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Meyer JD, Perkins SL, Gidley JM, Kuzniar JM, Phillips LA, Lansing JL, Wade NG, Herring MP, Lefferts WK. Feasibility and preliminary efficacy of a theory-informed resistance exercise training single-arm intervention for major depression. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 73:102642. [PMID: 38615899 DOI: 10.1016/j.psychsport.2024.102642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/27/2024] [Accepted: 04/05/2024] [Indexed: 04/16/2024]
Abstract
Many adults with major depressive disorder (MDD) do not receive effective treatment. The potential benefits of resistance exercise training (RET) are understudied and may be mechanistically related to cerebral blood flow changes. PURPOSE To assess feasibility, acceptability, and preliminary efficacy of a 16-week, theory-informed RET trial for the treatment of MDD and explore changes in cerebral blood flow. METHODS Ten adults with DSM-5-diagnosed MDD were enrolled in a single-arm, 16-week, twice-weekly, whole-body RET intervention, consistent with US and WHO Physical Activity resistance exercise guidelines. To build intrinsic motivation and develop exercise-preparatory habits, motivators and commitment were discussed weekly. Screening, enrollment, and intervention attendance and compliance rates documented feasibility. At baseline and weeks 8, 16, and 26, current MDD diagnosis, clinician-rated, and self-reported symptom severity were evaluated along with cerebral blood flow which was assessed as middle cerebral artery (MCA) mean blood velocity, conductance, and pulsatility. RESULTS Nine participants completed the intervention. Strong feasibility and acceptability (98 % adherence, 93 % compliance, and 90 % retention) were found. MDD remission was reached by 8/9 participants at week 16 and persisted through week 26. There were large decreases in clinician-rated and self-reported symptoms at each assessment (Hedges' g = 0.84-2.13). There were small-to-moderate increases in MCA velocity (g = 0.32-0.57) and conductance (g = 0.20-0.76) across time, with minimal changes in pulsatility (all g < 0.21). CONCLUSIONS Preliminary results suggest RET for MDD treatment is feasible and plausibly efficacious, finding large antidepressant effects. A sufficiently powered randomized controlled trial to assess RET's efficacy for treating MDD via potential cerebrovascular mechanisms is warranted.
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Affiliation(s)
- Jacob D Meyer
- Iowa State University, 534 Wallace Rd., Ames, IA, 50014, USA.
| | - Seana L Perkins
- Iowa State University, 534 Wallace Rd., Ames, IA, 50014, USA
| | - John M Gidley
- Iowa State University, 534 Wallace Rd., Ames, IA, 50014, USA
| | | | | | - Jeni L Lansing
- Iowa State University, 534 Wallace Rd., Ames, IA, 50014, USA
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Große J, Huppertz C, Röh A, Oertel V, Andresen S, Schade N, Goerke-Arndt F, Kastinger A, Schoofs N, Thomann PA, Henkel K, Malchow B, Plag J, Terziska A, Brand R, Helmig F, Schorb A, Wedekind D, Jockers-Scherübl M, Schneider F, Petzold MB, Ströhle A. Step away from depression-results from a multicenter randomized clinical trial with a pedometer intervention during and after inpatient treatment of depression. Eur Arch Psychiatry Clin Neurosci 2024; 274:709-721. [PMID: 37589727 PMCID: PMC10995038 DOI: 10.1007/s00406-023-01646-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/07/2023] [Indexed: 08/18/2023]
Abstract
Evidence for the effectiveness of physical activity (PA) in the treatment of depression prevails for outpatients with mild and moderate symptom levels. For inpatient treatment of severe depression, evidence-based effectiveness exists only for structured and supervised group PA interventions. The Step Away from Depression (SAD) study investigated the effectiveness of an individual pedometer intervention (PI) combined with an activity diary added to inpatient treatment as usual (TAU). In this multicenter randomized controlled trial, 192 patients were randomized to TAU or TAU plus PI. The two primary outcomes at discharge were depression-blindly rated with the Montgomery-Åsberg Depression Rating Scale (MADRS)-and average number of daily steps measured by accelerometers. Secondary outcomes were self-rated depression and PA, anxiety, remission and response rates. Multivariate analysis of variance (MANOVA) revealed no significant difference between both groups for depression and daily steps. Mean MADRS scores at baseline were 29.5 (SD = 8.3) for PI + TAU and 28.8 (SD = 8.1) for TAU and 16.4 (SD = 10.3) and 17.2 (SD = 9.9) at discharge, respectively. Daily steps rose from 6285 (SD = 2321) for PI + TAU and 6182 (SD = 2290) for TAU to 7248 (SD = 2939) and 7325 (SD = 3357). No differences emerged between groups in secondary outcomes. For severely depressed inpatients, a PI without supervision or further psychological interventions is not effective. Monitoring, social reinforcement and motivational strategies should be incorporated in PA interventions for this population to reach effectiveness.
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Affiliation(s)
- Julia Große
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
| | - Charlotte Huppertz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Astrid Röh
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Viola Oertel
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Frankfurt/Main, Frankfurt am Main, Germany
| | - Sara Andresen
- Fachklinik für Psychiatrie, Psychosomatik und Psychotherapie Flensburg der DIAKO NF, Flensburg, Germany
| | - Niklas Schade
- Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Franziska Goerke-Arndt
- Department of Psychiatry and Psychotherapy, Oberhavel Kliniken GmbH, Hennigsdorf, Germany
| | - Anna Kastinger
- Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Paracelsus Medical University, Salzburg, Austria
| | - Nikola Schoofs
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | | | - Karsten Henkel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
| | - Jens Plag
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Aleksandra Terziska
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Ralf Brand
- Sport and Exercise Psychology, University of Potsdam, Potsdam, Germany
| | - Frank Helmig
- Fachklinik für Psychiatrie, Psychosomatik und Psychotherapie Flensburg der DIAKO NF, Flensburg, Germany
| | - Alexander Schorb
- Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Paracelsus Medical University, Salzburg, Austria
| | - Dirk Wedekind
- Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
| | - Maria Jockers-Scherübl
- Department of Psychiatry and Psychotherapy, Oberhavel Kliniken GmbH, Hennigsdorf, Germany
| | - Frank Schneider
- University Hospital, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Moritz Bruno Petzold
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Psychology, Medical School Berlin, Berlin, Germany
| | - Andreas Ströhle
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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Whitworth JW, Checko ER, Rosenbaum S. Editorial: Lifestyle interventions for traumatic stress (LIFTS). Front Psychol 2024; 15:1367344. [PMID: 38328378 PMCID: PMC10848493 DOI: 10.3389/fpsyg.2024.1367344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 02/09/2024] Open
Affiliation(s)
- James W. Whitworth
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, United States
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Erica R. Checko
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, United States
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Simon Rosenbaum
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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Seiffer B, Rösel I, Welkerling J, Schuch FB, Sudeck G, Wolf S. The association of changes in leisure-time physical activity on depressive symptoms during Covid-19 in German adults: A longitudinal study. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 70:102562. [PMID: 37956817 DOI: 10.1016/j.psychsport.2023.102562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/12/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023]
Abstract
This longitudinal survey assessed preventive and curative antidepressant effects of at least 75 min/week of leisure-time physical activity (LTPA) at different timepoints of the Covid-19 pandemic. We further investigated if high self-regulation skills were associated with higher odds of initiating or maintaining LTPA during the pandemic. Data was collected online from 4253 participants (age: m = 33.65 years, SD = 0.79; 79 % female) during the first quarantine measures in Germany (T1), as well as 4 weeks (T2), and 8 months (T3) later. We performed linear mixed models with changes (T2-T1, T3-T1) in LTPA and baseline major depressive disorder (MDD) as predictors (main effects and interaction effect) and depressive symptoms (at T2, T3) as the primary outcome. We found significant interaction effects of baseline depression and change in LTPA on depressive symptoms at T2 and T3 (p < 0.001). For probable cases of MDD an increasing LTPA to ≥75 min/week (vs. no change, <75 min/week) was associated with less depressive symptoms at T2 and T3 (p = 0.003, d = 0.28). For absence of depression at baseline, remaining at ≥75 min/week of LTPA was associated with less depressive symptoms at T2 and T3 compared to remaining at <75 min/week (p = 0.006, d = 0.11) or decreasing LTPA to <75 min/week (p = 0.018, d = 0.11). Reporting high self-regulation at T1 was associated with higher odds of performing ≥75 min/week of LTPA at T2/T3 (OR = 1.74, p < 0.001). In general, studies report reduced LTPA during Covid-19. To benefit from the reported preventive and interventional effects, further interventions should focus on improving physical activity related self-regulation to identify and overcome barriers for LTPA.
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Affiliation(s)
- Britta Seiffer
- Institute of Sports Science, University of Tuebingen, 72074, Tuebingen, Germany.
| | - Inka Rösel
- Institute for Clinical Epidemiology and Applied Biometry, University Hospital Tuebingen, 72076, Tuebingen, Germany; Institute for General Practice and Interprofessional Care, University Hospital Tuebingen, 72076, Tuebingen, Germany
| | - Jana Welkerling
- Institute of Sports Science, University of Tuebingen, 72074, Tuebingen, Germany
| | - Felipe Barreto Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, 97105-900, Santa Maria, Brazil; Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Institue of Health Sciences, Universidad Autônoma de Chile, Providência, Chile
| | - Gorden Sudeck
- Institute of Sports Science, University of Tuebingen, 72074, Tuebingen, Germany
| | - Sebastian Wolf
- Institute of Sports Science, University of Tuebingen, 72074, Tuebingen, Germany
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SantaBarbara NJ, Swendeman D, Arnold EM, Nosrat S, Comulada WS. Exercise preferences for young people at-risk for and living with HIV: a short report. AIDS Care 2023; 35:1830-1835. [PMID: 36200381 PMCID: PMC10076448 DOI: 10.1080/09540121.2022.2128161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 09/14/2022] [Indexed: 10/10/2022]
Abstract
Exercise can improve physical and mental health for young people at risk for and with HIV, but prevalence rates remain low. This study explored exercise preferences and barriers among young people at risk for and with HIV, and potential gender differences. A total of 129 participants (66.7% male, mean age = 23.8 [SD = 2.1; range: 19-28], 35.7% Black/African American) at-risk for or with HIV were recruited from a larger study and completed an online survey of exercise preferences and barriers. Overall, participants preferred an exercise program that takes place at a fitness center, occurs alone, has a coach/instructor present, is between 30 and 60 minutes, lasts longer than 8 weeks, and includes aerobic and resistance exercises. The fatiguing nature of exercise and cost were common barriers among all genders. Few gender differences emerged. These results should be used to design exercise programs for young adults at risk for and with HIV.
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Affiliation(s)
- Nicholas J. SantaBarbara
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 10920 Wilshire Blvd, Suite 350, Los Angeles, CA 90024
- School of Health Sciences, Merrimack College, 315 Turnpike Street, North Andover, MA, 01845
| | - Dallas Swendeman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 10920 Wilshire Blvd, Suite 350, Los Angeles, CA 90024
| | - Elizabeth Mayfield Arnold
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd #303, Dallas, TX, 75390
| | - Sanaz Nosrat
- Department of Health Sciences, Lehman College/CUNY, 250 Bedford Park Boulevard Bronx, NY, 10468
| | - Warren Scott Comulada
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 10920 Wilshire Blvd, Suite 350, Los Angeles, CA 90024
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McGuinness C, Nordstokke D. Mindful self-care and resilience in first-year undergraduate students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2569-2577. [PMID: 34591744 DOI: 10.1080/07448481.2021.1978463] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 07/09/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Post-secondary students experience elevated levels of academic stress. The objective of the current study is to examine the relationship between a three factor model of resilience (ie, mastery, emotionality reactivity, and relatedness), mindful self-care and flourishing in first-year undergraduate students. PARTICIPANTS A sample (n = 177) of first-year undergraduates were recruited from a large urban university in Alberta during the 2019-2020 academic year. METHOD A multiple regression analysis was utilized to examine whether the three-factor model of resilience and mindful self-care predicted flourishing in undergraduate students. RESULTS Self-reported resilience significantly predicted flourishing. Specifically, a sense of mastery and a sense of relatedness was positively associated with flourishing. Additionally, mindful self-care significantly predicted flourishing. Specifically, supportive relationships and supportive structure. CONCLUSIONS University demands are significant and academic stress reduction interventions should be offered to support students entering post-secondary education.
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Affiliation(s)
- Claire McGuinness
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
| | - David Nordstokke
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
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Hwang DJ, Koo JH, Kim TK, Jang YC, Hyun AH, Yook JS, Yoon CS, Cho JY. Exercise as an antidepressant: exploring its therapeutic potential. Front Psychiatry 2023; 14:1259711. [PMID: 37772067 PMCID: PMC10523322 DOI: 10.3389/fpsyt.2023.1259711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
The COVID-19 pandemic has increased the prevalence of depressive disorders worldwide, requiring alternative treatments beyond medication and psychotherapy. Exercise has positive effects on the brain; therefore, it has emerged as a promising therapeutic option for individuals with depression. Considerable research involving humans and animals offers compelling evidence to support the mental health benefits of physical activity or exercise mediated by the regulation of complex theoretical paradigms. However, challenges such as conducting long-term follow-up assessments and considering individual characteristics remain in human studies despite extensive efforts. While animal studies provide valuable insights into the potential benefits of exercise and its impact on outcomes related to depression and anxiety in rodents exposed to different stress paradigms, translating the findings to humans requires careful evaluation. More research is needed to establish precise exercise prescription guidelines and to better understand the complex relationship between exercise and depressive disorders. Therefore, this concise review explores the evidence supporting exercise intervention as an antidepressant treatment and its underlying mechanisms.
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Affiliation(s)
- Dong-Joo Hwang
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Republic of Korea
- Sport Science Institute, Korea National Sport University, Seoul, Republic of Korea
| | - Jung-Hoon Koo
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Republic of Korea
| | - Tae-Kyung Kim
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Republic of Korea
- Sport Science Institute, Korea National Sport University, Seoul, Republic of Korea
| | - Yong-Chul Jang
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Republic of Korea
| | - Ah-Hyun Hyun
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Republic of Korea
| | - Jang-Soo Yook
- Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, Republic of Korea
| | - Chang-Sun Yoon
- Department of Physical Education, Korea National Sport University, Seoul, Republic of Korea
| | - Joon-Yong Cho
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Republic of Korea
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Pebole MM, Singleton CR, Hall KS, Petruzzello SJ, Alston RJ, Whitworth JW, Gobin RL. Impact of Military Affiliation on Exercise Perceptions Among Survivors of Sexual Violence. Mil Med 2023; 188:e2257-e2265. [PMID: 36653919 DOI: 10.1093/milmed/usac431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/06/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Military service members disproportionately experience sexual violence (SV) and its related health concerns. Although recent work has shown physical activity to be an effective strategy for improving physical and mental health among trauma-exposed military populations, little of this work has focused specifically on military service members with a history of SV. To address these gaps in knowledge and practice, this study identified the most salient perceived benefits/barriers of exercise among men and women survivors of SV with military affiliations. Additionally, these analyses explore willingness to engage in exercise programs, and preferences for the structure/content of these programs, among men and women survivors of SV with military affiliations. MATERIALS AND METHODS An online, cross-sectional survey of women (n = 355) and men (n = 198) survivors of SV was completed using Amazon Mechanical Turk. Inclusion criteria were men and women, age between 18 and 65 years, self-reported history of SV, and located in the United States. Information on sociodemographics and post-traumatic stress disorder symptoms was collected alongside perceived barriers and benefits to exercise, willingness to engage in exercise programs, and preferences for the structure/content of these programs. Analyses were stratified by sex. Comparisons by history of military involvement (active duty military or veteran; no military involvement/civilian) were reported. RESULTS Both military-involved men (n = 68) and women (n = 139) were more likely to prefer at-home and online exercise options when compared to civilians (Ps < .05; Cramer's Vs 0.19-0.36). Additionally, both men and women with military involvement reported strongly favoring exercising with an instructor over no instructor and preferred that this instructor identifies with their same gender (Ps < .01; Cramer's Vs 0.28-0.36). Women with military involvement also preferred shorter program durations and exercising alone or in a group online or in person, whereas men with military involvement were open to longer program durations, when compared to their civilian counterparts (Ps < .05; Cramer's Vs 0.19-0.37). Women and men with military involvement were more likely than their civilian counterparts to perceive that exercise benefits their psychological outlook and social interactions. They were also more likely than civilians to indicate poor exercise environment, high time expenditure, and family discouragement as perceived barriers to exercise (Ps < .05; Cohen's ds 0.21-0.97). Military-involved women were also more likely than civilian women to endorse the perceived barrier of hard physical exercise (P < .05; Cohen's d = 0.25). CONCLUSIONS This study identified perceived benefits and barriers to exercise, along with willingness to engage in exercise programs, and exercise preferences among men and women survivors of SV with military involvement. Targeting these factors in intervention planning will be important for physical activity promotion and program engagement among veterans to reduce the disproportionate impact of SV and disease burden among U.S. service members and veterans.
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Affiliation(s)
- Michelle M Pebole
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, MA 02130, USA
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61280, USA
| | - Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA
| | - Katherine S Hall
- Department of Medicine, Duke University, Durham, NC 27710, USA
- Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Healthcare System, Durham, NC 27705, USA
| | - Steven J Petruzzello
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61280, USA
| | - Reginald J Alston
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61280, USA
| | - James W Whitworth
- National Center for PTSD, Behavioral Science Division, Veterans Affairs Boston Healthcare System, 150 S Huntington Ave, Boston, MA 02130, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
| | - Robyn L Gobin
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61280, USA
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Rethorst CD, Trombello JM, Chen P, Carmody TJ, Lazalde A, Trivedi MH. Adaption of tele-behavioral activation to increase physical activity in depression: Protocol for iterative development and evaluation. Contemp Clin Trials Commun 2023; 33:101103. [PMID: 37128575 PMCID: PMC10147965 DOI: 10.1016/j.conctc.2023.101103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/13/2023] [Accepted: 03/10/2023] [Indexed: 05/03/2023] Open
Abstract
Background Poor treatment outcomes, disease recurrence, and medical co-morbidities contribute to the significant burden caused by depressive disorders. Increasing physical activity in persons with depression has the potential to improve both depression treatment outcomes and physical health. However, evidence for physical activity interventions that can be delivered as part of depression treatment remains limited. This study will examine a Behavioral Activation teletherapy intervention adapted to include a specific focus on increasing physical activity. Methods The two-phase study will include a preliminary pilot study (n = 15) to evaluate and refine the manualized intervention using a mixed-methods approach followed by a single-arm study to evaluate feasibility and preliminary efficacy of the adapted BA teletherapy. Participants will be adults, age 18-64, with moderate to severe depressive symptoms (defined as a PHQ-9 score ≥10) and who currently engage in 90 min or less of moderate-to-vigorous physical activity. Individuals will be excluded if they have a current or past manic or hypomanic episode, psychosis, schizophrenia or schizophreniform disorder, or active suicidal ideation, or if not medically-cleared to exercise. The BA intervention will consist of 8 weekly sessions, followed by 2 bi-weekly booster sessions. Feasibility outcomes will include metrics of screening, enrollment, intervention adherence and fidelity, and participant retention. Intervention preliminary efficacy will be evaluated through assessment of changes in depressive symptoms and moderate-to-vigorous physical activity. Conclusion Data from this trial will be used to support the conduct of a randomized controlled trial to evaluate the efficacy of the adapted BA intervention.
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Affiliation(s)
- Chad D. Rethorst
- Institute for Advancing Health through Agriculture, Texas A&M Agrilife Research, Dallas, TX, USA
- Corresponding author. Texas A&M Agrilife Research and Extension Center, Dallas 17360 Coit Rd, Dallas, TX, 75252.
| | - Joseph M. Trombello
- Janssen Research and Development, Titusville, NJ, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Patricia Chen
- Peter O'Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas J. Carmody
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Madhukar H. Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Perkins SL, Cook DB, Herring MP, Meyer JD. Dose-response effects of acute exercise intensity on state anxiety among women with depression. Front Psychiatry 2023; 14:1090077. [PMID: 37252133 PMCID: PMC10213268 DOI: 10.3389/fpsyt.2023.1090077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 04/17/2023] [Indexed: 05/31/2023] Open
Abstract
Anxiety is common in people with major depressive disorder (MDD), yet the anxiolytic effects of acute exercise in MDD are unknown. The purpose of this analysis was to determine a potentially optimal acute exercise intensity for reducing state anxiety in women with MDD, the duration of the response, and the potential influences of depression severity and preferred-intensity exercise. Using a within-subject, randomized, counter-balanced design, 24 participants completed five separate visits including 20 min of steady-state bicycling at prescribed (via RPE) light, moderate, or hard intensities, a preferred/self-selected session, or a quiet rest (QR) session. State anxiety was measured via the State-Trait Anxiety Inventory (STAI-Y1) and anxiety visual analog scale (VAS) at pre-, immediately (VAS only), 10 min, and 30 min post-exercise. Depression was measured via the Beck Depression Inventory (BDI-II) pre-exercise. Moderate exercise resulted in a moderate state anxiety reduction compared to QR 10 min (STAI-Y1: g = 0.59, padj = 0.040) and 30 min post-exercise (STAI-Y1: g = 0.61, padj = 0.032). Pairwise differences indicated each exercise session decreased state anxiety pre to 10 min and 30 min post-exercise (all padj < 0.05) for the STAI-Y1, and for moderate and hard exercise from pre to each time point post-exercise (all padj < 0.05) for the VAS. Depression severity was associated with state anxiety (p < 0.01) but did not influence the overall results. Prescribed moderate intensity exercise led to greater reductions in state anxiety compared to preferred at 30 m (STAI-Y1: g = 0.43, p = 0.04). These findings suggest steady-state prescribed moderate exercise reduces state anxiety in women with MDD for at least 30 min following exercise regardless of their depression severity.
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Affiliation(s)
- Seana L. Perkins
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Dane B. Cook
- Department of Kinesiology, University of Wisconsin, Madison, WI, United States
| | - Matthew P. Herring
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Jacob D. Meyer
- Department of Kinesiology, Iowa State University, Ames, IA, United States
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11
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Gilbert C, Earleywine M, Altman BR. Undergraduate student perceptions of cognitive behavioral therapy, aerobic exercise, and their combination for depression. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 36862695 DOI: 10.1080/07448481.2023.2185461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 01/21/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Both aerobic exercise and Cognitive Behavioral Therapy (CBT) improve depression, but perceptions of their credibility and efficacy are underexplored. These perceptions can contribute to treatment seeking and outcome. A previous online sample ranging in age and education rated a combined treatment higher than individual components and underestimated their efficacy. The current study is a replication exclusively focused on college students. PARTICIPANTS Undergraduates (N = 260) participated during the 2021-2022 school year. METHODS Students reported impressions of each treatment's credibility, efficacy, difficulty, and recovery rate. RESULTS Students viewed combined therapy as potentially better, but also more difficult, and underestimated recovery rates, replicating previous work. Their efficacy ratings significantly underestimated both meta-analytic estimates and the previous sample's perceptions. CONCLUSIONS Consistent underestimation of treatment effectiveness suggests that realistic education could prove especially beneficial. Students might be more willing than the broader population to accept exercise as a treatment or adjunct for depression.
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Affiliation(s)
- Cody Gilbert
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
| | - Mitch Earleywine
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
| | - Brianna R Altman
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
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12
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Uebelacker LA, Epstein-Lubow G, Sillice MA, O'Keeffe B, Kraines M, Battle CL, Anderson B, Miller IW, Abrantes AM. Project MOVE: A randomized controlled trial of Interventions for initiating and maintaining physical activity in depressed individuals. Ment Health Phys Act 2023; 24:100508. [PMID: 36967813 PMCID: PMC10032365 DOI: 10.1016/j.mhpa.2023.100508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Objective To test interventions for increasing aerobic exercise in depressed individuals. Methods We conducted a 3-arm randomized controlled trial aimed at increasing minutes of moderate-to-vigorous physical activity (MVPA) in depressed adults (N = 242). Each successive arm included an added component that might serve to increase and maintain physical activity. Arms were: 1) Brief advice (BA) to aerobic exercise; 2) BA + supervised and home-based aerobic exercise (SHE) + health education (HE); and 3) BA + SHE +cognitive-behavioral sessions focused on increasing and maintaining aerobic exercise (CBEX). HE was intended to serve as a control for CBEX. Assessments were conducted at baseline, Month 1.5, end of intervention (Month 3), Month 6, and Month 9. The primary outcome of MVPA was assessed via accelerometry. Secondary outcomes included self-reported MVPA, depression severity, and other aspects of mood and affect. Results At 3 months (the pre-designated primary outcome timepoint), the simple effect of treatment was statistically significant (F2, 569.0 = 4.17, p = .016), with BA+SHE+CBEX being superior to BA. We did not observe differences between BA+SHE+HE and either of the other arms. There were no statistically significant differences between treatment groups at 6- or 9-months. Treatment effects were not statistically significant for secondary outcomes. Conclusions Supervised and home-based exercise, when combined with a cognitive-behavioral exercise intervention, is effective in increasing aerobic exercise in depressed adults in the short-term, although the impact diminishes post-intervention period.
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Affiliation(s)
- Lisa A Uebelacker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
| | - Gary Epstein-Lubow
- Butler Hospital, Providence RI, USA
- Department of Health Services, Policy and Practice of Brown University, Providence RI, USA
| | - Marie A Sillice
- City University of New York School of Public & Health Policy, Department of Health Policy and Management, New York, NY, 10027
| | | | - Morganne Kraines
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
| | - Cynthia L Battle
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
- Center for Women's Behavioral Health, Women & Infants' Hospital of Rhode Island, Providence RI, USA
| | | | - Ivan W Miller
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
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13
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Self-Reported Physical Activity and Perception of Athleticism in American Equestrian Athletes. J Phys Act Health 2023; 20:169-179. [PMID: 36669501 DOI: 10.1123/jpah.2022-0398] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/23/2022] [Accepted: 11/18/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Over 75% of American adults are not meeting aerobic and muscular physical activity recommendations, with the majority being females. Equestrian activities are a potential avenue to increase physical activity, especially in females who account for approximately 90% of sport participants. This study describes perceptions of equestrian activities and establishes the patterns of self-reported equestrian, barn work, and nonequestrian physical activity engagement to understand participation in activities that may sustain physical activity across the lifespan. METHODS American equestrians (n = 2551) completed an anonymous online survey with questions about perceptions and benefits of equestrian activities, demographics, and engagement in equestrian activities, barn work, and nonequestrian activities. RESULTS There were 2039 completed responses, (95.6% female), with representation from all regions of the United States. Professionals (20.6%), amateurs (39.1%), and recreational (40.3%) comprised participation status. Significantly fewer recreational participants perceived equestrian as physical activity and as a sport than amateurs (P < .05) and professionals (P < .05). Engagement in equestrian and barn work physical activity was significantly higher in professionals (P < .0001), followed by amateurs (P < .0001), with the lowest in recreational equestrians (P = .001). Professional and amateur equestrians engaged in significantly more nonequestrian physical activity than recreational participants (P < .05). CONCLUSIONS Equestrian physical activity engagement is dependent on the status of participation. Equestrian, barn work, and nonequestrian physical activity do meet physical activity aerobic and muscular recommendations and should be encouraged as a physical activity for females across the lifespan.
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14
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Connolly ML, Bowden SC, Pascoe MC, Van Dam NT. Development and Psychometric Validation of the Mental Health-Related Barriers and Benefits to EXercise (MEX) Scale in Healthy Adults. SPORTS MEDICINE - OPEN 2023; 9:18. [PMID: 36821025 PMCID: PMC9947889 DOI: 10.1186/s40798-023-00555-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/24/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Physical exercise has been shown to reduce anxiety and depression symptoms, the most common mental health disorders globally. Despite the benefits of exercise in anxiety and depression, the symptoms of these disorders may directly contribute to a lack of engagement with exercise. However, mental health-related barriers and benefits to exercise engagement have not been addressed in quantitative research. We introduce the development and psychometric validation of the Mental health-related barriers and benefits to EXercise (MEX) scale. METHODS Three samples were collected online prospectively (sample 1 n = 492; sample 2 n = 302; sample 3 n = 303) for scale refinement and validation with exploratory and confirmatory factor analysis. All participants were generally healthy adults, aged 18-45, and had no history of severe mental illness requiring hospitalization and no physical disability impacting over 50% of daily function. RESULTS We identified a 30-item, two-factor model comprising 15 barrier and 15 benefit items. Overall model fit was excellent for an item-level scale across the three samples (Comparative Fit Index = 0.935-0.951; Root-Mean-Square Error of Approximation = 0.037-0.039). Internal consistency was also excellent across the three samples (α = 0.900-0.951). The barriers subscale was positively correlated with symptoms of anxiety, depression and stress, and negatively correlated with measures of physical activity and exercise engagement. The benefits subscale was negatively correlated with symptoms of anxiety, depression and stress, and positively correlated with measures of physical activity and exercise engagement. CONCLUSION The MEX is a novel, psychometrically robust scale, which is appropriate for research and for clinical use to ascertain individual and/or group level mental health-related barriers and benefits to exercise.
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Affiliation(s)
- Madeleine L. Connolly
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, The University of Melbourne, Level 12, Redmond Barry Building, Parkville, Melbourne, 3010 Australia
| | - Stephen C. Bowden
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, The University of Melbourne, Level 12, Redmond Barry Building, Parkville, Melbourne, 3010 Australia ,grid.413105.20000 0000 8606 2560Centre for Clinical Neurosciences and Neurological Research, St Vincent’s Hospital Melbourne, Melbourne, 3065 Australia
| | - Michaela C. Pascoe
- grid.1019.90000 0001 0396 9544Institute for Health and Sport, Victoria University, Melbourne, 3011 Australia
| | - Nicholas T. Van Dam
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, The University of Melbourne, Level 12, Redmond Barry Building, Parkville, Melbourne, 3010 Australia
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15
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Nuzzo JL. Narrative Review of Sex Differences in Muscle Strength, Endurance, Activation, Size, Fiber Type, and Strength Training Participation Rates, Preferences, Motivations, Injuries, and Neuromuscular Adaptations. J Strength Cond Res 2023; 37:494-536. [PMID: 36696264 DOI: 10.1519/jsc.0000000000004329] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
ABSTRACT Nuzzo, JL. Narrative review of sex differences in muscle strength, endurance, activation, size, fiber type, and strength training participation rates, preferences, motivations, injuries, and neuromuscular adaptations. J Strength Cond Res 37(2): 494-536, 2023-Biological sex and its relation with exercise participation and sports performance continue to be discussed. Here, the purpose was to inform such discussions by summarizing the literature on sex differences in numerous strength training-related variables and outcomes-muscle strength and endurance, muscle mass and size, muscle fiber type, muscle twitch forces, and voluntary activation; strength training participation rates, motivations, preferences, and practices; and injuries and changes in muscle size and strength with strength training. Male subjects become notably stronger than female subjects around age 15 years. In adults, sex differences in strength are more pronounced in upper-body than lower-body muscles and in concentric than eccentric contractions. Greater male than female strength is not because of higher voluntary activation but to greater muscle mass and type II fiber areas. Men participate in strength training more frequently than women. Men are motivated more by challenge, competition, social recognition, and a desire to increase muscle size and strength. Men also have greater preference for competitive, high-intensity, and upper-body exercise. Women are motivated more by improved attractiveness, muscle "toning," and body mass management. Women have greater preference for supervised and lower-body exercise. Intrasexual competition, mate selection, and the drive for muscularity are likely fundamental causes of exercise behaviors in men and women. Men and women increase muscle size and strength after weeks of strength training, but women experience greater relative strength improvements depending on age and muscle group. Men exhibit higher strength training injury rates. No sex difference exists in strength loss and muscle soreness after muscle-damaging exercise.
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Affiliation(s)
- James L Nuzzo
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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16
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Exercise preference and tolerance in youth with bipolar disorder. J Psychosom Res 2023; 165:111013. [PMID: 36670038 DOI: 10.1016/j.jpsychores.2022.111013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 07/15/2022] [Accepted: 08/12/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Despite the multiple potential benefits, individuals with bipolar disorder (BD) report lower levels of moderate-vigorous exercise. We examined the correlates of exercise preference and tolerance among youth with BD, to inform future exercise intervention studies. METHODS In this cross-sectional study 107 adolescents (n = 54 BD, n = 53 healthy controls [HC]) completed the self-reported Preference for and Tolerance of the Intensity of Exercise Questionnaire, a 20-minute bout of moderate intensity aerobic exercise, and the Borg Rating of Perceived Exertion. Cardiorespiratory fitness (CRF) was calculated using a proxy measure. Variables associated with either exercise preference or tolerance at p < 0.01 in univariate analyses were entered into multivariable models. Significance was set at p < 0.05 for all analyses. RESULTS Exercise tolerance and CRF were significantly lower in the BD group. There was no significant difference in exercise preference. Lower exercise preference among youth with BD was significantly associated with lower CRF (β = 0.39, p = 0.006) and higher perceived exertion (β = -0.33, p = 0.01), while higher exercise preference was associated with lifetime psychiatric hospitalization (β = 0.29, p = 0.04). Female sex (β = 0.31, p = 0.03), higher perceived exertion (β = -0.37, p = 0.007), and non-Caucasian race (β = 0.31, p = 0.02) were significantly associated with lower exercise tolerance in youth with BD. CONCLUSIONS The current study adds to the limited literature examining exercise preference and tolerance in youth with BD and provides an avenue to examine these correlates further in clinical and exercise interventions.
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Stults-Kolehmainen MA. Humans have a basic physical and psychological need to move the body: Physical activity as a primary drive. Front Psychol 2023; 14:1134049. [PMID: 37113126 PMCID: PMC10128862 DOI: 10.3389/fpsyg.2023.1134049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/13/2023] [Indexed: 04/29/2023] Open
Abstract
Physical activity, while less necessary for survival in modern times, is still essential for thriving in life, and low levels of movement are related to numerous physical and mental health problems. However, we poorly understand why people move on a day-to-day basis and how to promote greater energy expenditure. Recently, there has been a turn to understand automatic processes with close examination of older theories of behavior. This has co-occurred with new developments in the study of non-exercise activity thermogenesis (NEAT). In this narrative review, it is hypothesized that psycho-physiological drive is important to understand movement in general and NEAT, specifically. Drive, in short, is a motivation state, characterized by arousal and felt tension, energizing the organism to acquire a basic need. Movement is a biological necessity, like food, water, and sleep, but varies across the lifespan and having the greatest impact before adolescence. Movement meets various criteria for a primary drive: (a) deprivation of it produces feelings of tension, such as an urge or craving, known as affectively-charged motivation states, and particularly the feelings of being antsy, restless, hyper or cooped up, (b) provision of the need quickly reduces tension - one can be satiated, and may even over-consume, (c) it can be provoked by qualities of the environment, (d) it is under homeostatic control, (e) there is an appetite (i.e., appetence) for movement but also aversion, and (f) it has a developmental time course. Evidence for drive has mainly come from children and populations with hyperkinetic disorders, such as those with anorexia nervosa, restless legs syndrome, and akathisia. It is also stimulated in conditions of deprivation, such as bed rest, quarantine, long flights, and physical restraint. It seems to be lacking in the hypokinetic disorders, such as depression and Parkinson's. Thus, drive is associated with displeasure and negative reinforcement, subsuming it within the theory of hedonic drive, but it may fit better within new paradigms, such as the WANT model (Wants and Aversions for Neuromuscular Tasks). Recently developed measurement tools, such as the CRAVE scale, may permit the earnest investigation of movement drive, satiation, and motivation states in humans.
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Affiliation(s)
- Matthew A. Stults-Kolehmainen
- Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States
- Department of Biobehavioral Sciences, Teachers College – Columbia University, New York, NY, United States
- *Correspondence: Matthew A. Stults-Kolehmainen,
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18
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Exercise Preferences for a Workplace Wellness Program to Reduce Cardiovascular Risk and Increase Work Productivity. J Occup Environ Med 2022; 64:e545-e549. [DOI: 10.1097/jom.0000000000002608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Li L, Luo J, Reangsing C, Schneider JK. Effects of exercise on depressive symptoms among nursing home residents: a meta-analysis. Aging Ment Health 2022; 26:1514-1523. [PMID: 34282683 DOI: 10.1080/13607863.2021.1951658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We examined the effects of exercise on depression in older adults living in nursing homes and explored the moderator effects of participants, methods, and intervention characteristics. METHODS We searched 8 databases from inception to January 2020 without date restrictions. We retrieved primary studies measuring exercise with 60-year-olds with depression that were written in English. Two researchers independently coded each primary study and compared codes for discrepancies. They consulted a third researcher to come to consensus. We used random-effects model to compute effect sizes using Hedges' g, a forest plot, and Q and I2 statistics as measures of heterogeneity. We also examined moderator analyses. RESULTS Twenty-one studies included 2,594 participants (81.8 ± 4.8 years old). Overall, exercise showed a small improvement in depression compared to controls (ES=.25; 95%CI 0.11, 0.38; p=.000). Interestingly, interventionists by physiotherapists had a smaller effect on depressive symptoms (.04) than other health interventionists (.37). As people aged, exercise was less effective in reducing depression (slope=-.03, Qmodel=5.03, p=.025). Researchers who included a higher percentage of women in exercise showed less improvement of depression (slope=-.01, Qmodel=8.60, p=.003). Also, when researchers used depression scales with higher reliability values, they measured higher levels of depression (slope = 5.48, Qmodel=5.60, p=.018). No other quality indicators moderated the effects of exercise on depression. CONCLUSION Exercise significantly improved depressive symptoms among older adults in nursing homes. Exercise might be used as adjunct/alternative complementary treatment for improving depressive symptoms in older adults in nursing homes.
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Affiliation(s)
- Lixiang Li
- School of Nursing, Guizhou Medical University, The affiliated hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Jing Luo
- School of Nursing, Guizhou Medical University, Guiyang, Guizhou, China
| | - Chuntana Reangsing
- Trudy Busch Valentine School of Nursing, Saint Louis University, MO, USA.,School of Nursing, Mae Fah Luang University, Chiang Rai, Thailand
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20
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Burrows T, Teasdale S, Rocks T, Whatnall M, Schindlmayr J, Plain J, Latimer G, Roberton M, Harris D, Forsyth A. Effectiveness of dietary interventions in mental health treatment: A rapid review of reviews. Nutr Diet 2022; 79:279-290. [PMID: 35796181 PMCID: PMC9545734 DOI: 10.1111/1747-0080.12754] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 05/16/2022] [Accepted: 05/24/2022] [Indexed: 12/30/2022]
Abstract
Aim This rapid review of reviews aimed to determine the extent of research undertaken on the effectiveness of dietary interventions for individuals with a mental disorder. Methods Three databases (MEDLINE, Embase, Cochrane Reviews and Cochrane Trials) were searched to February 2021 for systematic reviews including experimental studies assessing the effectiveness of dietary interventions with physical or mental health related outcomes in adults or children with one or more of: severe mental illness, depression or anxiety, eating disorders, or substance use disorder. Results are presented descriptively. Results The number of included reviews was 46 (67% in severe mental illness, 20% in depression and anxiety, 7% in eating disorders, and 7% in substance use disorders). Most reviews were published since 2016 (59%), and included studies conducted in adults (63%). Interventions in the eating disorders and severe mental illness reviews were predominantly education and behaviour change, whereas interventions in the substance use disorders, and depression and anxiety reviews were predominantly supplementation (e.g. omega‐3). Twenty‐eight and twelve of the reviews respectively reported mental health and dietary outcomes for one or more included studies. Most reviews in severe mental illness, and depression and anxiety reported conclusions supporting the positive effects of dietary intervention, including positive effects on weight‐related or mental health outcomes, and on mental health outcomes, respectively. Conclusions A larger number of systematic reviews were identified which evaluated dietary interventions in individuals with severe mental illness, and depression and anxiety, compared with substance use disorders, and eating disorders. Dietary intervention is an important component of the treatment that should be available to individuals living with mental disorders, to support their physical and mental health.
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Affiliation(s)
- Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Food and Nutrition Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Scott Teasdale
- School of Psychiatry, UNSW Sydney, Kensington, New South Wales, Australia.,Mindgardens Neuroscience Network, Sydney, New South Wales, Australia
| | - Tetyana Rocks
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, Deakin University, Geelong, Victoria, Australia
| | - Megan Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Food and Nutrition Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Julia Schindlmayr
- Dietitians Australia, Deakin, Australian Capital Territory, Australia
| | - Janice Plain
- Mental Health Drug and Alcohol, Northern Sydney Local Health District, North Ryde, New South Wales, Australia
| | - Georgina Latimer
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University, Hawthorn, Victoria, Australia
| | - Michelle Roberton
- Victorian Centre of Excellence in Eating Disorders, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Deanne Harris
- Tamworth Rural Referral Hospital, Hunter New England Health, Tamworth, New South Wales, Australia
| | - Adrienne Forsyth
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
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21
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Couto N, Monteiro D, Cid L, Bento T. Effect of different types of exercise in adult subjects with fibromyalgia: a systematic review and meta-analysis of randomised clinical trials. Sci Rep 2022; 12:10391. [PMID: 35725780 PMCID: PMC9209512 DOI: 10.1038/s41598-022-14213-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/02/2022] [Indexed: 11/29/2022] Open
Abstract
Exercise has been recommended for fibromyalgia treatment. However, doubts related to exercise benefits remain unclear. The objective of this study was to summarise, through a systematic review with meta-analysis, the available evidence on the effects of aerobic, resistance and stretching exercise on pain, depression, and quality of life. Search was performed using electronic databases Pubmed and Cochrane Library. Studies with interventions based on aerobic exercise, resistance exercise and stretching exercise published until July 2020 and updated in December 2021, were identified. Randomized controlled trials and meta-analyses involving adults with fibromyalgia were also included. Eighteen studies were selected, including a total of 1184 subjects. The effects were summarised using standardised mean differences (95% confidence intervals) by random effect models. In general, aerobic exercise seems to reduce pain perception, depression and improves quality of life; it also improves mental and physical health-related quality of life. Resistance exercise decreases pain perception and improves quality of life and moreover improves the physical dimension of health-related quality of life. It was also observed that resistance exercise appears to have a non-significant positive effect on depression and the mental dimension of health-related quality of life. Studies revealed that stretching exercise reduces the perception and additionally improves quality of life and health-related quality of life. However, a non-significant effect was observed on depression. We conclude that exercise may be a way to reduce depression, and pain and improve the quality of life in adult subjects with fibromyalgia and should be part of the treatment for this pathology.
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Affiliation(s)
- Nuno Couto
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), Rio Maior, Portugal. .,Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal.
| | - Diogo Monteiro
- ESECS, Polytechnic of Leiria, Leiria, Portugal.,Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal.,Life Quality Research Center (CIEQV), Santarém, Portugal
| | - Luís Cid
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), Rio Maior, Portugal.,Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal.,Life Quality Research Center (CIEQV), Santarém, Portugal
| | - Teresa Bento
- Sport Sciences School of Rio Maior, Polytechnic of Santarém (ESDRM-IPSantarém), Rio Maior, Portugal.,Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
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22
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Ramsey CM, Lynch KG, Gehrman PR, Vairavan S, Narayan VA, Li QS, Oslin DW. Daily steps and depressive symptoms: A longitudinal evaluation of patients with major depressive disorder in the precision medicine in mental health care study. J Affect Disord 2022; 300:334-340. [PMID: 34979178 DOI: 10.1016/j.jad.2021.12.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/12/2021] [Accepted: 12/30/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Although the benefits of exercise on Major Depressive Disorder (MDD) are well established, longitudinal studies of objectively measured activity in clinical populations are needed to establish specific guidelines for exercise by persons with moderate-to-severe depression. This study examines the association between objectively assessed daily step count and depressive symptoms over a 24-week follow- up period in outpatients receiving treatment for moderate-to-severe depression. METHODS Participants were US Veterans with MDD enrolled in the Precision Medicine in Mental Health Care study (PRIME Care), a pragmatic, multi-site, randomized, controlled trial that examines the utility of genetic testing in the context of pharmacotherapy for MDD. Participants were a subset (N = 66) enrolled in actigraphy (using GT9X ActiGraph) monitoring component of the trial. Daily steps were examined as a predictor of depressive symptoms over 4-, 8-, 12-, 18-, and 24-weeks. RESULTS On average, participants took 3,460 (±1,768) steps per day. In generalized linear mixed models, an increase in 1,000 steps per day was associated with a 0.6-point decrease in depressive symptom severity at the subsequent follow-up assessment. LIMITATIONS Activity monitoring was observational and causal inferences cannot be made between daily steps and subsequent depressive symptom severity. Results may not generalize to non-treatment-seeking populations. CONCLUSIONS Study findings provide an initial metric for persons with clinically significant MDD, of whom most do not get sufficient daily activity. The findings can inform future trials aimed at determining how much daily activity is needed to improve symptoms in individuals with MDD.
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Affiliation(s)
- Christine M Ramsey
- VISN 4 Mental Illness, Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 5800 Woodland Ave, Philadelphia, PA 19130, United States; Yale School of Medicine, New Haven, CT, United States.
| | - Kevin G Lynch
- VISN 4 Mental Illness, Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 5800 Woodland Ave, Philadelphia, PA 19130, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Philip R Gehrman
- VISN 4 Mental Illness, Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 5800 Woodland Ave, Philadelphia, PA 19130, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Srinivasan Vairavan
- Neuroscience Data Science, Janssen Research & Development, LLC, Titusville, NJ, United States
| | - Vaibhav A Narayan
- Neuroscience Data Science, Janssen Research & Development, LLC, Titusville, NJ, United States; Science for Minds, Janssen Research & Development, LLC, Titusville, NJ, United States
| | - Qingqin S Li
- Neuroscience Data Science, Janssen Research & Development, LLC, Titusville, NJ, United States
| | - David W Oslin
- VISN 4 Mental Illness, Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 5800 Woodland Ave, Philadelphia, PA 19130, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Tomlinson-Perez S, Machaczek KK, Firth J, Pollard N, Meda G, Keddie E, Goyder E. Evaluation of the uptake, retention and effectiveness of exercise referral schemes for the management of mental health conditions in primary care: a systematic review. BMC Public Health 2022; 22:249. [PMID: 35130844 PMCID: PMC8822691 DOI: 10.1186/s12889-022-12638-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 01/24/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Exercise is a recognised element of health-care management of mental-health conditions. In primary health care, it has been delivered through exercise referral schemes (ERS). The National Institute for Health and Care Excellence has highlighted uncertainty regarding the effectiveness of ERS in improving exercise participation and health outcomes among those referred for mental-health reasons. This review aims, therefore, to evaluate ERSs for individuals who are referred specifically for mental-health reasons. METHODS Studies were reviewed that assessed the effectiveness of ERSs in improving initiation of and/or adherence to exercise and/or their effectiveness in improving long-term participation in exercise and health outcomes among primary care patients who had been referred to the scheme for mental-health reasons. The data were extracted and their quality assessed. Data were analysed through a narrative synthesis approach. RESULTS Nine studies met the eligibility criteria. Three assessed clinical effectiveness of the schemes, eight assessed ERS uptake and/or adherence to the exercise schedule, and two assessed the impact of the ERSs on long-term exercise levels. In one study, it was found that ERSs that were based in leisure centres significantly improved long-term symptoms in those who had been referred due to their mental ill health (P<0.05). ERSs that involved face-to-face consultations and telephone calls had the highest rates of mean uptake (91.5%) and adherence (71.7%), but a difference was observed between uptake/adherence in trials (86.8%/55.3%) and in routine practice (57.9%/37.2%). ERSs that included face-to-face consultations and telephone calls increased the amount of long-term physical activity that was undertaken by people who had been referred for mental-health reasons (P=0.003). CONCLUSIONS Uptake and effectiveness of ERSs for mental health conditions was related to programme content and setting with more effective programmes providing both face-to-face and telephone consultations. Good uptake of yoga among those referred for mental health reasons suggests that mindful exercise options should be investigated further. Existing ERSs could be improved through application of individual tailoring and the provision of more face-to-face consultations, and social support. Further research is required to identify the types of ERSs that are most clinically effective for those with mental ill health.
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Affiliation(s)
- Samuel Tomlinson-Perez
- grid.10025.360000 0004 1936 8470School of Medicine, University of Liverpool, Liverpool, UK
| | - Katarzyna Karolina Machaczek
- grid.5884.10000 0001 0303 540XCollege of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Joseph Firth
- grid.5379.80000000121662407Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Nicholas Pollard
- grid.5884.10000 0001 0303 540XDepartment of Allied Health Professionals, Sheffield Hallam University, Sheffield, UK
| | - Goutham Meda
- grid.10025.360000 0004 1936 8470School of Medicine, University of Liverpool, Liverpool, UK
| | - Ellis Keddie
- grid.10025.360000 0004 1936 8470School of Medicine, University of Liverpool, Liverpool, UK
| | - Elizabeth Goyder
- grid.11835.3e0000 0004 1936 9262School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Galán-Arroyo C, Pereira-Payo D, Hernández-Mocholí MÁ, Merellano-Navarro E, Pérez-Gómez J, Rojo-Ramos J, Adsuar JC. Depression and Exercise in Older Adults: Exercise Looks after You Program, User Profile. Healthcare (Basel) 2022; 10:healthcare10020181. [PMID: 35206796 PMCID: PMC8871945 DOI: 10.3390/healthcare10020181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 12/10/2022] Open
Abstract
Introduction: Depression is a challenge for public health policies, as it is the number one leading cause of disability in the world. In order to combat and prevent it, different social and health interventions are being developed to promote health through physical activity. Objective: Analyze and describe the user profile of the patients with depression from the Exercise Looks After You program, which is a physical activity program that works on improving public health and has an essential role preventing chronic diseases and improving the quality of life of the elderly in Extremadura. Design: Cross-sectional study. Participants: total sample of 1972 users (96.4% women, 3.6% men), of whom 724 (94.6% women, 5.4% men) suffer from depression. Results: It was observed that the dominant user profile of the patients with depression within the program is female, 71 years old, physically active, overweight, married, with low educational level, non-smoker, no alcohol consumption and below average physical fitness and health-related quality of life, which translates into a high incidence of primary care, nursing and prescription visits. Conclusions: This study presents the user profile of depressive versus non-depressive participants of the Exercise Looks After You physical activity program. This data could be meaningful in order to improve and optimize public health programs and resources.
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Affiliation(s)
- Carmen Galán-Arroyo
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (C.G.-A.); (J.C.A.)
| | - Damián Pereira-Payo
- Health Economy Motricity and Education (HEME), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (D.P.-P.); (J.P.-G.)
| | - Miguel Ángel Hernández-Mocholí
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain;
| | | | - Jorge Pérez-Gómez
- Health Economy Motricity and Education (HEME), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (D.P.-P.); (J.P.-G.)
| | - Jorge Rojo-Ramos
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Cáceres, Spain
- Correspondence:
| | - Jose Carmelo Adsuar
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (C.G.-A.); (J.C.A.)
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Meyer JD, Perkins SL, Brower CS, Lansing JE, Slocum JA, Thomas EBK, Murray TA, Lee DC, Wade NG. Feasibility of an Exercise and CBT Intervention for Treatment of Depression: A Pilot Randomized Controlled Trial. Front Psychiatry 2022; 13:799600. [PMID: 35599775 PMCID: PMC9115753 DOI: 10.3389/fpsyt.2022.799600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/20/2022] [Indexed: 11/16/2022] Open
Abstract
Depression (DEP) is prevalent and current treatments are ineffective for many people. This pilot study's purpose was to assess the feasibility, acceptability, and plausible efficacy of an 8-week intervention employing 30 min of prescribed moderate intensity exercise ("ActiveCBT") compared to 30 min of usual activities ("CalmCBT") immediately prior to weekly online CBT sessions. Ten adults with DSM-5-diagnosed current DEP were randomized to groups and completed: an intake assessment, eight weekly CBT sessions, final assessment, and 3-month follow-up. ActiveCBT participants were prescribed 30-min of moderate exercise immediately prior to each standardized 50-min CBT session. CalmCBT participants continued with normal activities for 30 min before therapy. Questionnaires regarding DEP symptom severity (Patient Health Questionnaire-9 [PHQ-9]), between-session effectiveness (Behavioral Activation for Depression Survey [BADS], Automatic Thoughts Questionnaire [ATQ]), in-session effectiveness (Working Alliance Inventory-Short Revised [WAI]), and state anhedonia (Dimension Analog Rating Scale [DARS], Visual Analog Scale [VAS]; assessed 3 times: before Active/Calm condition, after, and after therapy) were completed each week. Therapy fidelity ratings were independently coded via a standardized codebook. The Structured Clinical Interview for DSM-5 (SCID) and Hamilton Rating Scale for Depression (HAMD) were used to assess DEP at intake, final, and 3-month follow-up. We found strong feasibility and acceptability (100% adherence, 100% retention at final visit, 74.6% therapy fidelity, and high patient satisfaction ratings). Differences between groups favoring ActiveCBT in anhedonia (DARS, Hedges' g = 0.92; VAS, g = 3.16), within- (WAI, g = 0.1.10), and between-session effectiveness (ATQ g = -0.65; BADS g = -1.40), suggest plausible efficacy of ActiveCBT for enhancing CBT. DEP rates were reduced in both groups from baseline to final (60% MDD SCID remission) and at follow up (Active: 40%; Calm: 25%). Larger and potentially quicker symptom improvement was found favoring the Active condition to the final visit (HAMD, between-group changes g = -1.33; PHQ-9, g = -0.62), with small differences remaining at follow-up (HAMD, g = -0.45; PHQ-9, g = -0.19). Exercise priming appears acceptable and plausibly efficacious for enhancing mechanisms of CBT and overall outcomes, though the present small sample precludes efficacy determinations. It appears feasible to conduct a randomized controlled trial comparing ActiveCBT to CalmCBT. Future trials evaluating this potentially promising treatment approach and mediating mechanisms are warranted.
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Affiliation(s)
- Jacob D Meyer
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Seana L Perkins
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Cassandra S Brower
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Jeni E Lansing
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Julia A Slocum
- Department of Kinesiology, Iowa State University, Ames, IA, United States.,Department of Psychology, Iowa State University, Ames, IA, United States
| | - Emily B K Thomas
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Thomas A Murray
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, United States
| | - Duck-Chul Lee
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Nathaniel G Wade
- Department of Psychology, Iowa State University, Ames, IA, United States
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26
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Fairman CM, Lønbro S, Cardaci TD, VanderVeen BN, Nilsen TS, Murphy AE. Muscle wasting in cancer: opportunities and challenges for exercise in clinical cancer trials. JCSM RAPID COMMUNICATIONS 2022; 5:52-67. [PMID: 36118249 PMCID: PMC9481195 DOI: 10.1002/rco2.56] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Low muscle in cancer is associated with an increase in treatment-related toxicities and is a predictor of cancer-related and all-cause mortality. The mechanisms of cancer-related muscle loss are multifactorial, including anorexia, hypogonadism, anaemia, inflammation, malnutrition, and aberrations in skeletal muscle protein turnover and metabolism. METHODS In this narrative review, we summarise relevant literature to (i) review the factors influencing skeletal muscle mass regulation, (ii) provide an overview of how cancer/treatments negatively impact these, (iii) review factors beyond muscle signalling that can impact the ability to participate in and respond to an exercise intervention to counteract muscle loss in cancer, and (iv) provide perspectives on critical areas of future research. RESULTS Despite the well-known benefits of exercise, there remains a paucity of clinical evidence supporting the impact of exercise in cancer-related muscle loss. There are numerous challenges to reversing muscle loss with exercise in clinical cancer settings, ranging from the impact of cancer/treatments on the molecular regulation of muscle mass, to clinical challenges in responsiveness to an exercise intervention. For example, tumour-related/treatment-related factors (e.g. nausea, pain, anaemia, and neutropenia), presence of comorbidities (e.g. diabetes, arthritis, and chronic obstructive pulmonary disease), injuries, disease progression and bone metastases, concomitant medications (e.g., metformin), can negatively affect an individual's ability to exercise safely and limit subsequent adaptation. CONCLUSIONS This review identifies numerous gaps and oppportunities in the area of low muscle and muscle loss in cancer. Collaborative efforts between preclinical and clinical researchers are imperative to both understanding the mechanisms of atrophy, and develop appropriate therapeutic interventions.
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Affiliation(s)
- Ciaran M. Fairman
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina 29033, USA
- Correspondence to: Ciaran Fairman, Department of Exercise Science, University of South Carolina, Columbia, SC 29033, USA.
| | - Simon Lønbro
- Department of Public Health, Section for Sports Science, Aarhus University, Aarhus, Denmark
| | - Thomas D. Cardaci
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina 29033, USA
| | - Brandon N. VanderVeen
- Department of Pathology, Microbiology and Immunology, School of Medicine, University of South Carolina, Columbia, South Carolina, USA
| | - Tormod S. Nilsen
- Department of Physical Performance, Norwegian School of Sports Sciences, Oslo, Norway
| | - Angela E. Murphy
- Department of Pathology, Microbiology and Immunology, School of Medicine, University of South Carolina, Columbia, South Carolina, USA
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Jalene S, Pharr J, Sharma M, Poston B. Depression, fitness, and student willingness to pursue university counseling and alternative antidepressant options. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:480. [PMID: 35233427 PMCID: PMC8826772 DOI: 10.4103/jehp.jehp_1421_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 04/24/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Depression prevalence in college students is three to six times higher than US adults. Counseling utilization increased by 30%-40% despite reports of student unwillingness to pursue therapy. Pursuance of alternative options, like exercise or meditation, is rarely reported. This study examined students' willingness to seek depression treatment through university mental health services (UMHS) and alternative options (AO). MATERIALS AND METHODS This was a cross-sectional study. Students (n = 780) completed a survey including validated depression and estimated cardiorespiratory fitness instruments. Yes/Maybe/No responses regarding willingness to seek UMHS and AO were analyzed for associations with demographics, depression status, and fitness level. Descriptive and inferential analyses were employed. RESULTS Students were more likely to select "Yes" for AO than UMHS (χ 2 = 104.145, P < 0.001). Low-fit students (χ 2 = 8.35, P = 0.02) and those in depression treatment (χ 2 = 15.182, P < 0.001) selected "Yes" to UMHS more often than expected. Younger (χ 2 = 7.893, P = 0.02), nondepressed (χ 2 = 7.355, P = 0.03), and fit students (χ 2 = 10.617, P = 0.005) chose "Yes" while males selected "No" (χ 2 = 8.99, P = 0.01) more often than expected for AO. Approximately 31% of students reported having moderate-to-severe depression, 7.8% were in treatment, and 55% were classified as having low fitness levels. CONCLUSIONS The findings of this study should be considered when developing antidepressant programming on university campuses.
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Affiliation(s)
- Sharon Jalene
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Nevada, USA
| | - Jennifer Pharr
- Department of Environmental and Occupational Health, University of Nevada, Las Vegas, Nevada, USA
| | - Manoj Sharma
- Department of Environmental and Occupational Health, University of Nevada, Las Vegas, Nevada, USA
| | - Brach Poston
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Nevada, USA
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Drew RJ, Morgan PJ, Collins CE, Callister R, Kay-Lambkin F, Kelly BJ, Young MD. Behavioral and Cognitive Outcomes of an Online Weight Loss Program for Men With Low Mood: A Randomized Controlled Trial. Ann Behav Med 2021; 56:1026-1041. [PMID: 34964449 DOI: 10.1093/abm/kaab109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Depression and obesity are major health concerns and commonly co-exist, but men rarely seek help for these conditions. SHED-IT: Recharge was a gender-tailored eHealth program for men that generated clinically meaningful improvements in weight and depressive symptoms. PURPOSE To evaluate behavioral and psychological outcomes from the SHED-IT: Recharge intervention designed for overweight/obese men with low mood. METHODS Overall, 125 men (18-70 years) with a BMI between 25 and 42 kg/m2 and depressive symptoms (PHQ-9 ≥ 5) were randomly allocated to SHED-IT: Recharge (n = 62) or wait-list control (n = 63) groups. The self-directed program targeted key health behaviors combined with online mental fitness modules based on cognitive behavioral therapy. Behavioral (e.g., physical activity) and psychological outcomes (e.g., cognitive flexibility) were assessed with validated measures at baseline, 3 months (post-test) and 6 months (follow-up). Intention-to-treat linear mixed models examined treatment effects, which were adjusted for covariates, and effect size estimated (Cohen's d). RESULTS At post-test, intervention men achieved small-to-medium improvements in several health behavior outcomes including moderate-to-vigorous physical activity, light physical activity, sedentary behavior, sleep, energy intake, portion size, and risky alcohol consumption (range, d = 0.3-0.5), when compared with the control group. Intervention effects were also observed for perceived physical self-worth, perceived physical strength, cognitive flexibility, and behavioral activation (range, d = 0.3-0.8). No effects were found for fruit and vegetable intake, or mindful attention. Most effects were maintained at follow-up. CONCLUSIONS This gender-tailored, eHealth program with integrated mental fitness support elicited meaningful improvements in health behaviors and psychological outcomes for men with low mood. Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN12619001209189).
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Affiliation(s)
- Ryan J Drew
- Priority Research Centre for Physical Activity and Nutrition, School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, New South Wales, Australia
| | - Philip J Morgan
- Priority Research Centre for Physical Activity and Nutrition, School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, New South Wales, Australia
| | - Clare E Collins
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Frances Kay-Lambkin
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Brian J Kelly
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Myles D Young
- Priority Research Centre for Physical Activity and Nutrition, School of Psychology, College of Engineering, Science and Environment, University of Newcastle, Callaghan, New South Wales, Australia
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Individual vs. Team Sports-What's the Better Strategy for Meeting PA Guidelines in Children? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212074. [PMID: 34831826 PMCID: PMC8620740 DOI: 10.3390/ijerph182212074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/04/2021] [Accepted: 11/12/2021] [Indexed: 11/25/2022]
Abstract
There is insufficient evidence from previous studies dealing with structure of sport preferences referring to the interconnection between individual factors (socio-economic status, organized/structured physical activity (PA), location, etc.), although these factors can considerably influence total level of PA as well as the structure of sport preferences. The study investigated associations between PA frequency and specific sports activities according to the intensity with the impact on leisure, sport, and education domain, using data from an international health behavior in school-aged children survey. Participants were fifth and ninth grade students in the Czech Republic (seven schools) and Slovakia (nine schools). The results showed a significant association between intensity in team sports and PA frequency per week. Those who participated in high-intensity team sports were 2.5 times more likely to be more physically active.
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Bichler CS, Niedermeier M, Gufler A, Gálffy M, Sperner-Unterweger B, Kopp M. A case-control study on physical activity preferences, motives, and barriers in patients with psychiatric conditions. Compr Psychiatry 2021; 111:152276. [PMID: 34600310 DOI: 10.1016/j.comppsych.2021.152276] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/26/2021] [Accepted: 09/21/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Physical activity in individuals diagnosed with psychiatric conditions (patients) has antidepressant and anxiolytic effects, but levels of physical activity are still low in this population. This study aimed to identify physical activity preferences, motives, and perceived barriers in patients compared to individuals without a diagnosed psychiatric condition (controls). METHODS A total of 230 patients (age = 39.5 ± 14.0 years, 80% female) with major depression (34%), anxiety disorders (38%), or post-traumatic stress disorder (28%) completed a cross-sectional online survey to assess preferences, motives, and perceived barriers to physical activity (measured by the EMI-2). This group consisted of 100 patients with a clinical diagnosis (clinical subset) and 130 with self-reported psychiatric conditions (confirmed by the PHQ-4) from online help forums (online subset). Comparisons between patients of the clinical and the online subsets were performed and are referenced whenever significant. The patients group was compared to a healthy control group matched by sex and age (n = 230, age = 39.4 ± 14.9 years, 80% female). RESULTS More patients reported insufficient physical activity levels and more daily sitting hours (measured by the IPAQ) compared to controls. Patients reported lower preference in more ambitious types of physical activity, such as hiking, cycling, and running. The commonly most preferred type of physical activity in both groups was walking and yoga. Patients had fewer motives and more perceived barriers to physical activity in comparison to the control group. Some differences in motives and perceived barriers to physical activity were also found between patients of the clinical and the online subset. CONCLUSIONS Findings of low physical activity levels in patients are consistent with the literature. Due to the patients' lack of motivation and perception of barriers, health care providers should consider offering different and individualized forms of physical activity. Easier types of physical activity, such as walking and yoga, appear to be the most feasible and provide a good starting point to overcome perceived barriers to physical activity.
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Affiliation(s)
- Carina S Bichler
- Department of Sport Science, University of Innsbruck, Fuerstenweg 176, 6020 Innsbruck, Austria.
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Fuerstenweg 176, 6020 Innsbruck, Austria
| | - Andrea Gufler
- Department of Sport Science, University of Innsbruck, Fuerstenweg 176, 6020 Innsbruck, Austria
| | - Mátyás Gálffy
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Fuerstenweg 176, 6020 Innsbruck, Austria
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Dinardi JS, Egorov AY, Szabo A. The expanded interactional model of exercise addiction. J Behav Addict 2021; 10:626-631. [PMID: 34524973 PMCID: PMC8997218 DOI: 10.1556/2006.2021.00061] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/03/2021] [Accepted: 08/14/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Cited in over 100 articles, the interactional model of exercise addiction (Egorov & Szabo, 2013) forms the theoretical foundation of many studies on the risk of exercise addiction. Still, the inclusion of previously omitted determinants could make it more useful. Therefore, this review presents the expanded version of the original model. METHOD We added 'self-concept' as another determinant in the 'personal factors' domain and 'attractive alternatives' to the 'situational factors' domain. Further, we doubled the reasons for exercise in the 'incentives for exercise domain.' Last, we added a new domain, the 'exercise-related stressors,' to illustrate that exercise itself might be a source of stress. RESULTS The expanded model is more inclusive and accounts for a greater combination of interactions playing roles in exercise addiction. Overlooking the eventuality that stress resulting from exercise might also fuel the dysfunction was a significant omission from the original model, rectified in the current update. Finally, the new expansions make the model more applicable to competitive situations too. CONCLUSION The expanded interactional model of exercise addiction is more comprehensive than its original version. It also accounts for the exercise or sport-related stress as possible fuel in addictive exercise behavior.
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Affiliation(s)
- Jacob S. Dinardi
- Department of Kinesiology, San Francisco State University, San Francisco, CA, USA
| | - Alexei Y. Egorov
- Department of Psychiatry and Addictions, Faculty of Medicine, St. Petersburg State University, St. Petersburg, Russia,Laboratory of Behaviour Neurophysiology and Pathology I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry of Russian Academy of Sciences, St. Petersburg, Russia
| | - Attila Szabo
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary,Corresponding author. Tel.: +36 702437123. E-mail:
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Brush CJ, Burani K, Schmidt KM, Santopetro NJ, Hajcak G. The impact of a single session of aerobic exercise on positive emotional reactivity in depression: Insight into individual differences from the late positive potential. Behav Res Ther 2021; 144:103914. [PMID: 34218001 PMCID: PMC8610214 DOI: 10.1016/j.brat.2021.103914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 04/29/2021] [Accepted: 06/09/2021] [Indexed: 01/14/2023]
Abstract
Depression has been characterized by a broad disengagement from the environment, as reflected by dampened positive and negative emotional reactivity. Research has shown that acute exercise may enhance positive emotional reactivity in healthy adults. It is unknown whether it can alter positive emotional reactivity in depression. In the present study, positive emotional reactivity was assessed using the late positive potential (LPP) event-related potential before and after 30 min of moderate-intensity aerobic exercise in 43 adults with current or a lifetime history of depression (Mage = 32.74 years; Min/Max = 18/59) and 18 never-depressed healthy adults (Mage = 37.94 years; Min/Max = 21/61). Acute exercise increased the LPP for healthy adults; the LPP did not change among those with current or a lifetime history of depression. A secondary aim was to identify moderators of change in positive emotional reactivity among subgroups of adults with current depression. Compared to adults with impaired mood reactivity, those with intact mood reactivity had a pre-to-post increase in the LPP. The current study provides preliminary support for the LPP as a neural indicator of exercise efficacy and highlights individual differences in response to acute exercise in depression.
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Affiliation(s)
- C J Brush
- Department of Psychology, Florida State University, Tallahassee, FL, USA.
| | - Kreshnik Burani
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Kendall M Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | | | - Greg Hajcak
- Department of Psychology, Florida State University, Tallahassee, FL, USA; Department of Biomedical Sciences, Florida State University, Tallahassee, FL, USA
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Eight-week high-intensity interval training is associated with improved sleep quality and cardiorespiratory fitness in patients with depressive disorders. Sleep Breath 2021; 26:397-406. [PMID: 34046817 DOI: 10.1007/s11325-021-02388-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study aimed to examine the effect of high-intensity interval training (HIIT) on both sleep and cardiorespiratory fitness in patients with depression. METHODS Using a single pre- and post-test study design with no control group, 82 patients diagnosed with depressive disorders underwent HIIT comprising a total of 24 15-min sessions, three times per week for 8 weeks. Depressive symptoms, sleep quality, and cardiorespiratory fitness were evaluated using the Beck depression inventory-II, the Pittsburgh sleep quality index (PSQI), and cardiopulmonary exercise testing (CPET) in the form of maximum oxygen uptake (VO2 max), respectively. RESULTS All 82 patients completed the intervention. HIIT training was associated with significant improvements in BDI-II score (diff = - 1.57 [95% CI - 2.40 to - 0.73], P = 0.001), PSQI score (diff = - 1.20 [95% CI - 2.10 to - 0.32], P = 0.008), and CPET VO2 max (diff = 0.95 [95% CI 0.62-1.28], P = 0.001). Effect size calculations revealed that the greatest improvement occurred in CPET VO2 max (Cohen's d = 0.64) and that improvements in the BDI-II and PSQI scores were somewhat smaller in magnitude (Cohen's d = - 0.41 and - 0.30, respectively). Sleep quality improvements were observed in sleep latency, habitual sleep efficiency, and the use of sleep-promoting medications (Cohen's d = 0.18, 0.19, and 0.25, respectively). Change in cardiorespiratory fitness successfully predicted change in sleep quality but not in depressive symptoms. Adverse effects were limited to minor injuries which did not interfere with completion of training. CONCLUSIONS HIIT training delivered over 8 weeks was associated with improvements in depression symptoms, sleep quality, and cardiorespiratory fitness in patients with depressive disorders.
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Phadsri S, Shioji R, Tanimura A, Jaknissai J, Apichai S, Sookruay T. Nonpharmacological Treatment for Supporting Social Participation of Adults with Depression. Occup Ther Int 2021; 2021:8850364. [PMID: 34007254 PMCID: PMC8102128 DOI: 10.1155/2021/8850364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 03/16/2021] [Accepted: 04/09/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Social withdrawal is predominantly seen among adults with depression. However, a dearth of reviews exists that explore nonpharmacological treatments, especially occupational therapy (OT) interventions and their effect in promoting social participation. The aim of this research was to review what intervention programs are conducted to support the social participation of adults with depression and their effectiveness. METHOD A systematic review was performed wherein relevant articles were searched in PubMed, CINAHL, Wiley Online Library, PsycINFO, and OTseeker databases and AJOT, BJOT, SJOT, and OTMH journals. Only English articles published from January 2010 to December 2018, which tackled intervention for adults aged 20-60 years with depression, were considered. Ten out of 918 studies met the screening criteria. RESULT Among the ten studies, the effective intervention programs were categorized as either occupation-based intervention (OBI) or cognitive behavioral therapy-based intervention (CBT-BI). These programs sought the following outcomes: behavioral change in social participation (n = 4), reduction of depression or depressive symptoms (n = 13), life satisfaction (n = 4), and quality of life (QoL) (n = 1). Studies showed moderate (n = 3) to strong (n = 7) level of certainty, whereas they also revealed high to unclear (n = 3) and low (n = 7) risk of bias. CONCLUSION Both OBI such as animal-assisted therapy and CBT-BI such as behavioral change program and health education have a strong level of certainty and low risk of bias in promoting social participation by supporting positive behavioral change and reducing depressive symptoms. Furthermore, the sport and exercise program of OBI was popular in encouraging participation and engagement with other people. Other programs were suggested for combined interventions to support social participation, life satisfaction, and QoL.
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Affiliation(s)
- Supaluck Phadsri
- Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo 116-8551, Japan
- Department of Occupational Therapy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Rieko Shioji
- Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo 116-8551, Japan
| | - Atsuko Tanimura
- Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo 116-8551, Japan
| | - Jeerawit Jaknissai
- Occupational Therapy Unit, Thanyarak Khon Kaen Hospital, Khon Kaen 40000, Thailand
| | - Sopida Apichai
- Department of Occupational Therapy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Tippawan Sookruay
- Chiang Mai University Library, Chiang Mai University, Chiang Mai 50200, Thailand
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Große J, Petzold MB, Brand R, Ströhle A. Step Away from Depression-Study protocol for a multicenter randomized clinical trial for a pedometer intervention during and after in-patient treatment of depression. Int J Methods Psychiatr Res 2021; 30:e1862. [PMID: 33180994 PMCID: PMC7992280 DOI: 10.1002/mpr.1862] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/23/2020] [Accepted: 10/23/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Increasing the number of daily steps by using a pedometer and a diary leads to an activity increase and improved health outcomes in a variety of somatic disorders. Hence, for the inpatient treatment of depression, supervised exercise interventions are more widespread. We aim to examine if a self-managed pedometer intervention (PI) with the option of being proceeded after discharge leads to reduction of depression and to a physical activity (PA) increase. METHODS The Step Away from Depression (SAD) study is a multicenter randomized controlled trial targeting 400 patients with major depressive disorder. Treatment as usual (TAU) is compared to TAU plus PI after 4 weeks, at discharge, and 6 months after hospital admission. Primary outcomes are clinically rated depression severity and accelerometer-measured step counts. Secondary outcomes include self-reported depression symptoms and PA level, psychiatric symptoms, health-related quality of life, self-efficacy, and components of the Motivation Volition Process Model. RESULTS We report the design of the SAD study considering several methodological aspects for exercise studies, in general. CONCLUSIONS Results of our study will provide information about efficacy of PI for inpatient treatment and about interrelating processes of change concerning depression, PA, and aspects of motivation and volition.
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Affiliation(s)
- Julia Große
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Moritz Bruno Petzold
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ralf Brand
- Sport and Exercise Psychology, University of Potsdam, Potsdam, Germany
| | - Andreas Ströhle
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Glavin EE, Matthew J, Spaeth AM. Gender Differences in the Relationship Between Exercise, Sleep, and Mood in Young Adults. HEALTH EDUCATION & BEHAVIOR 2021; 49:128-140. [PMID: 33576253 DOI: 10.1177/1090198120986782] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Insufficient sleep is a serious public health problem in college students. Exercise is a widely prescribed behavioral treatment for sleep and mood issues; however, more focused and gender-specific prescriptions are needed. The present study examined relationships between exercise, sleep, and mood in undergraduate men and women. Students (N = 866, 19.6 ± 1.4 years, 38.7% women) were recruited from campus recreation facilities and completed demographic, the Pittsburgh Sleep Quality Index, mood (Patient-Reported Outcomes Measurement Information System), and exercise questionnaires. The Department of Health and Human Services Physical Activity Guidelines were used to dichotomize those who did and did not meet weekly aerobic and strength training exercise recommendations. In men, greater exercise frequency associated with less daytime dysfunction (β = 0.147) and less depressive mood (β = -0.64, ps < .05). In women, greater exercise frequency associated with earlier bedtime (β = -12.6), improved sleep quality (β = 0.17), increased positive affect (β = 0.91), less depressive mood (β = -0.71), and less anger (β = -1.24, ps < .05). Compared to men, women reported earlier bedtime, poorer sleep efficiency, and more anxiety and depressive mood (ps < .05, ηp2 range: 0.01-0.04). Compared to individuals who met physical activity guidelines, those who did not meet the guidelines reported later bedtimes, less positive affect, more anxiety, and more anger (ps < .05 ηp2s = 0.01). Among men, those who met physical activity guidelines reported falling asleep more quickly than those who did not meet guidelines (ηp2 = 0.01, p = .007); however, no relationship between guideline adherence and sleep latency was observed in women. Adhering to physical activity guidelines may be important for optimal sleep and emotional health. Clinicians should consider gender when creating exercise prescriptions for sleep issues.
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Affiliation(s)
- Emily E Glavin
- Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Juliet Matthew
- Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Andrea M Spaeth
- Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Aerobic Exercise Prevents Depression via Alleviating Hippocampus Injury in Chronic Stressed Depression Rats. Brain Sci 2020; 11:brainsci11010009. [PMID: 33374661 PMCID: PMC7822431 DOI: 10.3390/brainsci11010009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 02/01/2023] Open
Abstract
(1) Background: Depression is one of the overwhelming public health problems. Alleviating hippocampus injury may prevent depression development. Herein, we established the chronic unpredictable mild stress (CUMS) model and aimed to investigate whether aerobic exercise (AE) could alleviate CUMS induced depression-like behaviors and hippocampus injury. (2) Methods: Forty-eight healthy male Sprague-Dawley rats (200 ± 20 g) were randomly divided into 4 groups (control, CUMS, CUMS + 7 days AE, CUMS + 14 days AE). Rats with AE treatments were subjected to 45 min treadmill per day. (3) Results: AE intervention significantly improved CUMS-induced depressive behaviors, e.g., running square numbers and immobility time assessed by the open field and forced swimming test, suppressed hippocampal neuron apoptosis, reduced levels of phosphorylation of NMDA receptor and homocysteine in hippocampus, as well as serum glucocorticoids, compared to the CUMS rats. In contrast, AE upregulated phosphorylation of AMPAR receptor and brain-derived neurotrophic factor (BDNF) hippocampus in CUMS depression rats. The 14 day-AE treatment exhibited better performance than 7 day-AE on the improvement of the hippocampal function. (4) Conclusion: AE might be an efficient strategy for prevention of CUMS-induced depression via ameliorating hippocampus functions. Underlying mechanisms may be related with glutamatergic system, the neurotoxic effects of homocysteine, and/or influences in glucocorticoids-BDNF expression interaction.
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Rajoo Y, Wong J, Raj IS, Kennedy GA. Perceived barriers and enablers to physical activity participation in people with Alopecia Areata: a constructivist grounded theory study. BMC Psychol 2020; 8:132. [PMID: 33303012 PMCID: PMC7731756 DOI: 10.1186/s40359-020-00502-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 12/04/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Alopecia Areata (AA) is an autoimmune disease that is characterised by hair loss. Individuals diagnosed with it often describe feelings of trauma and social rejection due to cosmetic repercussions and are at high risk of experiencing psychological distress. Physical activity (PA) participation has been associated with better mental health outcomes in diverse populations. A preliminary study of individuals with AA indicated that severe hair loss is associated with symptomatic depression, anxiety and stress, which negatively impacted PA participation. While strategies to increase PA participation in the general population have been established, little is known about PA participation in people with AA. This study aimed to understand barriers and enablers to PA participation in people with AA to inform the development of evidence-based interventions. METHODS The study used a grounded theory (GT) methodology, relying on an iterative and simultaneous process of data collection, coding, theory development, and data comparisons to explore the perceived barriers and enablers to PA. Data were collected through a focus group (8 participants [33.38 ± 10.81 years]) and individual telephone interviews (8 participants [33.89 ± 11.87 years]). The study was conducted in Melbourne, Australia. Interview data were recorded digitally, transcribed verbatim and analysed. Recruitment continued until theoretical saturation was achieved. RESULTS The constructivist grounded theory method used has assisted to develop an explanatory model which is used to explain the themes for barriers and enablers to PA participation. The four phases in the explanatory model are as follows (1) onset of AA; (2) reaction towards the condition; (3) adjustment; and (4) acceptance. CONCLUSION The findings highlighted perceived barriers and enablers to PA participation in people with AA. Future interventions could consider addressing these barriers specifically to maximise effectiveness and to improve mental health status based on the phases of the explanatory model.
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Affiliation(s)
- Yamuna Rajoo
- School of Health and Biomedical Science, RMIT University, Bundoora Campus, Bundoora, Melbourne, VIC, 3083, Australia.
| | - J Wong
- School of Education, RMIT University, Melbourne, Australia
| | - I S Raj
- School of Health and Biomedical Science, RMIT University, Bundoora Campus, Bundoora, Melbourne, VIC, 3083, Australia
| | - G A Kennedy
- School of Health and Biomedical Science, RMIT University, Bundoora Campus, Bundoora, Melbourne, VIC, 3083, Australia
- School of Health and Life Sciences, Federation University, Ballarat, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
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Farris SG, Abrantes AM. Mental health benefits from lifestyle physical activity interventions: A systematic review. Bull Menninger Clin 2020; 84:337-372. [PMID: 33779237 DOI: 10.1521/bumc.2020.84.4.337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Lifestyle physical activity (LPA) interventions are a promising alternative to structured exercise interventions for addressing mental health problems. The authors conducted a systematic review of the literature on LPA interventions in any population in order to determine (a) the extent to which mental health outcomes were examined and (b) whether benefits in mental health outcomes were observed. Mental health outcomes were defined as depression, anxiety, perceived stress, health-related quality of life, and psychological well-being. A total of 73 articles were identified as LPA intervention, of which 24.7% (n = 18) reported the effect of LPA intervention on mental health outcomes. The most commonly evaluated mental health outcome was depression, and to a lesser extent anxiety and perceived stress. Overall, findings point to promising effects of LPA interventions across common mental health problems. Key areas for future research are discussed in light of emergent limitations in existing published studies.
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Affiliation(s)
- Samantha G Farris
- Department of Psychology, Rutgers, the State University of New Jersey, Piscataway, New Jersey
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.,Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, Rhode Island
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Stults-Kolehmainen MA, Blacutt M, Bartholomew JB, Gilson TA, Ash GI, McKee PC, Sinha R. Motivation States for Physical Activity and Sedentary Behavior: Desire, Urge, Wanting, and Craving. Front Psychol 2020; 11:568390. [PMID: 33240154 PMCID: PMC7677192 DOI: 10.3389/fpsyg.2020.568390] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/16/2020] [Indexed: 12/24/2022] Open
Abstract
To better explain daily fluctuations in physical activity and sedentary behavior, investigations of motivation are turning from social cognitive frameworks to those centered on affect, emotion and automaticity, such as the Affect and Health Behavior Framework (AHBF), Integrated Framework and Affective-Reflective Theory (ART). This shift has necessitated: (a) re-examination of older theories and their constructs, such as drives, needs and tensions and (b) an inspection of competing theories from other fields that also attempt to explain dynamic changes in health behaviors. The Dynamical Model of Desire, Elaborated Intrusion Theory and others commonly share with AHBF the idea that human behavior is driven strongly by desires and/or the similar concepts of wants, urges, and cravings. These affectively-charged motivation states (ACMS) change quickly and may better explain physical activity behavior from one moment to the next. Desires for movement predominantly derive from negative but also positive reinforcement. Data from clinical populations with movement dysfunction or psychiatric disorders provides further evidence of these drivers of movement. Those with Restless Legs Syndrome, akathisia, tic disorders and exercise dependence all report strong urges to move and relief when it is accomplished. Motor control research has identified centers of the brain responsible for wants and urges for muscular movement. Models elaborated herein differentiate between wants, desires, urges and cravings. The WANT model (Wants and Aversions for Neuromuscular Tasks) conceptualizes desires for movement and rest as varying by magnitude, approach or avoidance-orientation (wants versus aversions) and as occupying independent dimensions instead of opposite ends of the same axis. For instance, one hypothetically might be in a state of both high desire for movement and rest simultaneously. Variations in motivation states to move and rest may also be associated with various stress states, like freezing or fight and flight. The first validated instrument to measure feelings of desire/want for movement and rest, the CRAVE Scale (Cravings for Rest and Volitional Energy Expenditure) is already shedding light on the nature of these states. With these advances in theory, conceptual modeling and instrumentation, future investigations may explore the effects of desires and urges for movement and sedentary behavior in earnest.
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Affiliation(s)
- Matthew A. Stults-Kolehmainen
- Bariatric and Minimally Invasive Surgery Program, Yale-New Haven Hospital, New Haven, CT, United States
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
| | - Miguel Blacutt
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
| | - John B. Bartholomew
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - Todd A. Gilson
- Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL, United States
| | - Garrett I. Ash
- Pain Research, Informatics, Multi-morbidities, and Education (PRIME), VA Connecticut Healthcare System, West Haven, CT, United States
- Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States
| | - Paul C. McKee
- Department of Psychology, Southern Connecticut State University, New Haven, CT, United States
| | - Rajita Sinha
- Yale Stress Center, Yale School of Medicine, New Haven, CT, United States
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Rahimi S, Peeri M, Azarbayjani MA, Anoosheh L, Ghasemzadeh E, Khalifeh N, Noroozi-Mahyari S, Deravi S, Saffari-Anaraki S, Hemat Zangeneh F, Salari AA. Long-term exercise from adolescence to adulthood reduces anxiety- and depression-like behaviors following maternal immune activation in offspring. Physiol Behav 2020; 226:113130. [PMID: 32791182 DOI: 10.1016/j.physbeh.2020.113130] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 01/08/2023]
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Kruisdijk F, Hopman-Rock M, Beekman ATF, Hendriksen IJM. Personality traits as predictors of exercise treatment adherence in major depressive disorder: lessons from a randomised clinical trial. Int J Psychiatry Clin Pract 2020; 24:380-386. [PMID: 32657194 DOI: 10.1080/13651501.2020.1787452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The objective of this study was to explore the determinants of adherence in the EFFORT-D (EFFect Of Running Therapy) study in a specialised mental health care hospital setting. METHODS Patients with major depressive disorder (MDD) were given treatment as usual and half were randomised to an exercise intervention. Adherence was measured at 3 months (T3) and 6 months (T6) and was defined as participation in the overall study protocol (total n = 42, adhered n = 28) or intervention (total n = 24, adhered n = 9). Potential determinants were age, BMI, tobacco and alcohol use, severity of depression, anxiety, fitness (VO2max kg-1 and Wmax kg-1) and personality traits at baseline. ANOVA, Chi-square tests and block-wise logistic regression were performed, and reliability of the scales was determined. RESULTS Numbers were found too low for analyses on smoking, drinking and anxiety. Higher agreeableness was significantly associated with better adherence to the overall study protocol (OR 1.2; p = 0.03; 95% CI: 1.01-1.4) and severity of depression was negatively associated with adherence in the intervention group (OR 0.70; p = 0.046;95% CI: 0.49-0.99). CONCLUSIONS To adhere to a study protocol involving exercise or to a clinical exercise programme, MDD patients need substantial personal support. Measurement of personality traits and the severity of depression as potential predictors of adherence could be considered for this purpose. Keypoints Adherence to exercise and study protocols in a randomised controlled trial was low Patients with severe major depressive disorder need substantial personal support Measurement of personality traits could be considered.
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Affiliation(s)
- Frank Kruisdijk
- GGz Centraal Innova, Amersfoort, The Netherlands.,Body@Work, TNO-VU University Amsterdam Medical Center, Amsterdam, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Marijke Hopman-Rock
- Body@Work, TNO-VU University Amsterdam Medical Center, Amsterdam, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands.,The Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam University Medical Center, Location VUmc, Amsterdam, The Netherlands
| | - Ingrid J M Hendriksen
- Body@Work, TNO-VU University Amsterdam Medical Center, Amsterdam, The Netherlands.,The Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands
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43
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Physical activity for patients with severe mental illness: Preferences, barriers and perceptions of counselling. Sci Sports 2020. [DOI: 10.1016/j.scispo.2020.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Ferreira TL, Ribeiro HS, Ribeiro ALA, Bonini-Rocha AC, Lucena JMS, de Oliveira PA, Amorim FRS, Ferreira AP, Magno LAV, Martins WR. Exercise interventions improve depression and anxiety in chronic kidney disease patients: a systematic review and meta-analysis. Int Urol Nephrol 2020; 53:925-933. [PMID: 32869171 DOI: 10.1007/s11255-020-02612-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 08/12/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE This systematic review examined the effects of exercise interventions on depression and anxiety in chronic kidney disease patients. METHODS Electronic searches were conducted between August 2019 and February 2020 at PubMed, MEDLINE, Web of Science, EBSCO, Scopus, LILACS, EMBASE, Physiotherapy Evidence Database, and Cochrane Library databases. Original clinical trial studies that examined the effects of exercise on depression and anxiety in chronic kidney disease patients, stages 3-5, were included. A total of eight studies were included in the systematic review after applying the eligibility criteria, and six studies used for the meta-analysis procedures. RESULTS The meta-analysis demonstrated statistical difference on depression in favour to exercise when compared to active control (SMD = - 0.66 [- 1.00, - 0.33], p < 0.0001) and passive control (MD = - 6.95 [- 8.76, - 5.14], p < 0.00001). Same results on anxiety demonstrated statistical difference between exercise and active control (SMD = - 0.78 [- 1.21, - 0.34], p = 0.0004). CONCLUSION From the current limited number and quality of published studies, exercise seems to be more effective than sedentary control and other active control groups for improving depression and anxiety symptoms in chronic kidney disease patients.
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Affiliation(s)
| | - Heitor Siqueira Ribeiro
- University Center ICESP, QS 05 Rua 300 Lote 01, Águas Claras, Brasília, DF, 71961-540, Brazil.,Faculty of Physical Education, University of Brasília, Brasília, Brazil
| | | | | | | | | | | | | | | | - Wagner Rodrigues Martins
- Faculty of Physical Education, University of Brasília, Brasília, Brazil.,Department of Physiotherapy, University of Brasília, Brasília, Brazil
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Masuki S, Morikawa M, Nose H. Internet of Things (IoT) System and Field Sensors for Exercise Intensity Measurements. Compr Physiol 2020; 10:1207-1240. [PMID: 32941686 DOI: 10.1002/cphy.c190010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Although exercise training according to individual peak aerobic capacity ( V ˙ o2peak ) has been recommended at all ages, sensors available in the field are limited. The most popular sensors in the field are pedometers, but they cannot be used to monitor exercise intensity. Instead, although heart rate (HR) monitors are broadly available in the field to estimate exercise intensity, HR responses to exercise vary by individual according to physical fitness and environmental conditions, which hinders the precise measurement of energy expenditure. These issues make it difficult for exercise physiologists to collaborate with geneticists, nutritionists, and clinicians using the internet of things (IoT). To conquer these problems, we have developed a device that is equipped with a triaxial accelerometer and a barometer to measure energy expenditure during interval walking training (IWT) in the field with inclines. IWT is a training regimen to repeat fast and slow walking for 3 min each, equivalent to greater than 70% and approximately 40% of individual V ˙ o2peak , respectively. Additionally, we developed an IoT system that enables users to receive instructions from trainers according to their walking records even if they live far away. Since the system is available at low cost with minimum personnel, we can investigate any factors affecting the adherence to and effects of IWT in a large population for a long period. This system was also used to verify any effects of nutritional supplements during IWT and to examine the value of applying IWT to clinical medicine. © 2020 American Physiological Society. Compr Physiol 10:1207-1240, 2020.
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Affiliation(s)
- Shizue Masuki
- Department of Sports Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Japan.,Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan
| | - Mayuko Morikawa
- Department of Sports Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Japan.,Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan.,Jukunen Taiikudaigaku Research Center, Matsumoto, Japan
| | - Hiroshi Nose
- Department of Sports Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Japan.,Jukunen Taiikudaigaku Research Center, Matsumoto, Japan
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Fancourt D, Baxter L, Lorencatto F. Barriers and enablers to engagement in participatory arts activities amongst individuals with depression and anxiety: quantitative analyses using a behaviour change framework. BMC Public Health 2020; 20:272. [PMID: 32106843 PMCID: PMC7045421 DOI: 10.1186/s12889-020-8337-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 02/07/2020] [Indexed: 01/03/2023] Open
Abstract
Background There is a large literature on the health benefits of engagement with the arts. However, there are also well-recognised challenges in ensuring equity of engagement with these activities. Specifically, it remains unclear whether individuals with poor mental health experience more barriers to participation. This study used a behaviour change framework to explore barriers to engagement in participatory arts activities amongst people with either depression or anxiety. Methods Data were drawn from a large citizen science experiment focused on participation in creative activities. Participants who reported engaging infrequently in performing arts, visual arts, design and crafts, literature-related activities, and online, digital and electronic arts were included and categorised into no mental health problems (n = 1851), depression but not anxiety (n = 873) and anxiety but not depression (n = 808). Barriers and enablers to engagement were measured using an 18-item scale based on the COM-B Self-Evaluation Questionnaire, with subscales assessing psychological and physical capabilities, social and physical opportunities, and automatic and reflective motivations. Logistic regression analyses were used to identify whether individuals with either depression or anxiety reported greater barriers across any of the six domains than individuals without any mental health problems. Where differences were found, we calculated the percentage of protective association explained by various demographic, socio-economic, social, physical or geographical factors. Results Individuals with depression and anxiety felt they would be more likely to engage in arts activities if they had greater psychological and physical capabilities, more social opportunities, and stronger automatic and reflective motivations to engage. However, they did not feel that more physical opportunities would affect their engagement. Covariates explained only 8–37% of the difference in response amongst those with and without anxiety and depression. Conclusions Findings suggest that for individuals with poor mental health, there are certain barriers to participation that are not felt as strongly by those without any mental health problems. Mapping the behaviour change domains to potential interventions, activities that focus on increasing perceived capabilities, providing social opportunities, and reinforcing both automatic and reflective motivations to engage has the potential to help to redress the imbalance in arts participation amongst those with poor mental health.
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Affiliation(s)
- Daisy Fancourt
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Louise Baxter
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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Whitworth JW, Nosrat S, SantaBarbara NJ, Ciccolo JT. Feasibility of Resistance Exercise for Posttraumatic Stress and Anxiety Symptoms: A Randomized Controlled Pilot Study. J Trauma Stress 2019; 32:977-984. [PMID: 31743507 DOI: 10.1002/jts.22464] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/03/2019] [Accepted: 07/15/2019] [Indexed: 11/09/2022]
Abstract
Emerging evidence suggests that exercise may beneficially affect posttraumatic stress symptoms (PTSS), but few randomized trials exist. Additionally, the effects of resistance exercise (i.e., weight lifting or strength training) on PTSS have not been thoroughly examined. This study aimed to explore the feasibility of a brief high-intensity resistance exercise intervention for PTSS and related issues, such as anxiety, sleep, alcohol use, and depression, in non-treatment-seeking adults who screened positive for posttraumatic stress disorder (PTSD) and anxiety. The sample included 30 non-treatment-seeking, urban-dwelling adults (M age = 29.10 years, SD = 7.38; 73.3% female) who screened positive for PTSD and anxiety and were randomly assigned to either a 3-week resistance exercise intervention or a time-matched contact control condition. The results suggest the intervention was feasible, with 80.0% (n = 24) of participants completing the study, 88.9% of the resistance exercise sessions attended, and no adverse effects reported. Additionally, resistance exercise had large beneficial effects on symptoms of avoidance, d = 1.26, 95% CI [0.39, 2.14]; and hyperarousal, d = 0.90, 95% CI [0.06, 1.74], relative to the control condition. Resistance exercise also produced large improvements concerning sleep quality, d = 1.31, 95% CI [0.41, 2.21], and hazardous alcohol use, d = 0.99, 95% CI [0.13, 1.86], compared to the control condition. Overall, the findings suggest that 3 weeks of high-intensity resistance exercise is a feasible intervention for PTSS reduction in non-treatment-seeking adults who screen positive for PTSD and anxiety; additional research is needed to verify these preliminary findings.
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Affiliation(s)
- James W Whitworth
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.,The National Center for PTSD, Boston Veterans Affairs Healthcare System, Boston, Massachusetts, USA
| | - Sanaz Nosrat
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Nicholas J SantaBarbara
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Joseph T Ciccolo
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
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Svensson M, Brundin L, Erhardt S, Madaj Z, Hållmarker U, James S, Deierborg T. Long distance ski racing is associated with lower long-term incidence of depression in a population based, large-scale study. Psychiatry Res 2019; 281:112546. [PMID: 31622872 DOI: 10.1016/j.psychres.2019.112546] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 12/20/2022]
Abstract
Physical activity has been proposed to be beneficial for prevention of depression, although the importance of exercise intensity, sex-specific mechanisms, and duration of the effects need to be clarified. Using an observational study design, following 395,369 individuals up to 21 years we studied whether participation in an ultralong-distance cross-country ski race was associated with lower risk of developing depression. Skiers (participants in the race) and matched non-skiers from the general population (non-participants in the race) were studied after participation (same year for non-participation) in the race using the Swedish population and patient registries. The risk of depression in skiers (n = 197,685, median age 36 years, 38% women) was significantly lower, to nearly half of that in non-skiers (adjusted hazard ratio, HR 0.53) over the follow-up period. Further, a higher fitness level (measured as the finishing time to complete the race, a proxy for higher exercise dose) was associated with lower incidence of depression in men (adjusted HR 0.65), but not in women. Our results support the recommendations of engaging in physical activity as a preventive strategy decreasing the risk for depression in both men and women. Furthermore, the exercise could reduce risk for depression in a dose-dependent matter, in particular in males.
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Affiliation(s)
- Martina Svensson
- Experimental Neuroinflammation Laboratory, Department of Experimental Medical Science, Lund University, BMC B11, 221 84 Lund, Sweden.
| | - Lena Brundin
- Center for Neurodegenerative Sciences, Van Andel Research Institute, Grand Rapids, MI, United States
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Zachary Madaj
- Center for Neurodegenerative Sciences, Van Andel Research Institute, Grand Rapids, MI, United States
| | - Ulf Hållmarker
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Department of Internal Medicine, Mora hospital, Mora, Sweden
| | - Stefan James
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
| | - Tomas Deierborg
- Experimental Neuroinflammation Laboratory, Department of Experimental Medical Science, Lund University, BMC B11, 221 84 Lund, Sweden.
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Affiliation(s)
- Adam M Chekroud
- Spring Health, New York City, New York.,Department of Psychiatry, Yale University, New Haven, Connecticut
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50
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Gultyaeva VV, Zinchenko MI, Uryumtsev DY, Krivoschekov SG, Aftanas LI. [Exercise for depression treatment. Physiological mechanisms]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:112-119. [PMID: 31464298 DOI: 10.17116/jnevro2019119071112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This literature review considers meta-analyzes, systematic reviews and original research over the last decade addressing a comprehensive analysis of the antidepressant effect of targeted physical exercise and physical activity in general. Exercise is a promising non-pharmacological treatment for depression, showing effects that are comparable or may even exceed other first-line treatments of depression. The article introduces modern ideas about the mechanisms of depression and mechanisms of exercise effects on depression manifestations. The structures of the central nervous system, changing with the effective exercise-based treatment of depression, are indicated. Physical activity stimulates the secretion of growth factors, maintenance of angio-, synapto-, and neurogenesis. The regulation of antioxidant protection of neuronal mitochondria, a decrease in pro-inflammatory reactions and stress reactivity are also observed in response to regular exercise. Physical activity has a multimodal effect that stimulates biochemical pathways and restores neuronal structures disturbed in depression.
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Affiliation(s)
- V V Gultyaeva
- Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia
| | - M I Zinchenko
- Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia
| | - D Y Uryumtsev
- Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia
| | - S G Krivoschekov
- Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia
| | - L I Aftanas
- Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia
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