Cognitive Vulnerability to Mood Deterioration in an Exercise Cessation Paradigm.

Mood deterioration in response to exercise cessation is well-documented, but moderators of this effect remain unknown. This study tested the hypothesis that physically active individuals with higher levels of cognitive vulnerability (i.e., tendencies towards negative thought content and processes in response to stress or negative mood states) are at greater risk for increased anxiety and depressive symptoms when undergoing exercise cessation. Community adults meeting recommended physical activity guidelines (N=36) participated in a 4-week prospective, longitudinal study with 2 weeks each of maintained exercise and exercise cessation. Cognitive vulnerability measures included dysfunctional attitudes, brooding rumination, and cognitive reactivity (i.e., change in dysfunctional attitudes over a dysphoric mood induction). Anxiety and depression symptoms increased during exercise cessation. Brooding emerged as a risk factor for increases in Tension scores on the Profile of Mood States-Brief during exercise cessation. Future studies should explore brooding as a mediator (i.e., potential mechanism) of exercise-induced mood deterioration.

An Evidence Based Rationale for Health and Wellness Coaching as a Complementary Certification in Undergraduate Health Education.

Health and wellness coaching (HWC) is an effective intervention for many chronic lifestyle diseases. Chronic diseases represent a majority of our severe national healthcare burden. Yet, HWC certification programs vary in delivery method and degree awarded. The purpose of this paper is to provide an evidence based rationale for HWC as a complementary area of study to non-licensure granting, undergraduate health degrees in higher education. A comprehensive review of the literature related to the efficacy of HWC was completed. In addition, the national program directory was mined for descriptive data for approved HWC programs. Given the growing body of support for HWC as an effective intervention, we recommend that institutions deliver HWC curricula as an academic minor for undergraduate students in non-licensure granting health-related degrees to position graduates for entry level careers in HWC. Evidence from the successful deployment of an undergraduate program in HWC supports our contention that HWC be delivered as an academic minor in support of lifestyle health and wellness education. In doing so, the field can offer HWC in a way that is widely accessible to the undergraduate population, while providing a mechanism for direct employment as a professional health and wellness coach.

Using Body-Worn Sensors to Detect Changes in Balance and Mobility After Acute Aerobic Exercise in Adults with Multiple Sclerosis.

BACKGROUND: Current mobility and functional assessments do not capture the subtle changes in balance and gait that may predispose people with multiple sclerosis (MS) to falling. The purpose of this study was to use clinical and instrumented measures to examine the effects of an acute bout of aerobic exercise on balance and gait in individuals with MS. METHODS: Ten adults with MS performed 15 minutes of moderate-intensity recumbent cycling or 15 minutes of rest. Exercise and rest visit order was randomized and separated by 1 week. Balance and mobility were assessed before, immediately after, and 2 hours after each test condition. RESULTS: There were no significant differences across measurement periods for Timed 25-Foot Walk test times or Brief Balance Evaluation Systems Test scores. Significant improvements in mean sway radius and sway velocity when standing on foam and in percentage of stance stride time variability were found immediately after exercise compared with immediately after rest. CONCLUSIONS: This study lends further evidence that individuals with MS can safely engage in single bouts of aerobic exercise without detrimental short-term effects on function and may actually receive some short-term benefit regarding standing postural sway and gait variability. Future research should examine the dose-dependent relationship of varying types, intensities, or timing of exercise necessary to elicit short-term functional benefit and long-term health outcomes.

Bullying Environment Moderates the Relationship Between Exercise and Mental Health in Bullied US Children.

BACKGROUND: Exercise reduces the odds of sadness and suicidality in bullied students, but the role of the bullying environment on this relationship remains unknown. METHODS: Using combined data from the 2013 and 2015 Youth Risk Behavior Survey (N = 29,207), adjusted logistic regression models estimated odds ratios between exercise, sadness, and suicidal ideation and attempt, stratified by bullying exposure (electronically/at school). RESULTS: Overall, 40.2% of students bullied at school and 48.3% of students bullied electronically reported feeling sad, compared to 22.6% of those not bullied. Bullied students were 2-3 times more likely to report suicidal ideation, and 3-4 times more likely to report suicidal attempt, regardless of bullying context. Students who were bullied at school and exercised 4-7 days per week had lower odds of sadness (adjusted odds ratio [AOR]: 0.64; 95% confidence interval [CI]: 0.51-0.81), suicidal ideation (AOR: 0.66; 95% CI: 0.53-82), and suicidal attempt (AOR: 0.69; 95% CI: 0.48-0.98) compared to those who exercised 0-3 days. There were no protective effects of exercise for students bullied electronically. CONCLUSIONS: Exercise reduced sadness and suicidality in adolescents bullied at school but not for students who were cyberbullied. Bullying environment should be a primary consideration in school mental health treatment and maintenance paradigms.

An online model of international clinical mentoring for novice physical therapists.

OBJECTIVES: Clinical mentoring is important for novice clinicians as they are developing advanced critical-thinking skills. Research exploring innovative mentoring strategies to reduce barriers and enhance learning is needed. The purpose of this study was to examine the effects of providing online clinical mentoring to small international groups of novice clinicians treating patients with spinal dysfunction in the outpatient setting. METHODS: Eleven novice and four expert clinicians were allocated into small international groups. Four one-hour group video-conference mentoring sessions were held in which each novice clinician presented a case study. Data were collected from pre- and post-participation surveys and post-participation focus groups. Data were evaluated with a mixed-methods phenomenological analysis. RESULTS: Four themes emerged from the novice qualitative data: improved confidence, enhanced critical thinking, appreciation of the structured design and accessibility to peers and mentors. The quantitative data revealed significant improvement in three confidence measures, improvement of 1.48 points on self-selected clinical goals, and 82.0% reported improved clinical decision-making. Two themes emerged from the expert data: value of the model to fill a need within the profession and viability of the model to stand alone or as part of an educational program. All participants rated their experience on average at 8.76/10 and expressed interest in future mentoring programs. DISCUSSION: Online small group international clinical mentoring appears to be an effective strategy to provide clinical mentoring to promote confidence and critical-thinking skills. This research could provide a viable model to increase accessibility to clinical mentors and fill a need within the profession.

Symptom variability, affect and physical activity in ambulatory persons with multiple sclerosis: Understanding patterns and time-bound relationships.

BACKGROUND: Individuals with multiple sclerosis (MS) experience a clinical course that is highly variable with daily fluctuations in symptoms significantly affecting functional ability and quality of life. Yet, understanding how MS symptoms co-vary and associate with physical and psychological health is unclear. OBJECTIVE: The purpose of the study was to explore variability patterns and time-bound relationships across symptoms, affect, and physical activity in individuals with MS. METHODS: The study employed a multivariate, replicated, single-subject repeated-measures (MRSRM) design and involved four individuals with MS. Mood, fatigue, pain, balance confidence, and losses of balance were measured daily over 28 days by self-report. Physical activity was also measured daily over this same time period via accelerometry. Dynamic factor analysis (DFA) was used to determine the dimensionality and lagged relationships across the variables. RESULTS: Person-specific models revealed considerable time-dependent co-variation patterns as well as pattern variation across subjects. Results also offered insight into distinct variability structures at varying levels of disability. CONCLUSION: Modeling person-level variability may be beneficial for addressing the heterogeneity of experiences in individuals with MS and for understanding temporal and dynamic interrelationships among perceived symptoms, affect, and health outcomes in this group.

Addictive-Like Eating, Body Mass Index, and Psychological Correlates in a Community Sample of Preadolescents.

INTRODUCTION: The two main objectives were to identify addictive-like eating in youth and determine the relationship between addictive-like eating, hedonic hunger, and psychological variables. METHOD: A cross-sectional design was used. Each subject's objective heights and weights were measured. Subjects completed questionnaires about anxiety, depression, appetitive responsiveness, addictive-like eating, other forms of disordered eating, and exercise patterns. RESULTS: Sixty-five children, ages 9 to 14 years, participated in the study. The mean body mass index percentile for age and gender was 69%. Thirty-eight percent of the children were either overweight or obese. Sixteen percent reported three or more addictive-like eating behaviors, and 4% met the criteria for "food addiction." Addictive-like eating was significantly correlated with appetitive responsiveness but not body mass index, anxiety, depression, or other measures of disordered eating. DISCUSSION: Addictive-like eating occurs in children as young as 9 years and appears to be a different type of disordered eating. The hedonic value and proximity of food is a contributor to addictive-like eating behaviors.

Physical activity, sadness, and suicidality in bullied US adolescents.

OBJECTIVE: The consequences of bullying are well described, yet little is known about protective factors that may diminish the negative sequelae. One possible factor, physical activity (PA), improves mental health in general and clinical populations. The purpose of this study is to examine relationships among PA, sadness, and suicidality in bullied US adolescents. We hypothesized that physically active students would be less likely to feel sad or to report suicidal ideation or attempts, including bullied students. METHOD: Using the 2013 National Youth Risk Behavior Survey (N = 13,583), regression models adjusted for age, sex, and race estimated the odds ratios among PA, sadness, suicidal ideation, and suicide attempts, stratified by whether students were bullied. RESULTS: Overall, 30.0% of students reported sadness for 2 or more weeks, 22.2% reported suicidal ideation, and 8.2% reported suicide attempt in the previous 12 months. Bullied students were twice as likely to report feeling sad and 3 times as likely to report suicidal ideation or attempt. Students who reported exercising 4 to 5 days a week had lower adjusted odds of sadness, suicidal ideation, or suicide attempts than students who exercised 0 to 1 day a week (p ≤ .0001). After stratifying by bullying, similar but attenuated associations were observed. Overall, exercise for 4 or more days per week was associated with an approximate 23% reduction in suicidal ideation and attempt in bullied students. CONCLUSION: PA is inversely related to sadness and suicidality in adolescents, highlighting the relationship between PA and mental health in children, and potentially implicating PA as a salient option in the response to bullying in schools.

Psychosocial variables and time to injury onset: a hurdle regression analysis model.

CONTEXT: Psychological variables have been shown to be related to athletic injury and time missed from participation in sport. We are unaware of any empirical examination of the influence of psychological variables on time to onset of injury. OBJECTIVE: To examine the influence of orthopaedic and psychosocial variables on time to injury in college athletes. PATIENTS OR OTHER PARTICIPANTS: One hundred seventy-seven (men 5 116, women 5 61; age 5 19.45 6 1.39 years) National Collegiate Athletic Association Division II athletes. MAIN OUTCOME MEASURE(S): Hurdle regression analysis (HRA) was used to determine the influence of predictor variables on days to first injury. RESULTS: Worry (z = 2.98, P = .003), concentration disruption (z = -3.95, P < .001), and negative life-event stress (z = 5.02, P < .001) were robust predictors of days to injury. Orthopaedic risk score was not a predictor (z = 1.28, P = .20). CONCLUSIONS: These findings support previous research on the stress-injury relationship, and our group is the first to use HRA in athletic injury data. These data support the addition of psychological screening as part of preseason health examinations for collegiate athletes.

C57 mice increase wheel-running behavior following stress: preliminary findings.

Exercise has been shown to reduce anxiety in both humans and animals. To date, there are few, if any studies that examine the effect of stress on self-selected exercise using an animal model. This study examined the effect of acute stress on wheel-running distance in mice. Forty 8-week-old, male C57BL/6J mice were randomly assigned to one of three groups: no stress + wheel-running experience, stress + wheel-running experience, or stress with no wheel-running experience. Stressed mice were exposed to foot shock in a brightly lit environment. Following treatment, wheel-running distances were observed for three hours. Stress significantly increased voluntary wheel-running in mice with wheel-running experience as compared to nonstressed controls and stressed mice with no wheel-running experience. These results suggest that mice familiar with wheel-running may self-select this exercise as a modality for the mitigation of accumulated anxiety.

Mood enhancement persists for up to 12 hours following aerobic exercise: a pilot study.

The objective was to estimate the duration of the effects of aerobic exercise on mood. Healthy men (n = 13) and women (n = 35) ages 18 to 25 years (M = 20.2, SD = 3.4) were randomly assigned to either a control or exercise group. Participants completed the Profile of Mood States before, after, and at 1, 2, 4, 8, 12, and 24 hours following either exercise at 60% VO2 peak or quiet rest. Repeated-measures analysis of covariance was utilized with VO2 peak entered as a covariate. The exercise group showed significantly lower total mood disturbance immediately after and at 4, 8, and 12 hours following exercise.