‘Some of these people aren’t as fit as us …’: experiencing the ageing, physically active body in cardiac rehabilitation

Abstract

There is a dearth of research on how the physically active body is experienced during rehabilitation from serious illness. The present study investigated older adults’ embodied experiences and changing perceptions of self in one cardiac rehabilitation (CR) scheme in the East of England. Fourteen interviews were completed with participants in a CR scheme. A figurational approach was utilised which emphasised the need for participants to delineate their own logic of experience from the perspective of their active body during CR. Data were thematically analysed and individual experiences were situated in wider power relationships within and beyond the exercise class. Recurring themes emerged including participants’ perceptions of lost control during illness, the centrality of embodied sensations during rehabilitation and the interdependence of their embodied experiences with those of other bodies through overt and covert monitoring of physiological, emotional and psychological responses to rehabilitation. During rehabilitation, participants negotiated a complex interweaving of identities which centred upon their changing sense of embodied ‘I’ in relation to other bodies in the rehabilitation figuration, who were conceptualised according to fluid ‘we’ and ‘them’ relationships. Self-images were socially produced and moderated by health and exercise professionals and other participants. The extent to which participants were empowered within the exercise setting was highly heterogeneous. Findings suggest that the messages participants receive about CR must reflect the heterogeneity of recovery trajectories that could be experienced

Recovery From Heart Attack, Biomedicalization, and the Production of a Contingent Health Citizenship

“…This is far from straightforward, however, with figures around 50% for adherence to drug and lifestyle regimes following a heart attack (ibid). There is evidence of a tension between biomedical regimes of recovery from heart attack (and its associated health governmentality) and individual experiences and strategies (Evans & Crust, 2015;Wiles, 1998;Robertson, Sheikh & Moore, 2010). In their study of older patients' experience of cardiac rehabilitation, Evans & Crust (2015: 30) highlight the processual nature of rehabilitation and "changing 'I' identities", with participants negotiating multiple -sometimes competing -embodied identities.…”

“…Evans & Crust, 2015;Robertson, Sheikh & Moore, 2010), alongside the body of work from nursing and physiotherapy on a variety of therapeutic aspects of cardiac recovery care (e.g. Hanssen, Nordrehaug, Eide & Hanestad, 2009;O'Driscoll, Shave, Cushion, 2007;Salminen-Tuomaala, Astedt-Kurki, Rekiaro & Paavillainen, 2012).…”

Personal goals, group performance and ‘social’ networks: participants’ negotiation of virtual and embodied relationships in the ‘Workplace Challenge’ physical activity programme

“…It was unclear, for example, whether some participants took part for 'me,' for 'us,' or in order to compete with 'them.' This created a virtual-social hierarchy based upon performance which simultaneously created an 'I-We' identity where shared experiences were emphasised through face-to-face relationships, and an 'I-in-relationto-Them' identity in which participants sought to rationalise their own experiences in relation to both colleagues and virtual participants (Evans and Crust, 2014). Participants' autonomy within the WPC was contoured by their interdependence with others in enabling and constraining ways.…”

“…Moreover, outsider groups often accept the established group's characterisation of them (Elias and Scotson, 1994). These inter-and intra-group relationships have been shown to have a significant impact upon the experiences of being physically active, for example in terms of gendered activities (Maguire and Mansfield, 1998), class-based marginalisation (Lake, 2013) and amongst ageing populations Crust, 2014, Evans andSleap, 2012).…”

“…Indeed, the body plays a significant part in the figurational theoretical framework as a spatial and temporal fulcrum around which social processes act (Evans and Crust, 2014). The body, as a bearer of identity, is both acted upon by social, or sociogenetic processes, at the same time as social processes are constituted by the actions of individual bodies enacted through psychogenetic processes (Elias and Schröter, 1991).…”