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Physical activity, exercise, depression and anxiety disorders. Journal of Neural Transmission, 116, 777-784
Abstract
There is a general belief that physical activity and exercise have positive effects on mood and anxiety and a great number of studies describe an association of physical activity and general well-being, mood and anxiety. In line, intervention studies describe an anxiolytic and antidepressive activity of exercise in healthy subjects and patients. However, the majority of published studies have substantial methodological shortcomings. The aim of this paper is to critically review the currently available literature with respect to (1) the association of physical activity, exercise and the prevalence and incidence of depression and anxiety disorders and (2) the potential therapeutic activity of exercise training in patients with depression or anxiety disorders. Although the association of physical activity and the prevalence of mental disorders, including depression and anxiety disorders have been repeatedly described, only few studies examined the association of physical activity and mental disorders prospectively. Reduced incidence rates of depression and (some) anxiety disorders in exercising subjects raise the question whether exercise may be used in the prevention of some mental disorders. Besides case series and small uncontrolled studies, recent well controlled studies suggest that exercise training may be clinically effective, at least in major depression and panic disorder. Although, the evidence for positive effects of exercise and exercise training on depression and anxiety is growing, the clinical use, at least as an adjunct to established treatment approaches like psychotherapy or pharmacotherapy, is still at the beginning. Further studies on the clinical effects of exercise, interaction with standard treatment approaches and details on the optimal type, intensity, frequency and duration may further support the clinical administration in patients. Furthermore, there is a lack of knowledge on how to best deal with depression and anxiety related symptoms which hinder patients to participate and benefit from exercise training.
... Key facets of effective mHealth interventions depict the integration of behavior change techniques (BCTs) [17] and the foundation upon existing theoretical approaches [18]. Furthermore, there is empirical evidence that just-in-time interventions [19,20], individualized or tailored interventions [21], and interventions that incorporate multiple BCTs [22] show large potential in this respect. However, Chen et al [23] highlight that the design of mHealth interventions often lacks a theory-driven approach [24,25], and there is little emphasis on evidence-based content [26]. ...
... The positive effects of PA on health (e.g., on self-efficacy, wellbeing and quality of life) have been widely investigated over the last decades [16,17]. A certain amount of PA supports body weight control, cognition, self-efficacy, wellbeing, quality of life and mortality [16][17][18][19][20][21]. In addition, a reduction in the development of chronic diseases such as diabetes mellitus, hypertension and cardiovascular disease has been demonstrated [19,22]. ...
... A certain amount of PA supports body weight control, cognition, self-efficacy, wellbeing, quality of life and mortality [16][17][18][19][20][21]. In addition, a reduction in the development of chronic diseases such as diabetes mellitus, hypertension and cardiovascular disease has been demonstrated [19,22]. The health-promoting physiological, as well as psychological, effects of PA can be achieved if the World Health Organization's (WHO) recommendations for PA (for adults: ≥30 min of moderate daily exercise and >150 min of exercise per week) are fulfilled [23]. ...
Introduction: Insufficient physical activity has been established as a significant risk factor for non-communicable diseases, increasing the risk of conditions such as cardiovascular disease, hypertension, diabetes, dementia, obesity, and breast and colon cancer. Meanwhile regular physical activity is associated with positive effects on stress management and related health risks. The benefits of physical activ-ity are particularly impactful for children and adolescents, as behavioral changes during adolescence can extend into adulthood. However, the prevalence of insufficient physical activity and sedentary behavior among youth worldwide is steadily increasing, potentially due to the rise of digitalization and increased screen time. Surprisingly, longitudinal and representative data from the KIGGS study demonstrates no correlation between screen time and reduced physical activity in children. Addressing the digital realities of modern childhood and adolescents, digital health interventions (e.g., mHealth) may provide a life-relevant and motivating entry point for changing physical activity related behaviors. Numerous meta-analyses have demonstrated the effectiveness of smartphone interventions among youth, although effect sizes remain low. The lack of scientific foundations of content, non-specific approaches, inadequate age-appropriateness, low individualization, and poor usability are cited as possible reasons. Thus, innovative approaches are needed to increase the effectiveness and adherence of digital health interventions among children and adolescents, involving evidence-based techniques for behavior change (e.g., gamification, goal setting), age-appropriate developmental theories, motivational aspects, and multi-level individualization. As such, this dissertation focuses on the following research questions: (1) How does individualization and age as moderators impact the effectiveness of mHealth interventions for reducing sedentary behavior in children and adolescents? (2) What are the feasible mHealth-based physical activity and health objectives that can be achieved within the family context involving early adolescents? (3) How can digital health literacy be promoted in the school setting to encourage reflective and responsible use of mHealth applications among mid-adolescents? (4) How does individualization affect the effectiveness of physical activity-based mHealth interventions?
Methods: A cumulative dissertation consisting of seven pre-registered publications in national and international peer-reviewed journals was developed to address these research questions. To answer the first research question, a systematic review followed by a meta-analysis (1) was conducted to assess the effectiveness of digital health interventions for preventing insufficient physical activity and seden-tary behavior in children and adolescents across different developmental stages, as well as to compare individualized interventions with non-individualized interventions. To answer the next two research questions, which were based on the results of the aforementioned literature review, two mixed-methods cross-sectional studies were conducted to examine the prerequisites for digital health promotion for children and adolescents in (2) family and (3) school settings. Qualitative sub-studies were analyzed using qualitative content analysis with MAXQDA, while quantitative sub-studies were analyzed using SPSS, rStudio, and JASP. The family-focused study (2) was an explanatory sequential mixed-methods study that aimed to identify family health goals through interviews with N=60 parents and focus groups with N=120 adolescents. The subsequent quantitative sub-study surveyed N=1008 families nationwide on their interest in the identified family health goals and their health behavior. On the other hand, the school-focused study (3) was an exploratory sequential mixed-methods study that integrated an online survey of N=118 biology and physical education teachers and six focus group interviews with teachers and students (N=34). The surveys covered questions about the equipment and use of digital media, digital health literacy, and potential barriers of mHealth intervention in the context of physical education. The insights gained from the meta-analysis (1) and cross-sectional mixed-methods studies (2 & 3) were integrated into a multi-arm randomized controlled trial (4), including a study protocol, to answer the fourth research question and to evaluate individualized, sensory mHealth interventions. The experimental study includes N=995 participants, randomized to multiple study-arms with different levels of individualization including sensor- and app-based biofeedback, health needs of each individual, vital signs, and behavioral patterns. The study includes three measurement points at intervals of 8 weeks, with primary outcomes defined as heart rate variability, behavioral change (HAPA), and physical activity.
Results: The systematic literature search yielded 1101 studies, of which 12 were included in the qualitative synthesis and 10 in the meta-analysis (1). Findings indicated that digital health applications can effectively address insufficient physical activity, but their effectiveness in mitigating sedentary behavior remains uncertain. Additionally, our analysis suggested that highly individualized digital interventions may produce larger effect sizes in the context of insufficient physical activity, and that age-related differences may exist with respect to the degree of individualization required to achieve optimal outcomes. Addressing early adolescent target group, the subsequent family focused mixed methods study (2) found differences in health goals among families. Qualitatively identified mHealth related goals in the areas nutrition, mindfulness, abstinence, organized activities, resilience, nature as well as physical activity and combined the health behavior index of participants in a multiple regression model. The results revealed resilience, physical activity, and nature to be significant predictors of health behavior. Additional multiple logistic regression models identified healthier eating habits, communal cooking, outdoor activities, learning exercises for on-the-go, spending time in nature, stress management, and dietary changes as primary goals in the field of mHealth that children and adolescents would undertake with their parents. Addressing mid adolescents, both studies in the school focused project (3) identified a lack of knowledge and media infrastructure. The target groups showed a high interest in and need for the enhancement of digital health literacy. Compared to teachers of other subjects, physical education teachers showed lower digital health literacy and less interest. The results highlight the need for an improved infrastructure (e.g., access to Wi-Fi) and the exacerbated need for digital health literacy promotion in the school setting. In the randomized controlled trial focusing on late adolescents and adults (4), 170 of 995 eligible participants (26%) completed the post-measurement. MANOVA indicated small to moderate time*group interaction effects with physical activity-related outcomes of moderate to vigorous physical activity and inactivity-disruption counts in the app focused study-arms, but not for step counts and inactivity. Stress-related HRV parameters did not change over time. Despite high drop-out rates and a complex study design, individualized interventions revealed initial effects on physical activity but not the expected effects on stress-related outcomes.
Discussion: The aim of this dissertation was to investigate the impact of individualization on the effectiveness of mHealth interventions for children and adolescents at different developmental stages. The results revealed that each developmental stage of children has unique requirements. For instance, in early childhood and adolescence, the involvement of the social environment of the family was shown to be beneficial, whereas in middle adolescence, the development of health literacy for independent use of mHealth interventions obtains amplified relevance. In late adolescence, individualization of interventions through biofeedback or more complex methods such as machine learning becomes significant. Despite several limitations, the individualized mHealth interventions were found to affect the physical activity and health behaviors of children and adolescents more than non-individualized interventions, provided that they adequately address the digital health literacy according to the child's developmental stage, involve social systems, are based on central theories of health behavior change, and have an educational approach. Future approaches should focus on the appropriate use of health data to develop context-specific and relevant interventions that are adjusted according to gender, culture, and competence. Therefore, individualization alone appears to be a partial aspect of the effective application of mHealth interventions, but tackles many obstacles related to digital solutions for the reduction of insufficient physical activity and sedentary behavior as well as other health behaviors. These aspects are combined in the proposed Youth mHealth Behavior Change Model, which combines the HAPA model with the Self-Efficacy Model and the presented study findings of this dissertation, providing a framework for physical activity related health behavior change for children and adolescents via mHealth interventions.
... Physical activity often offers multiple mechanisms for alleviating mental disorders. It can reduce muscle tension and stimulate the production of endogenous cannabinoids and other brain chemicals that enhance mood (Ströhle, 2009;Hu et al., 2020). It can also divert individuals' attention away from negative thoughts, interrupting the cycle that fuels depression and anxiety (Ströhle, 2009;Pesce et al., 2021). ...
... It can reduce muscle tension and stimulate the production of endogenous cannabinoids and other brain chemicals that enhance mood (Ströhle, 2009;Hu et al., 2020). It can also divert individuals' attention away from negative thoughts, interrupting the cycle that fuels depression and anxiety (Ströhle, 2009;Pesce et al., 2021). Additionally, it can offer psychological and emotional advantages, such as boosting self-confidence through the achievement of exercise goals, improving body image, and facilitating social interaction and connections with others (Martinsen, 2008;Singh et al., 2023). ...
... Exercise has also been found to be effective in reducing symptoms of anxiety and depression, as it stimulates the release of endorphins and other neurotransmitters that enhance mood and reduce stress (Ströhle, 2009). Incorporating exercise into daily routines can not only improve overall physical health but also contribute to better sleep and reduced anxiety symptoms. ...
... Anxiety disorders are characterized by autonomic hyperactivity and dysregulated expression of anxiety. 1 Anxiety disorders are highly prevalent mental disorders globally, with an ever-increasing social and economic burden. [2][3][4] In Nigeria, anxiety disorders have also been reported as the commonest childhood mental disease and a highly prevalent class of mental disorders with a lifetime prevalence of 5.7% and a 12-month prevalence of 4.1% in the general population. ...
Anxiety disorders are among the most prevalent mental disorders in all age groups worldwide. The attendant socioeconomic burden is huge and on the increase. The currently used anxiolytic drugs are few and their usefulness are limited on account of toxicity, delay in, or lack of efficacy. This scenario calls for discovery of additional anti-anxiety therapeutic agents. This study investigated the acute anxiolytic effects of 50, 150 and 500 mg/kg aqueous A. africana whole-plant, F. sycomorus stem bark and T. globiferus leaf extracts, 10 ml/kg distilled water and 0.5 mg/kg diazepam in Swiss Albino mice in a battery of open-field and elevated zero-maze tests using key rodent anxiety parameters, one hour post extract/drug administration. Compared with distilled water treatment, aqueous T. globiferus leaf extract caused dose-dependent and significant (p<0.05) increase in mean % centre zone and open segment times and reduction in mean rears and stretch-attend postures. A. africana whole-plant and F. sycomorus stem bark extracts, when compared with water, caused dose-independent and insignificant (p > 0.05) anxiolytic activity on most of these anxiety parameters. The findings of this study indicate that aqueous T. globiferus leaf extract has an anxiolytic activity that is superior to that of A. africana whole-plant and F. sycomorus stem bark extracts and comparable to that of 0.5 mg/kg diazepam. There is a need for further investigation of different extracts and fractions of T. globiferus leaves for their potential anxiolytic activity.
... Even more strongly, as part of antidepressant treatment, it is increasingly recommended during last years [15,16,23]. The effectiveness of physical activity in the treatment of depression was shown in many reviews and confirmed in several meta-analyses [24][25][26][27][28][29]. Besides, results of no effectiveness have been Extended author information available on the last page of the article Content courtesy of Springer Nature, terms of use apply. ...
Evidence for the effectiveness of physical activity (PA) in the treatment of depression prevails for outpatients with mild and moderate symptom levels. For inpatient treatment of severe depression, evidence-based effectiveness exists only for structured and supervised group PA interventions. The Step Away from Depression (SAD) study investigated the effectiveness of an individual pedometer intervention (PI) combined with an activity diary added to inpatient treatment as usual (TAU). In this multicenter randomized controlled trial, 192 patients were randomized to TAU or TAU plus PI. The two primary outcomes at discharge were depression—blindly rated with the Montgomery–Åsberg Depression Rating Scale (MADRS)—and average number of daily steps measured by accelerometers. Secondary outcomes were self-rated depression and PA, anxiety, remission and response rates. Multivariate analysis of variance (MANOVA) revealed no significant difference between both groups for depression and daily steps. Mean MADRS scores at baseline were 29.5 (SD = 8.3) for PI + TAU and 28.8 (SD = 8.1) for TAU and 16.4 (SD = 10.3) and 17.2 (SD = 9.9) at discharge, respectively. Daily steps rose from 6285 (SD = 2321) for PI + TAU and 6182 (SD = 2290) for TAU to 7248 (SD = 2939) and 7325 (SD = 3357). No differences emerged between groups in secondary outcomes. For severely depressed inpatients, a PI without supervision or further psychological interventions is not effective. Monitoring, social reinforcement and motivational strategies should be incorporated in PA interventions for this population to reach effectiveness.
... The second independent variable in the study is anxiety. This scale was adapted from Ströhle (2009) and the 7 point Likert scale items consist of four items. ...
Purpose: The present study aims to investigate the effectiveness of computer-based and online rehabilitation therapy in managing depression and anxiety among Jordanian parents of children with special needs as well as explore the underlying psychodynamic mechanisms involved in the therapeutic process. Design/Methodology/Approach: The sample size consisted of 337 participants who were randomly assigned to either the experimental group (receiving computer-based and online rehabilitation therapy) or the control group (receiving traditional therapy). Data were collected through self-reported questionnaires assessing depression and anxiety levels as well as psychodynamic variables such as defense mechanisms and attachment styles. Findings: The relationship between the variables was examined by Partial least squares (PLS) analysis. Results indicated that computer-based and online rehabilitation therapy was effective in reducing levels of depression and anxiety among Jordanian parents of children with special needs to facilitate changes in defense mechanisms and attachment styles indicating the involvement of psychodynamic processes in the therapeutic process. Conclusion: The findings suggest that computer-based and online rehabilitation therapy may be a valuable resource for managing depression and anxiety in Jordanian parents of children with special needs and provide insight into the underlying mechanisms involved in psychodynamic therapy. Research Implications: The field of psychological counselling is being advanced by the current research which has several theoretical and practical implications. This study is significant because it provides key policy insights on how to enhance attractiveness. Research efforts when developing programs need to be in line with technical advancements.
... The repeated measures correlation analyzes intraindividual variance, whereas the linear mixed effects model can simultaneously analyze both intra-and interindividual variance using partial pooling [47]. Features such as step count were sensitive in detecting changes in depression symptom severity and in screening people with depression in line with previous studies [55,56]. This might be associated with inverse bidirectional relationships between depression and physical activity [57,58]. ...
BACKGROUND
Major depressive disorder (MDD) affects millions of people worldwide, but timely treatment is not often received owing in part to inaccurate subjective recall and variability in the symptom course. Objective and frequent MDD monitoring can improve subjective recall and help to guide treatment selection. Attempts have been made, with varying degrees of success, to explore the relationship between the measures of depression and passive digital phenotypes (features) extracted from smartphones and wearables devices to remotely and continuously monitor changes in symptomatology. However, a number of challenges exist for the analysis of these data. These include maintaining participant engagement over extended time periods and therefore understanding what constitutes an acceptable threshold of missing data; distinguishing between the cross-sectional and longitudinal relationships for different features to determine their utility in tracking within-individual longitudinal variation or screening individuals at high risk; and understanding the heterogeneity with which depression manifests itself in behavioral patterns quantified by the passive features.
OBJECTIVE
We aimed to address these 3 challenges to inform future work in stratified analyses.
METHODS
Using smartphone and wearable data collected from 479 participants with MDD, we extracted 21 features capturing mobility, sleep, and smartphone use. We investigated the impact of the number of days of available data on feature quality using the intraclass correlation coefficient and Bland-Altman analysis. We then examined the nature of the correlation between the 8-item Patient Health Questionnaire (PHQ-8) depression scale (measured every 14 days) and the features using the individual-mean correlation, repeated measures correlation, and linear mixed effects model. Furthermore, we stratified the participants based on their behavioral difference, quantified by the features, between periods of high (depression) and low (no depression) PHQ-8 scores using the Gaussian mixture model.
RESULTS
We demonstrated that at least 8 (range 2-12) days were needed for reliable calculation of most of the features in the 14-day time window. We observed that features such as sleep onset time correlated better with PHQ-8 scores cross-sectionally than longitudinally, whereas features such as wakefulness after sleep onset correlated well with PHQ-8 longitudinally but worse cross-sectionally. Finally, we found that participants could be separated into 3 distinct clusters according to their behavioral difference between periods of depression and periods of no depression.
CONCLUSIONS
This work contributes to our understanding of how these mobile health–derived features are associated with depression symptom severity to inform future work in stratified analyses.
... The second independent variable in the study is anxiety. This scale was adapted from Ströhle (2009) and the 7 point Likert scale items consist of four items. ...
Purpose: The present study aims to investigate the effectiveness of computer-based and online rehabilitation therapy in managing depression and anxiety among Jordanian parents of children with special needs as well as explore the underlying psychodynamic mechanisms involved in the therapeutic process. Design/Methodology/Approach: The sample size consisted of 337 participants who were randomly assigned to either the experimental group (receiving computer-based and online rehabilitation therapy) or the control group (receiving traditional therapy). Data were collected through self-reported questionnaires assessing depression and anxiety levels as well as psychodynamic variables such as defense mechanisms and attachment styles. Findings: The relationship between the variables was examined by Partial least squares (PLS) analysis. Results indicated that computer-based and online rehabilitation therapy was effective in reducing levels of depression and anxiety among Jordanian parents of children with special needs to facilitate changes in defense mechanisms and attachment styles indicating the involvement of psychodynamic processes in the therapeutic process. Conclusion: The findings suggest that computer-based and online rehabilitation therapy may be a valuable resource for managing depression and anxiety in Jordanian parents of children with special needs and provide insight into the underlying mechanisms involved in psychodynamic therapy. Research Implications: The field of psychological counselling is being advanced by the current research which has several theoretical and practical implications. This study is significant because it provides key policy insights on how to enhance attractiveness. Research efforts when developing programs need to be in line with technical advancements.
... 32 According to case reports from clinical studies, exercise therapy may also be effective for patients with anxiety neurosis, panic disorder, and clinical depression. [33][34][35][36][37] The strong correlation between increased exercise and decreased depression has been attributed to a number of developmental, neurobiological, and psychological hypotheses: Physical activity may increase a person's resilience to stress-related mental disorders by triggering a chain reaction of neurotransmitters. 33-40 ...
Background and aims
Depression is a major public health concern that affects over 4% of the global population. Identification of new nonpharmacologic recommendations will help decrease the burden of disease. The overarching of this study was to examine the association between physical activity and depressive symptoms in a large sample of adults in the United States.
Methods
Presently, researchers utilized data from the National Health and Nutrition Examination Surveys (NHANES 2017–2020), which is a retrospective, complex, multistage, representative, and modern cohort of the United States. Adult patients ( > 18 years; N = 8091) with complete 9‐item Patient Health Questionnaire (PHQ‐9) information were included in the study. The PHQ‐9 is a well‐validated survey, per literature, scores ≥10 are considered to have clinically relevant depression. Univariable and multivariable logistic regression was fit for active and sedentary activities on clinical depression (PHQ‐9 ≥ 10). The acquisition and analysis of the data within this study were approved by the National Center for Health Statistics Ethics Review Board.
Results
After adjusting for potential confounders like age, race, sex, and income, we found that increased vigorous exercise was associated with lower rates of depressive symptoms. Each extra day of vigorous exercise was associated with 11% decreased odds of depression (odd ratio [OR]: 0.89, confidence interval [CI]: 0.83–0.96, p < 0.01). Increased sedentary activity was associated with increased depression. Each extra hour per day of sedentary activity was associated with a 6% increase in odds of depression (OR: 1.06, (1.02–1.10, p < 0.01).
Conclusion
To conclude, exercise appears to be protective against depressive symptoms; however, further prospective studies are required to ascertain whether exercise causes decreased depressive symptoms.
... Studies have shown a significant negative correlation between physical activity and anxiety, which remains valid after controlling the interference factors (Horvath et al., 2019). Evidence suggests that participating in physical activity protects against anxiety disorders, except in case series and small uncontrolled studies (Ströhle, 2009). Epidemiological data shows that more active people are less likely to have anxiety disorders. ...
Objective
To explore the relationship between physical activity and depression among college students, as well as the mediating role of rumination and anxiety.
Methods
A total of 1,292 Chinese college students were investigated by physical activity questionnaire, rumination scale, self-rating anxiety scale (SAS), and depression scale.
Results
(1) There was a significant negative correlation between physical activity and depression (r = −0.399, p < 0.01), and the direct path of physical activity on depression was significant ( β = −0.399, t = −13.374, p < 0.01). (2) Physical activity negatively predicted rumination ( β = −0.322, t = −10.440, p < 0.01) and anxiety ( β = −0.222, t = −7.089, p < 0.01). Rumination positively predicted anxiety ( β = 0.283, t = 9.017, p < 0.01) and depression ( β = 0.267, t = 9.046, p < 0.01). Anxiety positively predicted depression ( β = 0.262, t = 8.902, p < 0.01). (3) Rumination and anxiety play a significant mediating role between physical activity and depression. The mediating effect involves three paths: physical activity → rumination → depression (the mediating effect value: −0.076); physical activity → anxiety → depression (the mediating effect value: −0.052). Physical activity → rumination → anxiety → depression (the mediating effect value: −0.021).
Conclusion
(1) Physical activity can negatively predict the rumination, anxiety, and depression of college students, which means physical activity can reduce rumination, anxiety, and depression of college students. (2) Physical activity can not only directly affect the depression of college students, but also indirectly affect depression through the independent intermediary role of rumination and anxiety, and the chain mediation of rumination and anxiety.
... Convergent evidence showed that emotional benefits were generated immediately after exercise starts and were maintained for one day after stopping exercise 35 . Depression and anxiety symptoms can only be improved by exercising for more than three times a week, and it is best to do moderate exercise every day 41,42 . Therefore, it is recommended to insist on doing exercise every day. ...
To explore the association between depression and anxiety symptoms among college students and the relationship between the two and physical activity. A cross-sectional study design was used to survey 1790 enrolled university students using the Depression Self-Rating Scale, Anxiety Self-Rating Scale and Physical Activity Rating Scale. 37.75% of male students and 39.73% of female students detected depressive symptoms, 17.65% of male students and 17.86% of female students detected anxiety symptoms, 11.89% of male students and 11.75% of female students detected both depressive and anxiety symptoms. Canonical correlation between depression and anxiety symptoms of college students were significant. The depression and anxiety score of college students in the high level group was significantly lower than that in the low and medium level groups, and no significant difference was found between the low and medium level groups. Affective disorder and anxious mood of male students correlated most closely with intensity, while somatic disorder, psychomotor disorder and depressive psychological disorder correlated most closely with duration. Affective disorder of female students correlated most closely with frequency, depressive psychological disorder and anxious mood correlated most closely with intensity, while premonition of misfortune and frequent urination correlated most closely with duration. Depression and anxiety symptoms of college students were closely related and co-occurrence was common. Students with high level of physical activity had milder symptoms. Different exercise interventions are recommended for different symptoms.
... Ряд авторов считает психологическое здоровье определяющим ФР развития инсомнии при COVID-19, потому что результаты исследований демонстрируют корреляцию между развитием депрессии, тревожных расстройств и нарушений сна [15]. Однако снижение уровня физической активности и количества социальных контактов в результате пандемических ограничений или перенесенного заболевания сами по себе могут быть независимыми ФР для развития психологических расстройств [16]. Потенциальные механизмы прямого влияния SARS-CoV-2 на качество сна точно не определены. ...
This review considers the risk factors for arterial hypertension (AH) progression, obstructive sleep apnea syndrome (OSAS) and novel coronavirus infection (COVID-19) as potential variables for the prognostic models of estimating the probability of destabilization of the mentioned conditions. The most published studies consider AH and OSAS as the risk factors influencing the course of COVID-19, while moderate and mild COVID-19 can be destabilizing factor regarding to AH and OSAS. In addition, COVID-19, AH and OSAS are interrelated with sleep quality. The worsening of sleep quality often can be both a consequence of these diseases and a factor aggravating their course, and also can cause the increased vulnerability to acute diseases. An increased body mass index is a universal risk factor for many diseases and clinical conditions, and the monitoring of body mass increases the degree of the control of the diseases associated with obesity. In addition, the worsening of sleep quality can be both a consequence of any of above-mentioned conditions and a factor aggravating their course. Also, a promising direction for improving prognostic models is the analysis of autonomic dysfunction in patients.
... Exercise can increase the production of certain neurotransmitters that regulate mood [45][46][47][48][49], reduce the release of the stress hormone cortisol, induce neurogenesis, and enhance the secretion of neurotrophic factors. For instance, brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), insulin-like growth factor-1 (IGF-1), and fibroblast growth factor-2 (FGF-2) have been found to improve neuronal survival, proliferation, and maturation [26,[50][51][52]. In addition to BDNF, other neurotrophic factors, including glial cell line-derived neurotrophic factor (GDNF), and the neurotrophins NT-3 and NT-4, are also released in response to exercise [53][54][55][56]. ...
Depression is a common mental disorder in which patients often experience feelings of sadness, fatigue, loss of interest, and pleasure. Exercise is a widely used intervention for managing depression, but the specific molecular mechanisms underlying its antidepressant effect are unclear. In this narrative review, we aim to synthesize current knowledge on the molecular, neural, and physiological mechanisms through which exercise exerts its antidepressant effect and discuss the various exercise interventions used for managing depression. We conducted a narrative review of the literature on the topic of exercise and depression. Our review suggests that exercise impacts peripheral tryptophan metabolism, central inflammation, and brain-derived neurotrophic factors through the peroxisome proliferator-activated receptor γ activating factor 1α (PGC-1α) in skeletal muscles. The uncarboxylated osteocalcin facilitates “bone-brain crosstalk”, and exercise corrects atypical expression of brain-gut peptides, modulates cytokine production and neurotransmitter release, and regulates inflammatory pathways and microRNA expression. Aerobic exercise is recommended at frequencies of 3 to 5 times per week with medium to high intensity. Here we highlight the significant potential of exercise therapy in managing depression, supported by the molecular, neural, and physiological mechanisms underlying its antidepressant effect. Understanding the molecular pathways and neural mechanisms involved in exercise’s antidepressant effect opens new avenues for developing novel therapies for managing depression.
... Günlük düzenli olarak yapılan fiziksel aktivitenin bireyler üzerinde stres başta olmak üzere mental açıdan birçok olumlu etkisinin olduğu bilinmektedir (Hassmen vd., 2000;Ströhle, 2009;Şahin vd., 2012). Fiziksel aktivitenin psikolojik açıdan bireylerin kendilerini iyi hissetmelerinde ve stres, kaygı, depresyon, negatif duygu gibi olumsuz durumların azaltılmasında önemli etkileri vardır (Keskin, 2014;Peluso ve Guerra de Andrade, 2005;Rodriguez Ayllon vd., 2019;Salar vd., 2012;Trainor vd., 2010). ...
Bu araştırmanın amacı; sedanter bireylerin 8 haftalık fiziksel aktiviteye göre stres, kaygı, depresyon, yaşam memnuniyeti, psikolojik iyi oluş ve pozitif-negatif duygu düzeylerini incelemek ve ön test son test puanlarını karşılaştırmaktır. Araştırma ön test-son test deney ve kontrol gruplu yarı deneysel bir araştırmadır. Araştırma grubu 50 deney grubu, 50 kontrol grubu toplam 100 bireyden oluşmaktadır. Veriler “Depresyon, Anksiyete ve Stres Ölçeği”, “Yaşam Memnuniyeti Ölçeği”, “Psikolojik İyi Oluş Ölçeği” ve “PozitifNegatif Duygu Ölçeği” kullanılarak elde edilmiştir. Elde edilen veriler grup içinde ve gruplar arasında karşılaştırılmıştır. Deney ve kontrol grubunun stres, kaygı, depresyon, yaşam memnuniyeti, psikolojik iyi oluş ve pozitif-negatif duygu düzeylerini ön test ve son test puanları açısından karşılaştırmak için bağımsız örneklem t testinden yararlanılmıştır. Bağımlı değişkenlerin birbiriyle olan ilişkisini incelemek amacıyla pearson korelasyon analizinden faydalanılmıştır. Deney grubundaki bireylerin ön test ve son test puanları bakımından stres, kaygı, depresyon, yaşam memnuniyeti, psikolojik iyi oluş ve pozitif-negatif duygu düzeylerinde anlamlı bir farklılığa rastlanırken, kontrol grubundaki bireylerin ön test ve son test puanlarında herhangi bir farklılığın olmadığı tespit edilmiştir. Araştırmada stres, kaygı, depresyon ve negatif duygu arasında pozitif bir ilişkinin olduğu görülmüştür. Yaşam memnuniyeti, psikolojik iyi oluş ve pozitif duygu arasında da pozitif ilişki olduğu belirlenmiştir. Ayrıca stres, kaygı, depresyon ve negatif duygu ile yaşam memnuniyeti, psikolojik iyi oluş ve pozitif duygu arasında negatif bir ilişkinin olduğu tespit edilmiştir.
... Nevertheless, international research provided data supporting escape strategies and pharmacological and non-pharmacological approaches to limit anxiety disorders. Digital mental health interventions and treadmill exercise have received interest from the public as well as the scientific community (Ströhle, 2009;Jayakody et al., 2014;Firth et al., 2018). ...
... Physical activity (PA) has numerous positive effects on mental and physical health (Warburton et al., 2006) including improving quality of life (Marquez et al., 2020;Penedo & Dahn, 2005), playing a protective role in depression (Ströhle, 2009) and cognitive decline (Sofi et al., 2011), and extending life expectancy (Arem et al., 2015;Gebel et al., 2015;Wen et al., 2011). Physical inactivity leads to a higher risk for many non-communicable diseases (NCDs) such as diabetes, cardiovascular diseases, hypertension, obesity and even some types of cancer (American Cancer Society, 2020; Lee et al., 2012; National Cancer Institute, 2020; Sattelmair et al., Swift et al., 2013), while higher levels of PA are consistently associated with reduced risk for NCDs and healthier body composition, blood pressure, and cholesterol levels (Warburton et al., 2006). ...
Self-expansion theory posits that people are motivated to pursue activities that expand one's efficacy and ability to accomplish goals. Self-expanding activities are associated with positive health behaviours including physical activity (PA). However, research to-date on self-expansion and PA has involved only urban samples within the USA. The objective of this cross-sectional study was to extend current knowledge by investigating the connection between self-expansion and self-reported PA levels in two independent rural samples, one in Bern, Switzerland (n=69) and one in Idaho, USA (n=45). Participants were adults' (≥18 years old) who completed online measures of PA, general self-expansion, and PA specific self-expansion. Both samples showed similar results and confirmed the hypotheses that self-expansion is positively related to PA; and that PA specific self-expansion exhibits a stronger relationship to PA compared to general self-expansion. Effect sizes with Cohen's f ranged from 0.220 to 0.443 in the Bernese sample and 0.451 to 0.641 in the Idaho sample. Effects were even stronger for moderate to vigorous physical activity (MVPA) and general self-expansion as well as PA specific self-expansion and MVPA with this relationship having the strongest effect for both independent samples. These two studies provide evidence that there is a medium to large relationship between self-expansion and PA. Future research including longitudinal and intervention studies and studies with larger samples in multiple countries are needed to test directionality of influence and whether leveraging existing intrinsic motivation via self-expansion could offer a novel approach to promoting PA.
... Anksiyete ve depresif bozukluklar yaygın bir halk sağlığı sorunudur ve bireye ve topluma maliyeti çok fazladır (Ströhle 2009). Fiziksel aktivite, farklı fiziksel hastalıklardan korunmasına yardımcı olduğu kadar anksiyete ve depresyon gibi bazı psikiyatrik rahatsızlıkların tedavisinde de kullanılmakta-dır. ...
Değerli okuyucularımız; Sağlık bilimleri alanında özveri ile çalışan akademisyenlerimizin büyük emekleri ile hazırladığımız kitabımız, geniş kapsamlı bir yaklaşım ile bizlere güncel bilgiler sunmaktadır. Tıpta temel bilimler ile klinik bilimler birlikte çalışarak sürekli önemli gelişmeler kaydetmektedir. Konular üzerinde araştırma yaparken ona birçok bakış açısı ile bakarak yaklaşmamız, ayrıntıları fark etmemize, yeni fikirler ve çözümler üretmemize katkı sağlamaktadır. Kitabın zengin içeriği ve perspektifi ile yazarlarımızın bilim dünyasına katkı sunan yorumlarının, bilime gönül veren insanlar için yararlı olacağını umut etmekteyim. Hastalıkların önlenmesi, erken tanısı ve etkin tedavisi için bilimsel alanlarda sabırla çalışan yol arkadaşlarımın çalışmalarına yeni ufuklar açmasını dilerim. Kitabımıza destek veren yazar kadromuz ve her seferinde aynı heyecan ile hazırladığımız yeni eserlerde büyük çabalarından dolayı yayın ekibimize teşekkür ederim. Prof. Dr. Hülya Çiçek
... Existing literature indicates that physical activity can attenuate depressive and anxious symptomatology [21]. Exercise has been shown to augment social support networks, facilitate stress reduction, and ultimately alleviate negative emotional states [22]. It is imperative for university students grappling with depression and anxiety to cultivate a proactive mindset toward physical exercise and consistently participate in structured physical activities [23]. ...
... The negative correlation between habitual physical activity and anxiety levels found in the present study might be explained by the fact that adults who engage in regular physical activity experience fewer anxious symptoms [26], and physical activity positively affects a number of physiological (e.g., lower sympathetic nervous system and hypothalamic-pituitary-adrenal axis reactivity) and psychological mechanisms (e.g., distraction, anxiety sensitivity, and sense of self-efficacy), which might result in a decrease in the anxiety levels [27]. Thus, this evidence supports the notion that habitual physical activity may be effective for improving anxiety levels and confirm our hypothesis that a structured physical exercise program is not necessary to improve anxiety levels. ...
Purposes: To examine the habitual physical activity levels and their relationship with mood disorders (anxious and depressive symptoms) in young healthy adults and evaluated sex differences for these variables. Methods: A total of 297 participants (144 women) answered the following questionnaires: Baecke questionnaire to evaluate habitual physical activity level; State–Trait Anxiety Inventory, to evaluate anxious symptoms; and Beck Depression Inventory, to evaluate depressive symptoms. Results: There was a significant negative correlation between habitual physical activity levels and depressive symptoms (rho = -0.132 “small effect”, p = 0.023), trait anxiety levels (rho = -0.205 “small effect”, p < 0.001), and state anxiety levels (r = -0.216 “small effect”, p < 0.001) of the participants. However, there was no significant difference (p > 0.05) between men and women correlations for all investigated variables. Men presented higher absolute total (p < 0.001, d = 0.549 “medium effect”) and mean (p < 0.001, d = 0.515 “medium effect”) habitual physical activity level, lower trait (p < 0.001, rB = -0.342 “medium effect”) and state (p < 0.001, d = -0.483 “small effect”) anxiety levels, and lower depressive symptoms (p = 0.007, rB = -0.181 “small effect”) than women. Conclusion: Habitual physical activity that is characterized by unstructured pattern seems to be inversely related to mood disorders.
... Research has demonstrated specific benefits such as improvements in physical and physiological health parameters [3,4]. Several lines of evidence have also shown that physical activity can effectively improve mental well-being and reduce the potential for preventing symptoms of mental health disorders such as depression and anxiety [5][6][7][8]. We see great potential to focus on health data analytics based on global impacts. ...
This research article presents an analysis of health data collected from wearable devices, aiming to uncover the practical applications and implications of such analyses in personalized healthcare. The study explores insights derived from heart rate, sleep patterns, and specific workouts. The findings demonstrate potential applications in personalized health monitoring, fitness optimization, and sleep quality assessment. The analysis focused on the heart rate, sleep patterns, and specific workouts of the respondents. Results indicated that heart rate values during functional strength training fell within the target zone, with variations observed between different types of workouts. Sleep patterns were found to be individualized, with variations in sleep interruptions among respondents. The study also highlighted the impact of individual factors, such as demographics and manually defined information, on workout outcomes. The study acknowledges the challenges posed by the emerging nature of wearable devices and technological constraints. However, it emphasizes the significance of the research, highlighting variations in workout intensities based on heart rate data and the individualized nature of sleep patterns and disruptions. Perhaps the future cognitive healthcare platform may harness these insights to empower individuals in monitoring their health and receiving personalized recommendations for improved well-being. This research opens up new horizons in personalized healthcare, transforming how we approach health monitoring and management.
... Sound aerobic exercise habits developed in the early age and it's also providing the foundation for a life time of fitness through exercise (Heyward & Gibson, 2014). Patients with anxiety and depression do better if exercise training is performed with other treatment (Ströhle, 2009). Students are vulnerable to a variety of mental disorders, which in turn leads to public concerned in different societies (Brown & Harris, 2012). ...
The purpose of this study was to investigate the effect of eight (08
... As the nature of harvesting work involves alternating nature environments leading to minor daily operational problems and decision-making, high WAI among operators is implying they are more likely to solve daily operational problems in order to improve work quality and fluency, and thus indirectly productivity. Improvements in maximum oxygen uptake (VO 2max ) are generally associated with better physical and mental health (Warburton et al. 2006;Ströhle 2009;Miller et al. 2016;Korge and Nunan 2018), and further physical health seems to correlate with work performance and productivity (Burton et al. 2005;Mills et al. 2007;Kumar et al. 2009), hence there are controversial results to productivity as well (Bernaards et al. 2007). In this study, VO 2max was estimated with the smartwatch's fitness test. ...
... Exercise without appropriate nutritional fueling can result in low energy availability, even in normal-weight athletes; this disrupts the hypothalamic-pituitary-gonadal (HPG) axis, leading to functional hypothalamic amenorrhea (FHA) and low estrogen levels (6). While numerous reports have demonstrated a positive effect of exercise on depression and anxiety (7,8), the role of estrogen deficiency resulting from physical activity in young athletes with amenorrhea on mood and anxiety has not been studied in detail. To our knowledge, only one study has evaluated mood issues in athletes with respect to their menstrual status and reported a trend for a higher prevalence of bipolar disorders or major depressive disorders in 23% of runners who had absent menses (amenorrhea) versus 0% runners with regular menses (eumenorrhea) (9). ...
Objective
Studies in estrogen deficiency states such as primary ovarian insufficiency and Turner syndrome suggest that estrogen status may be an important modulator of mood and emotions. In this study we compared depressive and anxiety symptoms between adolescent and young adult female oligo-amenorrheic athletes (AA) and eumenorrheic females (EM), and explored structural, and functional changes in related brain areas during reward processing, a behavioral construct that is altered in depression and anxiety.
Methods
We included (i) 24 AA participating in ≥4 hours/week of aerobic exercise or running ≥20 miles/week for ≥6 months in the preceding year, with lack of menstrual cycles for ≥3 months within at least 6 preceding months of oligo-amenorrhea, OR in premenarchal girls, absence of menses at >15 years), and (ii) 27 EM aged 14-25 years. Participants completed the Beck Depression Inventory-II (BDI-II), State and Trait Anxiety Inventory (STAI), and Mood and Anxiety Symptoms Questionnaire (MASQ). Structural MRI and brain activation during a functional MRI (fMRI) task that probes reward and punishment processing was examined in a subset of 10 AA and 23 EM.
Results
Median (IQR) age and BMI of AA and EM groups were 20.6 (19.0-22.6) vs. 20.6 (19.2-23.7) years, p=0.6 and v 20.3 (18.8-21.5) vs. 21.9 (19.6-23.5) kg/m2, p=0.005, respectively. While groups did not differ for BDI-II scores, AA had higher anhedonic depression MASQ scores (p=0.04), and STAI (p=0.03) scores vs. EM. In the fMRI subset, AA had higher caudate volumes vs. EM [F(1, 29)=9.930, p=0.004]. Lower activation observed in the right caudate during reward anticipation in AA compared with EM (p=0.036) suggests blunted reward processing in the striatum in estrogen deficient states.
Conclusion
Athletes with amenorrhea had higher depressive and anxiety symptomatology compared to eumenorrheic young women. Exploratory analyses demonstrated increased caudate volumes and decreased caudate activation during reward processing in athletes with amenorrhea suggesting that estrogen may play a role in reward processing.
... 8,9 Health benefits include increased skeletal muscle mass and strength and bone mineral density, improved cardiometabolic and physical functioning, reduced musculoskeletal symptoms and reduced symptoms of anxiety and depression. [10][11][12][13] Muscle-strengthening exercise has often been described as the "forgotten" PA guideline. 5,14,15 A 2018 review of international efforts identified only five surveys that included direct/explicit questions about muscle strengthening. ...
Introduction
Muscle-strengthening and balance activities are associated with the prevention of illness and injury. Age-specific Canadian 24-Hour Movement Guidelines include recommendations for muscle/bone-strengthening and balance activities. From 2000–2014, the Canadian Community Health Survey (CCHS) included a module that assessed frequency in 22 physical activities. In 2020, a healthy living rapid response module (HLV-RR) on the CCHS asked new questions on the frequency of muscle/bonestrengthening and balance activities. The objectives of the study were to (1) estimate and characterize adherence to meeting the muscle/bone-strengthening and balance recommendations; (2) examine associations between muscle/bone-strengthening and balance activities with physical and mental health; and (3) examine trends (2000–2014) in adherence to recommendations.
Methods
Using data from the 2020 CCHS HLV-RR, we estimated age-specific prevalence of meeting recommendations. Multivariate logistic regressions examined associations with physical and mental health. Using data from the 2000–2014 CCHS, sex-specific temporal trends in recommendation adherence were explored using logistic regression.
Results
Youth aged 12 to 17 years (56.6%, 95% CI: 52.4–60.8) and adults aged 18 to 64 years (54.9%, 95% CI: 53.1–56.8) had significantly greater adherence to the muscle/ bone-strengthening recommendation than adults aged 65 years and older (41.7%, 95% CI: 38.9–44.5). Only 16% of older adults met the balance recommendation. Meeting the recommendations was associated with better physical and mental health. The proportion of Canadians who met the recommendations increased between 2000 and 2014.
Conclusion
Approximately half of Canadians met their age-specific muscle/bonestrengthening recommendations. Reporting on the muscle/bone-strengthening and balance recommendations elevates their importance alongside the already recognized aerobic recommendation.
... Les avantages à la pratique d'une activité aérobique régulière sont bien connus 13 . Celleci constitue généralement l'élément central des initiatives de promotion de la santé ciblant les comportements 4 , et le respect de cette recommandation est la pierre angulaire de la surveillance en matière d'activité physique 5 6 . ...
Introduction
Les activités de renforcement des muscles et d’amélioration de l’équilibre sont associées à la prévention des maladies et des blessures. Les Directives canadiennes en matière de mouvement sur 24 heures offrent des recommandations concernant les activités de renforcement de l’appareil locomoteur et d’amélioration de l’équilibre. Entre2000 et 2014, l’Enquête sur la santé dans les collectivités canadiennes (ESCC) a intégré un module évaluant la fréquence de 22 activités physiques. En 2020, un module de réponse rapide sur le mode de vie sain (HLV-RR) posant de nouvelles questions sur la fréquence des activités de renforcement de l’appareil locomoteur et d’amélioration de l’équilibre a été intégré dans l’ESCC. Notre étude visait trois objectifs : 1) estimer et caractériser le respect des recommandations concernant les activités de renforcement de l’appareil locomoteur et d’amélioration de l’équilibre; 2) étudier les associations entre, d’une part, les activités de renforcement de l’appareil locomoteur et d’amélioration de l’équilibre et, d’autre part, l’état de santé physique et mentale et 3) analyser les tendances au fil du temps en matière de respect des recommandations (2000 à 2014).
Méthodologie
Nous avons estimé, à l’aide des données du module HLV-RR de l’ESCC 2020, la prévalence du respect des recommandations en fonction de l’âge. Des analyses de régression logistique multivariée ont porté sur les associations avec l’état de santé physique et mentale. Les données de l’ESCC de 2000 à 2014 ont fait l’objet de régressions logistiques visant à faire ressortir les tendances au fil du temps par sexe en matière de respect des recommandations.
Résultats
Les adolescents de 12 à 17 ans (56,6 %; IC à 95 % : 52,4 à 60,8) et les adultes de 18 à 64 ans (54,9 %; IC à 95 % : 53,1 à 56,8) étaient nettement plus nombreux à suivre la recommandation concernant le renforcement de l’appareil locomoteur que les adultes de 65 ans et plus (41,7 %; IC à 95 % : 38,9 à 44,5). Seulement 16 % des aînés respectaient la recommandation concernant l’amélioration de l’équilibre. Le respect des recommandations est associé à un meilleur état de santé physique et mentale. La proportion de Canadiens respectant les recommandations a augmenté entre 2000 et 2014.
Conclusion
Environ la moitié des Canadiens ont respecté les recommandations concernant le renforcement de l’appareil locomoteur pour leur âge. Rendre compte du respect des recommandations en matière de renforcement de l’appareil locomoteur et d’amélioration de l’équilibre assure de l’importance de ces recommandations au même niveau que celles en matière d’activité aérobique.
... According to Kalemdarolu et al. (2004), yacht tourism is responsive to changes in tourist demand and hence has huge development potential in terms of offering more sophisticated, nature sensitive experiences where feelings of freedom, exploration, being close to nature and history, sports and adventure prevail. Activities in the form of leisure or exercise can affect the mood of individuals (Strohle, 2009) and time spent on leisure contributes to the health of a nation (Khan et al., 2012). In an earlier study, Lusby and Anderson (2008) examined the lifestyle of boaters living on yachts and those who chartered for leisure in the port community of Georgetown, Bahamas. ...
Purpose
This study aims to advance the scholarship of yachting in the context of wellness by exploring the following research question: in what ways is wellness created and experienced by luxury yachting?
Design/methodology/approach
Since the extant journal literature from 2012–2023 in peer-reviewed journals is limited on the topic that links luxury yachting and wellness, the authors drew on other sources such as books and chapters in edited volumes. A third layer of material was drawn from the grey literature such as mass media and business websites. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) method, the authors examined 18 publications relating to the intersectionality of yachting and wellness.
Findings
Manufacturing and charter companies in the yachting industry are focused on creating and emphasizing features onboard that create a self-caring and wellness experience. The yacht design, spatial influences and the leisure time spent at destinations on anchor can also add value to wellness. This study enables us to understand the kinds of signals received by manufacturers and the media from yachting clients. These signals relate to the types of wellness needs and activities, as well as how crews and chefs create the best hospitality experiences for their clients.
Originality/value
Given the scarce and niche nature of research on yachting and wellness, this paper explores future research areas in wellness through luxury yachting which include hospitality aspects of creating and co-creating wellness experience on board the yacht and viewing yachting as a lifestyle necessity product for all levels of wealth and well-being.
... Regression models showed that those with moderate-to-vigorous recreational physical activity had an average 23.6% lower risk of developing sleep disorders compared to participants with no recreational physical activity. Related researches suggested that participation in moderate and regular recreational physical activity can be effective in reducing negative emotions such as stress, anxiety, and depression (17). Recreational activities can also improve sleep quality by reducing stress and increasing psychological resilience (18,19). ...
Background: Sleep disorder is an important psychological and public health burden, which seriously endangers physical and psychological health. Physical activities are closely related to sleep disorder, while different types of physical activities may have different effects on sleep disorder.
Objective: The aim of this study was to evaluate the association of different types of physical activity on sleep disorder independent from each other.
Materials and Methods: We extracted data from NHANES 2017-2018, including demographic characteristics, sleep disorder and physical activity. A total of 4157 adults aged 20 years or older (mean age 51.05 ± 17.52 years, 2029 males and 2128 females) was included. Types of physical activity (work, transportation, recreational physical activity and sedentary behavior) were defined and assessed by the Global Physical Activity Questionnaire (GPAQ); sleep disorder was assessed by patient self-report in the Munich Chronotype Questionnaire (MCTQ). Chi-square test and Kruskal-Wallis tests was used to compare differences between groups; the associations of each type of physical activity and sleep disorder were analyzed through binary Logistic regressions.
Results: 1) 1211 participants were found to have sleep disorder, accounting for 29.1% of the total sample size; 2) There were significant differences in work physical activity (P=0.043), sedentary behavior (P<0.001) and recreational physical activity (P=0.001) among sleep disorder, the difference of transportation physical activity was close to significant (P=0.055). 3) Work physical activity (OR=1.249, 95% CI: 1.126-1.385, P<0.001) and sedentary behavior (OR=1.524, 95% CI: 1.330-1.745, P<0.001) were positively associated with sleep disorder, while recreational physical activity (OR=0.776, 95% Cl: 0.700-0.860, P<0.001) was negatively associated.
Conclusions: 1) There are no significant associations between transportation physical activity and sleep disorder. 2) Both work physical activity and sedentary behavior are risk factors for sleep disorder. 3) Recreational physical activity is a protective factor for sleep disorder.
... Physical inactivity has been identified as one of the primary causes of chronic diseases (Małkiewicz et al., 2019) and associated with an increased risk and incidence of depression and anxiety (Gleeson et al., 2011;Pearce et al., 2022), suggesting that being physically inactive could be a predisposing factor to these disorders. In line with the possibility that exercise could limit anxiety and depressive symptoms, higher levels of physical activity have been associated with better mental health (Anderson & Shivakumar, 2013;De Moor et al., 2006;Ströhle, 2009). The antidepressant effects of exercise are also well-supported (Babyak et al., 2000;Blumenthal et al., 2007;Ignácio et al., 2019;Ross et al., 2022) and accumulating evidence points towards its anxiolytic properties (Asmundson et al., 2013;Wipfli et al., 2008). ...
Physical exercise has been positioned as a promising strategy to prevent and/or alleviate anxiety and depression, but the biological processes associated with its effects on mental health have yet to be entirely determined. Although the prevalence of depression and anxiety in women is about twice that of men, very few studies have examined whether physical exercise could affect mental health differently according to sex. This study examined, in singly-housed mice, the sex-specific effects of voluntary exercise on depressive- and anxiety-like behaviors as well as on different markers along the gut microbiota-immune-brain axis. Male and female C57BL/6N mice had voluntary access to running wheels in their home-cages for 24 days or were left undisturbed in identical home-cages without running wheels. Behaviors were then examined in the open field, splash, elevated plus maze, and tail suspension tests. Gene expression of pro-inflammatory cytokines, microglia activation-related genes, and tight junction proteins was determined in the jejunum and the hippocampus, while microbiota composition and predicted function were verified in cecum contents. Voluntary exercise reduced anxiety-like behaviors and altered grooming patterns in males exclusively. Although the exercise intervention resulted in changes to brain inflammatory activity and to cecal microbiota composition and inferred function in both sexes, reductions in the jejunal expression of pro-inflammatory markers were observed in females only. These findings support the view that voluntary exercise, even when performed during a short period, is beneficial for mental and intestinal health and that its sex-specific effects on behavior could be, at least in part, related to some components of the gut microbiota-immune-brain axis.
... The most commonly considered PA characteristic is unarguably the PA volume (or PA level). It has been linked to improved cardiorespiratory fitness [18] and reduced risk of chronic conditions [8], including cardiovascular disease [43], stroke [28], diabetes [26], breast [35] and colon cancers [48], osteoporosis [6], depression [40], and declining physical [16] and cognitive functioning [27]. While daily PA volumes are important themselves and have been extensively studied, high-fidelity data collected with wearable accelerometers create new and exciting opportunities for healthcarers to obtain more detailed information about PA. ...
Commercial and research-grade wearable devices have become increasingly
popular over the past decade. Information extracted from devices using accelerometers is fre- quently summarized as "number of steps" (commercial devices) or "activity counts" (research- grade devices). Raw accelerometry data that can be easily extracted from accelerometers used in research, for instance ActiGraph GT3X+, are frequently discarded.
Approach: Our primary goal is proposing an innovative use of the de-shape synchrosqueez- ing transform to analyze the raw accelerometry data recorded from a single sensor installed in different body locations, particularly the wrist, to extract gait cadence when a subject is walking. The proposed methodology is tested on data collected in a semi-controlled experiment with 32 participants walking on a one-kilometer predefined course. Walking was executed on a flat surface as well as on the stairs (up and down).
Main Results: The cadences of walking on a flat surface, ascending stairs, and descending stairs, determined from the wrist sensor, are 1.98±0.15 Hz, 1.99±0.26 Hz, and 2.03±0.26 Hz respectively. The cadences are 1.98±0.14 Hz, 1.97±0.25 Hz, and 2.02±0.23 Hz, respectively if determined from the hip sensor, 1.98±0.14 Hz, 1.93±0.22 Hz and 2.06±0.24 Hz, respectively if determined from the left ankle sensor, and 1.98±0.14 Hz, 1.97±0.22 Hz, and 2.04±0.24 Hz, respectively if determined from the right ankle sensor. The difference is statistically significant indicating that the cadence is fastest while descending stairs and slowest when ascending stairs. Also, the standard deviation when the sensor is on the wrist is larger. These findings are in line with our expectations.
Conclusion: We show that our proposed algorithm can extract the cadence with high accuracy, even when the sensor is placed on the wrist.
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Esta revisão sistemática analisou de maneira abrangente os efeitos da atividade física na saúde mental, explorando sua influência sobre o bem-estar emocional, a ansiedade, a depressão, o estresse e a qualidade de vida. A revisão considerou estudos observacionais, ensaios clínicos e revisões sistemáticas, avaliando os resultados de diferentes grupos demográficos e considerando possíveis mecanismos de ação. Os resultados obtidos revelam consistentemente que a atividade física regular está associada à melhoria do bem-estar psicológico e emocional, bem como à redução dos sintomas de ansiedade, depressão e estresse. A análise também destacou a importância da atividade física como uma estratégia de promoção da qualidade de vida e da saúde mental em populações específicas, como crianças, adolescentes, idosos e indivíduos com condições de saúde mental pré-existentes. Os possíveis mecanismos de ação discutidos incluem aspectos neurobiológicos, psicossociais e comportamentais que contribuem para os benefícios observados. A revisão ressalta a necessidade de considerar abordagens integradas para a promoção da saúde mental, reconhecendo que a atividade física é parte de um conjunto de estratégias. Em conclusão, esta revisão sistemática reforça a relevância da atividade física como uma intervenção eficaz na promoção da saúde mental. Os resultados apresentados têm implicações importantes para a prática clínica e política de saúde, destacando a importância da prescrição de atividade física como parte de estratégias de promoção do bem-estar emocional e psicológico.
Introduction:
Worldwide, there are more than 264 million people with depression, which is the second-leading cause of years lived with disability. Physical activity can be useful in both preventing and treating mild to moderate depression, but few studies have explored patients' experience of physical activity.
Purpose:
To explore experiences of facilitators to initiate and maintain regular physical activity in people with depression.
Methods:
Adults of working age with mild to moderate depression participated in semi-structured interviews. Two researchers analyzed the data using qualitative content analysis.
Results:
Four categories were identified: 1) Getting over the threshold; 2) Hoping for improvement; 3) A wish to be independent but needing help; and 4) Feeling safe on one's own terms.
Conclusion:
The results indicate that knowledge and personal experience of how physical activity affects well-being, and an environment including social support, increase the possibilities for people with depression to initiate and maintain physical activity. To promote physical activity, it is important to be receptive to the person's experiences, desires, and needs and to involve them in the planning and adjustment of physical activity. Follow-up appointments, a stepwise approach, and encouragement are important to increase motivation.
Background:
Major depressive disorder (MDD) affects millions of people worldwide, but timely treatment is not often received owing in part to inaccurate subjective recall and variability in the symptom course. Objective and frequent MDD monitoring can improve subjective recall and help to guide treatment selection. Attempts have been made, with varying degrees of success, to explore the relationship between the measures of depression and passive digital phenotypes (features) extracted from smartphones and wearables devices to remotely and continuously monitor changes in symptomatology. However, a number of challenges exist for the analysis of these data. These include maintaining participant engagement over extended time periods and therefore understanding what constitutes an acceptable threshold of missing data; distinguishing between the cross-sectional and longitudinal relationships for different features to determine their utility in tracking within-individual longitudinal variation or screening individuals at high risk; and understanding the heterogeneity with which depression manifests itself in behavioral patterns quantified by the passive features.
Objective:
We aimed to address these 3 challenges to inform future work in stratified analyses.
Methods:
Using smartphone and wearable data collected from 479 participants with MDD, we extracted 21 features capturing mobility, sleep, and smartphone use. We investigated the impact of the number of days of available data on feature quality using the intraclass correlation coefficient and Bland-Altman analysis. We then examined the nature of the correlation between the 8-item Patient Health Questionnaire (PHQ-8) depression scale (measured every 14 days) and the features using the individual-mean correlation, repeated measures correlation, and linear mixed effects model. Furthermore, we stratified the participants based on their behavioral difference, quantified by the features, between periods of high (depression) and low (no depression) PHQ-8 scores using the Gaussian mixture model.
Results:
We demonstrated that at least 8 (range 2-12) days were needed for reliable calculation of most of the features in the 14-day time window. We observed that features such as sleep onset time correlated better with PHQ-8 scores cross-sectionally than longitudinally, whereas features such as wakefulness after sleep onset correlated well with PHQ-8 longitudinally but worse cross-sectionally. Finally, we found that participants could be separated into 3 distinct clusters according to their behavioral difference between periods of depression and periods of no depression.
Conclusions:
This work contributes to our understanding of how these mobile health-derived features are associated with depression symptom severity to inform future work in stratified analyses.
Colleges are increasingly cognizant of the value of attending to the emotional needs of students in pandemic-altered learning conditions, recognizing that academic anxiety has significant adverse impacts on their academic performance. This study explored whether the personality trait, a personal belief in a just world (PBJW), provided distinctive explanatory power to the degree of academic anxiety after considering the specific nature of the pandemic and examining if the applicable physical activities afforded the positive additional effect on alleviating academic anxiety symptoms. The sample comprised 96 college students (51.0% female), with groups matched by age and gender and controlled for the level of a PBJW and specified physical activity (PA). An augmented academic emotional Stroop method to assess the academic anxiety of college students was proposed based on the objective indicator rather than the subjective index derived from the self-assessment tool. The results indicated the participant’s low level of a PBJW may serve as an early predictor to identify students with academic anxiety. In addition, high correlations among PA, a PBJW, and academic anxiety were identified, and the specified moderate PA, doing household chores, may serve as an early intervention to help college students manage academic anxiety. The findings hold relevance for further research on the role of personality traits in the academic process and the design of interventions addressing academic emotions.
Objective
To analyze how the physical activity influence life satisfaction of university students and the relationship between those factors. Additionally, this study aims to examine the mediating effects of self-efficacy and Resilience, and to offer recommendations for enhancing the life satisfaction, positive emotions, and behavioral patterns of university students.
Methodology
This study used the Physical Activity Rating Scale (PARS-3), the Self-Efficacy Scale (CGES), the Mental Toughness Scale (CD-RISC) and the Life Satisfaction Scale (CSLSS) to administer questionnaires to 353 university students from two universities in Chengdu, Sichuan Province. Using a random simple sampling method. The data were processed and analyzed using SPSS 22.0 and Excel software
Results
1) Physical activity was significantly and positively related to self-efficacy, Resilience and life satisfaction; self-efficacy was significantly and positively related to Resilience and life satisfaction; Resilience was significantly and positively related to life satisfaction. 2) Physical exercise had a positive predictive effect on life satisfaction (β = 0.2771; 95% confidence interval (CI): 0.01905, 0.3637, p < 0.001); 3) Self-efficacy (β = 0.0368, 95% confidence interval (CI): 0.0087, 0.0692, p < 0.001) and Resilience (β = 0.0137; 95% confidence interval (CI): 0.0919, 0.01894, p < 0.001) mediated the relationship between physical activity and life satisfaction, respectively. Also the chain mediating effect of self-efficacy and Resilience between physical activity and life satisfaction reached significant levels (β = 0.0483, 95% confidence interval (CI): 0.0279, 0.0745, p < 0.001).
Conclusion and outlook
Active participation in physical activity not only improves the level of life satisfaction of college students, but also indirectly influences the level of life satisfaction of college students by enhancing their self-efficacy and Resilience, thus improving the level of life satisfaction of college students.
Bu araştırmanın amacı; sedanter bireylerin 8 haftalık fiziksel aktiviteye göre stres, kaygı, depresyon, yaşam memnuniyeti, psikolojik iyi oluş ve pozitif-negatif duygu düzeylerini incelemek ve ön test son test puanlarını karşılaştırmaktır. Araştırma ön test-son test deney ve kontrol gruplu yarı deneysel bir araştırmadır. Araştırma grubu 50 deney grubu, 50 kontrol grubu toplam 100 bireyden oluşmaktadır. Veriler “Depresyon, Anksiyete ve Stres Ölçeği”, “Yaşam Memnuniyeti Ölçeği”, “Psikolojik İyi Oluş Ölçeği” ve “Pozitif-Negatif Duygu Ölçeği” kullanılarak elde edilmiştir. Elde edilen veriler grup içinde ve gruplar arasında karşılaştırılmıştır. Deney ve kontrol grubunun stres, kaygı, depresyon, yaşam memnuniyeti, psikolojik iyi oluş ve pozitif-negatif duygu düzeylerini ön test ve son test puanları açısından karşılaştırmak için bağımsız örneklem t testinden yararlanılmıştır. Bağımlı değişkenlerin birbiriyle olan ilişkisini incelemek amacıyla pearson korelasyon analizinden faydalanılmıştır. Deney grubundaki bireylerin ön test ve son test puanları bakımından stres, kaygı, depresyon, yaşam memnuniyeti, psikolojik iyi oluş ve pozitif-negatif duygu düzeylerinde anlamlı bir farklılığa rastlanırken (p0.05). Araştırmada stres, kaygı, depresyon ve negatif duygu arasında pozitif bir ilişkinin olduğu görülmüştür. Yaşam memnuniyeti, psikolojik iyi oluş ve pozitif duygu arasında da pozitif ilişki olduğu belirlenmiştir. Ayrıca stres, kaygı, depresyon ve negatif duygu ile yaşam memnuniyeti, psikolojik iyi oluş ve pozitif duygu arasında negatif bir ilişkinin olduğu tespit edilmiştir.
Introduction:
Despite the increasing amount of research regarding mental health in elite athletes in recent years, athletes with impairments are hardly represented. Due to this lack of data and the significant need of athlete specific mental health screening tools, a continuous mental health monitoring within elite Para athletes was implemented.
Objectives:
Validation of the Patient Health Questionnaire-4 (PHQ-4) as a suitable tool for continuous mental health evaluation in elite Para athletes.
Design:
A 43-week prospective observational cohort study SETTING: Online questionnaire, provided weekly via web browser and mobile app PARTICIPANTS: 78 Para athletes preparing for Paralympic Summer and Winter Games INTERVENTION: Not applicable MAIN OUTCOME MEASURES: Weekly PHQ-4 scores, stress level and mood.
Results:
With a mean weekly response rate of 82.7% (SD=8.0), 2149 PHQ-4, 2159 stress level and 2153 mood assessments were completed. Mean PHQ-4 score among all participating athletes was 1.2 (SD=1.8; 95% CI [1.1-1.3]). Individual weekly scores ranged from zero to 12 and showed significant floor effects, with 54% of the scores being zero. PHQ-4 scores were significantly higher among female athletes and team sport members (p<.001). Internal consistency of the PHQ-4 was satisfying, Cronbach's α being 0.839. There were significant cross-sectional as well as longitudinal correlations of PHQ-4 and stress level as well as mood values (p<.001). 39.7% of all athletes (n=31) had at least one positive screen for mental health symptoms.
Conclusion:
The PHQ-4 turned out to be a valid tool for mental health surveillance in elite Para athletes. Significant correlations of the PHQ-4 and stress level as well as mood were shown. High weekly response rates among participating athletes indicated good acceptance of the program. The weekly monitoring allowed for the identification of individual fluctuations and could identify potential athletes at risk for mental health problems when combined with clinical follow-up. This article is protected by copyright. All rights reserved.
Purpose
Depression disorder is the most commonly diagnosed type of mental illness among youths. Although a plethora of evidence suggests a positive relationship between exercise and lower levels of depression in youths, the findings regarding the variation in magnitude of this relationship are inconclusive with respect to the preventive and therapeutic effects of different types of exercise. This network meta-analysis aimed to determine the best type of exercise for the treatment and prevention of depression in youths.
Methods
A comprehensive search of databases, including PubMed, EMBASE, The Cochrane Library, Web of Science, PsychINFO, ProQuest, Wanfang, and CNKI, was conducted to identify relevant research on exercise interventions for depression in youth populations. The risk of bias in the included studies was evaluated using Cochrane Review Manager 5.4 according to the Cochrane Handbook 5.1.0 Methodological Quality Evaluation Criteria. The network meta-analysis was performed using STATA 15.1 to calculate the standardized mean difference (SMD) of all concerned outcomes. The node-splitting method was used to test the local inconsistency of the network meta-analysis. Funnel plots were used to evaluate the potential impact of bias in this study.
Result
Utilizing data extracted from 58 studies (10 countries, 4,887 participants), we found that for depressed youths, exercise is significantly better than usual care in reducing anxiety (SMD = −0.98, 95% CI [-1.50, −0.45]). For non-depressed youths, exercise is significantly better than usual care in reducing anxiety (SMD = −0.47, 95% CI [ −0.66, −0.29]). In the treatment of depression, resistance exercise (SMD = −1.30, 95% CI [ −1.96, −0.64]), aerobic exercise (SMD = −0.83, 95% CI [-1.10 −0.72]), mixed exercise (SMD = −0.67, 95% CI [−0.99, −0.35]), and mind-body exercise (SMD = −0.61, 95% CI [−0.84, −0.38]) all showed significant efficacy over usual care. For the prevention of depression, resistance exercise (SMD = −1.18, 95% CI [-1.65, −0.71]), aerobic exercise (SMD = −0.72, 95% CI [−0.98, −0.47]), mind-body exercise (SMD = −0.59, 95% CI [-0.93, −0.26]), and mixed exercise (SMD = −1.06, 95% CI [−1.37 to −0.75]) were all significantly effective compared to usual care. According to the test of the surface under the cumulative ranking score (SUCRA), the ranking of exercises for the treatment of depression in depressed youths is as follows: resistance exercise (94.9%) > aerobic exercise (75.1%) > mixed exercise (43.8%) > mind-body exercise (36.2%) > usual care (0%). For the prevention of depression in non-depressed youths, resistance exercise (90.3%) > mixed exercise (81.6%) > aerobic exercise (45.5%) > mind-body exercise (32.6%) > usual care (0%). Resistance exercise thus had the best comprehensive effect on both the treatment and prevention of depression in youths (clusterank value = 1914.04). Subgroup analyses show that a frequency of 3–4 times per week, a duration of 30–60 min, and a length of more than 6 weeks were found to be the most effective interventions for depression ( P > 0.001).
Conclusion
This study provides compelling evidence that exercise is a viable intervention for improving depression and anxiety in young individuals. In addition, the study emphasizes the importance of selecting the appropriate type of exercise to optimize treatment and prevention. Specifically, the results suggest that resistance exercise, performed 3–4 times per week, with sessions lasting 30–60 min and a length of more than 6 weeks, yields optimal results for the treatment and prevention of depression in young individuals. These findings have significant implications for clinical practice, particularly given the challenges associated with implementing effective interventions and the economic burden of treating and preventing depression in young people. However, it is worth noting that additional head-to-head studies are necessary to confirm these findings and strengthen the evidence base. Nevertheless, this study provides valuable insights into the role of exercise as a potential treatment and preventative measure for depression in young people.
Systematic review registration
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=374154 , identifier: 374154.
Objective:
This review aimed to collect evidence about the effectiveness of exercise programs for managing binge eating disorder (BED) (recurrent binge eating episodes).
Methods:
Meta-analysis was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Articles were searched in PubMed, Scopus, Web of Science, and Cochrane Library. Randomized controlled trials were eligible for inclusion if they reported the effect of an exercise-based program on BED symptoms in adults. Outcomes were changes in binge eating symptom severity, measured through validated assessment instruments, after an exercise-based intervention. Study results were pooled using the Bayesian model averaging for random and fixed effects meta-analysis.
Results:
Of 2,757 studies, 5 trials were included, with 264 participants. The mean age was 44.7 ± 8.1 years for the intervention group and 46.6 ± 8.5 years for the control group. All participants were female. A significant improvement was observed between groups (standardized mean difference, 0.94; 95% credibility interval, -1.46 to -0.31). Patients obtained significant improvements either following supervised exercise programs or home-based exercise prescriptions.
Implications for research and practice:
These findings suggest that physical exercise, within a multidisciplinary clinical and psychotherapeutic approach, may be an effective intervention for managing BED symptoms. Further comparative studies are needed to clarify which exercise modality is associated with greater clinical benefits.
Pregnancy and physiological and psychological variations can impact mental and emotional changes and thereby trigger depression and anxiety in expectant mothers. Being overly concerned about an individual’s financial, social, and health issues can promote depression and anxiety among pregnant women. Managing those associated factors during and after pregnancy is crucial. Although several studies reported depression and anxiety disorder in pregnant women, there are limited studies available in Saudi Arabia. Thus, this study measured the prevalence of both depression and anxiety among pregnant women in Al-Madinah Al-Muawarah, Saudi Arabia. A total of 250 surveys were conducted from five primary care centers randomly. A simple stratified sampling technique was used. General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire (PHQ-9) were used as research instruments for data collection. Of the seven items from GAD-7, the higher rate related to the response “not at all” for the following items; “Being so restless that it is hard to sit still” by 165 (66.5%) was obtained followed by “Becoming easily annoyed or irritated” 118 (47.2%). Similarly, from the nine items from the PHQ-9, the higher rate response was obtained with “not at all” for the following items; “Thoughts that you would be better off dead, or hurting yourself” by 243 (98.0%), followed the second-highest rate was obtained regarding “Several Days” for the following items; “Trouble falling or staying asleep, or sleeping too much” by 116 (46.8%). The current study is consistent with previous studies.
With the rapid development of society, population aging has emerged as a significant global challenge. This study aimed to evaluate the impact of baseline cognitive performance, current cognitive function, and cognitive decline on subsequent depressive symptoms. Data were obtained from participants aged 65 years and older in the Chinese Longitudinal Healthy Longevity Survey (CLHLS), Wave 2014-2018. Of the 7,192 participants in Wave 2014, 1,627 were included in the analysis. Multivariate regressions were conducted to estimate the associations between cognitive measures and depressive symptoms. Our results indicated that baseline cognitive function was not associated with subsequent depressive symptoms, but current cognitive function was. Furthermore, participants who experienced significant cognitive decline were more likely to develop depressive symptoms. Covariates, including marital status, economic status, physical activity, and recreational activity, were also associated with subsequent depressive symptoms. These findings suggest that slowing cognitive decline is an effective strategy for preventing depressive symptoms in older adults, promoting their health and wellbeing.
Physical activity interventions are proven to mitigate job stress and improve work performance. However, the recommended threshold of physical activity is rarely considered when evaluating the effect of physical activity. This study adopted case study approach to investigate the moderating effect of the threshold of physical activity on the relationship between emotional exhaustion and work performance, based on the conservation of resources theory. The research site was an Asian university wherein the university developed a mHealth application as a physical activity intervention to promote Exercise-is-Medicine® On Campus. A longitudinal survey was conducted to collect quantitative data for analysis, and interviews were conducted for further insights. The results supported the hypothesis that the threshold of physical activity was an effective moderator in the exhaustion-performance relationship. This study enriches the burnout literature and substantiates literature on technology-enabled solutions for improving work performance by engaging users to do regular and sufficient physical activity.
Unlabelled:
This paper aims to investigate the three areas [diet, physical activity (PA), and social relationship] and their relationship with depressive disorders in the North African population.
Study design:
This is an observational cross-sectional study of 654 participants residing in the urban commune of Fez (n=326) and the rural commune of Loulja (n=328) in the province of Taounate. Participants were categorized into two groups: G1 without a current depressive episode and G2 with a current depressive episode. Risk factors, including locality, gender, marital status, age, parental status, employment status, tobacco use, alcohol consumption, social habits, and dietary patterns, were assessed. A multinomial probit model in Stata software was used to identify factors associated with depression occurrence in the population.
Results:
A total of 94.52% of the participants who engaged in PA did not experience a depressive episode (P=0.001). Additionally, 45.39% of the participants in our series were on a processed diet and presented with a depressive disorder (P=0.0001), the social contact (time spent with friends >1.5 h) remained strongly associated with reduced depressive symptoms when comparing the two groups (P=0.001). The results showed that being rural, a smoker, an alcohol user, and having no spouse significantly increased depression in participants. The coefficient of age was negatively related to the probability of the occurrence of age-related depression; however, this factor was not significant in the model. Thus, having a spouse and/or children and spending time with friends on a healthy diet significantly decreased depression in our population.
Discussion:
The converging evidence suggests that physical exercise, a stable social relationship, a healthy diet, and the use of PA can alleviate depression symptoms, but limited understanding and few studies have attempted to characterize or identify the neural mechanisms of these effects.
Conclusion:
Nonpharmaceutical interventions such as PA and dietary changes have proven to be effective treatments for depression, while maintaining positive social relationships can act as a protective factor, serving a prophylactic role in the prevention of depression.
Students are always required to have good self-esteem. Still, psychological problems, such as excessive anxiety, will cause discomfort and distress, avoid social situations, and interfere with daily life, made them feel worthless. The purpose of the study was to determine the effect of self-esteem on anxiety through life skills training. The research subjects were 14 students divided into two groups, namely the experimental group and the control group. The measurement uses a self-esteem scale and an anxiety scale. Data analysis used non-parametric analysis, namely Mann Whitney, Wilcoxon, and Spearman's Rank Correlation Test. The results of this study indicate a significant decrease in anxiety with increased self-esteem using life skills training for students.
In a society that strives for appearance, fitness is increasingly viewed as a means to reach a certain aesthetic ideal, rather than a way to improve health and physical performance. Every day millions of posts appear on social media promoting a visual representation of apparently fit, healthy and 'perfect' bodies. Combining personal accounts, clinical cases, and scientific research, this book explores how such new trends in society can lead to the development of exercise addiction and body image disorders. It explains how such a concern with physical appearance can act as a precursor or be symptomatic of other conditions, such as eating disorders, mood disorders, and the use of performance and image enhancing drugs. It highlights throughout the importance of raising awareness amongst health professionals, including psychiatrists, psychologists, mental health nurses, social workers and primary care physicians, of this growing challenge to prevent harm and improve treatment.
The stress that the COVID pandemic has caused is immeasurable and is likely to impact people for many years to come. Service providers such as social workers are experiencing these impacts both personally and professionally. As new research emerges, a greater understanding of the emotional toll related to COVID can help to inform social work practice. To add to this gap in the literature, an online survey explored the factors that contribute to higher stress reactions among individuals in the general population (n = 412) and across the age spectrum. Bivariate analyses indicated a significant increase in stress from pre- to during-COVID for the entire sample and across the three age groups. Multivariate analysis revealed more conversations about COVID, more alcohol use, knowing someone who had tested positive, increased fear, greater avoidance of reading/watching information about COVID, decreased health status, and increased income contributed to stress during-COVID. Increased fear and decreased health status were significant when stress was examined separately among the three age groups. The results indicated the importance of understanding and responding to fear during public health crises and illustrate how interventions may shift for clinical social workers as they seek to address multi-layered concerns. Social workers can help manage the impact of the pandemic by providing clients with therapeutic services, psychoeducation, and case management.
Extensive research on humans suggests that exercise could have benefits for overall health and cognitive function, particularly in later life. Recent studies using animal models have been directed towards understanding the neurobiological bases of these benefits. It is now clear that voluntary exercise can increase levels of brain-derived neurotrophic factor (BDNF) and other growth factors, stimulate neurogenesis, increase resistance to brain insult and improve learning and mental performance. Recently, high-density oligonucleotide microarray analysis has demonstrated that, in addition to increasing levels of BDNF, exercise mobilizes gene expression profiles that would be predicted to benefit brain plasticity processes. Thus, exercise could provide a simple means to maintain brain function and promote brain plasticity.
Objective:
To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention.
Participants:
A planning committee of five scientists was established by the Centers for Disease Control and Prevention and the American College of Sports Medicine to organize a workshop. This committee selected 15 other workshop discussants on the basis of their research expertise in issues related to the health implications of physical activity. Several relevant professional or scientific organizations and federal agencies also were represented.
Evidence:
The panel of experts reviewed the pertinent physiological, epidemiologic, and clinical evidence, including primary research articles and recent review articles.
Consensus process:
Major issues related to physical activity and health were outlined, and selected members of the expert panel drafted sections of the paper from this outline. A draft manuscript was prepared by the planning committee and circulated to the full panel in advance of the 2-day workshop. During the workshop, each section of the manuscript was reviewed by the expert panel. Primary attention was given to achieving group consensus concerning the recommended types and amounts of physical activity. A concise "public health message" was developed to express the recommendations of the panel. During the ensuing months, the consensus statement was further reviewed and revised and was formally endorsed by both the Centers for Disease Control and Prevention and the American College of Sports Medicine.
Conclusion:
Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week.
Objective.
—To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention.
ACSM Position Stand on The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Adults. Med. Sci. Sports Exerc., Vol. 30, No. 6, pp. 975-991, 1998. The combination of frequency, intensity, and duration of chronic exercise has been found to be effective for producing a training effect. The interaction of these factors provide the overload stimulus. In general, the lower the stimulus the lower the training effect, and the greater the stimulus the greater the effect. As a result of specificity of training and the need for maintaining muscular strength and endurance, and flexibility of the major muscle groups, a well-rounded training program including aerobic and resistance training, and flexibility exercises is recommended. Although age in itself is not a limiting factor to exercise training, a more gradual approach in applying the prescription at older ages seems prudent. It has also been shown that aerobic endurance training of fewer than 2 d·wk-1, at less than 40-50% of V˙O2R, and for less than 10 min-1 is generally not a sufficient stimulus for developing and maintaining fitness in healthy adults. Even so, many health benefits from physical activity can be achieved at lower intensities of exercise if frequency and duration of training are increased appropriately. In this regard, physical activity can be accumulated through the day in shorter bouts of 10-min durations.
In the interpretation of this position stand, it must be recognized that the recommendations should be used in the context of participant's needs, goals, and initial abilities. In this regard, a sliding scale as to the amount of time allotted and intensity of effort should be carefully gauged for the cardiorespiratory, muscular strength and endurance, and flexibility components of the program. An appropriate warm-up and cool-down period, which would include flexibility exercises, is also recommended. The important factor is to design a program for the individual to provide the proper amount of physical activity to attain maximal benefit at the lowest risk. Emphasis should be placed on factors that result in permanent lifestyle change and encourage a lifetime of physical activity.
Associations between exercise and mental well-being have been documented repeatedly over the last two decades. More recently, there has been application of exercise interventions to clinical populations diagnosed with depression, anxiety, and eating disorders with evidence of substantial benefit. Nonetheless, attention to the efficacy of exercise interventions in clinical settings has been notably absent in the psychosocial treatment literature, as have been calls for the integration of these methods within the clinical practice of psychologists. In this article, we provide a quantitative and qualitative review of these efficacy studies in clinical samples and discuss the potential mechanism of action of exercise interventions, with attention to both biological and psychosocial processes. The meta-analysis of 11 treatment outcome studies of individuals with depression yielded a very large combined effect size for the advantage of exercise over control conditions: g = 1.39 (95% CI: .89–1.88), corresponding to a d = 1.42 (95% CI: .92–1.93). Based on these findings, we encourage clinicians to consider the role of adjunctive exercise interventions in their clinical practice and we discuss issues concerning this integration.
OBJECTIVE--To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention. PARTICIPANTS--A planning committee of five scientists was established by the Centers for Disease Control and Prevention and the American College of Sports Medicine to organize a workshop. This committee selected 15 other workshop discussants on the basis of their research expertise in issues related to the health implications of physical activity. Several relevant professional or scientific organizations and federal agencies also were represented. EVIDENCE--The panel of experts reviewed the pertinent physiological, epidemiologic, and clinical evidence, including primary research articles and recent review articles. CONSENSUS PROCESS--Major issues related to physical activity and health were outlined, and selected members of the expert panel drafted sections of the paper from this outline. A draft manuscript was prepared by the planning committee and circulated to the full panel in advance of the 2-day workshop. During the workshop, each section of the manuscript was reviewed by the expert panel. Primary attention was given to achieving group consensus concerning the recommended types and amounts of physical activity. A concise \"public health message was developed to express the recommendations of the panel. During the ensuing months, the consensus statement was further reviewed and revised and was formally endorsed by both the Centers for Disease Control and Prevention and the American College of Sports Medicine. CONCLUSION--Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the weekType: CONSENSUS DEVELOPMENT CONFERENCEType: JOURNAL ARTICLEType: REVIEWLanguage: Eng
Two clinical trials have been conducted in a sample of depressed patients to determine whether the addition of an aerobic exercise programme to their usual treatment improved outcome after 12 weeks. In the first trial, an aerobic exercise group had a superior outcome compared with a control group in terms of trait anxiety and a standard psychiatric interview. A second trial was then conducted to compare an aerobic exercise programme with low intensity exercise. Both groups showed improvement but there were no significant differences between the groups. In neither trial was there any correlation between the extent of change in the subjects' physical fitness due to aerobic exercise and the extent of the improvement of psychiatric scores.
The relationship between exercise and anxiety has been extensively examined over the last 15 years. Three separate meta-analysis were conducted to quantitatively review the exercise-anxiety literature for state anxiety, trait anxiety and psychophysiological correlates of anxiety. Such a procedure allows tendencies of the research to be characterised. The results substantiate the claim that exercise is associated with reductions in anxiety, but only for aerobic forms of exercise. These effects were generally independent of both subject (i.e. age and health status) and descriptive characteristics. Numerous design characteristics were different, but these differences were not uniform across the 3 meta-analyses. For state anxiety, exercise was associated with reduced anxiety, but had effects similar to other known anxiety-reducing treatments (e.g. relaxation). The trait anxiety meta-analysis revealed that random assignment was important for achieving larger effects when compared to the use of intact groups. Training programmes also need to exceed 10 weeks before significant changes in trait anxiety occur. For psychophysiological correlates, cardiovascular measures of anxiety (e.g. blood pressure, heart rate) yielded significantly smaller effects than did other measures (e.g. EMG, EEG). The only variable that was significant across all 3 meta-analyses was exercise duration. Exercise of at least 21 minutes seems necessary to achieve reductions in state and trait anxiety, but there were variables confounding this relationship. As such, it remains to be seen what the minimum duration is necessary for anxiety reduction. Although exercise offers therapeutic benefits for reducing anxiety without the dangers or costs of drug therapy or psychotherapy, it remains to be determined precisely why exercise is associated with reductions in anxiety. Since several mechanisms may be operating simultaneously, future research should be designed with the idea of testing interactions between these mechanisms.
The relation between level of physical activity and risk of subsequent depression was examined using three waves of data from the Alameda County Study. Among subjects who were not depressed at baseline, those who reported a low activity level were at significantly greater risk for depression at the 1974 follow-up than were those who reported high levels of activity at baseline. Adjustments for physical health, socioeconomic status, life events, social supports, and other health habits did not affect the association appreciably. Associations between 1965-1974 changes in activity level and depression in the 1983 follow-up suggest that the risk of depression can be altered by changes in exercise habits, although these associations were not statistically significant after adjustment for covariates. These results provide somewhat stronger evidence for an activity-depression link than do previous studies, and they argue for the inclusion of exercise programs as part of community mental health programs, as well as for further studies that focus on the relation between life-style and mental health.
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.
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.
This online version of the Mastery of Your Anxiety and Panic, Client Workbook has been updated to include strategies and techniques for dealing with both panic disorder and agoraphobia. The program outlined is based on the principles of cognitive-behavioural therapy (CBT) and is organised by skill, with each chapter building on the one before it. It covers the importance of record-keeping and monitoring progress, as well as breathing techniques and thinking skills. The main focus of the treatment involves learning how to face agoraphobic situations and the often frightening physical symptoms of panic from an entirely new perspective. Self-assessment quizzes, homework exercises, and interactive forms allow patients to become active participants in treatment and to learn to manage panic attacks, anxiety about panic, and avoidance of panic and agoraphobic situations.
This edition of the Mastery of Your Anxiety and Panic Workbook has been updated to include strategies and techniques for dealing with both panic disorder and agoraphobia. The program outlined is based on the principles of cognitive behavioral therapy (CBT) and is organized by skill, with each chapter building on the one before it. It covers the importance of recordkeeping and monitoring progress, as well as breathing techniques and thinking skills. The main focus of the treatment involves learning how to face agoraphobia situations and the often frightening physical symptoms of panic from an entirely new perspective. Self-assessment quizzes, homework exercises, and interactive forms allow patients to become active participants in treatment and to learn to manage panic attacks, anxiety about panic, and avoidance of panic and agoraphobic situations.
The purpose of the study was to develop an explanatory model of the exercise/ depression relationship using a rural-residing population of elderly aged 65 or older. Subjects were selected from the 3,673 persons who participated in the Iowa 65+ Rural Health Study. The 2,084 subjects with complete data, valid information about depressive symptoms, and ability to walk across a small room were divided into two cohort groups at baseline: those with few and those with more depressive symptoms. Logistic regression models using walking status, demographic variables, and chronic health conditions were developed to predict depressive symptoms for this population at a 3-year follow-up. Consistent with previous studies using mixed-age cohorts, physical activity was negatively associated with depressive symptoms. We concluded that the relationship between exercise and depressive symptoms may be manifested in both subjects with more and few depressive symptoms because both groups benefited from daily walking.
Objective.
—To determine the effectiveness of group- vs home-based exercise training of higher and lower intensities among healthy, sedentary older adults.Design.
—Year-long randomized, controlled trial comparing (1) higher-intensity group-based exercise training; (2) higher-intensity home-based exercise training; (3) lower-intensity home-based exercise training; or (4) assessment-only control.Setting.
—General community located in northern California.Participants.
—One hundred sixty women and 197 men 50 to 65 years of age who were sedentary and free of cardiovascular disease. One out of nine persons contacted through a community random-digit-dial telephone survey and citywide promotion were randomized.Interventions.
—For higher-intensity exercise training, three 40-minute endurance training sessions per week were prescribed at 73% to 88% of peak treadmill heart rate. For lower-intensity exercise training, five 30-minute endurance training sessions per week were prescribed at 60% to 73% of peak treadmill heart rate.Main Outcome Measures.
—Treadmill exercise test performance, exercise participation rates, and heart disease risk factors.Results.
—Compared with controls, subjects in all three exercise training conditions showed significant improvements in treadmill exercise test performance at 6 and 12 months (P<.03). Lower-intensity exercise training achieved changes comparable with those of higher-intensity exercise training. Twelve-month exercise adherence rates were better for the two home-based exercise training conditions relative to the group-based exercise training condition (P<.0005). There were no significant training-induced changes in lipid levels, weight, or blood pressure.Conclusions.
—We conclude that (1) this community-based exercise training program improved fitness but not heart disease risk factors among sedentary, healthy older adults; (2) home-based exercise was as effective as group exercise in producing these changes; (3) lower-intensity exercise training was as effective as higher-intensity exercise training in the home setting; and (4) the exercise programs were relatively safe.(JAMA. 1991;266:1535-1542)
Aerobic exercise seems to be effective in improving general mood and symptoms of depression and anxiety in healthy individuals and psychiatric patients. This effect is not limited to aerobic forms of exercise. There are almost no contraindications for psychiatric patients to participate in exercise programmes, provided they are free from cardiovascular and acute infectious diseases. However, very little is known about the effects of exercise in psychiatric disease other than those in depression and anxiety disorders. A few reports indicate the need for controlled investigations in psychotic and personality disorders.
Unfortunately, no general concept for a therapeutic application of physical activity has been developed so far. Reliance on submaximal measures is highly recommended for fitness assessment. Monitoring of exercise intensity during training sessions is most easily done by measuring the heart rate using portable devices (whereas controlling the exact workload may be preferable for scientific purposes). Appropriate pre- and post-training testing is emphasised to enable adequate determinations of fitness gains and to eventually allow positive feedback to be given to patients in clinical settings.
Previous studies assessing protective effects of physical activity on depression have had conflicting results; one recent study argued that excluding disabled subjects attenuated any observed effects. The authors' objective was to compare the effects of higher levels of physical activity on prevalent and incident depression with and without exclusion of disabled subjects. Participants were 1,947 community-dwelling adults from the Alameda County Study aged 50-94 years at baseline in 1994 with 5 years of follow-up. Depression was measured using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (Washington, DC: American Psychiatric Association, 1994). Physical activity was measured with an eight-point scale; odds ratios are based upon a one-point increase on the scale. Even with adjustments for age, sex, ethnicity, financial strain, chronic conditions, disability, body mass index, alcohol consumption, smoking, and social relations, greater physical activity was protective for both prevalent depression (adjusted odds ratio (OR) = 0.90, 95% confidence interval (Cl): 0.79, 1.01) and incident depression (adjusted OR = 0.83, 95% Cl: 0.73, 0.96) over 5 years. Exclusion of disabled subjects did not attenuate the incidence results (adjusted OR = 0.79, 95% Cl: 0.67, 0.92). Findings support the protective effects of physical activity on depression for older adults and argue against excluding disabled subjects from similar studies.
Presents a case of elevator phobia treated with a new method, using running to reduce anxiety. It is suggested that a reinterpretation of the condition of autonomic arousal involved in anxiety occurs upon the introduction of jogging in physical and temporal association with the fear-evoking stimulus. The technique is explored in the light of cognitive dissonance theory. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Our purpose was to examine the effects of cognitive group therapy, aerobic exercise, or their combination on anxiety reduction. Seventy participants were divided into four groups: cognitive group therapy, aerobic exercise, both treatments, or control. Participants were administered the State-Trait Anxiety Inventory (STAI) before and after the study, and at a two-month follow-up. Results indicate that all interventions were equally effective in reducing anxiety as compared to no intervention. The combination of cognitive group therapy and exercise was not significantly more effective than either cognitive group therapy or aerobic exercise alone. Although effects were not maintained after two months, it is unclear whether this is attributable to the limitations of such interventions in changing more enduring traits. Possible mechanisms for change are discussed.
A meta-analysis was conducted on 40 studies (76 effects) in order to examine exercise training as a method of stress-management treatment for adults. It offered evidence of a low-to-moderate positive effect in anxiety reduction. Exercise training studies that examined change from pre to post-treatment and studies that examined both change over time and between group differences were examined separately. The unbiased weighted average effect sizes were .45 and .36, respectively. Thus, exercise training improved anxiety levels an average of .36 standard deviations over alternative or control conditions. Adults who were more likely to have a stressful lifestyle benefited more from the exercise training than those who did not. Recommendations are made for both practice and research.
The effect of exercise on negative affect has been examined in hundreds of studies. However, the effect of exercise on diagnosed clinical depression has received far less attention. Furthermore, poor methodological techniques predominate and results have been conflicting. A meta-analysis was conducted to investigate the effect of exercise on clinical depression and depression resulting from mental illness. The 37 chosen studies (since 1996) examined the effect of a chronic exercise paradigm (independent variable) on depression (dependent variable). Each study's variables were coded: design, subjects, exercise, and dependent measure characteristics that could moderate the effect of exercise on depression. Moderator variables were analyzed using ANOVA. Results showed an overall mean effect of –.72. Therefore, individuals who exercised were –.72 of a standard deviation less depressed than individuals who did not exercise. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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)
Six-month physical activity and fitness changes in Project Active, a randomized trial. Med. Sci. Sports Exerc., Vol. 30, No. 7, pp. 1076-1083, 1998.
Purpose: Project Active is a randomized clinical trial (N = 235) comparing a lifestyle physical activity program with a structured exercise program in changing physical activity (total energy expenditure [kcal·kg-1·d-1]) and cardiorespiratory fitness (V˙O2peak in mL·kg-1·min-1).
Methods: Sedentary but healthy adults (N = 235) aged 35-60 years received 6 months of intensive intervention.
Results: Analysis of covariance (ANCOVA), adjusting for baseline measure, age, gender, body mass index (BMI), cohort, and ethnicity, showed that at 6 months both lifestyle and structured groups significantly increased energy expenditure over baseline (P < 0.001). The mean increases ± SE, 1.53 ± 0.19 kcal·kg-1·d-1 for the lifestyle group and 1.34 ± 0.20 kcal·kg-1 d-1 for the structured group, were not significantly different between groups (P = 0.49). For cardiorespiratory fitness, both groups had significant increases from baseline (P < 0.001). Mean increases ± SE were 1.58 ± 0.33 mL·kg-1·min-1 and 3.64 ± 0.33 mL·kg-1·min-1 for the lifestyle and structured groups, respectively. This was significantly greater in the structured group (P < 0.001). We also studied changes in intensity of physical activity. Both groups significantly increased moderate intensity activity from baseline, but the increase was significantly greater in the lifestyle group than the structured group (P = 0.02). In contrast, the structured group increased its hard activity more than the lifestyle group, but the difference was not significantly different (P = 0.18). Very hard activity significantly increased (P < 0.01) for both groups by 0.25 kcal·kg-1·d-1.
Conclusion: Both intervention approaches are effective for increasing physical activity and fitness over a 6-month period in initially sedentary men and women.
This study examined the separate and combined effects of verbal (cognitive) therapy and aerobic exercise for the treatment of individuals experiencing difficulties coping with dysphoric moods. Sixty-one volunteers who scored between 9 and 30 on the Beck Depression Inventory were randomly assigned to one of three conditions: running only, cognitive therapy only, or combined running and therapy. Cognitive therapy was provided in 10 weekly individual sessions, while supervised running was conducted in small groups three times a week for 10 weeks. All three treatment conditions produced significant but not differential improvement over time on measures assessing a variety of mood states. Posthoc analyses demonstrated that all treatments were equally effective for individuals who initially would have been considered to be mildly depressed (BDI < 20)="" and="" those="" who="" would="" have="" been="" considered="" moderately="" depressed="" (bdi=""> 20). Four-month follow-up data indicated that the improvement had been maintained. The correlation between improvement on depression scores and an index of improved physiological functioning was not significant. Thus, the mechanism through which exercise influences mood was not clarified. These results suggest that supervised involvement in aerobic exercise may be a viable and cost-efficient alternative treatment to traditional individual verbal therapy for some individuals experiencing difficulty with dysphoric moods.
Background. Epidemiological research suggests that regular physical activity may be associated with reduced depressive symptoms. The present study examines the predictive value of physical exercise in relation to depressive symptoms among samples of adults aged 65+ during an 8-year period.Methods. The subjects (N = 663) who participated both at the baseline (1988) and the follow-up (1996) interviews were selected for the analyses. The dependent variable depressive symptoms was assessed by the Finnish modified version of Beck's 13-item depression scale. The independent variable was the intensity of physical exercise.Results. The intensity of physical exercise decreased among the older men and women. Those who had reduced their intensity of physical exercise during the 8 years reported more depressive symptoms at the follow-up than those who had remained active or in creased their physical activity. Depressive symptoms were predicted by the intensity of baseline physical exercise, earlier depressive symptoms, older age, gender, having three or more chronic somatic conditions, and difficulties in performing ADL activities.Conclusions. Age-related decrease in the intensity of physical exercise increases the risk of depressive symptoms among older adults. This calls for effective measures in maintaining and supporting an adequate level of physical exercise among the aging population.
For centuries, Man has had strong opinions about the importance of exercise in the maintenance of physical and mental health. Unfortunately, very little systematic study has been conducted to determine whether there is a relationship between exercise and mental health and, if a positive relationship exists, what specific factors under the broader rubric of “exercise” are responsible for its effectiveness in the maintenance and restoration of health.
Women can achieve improved qualitv of life’,2 and reduce risk of all-cause morbidity and mortality ” by regular participation in physical activity. In both men and women, physical activity has been associated with reduced risk of cardiovascular disease, hypertension, obesity, non-insulin-dependent diabetes mellitus, and depression”. Although less research has been conducted regarding benefits specific to women, physical activity has been shown to provide protection from osteoporosis, red-uced risk of breast and cervical cancer, reduction or alleviation of premenstrual syndrome and dysmenorrhea, reduced risk of gestational diabetes, reduced pregnancy-related pelvic and back pain, and the facilitation of labor and postnatal recovery.“,’ Unfortunately, 75% 0 f American women are inactive or underactive.” Women tend to be less active than men when vigorous activity is assessed; however, gender differences disappear when moderate and light intensity activity are considered.” Participation in physical activity decreases as women increase in age,7 and women of minority status are less active than their majority peers.8 Much of what is known about enhancing physical activity behavior comes from studies that have used psychological theories and models to guide intervention design and delivery. This area of research has identified several psychological, social, and environmental variables that are associated with patterns of physical activity behavior. The following discussion highlights some of these factors as they relate specifically to women.
Typescript. Thesis (Psy. D.)--Wright State University, 1991. Includes bibliographical references (leaves 47-57).
Typescript. Thesis (Ph. D.)--University of Massachusetts at Amherst, 1995. Includes bibliographical references (leaves 104-115).
The original Physical Activity Readiness Questionnaire (PAR-Q) offers a safe preliminary screening of candidates for exercise testing and prescription, but it screens out what seems an excessive proportion of apparently healthy older adults. To reduce unnecessary exclusions, an expert committee established by Fitness Canada has now revised the questionnaire wording. The present study compares responses to the original and the revised PAR-Q questionnaire in 399 men and women attending 40 accredited fitness testing centres across Canada. The number of subjects screened out by the revised test decreased significantly (p < .05), from 68 to 48 of the 399 subjects. The change reflects in part the inclusion of individuals who had made an erroneous positive response to the original question regarding high blood pressure. There is no simple gold standard to provide an objective evaluation of the sensitivity and specificity of either questionnaire format, but the revised wording has apparently had the intended effect of reducing positive responses, particularly to the question regarding an elevation of blood pressure.
The cardiovascular fitness, blood pressure, resting pulse, lung capacity and body fat of 246 subjects were measured and each subject completed activity, mental health and mood questionnaires. The results of this study support the hypothesis that participation in physical activity, rather than cardiovascular fitness, is the factor associated with better mental health and mood. Higher levels of physical activity were associated with better mood scores unless the individuals were unfit. This research has implications for how physical activity is prescribed; the emphasis needs to be on performing physical activity rather than improving fitness and should not be beyond the physical capabilities of the individual.
In the Upper Bavarian Field Study a representative community sample of 1,536 persons (from 15 years of age and upwards) was interviewed by research psychiatrists. Twenty-seven percent of the respondents reported taking regular and 26.2% occasional physical exercise. Physical inactivity as well as depression were significantly associated with the female gender, increasing age, low socioeconomic status and the presence of a somatic disorder. Using a logistic regression model, the relation between physical activity and depression was measured by the odds ratio with subjects reporting regular physical activity as the reference group. Cross-sectional analysis revealed that after controlling for potential confounder variables the odds ratio for depression was, at 3.15, significantly higher for the physically inactive compared to the regular exercisers. The odds ratio for the group practising occasionally (1.55) was also elevated but not statistically significant, 87.3% of the subjects who participated in the baseline study were reinterviewed five years later. In contrast to the cross-sectional findings, low physical activity at wave 1 was not a risk factor for developing depression at wave 2.
--To determine the effectiveness of group- vs home-based exercise training of higher and lower intensities among healthy, sedentary older adults.
--Year-long randomized, controlled trial comparing (1) higher-intensity group-based exercise training; (2) higher-intensity home-based exercise training; (3) lower-intensity home-based exercise training; or (4) assessment-only control.
--General community located in northern California.
--One hundred sixty women and 197 men 50 to 65 years of age who were sedentary and free of cardiovascular disease. One out of nine persons contacted through a community random-digit-dial telephone survey and citywide promotion were randomized.
--For higher-intensity exercise training, three 40-minute endurance training sessions per week were prescribed at 73% to 88% of peak treadmill heart rate. For lower-intensity exercise training, five 30-minute endurance training sessions per week were prescribed at 60% to 73% of peak treadmill heart rate.
--Treadmill exercise test performance, exercise participation rates, and heart disease risk factors.
--Compared with controls, subjects in all three exercise training conditions showed significant improvements in treadmill exercise test performance at 6 and 12 months (P less than .03). Lower-intensity exercise training achieved changes comparable with those of higher-intensity exercise training. Twelve-month exercise adherence rates were better for the two home-based exercise training conditions relative to the group-based exercise training condition (P less than .0005). There were no significant training-induced changes in lipid levels, weight, or blood pressure.
--We conclude that (1) this community-based exercise training program improved fitness but not heart disease risk factors among sedentary, healthy older adults; (2) home-based exercise was as effective as group exercise in producing these changes; (3) lower-intensity exercise training was as effective as higher-intensity exercise training in the home setting; and (4) the exercise programs were relatively safe.
Thirty community-dwelling, moderately depressed elderly were randomly assigned to 1 of 3 interventions: experimenter-accompanied exercise in the form of walking, a social contact control condition, and a wait-list control. Exercise and social contact both resulted in significant reductions in both the total and the psychological subscale of the Beck Depression Inventory (BDI). The exercise condition, however, unlike the control conditions, resulted in decreased somatic symptoms of the BDI. These results indicate that, at least in the short term, exercise has a broader effect compared with control conditions in reducing depressive symptoms in the moderately depressed elderly.