Perceived Effort Step-up Procedure for Self-Regulating Stationary Cycle Exercise Intensity by Patients with Cardiovascular Disease

This study examined the strategy utilized by patients with cardiovascular disease to regulate exercise intensity using the Rating of Perceived Exertion (RPE) and tested if a step-up procedure would reduce overshoot of target heart rate (HR). Also the study investigated if Prescription Congruence and Intensity Discrimination, components of the Intensity Self-regulation Model, could be validated for these patients. An estimation and production paradigm was used. HR was measured at 2-min. intervals during 6-min. stationary cycle ergometer exercise trials. Data for four experimental trials were compared: (1) a work intensity set by experimenter to achieve a target RPE of 11 (Estimation 11), (2) an intensity set by experimenter to achieve a target RPE of 13 (Estimation 13), (3) an intensity varied by participant every 2 min. to produce a target RPE of 13 (Production 13), and (4) a Step-up Procedure with the intensity varied by participant, first producing a target RPE of 11 during the first 2 min., followed by producing a target RPE of 13 from min. 2 to 6 of exercise (Production 11 + 13). A very small effect size was found for HR between Production 13 and Estimation 13, and a moderate effect size was noted for the increased HR when patients produced a target RPE of 13 as compared to 11. The participants could be divided into 2 groups: 10 patients comprised a Higher group whose HR at 2 min. during Production 13 was greater than HR at 2 min. during Estimation 13, and 6 patients in a Lower group with HR at 2 min. during Production 13 less than or equal to HR during Estimation 13. A large effect size was found at 6 min. for the reductions of the Higher group's HR overshoot and for the Lower group's HR undershoot during Production 13. All participants in the Higher group ( n = 10) had a clinically significant 1ER overshoot of 5 beats · min.−1 at 2 min. during Production 13. Using a Step-up Procedure (Production 11 + 13), a large effect size was found for the reduced number of patients ( n = 3) with an overshoot of 5 beats · min.−1 at 2 min. This supports the ability of participants in cardiac rehabilitation programs to meet the Prescription Congruence and Intensity Discrimination components of the Intensity Self-regulation Model in the RPE 11–13 zone. Evidence was found for overshoot/undershoot of target HR at 2 min., supporting a proposed third component, Production Strategy, of the Intensity Self-regulation Model. The 2-min. Step-up Procedure reduced some patients' tendency to “overshoot” target intensity.

[Mentality and behavior of children suffering from viral myocarditis]

OBJECTIVE

The present study was designed to investigate the influence of viral myocarditis on mental behavior of the children.

METHODS

Mentality and behavior of the 178 children suffering from viral myocarditis were examined with Achenbach Child Behavior Checklist (CBCL) edited by Gong Yao-xian in 1986 and 104 sex, age, education and achievement-matched children with pneumonia or upper respiratory infection were enrolled as controls.

RESULTS

The mentality and behavior of the children with viral myocarditis were distinctly abnormal. The abnormal rates of boys and girls suffering from acute and deferment viral myocarditis were evidently higher than those of control children (P < 0.01). The behavioral abnormalities of boys were hypochondria, social difficulties, unwell of body and attack. Whereas, the girls presented hypochondria, unwell of body, social flinch and disobeyed discipline, which was significantly different from the control children. The total and hypochondria cursory mark of the second check result of deferment boys were evidently higher than those of the first check (P < 0.05). The total cursory mark of the second check result of deferment girls was higher than that of the first check (P < 0.05) and evidently higher than that of the acute second check result (P < 0.01). The abnormal rates of mentality and behavior correlated positively with the age of children and they were associated with the severity of the illness.

CONCLUSION

Viral myocarditis evidently affected the mentality and behavior of children, which should be paid great attention to.

MMPI profiles of rheumatic fever adolescents and adults

MMPI elevations for adolescent and adult groups (N = 162) who had experienced rheumatic fever (RF) were generally lower than Mayo Clinic norms, particularly on scales K, 1, 2, 3, and 6. Significant age effects on Scales F, 3, 4, 8, and 9 confirm previous findings that adolescent groups score higher on the MMPI. Contrary to expectation, patients who had not experienced carditis as part of their RF scored significantly higher than carditis patients on scales 2, 3, and 4. The results are discussed from a chronic disease perspective.