By Kate Jacobson | January 25, 2021
For many of us, exercising is great—in theory.
Most of us understand the benefits of regular exercise, and for those working in cardiac and pulmonary rehabilitation, it’s even more clear how it can help the patients we serve. But how do we get people to actually do it?
Jasmin Hutchinson, PhD, says exercise is about so much more than following an exercise prescription. Sticking to exercise and wellness is just as much mental as it is physical. In an upcoming AACVPR webinar, Hutchinson—who serves as the director for Sport and Exercise Psychology at Springfield College in Massachusetts—hopes to provide valuable motivational tools for those working in CR and PR.
“Often approaches to behavioral change are based on the theory that if you give someone information and say, ‘Exercise is good for you,’ that they will act upon it,” she said. “But if the patient finds exercise unpleasant or scary, that information will fall on deaf ears.”
Hutchinson said CR and PR professionals need more than just information in their arsenal, and should be considering affective responses to exercise as well. And it all should start before a fitness journey even begins. Staff should ask their patients some critical questions to help understand what motivates them. What are their goals? What do they like about exercise? What don’t they like?
Once you understand what might positively motivate a patient, you can start crafting exercise plans that fit their likes and dislikes.
“Most people are feelings-driven,” she said. “Often times, people who hate exercise may not know there are subtle things you can do to make it more pleasurable. It’s not going to make someone who hates exercise love it, but it might tip the balance.”
There are some simple solutions that might make an immediate impact. She said music can be a huge mental boost for exercise. Offering group fitness classes might also push people who don’t necessarily like exercise to do it because they feel motivated by their peers.
Also, staff should consider the types of exercise they’re offering. Someone who might not like walking might love dancing, or someone who hates a stationary bike might find light strength exercises more interesting.
“We’re good at offering choice in terms of modality: Would you like to do the bike or treadmill today?” she said. “But the more choices you can give around exercise—with intensity in particular—the more likely you are to have adherence.”
It’s also important to set realistic expectations with your patients—and not just around overall fitness. Even those in the best shape of their life had to work to get there, and not all of them started out loving exercise. Hutchinson said it’s okay to let patients know that exercise, as it’s happening, isn’t something they need to love. But there can be parts of the exercise they love, even if it’s just the benefits down the road.
“I think setting realistic expectations is very helpful so our patient’s don’t feel frustrated,” she said. “If they’re putting in three to four weeks of effort and they’re not seeing any change in their numbers, it can be disheartening. I think if people focus on some of those short-term goals initially, it’s going to help people say, ‘I’m getting somewhere,’ instead of quitting before the critical six-month mark.”
She said it’s also important to help patients understand why some days are better than others.
“Some days you’re feeling bad, some days you’re feeling great and you can push yourself, and some days it’s a miracle you’re there,” she said. “One of the great myths is that exercise makes you feel better, but exercise usually makes you feel good when it’s over. If you’re unconditioned, exercise is one of the worst things in the world. Realizing that—it’s important to build up people’s efforts and let them know it will get better.”
And for those CR and PR professionals who are fit and love exercise, being honest about your own fitness can help move your patients along. Having empathy for our patients and being honest with them about what a fitness journey entails can help them see even the fittest of athletes have bad days.
She used her own life as an example. After her pregnancy, she struggled getting back into running. A lifelong runner, it was disheartening to her. She was slower than she used to be, and it hurt a lot more too, but she pushed through and got back in shape.
“When you’re out of shape—especially if you’ve been in shape before—it’s miserable,” she said. “So I know how it feels. I think it’s good for people to know that professionals have the same experiences as patients. They think it’s easy for you because you’re an exerciser. No, we’ve all felt this. We all feel this.”
Join Dr. Hutchinson at her webinar “Considering Affective Responses to Exercise in Exercise Adherence” on Feb. 23 at 12 pm CST.