Group-based exercise for Parkinson's: a qualitative study of participants and partners' perceptions of an exercise class delivered through a community-university collaboration.

BACKGROUND: Community-based exercise programmes (CBEPs) offer a practical and viable approach to providing people with Parkinson's disease (PwP) the opportunity to exercise as an ancillary therapeutic benefit to pharmacological management. This study explores the perceptions of exercising participants (PwP) and non-participating partners involved in an exercise class delivered through a community-university partnership. METHODS: Two separate focus group discussions were conducted: one with class participants (PwP: n = 7, H&Y scale I to III), and the other with non-participating partners of PwP (n = 4). RESULTS: Thematic analysis of the data identified that a range of physical, psychological and social factors were perceived to influence engagement: (1) actively taking control, (2) exercise is medicine for the mind and body, and (3) a community working together to promote exercise for parkinson's. Participants and partners felt that the support from the group, including the instructors and student volunteers, empowered and supported PwP to proactively self-manage their health, enjoy exercise in an inclusive group setting, and develop strong social connections with others in the local Parkinson's community. Support to exercise from healthcare professionals was identified as both an enabler and barrier to participation. CONCLUSIONS: This study underscores the significance of a community-university partnership as a complementary therapeutic approach for PwP. It also provides critical reflections on its sustainability, including implications for how exercise is considered as medicine for PwP. Additionally, it offers practical recommendations to galvanise community participation and provide inclusive and viable exercise opportunities for PwP.

Test-retest reliability of a 30-min fixed perceived effort cycling exercise.

PURPOSE: Using exercise protocols at a fixed rating of perceived effort (RPE) is a useful method for exploring the psychophysical influences on exercise performance. However, studies that have employed this protocol have arbitrarily selected RPE values without considering how these values correspond to exercise intensity thresholds and domains. Therefore, aligning RPE intensities with established physiological thresholds seems more appropriate, although the reliability of this method has not been assessed. METHODS: Eight recreationally active cyclists completed two identical ramped incremental trials on a cycle ergometer to identify gas exchange threshold (GET). A linear regression model plotted RPE responses during this test alongside gas parameters to establish an RPE corresponding to GET (RPEGET) and 15% above GET (RPE+15%GET). Participants then completed three trials at each intensity, in which performance, physiological, and psychological measures were averaged into 5-min time zone (TZ) intervals and 30-min 'overall' averages. Data were assessed for reliability using intraclass correlation coefficients (ICC) and accompanying standard error measurements (SEM), 95% confidence intervals, and coefficient of variations (CoV). RESULTS: All performance and gas parameters showed excellent levels of test-retest reliability (ICCs = > .900) across both intensities. Performance, gas-related measures, and heart rate averaged over the entire 30-min exercise demonstrated good intra-individual reliability (CoV = < 5%). CONCLUSION: Recreationally active cyclists can reliably replicate fixed perceived effort exercise across multiple visits when RPE is aligned to physiological thresholds. Some evidence suggests that exercise at RPE+15%GET is more reliable than RPEGET.

The Influence of a Pacesetter on Psychological Responses and Pacing Behavior during a 1600 m Run.

This study compared the effects of following a pacer versus following a self-paced plan on psychological responses and pacing behavior in well-trained distance runners. Pacing in the present study was individually tailored where each participant developed a personal strategy to ensure their goal time was achieved. We expected that following a pacer would associate with goal achievement, higher pre-run confidence, positive emotions and lower perceived exertion during performance. In a mixed-design repeated-measures study, nineteen well-trained runners completed two 1600m running time trials. Ten runners had a pacer (paced group) who supported their individual pacing strategy, and nine participants self-paced running alone (control group). Both groups could check pace using their wrist watch. In contrast to our expectation, results indicated that the paced group reported higher pre-run anxiety with no significant differences in finish time, goal confidence, goal difficulty, perceived exertion, and self-rated performance between groups. We suggest that following a pacer is a skill that requires learning. Following a personalised pacer might associate with higher anxiety due to uncertainty in being able to keep up with the pacer and public visibility of dropping behind, something that is not so observable in a self-paced run completed alone. Future research should investigate mechanisms associated with effective pacing.

Elevated muscle pain induced by a hypertonic saline injection reduces power output independent of physiological changes during fixed perceived effort cycling.

Pain is a naturally occurring phenomenon that consistently inhibits exercise performance by imposing unconscious, neurophysiological alterations (e.g., corticospinal changes) as well as conscious, psychophysiological pressures (e.g., shared effort demands). Although, several studies indicate that pain would elicit lower task outputs for a set intensity of perceived effort, no study has tested this. Therefore, this study investigated the impact of elevated muscle pain through a hypertonic saline injection on the power output, psychophysiological, cerebral oxygenation, and perceptual changes during fixed perceived effort exercise. Ten participants completed three visits (one familiarisation + two fixed perceived effort trials). Fixed perceived effort cycling corresponded to 15% above gas exchange threshold (mean RPE = 15; hard). Before the 30-minute fixed perceived effort exercise, participants received a randomised, bilateral hypertonic or isotonic saline injection in the vastus lateralis. Power output, cardiorespiratory, cerebral oxygenation, and perceptual markers (e.g., affective valence) were recorded during exercise. Linear mixed model regression assessed the condition and time effects and condition × time interactions. Significant condition effects showed that power output was significantly lower during hypertonic conditions (t_107= 2.08,p=.040,ß=4.77 Watts,95%CI [0.27 to 9.26 Watts]). Meanwhile all physiological variables (e.g., heart rate, oxygen uptake, minute ventilation) demonstrated no significant condition effects. Condition effects were observed for deoxyhaemoglobin changes from baseline (t_107= -3.29,p=.001,ß=-1.50 ΔµM,95%CI [-2.40 to-0.61 ΔµM]) and affective valence (t_127= 6.12,p=.001,ß=0.93,95%CI [0.63,1.23]). Results infer that pain impacts the self-regulation of fixed perceived effort exercise, as differences in power output mainly occurred when pain ratings were higher after hypertonic versus isotonic saline administration.

How should I regulate my emotions if I want to run faster?

The present study investigated the effects of emotion regulation strategies on self-reported emotions and 1600 m track running performance. In stage 1 of a three-stage study, participants (N = 15) reported emotional states associated with best, worst and ideal performance. Results indicated that a best and ideal emotional state for performance composed of feeling happy, calm, energetic and moderately anxious whereas the worst emotional state for performance composed of feeling downhearted, sluggish and highly anxious. In stage 2, emotion regulation interventions were developed using online material and supported by electronic feedback. One intervention motivated participants to increase the intensity of unpleasant emotions (e.g. feel more angry and anxious). A second intervention motivated participants to reduce the intensity of unpleasant emotions (e.g. feel less angry and anxious). In stage 3, using a repeated measures design, participants used each intervention before running a 1600 m time trial. Data were compared with a no treatment control condition. The intervention designed to increase the intensity of unpleasant emotions resulted in higher anxiety and lower calmness scores but no significant effects on 1600 m running time. The intervention designed to reduce the intensity of unpleasant emotions was associated with significantly slower times for the first 400 m. We suggest future research should investigate emotion regulation, emotion and performance using quasi-experimental methods with performance measures that are meaningful to participants.