Exercise rehabilitation is recommended increasingly for patients with chronic obstructive pulmonary disease (COPD). This study examined the effect of exercise and education on 79 older adults (M age = 66.6 +/- 6.5 years; 53% female) with COPD, randomly assigned to 10 weeks of (a) exercise, education, and stress management (EXESM; n = 29); (b) education and stress management (ESM; n = 25); or (c) waiting list (WL; n = 25). EXESM included 37 sessions of exercise, 16 educational lectures, and 10 weekly stress management classes. ESM included only the 16 lectures and 10 stress management classes. Before and after the intervention, assessments were conducted of physiological functioning (pulmonary function, exercise endurance), psychological well-being (depression, anxiety, quality of life), and cognitive functioning (attention, motor speed, mental efficiency, verbal processing). Repeated measures multivariate analysis of variance indicated that EXESM participants experienced changes not observed among ESM and WL participants, including improved endurance, reduced anxiety, and improved cognitive performance (verbal fluency).

This study evaluated outcomes of self-directed exercise activity on cognitive functioning and psychological well-being among 28 adults with chronic obstructive pulmonary disease (COPD). Participants had completed an intensive 10-week program of exercise training and were given an exercise prescription to follow. One year later, participants completed comprehensive assessments of physical, cognitive, and psychological functioning. At follow-up, 39% (n=11) had continued with a regular program of moderate intensity exercise. Repeated measures analysis of variance indicated that exercise adherent participants maintained gains they had achieved in the initial exercise intervention, but nonexercise participants experienced declines in functional capacity, cognitive performance, and psychological well-being. Continued exercise among patients with COPD is associated with maintenance of physical, cognitive, and psychological functioning.

Although some women report having little pain or discomfort during mammography, other women find mammography to be a painful and uncomfortable experience. Cognitive and behavioral factors may influence the perception of pain and discomfort during mammography. This review critically evaluates the research on mammography pain from a cognitive-behavioral perspective. The review is in three sections. The first reviews studies measuring pain and discomfort in women who have recently had mammograms and studies investigating the relative importance of pain and discomfort in influencing women's decisions to have a mammogram. The second section presents a cognitive-behavioral model of mammography pain that is based on theories of behavior and self-regulation developed by Kanfer and Hagerman (1987). The review concludes with a discussion of the implications of the cognitive-behavioral perspective for clinical management and research on mammography pain and discomfort.

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