Exercise restrictions can cause lasting psychological problems

31st October 2016

Exercise restrictions in sports-loving adults with hypertrophic cardiomyopathy (HCM) can cause lasting psychological problems, including uncertainty while exercising and feeling limited, says a new survey.

People at greatest risk of emotional problems are those who have competed at a high level, perceive themselves as an athlete, and who then spend much less time exercising, said researchers from Stanford University and University of South Carolina Greenville in America.

They say doctors need to identify patients at greatest risk of emotional problems and and help them to bolster their coping and adaptation to a new way of life.

For the survey, 54 people with HCM (mean age 55.9 years; 33% female) gave their athletic history and the psychological impact of exercise restrictions. Of these, 16 were further interviewed to dig deeper into the nature and origin of psychological problems.

More than half of the respondents (54%) said it was stressful and difficult to adjust to exercise restrictions.

The most problems were among those who had strongly identified themselves as an athlete both personally and socially; among those who had spent the most hours per week exercising; and among those who were previously elite or competitive athletes.

 “Athletic identity plays an important role in shaping one's experience, beyond level of competitiveness,” the researchers said. “Even when accounting for previous competitive and elite athletics, those who were perceived by themselves and/or others to be an athlete experienced greater psychological difficulty.”

In the interviews, nearly everyone interviewed said that exercise served multiple purposes in their life prior to their diagnosis. Exercise helped to create and maintain friendships and romantic relationships, cope with stress, maintain fitness, and manage other health concerns.

The contraction of the role that exercise played in their lives proved to be psychologically distressing for many as they struggled to fill its void. They often chose to pursue new pastimes, new forms of athletics or involvement in the community. Generally, the choice of coping strategies seemed to be highly individualised and variable, the researchers added.

Still, most interviewees reported getting social support from families and friends, including in lower intensity exercise. For that reason, lack of understanding from family or friends and avoiding exercise completely were detrimental to coping.

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