ArticleLiterature Review

Aerobic Exercise and Mood: A Brief Review, 1985-1990

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Abstract

The major reviews of research on aerobic exercise and mood published in the past 10 years and the well-controlled empirical studies in the last 5 years yield a number of consistent conclusions. First, researchers unanimously concluded that aerobic exercise and depression and anxiety are related in a inverse and consistent manner. Yet they consistently refrained from suggesting that this relationship involves causality. Second, studies consistently reported that aerobic exercise is effective in the treatment of mild to moderate forms of depression and anxiety. In fact, it was the conclusion of several researchers that aerobic exercise was as effective as more traditional methods of psychotherapy. Third, it consistently was reported that the increased benefits were greatest in those who were more depressed and more anxious. Fourth, it was reported consistently that an increase in cardiovascular fitness was not necessary for mood enhancement. Finally, because the few existing longitudinal studies predominantly involve pre-experimental and quasi-experimental designs, the hypothesis that exercise leads to mood changes cannot be accepted nor refuted at this time.

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... For example, some studies, focusing especially on young adults (20–30 years old), showed that acute exercise resulted in improved positive affect and less negative affect ( Hausenblas et al., 2008; LePage and Crowther, 2010; Kanning et al., 2012). In addition, numerous studies with older and depressive participants have demonstrated the immediate short-term improvements in depressive symptoms and the lasting improvements in affective states that can occur due to various types of PA (Folkins, 1976; LaFontaine et al., 1992; Fox, 1999; Bartholomew et al., 2005; Blake, 2009). Anxious and sedentary people seem to profit most from PA (Folkins, 1976; LaFontaine et al., 1992). ...
... We might speculate that our only currently inactive sample does profit more from small activity episodes, because of learned connections between PA and affect, compared to chronically inactive samples. Previous findings indicated that the effects of PA were stronger when initial mood levels were low (Folkins, 1976; LaFontaine et al., 1992). However, the current study did not confirm the existence of these ceiling effects. ...
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Regularly conducted exercise programs effectively influence affective states. Studies suggest that this is also true for short bouts of physical activity (PA) of 10 min or less. Accordingly, everyday life activities of short duration might be used to regulate affective states. However, this association has rarely been studied in reference to unstructured activities in ongoing real-life situations. The current study examined the influence of various everyday life activities on three dimensions of mood (valence, calmness, energetic arousal) in a predominantly inactive sample. Ambulatory Assessment (AA) was used to investigate the association between actual PA and affective states during the course of 1 day. Seventy-seven students ages 19-30 participated in the study. PA was assessed with accelerometers, and affective state assessments were conducted hourly using an e-diary with a six-item mood scale that was specially designed for AA. Multilevel analyses indicated that the mood dimensions energetic arousal (p = 0.001) and valence (p = 0.005) were positively influenced by the intensity of the activity carried out in the 10-min prior to the assessment. As their activity increased, the participants' positive feelings and energetic arousal increased. However, the students' calmness was not affected by their activity levels. The findings highlight the importance of integrating short activity intervals of 10 min or less into everyday life routines to improve affective states.
... There is also evidence that exercise independently provides a number of psychological benefits, including improvements in mood, self-image, body satisfaction, overall quality of life and psychological well-being, and reduced symptoms of depression and anxiety (24)(25)(26)(27)(28). To date no study has evaluated the effects of exercise training on depression and HRQOL outcomes in overweight and obese women with PCOS, despite the increasing prevalence of this condition in the community. ...
... This study demonstrated that a moderate energy-restricted diet in overweight and obese women with PCOS improved depression and HRQOL scores; however, exercise provided no additional benefit to that seen with diet alone. Previous research suggests that exercise independently improves psychological outcomes (24)(25)(26)(27)(28). We have previously shown that the addition of exercise did not result in any additional improvements in PCOS-related symptoms, which could potentially explain why no differences were seen (31). ...
Article
To assess the impact of adding exercise to dietary restriction on depressive symptoms and health-related quality of life (HRQOL) in women with polycystic ovary syndrome (PCOS). Analysis of depression and quality of life outcomes from a randomized, controlled prospective clinical intervention that evaluated the effects on a range of health outcomes in women with PCOS. Clinical research unit. One hundred four overweight/obese PCOS women (aged 29.3 ± 0.7 years; body mass index [BMI] 36.1 ± 0.5 kg/m(2)). Randomized to one of three 20-week lifestyle programs: diet only, diet and aerobic exercise, or diet and combined aerobic-resistance exercise. Depression and PCOS-specific HRQOL. Forty-nine women completed the intervention (diet only = 14, diet and aerobic exercise = 15, diet and combined aerobic-resistance exercise = 20). By week 20 all groups achieved weight loss and had improvements in depression and PCOS-specific HRQOL scores, except for body hair domain score. There was no difference between treatments for all outcomes. This study demonstrated that dietary restriction alone and combined with exercise had similar benefits for improving depression and HRQOL scores in overweight and obese women with PCOS.
... The varying percentage could be due to variation in sampling frame used for the respective study. The exercise was reported to be inversely related to 15,16 anxiety and depression A study done at NIMHANS by Sharma et al 17 reported prevalence of 5.8% risk for exercise addiction. ...
Article
Exercise is associated with the feeling of well-being. But it also leads to the manifestation of withdrawal symptoms on discontinuation. The present study has been done to explore the pattern of exercise behavior in the Indian context. 561 (288 males and 273 females) subjects in the age group of 18-50 years were approached for the administration of a sociodemographic data sheet, General Health Questionnaire and Exercise addiction inventory. 6.34 % were at risk category of exercise addiction and gender difference was present too. Psychiatric distress had a negative correlation with exercise addiction. 1.15% show the need for change in the exercise pattern. It has implications for enhancing the mental health professional understanding of exercise addiction.
... It makes sense to explore what type of physical activity can more effectively alleviate and treat depression in older adults. Aerobic exercises enable to ameliorate anxiety and depression symptoms scores and have a therapeutic effect on long-term mild to moderate anxiety and depression (LaFontaine et al., 1992). A study found that compared with resistance training, aerobic exercises showed a greater effect in reducing depressive symptoms in older adults (Penninx et al., 2002). ...
Article
This study provides a comprehensive and updated review of the literature with respect to the relationship between physical activity and depression in older adults. The evidence from both observational studies and experimental studies are collected to present a discussion on the type and dose of physical activity, as well as the underlying mechanisms of physical activity and depression in older adults. Overall, the results from previous studies support a solid inverse relationship between physical activity and depression in older adults, while the dose-effect relationship between them, as well as different effects among different types of physical activities, remains largely unexplored. Depression in older adults is related to an array of negative health outcomes and is more chronic compared to that in younger adults. Physical activity has been regarded as a promising non-pharmaceutical method in treating and preventing depression in older adults. Further experimental work and research need to be done to develop theoretically grounded and evidence-based interventions to better advance our knowledge of this topic and effectively promote physical activity in older adults.
... To date, a plethora of studies have received a great deal of attention on various strategies to manage and alleviate the stresses. Certain religion coping methods and spirituality [7][8][9], physical exercises [10,11], altruism [12,13] social connection and support [14,15], meditation [16,17], relaxation techniques, psycoeducation, coping skills training and cognitive reconstituting [18,19] music therapy [20,21], yoga [22], complex decongestive therapy which is a type of massage therapy [23] are known to be effective in adjustment to different types of psychological distresses over the past decades. The effects of mindfulness which is a type of meditation on stress mitigation and the associated improved cognitive function, physiological and psychological well-being of the stressed people also have long been discussed in the previous literature [24,25]. ...
... The varying percentage could be due to variation in sampling frame used for the respective study. The exercise was reported to be inversely related to anxiety and depression [15,16]. ...
... Physical exercise has an antidepressant effect, and many meta-analyses studies support this [12]. North et al. [13] showed that both one-time exercise and long-term physical exercise can effectively improve depression. ...
... In itself, this finding immediately provides an argument for the integration of exercise programs into comprehensive treatment programs for stress or depression. Although a number of studies stress the importance of using aerobic exercise in the treatment of clinical depression (LaFontaine et al. 1992), Martinsen (1990) found that the antidepressant effects linked with non-aerobic exercise were equally effective. North et al. (1990) conducted a meta-analysis based on 80 studies conducted between 1969 and 1989, and included 290 effect sizes in their analysis. ...
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This study was carried out with collegiate students who took part in an exercise program for 1 year. An exercise addiction (EA) questionnaire was used to classify EA and non-EA (NEA) groups. Exercise dependence (ED), compulsive exercise (CE), and obligatory exercise (OE) questionnaires were used to validate the EA results. A total of 38 male and 37 female college students were selected as the subjects for this study to investigate the effects of EA on psychophysiological health. The psychophysiological health variables were composed of depression, stress, body composition, and muscular joint health. This study showed that EA was significantly associated with ED (r = 0.746; P = 0.001), CE (r = 0.644; P = 0.001), and OE (r = 0.731; P = 0.001), respectively. Although there were no significant differences between EA groups and NEA groups for both males and females on depression (Z = − 0.813; P = 0.416 and Z = − 0.148; P = 0.882, respectively), physical stress (Z = − 0.777; P = 0.437 and Z = −0.074; P = 0.941, respectively), and emotional stress (Z = − 1.035; P = 0.300 and Z = − 0.573; P = 0.567, respectively), the elbow and knee joint functions of EA males were significantly higher compared with those of NEA males. However, the variables of body composition in EA females were not significantly different from those of NEA females. Being addicted to exercise for 1 year resulted in negative effects on the psychological health in both genders, while it had a negative effect on physical health for women only.
... However, the best forms of exercise for improving mental health and the specific effects of different exercises has yet to be determined. [3][4][5] This paper seeks to examine the current literature to illuminate some of the effects of various forms of physical activity upon mental health. ...
Article
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The purpose of this paper is to review the current literature to examine the effects of various forms of physical activity upon mental health. A literature review was conducted to examine specific findings of the relationship between exercise (aerobic and anaerobic) and psychological well being. It was found that aerobic exercise performed at a moderate intensity produces significantly greater positive psychological outcomes than does either high intensity aerobic exercise or anaerobic exercise. Additionally, no specific differences were discovered between various methods of aerobic exercise as long as it is conducted for over 20 minutes continuously. Low impact aerobic exercise, such as yoga or meditation was also found to have positive effects on mental health. Various mechanisms underlying the mood boosting effects of exercise are also briefly examined.
... An analysis based on 80 studies demonstrated a positive correlation between physical activity and clinical depression, regardless of gender, age or health status [27], and regular exercise by patients after termination of anti-depressants, had lower depression scores than those who were sedentary [28]. On the whole about or regular physical activity participation results in enhanced psychological well being. ...
Article
Menopausal symptoms in women can be severe and disruptive to overall quality of life. Hormone replacement therapy, is known to be effective in ameliorating symptoms, however, reporting of side effects has resulted in alternative treatment options. Exercise has been assessed as an alternative treatment option for alleviating menopausal symptoms, including, psychological, vasomotor, somatic and sexual symptoms. Here we report the effects of physical activity and exercise on menopause symptoms in menopausal women.
... The fact that RT did not lead to any significant gain is contrary to the literature and cannot be easily explained. One possible explanation is that more women were included in the RT group and that compared with men, they may have gained less benefit from exercise as suggested by LaFontaine et al. (9). ...
Article
Background: Despite various studies, supportive evidence for the efficacy of exercise in treatment of mental illness is still weak. Objective: The aim of this study was to compare two forms of exercise, namely running therapy (RT) and physiotraining therapy (PT), on stationary devices. Methods: Patients in a day treatment programme for treatment of affective disorders were randomly allocated to one of the exercise groups or to a control group. Depression scores, self-efficacy, physical conditions and appreciations of the training programme were measured. Results: After 6 weeks, no significant differences were found between both the training groups and the control group; however, after 12 weeks, the physiotraining group showed significant improvement on scores for blind-rated Hamilton Rating Scale for Depression and on scores for self-rated Beck Depression Inventory 21-item version. Conclusions: Our results suggest that PT has advantages over RT. We speculate that an improved feeling of self-efficacy may be a mediating factor.
... At this point, the research literature, which was sparse when my students examined it 10 years ago, is robust [107,108]. Exercise, it seems, can make significant contributions to the reduction of treatmentassociated side effects [109][110][111][112][113], to relieving the fatigue that often bedevils patients who have cancer [114,115], and especially to enhancing quality of life and mood [107,108,111,[116][117][118][119][120][121]. Exercise also seems to help prevent the occurrence of cancer [122][123][124][125][126][127] and may therefore have a role in preventing recurrence. ...
Article
Mind-body medicine, grounded in a respectful, therapeutic partnership, should be a central element in the care of every person diagnosed with cancer. This article reviews some of the physiologic foundations of mind-body medicine, the introduction of mind-body approaches to cancer care in the 1970s, the specific mind-body approaches that have been used, and the evidence that supports their use. The importance of group support for enhancing the effectiveness of these approaches is discussed. Guidelines are offered for integrating mind-body approaches and perspectives in the care of people who have cancer.
... For example, McAuley et al. (2002) found that increases in physical self-efficacy were associated with decreases in physique anxiety in older adult men and women in an exercise intervention. In addition to selfefficacy , exercise has also been related to a more positive body image directly through improvements in self-esteem, mood, depression (Nelson, 1991; Weyerer & Kupfer, 1994) and anxiety (LaFontaine et al., 1992). The hypothesis that within those who exercised, a greater improvement would be observed in the women who self-reported that they had osteoporosis compared to those who self-reported that they did not have osteoporosis, was not supported. ...
Article
The current study investigated body image differences in post-menopausal women who self-reported having (SRO) or not having (SRN) osteoporosis and the impact of a 16-week exercise program on body image in these groups. Participants completed a measure of body image, and were randomly assigned to a 16-week exercise program or control group, stratified by self-reported osteoporosis status. After 16 weeks, they completed the same body image measure. There were no differences in body image between the two osteoporosis groups. The exercise intervention had a positive impact on body image for both the SRO and SRN groups. The exercise groups showed increases in fitness and health orientation and body areas satisfaction from baseline to 16-weeks, while the non-exercise group showed decreases in appearance and health evaluation, health orientation and body areas satisfaction. The results suggest an exercise program for post-menopausal women can lead to improvements in body image, regardless of osteoporosis status.
... Cross-sectional, population-based studies have shown an inverse association between exercise and depression scores (20)(21)(22)(23)(24)(25)(26)(27)(28)(29), but it is unclear whether the beneficial effects of physical activity on mood persist over time. Prospective studies of exercise and depression have yielded inconsistent findings (5,20,22,27,28,(30)(31)(32). ...
Article
This study examined cross-sectional and prospective associations of exercise with depressed mood in a community-based sample of older men and women (aged 50--89 years in 1984--1987) in southern California. Regular strenuous exercise and exercise > or =3 times per week were reported; depressed mood was assessed by using the Beck Depression Inventory (BDI). After exclusion of persons with categorical depression and those rating themselves largely or extremely physically limited during the previous month, data on 932 men and 1,097 women were available for cross-sectional analysis. Exercise and depressed mood were reassessed for 404 men and 540 women in 1992--1995; these data were the focus of prospective analyses. In 1984--1987, exercise rates were high (>80%), and average BDI scores were low. Cross-sectional analyses indicated that before and after adjustment for covariates, exercise was significantly associated with less depressed mood. However, prospective analyses of the 944 persons who attended both clinic visits indicated no association between baseline exercise and either follow-up BDI score (p > 0.10) or change in BDI score between baseline and follow-up (p > 0.10). Results confirm that exercisers have less depressed mood. However, exercise does not protect against future depressed mood for those not clinically depressed at baseline.
Chapter
During menopause, women experience numerous symptoms of a psychological, somatic, vasomotor, and/or sexual nature. Women may experience none, some, or all of these types of symptoms to varying degrees, often having a significant negative impact on their overall quality of life. Data suggest that women who participate in regular exercise experience less menopausal symptoms than those who do not; hence, exercise may present a safe and accessible therapy for the symptoms of menopause. However, there are also many studies in the literature that show little or no effect of exercise alleviating these symptoms. We present the existing data and highlight the need for well-designed, appropriately powered studies in the future.KeywordsMenopauseExercisePhysical activitySomatic symptomsVasomotor symptomsPsychological symptomsInflammation
Chapter
During menopause, women experience numerous symptoms of a psychological, somatic, vasomotor and/or sexual nature. Women may experience none, some, or all of these types of symptoms to varying degrees, often having a significant negative impact on their overall quality of life. Data suggests that women who participate in regular exercise experience less menopausal symptoms than those who do not; therefore exercise may present a safe and accessible therapy for the symptoms of menopause. However, there are also many studies in the literature that show little or no effect of exercise alleviating these symptoms. Here we summarise the existing data, and highlight the need for more well-designed, appropriately powered studies in the future.
Article
Menopausal symptoms in women can be severe and disruptive to overall quality of life. Hormone replacement therapy, is known to be effective in ameliorating symptoms, however, reporting of side effects has resulted in alternative treatment options. Exercise has been assessed as an alternative treatment option for alleviating menopausal symptoms, including, psychological, vasomotor, somatic and sexual symptoms. Here we report the effects of physical activity and exercise on menopause symptoms in menopausal women.
Article
Physical inactivity and sedentary lifestyles are believed to be independent risk factors for the occurrence of numerous diseases, including, obesity, Type 2 diabetes, metabolic syndrome, cardiovascular disease, cancer and mental health, all leading to substantial morbidity and/or premature death. It has been found that regular exercise, is associated with better quality of life and health outcomes, and reduces the risk of cardiovascular disease and cancer. Here, we review the effects regular exercise has on mental health and well-being, on the immune system and in cancer, cardiovascular disease, autoimmunity and metabolic syndrome. Is exercise the new immunotherapy to treat diseases?
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Keywords:Anxiety;Alternative and complementary medicine;Relaxation;Biofeedback;Meditation;Exercise;Herbal remedies
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This study investigated the effects of exercise on mood states during the pre-menstrual (2-3 days prior to menstruation), and mid-cycle (14 days following onset of menstrual flow) stages of the menstrual cycle, in a group of regularly exercising females and in a group of non-exercising females. Mood was assessed using the Profile of Mood States (POMS) questionnaire (McNair, Lorr & Droppleman, 1971), identifying six mood state factors: Tension, Depression, Anger, Vigour, Fatigue and Confusion. ANOVA showed mood varied across the menstrual cycle with nonexercising females producing significant variations between pre-menstrual and mid-cycle mood scores in tension (p<0.001), depression (p<0.05), vigour (p<0.05) and total mood disturbance TMD (p<0.01). While mood stability as measured by TMD was lower and therefore more stable in exercising females than sedentary females, the mechanisms remain unclear. Unlike previous authors who have found exercise has a mediating effect on mood, this study showed exercise generated an enhancement in vigour for exercising females during the mid-cycle component of the menstrual cycle but negative mood states such as tension and depression were not reduced during the pre-menstruum for exercising females.
Article
This cross-sectional study examined the role of exercise in alleviating distress and the association between exercise and coping among women with early siage breast cancer (Stages O-II). Seventy-one women (mean age, 57.4 years) diagnosed over the previous 12 months participated in assessments of mood, coping, social support, and exercise behavior. Women who exercised at criterion levels recommended by the American College of Sports Medicine were compared with those who exercised irregularly and those who were inactive. After age and stage of disease were controlled for, both exercise groups reported less confusion and higher levels of social support than the inactive group did, and the women who exercised at criterion levels reported greater vigor than did their inactive peers. Cluster analyses used to explore the relationship between coping behaviors and exercise status revealed that the inactive women were less likely than the women in the other two groups to use either behavioral coping strategies or adaptive cognitive strategies. The implications of the study include the need for further exploration of the relationship between participation in exercise and mood and coping among cancer survivors.
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The hypothesis that 20-minutes of humour would result in affective benefits that are comparable to those of a 20-minute bout of aerobic exercise was analysed by using a within-participants research design. 39 university students [from the UK] were tested, at weekly intervals, three times: running or jogging at self-selected pace; watching a humorous stand-up comedy; and watching a documentary video. Mood and state anxiety were determined 5-minutes before and after each treatment by using the Subjective Exercise Experience Scale and the Spielberger State Anxiety Inventory. Both humour and exercise had an equally positive effect on psychological distress and positive wellbeing. However, humour exerted greater anxiety-lowering effect than exercise. Based on these results, it is tentatively concluded that humour could induce positive psychological changes that are at least comparable if not superior to the effects of exercise.
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The Exercise-Induced Feeling Scale (EFI; L. Gauvin and W. J. Rejeski, 1993) and the Subjective Exercise Experience Scale (SEES; E. McAuley and K. S. Courneya, 1994) were employed to compare post-exercise affect after sessions of aerobic dance, weight-training, martial arts, tai-chi and yoga, and a music appreciation (control). A sample of 195 male and female volunteers was tested before and after exercise or music appraisal. After controlling for pre-exercise levels in affect and self-reported exercising intensity, the combined tai-chi and yoga group reported higher levels of tranquillity than all other exercise groups. These individuals also reported lower psychological distress, fatigue, and exhaustion than participants in the martial arts group. The weight-training group scored higher on revitalization in contrast to the martial arts group. People in the aerobic dance and music appraisal groups were not different from the other groups. None of the exercise groups reported more positive affect than the music appreciation control group. Therefore, the exercise-specific nature of the EFI and SEES was not substantiated in the present study. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Examined relationships between a variety of exercise and fitness-related variables and heart rate recovery from a mental stressor. 108 women (mean age 26.4 yrs) participated in 2 laboratory sessions. In the 1st session, exercise and fitness measures were taken. In the 2nd session, Ss completed health and stress-related questionnaires, and heart rate recovery from a serial subtraction task was measured. Faster heart rate recovery was significantly correlated with several fitness indices including {v}{o}₂Max, self-reported fitness level, and level of activity in sports. However, faster heart rate recovery was not associated with improved health or mood, or lower general life stress; benefits in these areas were related to higher levels of fitness and exercise. (French abstract) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Exercise addiction is an area of great speculation with only limited evidence for its existence. Despite a growing body of such literature, there have been few empirical reports and very few case studies. This paper therefore outlines a case study of a female excessive exerciser. The case study has been modelled around Brown's (1993) addictive components of salience, tolerance, withdrawal, euphoria, conflict and relapse. It is demonstrated that in the case of this individual that exercise is addictive and fulfils all of Brown's addictive components.
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Depression is a common and important cause of morbidity and mortality worldwide. Depression is commonly treated with antidepressants and/or psychotherapy, but some people may prefer alternative approaches such as exercise. There are a number of theoretical reasons why exercise may improve depression. This is an update of an earlier review first published in 2009. To determine the effectiveness of exercise in the treatment of depression. Our secondary outcomes included drop-outs from exercise and control groups, costs, quality of life and adverse events. We searched the Cochrane Depression, Anxiety and Neurosis (CCDAN) Review Group's Specialised Register (CCDANCTR), CENTRAL, MEDLINE, EMBASE, Sports Discus and PsycINFO for eligible studies (to February 2010). We also searched www.controlled-trials.com in November 2010. The CCDAN Group searched its Specialised Register in June 2011 and potentially eligible trials were listed as 'awaiting assessment'. Randomised controlled trials in which exercise was compared to standard treatment, no treatment or a placebo treatment in adults (aged 18 and over) with depression, as defined by trial authors. We excluded trials of postnatal depression. For this update, two review authors extracted data on outcomes at the end of the trial. We used these data to calculate effect sizes for each trial using Hedges' g method and a standardised mean difference (SMD) for the overall pooled effect, using a random-effects model. Where trials used a number of different tools to assess depression, we included the main outcome measure only in the meta-analysis. We systematically extracted data on adverse effects and two authors performed the 'Risk of bias' assessments. Thirty-two trials (1858 participants) fulfilled our inclusion criteria, of which 30 provided data for meta-analyses. Randomisation was adequately concealed in 11 studies, 12 used intention-to-treat analyses and nine used blinded outcome assessors. For the 28 trials (1101 participants) comparing exercise with no treatment or a control intervention, at post-treatment analysis the pooled SMD was -0.67 (95% confidence interval (CI) -0.90 to -0.43), indicating a moderate clinical effect. However, when we included only the four trials (326 participants) with adequate allocation concealment, intention-to-treat analysis and blinded outcome assessment, the pooled SMD was -0.31 (95% CI -0.63 to 0.01) indicating a small effect in favour of exercise. There was no difference in drop-outs between exercise and control groups. Pooled data from the seven trials (373 participants) that provided long-term follow-up data also found a small effect in favour of exercise (SMD -0.39, 95% CI -0.69 to -0.09). Of the six trials comparing exercise with cognitive behavioural therapy (152 participants), the effect of exercise was not significantly different from that of cognitive therapy. There were insufficient data to determine risks, costs and quality of life.Five potentially eligible studies identified by the search of the CCDAN Specialised Register in 2011 are listed as 'awaiting classification' and will be included in the next update of this review. Exercise seems to improve depressive symptoms in people with a diagnosis of depression when compared with no treatment or control intervention, however since analyses of methodologically robust trials show a much smaller effect in favour of exercise, some caution is required in interpreting these results.
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For elderly hemodialysis (HD) patients we designed an original exercise rehabilitation program and investigated its effects. The findings of a two years study in 13 elderly HD patients who participated in a gymnastics program at least twice a week were compared with those in 6 control subjects. In the exercise group, VO2 at ventilatory threshold (VT) increased from 9.7±1.4 ml/min/kg to 10.3±1.4 ml/min/kg after one year, grip strength increased from 20.5±5.2 kg to 23.8±5.7 kg, and flexibility improved from 1.8±9.6cm to 3.9±9.9 cm by sit-and-reach test after two years. The changes of the three indices in the exercise and the control group were significantly different using two way repeated ANOVA test. With the improving of the instrumental activity of daily living (IADL) score, the number of patient with prolonged hospital stays more than 6 months decreased steadily in the patients group after they started the exercise rehabilitation program. Initiation of exercise rehabilitation in elderly HD patients can improve their IADL and gradually improve their physical fitness over the long term.
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هدفت الدراسة إلى الكشف عن مدى وجود أعراض اكتئابية لدى عينات مختارة من طلبة كلية التربية بجامعة السلطان قابوس خلال الفصل الدراسي الأول لهم في الجامعة. كما وهدفت الدراسة إلى استطلاع الفروق في أعراض الاكتئاب بين طلبة تخصص التربية البدنية وطلبة تخصص العلوم الإسلامية. ولتحقيق أهداف الدراسة فقد تم إجراء بعض التعديلات الطفيفة على قائمة بيك Beck للاكتئاب (BDI) لتصبح ملائمة للاستخدام في البيئة العمانية، ومن ثم تطبيقها على عينة قوامها 186 طالبا وطالبة من المسجلين بقسمي التربية البدنية والعلوم الإسلامية في بداية الفصل الأول وفي نهايته خلال العام الأكاديمي 2003/2004. وقد أظهرت النتائج أن 68% من أفراد عينة الدراسة لديهم أعراض اكتئابية تتراوح ما بين خفيفة ومتوسطة وشديدة وذلك مع بداية الفصل الدراسي الأول، وأن هذه النسبة وصلت إلى 71% في نهايته. وأظهرت النتائج أيضا أن أفراد عينة الدراسة من طلبة تخصص العلوم (ن=95) لديهم أعراض اكتئابية أكثر مما لدى أفراد عينة الدراسة من تخصص التربية البدنية (ن=89) وذلك في بداية الفصل الدراسي الأول وفي نهايته أيضا. وكشفت النتائج أن دراسة أفراد عينة الدراسة من طلبة تخصص التربية البدنية لمقرر التمرينات البدنية لم يؤدي إلى أية تغييرات ذات دلالة على أعراض الاكتئاب لديهم وذلك بمقارنتهم مع أفراد عينة الدراسة من تخصص العلوم الإسلامية الذين لم يدرسوا سوى مقررات نظرية. وأخيرا فقد بينت النتائج أن الإناث لديهن أعراض الاكتئاب بصورة أكبر مما لدى الذكور في بداية الفصل الدراسي الأول، في حين أن أعراض الاكتئاب لدى المجموعتين تتقارب مع نهاية الفصل.
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This study examined the interaction of exercise and music to establish the impact of these factors on state-anxiety and time to exhaustion comparing trained and active participants. Twenty-six university students (13 trained, 13 active) completed the State-anxiety Inventory questionnaire before and after a submaximal treadmill running until volitional exhaustion in both music and no-music condition. ANOVA showed that both trained and active groups significantly reduced their State-Anxiety scores after exercise tasks (P<0.01, partial η2=0.26) independently by the presence of music. Finding also revealed that active group reported a higher significant reduction of their state anxiety score after exercise in music condition compared to no-music task (P<0.05, d=0.80), while this effect in trained group was not significant. Moreover, data showed that only active-subjects significantly prolonged their exercise experience in presence of music (P<0.05, d=0.47), while trained group did not. This study supports the general finding that exercise is associated with state-anxiety reduction, and suggests that music during exercise may improve this effect in active but not in trained participants. Further, listening to music during exercise may prolong the participants' exercise experience but different training status seems to qualify differently this response.
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Evidence-based exercise and relaxation recommendations for people with breast cancer-related lymphedema (BCRL) are needed. We report a randomized controlled study of one program, designed to achieve synergistic improvements in physical and emotional BCRL symptoms. People in the treatment group received an exercise and relaxation program, The Breast Cancer Recovery Program (N=16). The control participants (N=16) continued with health professionals' recommendations. Participants were tested at entry, 2.5 weeks, 5 weeks, and 3 months. Treatment group participants, compared with control participants, demonstrated significant treatment effects for improved bioimpedance z, arm flexibility, quality of life, mood at 3 months, and weight loss. Adherence was high for this safe and effective program, which improved lymphedema physical and emotional symptoms.
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Physical activity is a useful tool for preventing and easing depression symptoms. When prescribing exercise as an adjunct to medication and psychotherapy, the complexity and the individual circumstances of each patient must be considered. Hopelessness and fatigue can make physical exertion difficult, and some patients are vulnerable to guilt and self-blame if they fail to carry out a regimen. A feasible, flexible, and pleasurable program has the best chance for success. Walking alone or in a group is often a good option.
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Depression is a common and important illness affecting at least 1 in 5 people during their lifetime. Exercise has been advocated as an adjunct to usual treatment. This review identified all available randomised trials which compared exercise with either no treatment or an established treatment (e.g. talking therapy) for people with a clinical diagnosis of depression. Data from 25 trials were combined. We found exercise did seem to improve the symptoms of depression, but we cannot be sure exactly how effective it is, or the most effective type of exercise. The evidence suggests that exercise probably needs to be continued in the longer-term for benefits on mood to be maintained.
Article
This study examined self-reports of physical activity behavior among college students from a stages of change perspective. A questionnaire on health needs was administered to a random sample of 800 students at a private university; 217 completed questionnaires were analyzed, using chi-square statistics. In addition to examining activity behavior from a stages of change approach, the authors explored the relationship of demographic variables to activity behavior. Forty-six percent of the students were inactive or were exercising irregularly. Gender and year in school were unrelated to stage of exercise adoption. Results from this pilot study indicate the need for stage-matched interventions to increase activity levels in young adults.
Article
Our purpose, in this prospective clinical study, was to identify the best predictors of 2-month return to work or retraining for a group of low back injured subjects (n = 40) who completed at least 8 weeks of a community-based rehabilitation program that combined aerobic and flexibility exercise conducted in the water (aquafitness) with muscle strength and endurance training. Baseline demographic characteristics and changes in physical fitness, pain, disability, and psychological well-being during the course of program participation were compared between two groups of low back injured subjects: those who returned to work (RTW) [n = 24], and those who did not (N-RTW) [n = 16]. Subjects in both groups showed comparable improvement in measures of physical fitness at 8 weeks. However, multivariate analyses showed significant between-group differences in self-report measures. The RTW group showed significant improvement in measures of pain, disability, anxiety, and vigor while self-esteem and affect remained stable. The N-RTW group displayed no change in pain and disability variables and had significant deterioration in mean overall psychological well-being over time. The best predictors of return to work using logistic regression analyses were a first injury rather than a repeat injury to the lower back, and stability in self-esteem. Suggestions are offered for further research to examine the benefits of aquafit exercise for the low back injured, for additional interventions for those with a reinjury, and for maintaining or enhancing self-esteem as a treatment goal.
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To measure the previously reported beta blocker induced adverse changes in mood state and anxiety measures, and to determine if prolonged aerobic exercise attenuates such mood modifications. After 4 days of drug treatment with comparable doses of propranolol (40 and 80 mg), metoprolol (50 and 100 mg), or placebo, mood (POMS) and anxiety states (STAI) were assessed in healthy volunteers, before and after 1 h of treadmill walking exercise at 50% maximum oxygen uptake. Compared to placebo, resting "tension", "depression", and "total mood disturbance" were significantly higher on propranolol 80 mg, but all were reduced with exercise. "Fatigue" and "confusion" were also higher on propranolol, and were unaffected by exercise. "Fatigue" was also higher than placebo after exercise on metoprolol 100 mg. "Anxiety" was unaffected by drug treatment or exercise. The evidence that beta blockers, and particularly propranolol, have adverse effects on mood was confirmed. It would be preferable to prescribe a beta blocker which does not adversely alter mood states. However, exercise significantly reduced the measures of "tension" and "depression" which were adversely increased by propranolol. Exercise prescription may therefore not only be compatible with beta blockade, but a highly desirable adjuvant therapy.
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28 college age students participating in a weight lifting class exhibited significant decreases in negative affect and increases in positive affect. Changes in affect were correlated with average exercise heart rates. Higher heart rates were correlated with reductions in negative affect and increases in positive affect. Correlations of .37 and .40 suggest that, in accordance with earlier studies, exercise intensity may be indirectly related to exercise.
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The potential health benefits derived from sustained physical activity in older people are numerous; however, whether exercise promotion should take place in general practice is unsubstantiated. Exercise promotion should use existing research evidence of the advantages of exercise for various conditions, and target those inactive individuals who currently have no intention of changing their level of physical activity. Research has also raised methodological issues and questions about the feasibility of exercise interventions which still need to be tested in exercise trials conducted in general practice.
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College health professionals deal with a range of medical problems and risky behaviors. Some medical conditions occur more frequently in the college-age population, but college health is not unique because of the types of medical problems seen. Community providers welcome the opportunity to deliver primary care to this relatively healthy population, with less emphasis on screening, intervention, mental health, social well-being, and altering unhealthy behaviors. Young people have been recognized as experiencing higher rates of morbidity, disability, and mortality from various developmental, environmental, and behavioral risk factors than the general population. These risk factors are so interrelated that successful efforts to change them require a more comprehensive approach that extends beyond the health of individuals to the wellness of an entire campus community. On the continuum of health and well-being, college health must move away from focusing on disease and move toward community wellness.
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To assess exercise habits and their relation to smoking habits and social and medical factors in postmenopausal women. A cross-sectional study with a questionnaire to all 1324 55-56 year old women in Linköping, Sweden. Response rate was 85%. About a third of the women took part in some kind of quite strenuous exercise for at least one hour a week. After a quarter worked out once a week; fewer did swimming and jogging. One in four women smoked. Women who used hormone replacement therapy, who were not smoking and who had a physically light occupation more often took part in strenuous sports. Women who had been treated for malignancies or with back problems exercised to the same extent as women in the general population. About a third of the post-menopausal women exercised on a regular basis, if exercise involved in getting to and from work was not counted. Since regular physical exercise has many health benefits, more women should be encouraged to take part in regular physical exercise. Factors probably associated with level of education and general awareness of the importance of a healthy lifestyle positively influenced the likelihood of these women to be physically active on a regular basis. A previous malignant disease or current back problems did not prevent women from taking part in exercise on a regular basis.
Article
The purpose of this study was to determine whether exercise mediates the psychological and nutritional effects of testosterone therapy in men with symptomatic HIV illness, low serum testosterone, and clinical symptoms of hypogonadism. A 12-wk open trial of biweekly intramuscular testosterone injections was conducted, with 54 men completing the trial and exercise assessments. Most (71%) men were diagnosed with AIDS; 41% had a CD4 < 50. One-third of the men were diagnosed with major depression, and nearly half had some evidence of wasting. Twenty-nine men (54%) engaged in exercise (predominantly resistance training) during the trial. Exercisers did not differ from nonexercisers on any measure of psychological well being or nutritional status at baseline. After 12 wk of testosterone treatment, those who exercised showed significant improvement in mood (Hamilton Rating Scale for Depression; HAM-D) and overall distress (Brief Symptom Inventory; BSI) (P < 0.000 for both), as well as a significant increase in body cell mass (P < 0.01) and lean body mass (mean increase of 2.6 kg; P < 0.000) as measured by bioelectric impedance analysis. In contrast, nonexercisers showed improvement on the HAM-D (P < 0.000), but not the BSI or measures of nutritional status. These findings indicate that exercise may be an important adjunct to testosterone therapy in the treatment of psychological distress and wasting symptoms in men with symptomatic HIV illness.
Article
The relation between physical exercise and psychological health has increasingly come under the spotlight over recent years. While the message emanating from physiological research has extolled the general advantages of exercise in terms of physical health, the equivalent psychological literature has revealed a more complex relation. The paper outlines the research evidence, focusing on the relation between physical exercise and depression, anxiety, stress responsivity, mood state, self esteem, premenstrual syndrome, and body image. Consideration is also given to the phenomena of exercise addiction and withdrawal, and implications for exercise prescription are discussed.
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Depression is one of the most common reasons for using complementary and alternative therapies. The aim of this article is to provide an overview of the evidence available on the treatment of depression with complementary therapies. Systematic literature searches were performed using several databases, reference list searching, and inquiry to colleagues. Data extraction followed a predefined protocol. The amount of rigorous scientific data to support the efficacy of complementary therapies in the treatment of depression is extremely limited. The areas with the most evidence for beneficial effects are exercise, herbal therapy (Hypericum perforatum), and, to a lesser extent, acupuncture and relaxation therapies. There is a need for further research involving randomized controlled trials into the efficacy of complementary and alternative therapies in the treatment of depression.
Article
Although the literature on increased physical fitness and psychological outcomes has grown large, a number of methodological limitations remain unaddressed. The present study was designed to address a number of these limitations while examining the short- and long-term psychological effects following completion of a 12-week aerobic fitness program using bicycle ergometry (and confirmed increases in fitness). Following completion of a 12-week aerobic fitness program (and through 12 months of follow-up), 82 adult participants completed the Beck Depression Inventory, Profile of Mood States, State-Trait Anxiety Inventory, and the Tennessee Self-Concept Scale. Physiological measures used to assess changes in aerobic fitness were maximal work load, submaximal heart rate at a standard work load, predicted maximum oxygen uptake, and resting heart rate. Exercise participants experienced a positive fitness change and psychological improvement over the initial 12-week program compared to a control group. At 1 year follow-up, physiological and psychological benefits remained significantly improved from baseline. Overall, results indicate that exercise-induced increases in aerobic fitness have beneficial short-term and long-term effects on psychological outcomes. We postulate that participants in the exercise group did not increase the amount of weekly exercise they performed over the 12-month follow-up period and thus the maintenance of the psychological improvements occurred concurrent with equal or lesser amounts of exercise.
Article
With the increase in the number of women who have survived breast cancer, there is a growing need to attend to the physical and emotional effects of cancer and its treatment as experienced by these survivors. Psychological distress, fatigue, weight gain, premature menopause and changes in body image are some of the long-term sequelae of breast cancer. Exercise as an adjunctive treatment may help to attenuate these effects and thereby contribute to rehabilitation of women with breast cancer. We present data from the exercise literature and from studies on breast cancer patients that support this role of exercise. Following a critique of the research efforts, we present a brief outline of questions that should be addressed in evaluating the role of exercise in cancer rehabilitation.
Article
To determine the effectiveness of exercise as an intervention in the management of depression. Systematic review and meta-regression analysis of randomised controlled trials obtained from five electronic databases (Medline, Embase, Sports Discus, PsycLIT, Cochrane Library) and through contact with experts in the field, bibliographic searches, and hand searches of recent copies of relevant journals. Standardised mean difference in effect size and weighted mean difference in Beck depression inventory score between exercise and no treatment and between exercise and cognitive therapy. All of the 14 studies analysed had important methodological weaknesses; randomisation was adequately concealed in only three studies, intention to treat analysis was undertaken in only two, and assessment of outcome was blinded in only one. The participants in most studies were community volunteers, and diagnosis was determined by their score on the Beck depression inventory. When compared with no treatment, exercise reduced symptoms of depression (standardised mean difference in effect size -1.1 (95% confidence interval -1.5 to -0.6); weighted mean difference in Beck depression inventory -7.3 (-10.0 to -4.6)). The effect size was significantly greater in those trials with shorter follow up and in two trials reported only as conference abstracts. The effect of exercise was similar to that of cognitive therapy (standardised mean difference -0.3 (95% confidence interval -0.7 to 0.1)). The effectiveness of exercise in reducing symptoms of depression cannot be determined because of a lack of good quality research on clinical populations with adequate follow up.
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The influence of exercise mode and practice qualities on the stress reduction benefits of exercise was examined. College students in swimming, body conditioning, hatha yoga, fencing, exercise, and lecture-control classes completed the Profile of Mood States and the State Anxiety Inventory before and after class on three occasions. Swimmers had unusually positive initial moods and reported less tension and confusion after swimming only on the first day of testing. Participants in yoga, an anaerobic activity that satisfied three of the four mode requirements, were significantly less anxious, tense, depressed, angry, fatigued, and confused after class than before on all three occasions. Supporting the importance of the four mode characteristics, participants in the exercise control activity of fencing reported improvements only in vigor. A possible influence of practice conditions was observed when members of the body conditioning class reported significant increases in fatigue, but no other mood changes. Results of this study supported the possibility that exercise mode and practice requirements in the proposed taxonomy moderate the stress reduction benefits.
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Evidence for an independent role of increased physical activity in the primary prevention of coronary heart disease has grown in recent years. The authors apply the techniques of meta-analysis to data extracted from the published literature by Powell et al. (Ann Rev Public Health 1987;8:253-87), as well as more recent studies addressing this relation, in order to make formal quantitative statements and to explore features of study design that influence the observed relation between physical activity and coronary heart disease risk. They find, for example, a summary relative risk of death from coronary heart disease of 1.9 (95% confidence interval 1.6-2.2) for sedentary compared with active occupations. The authors also find that methodologically stronger studies tend to show a larger benefit of physical activity than less well-designed studies.
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Using data from the National Health Interview Survey and the RAND Health Insurance Experiment, we estimated the external costs (costs borne by others) of a sedentary life-style. External costs stem from additional payments received by sedentary individuals from collectively financed programs such as health insurance, sick-leave coverage, disability insurance, and group life insurance. Those with sedentary life-styles incur higher medical costs, but their life expectancy at age 20 is 10 months less so they collect less public and private pensions. The pension costs come late in life, as do some of the medical costs, and so the estimate of the external cost is sensitive to the discount rate used. At a 5 percent rate of discount, the lifetime subsidy from others to those with a sedentary life style is $1,900. Our estimate of the subsidy is also sensitive to the assumed effect of exercise on mortality. The subsidy is a rationale for public support of recreational facilities such as parks and swimming pools and employer support of programs to increase exercise.
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Although a variety of psychological benefits have been attributed to regular exercise, few experimentally controlled studies of healthy individuals currently exist. One hundred twenty healthy, sedentary, middle-aged men and women were randomly assigned to either a 6-month home-based aerobic exercise training program or to an assessment-only control condition. Adherence across the 6-month period was found by both self-report and heart rate microprocessor methods to exceed 75% in both sexes. To assess changes in a variety of psychological variables over time, a 14-item Likert rating scale was completed and returned on a biweekly basis throughout the 6-month period. Slope analyses conducted on the 11 items attaining acceptable testretest reliability coefficients showed significant between-groups differences on the 3 items most closely associated with the actual physical changes that occurred with exercise (all ps < .004). Implications in relation to repeated measurement of psychological changes in nonclinical populations and the determination of the relevant population-, activity-, and program-specific parameters involved are discussed. Key words: aerobic exercise, psychological well-being, exercise in healthy adults
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The cardiovascular and behavioral adaptations associated with a 4-month program of aerobic exercise training were examined in 101 older men and women (mean age = 67 years). Subjects were randomly assigned to an Aerobic Exercise group, a Yoga and Flexibility control group, or a Waiting List control group. Prior to and following the 4-month program, subjects underwent comprehensive physiological and psychological evaluations. Physiological measures included measurement of blood pressure, lipids, bone density, and cardiorespiratory fitness including direct measurements of peak oxygen consumption (VO2) and anaerobic threshold. Psychological measures included measures of mood, psychiatric symptoms, and neuropsychological functioning. This study demonstrated that 4 months of aerobic exercise training produced an overall 11.6% improvement in peak VO2 and a 13% increase in anaerobic threshold. In contrast, the Yoga and Waiting List control groups experienced no change in cardiorespiratory fitness. Other favorable physiological changes observed among aerobic exercise participants included lower cholesterol levels, diastolic blood pressure levels, and for subjects at risk for bone fracture, a trend toward an increase in bone mineral content. Although few significant psychological changes could be attributed to aerobic exercise training, participants in the two active treatment groups perceived themselves as improving on a number of psychological and behavioral dimensions.
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Forty clinically depressed women were randomized to a running, weight lifting, or delayed treatment condition. Self-concept was assessed at baseline, pre-, mid-, and posttreatment for all subjects and at 1, 7, and 12 months for exercise groups. Significant improvements in self-concept were found for exercise groups relative to control groups. No significant differences between exercise groups were found, and improvements were reasonably well-maintained over time. Differential changes on dimensions of self-concept were not demonstrated. These results suggest that both running and weight lifting exercise programs improve self-concept in clinically depressed women.
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Thirty-two female students participated in a single-session experiment during which they carried out two 8-min trials of high-intensity exercise and two 8-min trials of low-intensity exercise. One high- and one low-exercise trial were accompanied by music; the other two trials were accompanied by metronome. Mood was assessed with a modification of the Profile of Mood States before and immediately after each trial. The purpose of the experiment was disguised to reduce the influence of subject expectations on mood responses. Participants were divided into fit and unfit groups based on heart rate responses during high-exercise trials. Overall, high-intensity exercise led to increases in tension/anxiety and fatigue, whereas positive mood changes (vigor and exhilaration) were seen following low-intensity exercise only. No group differences in mood responses were observed. Explanations of these results are considered in light of other literature concerning the acute effects of exercise on mood. Key words: aerobic exercise, mood, physical fitness
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We compared the effectiveness of an aerobic and nonaerobic exercise in the treatment of clinical depression in women. A total of 40 women, screened on the Research Diagnostic Criteria for major or minor depressive disorder, were randomly assigned to an 8-week running (aerobic), weight-lifting (nonaerobic), or wait-list control condition. Subjects were reassessed at mid- and posttreatment, and at 1-, 7-, and 12-month follow-ups. Depression was monitored by the Beck Depression Inventory, Lubin’s Depression Adjective Check List, and the Hamilton Rating Scale for Depression; fitness level was assessed using submaximal treadmill testing. Results were remarkably consistent across measures, with both exercise conditions significantly reducing depression compared with the wait-list control condition, and generally appearing indistinguishable from each other. No significant between-group fitness changes were noted. These findings indicate that both types of exercise conditions significantly reduce depression and that these results are not dependent on achieving an aerobic effect.
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To determine whether aerobic fitness training alters response to psychosocial stress, 38 males were randomly assigned to either aerobic, anaerobic (weight-lifting), or waiting-list control groups. Experimental groups met three to four times per week in 1-hr sessions aimed at improving either cardiovascular endurance or muscular strength. Aerobic fitness level, heart rate and subjective response to laboratory psychosocial stress, and self-reports of daily stress, coping resources and psychologic symptoms were assessed prior to and following 10 weeks of training. Although posttraining fitness measures confirmed the effectiveness of aerobic training, no group differences were seen on laboratory or self-report measures. However, for aerobic trainers alone, fitness improvement tended to correlate with faster heart rate recovery following psychosocial stress. Fitness improvement was not correlated with any other psychologic changes. This experiment provides only modest support for the hypothesis that aerobic training alters response to psychosocial stress. It is suggested that future work on the psychologic effects of aerobic fitness explore the contribution of training parameters as well as subject characteristics.
Article
To determine the antihypertensive efficacy of aerobic exercise training in mild essential hypertension, a prospective randomized controlled trial was conducted comparing an aerobic exercise regimen to a placebo exercise regimen, with a crossover replication of the aerobic regimen in the placebo exercise group. The study took place in an outpatient research clinic in a university-affiliated Veterans Administration medical center. Twenty-seven men with untreated diastolic blood pressure (DBP) of 90-104 mm Hg were randomized to the two exercise regimens. Ten patients completed the aerobic regimen. Nine patients completed the control regimen, seven of whom subsequently entered and completed the aerobic regimen. The aerobic regimen consisted of walking, jogging, stationary bicycling, or any combination of these activities for 30 minutes, four times a week, at 65-80% maximal heart rate. The control regimen consisted of slow calisthenics and stretching for the same duration and frequency but maintaining less than 60% maximal heart rate. DBP decreased 9.6 +/- 4.7 mm Hg in the aerobic exercise group but increased 0.8 +/- 6.2 mm Hg in the placebo control exercise group (p = 0.02). Systolic blood pressure (SBP) decreased 6.4 +/- 9.1 mm Hg in the aerobic group and increased 0.9 +/- 9.7 mm Hg in the control group (p = 0.11). Subsequently, seven of the nine controls entered a treatment crossover and completed the aerobic regimen with significant reductions in both DBP (-6.1 +/- 3.2 mm Hg, p less than 0.01) and SBP (-8.1 +/- 5.7 mm Hg, p less than 0.01). BP changes were not associated with any significant changes in weight, body fat, urinary electrolytes, or resting heart rate. This randomized controlled trial provides evidence for the independent BP lowering effect of aerobic exercise in unmedicated mildly hypertensive men.
Article
There are few data that specifically address the effects of exercise training on elderly patients with diabetes mellitus; thus, much of the information contained herein is extrapolated from studies on young and nondiabetic subjects. With acute exercise, there is a marked enhancement in glucose uptake and utilization despite a decline in plasma insulin concentration. Several hypotheses have been suggested to explain this well-described but seemingly paradoxical situation, and most recently, a muscle-contraction-induced increase in membrane-associated glucose-transporter units has been described. In diabetes, there is a breakdown in the usually precise balance between glucose delivery and utilization necessary to maintain stable blood glucose concentrations during acute exercise. In hypoinsulinemic states (untreated diabetes mellitus), glucose production by the liver can be greater than muscle uptake and utilization, resulting in hyperglycemia. Conversely, in hyperinsulinemic conditions (treatment with large doses of subcutaneous insulin), glucose production can be inordinately suppressed relative to uptake and utilization, resulting in hypoglycemia. Therefore, in diabetic patients, adequate glucose control is important before initiating an exercise program. Endurance exercise training has been suggested as an adjunct to diet therapy for noninsulin-dependent diabetes mellitus (NIDDM) patients. Although early studies showed improvement in insulin resistance (lower insulin levels) with endurance training, little or no benefit in glucose control was demonstrated. More recent studies have noted improvement in fasting plasma glucose and glycosylated hemoglobin concentrations and oral glucose tolerance with endurance training. The difference between these studies may be explained by the time at which the tests were conducted relative to the last episode of exercise, because there appears to be a rapid detraining effect on glucose tolerance after short-term endurance training. Even if the effects on plasma glucose levels are limited, there are other important potential benefits of endurance training in elderly diabetic patients. Maximal and submaximal aerobic capacity both decline with age and are at least partially reversible with endurance training. Potentially even more important are the effects of endurance training on risk factors for atherosclerosis. Endurance training may improve lipid profiles by reducing very-low-density lipoprotein triglyceride and low-density lipoprotein cholesterol while increasing high-density lipoprotein cholesterol. Small reductions in blood pressure are also frequently noted with endurance training. The fall in plasma insulin concentration associated with training may by itself also reduce cardiovascular risk. Obesity is an independent risk factor for cardiovascular disease, and endurance training can be beneficial in producing and maintaining weight loss. This is especially important in the elderly because they are often fatter than their younger counterparts. Recent data suggest that endurance training preferentially reduces central and intraabdominal adiposity in the elderly. This is significant because an increased central distribution of body fat is found in elderly and NIDDM patients. I conclude that, although there is little direct evidence, extrapolated data support a potentially important role for endurance exercise training in the treatment of elderly diabetic patients. The possible benefits are not limited to improvements in insulin and glucose levels but also extend to reduction of important risk factors for atherosclerosis. By following the suggestions contained herein, many elderly diabetic patients can safely benefit from endurance training.
Article
This study was designed to replicate and extend previous observations that the acute response to high intensity exercise is an increase in anxiety and other negative feelings. Forty female volunteers were allocated to two conditions—20 exercised at high level (100W) for 1.5 min, while 20 exercised at a low level (ZW). The purpose of the experiment was disguised. Mood was assessed before. during and immediately after exercise, and over a 1.5-min recovery period. Subjects were subsequently divided into highly and moderately fit groups on the basis of cardiac responses to a standard workload. It was found that tensiodanxiety increased immediately after high intensity exercise, declining over the recovery period. A similar pattern was found for mental fatigue. During exercise itself, anxiety diminished in the low but not the high intensity condition, No differences between fitness groups were observed in these patterns, although highly fit subjects reported greater mental vigour and exhilaration than moderately fit subjects following high intensity exercise. The mechanisms that may mediate these responses are discussed.
Article
This study was designed to assess the effects of exercise on psychological functioning in healthy Type A men. Seventy-three middle-aged men (M=42.2 years) were randomly assigned either to an aerobic exercise (AE) training group or to a strength and flexibility (SF) training group. Subjects completed a comprehensive psychological assessment battery prior to beginning the 12-week exercise programs, and after completing the programs. The psychological test battery included measures of depression, anxiety and stress, as well as various psychiatric symptoms. In addition, subjects underwent graded exercise treadmill tests (ETT) at both times of measurement in order to document changes in cardiorespiratory fitness. Aerobic exercise training consisted of walking, jogging or stair-climbing at an intensity of at least 70% of initial measured maximal oxygen consumption (VO2max determined during the treadmill test). Strength and flexibility training consisted of circuit Nautilus training with no aerobic exercise. Results at the conclusion of the 12-week programs indicated that [Vdot]O2max for the AE group increased by 15%, while the SF group did not change. Both groups improved on measures of psychological well-being; however, there were no differential effects of the two exercise programs on measures of psychological functioning. These results suggest that improved cardiovascular fitness is not necessary for psychological improvement among exercise participants.
Article
59 undergraduates were placed in 1 of 3 groups based on ability and commitment to running. Each group completed the Profile of Mood States (POMS) over a 6-hr period that centered on the time of day at which Ss ran; all Ss completed a commitment to running scale. Runners had significantly more positive POMS profiles than nonrunners. Mood changes over time suggest that the activity of running may improve one's mood and that moderate levels of running result in positive mood profiles comparable to those of advanced runners. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Investigated the psychophysiological effects of exercise on measures of cardiovascular fitness, depression, and anxiety in male psychiatric outpatients. In addition to self-report measures, electromyogram (EMG) assay and digital skin temperature were performed to measure physiological concomitants of anxiety. The 9 Ss in the running treatment group ran 3 days/week while the 9 Ss in the corrective therapy group were involved in noncardiovascular exercise for 1 hr, 3 times/week. Nine Ss were in a waiting list control group. Results demonstrate significant improvements in cardiovascular conditioning for the running treatment group and significant decrements in depression for the running treatment group compared with the waiting list controls. Results of EMG activity demonstrated that the running treatment group was significantly less tense; however, running was not effective in reducing cognitive anxiety. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Replicates and extends the present authors' (1979, 1984) previous research comparing the effects of running and various kinds of psychotherapy in the treatment of clinical depression, using improved procedures to increase compliance with all treatment conditions. 74 Ss (mean age 30 yrs) completed an assessment battery that included the Social Adjustment Self-Report Scale and the Cornell Medical Index–Health Scale and were randomly assigned to 1 of 3 treatment conditions: running therapy, meditation-relaxation therapy, or group therapy. Data analysis focused on selected variables from the assessment battery that reflected depression, general psychological distress, and symptom changes hypothesized to be specific to each of the 3 treatments. Findings reveal that the majority of Ss assigned to running started treatment, but many dropped out within the 1st 6 sessions. Ss who were assigned to the group or meditation conditions were more likely to drop out immediately (i.e., fail to start). Ss in each condition who completed treatment showed improvement in depression at termination and at 9-mo follow-up. The specific improvement in depression was accompanied by more general improvement in other areas such as global symptoms, interpersonal and somatic distress, anxiety, and tension. Comparisons among treatments suggested that the 3 treatments were generally of equal effectiveness. (53 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The modern lifestyle, including Western-style eating habits, cigarette smoking, and physical inactivity, is among the multiple contributors to development of atherosclerosis and increased risk of coronary heart disease (CHD). Recent epidemiologic evidence strongly suggests that risk of major CHD events can be substantially reduced with an average of 30 to 60 minutes per day of even moderate-intensity dynamic physical activity (PA). Attenuation of a number of atherogenic metabolic and physiologic risk factors appears to play a role. This includes reductions in elevated levels of plasma triglycerides and their lipoprotein carriers and an incerease in plasma levels of high-density lipoprotein (HDL) cholesterol; reduced blood pressure levels and risk of hypertension; and improved cell insulin sensitivity and glucose tolerance, reducing risk of non-insulin-dependent diabetes mellitus. An associated loss of excess weight and fat and an improvement in VO2 max levels with exercise contribute to these antiatherogic effects of exercise. Recent research also suggests that resistive exercise may also favorably alter atherogenic risk factors, but this remains to be confirmed. Other possible contributors to reduced risk of CHD by exercise training are reduced myocardial oxygen demands; increased coronary blood supply; improved myocardial function; reduced myocardial susceptibility to serious ventricular arrhythmias; and a reduced tendency for coronary thrombosis. Additional research is required to confirm and better define the dose-response relationships for these beneficial physiologic adaptations. (C) Lippincott-Raven Publishers.
Article
A search was made for exercise intervention studies with experimental designs on clinically depressed subjects. Nine studies were found and these were reviewed. The diagnostic categories were non-bipolar depressions of mild to moderate severity. The results of all studies tended to point in the same direction. Aerobic exercise was more effective than placebo or no treatment, and it was as effective as other treatment methods: group psychotherapy, different forms of individual psychotherapy and meditation-relaxation. Aerobic exercise was the most commonly used form of exercise, but divergent opinions exist regarding the importance of the aerobic element.
Article
Using 61 sedentary working women as subjects, this study evaluated the effects of two eight-session stress-reduction interventions. The programs were aerobic exercise (jogging) and progressive relaxation. Trait anxiety, self-efficacy, and problem- and emotion-focused coping scales were administered as pretests, posttests, and at eight-week follow-up. Both programs significantly reduced trait anxiety and increased self-efficacy from pre- to posttreatment, and these effects were maintained at follow-up. Unexpectedly, coping strategies did not change significantly over treatments. No significant differences were found between the two programs.
Article
The traditional treatments for nonbipolar affective disorders have been pharmacological. Recently, a number of well-designed studies have demonstrated the efficacy of different nonpharmacological treatments for depression. Exercise has been among the more novel approaches to the treatment of depression, and the antidepressant effects of exercise have received considerable popular attention. The early research reports on the effects of exercise on depression suffer from conceptual confusion and methodological problems. An appraisal of recent research, however, provides grounds for cautious optimism regarding the potential therapeutic effects of exercise.
Article
Thesis (M.P.E.)--University of British Columbia, 1987. Includes bibliography.
Article
A proportion of postcoronary patients seen 16 to 18 months after infarction are seriously depressed (high D score on Minnesota Multiphasic Personality Inventory). A follow-up of 44 such depressed patients showed a significant (p less than 0.001) decrease of standardized D scores, from 80 to 72 units over 4 years of exercise-based rehabilitation. There were associated decreases in scores for hysteria, hypochondriasis, and psychasthenia. A decrease of D score was associated with exercise compliance. An increase of D score was associated with a significant (p less than 0.05) worsening of ST segmental sagging, suggesting that progression of the disease process had contributed to the increase of depression. All of the patients had high (feminine) scores on the masculinity/femininity scale of the MMPI test. This finding was unrelated to the daily running distance or medication; it could represent a "feminine" personality, or be a typical response in a well-educated white collar group. Evidence of successful group interaction may be indicated by reduction in scores for social introversion and schizophrenic traits.
Article
The relationship between moderate exercise training (five 45 min sessions/week, brisk walking at 62 beta +/- 2% VO2max for 15 weeks, psychological well-being and mood state was investigated in a group of 35 sedentary, mildly obese women. A 2 (exercise (EX) (N = 18), and nonexercise (NEX) (N = 17) groups) x 3 (baseline, 6-week, 15-week testing sessions) factorial design was used with data analyzed using repeated measures ANOVA. Four psychological tests were administered: Daily Hassles Scale (DHS), General Well-being Schedule (GWB), Spielberger State Anxiety Inventory (S-Anxiety), and Profile of Mood States (POMS). The EX and NEX groups had significantly different patterns of change over time for GWB total scores [F(2,66) = 5.72, p = 0.005] and the GWB subscales 'energy level' and 'freedom from health concern or worry'. Scores for the EX group were elevated at both 6 and 15 weeks. General well-being total scores and subscale 'energy level' scores were significantly correlated with improvement in submaximal cardiorespiratory fitness (r = -0.41, p = 0.014; r = -0.40, p = 0.017, respectively). Exercise training also had a significant effect on frequency but not intensity of DHS scores, and S-Anxiety, with a significant decrease seen in the EX group at 6 weeks but not 15 weeks. Profile of Mood States scores were not significantly related to exercise training. These data support the results of other studies that have reported improvement in general psychological well-being with exercise training.
Article
The achievement of chronic blood pressure (BP) control in persons with mild hypertension is of central strategic concern in the prevention of hypertension-related morbidity and mortality. Epidemiologic and longitudinal studies suggest that regular participation in physical activity may be beneficial both in preventing hypertension and in lowering an already elevated BP. Moreover, preliminary analyses from our center suggest that cardiorespiratory fitness and, by inference, aerobic exercise may be of benefit in reducing mortality rates in hypertensive patients. When prescribing exercise with the intention of reducing an elevated BP and attenuating the risk for coronary artery disease, several factors must be considered to optimize the likelihood of a safe and effective response. These factors include specific safety aspects, and the type, frequency, intensity, and duration of exercise. In this respect, we recommend that aerobic exercise be performed at an intensity corresponding to 55 and 85% of the maximal heart rate and that the duration and frequency of training be modulated to achieve a weekly energy expenditure of between 14 and 20 kcal/kg of body weight. For those patients who require drug therapy, the interaction between the specific antihypertensive agent and exercise must also be considered.
Article
To determine the antihypertensive efficacy of aerobic exercise training in mild essential hypertension, a prospective randomized controlled trial was conducted comparing an aerobic exercise regimen to a placebo exercise regimen, with a crossover replication of the aerobic regimen in the placebo exercise group. The study took place in an outpatient research clinic in a university-affiliated Veterans Administration medical center. Twenty-seven men with untreated diastolic blood pressure (DBP) of 90-104 mm Hg were randomized to the two exercise regimens. Ten patients completed the aerobic regimen. Nine patients completed the control regimen, seven of whom subsequently entered and completed the aerobic regimen. The aerobic regimen consisted of walking, jogging, stationary bicycling, or any combination of these activities for 30 minutes, four times a week, at 65-80% maximal heart rate. The control regimen consisted of slow calisthenics and stretching for the same duration and frequency but maintaining less than 60% maximal heart rate. DBP decreased 9.6 +/- 4.7 mm Hg in the aerobic exercise group but increased 0.8 +/- 6.2 mm Hg in the placebo control exercise group (p = 0.02). Systolic blood pressure (SBP) decreased 6.4 +/- 9.1 mm Hg in the aerobic group and increased 0.9 +/- 9.7 mm Hg in the control group (p = 0.11). Subsequently, seven of the nine controls entered a treatment crossover and completed the aerobic regimen with significant reductions in both DBP (-6.1 +/- 3.2 mm Hg, p less than 0.01) and SBP (-8.1 +/- 5.7 mm Hg, p less than 0.01). BP changes were not associated with any significant changes in weight, body fat, urinary electrolytes, or resting heart rate. This randomized controlled trial provides evidence for the independent BP lowering effect of aerobic exercise in unmedicated mildly hypertensive men.
Article
Chronic essential hypertension is a major public health problem afflicting an estimated 15 to 30% of persons from most Western industrialised countries. Persons with mild hypertension (diastolic blood pressure between 90 and 104mm Hg and/or systolic blood pressure between 140 and 159mm Hg) represent the overwhelming majority of hypertensive individuals in the general population. The achievement of long term blood pressure control in these individuals is of central strategic concern in the prevention of hypertension-related morbidity and mortality. Epidemiological studies suggest that regular participation in physical activity may be beneficial in preventing hypertension. The findings of epidemiological studies are supported by a recent meta-analysis of 25 longitudinal aerobic training studies, in which the average sample-size-weighted reductions in resting systolic and diastolic blood pressures were 10.8mm Hg and 8.2mm Hg, respectively. Moreover, preliminary analyses from our centre suggest that cardiorespiratory fitness and, by inference, aerobic exercise training may be of benefit in reducing mortality rates in hypertensive patients. When compiling an exercise prescription with the intention of reducing an elevated blood pressure and attenuating the risk for coronary artery disease, several factors must be considered in order to optimise the likelihood of a safe and effective response. Specifically, the 5 basic components of the exercise prescription for patients with mild hypertension are safety aspects, the type of exercise to be performed, and the frequency, intensity and duration of exercise training. For those patients who require pharmacotherapy, the interaction between the specific antihypertensive agent and exercise responses must also be considered. We recommend that aerobic exercise training be performed at an intensity corresponding to 60 to 85% of the maximal heart rate and that the duration and frequency be modulated to achieve a weekly energy expenditure of between 14 and 20 kcal/kg of bodyweight.
Article
We studied separately the effects of weight loss by calorie restriction (dieting) and by calorie expenditure (primarily, running) on lipoprotein subfraction concentrations in sedentary, moderately overweight men assigned at random into three groups as follows: exercise without calorie restriction (n = 46), calorie restriction without exercise (n = 42), and control (n = 42). Plasma lipoprotein mass concentrations were measured by analytic ultracentrifugation for flotation rates (F0(1.20), S0f) within high density lipoprotein (HDL) (F0(1.20) 0-9), low density lipoprotein (LDL) (S0f 0-12), intermediate density lipoprotein (IDL) (S0f 12-20), and very low density lipoprotein (VLDL) (S0f 20-400) particle distributions. Particle diameter and flotation rate of the most abundant LDL species were determined by nondenaturing polyacrylamide gradient gel electrophoresis and analytic ultracentrifugation, respectively. During the 1-year trial, the exercisers ran (mean +/- SD) 15.6 +/- 9.1 km/wk, and the dieters ate 340 +/- 71 fewer kilocalories per day than at baseline. Total body weight was reduced significantly more in dieters (-7.2 +/- 4.1 kg) and exercisers (-4.0 +/- 3.9 kg) than controls (0.6 +/- 3.7 kg). As compared with mean changes in controls, the exercisers and dieters significantly increased HDL2 mass (48.6% and 47.1%, respectively), decreased VLDL mass (-23.9% and -25.5%), and increased LDL peak particle diameter (2.4 and 3.2 A). When adjusted to an equivalent change in body mass index by analysis of covariance, 1) exercise-induced and diet-induced weight loss produced comparable mean changes in the mass of small LDL and VLDL, and in LDL peak particle diameter; 2) the exercisers versus control group difference in HDL2 was attributed to the exercisers' reduced body mass index; and 3) HDL2 increased significantly less in dieters than in exercisers. In dieters, low calorie intake might mitigate the effects of weight loss on HDL2.
Article
Nine thousand three hundred and seventy six male civil servants, aged 45-64 at entry, with no clinical history of coronary heart disease, were followed for a mean period of 9 years and 4 months during which 474 experienced a coronary attack. The 9% of men who reported that they often participated in vigorous sports or did considerable amounts of cycling or rated the pace of their regular walking as fast (over 4 mph, 6.4 km/h) experienced less than half the non-fatal and fatal coronary heart disease of the other men. In addition, entrants aged 55-64 who reported the next lower degree of this vigorous aerobic exercise had rates less than two thirds of the remainder; entrants of 45-54 did not show such an effect. When these forms of exercise were not vigorous they were no protection against the disease, nor were other forms of exercise or high totals of physical activity per se. A history of vigorous sports in the past was not protective. Indications in these men are of protection by specific exercise: vigorous, aerobic, with a threshold of intensity for benefit and "dose response" above this threshold, exercise that has to be habitual, and continuing, which suggests that protection is against the acute phases of the disease. Those men who took vigorous aerobic exercise were demonstrably a favourably "selected" group; they suffered less of the disease, however, whether at low risk or high by the several risk factors that were studied. Men with exercise-related reduction in coronary heart disease also had lower death rates from the total of other causes, and so lower total death rates than the rest of the men.
Article
To determine whether fitness alters psychological and physiological indices of well-being, male police officers were assigned to either an aerobic or anaerobic training condition or to a no treatment control group. The training groups met three times per week in 45 min sessions aimed at improving either cardiovascular endurance or muscle strength. Aerobic fitness level, heart rate, blood pressure and self-report of stress and well-being were measured prior to and following 10 weeks of training. Post-training fitness measures confirmed the effectiveness of training and between group differences for physiological and self-report measures were found. Subjects undergoing aerobic training evinced larger changes on the self-report measures of well-being and stress than the anaerobic trainers and both groups showed significant improvement when compared to controls. This experiment provides support for the hypothesis that exercise, and in particular aerobic exercise, has positive effects of well-being. It is suggested that future research might usefully explore the particular contribution of different aspects of the training situation to these effects.
Article
We measured the association between walking for exercise and the ratio of total cholesterol/HDL cholesterol in 3,621 adults. After controlling for age, gender, income, body fat, alcohol use, exercise other than walking, and cigarette smoking, adults in the high, moderate, and low duration walking categories were compared to those in the no walking-no exercise category. The relative risk for total/HDL ratios of 5.0 or more were .46 (95% CI = .27, .80), .48 (95% total/HDL ratios of 5.0 or more were .46 (95% CI = .27, .80), .48 (95% CI = .30, .76), and 1.11 (95% CI = .81, 1.53) respectively.
Article
It has been suggested that regular exercise produces favorable changes in serum lipid and lipoprotein-cholesterol concentrations. However, most of the subjects in this area of research have been men. Given the differences in lipid profiles between men and women, we wanted to determine if these same favorable changes took place in women. Of the 145 longitudinal studies available in this area, 27 met the criteria for inclusion in this analysis (i.e., an exercise training study that used women subjects and measured changes in lipid concentrations). Results show that exercise does favorably alter serum lipid profiles in women by reducing total cholesterol (194 to 190 mg.dl-1; P = 0.02), triglyceride (91 to 82 mg.dl-1; P = 0.01), and the ratio of total cholesterol to high-density lipoprotein-cholesterol (3.28 to 3.16; mg.dl-1; P = 0.03). However, a significant increase in high-density lipoprotein-cholesterol or decrease in low-density lipoprotein-cholesterol concentration was not observed. Results also show that changes in body weight during exercise are associated with changes in total cholesterol (r = 0.56; P = 0.01) and triglyceride (r = 0.42; P = 0.06) concentrations, indicating that greater body weight losses resulted in larger decreases in cholesterol and triglyceride concentrations. Further analysis indicates that those women most at risk for heart disease (elevated pre-exercise cholesterol concentrations) responded most favorably to exercise training. These results suggest that exercise training, especially for those at risk for heart diseases is beneficial to the lipid profile of women.
Article
Of 22 randomized trials of rehabilitation with exercise after myocardial infarction (MI), one trial had results that achieved conventional statistical significance. To determine whether or not these studies, in the aggregate, show a significant benefit of rehabilitation after myocardial infarction, we performed an overview of all randomized trials, involving 4,554 patients; we evaluated total and cardiovascular mortality, sudden death, and fatal and nonfatal reinfarction. For each endpoint, we calculated an odds ratio (OR) and 95% confidence interval (95% CI) for the trials combined. After an average of 3 years of follow-up, the ORs were significantly lower in the rehabilitation than in the comparison group: specifically, total mortality (OR = 0.80 [0.66, 0.96]), cardiovascular mortality (OR = 0.78 [0.63, 0.96]), and fatal reinfarction (OR = 0.75 [0.59, 0.95]). The OR for sudden death was significantly lower in the rehabilitation than in the comparison group at 1 year (OR = 0.63 [0.41, 0.97]). The data were compatible with a benefit at 2 (OR = 0.76 [0.54, 1.06]) and 3 years (OR = 0.92 [0.69, 1.23]), but these findings were not statistically significant. For nonfatal reinfarction, there were no significant differences between the two groups after 1 (OR = 1.09 [0.76, 1.57]), 2 (OR = 1.10 [0.82, 1.47]), or 3 years (OR = 1.09 [0.88, 1.34]) of follow-up. The observed 20% reduction in overall mortality reflects a decreased risk of cardiovascular mortality and fatal reinfarction throughout at least 3 years and a reduction in sudden death during the 1st year after infarction and possibly for 2-3 years. With respect to the independent effects of the physical exercise component of cardiac rehabilitation, the relatively small number of "exercise only" trials, combined with the possibility that they may have had a formal or informal nonexercise component precludes the possibility of reaching any definitive conclusion. To do so would require a randomized trial of sufficient size to distinguish between no effect and the most plausible effect based on the results of this overview.
Article
The effect of physical exercise conditioning on fasting and postprandial lipoprotein levels was studied in six normolipidemic subjects. The study consisted of two phases: a baseline stabilization phase in which subjects maintained their regular physical activity and an exercise conditioning phase in which subjects had 29 exercise sessions during a 7-week period. Each of these sessions consisted of jogging on a treadmill for 30 minutes. The subjects averaged 15.2 miles/wk. To control for possible confounding factors, such as changes in diet composition and weight loss, we placed the subjects on a metabolic diet and increased their daily caloric intake during the exercise phase. At the end of each phase of the study, a vitamin A-fat loading test was done to specifically label and follow postprandial lipoprotein levels, and a maximum oxygen consumption test was done to evaluate the subjects' physical fitness. The exercise conditioning phase significantly increased the subjects' aerobic capacity and postheparin lipoprotein lipase activity, and the phase decreased fasting triglyceride levels. Physical exercise also significantly decreased chylomicron (Sf greater than 1,000) levels by 37%. In summary, this study suggests that physical exercise conditioning reduces fasting and postprandial lipoprotein levels by increasing the catabolism of triglyceride-rich particles. Because these particles may have a role in atherogenesis, this could be a major mechanism by which exercise prevents coronary heart disease.
Article
We studied physical fitness and risk of all-cause and cause-specific mortality in 10,224 men and 3120 women who were given a preventive medical examination. Physical fitness was measured by a maximal treadmill exercise test. Average follow-up was slightly more than 8 years, for a total of 110,482 person-years of observation. There were 240 deaths in men and 43 deaths in women. Age-adjusted all-cause mortality rates declined across physical fitness quintiles from 64.0 per 10,000 person-years in the least-fit men to 18.6 per 10,000 person-years in the most-fit men (slope, -4.5). Corresponding values for women were 39.5 per 10,000 person-years to 8.5 per 10,000 person-years (slope, -5.5). These trends remained after statistical adjustment for age, smoking habit, cholesterol level, systolic blood pressure, fasting blood glucose level, parental history of coronary heart disease, and follow-up interval. Lower mortality rates in higher fitness categories also were seen for cardiovascular disease and cancer of combined sites. Attributable risk estimates for all-cause mortality indicated that low physical fitness was an important risk factor in both men and women. Higher levels of physical fitness appear to delay all-cause mortality primarily due to lowered rates of cardiovascular disease and cancer.
Article
A comparison was carried out of the psychological effects of a moderate aerobic training programme (n = 24) and an attention-placebo strength and flexibility training programme (n = 23) in previously inactive anxious adults from the general population. Training consisted of one supervised and three unsupervised sessions per week for 10 weeks. Effects were assessed with the Profile of Mood States, the State-Trait Anxiety Inventory and questionnaires indexing perceived coping ability. Seven participants dropped out of each condition during the training period. Expectations of benefit assessed pre-training, and satisfaction assessed post-training, did not differ between conditions. The moderate exercise programme led to significant improvements in aerobic fitness, and was associated with significantly greater reductions in tension-anxiety, depression and other moods than the attention-placebo condition, together with increases in perceived ability to cope with stress. Psychological responses were not correlated with changes in fitness assessed with bicycle ergometry or the 12 min walk/run test. These effects were maintained on 3 month follow up.
Article
The psychological benefits of walking and jogging were compared in 52 symptomatic neurotics over an 8-week training period and subsequent 6-month follow-up. Both groups showed marked reduction of anxiety, depression and global symptoms. Joggers had greater aerobic gain, but no greater psychologic benefit. Significantly larger numbers of joggers dropped out of the study. There was no relationship between aerobic gain and reduction of symptoms at the end of the program. However, at 6 months' follow-up, those with greater aerobic fitness had much lower anxiety levels. Changes in exercise frequency and aerobic capacity were also maintained at follow-up. Depression levels were not associated with aerobic fitness at follow-up. High initial exercise intensity appears to inhibit the forming of new exercise habits.
Article
Several psychological outcomes that accompany acute and chronic exercise have medical significance. Transient reductions in somatic tension and subjective anxiety appear most reliable. Symptom abatement in moderate depression can occur with chronic exercise in a manner comparable to psychotherapy and may offer a better prognosis in some instances. Other cognitive, behavioral, and perceptual events associated with exercise may assist in managing mental health, and exercise has been successfully used as a therapeutic adjunct in a variety of psychiatric disorders. Regular exercise may also complement treatments designed to manage aspects of coronary-prone behavior and psychoendocrine responsivity to mental stress. The lack of strict experimental control or effective placebo contrasts in most exercise studies precludes a convincing argument that exercise causes the psychological outcomes observed. Rather, expectancy of benefits, generalized treatment or attention effects, social reinforcement, and past history or selection bias represent likely alternatives. These competing explanations do not discount, however, that many individuals benefit in a clinically significant way. Exercise offers a low-cost alternative or adjunct with side effects that appear largely health-related. Although the effective psychological dosage or modality has not been quantified, current physiologic guidelines of the American College of Sports Medicine (large muscle rhythmic activity, for 20 to 60 minutes, 3 to 5 days per week at 60 to 80 per cent age-adjusted maximal heart rate), or a weekly caloric cost of 2000 kcal, should be effective with little medical risk. However, no evidence confirms that an increase in metabolic or psychoendocrine tolerance to exercise is necessary or sufficient for psychological outcomes to occur. Although biologic adaptations are known to follow exercise training and subside with diminished activity, there is currently no objective evidence that habitual exercise leads to dependence. If exercise has use in managing subjective or somatic symptoms, these may return during periods of exercise abstinence. Moreover, despite popular hypotheses concerning endorphins and biogenic amines, no direct relationships have yet been shown between exercise-induced mood swings and peripheral biochemical events. A proportion of habitual runners have reported acute episodes of euphoria-like states during or following exercise, but this remains a subjective and unpredictable event that may be related to psychophysiologic relaxation or acute changes in self-esteem.(ABSTRACT TRUNCATED AT 400 WORDS)
Article
This study was designed to compare the effects of two aerobic training programmes of differing intensities on mood and mental well-being with those of a credible attention-placebo condition. One hundred and nine sedentary adult volunteers from the local population were assigned to four conditions: high intensity aerobic training, moderate intensity aerobic training, attention-placebo and waiting list. Training was carried out over a 10 week period. Subjects were assessed before and after training with psychological measures and the 12 min walk-run test, and follow-up evaluations were undertaken after 3 months. Ninety-four subjects began the programme and the adherence rate averaged 80%, with no significant differences in number of drop-outs between conditions. Appropriate changes in estimated maximum oxygen consumption were observed in the three active conditions with the 12 min walk-run test. Psychological benefits were seen with the moderate exercise condition but not in the high exercise or attention-placebo conditions. These effects were manifest immediately after training on measures of tension/anxiety and confusion, and at follow-up on measures of perceived coping ability. The mechanisms underlying this pattern of results are discussed and the relative importance for health of vigorous activity and physical fitness is considered.
Article
Aerobic exercise which resulted in a significant improvement in cardiovascular functioning had no more effect on psychological mood states than did the placebo control of participation in nonaerobic recreational games or no exercise and sport at all (N = 430 college students). Beta-endorphin levels with the 41 depressed subjects were not a biochemical link that might explain the possible influence of physical activity on depression.
Article
We used cost-effectiveness analysis to estimate the health and economic implications of exercise in preventing coronary heart disease (CHD). We assumed that nonexercisers have a relative risk of 2.0 for a CHD event. Two hypothetical cohorts (one with exercise and the other without exercise) of 1,000 35-year-old men were followed for 30 years to observe differences in the number of CHD events, life expectancy, and quality-adjusted life expectancy. We used jogging as an example to calculate cost, injury rates, adherence, and the value of time spent. Both direct and indirect costs associated with exercise, injury, and treating CHD were considered. We estimate that exercising regularly results in 78.1 fewer CHD events and 1,138.3 Quality Adjusted Life Years (QALYs) gained over the 30-year study period. Under our base case assumptions, which include indirect costs such as time spent in exercise, exercise does not produce economic savings. However, the cost per QALY gained of $11,313 is favorable when compared with other preventive or therapeutic interventions for CHD. The value of time spent is a crucial factor, influencing whether exercise is a cost-saving activity. In an alternative model, where all members of the cohort exercise for one year, and then only those who like it or are neutral continue, exercise produces net economic savings as well as reducing morbidity.
Article
Thirty-nine females and 63 males participated in a 10-week physical conditioning class involving aerobic (running) and anaerobic (weight training) exercise. Aerobic fitness, anaerobic fitness, and personality were measured before and after the 10-week training period. Multiple regression analyses revealed that changes in personality were generally associated with changes in aerobic rather than anaerobic fitness, and that the relationship were most likely to be found with women. Possible explanations were offered.
Article
The purpose of this study was to compare the moods and mood variations of runners to those of aerobic dancers, weight-lifters, and nonexercising controls. The subjects, 70 undergraduates, were participants in a jogging and conditioning, a weight training, an aerobic dance, or an introductory psychology class. A time-series design was used in which all participants completed eight Profile of Mood State questionnaires over a 6-hr. period that centered on the time of the class. Four questionnaires were completed during the second week of classes and the other four about midsemester, approximately 6 wk. later. Runners had a significantly more positive mood profile than nonexercisers and a somewhat more positive one than weight-lifters, but those of runners and aerobic dancers were similar. Changes in moods across time in relation to activity and across semester suggest that exercise, particularly aerobic exercise, helps the regular participant not only to cope with stress but also to have a generally more positive feeling of well-being.
Article
Secondary analysis of four surveys was carried out in order to examine the association of physical activity and various aspects of mental health in the household populations of the United States and Canada. Level of physical activity was shown to be positively associated with general well-being, lower levels of anxiety and depression, and positive mood. This relationship is independent of the effects of socioeconomic status and physical health, and described younger and older members of both sexes. The association is particularly strong for women and persons age 40 years and over. The robustness of this conclusion stems from the nature of the data sources: four population samples in two countries over the span of 10 years in which physical activity levels were assessed by four techniques and psychological status was assessed by six distinct scales. Although the surveys are cross-sectional, the most plausible explanation for the results is that physical activity enhances mental health in certain respects. Data on the comparative effects of recreation and housework suggest that quality of time, and not mere energy expenditure, must be taken into account in attempts to explain the psychological benefits of physical activity.
Article
An experiment was conducted to determine whether aerobic exercise training or relaxation training would be effective for reducing the deleterious effects of life stress on physical and psychologic health. Over 1000 college students were surveyed, and 55 of those who reported experiencing a high number of negative life events over the preceding year were assigned to an aerobic exercise training condition, a relaxation training condition, or a no-treatment control condition. Physical and psychologic health were assessed with self-report measures before, halfway through, immediately following, and 8 weeks after the 11-week training (and control) period. Heart rate data collected during a treadmill test indicated that the aerobic exercise training was effective for improving cardiovascular fitness. Psychologic measures indicated that the exercise training condition was more effective than the other two conditions for reducing depression during the first 5 weeks of training. No differences were found among the conditions on self-report measures of physical health. These findings suggest that aerobic exercise training may be useful for reducing the severity and duration of depressive reactions following stressful life change.
Article
This study explored variables which predict effects of an aerobic exercise program on mood. Adult members of an eight-week conditioning program improved significantly in mood, in comparison with non-exercising controls, immediately after and three months after the program. Mood improvement was predicted by initial mood, with improvement limited to the most mood-disturbed subjects. It was not, however, predicted by improvement on cardiovascular or other physical indices, by other psychological or demographic ratings, or by beliefs and expectations about physical fitness or about mood state.
Article
We tested the effect of beginning an exercise program on the mood of sedentary men who were free of psychopathology. Fourteen men were randomly assigned to either an exercise program or a control period for 12 weeks and then switched to the converse condition. The exercise was nonsocial and of moderate intensity. Exercise did not improve anger, tension, confusion, depression, fatigue, vigor, or total mood disturbance more than a control period. We conclude that beginning an exercise program, in itself, produces minimal psychological benefits. We hypothesize that other conditions, e.g. the presence of emotional problems, socialization along with exercise, or a training effect must be present for exercise to produce psychological benefits.
Article
Mental disorders are of major public health significance. It has been claimed that vigorous physical activity has positive effects on mental health in both clinical and nonclinical populations. This paper reviews the evidence for this claim and provides recommendations for future studies. The strongest evidence suggests that physical activity and exercise probably alleviate some symptoms associated with mild to moderate depression. The evidence also suggests that physical activity and exercise might provide a beneficial adjunct for alcoholism and substance abuse programs; improve self-image, social skills, and cognitive functioning; reduce the symptoms of anxiety; and alter aspects of coronary-prone (Type A) behavior and physiological response to stressors. The effects of physical activity and exercise on mental disorders, such as schizophrenia, and other aspects of mental health are not known. Negative psychological effects from exercise have also been reported. Recommendations for further research on the effects of physical activity and exercise on mental health are made.