Relationships among age, motivation, and exercise among women Veterans.

Physical activity (PA) and exercise are central to maintaining health, however research has shown steep declines in PA and exercise among women Veterans as they age. Though motivation may be an important contributor to initiating and sustaining exercise that may change across the lifespan, little is known about exercise motivation and its relation to age and exercise behavior among women Veterans. This cross-sectional study sought to describe exercise motivations, examine relationships among exercise motivations and age, and explore the degree to which age and motivation predict self-reported exercise behavior among women Veterans. We conducted a secondary data analysis from a regional mail survey of 197 women Veterans (mean age = 51; SD = 10.5) enrolled in Veterans Health Administration primary care in a northeastern region (N = 180 in analysis). Measures included demographics (age, body mass index), self-reported exercise motivation, and an estimate of average weekly exercise. Participants endorsed multiple motivators for exercise, most prominently fitness and health management. Age was significantly negatively related to amount of exercise and with socializing as an exercise motivation. After accounting for body mass index, age was a significant predictor of exercise behavior, and exercise motivations accounted for an additional 7.3% of variance in self-reported weekly exercise. Our results suggest that although motivation is a potentially important predictor of exercise, factors beyond motivation may better predict exercise in women Veterans. Further research is needed on personal and practical facilitators and barriers to exercise in this population.

The promoting effect of exercise motivation on physical fitness in college students: a mediation effect model.

BACKGROUND: In recent years, the physical fitness situation of college students is worrying in China. Exercise motivation is of great importance for the physical activity and physical fitness. However, existing studies have paid limited attention to the specific effect between exercise motivation, physical activity and physical fitness, and even less to the different genders and exercise motivation dimensions. This study aimed to investigate the promoting effect of sport motivation on physical fitness with different gender and dimension in college students. METHODS: Physical fitness levels of 2544 college students in Wuhan and Jingzhou city were measured. Exercise motivation and physical activity was assessed using the Chinese version of the motives for physical activities measure-revised scale and the physical activity survey scale, respectively. Correlation analysis and structural equation model were used to explore the relationship between exercise motivation, physical activity and physical fitness. Bootstrap method was used to test the mediating effect. Multilevel regression analysis was used to examine the effects of different dimensions of exercise motivation on PF. RESULTS: The exercise motivation of college students was directly related to physical fitness (effect value: 0.307) or indirectly related through the mediating effect of physical activity (effect value: 0.092). The mediation effect percentage of physical activity on exercise motivation and physical fitness in male (51.20%) was greater than female (27.18%), and the standardized regression coefficient of the health dimension to PF was ß = 0.151, P < 0.001, and the competence dimension to PF was ß = 0.189, P < 0.001. CONCLUSIONS: The exercise motivation of college students can directly influence PF or indirectly influence PF through the mediating effect of PA. The promoting effect of exercise motivation and PA on PF in college students is related to gender and dimensions of exercise motivation. Therefore, we can improve physical fitness levels of college students by promoting their exercise motivation (especially for health motivation and competence motivation) and increasing their participation in physical activity. This study provides new strategies for improving physical fitness in college students.

Effects of supervised high-intensity interval training on motivational outcomes in men with prostate cancer undergoing active surveillance: results from a randomized controlled trial.

BACKGROUND: Understanding the motivational effects of supervised aerobic high-intensity interval training (HIIT) may help men with prostate cancer undergoing active surveillance initiate and maintain exercise behavior, however, few studies have addressed this question. This report explored exercise motivation in men with prostate cancer undergoing active surveillance participating in a randomized exercise trial. METHODS: The Exercise during Active Surveillance for Prostate Cancer (ERASE) trial randomized 52 men with prostate cancer on active surveillance to the HIIT exercise group or the usual care (UC) group. The exercise program was supervised aerobic HIIT conducted three times per week for 12 weeks. The motivation questions were developed using the Theory of Planned Behavior and included motivational constructs, anticipated and experienced outcomes, and barriers to HIIT during active surveillance. RESULTS: The HIIT group attended 96% of the planned exercise sessions with 100% compliance to the exercise protocol. Motivation outcome data were obtained in 25/26 (96%) participants in the HIIT group and 25/26 (96%) participants in the UC group. At baseline, study participants were generally motivated to perform HIIT. After the intervention, the HIIT group reported that HIIT was even more enjoyable (p < 0.001; d = 1.38), more motivating (p = 0.001; d = 0.89), more controllable (p < 0.001; d = 0.85), and instilled more confidence (p = 0.004; d = 0.66) than they had anticipated. Moreover, compared to UC, HIIT participants reported significantly higher perceived control (p = 0.006; d = 0.68) and a more specific plan (p = 0.032; d = 0.67) for performing HIIT over the next 6 months. No significant differences were found in anticipated versus experienced outcomes. Exercise barriers were minimal, however, the most often reported barriers included pain or soreness (56%), traveling to the fitness center (40%), and being too busy and having limited time (36%). CONCLUSION: Men with prostate cancer on active surveillance were largely motivated and expected significant benefits from a supervised HIIT program. Moreover, the men assigned to the HIIT program experienced few barriers and achieved high adherence, which further improved their motivation. Future research is needed to understand long-term exercise motivation and behavior change in this setting. TRIAL REGISTRATION: Clinicaltrials.gov, NCT03203460 . Registered on June 29, 2017.

Postmenopausal women's experiences of a resistance training intervention against vasomotor symptoms: a qualitative study.

INTRODUCTION: Resistance training may be an effective intervention to improve menopausal symptoms and increase women's quality of life. However, most postmenopausal women do not perform regular resistance training. The purpose of this study was to explore postmenopausal women's experiences of participation in a resistance-training intervention to find barriers and motivators for the training. METHODS: Fifteen postmenopausal women with low physical activity, who participated in a randomized controlled trial evaluating the effect of a resistance-training program on vasomotor symptoms and health-related outcomes, were consecutively recruited to this qualitative study. After completion of the 15-week resistance-training program, they took part in individual semi-structured interviews, followed by a telephone interview 1 year later. All interviews were transcribed verbatim and thematic analysis was used to analyse the data. RESULTS: The analysis generated three themes that were involved at different time points. These were: "Trigger-Hopes of symptom relief", "An evolving motivation as a driving force for change" and "Finding new triggers". Accountability, and continuous professional and emotional support, were factors that fueled the women's motivation to perform regular resistance training during the study. Resistance training improved general well-being and most women experienced improvement in vasomotor symptoms. The women's motivation changed from being driven by a wish to improve bothersome symptoms, into a wish to achieve feelings of well-being and enjoyment. The change was seen regardless of effects of the intervention on vasomotor symptoms. CONCLUSION: This first qualitative evaluation of physical exercise as an intervention to treat vasomotor symptoms in postmenopausal women, found that the symptoms acted as a motivational trigger to initiate resistance training in low-active women. The motivation to exercise changed during the intervention from a wish to ameliorate symptoms into something the women did for enjoyment and well-being in general. This change in motivating factors may have contributed to a behavior change since all participants had increased their physical activity after 1 year regardless of effects on VMS. Trial registration The trial was preregistered at ClinicalTrials.gov; www. CLINICALTRIALS: gov , ID: NCT01987778 , date of first registration: 19/11/2013.

Exercise motives impact on physical activities measured using wearable devices.

Health officials advocate for increased physical activity to address negative health consequences. While previous studies have investigated what motivates different individuals to exercise, the motives were not verified using unbiased measurements. Information and Communication Technologies (ICT), including wearables, are essential for collecting and sharing data necessary for improving health initiatives. The purpose of this study was to use objective measures collected by wearable devices (Fitbit) to track activity and explore whether specific exercise motives impact participants' physical activities. Ninety-six college freshmen enrolled in the 90-day study. During orientation, participants completed an Exercise Motives Inventory-2 (EMI-2), and their current physical state was baselined. Partial Least Squares (PLS)-Structural Equation Modeling (SEM) was used to model the relationship between variables. The results revealed a relationship between Interpersonal Motives, Health Motives, and Fitness Motives, and participants' physical activities. Those striving to facilitate a change in exercise behavior in young adults should leverage activities that align with their motives of interest and consider the use of wearable devices to track physical activity.

While many think that individuals can use exercise alone to lose weight, exercise only accounts for roughly 25% of weight loss. However, physical activity has many other benefits including to combatting health conditions and improving sleep, mood, and energy levels. With all of the health benefits, we feel one must understand which motives interest individuals to exercise. The purpose of this study is to determine which exercise motives influence participant's physical activities using objective measures as collected by a wearable device. To do so, we recruited 96 college Freshmen to participate in this 90-day study. Participants completed the Exercise Motives Inventory-2 (EMI-2) and received a Fitbit during a pre-study orientation where we also collected their weight, height, and blood pressure. A Fitbit was issued so that we could track their activity using an unbiased measurement. Motivators for this age group included Interpersonal Motives, Health Motives, and Fitness Motives, and participants' physical activities. These individuals were not influenced by Body-Related or Psychological Motives.

Motivations and barriers to exercise among clinicians.

According to Kirk & Rhodes (2011), Nooijen et al. (2018), and Saridi et al. (2019), the motivators and barriers to exercise are influenced by one's occupation, especially among those in the healthcare field. We sought to examine the barriers and motivators to physical activity that are distinctive to clinicians. Community hospital clinicians were surveyed regarding motivators and barriers to exercise that they experience, their burnout levels as described by an adaptation of the Mini-Z single item burnout scale, and average weekly exercise habits. The top barriers and motivators were then correlated to burnout levels, levels of physical activity, and demographics. We received 64 total responses from clinicians. The overall average level of burnout was 2.37 and the median level was 2. Approximately 38% of clinicians reported adhering to American Heart Association (AHA) guidelines of 150 minutes of exercise per week, while 33% of clinicians exercise <75 minutes per week. The top general motivator was for one's own well-being and the top clinician-related motivator was reducing stress. The top two barriers to exercise were COVID-19 concerns at an indoor exercise facility and a lack of time. Higher average levels of burnout were experienced by those who marked being too stressed or too burnt out as barriers to exercise. Because of clinicians' roles in propagating healthy practices in their patients from their own habits, wellness programs should be aimed at capitalizing motivators to combat barriers that this group distinctively experiences. Efforts to improve physical and mental wellness among clinicians will translate into better provider and patient health outcomes.

Exergaming as a Community Program for Older Adults: The Effects of Social Interaction and Competitive Information.

This study examined how different types of social interaction and competitive information in exergaming affect older adults' motivation and attitude toward playing exergames. A 2 (time: pre- vs. posttest) × 3 (social interaction: play alone vs. play with peer vs. play with youth) × 2 (competition: competition informed vs. noncompetition informed) mixed experiment was conducted with 319 Singaporean older adults over 6 weeks through a three-way analysis of variance. Social interaction was found to significantly affect the changes of extrinsic motivation over time, while competitive information affected intrinsic motivation significantly. The results showed significant three-way interaction effects between time, social interaction, and competitive information on older adults' extrinsic and intrinsic motivations. The changes of attitude over time were not affected by either social interaction or competitive information. The findings contribute to aging research and advance the knowledge of potential factors that promote the effective implementation of exergames for community older adults.

Development and Validation of the Diet-Related Beliefs of Exercisers Scale.

Many exercise-based weight-loss interventions result in considerably less weight loss than predicted. One possible explanation could be that people have certain beliefs about the interplay of exercise and food that also influence their eating behavior, such as the belief that food is a reward for exercise. The current research outlines a systematic multiphase process to develop a psychometrically sound scale to assess these beliefs. In Study 1, regular exercisers (N = 520) completed an exploratory questionnaire on their beliefs related to diet and exercise. In Study 2 (N = 380), the factor structure of the newly developed scale was corroborated by confirmatory factor analysis. In addition, a test-retest (N = 166) was used to confirm reliability and stability. In sum, the Diet-Related Beliefs of Exercisers Scale with its four subscales ("Refrain from Eating," "Food as Reward," "Healthy Eating," and "Nutritional Replenishment") represents a valid and reliable measure of exercisers' diet-related beliefs.

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.

Prevalence and correlates of body dysmorphic disorder in health club users in the presence vs absence of eating disorder symptomology.

PURPOSE: Body dysmorphic disorder (BDD) has been consistently linked with eating disorders, however studies that stratify associations between BDD in subjects with and without eating disorder symptomology are sparse. It was, therefore, the aim of this study to assess correlates of BDD (including social media use, motivations for exercise, exercise addiction, and sexuality) stratified by eating disorder symptomology. METHODS: Cross-sectional study of 1665 health club users recruited online completed a battery of surveys. BDD prevalence rates were calculated and logistic regression models were created in two sub-samples: indicated or no-indicated eating disorder symptomology. RESULTS: The key findings showed the prevalence of BDD in participants with indicated-eating disorder symptomology was significantly higher than in participants without indicated-eating disorder symptomology, yielding an odds ratio of 12.23. Furthermore, several correlates were associated with BDD only participants with an absence of eating disorder symptomology (gender, BMI, exercise addiction, exercising for mood improvement, attractiveness and tone), with others being significantly associated with BDD in participants in the presence of indicated eating disorders symptomology (exercising for health and enjoyment, relationship status, and ethnicity). CONCLUSIONS: This study provides more evidence of the complex relationship that exists between BDD and eating disorders. Furthermore, it is recommended that practitioners working with BDD subjects should screen for eating disorders due to the high morbidity associated with eating disorders. LEVEL OF EVIDENCE: Level III: case-control analytic study.

Meeting the Canadian strength training recommendations: Implications for the cardiometabolic, psychological and musculoskeletal health of nurses.

AIM: To examine the proportion of nurses meeting the strength training recommendation and its associated cardiometabolic, psychological and musculoskeletal benefits. BACKGROUND: Strength training targets poor physical and mental health often reported by nurses; however, it is unknown whether nurses are meeting the strength training guidelines. METHODS: Nurses from 14 hospitals completed a 7-day physical activity log. Nurses were considered meeting the recommendation if they reported ≥2 strength training sessions per week. Cardiometabolic, psychological and musculoskeletal health, and levels of motivation were compared between nurses meeting and not meeting the guidelines. RESULTS: Of the 307 nurses (94% female; age: 43 ± 12 years), 29 (9.4%) met the strength training recommendation. These nurses had lower body mass index (24.1 ± 2.6 vs. 27.3 ± 5.5 kg/m2 , p = .007) and waist circumference (73.8 ± 8.3 vs. 81.1 ± 11.7 cm, p = .017); and higher vigour-activity (18.0 ± 5.8 vs. 15.6 ± 6.5 points, p = .046) and self-determined motivation (relative autonomic index: 54.9 ± 20.3 vs. 45.0 ± 23.8 points, p = .042) scores than nurses not meeting the recommendation. CONCLUSION: While the proportion of nurses meeting the strength training recommendation was small (<10%), they had lower body mass and waist circumference, and higher vigour-activity. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies to increase the strength training engagement may improve the cardiometabolic health and increase vigour among nurses.

The Combined Effects of Sports Smart Bracelet and Multi-Component Exercise Program on Exercise Motivation among the Elderly in Macau.

Background and objectives: Faced with the serious problem of an aging population, exercise is one of the most effective ways to maintain the health of the elderly. In recent years, with the popularization of smartphones, the elderly have increasingly accepted technological products that incorporate artificial intelligence (AI). However, there is not much research on using artificial intelligence bracelets to enhance elders' motivation and participation in exercise. Therefore, the purpose of this study is to evaluate the effectiveness of the combination of sports smart bracelets and multi-sport training programs on the motivation of the elderly in Macau. Materials and Methods: The study was conducted with a randomized trial design in a 12 week multi-sport exercise training intervention. According to the evaluation, a total of sixty elders' pre- and post-test data were included in this study. Results: After 12 weeks of multi-sport exercise training, the evaluation scores on the exercise motivation scale (EMS) increased significantly in the group wearing exercise bracelets and those taking part in the multi-component exercise program, and the degree of progress reached a statistically significant level, but the control group did not show any statistically significant difference. The influence of the combination of sports smart bracelets and multi-sport training programs on elders' motivation is clearer. Conclusions: The use of sports smart bracelets by elderly people in conjunction with diverse exercise training can effectively enhance elders' motivation and increase their participation in regular exercise. The combination of sports smart bracelets and multi-sport training programs is worth promoting in the elderly population.

A physical activity coaching intervention can improve and maintain physical activity and health-related outcomes in adult ambulatory hospital patients: the Healthy4U-2 randomised controlled trial.

BACKGROUND: The Healthy 4 U-2 study sought to evaluate the effect of a twelve-week, physical activity (PA) coaching intervention for changes and maintenance in PA, anthropometrics and health-related outcomes in adults presenting to an ambulatory hospital clinic. METHODS: One hundred and twenty insufficiently active adults were recruited from an ambulatory hospital clinic and randomised to an intervention group that received an education session and five 20-min telephone sessions of PA coaching, or to a control group that received the education session only. ActiGraph GT3X accelerometers were used to measure moderate-to-vigorous physical activity (MVPA) at baseline, post-intervention (3-months) and follow-up (9-months). Secondary outcome measures (anthropometrics, PA self-efficacy, and health-related quality of life) were also assessed at the three time points. RESULTS: At baseline, the mean age and body mass index of participants were 53 ± 8 years and 31 ± 4 kg/m2, respectively. Relative to control, the intervention group increased objectively measured MVPA at post-intervention (p < 0.001) and 9 months follow-up (p < 0.001). At the 9-month follow-up the intervention group completed 22 min/day of MVPA (95% CI: 20 to 25 min/day), which is sufficient to meet the recommended PA guidelines. The intervention group exhibited beneficial changes in body mass (p < 0.001), waist circumference (p < 0.001), body mass index (p < 0.001), PA self-efficacy (p < 0.001), and health-related quality of life (p < 0.001) at the 9-month follow-up. CONCLUSIONS: This study demonstrates that a low contact PA coaching intervention results in beneficial changes in PA, anthropometrics and health-related outcomes in insufficiently active adults presenting to an ambulatory care clinic. The significant beneficial changes were measured at post-intervention and the 9-month follow-up, demonstrating a maintenance effect of the intervention. TRIAL REGISTRATION: Prospectively registered on the Australian and New Zealand Clinical Trials Registry (ANZCTR, Trial registration number: ACTRN12619000036112 .

The effect of descriptive age norms on the motivation to exercise among older adults.

Based on the principles of the Social Identity Approach (SIA), the present experiment aimed to examine the impact of communicating descriptive age norms on older adults' autonomous motivation to exercise. Under the cover of a marketing study, older adults (n = 120; age = 65-70 years) participated in a newly created exercise activity, 'Pattern Stepping'. This activity was framed as an activity that was descriptively normative either for older adults, for younger adults, for both groups, or for none. Repeated measures ANOVAs revealed that participants felt greater satisfaction of their basic psychological needs and were more autonomously motivated to exercise if Pattern Stepping was framed as an activity popular among the young, rather than among older adults. These findings suggest that framing an exercise as descriptively normative for the elderly can thwart older adults' autonomous motivation if they do not identify as an older adult.

Perceptual and Cardiorespiratory Responses to High-Intensity Interval Exercise in Adolescents: Does Work Intensity Matter?

High-intensity interval exercise (HIIE) may not elicit prominent unpleasant feelings even with elevated perceived exertion and physiological stress in adolescents. However, the influence of different HIIE work intensities on the affective experience and cardiorespiratory responses is unknown. This study examined the acute affective, enjoyment, perceived exertion and cardiorespiratory responses to HIIE with different work intensities in adolescents. Participants (n = 16; 8 boys; age 12.0 ± 0.3 years) performed, on separate days, HIIE conditions consisting of 8 x 1-minute work-intervals at 70%, 85%, or 100% peak power separated by 75 seconds recovery at 20 W. Affect, enjoyment and rating of perceived exertion (RPE) were recorded before, during, and after HIIE. Heart rate (HR) and oxygen uptake were collected during HIIE. Affect declined in all conditions (p < 0.01) but 100%HIIE elicited significantly lower affect than 70%HIIE and 85%HIIE at work-interval 8 (all p < 0.02, ES > 1.74; 70%HIIE = 2.5 ± 0.8; 85%HIIE = 1.1 ± 1.5; 100%HIIE = -1.5 ± 1.4 on feeling scale). Similar enjoyment was evident during and after all conditions (all p > 0.44). RPE was significantly higher during 100%HIIE than 70%HIIE and 85%HIIE across all work-intervals (all p < 0.01, ES > 1.56). The majority of the participants attained ≥90%HRmax during 85%HIIE (87%) and 100%HIIE (100%), but not during 70%HIIE (6%). Affect responses during HIIE are dependent on the intensity of the work-interval and are not entirely negative (unpleasant feelings). Despite similar enjoyment, positive affect experienced during 70%HIIE and 85%HIIE could serve as a strategy to encourage exercise adoption and adherence in adolescents, but only 85%HIIE elicits sufficient HR stimulus to facilitate potential health benefits.

The Influence of Psychological Needs and Exercise Motivation on Exercise Dependence among Chinese College Students.

To explore the influence of exercise motivation and basic psychological needs on exercise dependence among Chinese college students. 1689 college students engaged in long-term exercise were selected from three universities in Hunan province in China as the objects of the survey. 1601 valid copies of the questionnaire were collected. Exercise Addiction Inventory, Motivation for Physical Activity Measure-Revised, Psychological Need Satisfaction in Exercise Scale and other questionnaires were used in the correlation analysis and structural equation model to investigate the influence of psychological needs and exercise motivation on exercise dependence among Chinese college students. Appearance motivation and ability motivation directly affect exercise dependence positively (r = 0.303, r = 0.269), while competence need directly affects exercise dependence positively (r = 0.309), and indirectly affects exercise dependence through appearance motivation and ability motivation. Appearance motivation and ability motivation directly affect exercise dependence positively; competence need not only directly affects exercise dependence but also indirectly affects it through appearance and ability.

Orthorexic eating behaviors related to exercise addiction and internal motivations in a sample of university students.

PURPOSE: This research explored the exercise tendencies and motivations of individuals varying in orthorexia symptomatology. METHOD: Participants were 411 university students, who completed the Eating Habits Questionnaire alongside measures of exercise activity and addiction in Study 1 (a modified version of the Leisure-Time Exercise Questionnaire, the Exercise Addiction Inventory, and the Compulsive Exercise Test) and various exercise motivations in Study 2 (the Behavioural Regulations in Exercise Questionnaire and the Exercise Motivations Inventory-2). RESULTS: Orthorexia symptomatology was positively correlated with aerobic and strength-training exercise levels; all measures of exercise addiction; all measures of internal exercise motivation; and nearly all measures of exercise motivation for the purposes of psychological, social, health, and body improvement. Symptomatology was not significantly related to either measure that specifically assessed external motivation to exercise. CONCLUSION: Individuals high in orthorexia symptomatology are internally driven to exercise for the purposes of improving their physical and mental health, but these strong motivations also lead to exercise addiction characterized by a compulsive need to follow a rigid schedule of intensive exercise even in the face of injury, illness, or other problems. LEVEL OF EVIDENCE: Level V, descriptive cross-sectional study.

The effects of training group exercise class instructors to adopt a motivationally adaptive communication style.

Drawing from self-determination theory (Deci & Ryan, 2002), we developed and tested an intervention to train fitness instructors to adopt a motivationally adaptive communication style when interacting with exercisers. This was a parallel group, two-arm quasi-experimental design. Participants in the intervention arm were 29 indoor cycling instructors (n = 10 for the control arm) and 246 class members (n = 75 for the control arm). The intervention consisted of face-to-face workshops, education/information video clips, group discussions and activities, brainstorming, individual planning, and practical tasks in the cycling studio. Instructors and exercisers responded to validated questionnaires about instructors' use of motivational strategies and other motivation-related variables before the first workshop and at the end of the third and final workshop (4 months later). Time × arm interactions revealed no significant effects, possibly due to the large attrition of instructors and exercisers in the control arm. Within-group analyses in the intervention arm showed that exercisers' perceptions of instructor motivationally adaptive strategies, psychological need satisfaction, and intentions to remain in the class increased over time. Similarly, instructors in the intervention arm reported being less controlling and experiencing more need satisfaction over time. These results offer initial promising evidence for the positive impact of the training.

Role of the dorsal medial habenula in the regulation of voluntary activity, motor function, hedonic state, and primary reinforcement.

The habenular complex in the epithalamus consists of distinct regions with diverse neuronal populations. Past studies have suggested a role for the habenula in voluntary exercise motivation and reinforcement of intracranial self-stimulation but have not assigned these effects to specific habenula subnuclei. Here, we have developed a genetic model in which neurons of the dorsal medial habenula (dMHb) are developmentally eliminated, via tissue-specific deletion of the transcription factor Pou4f1 (Brn3a). Mice with dMHb lesions perform poorly in motivation-based locomotor behaviors, such as voluntary wheel running and the accelerating rotarod, but show only minor abnormalities in gait and balance and exhibit normal levels of basal locomotion. These mice also show deficits in sucrose preference, but not in the forced swim test, two measures of depression-related phenotypes in rodents. We have also used Cre recombinase-mediated expression of channelrhodopsin-2 and halorhodopsin to activate dMHb neurons or silence their output in freely moving mice, respectively. Optical activation of the dMHb in vivo supports intracranial self-stimulation, showing that dMHb activity is intrinsically reinforcing, whereas optical silencing of dMHb outputs is aversive. Together, our findings demonstrate that the dMHb is involved in exercise motivation and the regulation of hedonic state, and is part of an intrinsic reinforcement circuit.

Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study.

AIMS AND OBJECTIVES: To explore factors influencing exercise adherence among women with breast cancer while following an exercise programme. BACKGROUND: Earlier research shows that women with breast cancer decrease physical activity following the cancer diagnosis and that adhering to exercise interventions can be a challenge. Research is needed to identify motivational factors and barriers for exercise adherence among women during treatment for breast cancer. DESIGN: This was a qualitative study to explore patient's perceptions of the challenges to exercise adherence during a randomised, controlled trial. METHODS: Twenty-seven women with early-stage breast cancer were purposively sampled for focus group interviews during 2011-2012 from their participation in the exercise intervention group during 2010-2012. Five focus groups were performed, and data analysis was completed using the systematic text condensation method. RESULTS: During the focus group study, five main themes were identified, which described factors participants perceived to influence their adherence to exercise during chemotherapy: 'side effects of breast cancer treatment as a barrier to exercise', 'restoring and maintaining normality in daily life motivates exercise', 'other valued activities compete with exercise', 'constructive support enhances exercise' and 'positive beliefs about efficacy and outcomes motivate exercise'. CONCLUSION: Adherence to exercise in women with breast cancer is challenged by internal and external conditions and may be improved by attention to the impact of treatment side effects and by supporting patient self-efficacy towards changing health behaviour. RELEVANCE TO CLINICAL PRACTICE: Nurses should be aware that exercise adherence could be a challenge among women with breast cancer. They should help identify obstacles to exercise for women and ways to overcome them, as well as support them in their beliefs that they are capable of changing their health behaviour.