many psychological variables and BCSs and between psychological variables and specific owner behaviors: for example, the relationship of low levels of intentions to feed appropriately to ambivalent beliefs toward feeding appropriately and low perceived control. Careful consideration of the specific variables identified will permit the development of more effective interventions.

Correlation Between Physical Activity In Patients With Inflammatory Arthritis And Beliefs About Aerobic Exercise-pilot Study

PURPOSE: Patients with inflammatory arthritis are at increased risk of cardiovascular disease. Regular aerobic exercise (AE) significantly reduces the risk of CV events in the general population. Current ACR guidelines recommend that regular AE should be introduced as part of routine care for rheumatoid arthritis. Aims: To survey the ideas and perceptions about AE in adults, children and adolescents with inflammatory arthritis. To quantify the level of activity undertaken by these patients. To identify any correlation between the outcome expectations and perceptions about AE with self reported physical activity levels. METHODS: 108 patients sequentially attending rheumatology clinics. A questionnaire of 5 questions concerning exercise perceptions, fears and beliefs was given to adults(n=84), adolescents(n=9) and parents of children (n=19) with inflammatory arthritis. This was answered on a 4 point Likert scale -2(least positive) to +2(most positive). The same adults, adolescents and parents completed internationally validated physical activity questionnaires.(IPAQ, PAC-A and PAQ-C respectively). Physical activity levels and positivity of outcome expectation were calculated for each group. Outcome expectation was then correlated with physical activity levels using the Spearman correlation. RESULTS: On a scale of -10(least positive) to +10(most positive), the mean outcome expectation among adults was 1.65, among adolescents was 5.1 and among children was 7. Adults felt most negative about the impact AE would have on their joints and general health but felt most positive about the effect it would have on their heart. Exercise levels were generally low with only 25% of adults scoring high on IPAQ. Exercise levels correlated significantly with outcome expectations in adults(p=0.01). The correlation in adolescents and children was not significant (p=0.089). CONCLUSIONS: Children and adolescents have higher outcome expectations of AE than adults. Outcome expectation of AE in adults correlates significantly with self reported physical activity level. Adults with inflammatory arthritis are poorly informed about the benefits of AE, have inaccurate beliefs about the safety of AE and exercise below recommended levels. These findings suggest that improved education may improve AE levels in patients with inflammatory arthritis.

The Hip and Knee Book: developing an active management booklet for hip and knee osteoarthritis.

The pain and disability of hip and knee osteoarthritis can be improved by exercise, but the best method of encouraging this is not known. To develop an evidence-based booklet for patients with hip or knee osteoarthritis, offering information and advice on maintaining activity. Systematic review of reviews and guidelines, then focus groups. Four general practices in North East Wales. Evidence-based messages were developed from a systematic review, synthesised into patient-centred messages, and then incorporated into a narrative. A draft booklet was examined by three focus groups to improve the phrasing of its messages and discuss its usefulness. The final draft was examined in a fourth focus group. Six evidence-based guidelines and 54 systematic reviews were identified. The focus groups found the draft booklet to be informative and easy to read. They reported a lack of clarity about the cause of osteoarthritis and were surprised that the pain could improve. The value of exercise and weight loss beliefs was accepted and reinforced, but there was a perceived contradiction about heavy physical work being causative, while moderate exercise was beneficial. There was a fear of dependency on analgesia and misinterpretation of the message on hyaluranon injections. The information on joint replacement empowered patients to discuss referral with their GP. The text was revised to accommodate these issues. The booklet was readable, credible, and useful to end-users. A randomised controlled trial is planned, to test whether the booklet influences beliefs about osteoarthritis and exercise.

Analysis of the Relationship between Diet and Exercise Beliefs and Actual Behaviors among Breast Cancer Survivors in Northwest Ohio

Studies have shown that a diet high in fruit and vegetable intake, as well as a routine including daily exercise or physical activity, can independently affect relapse rates and survivorship in breast cancer patients. Fruits and vegetables contain powerful anti-oxidant molecules, capable of preventing tumor formation and proliferation. Exercise can lower circulating levels of estrogen, the female hormone responsible for tumor proliferation in the estrogen-sensitive form of the disease. The most beneficial results have been shown in women who exercise and consume a diet rich in fruits and vegetables. We studied the attitudes towards and behaviors related to fruit and vegetable intake and exercise in a cohort of breast cancer survivors in northwest Ohio. Data were gathered from a survey sent out by the Northwest Ohio Branch of the Susan G. Komen For the Cure Foundation. We assessed and evaluated survivors' self-reported beliefs, attitudes, and behaviors regarding exercise and fruit and vegetable intake. Nearly half of the survivors (46.5%) reported being unsure or in disagreement with the statement "Eating at least 5 servings of fruits and/or vegetables per day will reduce the risk of breast cancer recurrence." Only 46.8% of those in agreement with the previous statement actually report eating at least 5 fruits and/or vegetables per day. With respect to exercise, 32.9% reported being unsure or in disagreement with the statement "Engaging in regular physical activity will reduce the risk of breast cancer recurrence." Only 68.5% of those in agreement with the previous statement report any physical activity in the past 30 days. Many breast cancer survivors do not appear to be aware of the benefits of diet and exercise. Further, a large proportion of those who are aware of the benefits do not adapt a healthy diet and exercise as part of their lifestyle. A majority of these survivors see a primary care physician, which we believe is the best venue to bridge this education gap. It is apparent by the pattern our data shows that more needs to be done to educate breast cancer survivors about the benefits of exercise and fruit and vegetable intake. Steps need to be taken to ensure that those who are educated also remain motivated to engage in a healthy lifestyle with the hopes of avoiding breast cancer recurrence.