Be brave, BE-FIT! A pilot investigation of an ACT-informed exposure intervention to reduce exercise fear-avoidance in older adults

Exercise sensitivity, fear of physical sensations of exertion, is particularly elevated in individuals with cardiovascular disease and can promote fear-avoidance of physical activity. We developed an ACT-informed exposure intervention to target exercise sensitivity, called Behavioral Exposure For In...

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Bibliographic Details
Published in:Cognitive behaviour therapy 2022-07, Vol.51 (4), p.273-294
Main Authors: Farris, Samantha G., Kibbey, Mindy M.
Format: Article
Language:English
Subjects:
acceptance and commitment therapy
Aged
Exercise
Exercise sensitivity
Exercise Therapy
Fear
Humans
interoceptive exposure
kinesiophobia
Physical fitness
Pilot Projects
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Summary:Exercise sensitivity, fear of physical sensations of exertion, is particularly elevated in individuals with cardiovascular disease and can promote fear-avoidance of physical activity. We developed an ACT-informed exposure intervention to target exercise sensitivity, called Behavioral Exposure For Interoceptive Tolerance (BE-FIT). In this Stage I pilot trial, we developed and evaluated the feasibility, safety, and initial efficacy of BE-FIT in low active patients with elevated exercise sensitivity enrolled in outpatient cardiac rehabilitation. BE-FIT is a 6-session, manualized, program-adjunctive treatment delivered during the initial weeks of cardiac rehabilitation and involves exposure to feared bodily sensations and exercise situations, bolstered by acceptance and values-focused processes. Patients (Mage = 70.7 years) were assigned to BE-FIT (n = 12) or an activity monitoring-only control (n = 7). Patients in the BE-FIT condition reported high satisfaction, completed 100% of sessions, and 86.3% (SD = 16.4%) of homework exposures. There were no adverse events reported. BE-FIT produced large-sized effects on reductions in exercise sensitivity and increases in both average steps/day and moderate-to-vigorous physical activity (MVPA) mins/day, from baseline to end-of-treatment. In contrast, the monitoring-only cohort evidenced small-sized reductions in exercise sensitivity and no change in average steps/day or MVPA mins/day. BE-FIT is safe, feasible, acceptable with promising findings from this Stage I trial.
ISSN:1650-6073
1651-2316
DOI:10.1080/16506073.2022.2037017