A Randomized Controlled Trial to Assess the Effect of Self-Paced Walking on Task-Specific Anxiety in Cardiac Rehabilitation Patients

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Cardiac rehabilitation can reduce overall anxiety. However, task-specific anxiety is yet to be investigated in the cardiac patient. This study investigates the effect of an outdoor walking intervention (WI) in alleviating the high degree of task-specific anxiety in cardiac patients.


Participants (N = 22, mean age ± SD = 62.0 ± 10.8 years, 9 women), who had experienced a cardiac event and exhibited a moderate to high level of anxiety for outdoor walking (anxiety score ≥ 7 on a modified version of the Hospital Anxiety and Depression Scale), were initially assessed during an incremental shuttle walk test and a self-paced 1-mile walk. Heart rate and the ratings of perceived exertion were monitored during both tests. Participants also completed an exercise self-efficacy (ESE) questionnaire. Following this, participants were randomized to either a 3 sessions per week, 4 weeks, self-paced WI on a predetermined variable topographic course, or to a control group (CG; 30-minute stationary cycling, 3 sessions per week for 4 weeks). Identical assessments (Incremental Shuttle Walk Test, Self-Paced 1-Mile Walk, Hospital Anxiety and Depression Scale, ESE) were used postintervention. The 2 groups were compared for anxiety, ESE, and fitness by analysis of variance.


The WI group exhibited a significantly greater decrease in task-specific anxiety (51%; P < .01), increased self-efficacy (6.6%; P < .001) and improved fitness (P < .05) in comparison with CG.


This study demonstrated that task familiarization reduced the task-specific anxiety associated with outdoor walking in cardiac patients and, as such, may help in changing exercise behavior patterns in patients undergoing cardiac rehabilitation.

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