Clinical trial NCT06795802: Effect of Evaluative Conditioning on Intensity of Physical Activity of Patients Doing Cardiac Rehabilitation
Official title: Effect of Evaluative Conditioning on the Intensity of Physical Activity of Patients in a Cardiac Rehabilitation Program
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Cardiovascular Diseases
Keywords: Cardiovascular Rehabilitation
Motivation
Physical Activity
Lead sponsor: Centre Hospitalier Universitaire de Nīmes
Sponsor class: OTHER
First posted: 2025-01-28
Enrollment: 28
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Post-myocardial infarction patients involved in a cardiac rehabilitation program at Nîmes University Hospital, France.

Brief summary: The hypothesis is that, compared to those in the control group (i.e., diet-related evaluative conditioning), participants in the Physical Activity (PA) group (i.e. PA-friendly evaluative conditioning) will exhibit (1) a higher intensity (power setting) on an ergocycle during a free Physical Activity session in their rehabilitation program and (2) A greater increase in the implicit attitude score.

The primary objective will be to evaluate the effect of evaluative conditioning (EC) on the intensity of physical activity produced by post-myocardial infarction patients involved in a cardiac rehabilitation program.The secondary objective of this study will be to evaluate the mediating effect of implicit attitude change in the effect of evaluative conditioning on adopted behaviors.

Detailed description: More specifically, post-myocardial infarction physical activity has been shown to reduce cardiac morbidity and mortality. Indeed, exercise improves cardiovascular health through mechanisms such as lowering blood pressure, weight reduction, and increased insulin sensitivity. Although there are no formal guidelines for physical activity (PA) after Myocardial Infarction, patients are encouraged to achieve 150 minutes of low-to-moderate intensity PA per week.

Nevertheless, despite the growing body of scientific evidence and the widespread dissemination of information about the benefits of PA, the recommendations have been difficult for post-myocardial infarction patients to comply with. There is evidence to suggest that post-cardiac rehabilitation patients struggle to maintain sustained PA. This may be due to a number of barriers, including fatigue, mood disorders, a lack of motivation, or kinesiophobia.

Continued improvements in monitoring physical activity and the development of policies and programs to increase activity levels appears to be a necessity. This may reduce the burden of physical inactivity and noncommunicable diseases (eg, cardiovascular disease). Therefore, one of the major challenges is to succeed in identifying the main determinants playing a role in the lack of adoption of regular PA. Indeed, targeting these determinants would ultimately allow us to improve the PA promotion strategies already in place for the population. However, maintenance of a practice over time is a complex issue that may be influenced by a multitude of factors. Among these, previous work suggests that the identification of motivational determinants of physical activity represents a relevant research object in this context.

Eligibility criteria: Inclusion Criteria:

* Patients must have given written informed consent to participate in the trial
* Patients must be aged18 to 75 years old
* It must be less than 6 months after a first episode of myocardial infarction treated medically or by revascularization

Exclusion Criteria:

* Patients with a disability preventing the performance of a bimanual test or an ergocycle task
* Patients who are unable to give written informed consent or who have refused to sign the consent form

Primary outcomes:
measure: Effect of evaluative conditioning on the intensity of physical activity produced by post-myocardial infarction patients involved in a cardiac rehabilitation program. Control group
timeFrame: Day 0 before completing the Implicit Association Test
measure: Effect of evaluative conditioning on the intensity of physical activity produced by post-myocardial infarction patients involved in a cardiac rehabilitation program. Control group
timeFrame: Day 0 after completing the Implicit Association Test
measure: Effect of evaluative conditioning on the intensity of physical activity produced by post-myocardial infarction patients involved in a cardiac rehabilitation program. Experimental group
timeFrame: Day 0 before completing the Implicit Association Test
measure: Effect of evaluative conditioning on the intensity of physical activity produced by post-myocardial infarction patients involved in a cardiac rehabilitation program. Experimental group
timeFrame: Day 0 after completing the Implicit Association Test
Secondary outcomes:
measure: Mediating effect of implicit attitudinal change in the effect of evaluative conditioning on adopted behaviors. Control group
timeFrame: Time 0, before taking the test
measure: Mediating effect of implicit attitudinal change in the effect of evaluative conditioning on adopted behaviors. Experimental group
timeFrame: Time 0, before taking the test
measure: Mediating effect of implicit attitudinal change in the effect of evaluative conditioning on adopted behaviors. Control group
timeFrame: Time 0, after taking the test
measure: Mediating effect of implicit attitudinal change in the effect of evaluative conditioning on adopted behaviors. Experimental group
timeFrame: Time 0, after taking the test
Other outcomes:
Locations:
city: Nîmes,
country: France
facility: Centre Hospitalier Universitaire de Nîmes
state: Gard
Study officials:
References:
citation: Hamer M, O'Donovan G, Murphy M. Physical Inactivity and the Economic and Health Burdens Due to Cardiovascular Disease: Exercise as Medicine. Adv Exp Med Biol. 2017;999:3-18. doi: 10.1007/978-981-10-4307-9_1.
citation: Clark AM, Hartling L, Vandermeer B, McAlister FA. Meta-analysis: secondary prevention programs for patients with coronary artery disease. Ann Intern Med. 2005 Nov 1;143(9):659-72. doi: 10.7326/0003-4819-143-9-200511010-00010.
citation: Birtwistle SB, Jones I, Murphy R, Gee I, Watson PM. "Do what you can with a happy heart": a longitudinal study of patient and family members' lived experiences of physical activity post-myocardial infarction. Disabil Rehabil. 2022 Jul;44(14):3661-3670. doi: 10.1080/09638288.2021.1878560. Epub 2021 Mar 1.
citation: Karmali KN, Davies P, Taylor F, Beswick A, Martin N, Ebrahim S. Promoting patient uptake and adherence in cardiac rehabilitation. Cochrane Database Syst Rev. 2014 Jun 25;(6):CD007131. doi: 10.1002/14651858.CD007131.pub3.
citation: Antoniewicz F, Brand R. Learning to Like Exercising: Evaluative Conditioning Changes Automatic Evaluations of Exercising and Influences Subsequent Exercising Behavior. J Sport Exerc Psychol. 2016 Apr;38(2):138-48. doi: 10.1123/jsep.2015-0125. Epub 2016 Mar 15.
citation: Chevance G, Bernard P, Chamberland PE, Rebar A. The association between implicit attitudes toward physical activity and physical activity behaviour: a systematic review and correlational meta-analysis. Health Psychol Rev. 2019 Sep;13(3):248-276. doi: 10.1080/17437199.2019.1618726. Epub 2019 Jun 12.
citation: Rebar AL, Dimmock JA, Jackson B, Rhodes RE, Kates A, Starling J, Vandelanotte C. A systematic review of the effects of non-conscious regulatory processes in physical activity. Health Psychol Rev. 2016 Dec;10(4):395-407. doi: 10.1080/17437199.2016.1183505. Epub 2016 May 20.
citation: Hofmann W, De Houwer J, Perugini M, Baeyens F, Crombez G. Evaluative conditioning in humans: a meta-analysis. Psychol Bull. 2010 May;136(3):390-421. doi: 10.1037/a0018916.
citation: Rogerson MC, Murphy BM, Bird S, Morris T. "I don't have the heart": a qualitative study of barriers to and facilitators of physical activity for people with coronary heart disease and depressive symptoms. Int J Behav Nutr Phys Act. 2012 Nov 30;9:140. doi: 10.1186/1479-5868-9-140.
citation: Rhodes RE, Janssen I, Bredin SSD, Warburton DER, Bauman A. Physical activity: Health impact, prevalence, correlates and interventions. Psychol Health. 2017 Aug;32(8):942-975. doi: 10.1080/08870446.2017.1325486. Epub 2017 May 30.