Exercise Program 10 Minutes per Patient

Patients take part in a home-based, self-paced, exercise program of 5-8 different exercise sets. An individual baseline for each set is agreed in an initial session with a physiotherapist. A time limit of 10 minutes is set because one of the main reasons given by patients for stopping their exer cising program after CR is "no time": no one can claim not to have 10 minutes free once or twice during the day. The training effect comes from increasing the number of repetitions in that fixed time. Patients are asked to practice at least once per day. Initial levels are deliberately set low because of the behavioral laws that: (1) behaviors that are punished, (through pain, tiredness, soreness, etc.) die out; and (2) the easier it is, the more likely it is they will succeed, thus rewarding them and raising their self-efficacy for exercise at the same time. They rate each exercise on a 10 cm line on two qualities: (1) on a scale "very pleas-ant"/"very unpleasant" and (2) as "very high effort"/"very low effort." The center of both lines is marked as "just right." They record their program on charts and score each set on both 10 cm lines on each occasion. As they become fitter, the effort scores become easier, and after 3 successive days of scoring a set lower on effort than "just right" they can add one extra repetition to the number of repetitions for that exercise but only if the new level chosen would still be "about right" on the pleasant/unpleasant line: no pain, more gain!

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