Exercise-related thoughts in cardiac exercise programs: A study of exercise-adherent cardiac rehabilitation patients

Exercise plays an important preventive and rehabilitative role in coronary heart disease. Unfortunately, cardiac rehabilitation exercise programs have high drop out rates. Several studies with noncardiac patients indicate that exercise-related strategies engaged in during exercise play an important role in exercise performance and adherence. We assessed exercise-related cognitions utilized by a group of cardiac rehabilitation patients who were adherent to a structured exercise program. Thirty-six subjects provided information on their cardiac history and exercise patterns and reported on the thoughts that they might have when exercising in situations depicted in 11 vignettes. Responses, rated using a reliable coding scheme, revealed that the majority of thoughts involved evaluating progress relative to goals and engaging in motivational self-talk. Other strategies reported included using cognitive distraction, thinking about body shape and arousal, making comparisons between self and others, and engaging in social distraction and interaction. Findings suggest that the exercise adherent subjects in this study use specific cognitive and behavioral strategies. Future studies comparing exercise thoughts of both adherent and nonadherent persons and prospective evaluation of their relationships to exercise adherence appear warranted.