However, regular (≥3 days/week) exercise at home, compared with minimal or no exercise, was associated with significantly lower state and trait hopelessness among subjects with moderate to severe baseline hopelessness.
Interestingly, the study showed that hospital exercise was not associated with significant changes in state or trait hopelessness. After adjusting for hospital exercise, depression and demographic variables, home exercise remained significantly predictive of decreased state hopelessness.
No differences were found between the two exercise types (biking or walking).
The researchers were surprised to find that hospital-based cardiac rehabilitation exercise didn’t impact current hopelessness. Dr. Dunn said the initiative required to exercise at home may have increased patients’ sense of empowerment about their health.
She also noted a key limitation of the study was that some patients who felt the most hopeless dropped out over time.
Putting the Findings in Perspective
Clinicians need to assess the presence and severity of hopelessness in patients before hospital discharge and all patients should be encouraged to participate in a regular exercise program, Dr. Dunn said.
Lori Mosca, MD, MPH, PhD, who is a Professor of Medicine at Columbia University Medical Center and Director of Preventive Cardiology at New York-Presbyterian Hospital, said this study is important because there has been a lack of research in this area.
Yet, she said more and more patients with CHD are suffering from hopelessness.
“Exercise has been shown in many studies to help with depression, and after heart attacks, patients are often sent to rehabilitation centers and there is often a barrier to get to the centers. So this shows that removing that barrier helps. This may be especially true for the elderly or people who have care-taking responsibilities at home or problems with transportation,” Dr. Mosca said in an interview with Endocrinology Advisor.
- Dunn SL et al. Abstract 11032. Presented at: American Heart Association’s Scientific Sessions 2014; Nov. 15-19, 2014; Chicago.