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Effects of Exercise and Physical Activity on Anxiety

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Abstract

The beneficial effects of regular physical activity on health are indisputable in the field of modern medicine. Exercise is often the first step in lifestyle modifications for the prevention and management of chronic diseases. According to a US Department of Health and Human Services report on physical activity, regular exercise significantly reduced causes of mortality by up to 30% for men and women (DHHS, 2002). These health benefits are seen consistently across all age groups and racial/ethnic categories. The Centers for Disease Control and Prevention currently recommends 30 min of moderate- to high-intensity exercise for at least 5 days a week for all healthy individuals (DHHS, 2002). In addition to significantly lowering causes of mortality, regular exercise and physical activity lowers prevalence of chronic disease(s). There is a strong evidence to support that 2–2.5 h of moderate- to high-intensity exercise per week is sufficient to reduce one’s risk for the occurrence of a chronic disease(s). Numerous epidemiological studies have shown that exercise improves one’s self-esteem, and a sense of wellbeing. Individuals who exercise regularly exhibit slower rates of age-related memory and cognitive decline in comparison to those who are more sedentary. Such observations have provided the basis for using exercise to improve memory and cognition in cognitive disorders such as Alzheimer’s Dementia. Adults who engage in regular physical activity experience fewer depressive and anxiety symptoms, thus supporting the notion that exercise offers a protective effect against the development of mental disorders (van Minnen et al., 2010). Anxiety disorders are common psychiatric conditions with a lifetime prevalence of nearly 29% in the United States (Kessler et al., 2005). These disorders are chronic, debilitating, and impact multiple aspects of one’s life. The economic burden of anxiety disorders in the US was estimated to be $42.3 billion in the 1990s (Greenberg et al., 1999). The prominent anxiety disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are General Anxiety Disorder (GAD), Panic Disorder (PD), Posttraumatic Stress Disorder (PTSD), Obsessive Compulsive Disorder (OCD), Social Anxiety Disorder, and Specific Phobia (APA, 2000). The exact etiology and pathophysiology of these conditions is not fully understood. Comprehending the effects of exercise and physical activity on the mechanisms of anxiety disorders might further our knowledge of these psychiatric disorders. The purpose of this article is to highlight the known and emerging mechanisms that may result in the anxiolytic effects of exercise.
www.frontiersin.org April 2013 | Volume 4 | Article 27 | 1
OpiniOn Article
publishe d: 23 A pril 2013
doi: 10.3389 /fpsyt.2013.00027
PSYCHIATRY
IntroductIon
The beneficial effects of regular physical
activity on health are indisputable in the
field of modern medicine. Exercise is often
the first step in lifestyle modifications for
the prevention and management of chronic
diseases. According to a US Department
of Health and Human Services report on
physical activity, regular exercise signifi-
cantly reduced causes of mortality by up
to 30% for men and women (DHHS, 2002).
These health benefits are seen consistently
across all age groups and racial/ethnic cate-
gories. The Centers for Disease Control and
Prevention currently recommends 30 min
of moderate- to high-intensity exercise for
at least 5 days a week for all healthy indi-
viduals (DHHS, 2002).
In addition to significantly lower-
ing causes of mortality, regular exercise
and physical activity lowers prevalence of
chronic disease(s). There is a strong evi-
dence to support that 2–2.5 h of moder-
ate- to high-intensity exercise per week is
sufficient to reduce one’s risk for the occur-
rence of a chronic disease(s). Numerous
epidemiological studies have shown that
exercise improves one’s self-esteem, and a
sense of wellbeing. Individuals who exercise
regularly exhibit slower rates of age-related
memory and cognitive decline in compari-
son to those who are more sedentary. Such
observations have provided the basis for
using exercise to improve memory and
cognition in cognitive disorders such as
Alzheimer’s Dementia. Adults who engage
in regular physical activity experience fewer
depressive and anxiety symptoms, thus
supporting the notion that exercise offers a
protective effect against the development of
mental disorders (van Minnen et al., 2010).
Anxiety disorders are common psychi-
atric conditions with a lifetime prevalence
of nearly 29% in the United States (Kessler
et al., 2005). These disorders are chronic,
debilitating, and impact multiple aspects of
one’s life. The economic burden of anxi-
ety disorders in the US was estimated to be
$42.3 billion in the 1990s (Greenberg et al.,
1999). The prominent anxiety disorders
defined in the Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV)
are General Anxiety Disorder (GAD),
Panic Disorder (PD), Posttraumatic Stress
Disorder (PTSD), Obsessive Compulsive
Disorder (OCD), Social Anxiety Disorder,
and Specific Phobia (APA, 2000). The
exact etiology and pathophysiology of
these conditions is not fully understood.
Comprehending the effects of exercise and
physical activity on the mechanisms of anxi-
ety disorders might further our knowledge
of these psychiatric disorders. The purpose
of this article is to highlight the known and
emerging mechanisms that may result in the
anxiolytic effects of exercise.
PhysIologIcal MechanIsMs
Broadly, regular exercise results in physi-
ological changes and adaptations in the
human body. Studies have shown that regu-
lar aerobic exercise is associated with lower
sympathetic nervous system and hypotha-
lamic-pituitary-adrenal (HPA) axis reactiv-
ity (Crews and Landers, 1987; Åstrand, 2003;
Jackson and Dishman, 2006; Rimmele et al.,
2007).
hyPothalaMIc-PItuItary-adrenal
axIs
The HPA axis plays a critical role in develop-
ing adaptive responses to physical and psy-
chological stressors (De Kloet et al., 2005).
Dysregulations in the HPA axis have long
been implicated in the manifestations of
depressive and anxiety symptoms (Landgraf
et al., 1999; Steckler et al., 1999). Acute stress
leads to alterations in adrenocorticotropic
hormone (ACTH) and excess levels of
glucocorticoids. Chronic stress, as seen
in PTSD, has been associated with lower
concentrations of peripheral cortisol and
upregulation of the glucocorticoid recep-
tors resulting in increased central feedback
sensitivity. Depending on the experimen-
tal paradigm used for chronic stress, some
studies have shown decreased plasma ACTH
and corticosterone levels while other studies
have shown increased corticosterone secre-
tion (Irwin et al., 1986; Kant et al., 1987). In
preclinical studies, voluntary exercise alters
the releases of corticotrophin-releasing
factor (CRF) from the hypothalamus and
ACTH from the anterior pituitary (Salmon,
2001; Droste et al., 2003). These findings
suggest that exercise induced changes in
the HPA axis modulates stress reactivity
and anxiety in humans.
MonoaMIne systeM
Abnormalities in monoamine function in
the brain have been implicated in the patho-
physiology of anxiety spectrum disorders. In
animal studies, learned helplessness resulting
from chronic electric shock was associated
with a reduced release of serotonin in the
frontal cortex (Miller et al., 1975; Petty et al.,
1992). Learned helplessness is also associated
with a depletion of norepinephrine (Petty
et al., 1993). It is postulated that the reduc-
tions in serotonergic and noradrenergic lev-
els reflects synthesis not being able to keep up
with demand (Charney et al., 2004). Animal
models also provide evidence that regular
aerobic exercise increases serotonergic and
noradrenergic levels in the brain, similar to
the effects of antidepressants (Praag, 1982;
Veale, 1987; Chaouloff, 1989; Meeusen
and De Meirleir, 1995). Researchers have
observed increased extraneuronal uptake
of norepinephrine and increased levels of
norepinephrine in the hippocampus and
frontal cortex of rodents after treadmill
training and wheel running (Dunn et al.,
1996; Dishman, 1997). Increases in serotonin
Effects of exercise and physical activity on anxiety
Elizabeth Anderson 1 and Geetha Shivakumar1,2*
1 VA North Texas Health Care System, Dallas, TX, USA
2 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
*Correspondence: geetha.shivakumar@va.gov
Edited by:
Eduardo Lusa Cadore, Federal University of Rio Grande do Sul, Brazil
Reviewed by:
Eduardo Lusa Cadore, Federal University of Rio Grande do Sul, Brazil
Frontiers in Psychiatry | Affective Disorders and Psychosomatic Research April 2013 | Volume 4 | Article 27 | 2
Anderson and Shivakumar Effects of exercise on anxiety
synthesis, metabolism, and release have
been noted following exercise (Dunn and
Dishman, 1991; Meeusen and De Meirleir,
1995; Wilson and Marsden, 1996; Chaouloff,
1997). Animal models utilizing chronic vol-
untary wheel running have also shown small
increases in serotonergic neural activity in
the dorsal raphe nucleus, an area of brain
that is abundant in serotonergic neurons,
during uncontrollable stress (Greenwood
et al., 2003). Treadmill exercise training also
increases levels of prepro-galanin mRNA,
suggesting that gene expression for galanin
is sensitive to the stress from exercise train-
ing and may have a “neuromodulating role”
in the noradrenergic response in the locus
ceruleus, an area of brain rich in noradren-
ergic neurons (O’Neal et al., 2001).
oPIoId systeM
Another possible mechanism for the anxio-
lytic effects of exercise is via mediation by
the endogenous opioid system. Endogenous
opioids have a role in the regulation of mood
and emotional responses (Bodnar and Klein,
2005). For example, abnormal levels of both
central and peripheral β-endorphins have
been discovered in individuals diagnosed
with depression (Scarone et al., 1990; Darko
et al., 1992). The endorphin hypothesis posits
that the mood elevations and reduced anxiety
following acute exercise is due to the release
and binding of β-endorphins (endogenous
opioids) to their receptor sites in the brain.
Studies demonstrate that exercise increases
endogenous opioid activity in the central and
peripheral nervous system and may induce a
euphoric state and reduce pain (Harber and
Sutton, 1984; Morgan, 1985; North et al.,
1990; Thorén et al., 1990). When opioid
antagonists were administered following
regular exercise, the endorphin produced
analgesic effects were attenuated, but there
were no changes in the mental health benefits
suggesting that the exercise-related surge in
endorphins may not completely account for
mental health benefits in these studies (Carr
et al., 1981; Moore, 1982; Howlett et al., 1984;
Thorén et al., 1990; Yeung, 1996).
neurotroPIc Factors
Brain-derived neurotrophic factor (BDNF),
the most abundant neurotrophin in the
brain has been linked to both anxiety and
depression. Stress-induced depressive and
anxious behaviors are correlated with
decreased BDNF levels especially in the hip-
pocampus (Duman and Monteggia, 2006).
Furthermore, infusions of BDNF into the
dorsal raphe nucleus have been shown to
have an a antidepressant effect (Altar, 1999).
Evidence also suggests that BDNF may be
a mediator of the anxiety reducing effects
of antidepressant medications (Chen et al.,
2006). Increases in BDNF following physical
activity have also been observed. Following
20 days of voluntary wheel running com-
pared to non-wheel running rats, BDNF
mRNA levels increased in the hippocam-
pus and caudal neocortex (Meeusen and De
Meirleir, 1995; Russo-Neustadt et al., 1999).
These changes in BDNF increases function-
ing in the serotonergic system and may pro-
mote neuronal growth (Altar, 1999).
evIdence For neurogenesIs
New neuronal growth in the adult brain,
particularly in the hippocampus, has been
implicated in the treatment of psychiatric
conditions including depression and anxi-
ety (Eisch, 2002). Detection and evaluation
of hippocampal neurogenesis is an active
area of investigation in recent years (Eisch,
2002). In primate models of chronic stress,
the hippocampus has been shown to be
highly sensitive to the toxic effects of exces-
sive glucocorticoids, thus impairing the
process of neurogenesis (Uno et al., 1989).
Neuroplasticity is further supported by the
stress-related changes found in studies of
hippocampus function. Animal studies have
shown exercise up regulates hippocampal
neurogenesis (Duman et al., 2001). Exercise
is also believed to positively influence sur-
rogate measures of adult hippocampal
neurogenesis such as β-endorphins, vas-
cular endothelial growth factor, BDNF,
and serotonin, all of which are thought be
common pathophysiologic mechanisms for
anxiety disorders.
PsychologIcal MechanIsMs
anxIety sensItIvIty and exPosure
Anxiety sensitivity is a term for the tendency
to misinterpret and catastrophize anxiety-
related sensations based on the belief that
they will result in disastrous physical, psy-
chological, and/or social outcomes (Broman-
Fulks and Storey, 2008; Smits et al., 2008).
McWilliams and Asmundson (2001) found
an inverse relationship between anxiety sen-
sitivity and exercise frequency and suggested
that this relationship was due to avoidance
of the physiological sensations of exercise
that may be interpreted as anxiety and
panic. A number of research studies have
pointed to the effectiveness of short-term
aerobic exercise to reduce anxiety sensitiv-
ity (Broman-Fulks and Storey, 2008; Smits
et al., 2008; Ströhle et al., 2009). Exposing
someone with high anxiety sensitivity to the
physiological symptoms they fear, such as
rapid heartbeat, in the context of physical
exercise increases their tolerance for such
symptoms (McWilliams and Asmundson,
2001). This exposure reveals that the feared
physiological sensations may be uncom-
fortable, but do not pose a serious threat
(Ströhle et al., 2009). Repeated exposures
through regular aerobic exercise may also
facilitate habituation to the feared sensations
(Beck and Shipherd, 1997).
selF-eFFIcacy
According to social cognitive theory, one’s
sense of self-efficacy regarding their ability
to exert control over potential threats has an
important relationship to anxiety arousal.
Individuals who trust their ability to man-
age potential threats (high self-efficacy) are
not plagued by thoughts of worry and expe-
rience lower levels of anxiety arousal. Based
on the theory of self-efficacy, Bandura pos-
ited that a treatment will be successful if
it is able to rebuild a sense of self-efficacy
by supplying experiences of self-mastery. It
has been debated that exercise can increase
self-efficacy by supplying experiences of
successfully coping with the stress of exer-
cising (Petruzzello et al., 1991). As fitness
improves, the individual receives feedback
of greater endurance, less pain, greater
duration capabilities, etc. As a result, self-
efficacy should increase (Petruzzello et al.,
1991). In fact, one study suggeste d that exer-
cise with an emphasis on increasing self-
efficacy, in this case, martial arts, was more
effective in reducing state anxiety than exer-
cise such as riding a stationary bike (Bodin
and Martinsen, 2004). In a study examining
the relationship between exercise intensity
and self-efficacy effects on anxiety reduc-
tion in a non-clinical population, research-
ers found that the influence of self-efficacy
on decreased anxiety was exhibited in the
moderate intensity exercise group, but not
in the light- and high-intensity exercise
groups (Katula et al., 1999). These two
studies suggest that exercise providing an
optimal level of challenge best utilizes the
power of self-efficacy.
www.frontiersin.org April 2013 | Volume 4 | Article 27 | 3
Anderson and Shivakumar Effects of exercise on anxiety
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dIstractIon
Distraction or “time out” has been proposed
as another reason why exercise is effective at
reducing anxiety. Based on their study that
found that distraction techniques such as
meditation, and quiet rest were as effective
as a single session of exercise in reducing
state anxiety, Bahrke and Morgan (1978)
suggested that the anxiolytic benefits of
exercise may result from it being a distrac-
tion from stressors and a “time out” from
daily activities. The results of meta-analy-
ses supporting this hypothesis are mixed.
Exercise and cognitively based distraction
techniques were shown to have equal effec-
tiveness at reducing state anxiety, however
exercise was more effective in reducing
trait anxiety (Petruzzello et al., 1991). In
addition, the anxiolytic effects of exercise
have been shown to last for a longer period
of time than those produced by therapies
based on distraction techniques (Raglin and
Morgan, 1985).
conclusIon
There is strong evidence from animal
studies that exercise and regular activity
positively impacts the pathophysiological
processes of anxiety. Numerous studies
and meta-analyses show that exercise is also
associated with reduced anxiety in clinical
settings. Similar to the heterogenic nature
of the anxiety, no single mechanism suffi-
ciently accounts for the anxiolytic nature of
exercise. Physical activity positively impacts
a number of biological, as well as psycholog-
ical, mechanisms. The role of exercise in the
enhancement of neurogenesis in humans
has drawn significant attention in recent
years and its implications for anxiety dis-
orders are an exciting area of investigation.
Future studies are needed to further this
type of work, as well as studies specifically
exploring clinical applications of exercise in
anxiety disorders.
acknowledgMents
This work was supported by VISN 17 New
Investigator Award (PI Shivakumar).
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Conflict of Interest Statement: The authors declare
that research was conducted in the absence of any
commercial or financial relationships that could be
construed as a potential conflict of interest.
Received: 11 April 2013; accepted: 11 April 2013; published
online: 23 April 2013.
Citation: Anderson E and Shivakumar G (2013) Effects of
exercise and physical activity on anxiety. Front. Psychiatry
4:27. doi: 10.3389/fpsyt.2013.00027
This article was submitted to Frontiers in Affective Disorders
and Psychosomatic Research, a specialty of Frontiers in
Psychiatry.
Copyright © 2013 Anderson and Shivakumar. This is
an open-access article distributed under the terms of the
Creative Commons Attribution License, which permits use,
distribution and reproduction in other forums, provided the
original authors and source are credited and subject to any
copyright notices concerning any third-party graphics etc.
... One of the most frequently studied protective factors against stress, anxiety, and depression is physical activity (PA) (Anderson & Shivakumar, 2013;Chi, Liang, et al., 2021;Moljord et al., 2014). PA is defined as a type of bodily movement that consumes energy from skeletal muscles and (US Department of Health & Human Services, 1996) has beneficial psychological effects (Miles, 2007). ...
... There is evidence to suggest that decreased BDNF levels, especially in the hippocampus, are correlated with stress-induced depression and anxiety (Altar, 1999;Duman & Monteggia, 2006). In terms of brain structure and function, the exercise-induced changes in the hypothalamic-pituitary-adrenal (HPA) axis are observed to play a critical role in the manifestations of depression and anxiety symptoms (Anderson & Shivakumar, 2013). With respect to psychological factors, researchers have recently paid great attention to resilience and have proposed that PA reduces negative emotion through improved resilience (Moljord et al., 2014). ...
... Firstly, our findings reveal a significant and negative association between PA level and emotional states. This finding is consistent with previous studies and supported the positive effect of a relatively high PA level on emotional states (Anderson & Shivakumar, 2013;Dinas et al., 2011;Kruk et al., 2019;Teixeira et al., 2013). More importantly, the promising results of the present study helped to explain how PA results in reductions of negative emotional states (stress, anxiety, and depression), mainly due to the serial mediation effects of exercise tolerance and resilience. ...
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Background/objective Negative emotional states, such as depression, anxiety, and stress challenge health care due to their long-term consequences for mental disorders. Accumulating evidence indicates that regular physical activity (PA) can positively influence negative emotional states. Among possible candidates, resilience and exercise tolerance in particular have the potential to partly explain the positive effects of PA on negative emotional states. Thus, the aim of this study was to investigate the association between PA and negative emotional states, and further determine the mediating effects of exercise tolerance and resilience in such a relationship. Method In total, 1117 Chinese college students (50.4% female, Mage=18.90, SD=1.25) completed a psychosocial battery, including the 21-item Depression Anxiety Stress Scale (DASS-21), the Connor-Davidson Resilience Scale (CD-RISC), the Preference for and Tolerance of the Intensity of Exercise Questionnaire (PRETIE-Q), and the International Physical Activity Questionnaire short form (IPAQ-SF). Regression analysis was used to identify the serial multiple mediation, controlling for gender, age and BMI. Results PA, exercise intensity-tolerance, and resilience were significantly negatively correlated with negative emotional states (Ps<.05). Further, exercise tolerance and resilience partially mediated the relationship between PA and negative emotional states. Conclusions Resilience and exercise intensity-tolerance can be achieved through regularly engaging in PA, and these newly observed variables play critical roles in prevention of mental illnesses, especially college students who face various challenges. Recommended amount of PA should be incorporated into curriculum or sport clubs within a campus environment.
... The emotion of fear is omnipresent in climbing, and the combination of confronting it and working out solution strategies regarding how to deal with it has a positive effect on coping with anxiety [33,35,46]. Another reason for the successful anxiety reduction in CT could be the 'leaning towards the exposure procedure' [73]. Getting confronted with physiological sensations of exercise (sweat, rapid heartbeat), which are associated with anxiety and panic, could increase the tolerance for such symptoms and facilitate the handling of them [73]. ...
... Another reason for the successful anxiety reduction in CT could be the 'leaning towards the exposure procedure' [73]. Getting confronted with physiological sensations of exercise (sweat, rapid heartbeat), which are associated with anxiety and panic, could increase the tolerance for such symptoms and facilitate the handling of them [73]. The mastering of the situation could be associated with self-efficacy and internal locus of control [35]. ...
... By confronting anxiety symptoms during physical activity, patients with mental health disorders might learn to deal with anxiety naturally and can cognitively reclassify and process the new experiences. In combination with other aspects (social, self-effective), this could improve the psychological symptomatology [73,74]. ...
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As climbing therapy is increasingly used for mental health disorders, the present study aimed to compare acute effects of a therapeutic climbing intervention (CT) on affective responses, anxiety, and self-efficacy with those of Nordic walking (NW) and a sedentary control condition (SC) in an inpatient setting with persons with depression, anxiety, or obsessive–compulsive disorders. A total of 21 inpatients (32 ± 12.2 years) participated in a clinical trial in all interventions using an experimental within-subject design. Anxiety and self-efficacy were assessed preintervention (t0) and postintervention (t2) using the State-Trait Anxiety Inventory and the General Self-Efficacy Scale, and affective responses were additionally evaluated during (t1) and 180 min after the intervention (t3) using the Feeling Scale, Felt Arousal Scale, and Positive and Negative Affect Schedule. Statistical evaluation was performed with a 3 × 2 or 3 × 4 repeated measures ANOVA. Significant interaction effects were found for affective responses regarding positive affect, affective valence, and perceived activation (p < 0.015) favoring CT over NW and SC. For anxiety, a significant interaction effect was found (F(2.40) = 6.603; p = 0.003; η2 = 0.248), and also perceived self-efficacy increased significantly (F(2.40) = 6.046; p = 0.005; η2 = 0.232). Single CT sessions may enhance affective responses and self-efficacy and reduce anxiety in inpatients with mental health disorders to a higher extent than NW. CT as part of an inpatient therapy program may help to improve key affective mechanisms and should be further studied in comparison with other exercise interventions with comparable intensity.
... According to research about exercising and its beneficial outcomes on quality of treatment [66,67], the chair is equipped for aerobic exercise during dialysis (Figure 7). An original study in 2018 investigated the beneficial clinical outcomes of combination and aerobic exercises by stationary bike during dialysis with improvements in sleep quality and physical activity [68]. ...
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Acute kidney failure patients while detoxificated by hemodialysis (HD) mostly or continuously faced regular problems such as low blood pressure (hypotension), muscle cramps, nausea, or vomiting. Higher intradialytic symptom leads to low-quality HD treatment. Although more known therapeutic interventions are used to relieve the HD side effects, this study was designed to investigate how intelligent systems can make highly beneficial alterations in dialysis facilities and equipment to ease intradialytic complications and help the staff deliver high-quality treatment. A search was performed among relevant research articles based on nonpharmacological intervention methods considered to prevent adverse effects of renal replacement therapy until 2020 in the PubMed databases using the terms “intradialytic complications,” “intradialytic complication interventions,” “nonpharmacological interventions,” “intradialytic exercises,” and “adequacy calculation methods.” Studies included the prevalence of intradialytic complications, different strategies with the aim of preventing complications, the outcome of intradialytic exercises on dialysis symptoms, and dialysis dose calculation methods. The results showed the incidence of hypotension varying between 5% and 30%, fatigue, muscular cramps, and vomiting as the most common complications during dialysis, which greatly affect the outcome of HD sessions. To prevent hypotension, ultrafiltration profiling, sodium modeling, low dialysate temperature, and changing the position to Trendelenburg are some strategies. Urea reduction ratio (URR), formal urea kinetic modeling (FUKM), formal single-pool urea kinetics, and online clearance monitoring (OCM) are methods for calculating the delivered dose of dialysis in which OCM is a low-cost and accessible way to monitor regularly the quality of dialysis delivered. Integration of the chair and HD machine which is in direct contact with the patient provides an intelligent system that improves the management of the dialysis session to enhance the quality of healthcare service.
... 25 Also, physical exercise is important in maintaining the proper functioning of the hypothalamic-pituitary-adrenal (HPA) axis, and several studies have demonstrated dysfunction of the HPA axis in people suffering from mental disorders. 26 Additionally, it might divert prisoners from a sleep disorder and use smokeless tobacco. The odds of developing depression were 2 times higher among inmates who had no income-generating job in prison compared with those who had income-generating jobs in prison. ...
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Introduction: Globally, there is a rapid increase in the prison population, and one out of nine prisoners suffers from common mental disorders such as depression and anxiety. However, there is a limitation of study on the magnitude of depression and its associated factors among prisoners in low- and middle-income countries including Ethiopia. Purpose: To assess the magnitude of depression and its associated factors among prisoners in Arba Minch and Jinka Town, Southern Ethiopia, 2021. Patients and methods: A cross-sectional study was conducted among 650 selected prisoners in Arba Minch and Jinka Town. A simple random sampling technique was used to select the study participants. Data was collected using an open data kit and then exported to SPSS version 25 for analysis. Binary logistic regression analysis with a p-value <0.05 with a 95% confidence level was used to declare statistical significance. Results: The magnitude of depression among the prisoners was 445 (72.0%) (95% CI: 68-76%). Age ≥48 years (AOR = 3.09 95% CI 1.16-8.28), being an urban resident (AOR = 2.21 95% CI 1.39-3.49), using smokeless tobacco (AOR = 2.80 95% CI 1.50-5.22), not doing physical exercise (AOR = 2.42 95% CI 1.54-3.81), and lack of income generating job in the prison (AOR = 1.89 95% CI 1.19-3.04) were significantly associated with depression. Conclusion: The magnitude of depression among prisoners was high. Age ≥48, urban residence, using smokeless tobacco, not doing physical exercise, and lack of income-generating job in prison were significantly associated with depression. Giving special attention and being supportive to older age, prohibiting the use of smokeless tobacco; facilitating places and materials for physical exercise and creating income generating opportunities by using prisoner's skills and available resources, giving training for the health professionals working in the prison about diagnosis and treatment of depression, additionally giving training for the prisoners how to cope up with prison life may decrease the magnitude of depression among prisoners.
... Physical activity was also proven to reduce depression [22][23][24][25], reduce anxiety [23,26,27], and protect against stress [28]. A randomized experiment by Babyak and colleagues [22] showed that exercise was as effective as pharmacotherapy for depression. ...
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Background Studies on physical activity’s psychological benefits are generally fewer than those on its physiological benefits, and these limited studies have mostly investigated its impact on cognitive functions. Studies exclusively investigating physical activity’s effects on happiness are rare. This study aims to investigate the effect of physical activity on psychological functions, especially on happiness. Methods Analysis was based on a large field of nationally representative Indonesian adult data. Data were compiled based on face-to-face interviews with 12,051 adults. Participants provided measures of physical activity, subjective health, and happiness, and responses were recorded with computer-assisted personal interviewing (CAPI) software. Demographic data, including gender, subjective wealth, education, and age, were also included in the analysis. Structural equation modeling (SEM) was conducted to determine the relationship between physical activity, health, subjective wealth, and happiness. Results The tested model of the association between physical activity, health, subjective wealth, and happiness indicated a good fit, based on χ² (1, n = 12,051) = 48.733, p = .001, RMSEA = .063, and CFI = .97. Path analysis results showed that health conditions mediated the effects of physical activity on happiness. The result also showed positive effects of education level and subjective wealth on happiness. Conclusion This study provides evidence that engagement in physical activity has a positive impact on happiness. Indonesian adults should engage in more active lifestyles since more than one-third of Indonesians did not get enough physical activity.
... The exact mechanism responsible for the reduction in anxiety following physical activity is unclear. There are several physiological adaptations following exercise proposed in neurotypical individuals [25]. It is possible that some of these adaptations may also occur in children with ASD. ...
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Physical activity interventions have been shown to decrease anxiety in children with ASD. There is little known regarding the effects of an exercise program on anxiety in both home and school settings and the optimal dosage to reduce anxiety. Therefore, the aim of this study was to assess the effects of a 16-week exercise program on the anxiety levels of children with moderate to severe symptoms of ASD in home and school settings, and to compare the effects at 8 and 16 weeks. This study was a within-subject, non-controlled design, intervention study. Twenty-four children (5–18 years) with moderate to severe ASD were included. A school-based exercise program was implemented three days a week for 16 weeks. Parents and teachers completed the Anxiety Scale for Children for ASD (ASC-ASD) at baseline, week 8, and week 16. A one-way repeated-measure ANOVA with post hoc analysis using Bonferroni adjustment was used to test for a significant effect for time (p < 0.05), with Cohen’s d used to calculate the effect size. For teacher-reported anxiety, there were significant decreases from baseline to week 16 for total ASC-ASD (p < 0.001), performance anxiety (p < 0.001), anxious arousal (p < 0.001), and uncertainty (p < 0.001). There was no significant decrease in parent-reported anxiety. The findings demonstrate that a 16-week exercise program can reduce anxiety in children with ASD in school settings. Results demonstrate that 16 weeks, as opposed to 8, may be necessary to have a significant effect on in-school anxiety.
... Accordingly, the elderly may have taken hypnotics to cope with these problems. Bahrami Ein-al-Qassi et al. (2016) showed that physical activity improved all aspects of sleep quality (32); on the other hand, exercise and regular physical activity reduced anxiety (33). Rasoulli et al. also reported no significant difference in taking hypnotics before and after reflexology (30). ...
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Background: Aging is accompanied by the mitigation of sleep quality in the elderly, thereby affecting their physical and social dimensions and quality of life. However, studies have not addressed sleep problems in the elderly by means of a holistic approach, such as continuous care model (CCM). Aim: The aim of this study was to determine the effects of CCM on sleep quality among the elderly. Method: This quasi-experimental study was performed on 70 elderly individuals in a retirement center located in Zirab, Iran, in 2017, selected by convenience sampling method and randomly divided into two groups of control and intervention. Consequently, CCM was applied to the intervention group under four stages (i.e., orientation, sensitization, control, and evaluation) for 2 months averagely in 3-8 sessions in the retirement center under study. The data were collected in three stages using the Pittsburgh Sleep Quality Index (PSQI). Data analysis was performed in SPSS software (version 21), using generalized estimation equations (GEE). Results: The participants of the control and intervention groups had the mean ages of 66.76±6.13 and 64.73±6.14 years, respectively. The GEE showed that the sleep quality of the intervention group differed significantly from that of the control group 1 and 2 months after the implementation of the CCM (P<0.001). Implications for Practice: Provision of CCM-based care for the elderly could improve their sleep quality. Therefore, this model could be used to promote sleep quality in the elderly in various clinical settings.
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The Covid-19 pandemic is a global health problem that is affecting the entire population of the world. Decreased social interaction and lack of social support, also the demands to get good grades have a negative impact on student's mental health levels, one of the mental health problems is anxiety. The purpose of this study was to determine the relationship between the levels of physical activity and anxiety during the distance learning process in the Covid-19 pandemic era. This study used an observational analytical study with a cross-sectional design. The respondents were 107 Bengkulu University college students, consecutive sampling technique. Assessment using the Global Physical Activity Questionnaire and the Hamilton Anxiety Rating Scale questionnaire. The relationship between variable was analyzed by the Gamma correlation test. The results showed that the most level of physical activity in the research subjects was in the low category (59,8%), with the most anxiety level being mild anxiety (47,7%). Based on statistical analysis obtained p = 0,000 and r =-0,499. This study shows that there is a significant relationship between the levels of physical activity and anxiety in Bengkulu University students during the distance learning process in the Covid-19 pandemic era with a moderate correlation.
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Background To achieve better academic performance, students should improve their cognitive faculties and overcome anxiety. Therefore, the present research was conducted to assess the effect of yoga on the cognitive functions of female adolescents with low academic performance. Methods The present study is a randomized control trial (RCT). Eighty-nine female students in the age range of 12–14 years were randomly assigned into two groups [yoga (N = 45); physical exercise (N = 44)] at a school setting. Both groups were assessed before and after on Raven's standard progressive matrices (RSPM), Corsi Block Tapping Test (CBTT), Six Letter Cancellation Test (SLCT), Digit Letter Substitution Test (DLST), Stroop Color and Word Test (SCWT), and State-Trait Anxiety Inventory for Children (STAIC). Results Findings of the present study showed significant (p < .05) differences in scores of forward CBTT, SWCT, and SLCT in group × time interaction. Both the groups showed significant (p < .05) improvement in SLCT, backward scores of CBTT, and STAIC-T. All outcomes measured were significantly (p < .05) improved in the yoga group except STAIC-S. Conclusion Yoga improves general intelligence, visuospatial working memory, and attention, as well as reduces the anxiety of students with low academic performance. Similarly, physical exercise was also found to be improving visuospatial working memory, sustained attention, and reduce trait anxiety. However, the finding of the present study indicated yoga to be more effective compared to physical exercise in regards to students' fluid intelligence and executive function. Improvement in general intelligence, visuospatial working memory, and attention is expected to positively influence students’ academic performance.
Chapter
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Errors in Byline, Author Affiliations, and Acknowledgment. In the Original Article titled “Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication,” published in the June issue of the ARCHIVES (2005;62:593-602), an author’s name was inadvertently omitted from the byline and author affiliations footnote on page 592, and another author’s affiliation was listed incorrectly. The byline should have appeared as follows: “Ronald C. Kessler, PhD; Patricia Berglund, MBA; Olga Demler, MA, MS; Robert Jin, MA; Kathleen R. Merikangas, PhD; Ellen E. Walters, MS.” The author affiliations footnote should have appeared as follows: “Author Affiliations: Department of Health Care Policy, Harvard Medical School, Boston, Mass (Dr Kessler; Mss Demler and Walters; and Mr Jin); Institute for Social Research, University of Michigan, Ann Arbor (Ms Berglund); and Section on Developmental Genetic Epidemiology, National Institute of Mental Health, Rockville, Md (Dr Merikangas).” On page 601, the first sentence of the acknowledgment should have appeared as follows: “The authors appreciate the helpful comments of William Eaton, PhD, and Michael Von Korff, ScD.” Online versions of this article on the Archives of General Psychiatry Web site were corrected on June 10, 2005.
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