{"id":170,"date":"2004-03-07T13:48:52","date_gmt":"2004-03-07T19:48:52","guid":{"rendered":""},"modified":"2015-03-20T08:36:36","modified_gmt":"2015-03-20T13:36:36","slug":"evaluation-of-motivation-in-patients-with-coronary-heart-disease-who-participate-in-different-rehabilitation-programs","status":"publish","type":"post","link":"https:\/\/thesportjournal.org\/article\/evaluation-of-motivation-in-patients-with-coronary-heart-disease-who-participate-in-different-rehabilitation-programs\/","title":{"rendered":"Evaluation of Motivation in Patients with Coronary Heart Disease Who Participate in Different Rehabilitation Programs"},"content":{"rendered":"<div class=\"submitted\">Submitted by: Panagiota Papageorgiou, Panagiotis Fotinakis, Efstratia Tsitskari &amp; Vasiliki Giasoglou<\/div>\n<p><strong>ABSTRACT<\/strong><\/p>\n<p>The purpose of this study was to evaluate &#8220;motivation in patients<br \/>\nwith coronary heart disease, who participated in different rehabilitation<br \/>\nprograms and those who did not participate.&#8221; Fifty-one (n=51) male patients<br \/>\nsuffering from coronary heart disease participated in the present study.<br \/>\nFifteen participated in a rehabilitation program in a gym; eighteen participated<br \/>\nin a swimming program and eighteen consisted of the control group. The<br \/>\nmean age of the participants was 60.83 (SD=\u00b13.3). Participants completed<br \/>\nthe Sport Motivation Scale (SMS). According to the results, patients who<br \/>\nparticipated in the gym program had statistically higher levels in IM<br \/>\nto knowledge, to stimulation, to accomplishment and EM to interjected<br \/>\nregulation. On the contrary, the control group had statistically higher<br \/>\nlevels in EM to external regulation and motivation.<\/p>\n<p><!--break--><\/p>\n<h2><strong>INTRODUCTION<\/strong><\/h2>\n<p>Atherosclerotic cardiovascular diseases are the major cause of death<br \/>\nin middle-aged and older-adults in Europe and United States (BC Ministry<br \/>\nof Health and Ministry Responsible for Seniors, 1996; Giannuzzi et al.,<br \/>\n2003; Sarafino, 1990).<\/p>\n<p>Cardiac Rehabilitation programs were first developed in the 1960s when<br \/>\nthe benefits of ambulation during prolonged hospitalization for coronary<br \/>\nevents had been documented. Exercise was the primary component of these<br \/>\nprograms (Giannuzzi et al., 2003). Over the past 4 decades, numerous scientific<br \/>\nreports have examined the relationships between physical activity, physical<br \/>\nfitness and cardiovascular health (Cerubini, Lowenthal, Williams &amp;<br \/>\nAging Clinical and Experimental Research, 1997; Fletcher, Balady &amp;<br \/>\nAmsterdam, 2001; Oldridge, et al., 1993; Pate et al., 1995). Randomized<br \/>\nclinical trials of exercise training showed improvement in coronary risk<br \/>\nfactors such as blood pressure, body composition, fitness, lipid and lipoprotein<br \/>\nprofiles (Dunn et al., 1997; European Hear Failure Training Group, 1998;<br \/>\nEUROASPIRE II Study Group, 2001; Myers, 2003; Rockhill, Willet &amp; Manson,<br \/>\n2001). Swimming and exercise in a gym are included in the so-called coronary<br \/>\nsport groups; as endurance sports with training effects suitable for rehabilitation<br \/>\n(Lins et al., 2003).<\/p>\n<p>Although exercise is considered to be the easiest type of rehabilitation<br \/>\nfor patients with coronary heart disease (CHD), their maintenance into<br \/>\nexercise programs is difficult most of the times (Harlan et al., 1995).<br \/>\nReported rates of uptake of cardiac rehabilitation range from 15% to 59%<br \/>\n(Gattiker, Goins &amp; Dennis, 1992; Pell, Pell &amp; Morrison, 1996).<br \/>\nApproximately 20-25% of patients dropout of exercise programs within the<br \/>\nfirst three months and about 40-50% within 6 to 12 months (Song et al.,<br \/>\n2000; Oldridge, 1998; Oldridge, 1982).<\/p>\n<p>Psychosocial variables that were found to influence the entrance and<br \/>\ncompletion of a CR program include motivation, mood states, and social<br \/>\nsupport (Myers, 2003). Motivation consistently has been shown to be a<br \/>\nstrong indicator of initiation and maintenance of participation in a CR<br \/>\nprogram. It was found that the people that seem to have lower levels of<br \/>\nmotivation perceive more barriers or problems associated with their exercise<br \/>\nprograms. (Dishman &amp; Ickes, 1981; Evenson &amp; Fleury, 2000). The<br \/>\nliterature on physical rehabilitation frequently refers to patient motivation<br \/>\nin explaining differences in outcome among patient groups with similar<br \/>\npathologies (King, Taylor &amp; Haskel, 1993; Maclean, &amp; Pound, 2000).<br \/>\nSeveral studies have lent empirical support to the hypothesis that patient<br \/>\nmotivation is a determinant of rehabilitation outcome (Clark &amp; Smith,<br \/>\n1997; King &amp; Barrowclough, 1989; Oldridge &amp; Stoedefalke, 1984;<br \/>\nWolf, 1969).<\/p>\n<p>In general, motivation expresses the needs and the wishes that regulate<br \/>\nthe direction, the intensity and the continuation of a specific behavior<br \/>\n(Deci &amp; Ryan, 1985). Deci and Ryan (1985) explained intrinsic and<br \/>\nextrinsic motivators and their influence on self-determination in their<br \/>\ntheory of self-determination. Self-determination is a quality of human<br \/>\nfunctioning that involves the experience of a choice. An important distinction<br \/>\nconcerning motivation in exercise and sports is the one between intrinsic<br \/>\nand extrinsic motivated behavior for participation (Ryan et al., 1984).<br \/>\nIntrinsic motivation (IM) refers to an individual who participates in<br \/>\nan activity simply for the satisfaction of doing so (Fortier, et al.,<br \/>\n1995). Intrinsic motivation has been postulated to have three separate<br \/>\ncategories: IM to know, to accomplish things and to stimulation (Vallerand<br \/>\n&amp; Losier, 1999; Vallerand, et al., 1989; Vallerand &amp;Bissonnette,<br \/>\n1992).<\/p>\n<p>Extrinsic Motivation (EM), on the other hand, is related to external<br \/>\nfactors, such as rewards and punishment (Vallerand &amp; Perrault, 1999;<br \/>\nRyan &amp; Deci, 2000). The three types of extrinsic motivation, from<br \/>\nthe least self-determined to the most self-determined, are external regulation,<br \/>\ninterjected regulation and identification (Ryan et al., 1990).<\/p>\n<p>The third type of motivation, <em>amotivation<\/em>, is characterized by<br \/>\nthe thought that actions have no control over outcomes (Deci &amp; Ryan,<br \/>\n1985). In other words, amotivated individuals believe that forces out<br \/>\nof their control determine behaviors.<\/p>\n<p>The specific purpose of this study was to examine the differences in<br \/>\nmotivation between patients, who participated in different cardiac rehabilitation<br \/>\nprograms and patients who did not participated.<\/p>\n<h2><strong>METHOD<\/strong><\/h2>\n<h3><strong>Sample<\/strong><\/h3>\n<p>A sample of 51 male patients suffering from coronary heart disease was<br \/>\nselected and divided into 3 groups. Fifteen (n=15) participated in a rehabilitation<br \/>\nprogram in a gym, eighteen (n=18) participated in a swimming program and<br \/>\neighteen (n=18) patients consisted of the control group. The participants<br \/>\ncouldn\u2019t choose the type of activity and all of them followed a<br \/>\nphase III cardiac rehabilitation program. The mean age of patients was<br \/>\n(mean\u00b1S.D. 60.83 \u00b1 3.3).<\/p>\n<h3><strong>Procedures<\/strong><\/h3>\n<p>The sampling procedure required that the prospective subjects met the<br \/>\nfollowing criteria: (1) having undergone cardiac-related procedures such<br \/>\nas coronary artery bypass graft surgery (CABG) or percutaneous transluminal<br \/>\ncoronary angioplasty (PTCA); (2) able to participate in the cardiac rehabilitation<br \/>\nprograms for more than 15 weeks (for the exercise groups) with an attendance<br \/>\nrate of more than 70%. Exclusion criteria were clinically unstable heart<br \/>\nfailure, unstable arrhythmias and other exercise limiting concurrent condition<br \/>\nas skeletal or muscular disorders. All exercise patients followed the<br \/>\nroutine 3 times per week for 45-90 minutes per session at an intensity<br \/>\nof 60-85% of the maximum heart rate (MHR).<\/p>\n<p>The duration of the rehabilitation programs was 20 weeks. During the<br \/>\n20-week period, the type and intensity of exercise and heart rate and<br \/>\nblood pressure before, during and after exercise were recorded for all<br \/>\nsubjects in the exercise groups. Exercise patients did not participate<br \/>\nin any other physical training.<\/p>\n<p>Each training-session in the gym rehabilitation program consisted of<br \/>\nwalking, cycling or running on an ergometer. It consisted of 10 minutes<br \/>\nwarm\u2013up, 10 minutes stretching and flexibility exercises, of 25<br \/>\nminutes endurance training with heart rate (HR) maintained on 60% &#8211; 85%<br \/>\nof the maximum heart rate (MHR) and 10 minutes cool\u2013down.<\/p>\n<p>The swimming exercise program included 10 minutes warm-up, 10 minutes<br \/>\nstretching and flexibility exercises in the pool, 12 minutes walking in<br \/>\nthe pool with kickboards and barbell and 12 minutes running or walking<br \/>\nin the pool with alternative intensity in a distance of about 200-250m,<br \/>\nwith heart rate (HR) maintained on 60% &#8211; 85% of the maximum heart rate<br \/>\n(MHR) and 10 minutes cool-down.<\/p>\n<p>Permission to conduct the investigation was received from the local athletic<br \/>\nassociation and the individual coaches. Each participant took 10-15 minutes<br \/>\nto complete the questionnaire and responses to the instrument were kept<br \/>\nanonymous. The participants were advised to ask for help if confused about<br \/>\neither the instructions or the clarity of any particular item. No problems<br \/>\nwere encountered in completing either of the inventories or understanding<br \/>\nthe nature of the questions.<\/p>\n<h3><strong>Questionnaire<\/strong><\/h3>\n<p>Patients completed the Sport Motivation Scale (SMS) developed by Pelletier,<br \/>\nFortier, Vallerand and Tuson (1995). The SMS consists of seven sub-scales<br \/>\nthat measure the three types of motivation: intrinsic, extrinsic, and<br \/>\namotivation. There are four items per sub-scale, thus there are a total<br \/>\nof 28 items being assessed. Each item represents a possible reason why<br \/>\npatients with coronary heart disease participated in an exercise rehabilitation<br \/>\nprogram. Subjects must rate the extent to which each item corresponds<br \/>\nto one of their participation motives on a seven-point Likert scale, ranging<br \/>\nfrom \u201cnot at all\u201d (1) to \u201cexactly\u201d (7). The English<br \/>\nquestionnaire is valid, consistent, and reliable. Pelletier et al. (1995)<br \/>\nfound that the English translation of the questionnaire had a satisfactory<br \/>\nlevel of internal consistency. Additionally, correlations between the<br \/>\nsubscales and confirmatory factor analysis have confirmed the determination<br \/>\ncontinuum and the construct validity of the scale (Pelletier, et al. 1995).<\/p>\n<h3><strong>Statistical Analysis<\/strong><\/h3>\n<p>The data was analyzed in two steps. First, internal consistency of subscales<br \/>\nwas assessed using Cronbach alphas (Cronbach, 1951). Secondly, a one \u2013way<br \/>\nMANOVA was used to determine if significant differences existed among<br \/>\npatients exercise groups and control group across the seven SMS subscales.<br \/>\nWhen the results of the one \u2013way MANOVA were statistically significant,<br \/>\nPost hoc Scheffe analysis were conducted to determine which specific patient-group<br \/>\nmeans were significantly different from one another. The level of significance<br \/>\nwas 0.5.<\/p>\n<h2><strong>RESULTS<\/strong><\/h2>\n<p>The internal consistency of the Sport Motivation subscales was determined<br \/>\nby calculating Cronbach\u2019s Coefficient Alpha. The seven subscales<br \/>\nof SMS demonstrated acceptable internal reliability (IM to know =. 70,<br \/>\nIM to stimulation =. 80, IM to accomplishment =. 75, EM to external regulation<br \/>\n=. 69, EM to interjected regulation =. 66, EM to identified regulation<br \/>\n=. 75 and amotivation =. 70). These findings are supported by previous<br \/>\nstudy (Papageorgiou, 2001).<\/p>\n<p>A one &#8211; way MANOVA indicated significant differences between the three<br \/>\npatients groups across the seven SMS subscale, Wilk\u2019s Lambda=. 113,<br \/>\n(F<sub>7,14<\/sub>=9.892, P&lt;0.05, eta squared=0.664).<\/p>\n<p>Univariate ANOVA results indicated a significant difference only for<br \/>\nthe six dependent variables. Statistically significant differences were<br \/>\nfound for IM to know (F<sub>2,41<\/sub>=13.485, P&lt;0.05, eta squared=0.397),<br \/>\nIM to stimulation (F<sub>2,41<\/sub>=43.581, P&lt;0.05, eta squared=0.680),<br \/>\nIM to accomplishment (F<sub>2,41<\/sub>=6.581, P&lt;0.05, eta squared=0,243),<br \/>\nEM to external regulation (F<sub>2,41<\/sub>=6.548, P&lt;0.05, eta squared=0.242),<br \/>\nEM to interjected regulation (F<sub>2,41<\/sub>=22.913, P&lt;0.05, eta<br \/>\nsquared=0.528) and amotivation (F<sub>2,41<\/sub>=5.707, P&lt;0.05, eta<br \/>\nsquared=0.218). Scheffe post hock analysis indicated that patients who<br \/>\nparticipated in the gym rehabilitation program had statistically higher<br \/>\nlevels in IM to know, to stimulation. to accomplishment and EM to interjected<br \/>\nregulation. Additionally, the control group had statistically higher levels<br \/>\nin EM to external regulation and Amotivation. Table 1 provides the means<br \/>\nand standard deviations for these dependent variables.<\/p>\n<p>Table 1 Means and Standard Deviations of Motivation Variables by Group<\/p>\n<table>\n<tbody>\n<tr>\n<td><strong>Variables<\/strong><\/td>\n<td><strong>Gym Group<\/strong><\/td>\n<td><strong>Swimming Group<\/strong><\/td>\n<td><strong>Control Group<\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>M<\/strong><strong>\u00b1<\/strong><strong>SD<\/strong><\/td>\n<td><strong>M<\/strong><strong>\u00b1<\/strong><strong>SD<\/strong><\/td>\n<td><strong>M<\/strong><strong>\u00b1<\/strong><strong>SD<\/strong><\/td>\n<\/tr>\n<tr>\n<td>IM to know<\/td>\n<td>4.56\u00b10.798<\/td>\n<td>3.73\u00b10.504<\/td>\n<td>3.44\u00b10.455<\/td>\n<\/tr>\n<tr>\n<td>IM to stimulation<\/td>\n<td>4.64\u00b10.432<\/td>\n<td>4.18\u00b10.175<\/td>\n<td>3.39\u00b10.433<\/td>\n<\/tr>\n<tr>\n<td>IM to accomplishment<\/td>\n<td>4.41\u00b10.701<\/td>\n<td>3.75\u00b10.365<\/td>\n<td>3.98\u00b10.358<\/td>\n<\/tr>\n<tr>\n<td>EM to external regulation<\/td>\n<td>4.10\u00b10.991<\/td>\n<td>3.76\u00b10.240<\/td>\n<td>4.5\u00b10.342<\/td>\n<\/tr>\n<tr>\n<td>EM to introjected regulation<\/td>\n<td>3.79\u00b10.729<\/td>\n<td>3.46\u00b10.311<\/td>\n<td>2.69\u00b10.286<\/td>\n<\/tr>\n<tr>\n<td>Amotivation<\/td>\n<td>1.47\u00b10.588<\/td>\n<td>1.63\u00b10.208<\/td>\n<td>2.0\u00b10.450<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>DISCUSSION AND CONCLUSION<\/h2>\n<p>This study explored the influence of two specific types, frequency and<br \/>\nduration of exercise cardiac rehabilitation programs in-patient motivations.<\/p>\n<p>Findings from this study indicated that patients who participated in<br \/>\nthe gym rehabilitation program had statistically higher levels in IM to<br \/>\nknow, to stimulation<strong>,<\/strong> to accomplishment and EM to interjected regulation,<br \/>\nthan patients who participated in the swimming rehabilitation program<br \/>\nand patients who did not participate in any program (control group). One<br \/>\nof the possible reasons for the differences between the two exercise patient<br \/>\ngroups may be due to the fact that swimming is not very much allowed for<br \/>\ncardiac patients, despite the valuable advantages as an overall physical<br \/>\nconditioning and leisure avocation (Kawahatsu et al., 1986). According<br \/>\nEbbeck, Gibbons and Loken-Dahle (1995) the differences in reasons for<br \/>\nparticipating depend on the type of physical activity in which the individual<br \/>\nis involved.<\/p>\n<p>Specifically, patients who participated in a gym program to fulfill intimacy<br \/>\nor acceptance needs were motivated intrinsically to participate in order<br \/>\nto gain knowledge, to experience stimulation and accomplishment (Stults,<br \/>\n2001). According to previous studies, personal satisfaction, knowledge<br \/>\nand pleasure (IM) constitute the main reasons of adult\u2019s participation<br \/>\nin exercise programs (Ebeck et al., 1995; Eix, 2001; Brodkin &amp; Weiss,<br \/>\n1990). These findings are consistent with the findings of previous studies<br \/>\nthat suggest effects of the type of rehabilitation in-patients motivation<br \/>\n(Papageorgiou, 2001).<\/p>\n<p>However, the gym exercise group differs significantly from the swimming<br \/>\nand control group in EM to introjected regulation. Introjection is related<br \/>\nto the internal pressures that the patient may put on himself. The guilt<br \/>\nthat they feel when they fail to complete a health task or a training<br \/>\nsession, will motivate them so as to make it up (Vlachopoulos, Karageorghis<br \/>\n&amp; Terry, 2000). According to Brodkin &amp; Weiss (1990) health reasons<br \/>\nwere rated highest by older adults for participating in exercise programs.<br \/>\nAdditionally control group had statistically higher levels in EM to external<br \/>\nregulation and Amotivation.<\/p>\n<p>Given the study findings, further research is suggested. A research design<br \/>\nfor assessing long-term adherence is recommended. Previous studies indicated<br \/>\nthat the dropout rate for an exercise program remains high until 12 months,<br \/>\nwith an average attrition rate of 50% (Comoss, 1988; Oldridge, 1979; Song<br \/>\net al., 2001). 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Economic evaluation of cardiac rehabilitation<br \/>\nsoon after acute myocardial infarction. <span style=\"text-decoration-line: underline;\">American Journal of Cardiology,<br \/>\n72, <\/span>154-61.<\/li>\n<li>Oldridge, N.B., Guyatt, G.H., Fischer, M.E. &amp; Rimm, A.A. (1998).<br \/>\nCardiac rehabilitation after myocardial infarction. Combined experience<br \/>\nof randomized clinical trials. <span style=\"text-decoration-line: underline;\">Journal of the American Medical Association,<br \/>\n260,<\/span> 5-50.<\/li>\n<li>Papageorgiou, P. (2001). <span style=\"text-decoration-line: underline;\">Forecast of participation in exercise<br \/>\nprogram: Health adults and patients with coronary heart disease<\/span>.<br \/>\nUnpublished Master Dissertation, University of Thrace, Department of<br \/>\nPhysical Education and Sports Science<\/li>\n<li>Pate, R.R., Pratt, M., Blair, S.N., Haskell, W.L., Macera, C.A., Buchenr,<br \/>\nD., Ettinger, W., Heath, G.W., King, A.C., Kriska, A., Leon, A.S., Marcus,<br \/>\nB.H., Morris, J., Paffenbarger, R.S., Patrick, K., Pollock, M.L., Rippe,<br \/>\nJ.M., Sallis, J. &amp; Wilmore, J.H. (1995). Physical activity and public<br \/>\nhealth. <span style=\"text-decoration-line: underline;\">Journal of the American Medical Association, 273<\/span>, 402-407.<\/li>\n<li>Pelletier, L.G., Fortier, M.S., Vallerand, R.J., Tuson, K., Brier,<br \/>\nN.M. &amp; Blais, N.M. (1995). 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Williams (Eds.),<span style=\"text-decoration-line: underline;\">Cognitive Sport Psychology<\/span><br \/>\n(pp. 231-242). Lansing, NY: Sport Science Associates.<\/li>\n<li>Ryan, R.M., Connell, J.P. &amp; Crolnick, W.S. (1990). When achievement<br \/>\nis not intrinsically motivated: A theory of self regulation in school.<br \/>\nIn A.K. Boggiano &amp; T.S.<\/li>\n<li>Pittman (Eds.),<span style=\"text-decoration-line: underline;\">Achievement and Motivation: A social-development<br \/>\nperspective (<\/span>pp. 143-158). New York: Cambridge University Press.Ryan,<br \/>\nR.M. &amp; Deci, E.L. (2000). Intrinsic and extrinsic motivation: Classic<br \/>\ndefinition and new directions. <span style=\"text-decoration-line: underline;\">Contemporary Educational Psychology,<br \/>\n25,<\/span> 54-67.<\/li>\n<li>Sarafino, E.P. (1990). <span style=\"text-decoration-line: underline;\">Health psychology: biopsychological interactions<\/span><em>.<\/em><br \/>\nNew York: John Wiley &amp; Sons.<\/li>\n<li>Song, R. &amp; Lee, H. (2001). Effects oa 12-week cardiac rehabilitation<br \/>\nexercise program on motivation and health promoting lifestyle. <span style=\"text-decoration-line: underline;\">Heart<br \/>\nand Lung, 30<\/span>, 3, 200-209.<\/li>\n<li>Stults, M.P. (2001). Motivation and Perceived Relatedness. Presented<br \/>\nat the <span style=\"text-decoration-line: underline;\">Meeting of the Midwesten Psychological Association.<\/span> Psi<br \/>\nChi Poster Session, Chicago, May.<\/li>\n<li>Vallerand, R.J., Blais, M.R., Briere, N.M. &amp; Pelletier, L.G. (1989).<br \/>\nConstruction et validation de l\u2019echelle de motivation en education<br \/>\n(EME). <span style=\"text-decoration-line: underline;\">Revue Canadienne des Sciences du Comportement, 21<\/span>, 323-349.<\/li>\n<li>Vallerand, R.J. &amp; Bissonnette, R. (1992). Intrinsic, extrinsic<br \/>\nand amotivational styles as predictors of behavior: A prospective study.<br \/>\n<span style=\"text-decoration-line: underline;\">Journal of Personality, 60<\/span>, 599-620.<\/li>\n<li>Vallerand, R.J. &amp; Losier, G. F. (1999). An integrative analysis<br \/>\nof intrinsic and extrinsic motivation in sport. <span style=\"text-decoration-line: underline;\">Journal of Applied<br \/>\nSport Psychology, 11<\/span>, 142-169.<\/li>\n<li>Vallerand, R.J. &amp; Perrault, S. (1999). Intrinsic and extrinsic<br \/>\nmotivation in sport: Toward a hierarchical model. In R. Lidor &amp;<br \/>\nM. Bar-Eli (Eds.), <span style=\"text-decoration-line: underline;\">Sport Psychology: Linking Theory and Practice<\/span><br \/>\n(pp. 191-212). Morgantown, WV: Fitness Information Technology, Inc.<\/li>\n<li>Vlachopoulos, S.P., Karageorghis, C.I. &amp; Terry, P.C. (2000). Motivation<br \/>\nprofiles in sport: A self-determination theory perspective. <span style=\"text-decoration-line: underline;\">Research<br \/>\nQuarterly for Exercise and Sport, 71<\/span>(4), 387-397.<\/li>\n<li>Wolff, B.B. (1969). How do rheumatic diseases relate to economic potential<br \/>\nas influenced by personal attitudes and motivation. <span style=\"text-decoration-line: underline;\">Palliative Medicine,<br \/>\n72,<\/span> 68-70.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<div class=\"submitted\">Submitted by: Panagiota Papageorgiou, Panagiotis Fotinakis, Efstratia Tsitskari &amp; Vasiliki Giasoglou<\/div>\n<p><strong>ABSTRACT<\/strong><\/p>\n<p>The purpose of this study was to evaluate &#8220;motivation in patients<br \/>\n        with coronary heart disease, who participated in different rehabilitation<br \/>\n        programs and those who did not participate.&#8221; Fifty-one (n=51) male patients<br \/>\n        suffering from coronary heart disease participated in the present study.<br \/>\n        Fifteen participated in a rehabilitation program in a gym; eighteen participated<br \/>\n        in a swimming program and eighteen consisted of the control group. The<br \/>\n        mean age of the participants was 60.83 (SD=\u00b13.3). Participants completed<br \/>\n        the Sport Motivation Scale (SMS). According to the results, patients who<br \/>\n        participated in the gym program had statistically higher levels in IM<br \/>\n        to knowledge, to stimulation, to accomplishment and EM to interjected<br \/>\n        regulation. On the contrary, the control group had statistically higher<br \/>\n        levels in EM to external regulation and motivation.<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"jetpack_publicize_message":"","jetpack_is_tweetstorm":false,"jetpack_publicize_feature_enabled":true,"jetpack_social_options":[]},"categories":[290,292,296],"tags":[60,8,31,61],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p4btio-2K","jetpack-related-posts":[{"id":5938,"url":"https:\/\/thesportjournal.org\/article\/fitness-and-health-center-evaluation-by-resigned-female-members\/","url_meta":{"origin":170,"position":0},"title":"Fitness and Health Center Evaluation by Resigned Female Members","date":"August 23, 2018","format":false,"excerpt":"Authors: Dr. George F. Zarotis Corresponding Author: Dr. George F. Zarotis Von-Andreae-Str. 1 51427 Bergisch Gladbach, Germany E-Mail: drgzarotis@t-online.de, E-Mail: zarotisg@rhodes.aegean.gr Dr. George F. Zarotis studied sports science at the German Sport University Cologne, prevention and rehabilitation through sport at the Ruhr-University Bochum (Master Degree) and sports economics and sports\u2026","rel":"","context":"In &quot;Commentary&quot;","img":{"alt_text":"Table 2","src":"https:\/\/i0.wp.com\/thesportjournal.org\/wp-content\/uploads\/2018\/08\/Table-2-2.png?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":32,"url":"https:\/\/thesportjournal.org\/article\/international-youth-sport-tour-benefits\/","url_meta":{"origin":170,"position":1},"title":"International Youth Sport Tour Benefits","date":"February 11, 2008","format":false,"excerpt":"Submitted by: Joe Manjone, Ed.D. International youth sport tours are travel programs that provide youth teams with the opportunity to travel to and compete against sport teams from other countries. In addition to competing, the team members and their family and\/or friends are able to tour the countries, cities and\u2026","rel":"","context":"In &quot;Sports Facilities&quot;","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":1778,"url":"https:\/\/thesportjournal.org\/article\/world-masters-games-north-american-participant-medical-and-health-history-survey\/","url_meta":{"origin":170,"position":2},"title":"World Masters Games: North American Participant Medical and Health History Survey","date":"April 17, 2014","format":false,"excerpt":"Submitted by Mark DeBeliso, Joe Walsh, Mike Climstein, Ian Timothy Heazlewood, Jyrki Kettunen, Trish Sevene and Kent Adams ABSTRACT Athletes competing at the World Masters Games have either initiated exercise later in life or pursued a physically active lifestyle for an extended period. \u00a0There is a paucity of information regarding\u2026","rel":"","context":"In &quot;Contemporary Sports Issues&quot;","img":{"alt_text":"Figure1","src":"https:\/\/i0.wp.com\/thesportjournal.org\/wp-content\/uploads\/2014\/04\/Figure1.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":439,"url":"https:\/\/thesportjournal.org\/article\/psychological-and-physiological-effects-of-aquatic-exercise-program-among-the-elderly\/","url_meta":{"origin":170,"position":3},"title":"Psychological and Physiological Effects of Aquatic Exercise Program Among the Elderly","date":"January 2, 2012","format":false,"excerpt":"Matsouka Ourania, Yfantidou Georgia, Trigonis Ioannis, Michailidou Marina ### Abstract The purpose of this study was to investigate the effectiveness of a 3-week daily physical activity program in outdoor spring hot water on joint mobility and mood state in 31 healthy elderly people aged between 60 and 82. The variables\u2026","rel":"","context":"In &quot;Sports Coaching&quot;","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":45,"url":"https:\/\/thesportjournal.org\/article\/exercise-testing-and-prescription-for-the-senior-population\/","url_meta":{"origin":170,"position":4},"title":"Exercise Testing and Prescription for the Senior Population","date":"February 11, 2008","format":false,"excerpt":"Submitted by: Jon YeanSub Lim, CSCS, USSA Doctoral Student INTRODUCTION Today, the average of life expectancy has gone up in the United States (U.S.) and is expected to increase even more in the future. The U.S. Bureau of Census (1994) predicted there will be more than 40 million people over\u2026","rel":"","context":"In &quot;Contemporary Sports Issues&quot;","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":185,"url":"https:\/\/thesportjournal.org\/article\/a-look-at-womens-participation-in-sports-in-maryland-two-year-colleges\/","url_meta":{"origin":170,"position":5},"title":"A Look at Women&#8217;s Participation in Sports in Maryland Two-Year Colleges","date":"January 10, 2005","format":false,"excerpt":"Submitted by: Vincent E. Mumford Abstract Much research has been conducted on college athletics. The populations studied most often are four-year, NCAA member institutions. In higher education, 40 percent of the institutions in the United States are two-year colleges. These two-year colleges enroll more than ten million students annually (IPEDS,\u2026","rel":"","context":"In &quot;Contemporary Sports Issues&quot;","img":{"alt_text":"Figure One","src":"https:\/\/i0.wp.com\/thesportjournal.org\/wp-content\/uploads\/2008\/03\/fig1.jpg?resize=350%2C200","width":350,"height":200},"classes":[]}],"_links":{"self":[{"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/posts\/170"}],"collection":[{"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/comments?post=170"}],"version-history":[{"count":3,"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/posts\/170\/revisions"}],"predecessor-version":[{"id":2464,"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/posts\/170\/revisions\/2464"}],"wp:attachment":[{"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/media?parent=170"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/categories?post=170"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/tags?post=170"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}