Cross-Lagged Relations Between Exercise Capacity and Psychological Distress During Cardiac Rehabilitation
Abstract Background Poorer mental health is associated with lower exercise capacity, above and beyond the effect of other cardiovascular risk factors. However, the directionality of this relationship remains unclear. Purpose The main aim of the present study was to clarify, with a cross-lagged panel...
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| Veröffentlicht in: | Annals of behavioral medicine 2018-10, Vol.52 (11), p.963-972 |
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| container_title | Annals of behavioral medicine |
| container_volume | 52 |
| creator | Spatola, Chiara A M Cappella, Emanuele A M Goodwin, Christina L Castelnuovo, Gianluca Cattivelli, Roberto Rapelli, Giada Malfatto, Gabriella Facchini, Mario Mollica, Chiara Molinari, Enrico |
| description | Abstract
Background
Poorer mental health is associated with lower exercise capacity, above and beyond the effect of other cardiovascular risk factors. However, the directionality of this relationship remains unclear.
Purpose
The main aim of the present study was to clarify, with a cross-lagged panel design, the relationship between psychological status and exercise capacity among patients in a cardiac rehabilitation (CR) program.
Methods
A clinical sample of 212 CR patients completed exercise-capacity testing and measures of depression and anxiety (Hospital Anxiety and Depression Scale) pre-CR and post-CR. Demographic and clinical data, including BMI and smoking history, were also collected. Multivariate stepwise regression analysis was performed to identify the best predictors of exercise capacity at discharge. Structural equation modeling was utilized to quantify the cross-lagged effect between exercise capacity and psychological distress.
Results
Multivariate regression analysis revealed that higher levels of psychological distress pre-CR are predictively associated with less improvement in exercise capacity post-CR, beyond the effects of age, sex, and baseline functional status. Results from structural equation modeling supported a 1-direction association, with psychological distress pre-CR predicting lower exercise capacity post-CR over and above autoregressive effects.
Conclusions
Study results did not support the hypothesis of a bidirectional relationship between psychological distress and EC. High levels of psychological distress pre-CR appeared to be longitudinally associated with lower exercise capacity post-CR, but not vice versa. This finding highlights the importance of assessing and treating both anxiety and depression in the early phase of secondary prevention programs.
Psychological distress is associated with lower improvement of cardio-respiratory fitness achieved by patients participating in a cardiac rehabilitation program. |
| doi_str_mv | 10.1093/abm/kax069 |
| format | Article |
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Background
Poorer mental health is associated with lower exercise capacity, above and beyond the effect of other cardiovascular risk factors. However, the directionality of this relationship remains unclear.
Purpose
The main aim of the present study was to clarify, with a cross-lagged panel design, the relationship between psychological status and exercise capacity among patients in a cardiac rehabilitation (CR) program.
Methods
A clinical sample of 212 CR patients completed exercise-capacity testing and measures of depression and anxiety (Hospital Anxiety and Depression Scale) pre-CR and post-CR. Demographic and clinical data, including BMI and smoking history, were also collected. Multivariate stepwise regression analysis was performed to identify the best predictors of exercise capacity at discharge. Structural equation modeling was utilized to quantify the cross-lagged effect between exercise capacity and psychological distress.
Results
Multivariate regression analysis revealed that higher levels of psychological distress pre-CR are predictively associated with less improvement in exercise capacity post-CR, beyond the effects of age, sex, and baseline functional status. Results from structural equation modeling supported a 1-direction association, with psychological distress pre-CR predicting lower exercise capacity post-CR over and above autoregressive effects.
Conclusions
Study results did not support the hypothesis of a bidirectional relationship between psychological distress and EC. High levels of psychological distress pre-CR appeared to be longitudinally associated with lower exercise capacity post-CR, but not vice versa. This finding highlights the importance of assessing and treating both anxiety and depression in the early phase of secondary prevention programs.
Psychological distress is associated with lower improvement of cardio-respiratory fitness achieved by patients participating in a cardiac rehabilitation program.</description><identifier>ISSN: 0883-6612</identifier><identifier>EISSN: 1532-4796</identifier><identifier>DOI: 10.1093/abm/kax069</identifier><identifier>PMID: 30346500</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Anxiety ; Cardiovascular disease ; Exercise ; Health psychology ; Mental depression ; Regression analysis ; Rehabilitation</subject><ispartof>Annals of behavioral medicine, 2018-10, Vol.52 (11), p.963-972</ispartof><rights>Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. 2018</rights><rights>Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c345t-617ea0f6f30a7c0667bca6ef5f534c686a02ece0a05f86e8095bca3d69cd0c013</citedby><cites>FETCH-LOGICAL-c345t-617ea0f6f30a7c0667bca6ef5f534c686a02ece0a05f86e8095bca3d69cd0c013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,1579,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30346500$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Spatola, Chiara A M</creatorcontrib><creatorcontrib>Cappella, Emanuele A M</creatorcontrib><creatorcontrib>Goodwin, Christina L</creatorcontrib><creatorcontrib>Castelnuovo, Gianluca</creatorcontrib><creatorcontrib>Cattivelli, Roberto</creatorcontrib><creatorcontrib>Rapelli, Giada</creatorcontrib><creatorcontrib>Malfatto, Gabriella</creatorcontrib><creatorcontrib>Facchini, Mario</creatorcontrib><creatorcontrib>Mollica, Chiara</creatorcontrib><creatorcontrib>Molinari, Enrico</creatorcontrib><title>Cross-Lagged Relations Between Exercise Capacity and Psychological Distress During Cardiac Rehabilitation</title><title>Annals of behavioral medicine</title><addtitle>Ann Behav Med</addtitle><description>Abstract
Background
Poorer mental health is associated with lower exercise capacity, above and beyond the effect of other cardiovascular risk factors. However, the directionality of this relationship remains unclear.
Purpose
The main aim of the present study was to clarify, with a cross-lagged panel design, the relationship between psychological status and exercise capacity among patients in a cardiac rehabilitation (CR) program.
Methods
A clinical sample of 212 CR patients completed exercise-capacity testing and measures of depression and anxiety (Hospital Anxiety and Depression Scale) pre-CR and post-CR. Demographic and clinical data, including BMI and smoking history, were also collected. Multivariate stepwise regression analysis was performed to identify the best predictors of exercise capacity at discharge. Structural equation modeling was utilized to quantify the cross-lagged effect between exercise capacity and psychological distress.
Results
Multivariate regression analysis revealed that higher levels of psychological distress pre-CR are predictively associated with less improvement in exercise capacity post-CR, beyond the effects of age, sex, and baseline functional status. Results from structural equation modeling supported a 1-direction association, with psychological distress pre-CR predicting lower exercise capacity post-CR over and above autoregressive effects.
Conclusions
Study results did not support the hypothesis of a bidirectional relationship between psychological distress and EC. High levels of psychological distress pre-CR appeared to be longitudinally associated with lower exercise capacity post-CR, but not vice versa. This finding highlights the importance of assessing and treating both anxiety and depression in the early phase of secondary prevention programs.
Psychological distress is associated with lower improvement of cardio-respiratory fitness achieved by patients participating in a cardiac rehabilitation program.</description><subject>Anxiety</subject><subject>Cardiovascular disease</subject><subject>Exercise</subject><subject>Health psychology</subject><subject>Mental depression</subject><subject>Regression analysis</subject><subject>Rehabilitation</subject><issn>0883-6612</issn><issn>1532-4796</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp90cFq20AQBuClJDSO20sfIAhKoBQUz2pXI-nYOG4SMKSE9izGq5G9iSy5uxKN3z7r2Mmhh5xmDh8_w_xCfJFwIaFQE1qsJ4_0BFh8ECOZqiTWWYFHYgR5rmJEmZyIU-8fAEBpiR_FiQoLpgAjYaeu8z6e03LJVXTPDfW2a310yf0_5jaaPbEz1nM0pQ0Z228jaqvol9-aVdd0S2uoia6s7x17H10NzrbLQF1lyYS0FS1sY_uXzE_iuKbG8-fDHIs_P2e_pzfx_O76dvpjHhul0z5GmTFBjbUCygwgZgtDyHVap0obzJEgYcNAkNY5cg5FGoCqsDAVGJBqLL7tczeu-zuw78u19YabhlruBl8mMiuSRGOuAv36H33oBteG68pEg0atFOigvu-V2b3KcV1unF2T25YSyl0BZSig3BcQ8NkhclisuXqjrx8P4HwPumHzXtAzws6O8A</recordid><startdate>20181022</startdate><enddate>20181022</enddate><creator>Spatola, Chiara A M</creator><creator>Cappella, Emanuele A M</creator><creator>Goodwin, Christina L</creator><creator>Castelnuovo, Gianluca</creator><creator>Cattivelli, Roberto</creator><creator>Rapelli, Giada</creator><creator>Malfatto, Gabriella</creator><creator>Facchini, Mario</creator><creator>Mollica, Chiara</creator><creator>Molinari, Enrico</creator><general>Oxford University Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20181022</creationdate><title>Cross-Lagged Relations Between Exercise Capacity and Psychological Distress During Cardiac Rehabilitation</title><author>Spatola, Chiara A M ; Cappella, Emanuele A M ; Goodwin, Christina L ; Castelnuovo, Gianluca ; Cattivelli, Roberto ; Rapelli, Giada ; Malfatto, Gabriella ; Facchini, Mario ; Mollica, Chiara ; Molinari, Enrico</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c345t-617ea0f6f30a7c0667bca6ef5f534c686a02ece0a05f86e8095bca3d69cd0c013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Anxiety</topic><topic>Cardiovascular disease</topic><topic>Exercise</topic><topic>Health psychology</topic><topic>Mental depression</topic><topic>Regression analysis</topic><topic>Rehabilitation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Spatola, Chiara A M</creatorcontrib><creatorcontrib>Cappella, Emanuele A M</creatorcontrib><creatorcontrib>Goodwin, Christina L</creatorcontrib><creatorcontrib>Castelnuovo, Gianluca</creatorcontrib><creatorcontrib>Cattivelli, Roberto</creatorcontrib><creatorcontrib>Rapelli, Giada</creatorcontrib><creatorcontrib>Malfatto, Gabriella</creatorcontrib><creatorcontrib>Facchini, Mario</creatorcontrib><creatorcontrib>Mollica, Chiara</creatorcontrib><creatorcontrib>Molinari, Enrico</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of behavioral medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spatola, Chiara A M</au><au>Cappella, Emanuele A M</au><au>Goodwin, Christina L</au><au>Castelnuovo, Gianluca</au><au>Cattivelli, Roberto</au><au>Rapelli, Giada</au><au>Malfatto, Gabriella</au><au>Facchini, Mario</au><au>Mollica, Chiara</au><au>Molinari, Enrico</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cross-Lagged Relations Between Exercise Capacity and Psychological Distress During Cardiac Rehabilitation</atitle><jtitle>Annals of behavioral medicine</jtitle><addtitle>Ann Behav Med</addtitle><date>2018-10-22</date><risdate>2018</risdate><volume>52</volume><issue>11</issue><spage>963</spage><epage>972</epage><pages>963-972</pages><issn>0883-6612</issn><eissn>1532-4796</eissn><abstract>Abstract
Background
Poorer mental health is associated with lower exercise capacity, above and beyond the effect of other cardiovascular risk factors. However, the directionality of this relationship remains unclear.
Purpose
The main aim of the present study was to clarify, with a cross-lagged panel design, the relationship between psychological status and exercise capacity among patients in a cardiac rehabilitation (CR) program.
Methods
A clinical sample of 212 CR patients completed exercise-capacity testing and measures of depression and anxiety (Hospital Anxiety and Depression Scale) pre-CR and post-CR. Demographic and clinical data, including BMI and smoking history, were also collected. Multivariate stepwise regression analysis was performed to identify the best predictors of exercise capacity at discharge. Structural equation modeling was utilized to quantify the cross-lagged effect between exercise capacity and psychological distress.
Results
Multivariate regression analysis revealed that higher levels of psychological distress pre-CR are predictively associated with less improvement in exercise capacity post-CR, beyond the effects of age, sex, and baseline functional status. Results from structural equation modeling supported a 1-direction association, with psychological distress pre-CR predicting lower exercise capacity post-CR over and above autoregressive effects.
Conclusions
Study results did not support the hypothesis of a bidirectional relationship between psychological distress and EC. High levels of psychological distress pre-CR appeared to be longitudinally associated with lower exercise capacity post-CR, but not vice versa. This finding highlights the importance of assessing and treating both anxiety and depression in the early phase of secondary prevention programs.
Psychological distress is associated with lower improvement of cardio-respiratory fitness achieved by patients participating in a cardiac rehabilitation program.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>30346500</pmid><doi>10.1093/abm/kax069</doi><tpages>10</tpages></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current) |
| subjects | Anxiety Cardiovascular disease Exercise Health psychology Mental depression Regression analysis Rehabilitation |
| title | Cross-Lagged Relations Between Exercise Capacity and Psychological Distress During Cardiac Rehabilitation |
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