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An Investigation of the Benefits of Stress Management Within a Cardiac Rehabilitation Population

Campbell, Tavis S. PhD; Stevenson, Andrea MSc; Arena, Ross PhD, PT; Hauer, Trina BPAS, MSc; Bacon, Simon L. PhD; Rouleau, Codie R. BA; Cannon, Colleen PhD, RPsych; Stone, James A. MD, PhD, FRCPC

Journal of Cardiopulmonary Rehabilitation and Prevention: September/October 2012 - Volume 32 - Issue 5 - p 296–304
doi: 10.1097/HCR.0b013e318265e0eb
Stress Management

PURPOSE: Research describing whether stress management can improve clinical outcomes for patients in cardiac rehabilitation (CR) has yielded equivocal findings.

METHODS: The present investigation retrospectively examined the incremental impact of exercise and stress management (n = 188), relative to exercise only (n = 1389), on psychosocial and physical health outcomes following a 12-week CR program.

RESULTS: Participation in stress management and exercise was associated with greater reductions in waist circumference and systolic blood pressure, relative to exercise alone, for patients with baseline clinical elevations on these measures. The stress management group had more depressive symptoms (as measured by the Hospital Anxiety and Depression Scale; t[1] = 3.81, P < .001) and lower physical quality of life (as measured by the 12-Item Short Form Health Survey Physical Component; t[1] = 3.00, P = .003) than the exercise-only group at baseline, but there were no differences between the groups at 12 weeks in terms of depressive symptoms (t[1] = 1.74, P = .082) or physical quality of life (t[1] = 1.56, P = .120).

CONCLUSION: These findings suggest that stress management may offer additional benefits in selected patients over and above exercise in CR.

This study retrospectively evaluated the impact of exercise and stress management relative to exercise on health following cardiac rehabilitation (CR). Stress management was associated with greater reductions in waist circumference and systolic blood pressure for patients with clinical elevations on these measures, suggesting additional benefits of stress management in CR.

Department of Psychology, University of Calgary (Dr Campbell and Mss Stevenson and Rouleau), Cardiac Wellness Institute of Calgary (Ms Hauer and Dr Stone), Libin Cardiovascular Institute of Alberta (Dr Stone), and University of Calgary (Dr Stone), Calgary, Alberta, Canada; Physical Therapy Program, Department of Orthopeadics and Division of Cardiology, and Department of Internal Medicine, University of New Mexico, Albuquerque (Dr Arena); Department of Exercise Science, Concordia University, Montréal, Québec, Canada (Dr Bacon); and Heart Centre, St. Paul's Hospital, Vancouver, British Columbia, Canada (Dr Cannon).

Correspondence: Tavis S. Campbell, PhD, Department of Psychology, University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada (

The authors declare no conflict of interest.

© 2012 Lippincott Williams & Wilkins, Inc.