Dec. 24, 1997 When you haul yourself out of bed to jog around the park, do you curse the dark mornings and think about your aches and pains? Or do you slip into the sunrise and feel good about cranking your body into gear? Although researchers know that half of all folks who take up exercise quit during the first six months, they have failed to ask how people's thoughts and feelings during workouts affect their decision to drop out.
Wanting to look at how people interpret the exercise experience itself, Joanne Kraenzle Schneider, Ph.D., R.N., questioned 364 women over 55 after they finished exercising. She found that those who believed in the health benefits of working out tended to exercise more often, more intensely or for longer periods than those with negative beliefs. Those who concentrated on their bodily movements reported exercising less often, less intensely or for shorter periods of time than those who didn't. "It appears that if you can interpret your experience positively, you will want to exercise more," Schneider says.
Schneider is a postdoctoral research fellow in medicine at Washington University School of Medicine in St. Louis. Her paper, which appears in a recent issue of the Journal of Gerontology, is based on a doctoral dissertation she wrote at the University of Kansas School of Nursing in Kansas City. An award from the National Institute of Nursing Research (NINR) supported the study.
Focus on older women
Schneider studies women because most previous exercise maintenance research has focused on men. She works with older people because they're a fast-growing group of health-care consumers in the United States. "Little is known about exercise maintenance in this population, though regular physical exercise may reduce their health-care costs to society," she says.
Scouring shopping malls and senior centers in Kansas City and Wichita, Kan., Schneider found 364 women between the ages of 55 and 90 who attended an exercise session of their choice. She gave each woman several questionnaires to complete after the exercise session was over.
One set of questionnaires measured exercise behavior -- the number of times the women had exercised during a seven-day period, how hard they had worked and for how long. Another instrument probed the women's beliefs about exercise -- improved well-being, reduced tension or improved disposition, for example. A questionnaire that Schneider designed with input from a previous study asked each woman about her sensations, thoughts and feelings during the actual exercise session. The questions revealed the women's feelings of well-being, how intensely they concentrated on the movements they were making, the intensity of their sweating, their muscle and joint discomfort and the sights and sounds they enjoyed. "This type of episode-specific information was missing from previous studies," Schneider says.
When Schneider analyzed the responses, she found that three factors accounted for differences in exercise behavior in this group of women. The first was a well-known factor, age -- the older people get, the less likely they are to stick to a regular exercise routine. Second, those who believed in the physical or psychological benefits of exercise were those who exercised more often, more intensely or for longer periods, the data showed. Most importantly, the responses revealed that women who concentrated on their bodily movements during the exercise session were those who exercised less often, less intensely or for shorter periods.
This third factor may be important because women who focus on what they're doing are likely to concentrate on their internal sensations. Or they may become so involved in what they're doing that their exercise intensity drops. Schneider will examine these different explanations in her next study.
Attitude change is possible
While it isn't feasible to change a person's age, it might be possible to change negative thoughts into positive ones, Schneider suggests. "In contrast to experiences outside the actual exercise episodes, episode-specific interpretations are more immediate than general interpretations and therefore are accessible to change," she concludes. "So they're a prime target for interventions."
n a recent pilot study at Washington University, Schneider tried to restructure the thoughts of five volunteers. Each woman picked an aspect of exercising she hated, such as sweating, and was taught to think positive thoughts about it instead. Schneider used the encouraging results in an application for a future grant from the NINR to conduct a larger five-year study.
As part of her postdoctoral research, which also is funded by NINR, Schneider is examining episode-specific interpretations over a nine-month period and across different types of exercise in people who are 78 years or older. She also is taking her findings to heart because she has a tough time working out. "I'm telling myself that exercise is healthy and is improving my endurance and physical fitness instead of thinking that it doesn't feel good," she says.
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