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

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.

[1]  Jacquelyn Allen-Collinson Feminist Phenomenology and the Woman in the Running Body , 2011 .

[2]  Elizabeth E. Wheatley Discipline and Resistance: Order and Disorder in a Cardiac Rehabilitation Clinic , 2005, Qualitative health research.

[3]  Peter E. S. Freund The expressive body: a common ground for the sociology of emotions and health and illness , 1990 .

[4]  E. Tulle Running to Run: Embodiment, Structure and Agency amongst Veteran Elite Runners , 2007 .

[5]  K. Petersson,et al.  The illness experiences of patients after a first time myocardial infarction. , 2003, Patient education and counseling.

[6]  M. Poole Fit for Life: Older Women's Commitment to Exercise , 2001 .

[7]  T. Pavey,et al.  The Lived Experience of Diagnosis Delivery in Motor Neurone Disease: A Sociological-Phenomenological Study , 2013 .

[8]  A. Bryman Social Research Methods , 2001 .

[9]  C. Laz Age embodied , 2003 .

[10]  Alena Glajchová,et al.  LUPTON, Deborah (2012): Medicine as Culture. Illness, Disease and the Body in Western Societies (3rd edition). London: Sage. , 2015 .

[11]  E. Dunning,et al.  The Civilizing Process: Sociogenetic and Psychogenetic Investigations , 2000 .

[12]  Norbert Elias,et al.  The Society of Individuals , 1993 .

[13]  S. Dupuis,et al.  Leisure and Ageing Well , 2008 .

[14]  S. Mennell Norbert Elias: Civilization, and the human self-image , 1989 .

[15]  L. Mansfield,et al.  “No-Body’s Perfect”: Women, Aerobics, and the Body Beautiful , 1998 .

[16]  C. Shilling The Body And Social Theory , 1995 .

[17]  V. Taylor,et al.  A randomised controlled trial of senior Lay Health Mentoring in older people with ischaemic heart disease: The Braveheart Project. , 2004, Age and ageing.

[18]  A. Clark,et al.  Promoting participation in cardiac rehabilitation: patient choices and experiences. , 2004, Journal of advanced nursing.

[19]  Adam Evans,et al.  "Swim for Health": Program Evaluation of a Multiagency Aquatic Activity Intervention in the United Kingdom , 2013 .

[20]  E. Tulle,et al.  Acting your age? Sports science and the ageing body , 2008 .

[21]  Richard Kilminster Norbert Elias: Post-philosophical Sociology , 2007 .

[22]  Steve Robertson,et al.  Embodied masculinities in the context of cardiac rehabilitation. , 2010, Sociology of health & illness.

[23]  B. Wearing Leisure and resistance in an ageing society , 1995 .

[24]  C. Shilling The body in culture, technology and society , 2004 .

[25]  Brett Smith,et al.  Telling a (good?) counterstory of aging: natural bodybuilding meets the narrative of decline. , 2011, The journals of gerontology. Series B, Psychological sciences and social sciences.

[26]  J. Bullington Body and self: a phenomenological study on the ageing body and identity , 2006, Medical Humanities.

[27]  L. Clarke,et al.  Aging and the Body: A Review* , 2011, Canadian Journal on Aging / La Revue canadienne du vieillissement.

[28]  M. Johnson,et al.  Men making sense of their chest pain--niggles, doubts and denials. , 2000, Journal of clinical nursing.

[29]  R. Booth,et al.  Positive effects of illness reported by myocardial infarction and breast cancer patients. , 1999, Journal of psychosomatic research.

[30]  John Hockey,et al.  Grasping the Phenomenology of Sporting Bodies , 2007 .

[31]  Jacquelyn Allen-Collinson,et al.  Feeling the way: Notes toward a haptic phenomenology of distance running and scuba diving , 2011 .

[32]  F. Stuart Chapin,et al.  What is Sociology , 1918 .

[33]  M. Foucault,et al.  Discipline and Punish: The Birth of the Prison , 2020, On Violence.

[34]  M. Carlsson,et al.  Managing consequences and finding hope--experiences of Swedish women and men 4-6 months after myocardial infarction. , 2008, Scandinavian journal of caring sciences.

[35]  D. Thompson Improving cardiac rehabilitation: a view from the United Kingdom. , 2002, European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology.

[36]  Arlie Russell Hochschild,et al.  The Sociology of Emotion as a Way of Seeing in Gillian Bendelow and Simon J , 2002 .

[37]  R. Wiles,et al.  Patients' perceptions of their heart attack and recovery: the influence of epidemiological "evidence" and personal experience. , 1998, Social science & medicine.

[38]  E. Tulle,et al.  The Ageing Body and the Ontology of Ageing: Athletic Competence in Later Life , 2008 .

[39]  Brett Smith,et al.  Judging the quality of qualitative inquiry: Criteriology and relativism in action , 2009 .

[40]  Eric Dunning,et al.  Sport Matters: Sociological Studies of Sport, Violence, and Civilization , 2002 .

[41]  R. Dionigi,et al.  Competitive Sport as Leisure in Later Life: Negotiations, Discourse, and Aging , 2006 .

[42]  J. Maguire Body Lessons , 2002 .

[43]  Nina Baur,et al.  Towards a Process-Oriented Methodology: Modern Social Science Research Methods and Norbert Elias's Figurational Sociology , 2011 .

[44]  M. Rebecca Genoe,et al.  Leisure as resistance within the context of dementia , 2010 .

[45]  M. Bury Chronic illness as biographical disruption. , 1982, Sociology of health & illness.

[46]  C. Campbell,et al.  “Maybe It Could Be a Heart Attack . . . But I'm Only 31”: Young Men's Lived Experience of Myocardial Infarction—An Exploratory Study , 2009, American journal of men's health.

[47]  International Review for the Sociology of Sport , 1984 .

[48]  薄葉 毅史,et al.  The Established and the Outsiders : A Sociological Enquiry into Community Problems. By Norbert Elias and John L. Scotson, 1994(First Edition 1965) Sage Publications. , 1997 .

[49]  J. Hutton,et al.  A qualitative study of men's experience of myocardial infarction , 2008, Psychology, health & medicine.

[50]  C. Phoenix,et al.  Expanding the agenda for research on the physically active aging body. , 2009, Journal of aging and physical activity.

[51]  M. Sleap,et al.  "You feel like people are looking at you and laughing": older adults' perceptions of aquatic physical activity. , 2012, Journal of aging studies.

[52]  B. Hølge-Hazelton [The loneliness of the dying]. , 1994, Sygeplejersken.

[53]  J. Krantz,et al.  The birth of the clinic. An archaeology of medical perception , 1975, Medical History.

[54]  Mike Featherstone,et al.  Images of aging: cultural representations of later life , 1995 .

[55]  C. Berterö,et al.  You can do it if you set your mind to it: a qualitative study of patients with coronary artery disease. , 2001, Journal of advanced nursing.

[56]  Norbert Elias,et al.  The established and the outsiders : a sociological enquiry into community problems , 1966 .

[57]  M. Carlsson,et al.  Striving for balance in daily life: experiences of Swedish women and men shortly after a myocardial infarction. , 2007, Journal of clinical nursing.

[58]  M. Visser,et al.  Explaining the Decline in Coronary Heart Disease Mortality in the Netherlands between 1997 and 2007 , 2016, PloS one.

[59]  G. Furze,et al.  Health-related quality of life after myocardial infarction: an interview study. , 2001, Journal of advanced nursing.

[60]  P. Higgs,et al.  ‘Ageing well’: Competing discourses and tensions in the management of knee pain , 2011 .

[61]  S. Katz Busy Bodies: Activity, aging, and the management of everyday life , 2000 .

[62]  Norbert Elias,et al.  Involvement And Detachment , 1987 .

[63]  Darrin Hodgetts Male Bodies: Health, Culture and Identity , 2001, Journal of health psychology.

[64]  Elizabeth E. Wheatley Disciplining Bodies at Risk , 2005 .

[65]  G. Jarvie,et al.  Sport and leisure in social thought , 1996 .

[66]  Jacquelyn Allen-Collinson,et al.  Sporting embodiment: sports studies and the (continuing) promise of phenomenology , 2009 .

[67]  Eric Dunning,et al.  Sport Matters: Sociological Studies of Sport, Violence and Civilisation , 1999 .

[68]  T. Csordas Somatic Modes of Attention , 1993 .

[69]  Rn Alan K. White BSc,et al.  Men making sense of their chest pain--niggles, doubts and denials. , 2000 .

[70]  R. Galvin Disturbing Notions of Chronic Illness and Individual Responsibility: Towards a Genealogy of Morals , 2002 .

[71]  D. Leder The Absent Body , 1990 .

[72]  Maxim J. Schlossberg,et al.  Quest for Excitement: Sport and Leisure in the Civilizing Process. , 1987 .

[73]  D. Meagher-stewart,et al.  The uncertain journey: women's experiences following a myocardial infarction. , 2003, Canadian journal of cardiovascular nursing = Journal canadien en soins infirmiers cardio-vasculaires.

[74]  Ian Jones,et al.  Research Methods for Sports Studies , 2003 .

[75]  F. McGowan The Body in Society: An Introduction , 2005 .

[76]  E. Tulle,et al.  Back from the brink: ageing, exercise and health in a small gym , 2011, Ageing and Society.

[77]  S. Ebrahim,et al.  Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. , 2004, The American journal of medicine.

[78]  James M. Morley Inspiration and Expiration: Yoga Practice Through Merleau-Ponty's Phenomenology of the Body , 2001 .

[79]  CASSANDRA PHOENIX,et al.  Narratives at work: what can stories of older athletes do? , 2011, Ageing and Society.

[80]  M. Al-Hassan,et al.  Stress and stressors of myocardial infarction patients in the early period after discharge. , 2002, Journal of advanced nursing.

[81]  R. D'amico Discipline and Punish: The Birth of the Prison , 1978, Telos.

[82]  Jacquelyn Allen-Collinson,et al.  Take a deep breath: Asthma, sporting embodiment, the senses and ‘auditory work’ , 2014 .

[83]  Deborah Lupton Medicine as Culture: Illness, Disease and the Body , 2012 .

[84]  Norbert Elias Time: An Essay , 1993 .

[85]  Simon Capewell,et al.  Explaining the Decline in Coronary Heart Disease Mortality in England and Wales Between 1981 and 2000 , 2004, Circulation.