Relationship between affective response to exercise and physical activity practice in 144 cardiac patients: findings from an observational study

Purpose: Literature has extensively shown how physical activity plays a crucial role in the management of individuals with cardiovascular diseases. However, the motivation and adherence to exercise-based secondary prevention program may differ significantly among patients. Assessing the affective response to physical exercise in this population can provide important insights into the factors influencing their engagement in physical activity.1 Therefore, the aim of this study was to examine the relationship between affective response, physical activity volume, and functional parameters in cardiac patients. Methods: The patients attending the secondary prevention program at the Study Center for Motor and Sports Sciences in Ferrara between December 2021 and May 2023 were recruited for the study. Each participant underwent a comprehensive assessment that included risk factors, demographic and anthropometric variables, diagnosis, and therapy. They were then evaluated using the following measures: (a) 1-km treadmill walk test (1 K-TWT) performed at a moderate intensity, (b) assessment of affective response to exercise using the AFFEX questionnaire, and (c) self-reported weekly physical activity using the Seven Day Physical Activity Recall. Results: A total of 144 male participants, (mean age 72 ± 9 years, BMI 27.44 ± 3.87) were analyzed. The average speed achieved during the 1 K-TWT was 4.7 ± 1.1 km/h. Participants reported engaging in 12.5 ± 9.22 MET/h/week of physical activity. Significant correlations were observed between the amount of physical activity performed and various AFFEX domains, including ‘‘honor’’ (r = 0.44; p\0.001), ‘‘attraction’’ (r = 0.37; p\0.001), ‘‘calmness’’ (r = 0.24; p = 0.004), ‘‘competence’’ (r = 0.25; p = 0.003), ‘‘empower’’ (r = 0.24; p = 0.004), ‘‘energy’’ (r = 0.25; p = 0.002), ‘‘interest’’ (r = 0.25; p = 0.002), and ‘‘pleasure’’ (r = 0.28; p = 0.001). Furthermore, the study population was divided into tertiles based on the walking speed achieved during the 1 K-TWT. A statistically significant difference was observed between the first and third tertiles for the ‘‘energy’’ (p = 0.013) domain. Conclusions: These findings suggest that affective response plays a role in integrating physical exercise into the lifestyle of cardiac patients. Assessing affective response in a clinical setting can be a valuable tool, both for exercise specialist and sports physician, to understand the effectiveness of educational interventions aimed at promoting physical activity and improving functional parameters.