Psychological benefits of bench-step aerobics program in overweight or obese adult women: its effects on anger, exercise self-efficacy, exercise-related affect, and body image

과체중 및 비만 성인 여성 대상 스텝운동 프로그램의 심리적 효과: 분노, 운동관련 자기 효능감, 운동관련 정서 및 신체상에 미치는 효과

  • Lee, Mi-Ra (Department of Nursing, Kimcheon Science College) ;
  • Kim, Wan-Soo (Department of Exercise Prescription, Konyang University)
  • Published : 2007.12.30

Abstract

Objectives: The efficacy, feasibility, and safety of bench-step aerobics (BSA) program in overweight or obese Korean adult women have been implied. However, there has been almost no evidence for its psychological benefits. As such, the purpose of this study was to investigate the psychological benefits of BSA program in overweight or obese (body mass index ${\geq}\;23\;kg/m^2$) Korean adult women. Method: Anger, exercise self-efficacy, exercise-related affect, and body image of overweight or obese women who participated in a 12-week BSA program (n=15) were compared with those of their counterparts in the control group (n=13). Subjects were selected among public health center visitors and those recruited by putting an advertisement in local newspapers and the public health center homepage. Data from the exercise and control groups were collected before and after the 12-week BSA program (from August to November in 2006) at the public health centers. The exercise program consisted of 45 to 60 min moderate-intensity (40/50 to 50/60% of their hear rate reserve) BSA performed for 3 days a week. Results: After the BSA program, body image of the subjects in the exercise group was significantly improved and there was a significant difference between the exercise and control groups. Anger, exercise self-efficacy, and exercise-related affect were improved after the BSA program but the changes did not reach the level of statistical significance and there were no significant differences between the exercise and control groups. Conclusions: In conclusion, BSA appears to significantly enhance body image in overweight or obese Korean adult women but its effects on anger, exercise self-efficacy, and exercise-related affect do not appear to be statistically significant. Further studies involving different subjects, particularly whose levels of anger are high or whose levels of exercise-related affect are low to exclude the influence of the ceiling or floor effect, are warranted in a randomized controlled design.

스텝운동(bench-step aerobics: BSA)이 과체중 및 비만 우리나라 성인 여성을 위한 효과성, 안전성 및 실행 가능성을 갖춘 운동 프로그램이라는 것이 다수 연구자들에 의해 시사되어 왔다. 그러나 그 효과성은 일부 생리적 효과에 한하여 검증되었을 뿐 심리적 효과에 대해서는 거의 연구되지 않았다. 따라서 본 연구는 스텝운동 프로그램이 우리나라 과체중 및 비만(체질량지수 ${\geq}\;2\;kg/m^2$) 성인 여성에게 미치는 심리적 효과를 알아보기 위해 수행되었다. 이러한 목적을 달성하기 위해 보건소 방문자와 지역신문 및 보건소 홈페이지 홍보를 통해 모집된 여성 중 편의 추출한 운동군 15명과 대조군 13명의 분노(anger), 운동관련 자기 효능감(exercise self-efficacy), 운동관련 정서(exericse-related affect), 그리고 신체상(body image)을 운동 프로그램 전후에 측정하여 비교하였다. 자료 수집은 12주 스텝운동 프로그램(2006년 8월${\sim}$11월) 전과 후에 보건소에서 이루어졌다. 운동군에게 적용된 스텝운동 프로그램은 중강도[개인의 예비 심박 수(Heart Rate Reserve : HRR)의 $40/50{\sim}50/60%$]로 $45{\sim}60$분 동안 주 3회 이루어졌으며, 상기 운동 강도 및 운동 시간은 대상자의 적응도에 따라 12주에 걸쳐 점진적으로 증가되었다. 12주간의 스텝운동 후 운동군의 신체상이 유의하게 개선되었으며, 이는 대조군에서의 변화와도 유의한 차이를 보였다. 분노, 운동관련 자기 효능감, 그리고 운동관련 정서 또한 개선되는 경향이었으나 통계적으로 유의한 변화는 보이지 않았다. 이로써 우리나라 과체중 및 비만 성인 여성 대상 스텝운동의 심리적 효과가 부분적으로 지지되고 있으나, 현재까지 이루어진 관련 연구가 거의 없고 본 연구 또한 연구 설계상의 제한점을 갖고 있으므로 연구결과의 일반화를 위한 추후 연구가 요구된다. 특히 Floor effect 및 Ceiling effect 등에 의한 효과를 배제하기 위해 분노 수준이 상대적으로 더욱 높거나 운동관련 정서 수준이 상대적으로 낮은 과체중 및 비만여성을 대상으로 반복 연구를 수행할 필요가 있다.

Keywords

References

  1. American College of Sports Medicine. 2006. ACSM's guidelines for exercise testing and prescription, seventh edition. Philadelphia : Lippincott Williams & Wilkins
  2. Bandura, A. 1986. Social foundations of though and action. A social cognitive theory. New Jersey: Prentice-hall Inc.
  3. Buchman, B.P., Sallis, J.F., Criqui, M.H., Dimsdale, J.E., and Kaplan, R.M. 1991. Physical activity, physical fitness, and psychological characteristics of medical students. J. Psychosom. Res., 35: 197-208 https://doi.org/10.1016/0022-3999(91)90074-X
  4. Christman, S.K., Fish, A.F., Frid, D.J., Smith, B.A., and Bryant, C.X. 1998. Stepping as an exercise modality for improving fitness and function. Applied Nursing Research, 11 (2):49-54 https://doi.org/10.1016/S0897-1897(98)80174-2
  5. Dallow, C.B. and Anderson, J. 2003. Using self-efficacy and a transtheoretical model to develop physical activity intervention for obese women. Am. J. Health Promot., 17(6):378-381
  6. Dishman, R.K. 1994. Advances in exercise adherence. Champaign, Illinois: Human Kinetics
  7. Edman, J.L., Yates, A., Aruguete, M.S., and DeBord, K.A. 2005. Negative emotion and disordered eating among obese college students. Eating Behaviors, 6:308-317 https://doi.org/10.1016/j.eatbeh.2005.05.004
  8. Edmunds J., Ntoumanis N., and Duda J.L. 2007. Adherence and well-being in overweight and obese patients referred to an exercise on prescription scheme: a self-determination theory perspective. Psychol. Sport. Exerc., 8(5):722-740 https://doi.org/10.1016/j.psychsport.2006.07.006
  9. Fox, K.R. 2000. Self-esteem, self-perception and exercise. Int. J. Sport. Psychol., 31 :228-240
  10. Friedman, K.E., Reichmann, S.K., Costanzo, P.R., and Musante, G.J. 2002. Body image partially mediates the relationship between obesity and psychological distress. Obes. Res., 10(1):33-41 https://doi.org/10.1038/oby.2002.5
  11. Godin, G. 1987. Importance of the emotional aspect of attitude to predict intention. Psychol. Rep., 61 :719-723 https://doi.org/10.2466/pr0.1987.61.3.719
  12. Hassmen, P., Koivula, N., and Uutela, A. 2000. Physical exercise and psychological well-beigh: A population study in Finland. Prev. Med., 30(1): 17-25 https://doi.org/10.1006/pmed.1999.0597
  13. Haynes, S.G., Feinleib, M., and Kannel, W.B. 1980. The relationship of psychosocial factors to coronary heart disease in the Framingham Study. III. Eight-year incidence of coronary heart disease. Am. J. Epidemiol., 111 :37-58 https://doi.org/10.1093/oxfordjournals.aje.a112873
  14. IOM of the National Academies of Science. 2002. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). Washington, DC: National Academy Press
  15. Jeon, K.K., Han, D.W., and Lee, J.H. 1997. Korean adaptation of the state-trait anger expression inventory. Korean J. Health Psycho., 2(1):60-78
  16. Jones, W.K. 2003. Undrstanding barriers to physical activity is a first step in removing them. Am. J. Prev. Med., 25(3 Suppl 1):2-4 https://doi.org/10.1016/S0749-3797(03)00171-5
  17. Kim, J.H., Jeong, N.H., and Nho, H.S. 2006. The effect of bench-step exercise training for 16 weeks on risk factors for metabolic syndrome in middle aged obese women with hypertension. The Kor. J. Exerc. Nurtri., 10:347-351
  18. Kim, H.J. 1994. An effect of muscle strength training program on muscle strength, muscle endurance, instrumental activities of daily living and quality of life in instrumental activities of daily living and quality of life in institutionalized elderly. Doctoral dissertation. Seoul National University, Seoul
  19. Klein, S., Burke, L.E., Bray, G.A., Blair, S., Allison, B.D., Pi-Sunyer, X., Hong, Y., and Eckel, R.H. 2004.. Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition. Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation, 110:2952-2967 https://doi.org/10.1161/01.CIR.0000145546.97738.1E
  20. Ko, Y.W. and Park, G.T. 1997. Effects on serum lipid profile after maximal exercise of two different bench-stepping training intensities in place in 40-49 healthy middle-aged women. Exerc. Sci., 6(1): 13-22
  21. Kraemer, W.J., Keuning, M., Ratamess, N.A., Volek, J.S., McCormick, M., Bush, J.A., Nindle, B.C., Gordon, S.E., Mazzetti, S.A., Newton, R.U., Gomez, A.L., Wickham, R.B., Rubin, M.R., and Hakkinen, K. 2001. Resistance training com bined with bench-step aerobics enhances women's health profile. MSSE, 259-269
  22. Lee, M.R. 2001. Predicting exercise behavior in middle-aged women: extended theory of planned behavior. J. Korean Acad. Adult. Nurs., 13(4):610-619
  23. Lee, M.R. 2004. Effects of dance exercise on exercise intention and exercise-related affect of postmenopausal women. J. Korean Acad. Nurs., 34(6):1092-1096 https://doi.org/10.4040/jkan.2004.34.6.1092
  24. Lee, P.S. and Jang, S.O. 2001. The study on the effect of stage based exercise motivational intervention program for the elderly. J. Korean Acad. Nurs., 31 (5):818-834 https://doi.org/10.4040/jkan.2001.31.5.818
  25. Lee, Y.M. 2002. The lived experiences of the middle-aged women's anger. Doctoral dissertation of Korea University
  26. Leuenberger, A. 2006. Endorphins, exercise, and addictions: a review of exercise dependence. Impulse: The premier Journal of Undergraduate Publications in the Neurosciences, 1-9
  27. McAuley, E., Courney, K.S., Rudolph, D.L., and Lox, C.L. 1994. Enhancing exercise adherence in middle-aged males and female, Prev. Med., 23:498-506 https://doi.org/10.1006/pmed.1994.1068
  28. Ministry of Health and Welfare. 2006. 2005 National Health Nutrition Survey. Ministry of Health and Welfare
  29. Netz, Y., Wu, MJ., Becker, BJ., and Tenenbaum, G. 2005. Physical activity and psychological well-being in advanced age: a meta-analysis of intervention studies. Psychol. Aging, 20(2):272-284 https://doi.org/10.1037/0882-7974.20.2.272
  30. Penedo, FJ. and Dahn, J.R. 2005. Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Curr. Opin. Psychiatry, 18(2): 189-193 https://doi.org/10.1097/00001504-200503000-00013
  31. Pender, NJ. 1996. Health promotion in nursing practice. third edition. Appleton & Lange: Stamford, Connecticut
  32. Raikkonen, K., Matthews, K.A., Kuller, L.H., Reiber, C., and Bunker, C.H. 1999. Anger, hostility, and visceral adipose tissue in healthy postmenopausal women. Metabolism, 48(9):4116-1151
  33. Raikkonen, K., Metthews, K.A., Sutton-Tyrrell, K., and Kuller, L.H. 2004. Trait anger and the metabolic syndrome predict progression of carotid atherosclerosis in healthy middle-aged women. Psychosom. Med., 66:903-908 https://doi.org/10.1097/01.psy.0000143638.31297.11
  34. Riley, N.M., Bild, D.E., Cooper, L., Schreiner, P., Smith, D.E., Sorlie, P., and Thompson, J.K. 1998. Relation of self-image to body size and weight loss attempts in black women. Am. J. Epidemiol., 148(11): 1062-1068 https://doi.org/10.1093/oxfordjournals.aje.a009583
  35. Ryu, S.M. 2005. The effects of the body image enhancement program on the body image improvement of single career women - centered on the care personnel -. Unpublished mastoral thesis of Kyungpook National University
  36. Sallis, J.F., Haskell, W.L., Fortman, S.P., Vranizan, K.M., Taylor, C.B. et al.. 1986. Predictors of adoption and maintenance of physical activity in a community sample. Prev. Med., 15:331-341 https://doi.org/10.1016/0091-7435(86)90001-0
  37. Saris, W.H., Blair, S.N., van Baak, M.A., Eaton, S.B., Davies, P.S., Pietro, L., Fogelholm, M., Rissanen, A., Schoeller, D., Swinburn, B., Tremblay, A., Westerterp, K.R., and Wyatt, H. 2003. How much physical activity is enough to prevent unhealthy weight gain? Outcome of the IASO 1st Stock Conference and consensus statement. Obes. Rev., 4:101-114 https://doi.org/10.1046/j.1467-789X.2003.00101.x
  38. Sarwer, B.B., Wadden, T.A., and Foster, G .D. 1998. Assessment of body image dissatisfaction in obese women: specificity, severity, and clinical significance. J. Consult. Clin. Psychol., 66:651-654 https://doi.org/10.1037/0022-006X.66.4.651
  39. Seo, N.S. 2003. The effect of stage based exercise program on the physical and psychological variables in stroke survivors-using the Transtheoretical mdel-. Doctoral dissertation of Chonnam National University
  40. Speck, B.J. and Looney, S.W. 2001. Effects of a minimal intervention to increase physical activity in women: daily activity records. Nurs. Res., 50:374-378 https://doi.org/10.1097/00006199-200111000-00008
  41. Triandis, H.C. 1977. Interpersonal behavior theory. Monterey, Calif: Books/Cole Publishing Co.
  42. US Department of Health and Human Services. 1996. Physical activity and health: a report of the Surgeon General. Atlanta, GA: US Department Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion
  43. Wattanakit, K. 2005. Association of anger proneness, depression and low social support with peripheral arterial disease: the atherosclerosis risk in communities study. Vase. Med., 10(3):199-206 https://doi.org/10.1191/1358863x05vm622oa
  44. Williams, J.E., Paton, C.C., Siegler, I.C., Eigenbrodt, M.L., Nieto, F.J., and Tryoler, H.A. 2000. Anger proneness predicts coronary heart disease risk. Circulation, 101 :2034-2039 https://doi.org/10.1161/01.CIR.101.17.2034
  45. World Health Organization Office for the Western Pacific (WPRO), the International Association for the Study of Obesity (IASO), and the International Obesity Task Force (IOTF) (2000). The asia-pacific perspective: redefining obesity and its treatment
  46. Yukari, M., Takuya, Y., Akira, K., Munehiro, S., and Hiroaki, T. 2005. Effect of step exercise on aerobic capacity, muscle strength of the thigh and balance in elderly. MSSE, 37(5):S95