Correlates of Exercise Self-efficacy in a Randomized Trial of Mind-Body Exercise in Patients With Chronic Heart Failure

Abstract

Purpose Exercise self-efficacy is one of the strongest predictors of physical activity behavior. Prior literature suggests that tai chi, a mind-body exercise, may increase self-efficacy, however this is not well-studied. Little is known about the factors associated with development of exercise self-efficacy in a heart failure population. Methods We utilized data from a randomized controlled trial of 12 weeks group tai chi classes vs. education in patients with chronic heart failure (N=100). We used multivariable linear regression to explore possible correlates of change in exercise self-efficacy in the entire sample, and in the subgroup who received tai chi (N=50). Covariates included baseline quality-of-life, social support, functional parameters, physical activity, serum biomarkers, sociodemographics, and clinical HF parameters. Results Baseline 6-minute walk (β= −0.0003;SE 0.0001;p=0.02) and fatigue score (β= 0.03;SE 0.01;p=0.004) were significantly associated with change in self-efficacy, with those in the lowest tertile for 6-minute walk and higher tertiles for fatigue score having the greatest change. Intervention group was highly significant, with self-efficacy significantly improved in the tai chi group compared to the education control over 12 weeks (β= 0.39;SE: 0.11;p< 0.001). In the tai chi group alone, lower baseline oxygen consumption (β= −0.05;SE 0.01;p=0.001), decreased mood (β= −0.01;SE 0.003;p=0.004), and higher catecholamine level (epinephrine β= 0.003;SE 0.001;p=0.005) were significantly associated with improvements in self-efficacy. Conclusions In this exploratory analysis, our initial findings support the concept that interventions like tai chi may be beneficial in improving exercise self-efficacy, especially in patients with heart failure who are deconditioned, with lower functional status and mood.

Physical Fitness, Exercise Self-Efficacy, and Quality of Life in Adulthood: A Systematic Review

“…Figure 1 presents all the articles that were selected for this systematic review. Of the 37 articles reviewed focused on clarifying the relationship between fitness parameters and exercise self-efficacy, 32 articles were focused on populations with some type of pathology [ 6 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. Five articles focused on the pathology-free middle-aged population [ 62 , 63 , 64 , 65 , 66 ].…”

“…On 24 occasions, the test used was “The 6-Min Walk Test” (6MWT) that assesses aerobic endurance Self-perceived physical fitness was assessed on 14 occasions [ 6 , 34 , 37 , 39 , 40 , 43 , 47 , 53 , 56 , 58 , 59 , 61 , 65 , 66 ]. “The Foot Up and Go” test was used on six occasions [ 34 , 42 , 48 , 54 , 55 , 62 ]; “The Sit to Stand Test” [ 34 , 39 , 46 , 57 , 61 , 62 ]; “The Handgrip forced test” was used to evaluate the strength of the upper and lower body, agility in the face of possible falls, flexibility of the upper and lower body, and dynamic balance [ 39 , 42 , 46 , 57 , 61 , 63 ]. In five occasions “Treadmill Test” was used [ 6 , 45 , 60 , 63 , 64 ].…”

“…In 15 articles, self-efficacy was assessed as a secondary objective. On three occasions, the following instruments were used: “The Arthritis Self- Efficacy Scale” [ 34 , 43 , 53 ]; “The 16-items Cardiac Exercise Self-Efficacy” [ 6 , 54 , 55 ]; “ABC Scale” [ 42 , 50 , 66 ]. Furthermore, the following instruments were used one two occasions: “The Exercise Self-Efficacy Scale” [ 45 , 46 ].…”

Tai Chi Is a Promising Exercise Option for Patients With Coronary Heart Disease Declining Cardiac Rehabilitation

“…In fact, an analysis of data from a randomized controlled trial of tai chi for patients with heart failure has shown that increases in exercise selfefficacy mediated changes in functional status. 52 To our knowledge, this is the first study that examined the effect of tai chi on objectively assessed PA among patients not attending CR. One study conducted in outpatients with class I to III systolic heart failure found that participation in a 12-week tai chi training program improved self-reported PA (CHAMPS (Community Healthy Activities Model Program for Seniors/CHAMPS activities questionnaire)) compared with controls.…”

“…As a result, participants do not see tai chi exercise as threatening, and this may result in improvements in exercise self‐efficacy. In fact, an analysis of data from a randomized controlled trial of tai chi for patients with heart failure has shown that increases in exercise self‐efficacy mediated changes in functional status …”