Multidisciplinary understanding of modifiable physical disability risk factors for health professionals: A scoping review protocol.

INTRODUCTION: Physical disability represents a major burden to health and lifespan, particularly as the proportion of older adults within the United States is expected to grow. Prevention efforts for physical disability targets methods and strategies to decrease modifiable risk factors. Potential challenges for health professionals may exist in synthesizing and interpreting this broad spectrum of literature due to the discipline-specific nuance of language used, practice type or specialty, and lack of interdisciplinary resources. This scoping review will map and synthesize the literature across healthcare disciplines to identify modifiable risk factors and the evidence related to their ability to predict physical disability. We will also draw attention to the possibility of modifiable risk factors for physical disability being operationalized as pre-disability in order to strengthen primary and secondary prevention efforts. METHODS: A planned search strategy using physical disability terminology will be searched in English across MEDLINE, CINAHL, Health Source, PEDro, and REHABDATA by two reviewers in line with our review objectives and inclusion criteria. Eligibility for inclusion include peer-reviewed primary research published in the English language and have established a relationship between a person-level measurable characteristic that is modifiable by changes in lifestyle behaviors and any of the commonly accepted terms used to categorize or describe physical disability. EXPECTED RESULTS: Presentation of results will be using the PRISMA flowchart, with additional mapping and synthesis of evidence for modifiable risk factors for physical disability to clarify divergent terms used in classifying and measuring these factors and their potential for prediction of physical disability. EXPECTED CONCLUSION: It is anticipated that this scoping review will identify and highlight a variety of modifiable risk factors for physical disability that may aid primary and secondary prevention efforts for health professionals.

Motivation in Team Exergames: Testing the Köhler Discrepancy Effect with a Software-Generated Partner During Plank Exercise.

Objective: The Köhler effect is a social-psychological group motivation gain phenomenon that has been successfully adapted to video-based exercise games (exergames) using human partners. This research then shifted to using software-generated partners (SGPs), providing greater flexibility and adaptability to manipulate the game environment to be most motivating for the user. However, recent SGP-based experiments have demonstrated a diminished motivation gain effect. Extending previous work with human-human partners, this experiment varied the perceived exercise ability of the SGP as a potential motivation gain effect moderator on the participant's exercise persistence. Materials and Methods: Male and female college students (n = 176; mean age, 21.5 years) completed two series of abdominal plank exercises using an exergame developed specifically for a previous Köhler study. Participants completed the exercises individually and, after a rest, were randomly assigned to complete the same exercises again alone or with one of three SGPs: low ability discrepancy partner (LP), moderate ability discrepancy partner (MP), and high ability discrepancy partner (HP). Results: A 2 (sex) × 4 (condition) analysis of covariance main effect for Condition was not significant after controlling for Block 1 times (P = 0.093). However, contrast estimates of plank persistence times between the MP condition and individual no-partner control were significant, P = 0.014, 95% confidence interval [4.34-37.68]. There were no other significant condition persistence differences. Conclusions: A moderate discrepancy between the participant and the superior nonhuman partner is more motivating in a conjunctive task paradigm than exercising alone or with an SGP that is low or high in ability discrepancy.

Attenuation of the Köhler Effect in Racially Dissimilar Partnered Exercise Reversed Using Team Identity Strategy.

The authors describe two research experiments exploring the influence of race on the Köhler motivation gain effect with exercise tasks. Experiment 1 tested whether partner racial dissimilarity affects individual performance. Experiment 2 created a team identity recategorization intervention to potentially counter the influence on performance observed in Experiment 1. White male participants were partnered with either a Black or Asian partner (Experiment 1) or with a Black partner utilizing team names and shirt colors as a team identity recategorization strategy (Experiment 2). Racially dissimilar dyads completed two sets of abdominal plank exercises with a Köhler conjunctive task paradigm (stronger partner; team performance outcome dependent upon the weaker-ability participant's performance). The results of Experiment 1 suggest attenuation of the previously successful group motivation gain effect in the racially dissimilar condition. The simple recategorization strategy utilized in Experiment 2 appeared to reverse motivation losses under conjunctive-task conditions in racially dissimilar exercise dyads.

P-Curve Analysis of the Köhler Motivation Gain Effect in Exercise Settings: A Demonstration of a Novel Technique to Estimate Evidential Value Across Multiple Studies.

BACKGROUND: Practitioners and researchers may not always be able to adequately evaluate the evidential value of findings from a series of independent studies. This is partially due to the possibility of inflated effect size estimates for these findings as a result of researcher manipulation or selective reporting of analyses (i.e., p-hacking). In light of the possible overestimation of effect sizes in the literature, the p-curve analysis has been proposed as a worthwhile tool that may help identify bias across a series of studies focused on a single effect. The p-curve analysis provides a measure of the evidential value in the published literature and might highlight p-hacking practices. PURPOSE: Therefore, the purpose of this paper is to introduce the mechanics of the p-curve analysis to individuals researching phenomena in the psychosocial aspects of behavior and provide a substantive example of a p-curve analysis using findings from a series of studies examining a group dynamic motivation gain paradigm. METHODS: We performed a p-curve analysis on a sample of 13 studies that examined the Köhler motivation gain effect in exercise settings as a means to instruct readers how to conduct such an analysis on their own. RESULTS: The p-curve for studies examining the Köhler effect demonstrated evidential value and that this motivation effect is likely not a byproduct of p-hacking. The p-curve analysis is explained, as well as potential limitations of the analysis, interpretation of the results, and other uses where a p-curve analysis could be implemented.

Can Simulated Partners Boost Workout Effort in Long-Term Exercise?

Feltz, DL, Hill, CR, Samendinger, S, Myers, ND, Pivarnik, JM, Winn, B, Ede, A, and Ploutz-Snyder, L. Can simulated partners boost workout effort in long-term exercise? J Strength Cond Res 34(9): 2434-2442, 2020-We tested whether exercising with a stronger simulated (i.e., software-generated) partner leads to greater work effort compared to exercising alone, to help those seeking to maintain or improve fitness levels with long-term high-intensity training, but who find it necessary or practical to exercise in social isolation. Forty-one middle-aged adults, who participated in at least 30 minutes of vigorous exercise 3x·wk, trained on a cycle ergometer 6 days per week for 24 weeks in an alternating regimen of moderate-intensity 30-minute continuous and 3 types of high-intensity interval sessions (8 × 30-second sprints, 6 × 2-minute ladders, and 4 × 4-minute intervals). They were assigned either no partner (control), an always superior partner, or a not always superior partner. Participants varied cycle power output to increase or decrease session intensity during the repeated moderate-intensity sessions (30-minute continuous) and 1 of the 3 high-intensity sessions (4 × 4-minute intervals). Changes in intensity were used as a measure of effort motivation over time. Nested multilevel models of effort trajectory were developed and alpha was set to 0.05. For continuous and interval sessions, effort trajectory was positive and significant for those with an always superior partner, but not significantly different from control. Within interval sessions, those with an always superior partner significantly increased effort in the fourth interval compared to control (p = 0.02). Exercising with an always superior partner leads to greater work efforts during the hardest interval training compared to exercising alone.

Group dynamics motivation to increase exercise intensity with a virtual partner.

BACKGROUND: The effect of the Köhler group dynamics paradigm (i.e., working together with a more capable partner where one's performance is indispensable to the team outcome) has been shown to increase motivation to exercise longer at a strength task in partnered exercise video games (exergames) using a software-generated partner (SGP). However, the effect on exercise intensity with an SGP has not been investigated. The purpose of this study was to examine the motivation to maintain or increase exercise intensity among healthy, physically active middle-aged adults using an SGP in an aerobic exergame. METHODS: Participants (n = 85, mean age = 44.9 years) exercised with an SGP in a 6-day cycle ergometer protocol, randomly assigned to either (a) no partner control, (b) superior SGP who was not a teammate, or (c) superior SGP as a teammate (team score was dependent on the inferior member). The protocol alternated between 30-min continuous and 4-min interval high-intensity session days, during which participants could change cycle power output (watts) from target intensity to alter distance and speed. RESULTS: Mean change in watts from a targeted intensity (75% and 90% maximum heart rate) was the primary dependent variable reflecting motivational effort. Increases in performance over baseline were demonstrated without significant differences between conditions. Self-efficacy and enjoyment were significantly related to effort in the more intense interval sessions. CONCLUSION: Under these conditions, no Köhler effect was observed. Exercise performance during the higher-intensity interval format is more closely related to enjoyment and self-efficacy beliefs compared to the continuous sessions.

Why Residuals Are Important in the Self-Efficacy-Performance Relationship Analysis: A Study Across 12 Cycling Sessions.

Background: The positive role of self-efficacy in directing a wide range of health-related interventions has been well documented, including those targeting an increase in physical activity. However, rarely do researchers control the influence of past performance and past self-efficacy perception ratings when exploring the interaction of self-efficacy and performance, allowing for a refined understanding of this relationship and the unique contribution of each factor. Methods: A residualized past performance, residualized self-efficacy hierarchical regression model was used to examine the effect of prior past performance and pre-exercise self-efficacy on performance with a health-related task (12 aerobic exercise cycling sessions). Results: The previous day's residualized performance was a significant predictor of performance, as was same-day residualized self-efficacy (P < .001). However, residualized self-efficacy became a stronger predictor over time. Conclusions: While maintaining a consistent level of moderate-vigorous physical activity over 12 exercise sessions, participants increased their ratings of task self-efficacy, explaining an increasing portion of the variance in the self-efficacy-performance relationship days 9 to 12.

Introductory Dialogue and the Köhler Effect in Software-Generated Workout Partners.

OBJECTIVES: This study explored the Köhler motivation gain effect utilizing adults and software-generated partners (SGPs) during an abdominal exercise regimen and compared the type of participant-SGP introductory dialogue as a moderator. The Köhler effect applies interdependent team dynamics in which group performance is dependent upon the weaker member. The third objective was to examine if this motivation paradigm would result in adverse consequences to secondary variables: exertion, enjoyment, and self-efficacy beliefs. DESIGN: Adults (Mage = 38.8 +/- 7.7) were randomly assigned to 1 of 3 conditions: Interactive Partner SGP (IP), Linear Dialogue Partner SGP (LDP), or individual control (IC), to complete a series of abdominal exercises. The experiment used a 3 (condition) x 2 (gender) ANCOVA design, with a baseline block of exercises as a covariate. METHOD: Participants completed abdominal exercises individually and, after a rest, repeated the same exercises with either an SGP programmed to be moderately stronger or individually (IC). Prior to the second exercise block, IP participants interacted with the SGP using a dialog tree optional-response format. The LDP participant introduction was a linear, scripted exchange of basic information. RESULTS: The LDP and IP conditions persisted significantly longer than IC, generating moderate effect sizes (d = .62; d = .76). The mean difference between partnered conditions was not significant. CONCLUSIONS: The Köhler motivation exercise paradigm resulted in a considerable increase in persistence (Madj = 28.9, SE = 10.6) in the first study to use middle-aged adults with superior SGPs. Differences between introductory dialogue methods were not significant.

Simulated Partners and Collaborative Exercise (SPACE) to boost motivation for astronauts: study protocol.

BACKGROUND: Astronauts may have difficulty adhering to exercise regimens at vigorous intensity levels during long space missions. Vigorous exercise is important for aerobic and musculoskeletal health during space missions and afterwards. A key impediment to maintaining vigorous exercise is motivation. Finding ways to motivate astronauts to exercise at levels necessary to mitigate reductions in musculoskeletal health and aerobic capacity have not been explored. The focus of Simulated Partners and Collaborative Exercise (SPACE) is to use recently documented motivation gains in task groups to heighten the exercise experience for participants, similar in age and fitness to astronauts, for vigorous exercise over a 6-month exercise regimen. A secondary focus is to determine the most effective features in simulated exercise partners for enhancing enjoyment, self-efficacy, and social connectedness. The aims of the project are to (1) Create software-generated (SG) exercise partners and interface software with a cycle ergometer; (2) Pilot test design features of SG partners within a video exercise game (exergame), and (3) Test whether exercising with an SG partner over 24-week time period, compared to exercising alone, leads to greater work effort, aerobic capacity, muscle strength, exercise adherence, and enhanced psychological parameters. METHODS/DESIGN: This study was approved by the Institutional Review Board (IRB). Chronic exercisers, between the ages 30 and 62, were asked to exercise on a cycle ergometer 6 days per week for 24 weeks using a routine consisting of alternating between moderate-intensity continuous and high-intensity interval sessions. Participants were assigned to one of three conditions: no partner (control), always faster SG partner, or SG partner who was not always faster. Participants were told they could vary cycle ergometer output to increase or decrease intensity during the sessions. Mean change in cycle ergometer power (watts) from the initial continuous and 4 min. interval sessions was the primary dependent variable reflecting work effort. Measures of physiological, strength, and psychological parameters were also taken. DISCUSSION: This paper describes the rationale, development, and methods of the SPACE exergame. We believe this will be a viable intervention that can be disseminated for astronaut use and adapted for use by other populations.

Enhancing Aerobic Exercise with a Novel Virtual Exercise Buddy Based on the Köhler Effect.

OBJECTIVE: Research on active videogames (AVGs) has demonstrated the motivation-boosting power of the Köhler effect (a motivating force for "weak links" in groups based on group principles of upward social comparison and indispensability) with software-generated partners (SGPs), but the effect has yet to be examined over time. We tested the viability of the Köhler effect in an AVG with an SGP over 12 exercise sessions using a cycle ergometer and whether a fatiguing partner (FP) could further boost the effect. MATERIALS AND METHODS: A repeated-measures design was used to assess mean changes in exercise persistence over time. Participants were randomly assigned to one of three game conditions: AVG alone (individual-control [IC]), AVG with a consistently superior partner (CSP), or AVG with a superior partner who showed signs of fatigue (FP). Assessments were conducted on 82 participants (42 college students and 40 adults from the community) in a laboratory over 12 experimental sessions. The main outcome measure was exercise persistence (minutes of gameplay cycling at 75% HRmax). RESULTS: Data yielded significant improvements in exercise duration for men in the FP condition when compared with men in the IC condition (Mdiff = 12:32 minutes, SEdiff = 4:54). Women showed no change in exercise persistence over time and no condition differences. CONCLUSION: Exercising in an AVG with a superior SGP, who shows signs of fatigue over time, improved exercise persistence for men but not for women under present experimental conditions.