Michael H. Kelemen

Self-efficacy mediates strength gains during circuit weight training in men with coronary artery disease.

Motivation to engage in health-promoting exercise has been ascribed to global personality traits such as self-esteem or athletic self-confidence. Self-Efficacy Theory challenges this view by proposing that highly specific estimates of personal capabilities mediate adoption of new or difficult behavior patterns. We tested this assumption by measuring self-efficacy perceptions in 40 men with coronary artery disease who participated in an experiment evaluating effects of circuit weight training (CWT). Specific self-efficacy estimates were assessed during baseline strength/endurance testing and after 10 wk participation in CWT or volleyball. Correlational analyses of self-efficacy in relation to performance on strength/endurance tests strongly supported the contention that adoption of novel activities is governed by highly specific self-perceptions. Participation in CWT produced greater strength and endurance gains than did volleyball, and these changes were accompanied by increased self-efficacy in CWT subjects for activities resembling the training tasks. The assertion that self-efficacy perceptions directly mediate involvement in challenging physical activities was supported by multiple regression analyses. These revealed that pre-training self-efficacy judgments predicted post-test strength gains even after controlling for baseline strength, type of training and frequency of participation in exercise sessions.

Diagnosis of Obstructive Coronary Disease by Maximal Exercise and Atrial Pacing

The reliability of graded maximal exercise treadmill testing and right atrial pacing in diagnosing significant obstructive coronary artery disease was evaluated in 74 consecutive patients referred to a cardiac unit with chest pain consistent with angina pectoris. The results of maximal exercise testing and right atrial pacing, with regard to the presence or absence of the patients characteristic chest pain or discomfort and ischemic ST segment depression, were compared with the findings determined by selective coronary arteriography. Ischemic ST segment depression was defined as a downward displacement of one full mm or more of a horizontal or downward sagging ST segment.Forty-nine of the 74 patients studied were found to have significant coronary arteriographic obstruction, i.e., greater than 75% obstruction of one major coronary artery. The occurrence of the patients characteristic chest pain or discomfort during maximal exercise testing or right atrial pacing is an excellent indicator of the presence of obstructive coronary artery disease, since all of the 41 patients developing their characteristic pain on maximal exercise testing had coronary arteriograms positive for obstructive coronary disease (no false positives), and 46 of 47 patients with characteristic chest pain on right atrial pacing had selective coronary arteriograms positive for obstructive coronary disease. When present, one mm ST depression during maximal exercise treadmill testing also reliably indicates arteriographic obstructive coronary disease (26 of 27 patients). However, the presence or absence of ischemic ST depression during right atrial pacing is a particularly unreliable indication of the presence or absence of arteriographic obstructive coronary disease: 15 of 25 false positive tests, and 13 of 49 false negative tests.

Resistive training safety and assessment guidelines for cardiac and coronary prone patients

The past few years have seen increased use of resistive training programs for cardiac and coronary prone individuals. There is growing evidence that using moderate resistance with frequent repetitions is safe and beneficial. This review provides guidelines for selection and assessment of patients for resistive training programs. For the most part, the criteria for participation in resistive training are the same as those used for the more traditional cardiac and high risk exercise programs.

Three year participation in circuit weight training improves muscular strength and self-efficacy in cardiac patients.

Circuit weight training (CWT) has been used in our cardiac exercise program since 1983. In 1986, 3-year changes in strength, self-efficacy (SE), body weight, and skinfolds were studied in 25 men (58 ± 8 years) involved in the cardiac exercise program. All patients regularly performed cardiovascular

Relationships between self-efficacy and mood before and after exercise training

Background Exercise improves physiological function and may improve mood. Some psychologists suggest that mood changes are mediated predominately by self-efficacy rather than physical ability. We examined self-efficacy, mood, aerobic power, and strength in men undergoing exercise training and antihypertensive therapy of calcium-channel and beta-blocking drugs. Because beta blockers limit the physiological benefits of exercise, we evaluated psychological responses independent of physiological gains. Methods Fifty-one men (25–59 years) with mild hypertension were randomized to diltiazen (calcium-channel blocker), propranolol (beta-blocker), or placebo. Subjects completed 10 weeks of circuit weight training, and walking, jogging, or cycling. Study variables included Profile of Mood States (POMS), self-efficacy (SE) for arms and legs, maximal oxygen uptake, and maximal strength for arm and leg exercises. Results Baseline aerobic power, POMS, and SE scores were unrelated. POMS did not relate to strength. Arm SE related to arm and leg strength. Leg SE related to leg strength only. After training, aerobic power increased in the diltiazem and placebo groups, but not in the propranolol group. Strength, and arm and leg SE increased in all groups. After training, POMS tension/anxiety and total mood disturbance decreased and vigor/alertness increased in all groups. Gains in aerobic power and strength were not related to mood or SE changes. Results Tension/anxiety, depression/dejection, confusion/bewilderment, and total mood disturbance changes related to SE changes. Conclusions Thus, psychological changes were unrelated to physical ability. Self-efficacy and several mood dimensions were related. The data suggest that changes in mood may be mediated by changes in perceived abilities.

Introduction to the symposium: Resistive weight training: A new approach to exercise for cardiac and coronary disease prone populations

This symposium is concerned with the use of resistive exercise in cardiac and coronary prone populations. In the past, these populations have been refrained from resistive exercise. However, recent studies suggest that this form of exercise is safe and has favorable effects on physical fitness, cardiac risk factors such as hypertension and hyperlipidemia, and psychological status.