Implicit attitudes and the improvement of exercise capacity during pulmonary rehabilitation

Abstract

The aim of this study was to examine the role of explicit and implicit attitudes in the improvement of exercise capacity during a 5-week pulmonary rehabilitation (PR). A total of 105 patients performed walking tests at baseline and at the end of PR. Change between performances was computed at the end of PR, and Minimal-Clinically-Important-Difference (MCID) were used to categorize patients as responders (i.e. change above MCID, N = 54) or non-responders (i.e. change below MCID, N = 51). At baseline, implicit attitudes were measured through a physical activity versus sedentary behavior Implicit Association Test; explicit attitudes toward physical activity and sedentary behavior were measured by questionnaires. Only implicit attitudes significantly differed between the two groups (p = .015), responders displaying implicit attitudes significantly more in favor of physical activity (M = .91, SD = .54) than non-responders (M = .60, SD = .71) at baseline. Measuring implicit attitudes in PR could help to accurately estimate patients’ motivation, and design more individualized rehabilitation programs.

Keywords:

• Dual processes
• automatic processes
• unconscious processes
• motivation

Notes

1. This study is based on a larger dataset aiming at investigating the role of motivation in different PR’s outcomes. Changes in implicit and explicit motivational processes during PR, and their role in 6-month post-rehabilitation physical activity and sedentary behaviors were examined in a first study (Chevance, Héraud, Varray, & Boiché, 2017a). The present study completes these previous results by examining the associations between baseline implicit and explicit attitudes and the improvement of exercise tolerance during a PR program. These results are presenting in two separate studies because physical activity maintenance post-rehabilitation and the improvement of exercise tolerance at the end of a PR program are two different and specific outcomes (see Zwerink, Palen, Valk, Brusse-Keizer, & Effing, 2013).