Beyond Rubik: The Embodiment-Presence-Interactivity Cube Applied to Exercise.

Evidence-based interventions are needed to promote engagement in physical activity. Audio-visual stimuli are frequently employed to enhance the exercise experience. Nonetheless, there is a paucity of research that examines the qualities of technological devices that are employed. Using the Embodiment-Presence-Interactivity Cube (Flavián et al., 2019) as a guiding conceptual framework, the aim of this registered report was to examine how each dimension of the cube (i.e., embodiment, presence and interactivity) influenced a range of exercise-related affective and perceptual variables. A counterbalanced within-subjects design was employed (N = 24). Participants completed 20-min exercise bouts on a cycle ergometer under four conditions: Television, augmented reality, 360° video and virtual reality. A repeated-measures ANOVA indicated a significant Condition × Timepoint interaction for affective valence (p = .046), with greater embodiment offered by technological devices leading to more positive responses. Analyses also indicated main effects of condition for exercise enjoyment, remembered pleasure and forecasted pleasure, with greater presence of technological devices leading to more positive responses. Technologies that combine high levels of embodiment, presence and interactivity (e.g., virtual reality) appear to yield several benefits in terms of in-task (e.g., affective valence) and post-task (e.g., remembered pleasure) responses for exercise conducted at ventilatory threshold.

Heightened interoception in adults with fibromyalgia.

Previous research suggests that the processing of internal body sensations (interoception) affects how we experience pain. Some evidence suggests that people with fibromyalgia syndrome (FMS) - a condition characterised by chronic pain and fatigue - may have altered interoceptive processing. However, extant findings are inconclusive, and some tasks previously used to measure interoception are of questionable validity. Here, we used an alternative measure - the Phase Adjustment Task (PAT) - to examine cardiac interoceptive accuracy in adults with FMS. We examined: (i) the tolerability of the PAT in an FMS sample (N = 154); (ii) if there are differences in facets of interoception (PAT performance, PAT-related confidence, and scores on the Private Body Consciousness Scale) between an FMS sample and an age- and gender-matched pain-free sample (N = 94); and (iii) if subgroups of participants with FMS are identifiable according to interoceptive accuracy levels. We found the PAT was tolerable in the FMS sample, with additional task breaks and a recommended hand posture. The FMS sample were more likely to be classified as 'interoceptive' on the PAT, and had significantly higher self-reported interoception compared to the pain-free sample. Within the FMS sample, we identified a subgroup who demonstrated very strong evidence of being interoceptive, and concurrently had lower fibromyalgia symptom impact (although the effect size was small). Conversely, self-reported interoception was positively correlated with FMS symptom severity and impact. Overall, interoception may be an important factor to consider in understanding and managing FMS symptoms. We recommend future longitudinal work to better understand associations between fluctuating FMS symptoms and interoception.

Relationships among behavioural regulations, physical activity, and mental health pre- and during COVID-19 UK lockdown.

A nationwide survey was conducted during the first UK lockdown to further understanding of the degree to which motives for exercise were associated with physical activity (PA) behaviours and, in turn, how PA behaviours were associated with mental health. A cross-sectional design was employed and data were collected by use of a one-off online survey (N = 392; 18-85 years; M BMI = 25.48; SD BMI = 5.05; 314 women). Exercise motives, PA, and mental health were measured by use of the Behavioural Regulations in Exercise Questionnaire-3, Brunel Lifestyle Physical Activity Questionnaire, and General Health Questionnaire-12, respectively. Participants were also asked to specify their average step count per day, if they used a mobile device for this purpose (n = 190). Analyses comprised hierarchical regressions and partial correlations. Results indicated that behavioural regulations were more strongly associated with planned PA pre-lockdown, compared to during lockdown. There were no differences observed in explained variance between pre- and during lockdown for unplanned PA and steps per day. Planned and unplanned PA were significant explanatory variables for mental health both pre- and during lockdown, but sedentary behaviour was not. Partial correlations, with BMI and age partialled out, showed that steps per day were not correlated with mental health either pre- or during lockdown. The range of variables used to explain planned and unplanned PA and mental health suggest that people's motives to exercise were tempered by lockdown. For those who routinely measured their steps per day, the step count was unrelated to their mental health scores both pre- and during lockdown. It appears that engagement in regular PA confers some minor benefits for mental health.

Physical activity and mental well-being under COVID-19 lockdown: a cross-sectional multination study.

BACKGROUND: COVID-19 lockdowns have reduced opportunities for physical activity (PA) and encouraged more sedentary lifestyles. A concomitant of sedentariness is compromised mental health. We investigated the effects of COVID-19 lockdown on PA, sedentary behavior, and mental health across four Western nations (USA, UK, France, and Australia). METHODS: An online survey was administered in the second quarter of 2020 (N = 2541). We measured planned and unplanned dimensions of PA using the Brunel Lifestyle Physical Activity Questionnaire and mental health using the 12-item General Health Questionnaire. Steps per day were recorded only from participants who used an electronic device for this purpose, and sedentary behavior was reported in hours per day (sitting and screen time). RESULTS: In the USA and Australia samples, there was a significant decline in planned PA from pre- to during lockdown. Among young adults, Australians exhibited the lowest planned PA scores, while in middle-aged groups, the UK recorded the highest. Young adults exhibited the largest reduction in unplanned PA. Across nations, there was a reduction of ~ 2000 steps per day. Large increases in sedentary behavior emerged during lockdown, which were most acute in young adults. Lockdown was associated with a decline in mental health that was more pronounced in women. CONCLUSIONS: The findings illustrate the deleterious effects of lockdown on PA, sedentary behavior, and mental health across four Western nations. Australian young and lower middle-aged adults appeared to fare particularly badly in terms of planned PA. The reduction in steps per day is equivalent to the non-expenditure of ~ 100 kcal. Declines in mental health show how harmful lockdowns can be for women in particular.

Ready Exerciser One: Effects of music and virtual reality on cycle ergometer exercise.

OBJECTIVES: Physical inactivity remains a major global health concern, and researchers have been encouraged to explore the role of technology in the promotion of physical activity. Technologies that deliver audio-visual stimuli are frequently applied in the exercise domain. However, there is a paucity of research that examines the efficacy of modern virtual reality (VR) technology in this context. We investigated the effects of VR and music on affective, perceptual, enjoyment, and cardiac responses to aerobic-type exercise. DESIGN: A fully counterbalanced, within-subjects design was employed. METHODS: A convenience sample of recreationally active adult volunteers (N = 24) completed a 12-min protocol during which they exercised under music, VR, VR-with-music, and control conditions. RESULTS: Analyses indicated a Condition × Time interaction for affective valence and perceived activation. Moreover, a main effect of condition emerged for state attention and perceived enjoyment. The VR and VR-with-music conditions elicited the most positive affective valence, highest levels of perceived activation, greatest number of dissociative thoughts, and most exercise enjoyment. Differences between these two conditions were negligible across the breadth of dependent variables. CONCLUSIONS: The present findings illustrate the efficacy of modern VR technology in the exercise context, applied both with and without musical accompaniment. Additional research is required to assess the degree to which the findings are replicable among sedentary or ageing segments of the population. Given the emerging support pertaining to a positive relationship between affective responses and exercise adherence, VR technology should be considered as a means by which to promote an enjoyable exercise experience.

A Framework for the Testing and Validation of Simulated Environments in Experimentation and Training.

New computer technologies, like virtual reality (VR), have created opportunities to study human behavior and train skills in novel ways. VR holds significant promise for maximizing the efficiency and effectiveness of skill learning in a variety of settings (e.g., sport, medicine, safety-critical industries) through immersive learning and augmentation of existing training methods. In many cases the adoption of VR for training has, however, preceded rigorous testing and validation of the simulation tool. In order for VR to be implemented successfully for both training and psychological experimentation it is necessary to first establish whether the simulation captures fundamental features of the real task and environment, and elicits realistic behaviors. Unfortunately evaluation of VR environments too often confuses presentation and function, and relies on superficial visual features that are not the key determinants of successful training outcomes. Therefore evidence-based methods of establishing the fidelity and validity of VR environments are required. To this end, we outline a taxonomy of the subtypes of fidelity and validity, and propose a variety of practical methods for testing and validating VR training simulations. Ultimately, a successful VR environment is one that enables transfer of learning to the real-world. We propose that key elements of psychological, affective and ergonomic fidelity, are the real determinants of successful transfer. By adopting an evidence-based approach to VR simulation design and testing it is possible to develop valid environments that allow the potential of VR training to be maximized.

A Grounded Theory of Music-Video Use in an Exercise Facility.

Purpose: Despite considerable interest in the effects of music in an exercise context, there is a dearth of research examining the use of music-videos. This is surprising given the ubiquity of this medium in exercise facilities. The present study sought to examine the impact of a music-video channel on the social process of exercising in a public exercise facility. Method: A grounded theory approach underpinned by pragmatism and symbolic interactionism was employed. Thirteen exercisers completed reflective diaries following each attendance at the facility over a 4-week period. Subsequently, 11 exercisers were interviewed regarding the impact of the music-video channel on the social process of exercising at the facility. Staff members' perspectives were deemed important throughout the iterative process of data collection and analysis. Accordingly, four staff members were interviewed with reference to the social process of managing an exercise facility that featured a music-video channel. Data were analyzed using open, axial, and selective coding. Results: The results provide support for a three-stage substantive theory that commences with the content of the music-video channel. The second stage depicts a series of moderators (e.g., exercise factors, temporal factors) that revolve around the core category, appraisal of the appropriateness of channel content. Lastly, a range of effects pertaining to exercisers and facility staff are predicted, and relevant social processes are expounded. Conclusion: Given the prevalence of music-video channels in contemporary exercise and health facilities, the substantive theory bears relevance to exercisers, health/performance practitioners, and researchers.

Effects of music, video, and 360-degree video on cycle ergometer exercise at the ventilatory threshold.

Despite the seemingly ubiquitous presence of audiovisual stimuli in modern exercise facilities, there is a dearth of research examining the effects of audiovisual stimuli in combination during exercise. Accordingly, we examined the influence of a range of audiovisual stimuli on the improvement of affective, perceptual, and enjoyment responses to cycle ergometer exercise at the ventilatory threshold (VT), an intensity that is associated with the most affect-related interindividual variability. A within-subject design was employed, and participants (N = 18) completed a 25-minute protocol that consisted of 2 minutes of seated rest, 5 minutes of warm-up, 10 minutes of exercise at VT, 5 minutes of cooldown, and 3 minutes of seated rest. Participants exercised at VT under music, video, music-video, 360-degree video, 360-degree video with music, and control conditions. The results revealed a condition × time interaction for perceived activation and a main effect of condition for state attention and perceived enjoyment. The 360-degree video with music condition elicited the most positive affective valence, greatest perceived activation, most dissociative thoughts, and highest ratings of perceived enjoyment. The present findings indicate that audiovisual stimuli can influence affective, perceptual, and enjoyment responses to cycle ergometer exercise at the VT. Given the emerging support pertaining to a positive relationship between affective responses and exercise adherence, audiovisual stimuli, such as 360-degree video with music, should be considered as a means by which to promote an enjoyable exercise experience.

Brain mechanisms that underlie the effects of motivational audiovisual stimuli on psychophysiological responses during exercise.

Motivational audiovisual stimuli such as music and video have been widely used in the realm of exercise and sport as a means by which to increase situational motivation and enhance performance. The present study addressed the mechanisms that underlie the effects of motivational stimuli on psychophysiological responses and exercise performance. Twenty-two participants completed fatiguing isometric handgrip-squeezing tasks under two experimental conditions (motivational audiovisual condition and neutral audiovisual condition) and a control condition. Electrical activity in the brain and working muscles was analyzed by use of electroencephalography and electromyography, respectively. Participants were asked to squeeze the dynamometer maximally for 30s. A single-item motivation scale was administered after each squeeze. Results indicated that task performance and situational motivational were superior under the influence of motivational stimuli when compared to the other two conditions (~20% and ~25%, respectively). The motivational stimulus downregulated the predominance of low-frequency waves (theta) in the right frontal regions of the cortex (F8), and upregulated high-frequency waves (beta) in the central areas (C3 and C4). It is suggested that motivational sensory cues serve to readjust electrical activity in the brain; a mechanism by which the detrimental effects of fatigue on the efferent control of working muscles is ameliorated.

An electroclinical case-control study of sudden unexpected death in epilepsy.

OBJECTIVE: Sudden unexpected death in epilepsy (SUDEP) accounts for approximately 1 in 5 deaths in patients with epilepsy, but its cause remains unexplained. A recorded seizure resulting in death in our center appeared to suggest that postictal generalized electroencephalographic (EEG) suppression (PGES) and apnea are implicated in SUDEP. Our objective was to determine the association between PGES, as a possible identifiable EEG marker of profound postictal cerebral dysfunction, and SUDEP. METHODS: We studied 10 adult patients from our video-telemetry database who had 30 documented epileptic seizures during video-EEG recording and who later died of SUDEP. They were compared with 30 matching live controls with 92 epileptic seizures taken from the same database. Clinical and EEG findings were analyzed. RESULTS: PGES was seen in 15/30 (50%) case and 35/92 (38%) control seizures. A Mann-Whitney U test showed that PGES was significantly longer in the generalized motor seizures of the SUDEP group (p < 0.001). After adjustment for variables, odds ratio analysis of all seizures indicated significantly elevated odds of SUDEP with PGES durations of >50 seconds (p < 0.05). Beyond 80 seconds, the odds were quadrupled (p < 0.005). After adjustment for variables, for each 1-second increase in duration of PGES, the odds of SUDEP increased by a factor of 1.7%(p < 0.005). INTERPRETATION: Prolonged PGES (>50 seconds) appears to identify refractory epilepsy patients who are at risk of SUDEP. Risk of SUDEP may be increased in direct proportion to duration of PGES. Profound postictal cerebral dysfunction, possibly leading to central apnea, may be a pathogenetic mechanism for SUDEP.

Levetiracetam in clinical use--a prospective observational study.

This prospective observational study explored the efficacy and tolerability of levetiracetam (LEV) in a prospective series of 200 patients with refractory epilepsy attending a single epilepsy service. Patients were started on adjunctive LEV using one of two titration schedules (slow and fast) and patients were studied for at least 6 months after commencing LEV. Fifty-three patients had severe learning disabilities. 14.3% became seizure free, 57.7% showed >50% reduction, 15.4% showed seizure increase. Patients with learning disability showed less positive but still very worthwhile results. A highly significant improvement in clinical outcomes overall is shown (P<0.0001). 56.6% showed no adverse effects, 27.4% showed minor adverse effects, 16% were withdrawn. The most common adverse effect causing drug withdrawal was seizure exacerbation (12%) which was much commoner in primary generalised epilepsies (P=0.00035). LEV appears to be an effective and well-tolerated anti-epileptic drug in drug resistant partial epilepsies.