Evaluating safety risks of whole-body cryotherapy/cryostimulation (WBC): a scoping review from an international consortium.

Over the two last decades, whole-body cryotherapy/cryostimulation (WBC) has emerged as an exciting non-pharmacological treatment influencing inflammatory events at a cellular and physiological level, which can result in improved sleep quality, faster neuromuscular recovery after high-intensity exercise, and chronic pain relief for patients suffering different types of diseases (fibromyalgia, rheumatism, arthritis). Some evidence even suggests that WBC has benefits on mental health (depression, anxiety disorders) and cognitive functions in both adults and older adults, due to increased circulating BDNF levels. Recently, some safety concerns have been expressed by influential public health authorities (e.g., FDA, INSERM) based on reports from patients who developed adverse events upon or following WBC treatment. However, part of the data used to support these claims involved individuals whose entire body (except head) was exposed to extreme cold vaporized liquid nitrogen while standing in a narrow bathtub. Such a procedure is known as partial-body cryotherapy (PBC), and is often erroneously mistaken to be whole-body cryotherapy. Although having similarities in terms of naming and pursued aims, these two approaches are fundamentally different. The present article reviews the available literature on the main safety concerns associated with the use of true whole-body cryotherapy. English- and French-language reports of empirical studies including case reports, case series, and randomized controlled trials (RCTs) were identified through searches of PubMed, Scopus, Cochrane, and Web of Science electronic databases. Five case reports and two RCTs were included for a total of 16 documented adverse events (AEs). A critical in-depth evaluation of these AEs (type, severity, context of onset, participant's medical background, follow-up) is proposed and used to illustrate that WBC-related safety risks are within acceptable limits and can be proactively prevented by adhering to existing recommendations, contraindications, and commonsense guidelines.

[Exercise for the promotion of mental health : Putative mechanisms, recommendations, and scientific challenges]. / L'exercice physique pour la santé mentale : mécanismes, recommandations, recherches futures.

The idea of applying various forms of physical activity for the betterment of physical health and the reduction of chronic medical conditions is ubiquitous. Despite evidence of successful applications of physical activity for improvement of mental health dating back to antiquity, it has until recent years remained unconventional to consider exercise as an intervention strategy for various mental health conditions. The past two decades, however, have seen a relative explosion of interest in understanding and applying various programs and forms of exercise to improve mental health. Here, our purpose is to provide a comprehensive and updated overview of the application of exercise as a strategy for improving mental health. In the present paper we first summarize contemporary research regarding short- and long-term impacts of exercise on mental health. Then an overview of the putative mechanisms and neurobiological bases underpinning the beneficial effects of exercise is provided. Finally, we suggest directions for future research as well as a series of concrete recommendations for clinicians who wish to prescribe physical activity as part of patient mental health management.

Physical activity can reduce hopelessness among women admitted to psychiatric short stay unit following a suicide crisis.

BACKGROUND: In a growing number of countries, brief hospitalizations in psychiatric short stay units (SSUs) are proposed to patients in acute mental health crisis (typically suicide crisis). AIMS: This pilot study's purpose was to assess the feasibility, acceptability, and plausible efficacy of two days of 30 min of brisk-walking/jogging compared to 30 min of sedentary activities in suicidal inpatients from a French psychiatric SSU. METHODS: Twelve female adults completed the study. Participants in the brisk-walking/jogging group (n = 6) received two exercise sessions of 30 min separated by a time interval of 24 h. Participants in the control group (n = 6) did not receive the exercise intervention, but were asked to engage in sedentary activities of similar duration at the same time of the day. Measures of hopelessness and optimism/pessimism were administered at the intake and final assessments. In addition, other performance indicators were explored and provide the readers with information about the feasibility and acceptability of intervention. RESULTS: Findings showed strong feasibility and acceptability (no serious adverse event, adherence and retention rates around 75%-80%, and high patients satisfaction ratings). Significant differences between groups favoring women who exercised were oberved in the score change of hopelessness (Hedges's g = -1.29, 95% CI [-2.65, -0.08]). CONCLUSION: The present study provides preliminary evidence for the plausible adjunctive efficacy of physical activity to alleviate the psychological distress suffered by suicidal patients in a psychiatric SSU.

Effects of Outdoor Walking on Positive and Negative Affect: Nature Contact Makes a Big Difference.

It has been consistently demonstrated that physical exercise is a cost-effective way to promote emotional well-being. However, the environment in which it takes place might amplify or mitigate this beneficial effect. The present study aimed at comparing the effects of walking in a natural or urban field setting on positive and negative affect. For this purpose, 150 students (46 female, 104 male; mean age: 20.2 years) were randomized into one of three groups: Green Walking (GW, n = 50), Urban Walking (UW, n = 50), or no-exercise (control; CTRL, n = 50). Positive and negative affect ratings were collected for each participant before and after walking (or before and after attending a class in the CTRL group). Exercise parameters (duration, intensity, weather conditions, group size) were identical in the GW and UW groups. The walking routes differed in terms of vegetation density, proximity of water, presence of traffic, and amount of asphalted surfaces. Participants in the GW and UW groups reported significant reductions in negative affect pre- to post walking. However, positive affect was increased only for participants in the GW group. This finding may have meaningful implications for mental health professionals who treat patients with significant emotional distress or mood instability. Several explanations are discussed as potential mechanisms for the more beneficial effect of Green walking, and presented as an important avenue for future research.

Retracted: Whole-Body Cryotherapy as an Innovative Treatment for COVID 19-Induced Anosmia-Hyposmia: A Feasibility Study.

The article entitled, "Whole-Body Cryotherapy as an Innovative Treatment for COVID 19-Induced Anosmia-Hyposmia: A Feasibility Study," by Legrand FD, Polidori G, Beaumont F, Bouchet B, Morin A, Derruau S, and Brenet E (Epub ahead of print Jan 13, 2022; DOI: 10.1089/jicm.2021.0254) is officially retracted at the request of the authors. This request came after the paper had undergone full peer review, three rounds of revisions, acceptance, page proofs, and ultimately, online publication. The Methods section of the published paper states that the study had "secured University ethics clearance…"1 but the authors explained that, "after re-discussion and internal reassessment, it appears clearly that this study required, according to French law, the approval of a specific committee known as the '[C]ommittee for the [P]rotection of [P]ersons (CPP)' and not a simple ethical agreement. For this reason, [we] request, in good faith, that the article be retracted. We apologize for this delay in taking a position, but this study gave rise to a re-discussion with our peers of the methodology which led us to realize our error 'a posteriori.'" The authors' respective institutions have been notified by the publisher. Journal of Integrative and Complementary Medicine is committed to upholding the rigors of scientific publishing and the veracity of the literature. Reference 1. Legrand FD, Polidori G, Beaumont F, et al. Whole-body cryotherapy as an innovative treatment for COVID 19-induced anosmia-hyposmia: a feasibility study. Epub ahead of print Jan 13, 2022; DOI: 10.1089/jicm.2021.0254.

Physical Exercise and Self-Esteem in Women Facing Lockdown-Related Domestic Violence.

The purpose of the present brief report was to examine the effects of a 6-week long physical exercise program on global self-esteem and physical self-perceptions among women who faced lockdown-related domestic violence. Thirty-six domestic violence victims (mean age: 33.4 ± 3.5 yrs-old) were enrolled in this study. Participants were randomly and equally assigned to two intervention (physical exercise, counseling/support group therapy) and one control (no intervention) groups. The French version of the Physical Self-Perception Profile (ISP-25) was administered to all participants pre- and post-study. Mixed-design ANOVAs revealed significant Group by Time interactions for Global Self-Esteem, Physical Condition, and Body Attractiveness. Global Self-Esteem significantly improved in the two intervention groups, with a trend for better improvement in women who exercised compared to those who took part in support group meetings, Cohen's d = 0.68, 95% confidence interval [‒0.18, 1.54]. On the other hand, only women from the Physical Exercise group reported significant gains in Physical Condition and Body Attractiveness. There was no change in any of the assessed variables for women in the control group. The present study provides new insights on the role of physical exercise in the understudied population of women with domestic violence. Our findings are discussed and related to previous studies.

Evaluation of a brief interval exercise training (IET) intervention for first-time prisoners with elevated anxiety symptoms.

ABSTRACTBackground: Exercise training has a history of alleviating anxiety in various populations, but research into its effects on prison inmates is limited. Confinement to prison is a highly distressing event for those who have never experienced incarceration, which can dramatically increase anxiety-related symptoms and may exacerbate suicidal risk. Methods: Thirty-seven first-time prisoners with elevated anxiety symptoms completed the State-Trait Anxiety Inventory before and after a 6-week long treatment period consisting of interval exercise training (IET; n = 20) or no intervention (waiting-list; n = 17). Prisoners in the IET intervention had to exercise three times per week (40 min per session) under the supervision of the first and/or second author. Exercise intensity was self-monitored using the Borg's RPE-15 scale, with targets in the range 13-15 ("somewhat hard"-"hard"). Results: Those who received the IET intervention showed a significantly greater reduction in anxiety than prisoners in the waiting-list. The effect size for IET was of moderate-to-large magnitude (Cohen's d = -0.71). Conclusion: The authors conclude that the lower levels of anxiety reported following IET suggest that supervised exercise training is an effective coping strategy to deal with incarceration. Trial registration: ClinicalTrials.gov identifier: NCT04019171.

Brief aerobic exercise immediately enhances visual attentional control and perceptual speed. Testing the mediating role of feelings of energy.

While the effects of acute exercise on mood and cognitive functions have been separately documented over the last decade, recent findings have pointed to a possible connection between affective responses to exercise and cognitive performance. The main objective of this study was to test whether the effects of acute exercise on cognition were mediated by changes in feelings of energy. One-hundred-and-one undergraduate students were randomized into one of two experimental conditions: 15 min of jogging at "moderate" intensity, or 15 min of relaxation/concentration (control condition). Perceptual speed, visual attentional control, working memory, and cognitive flexibility were assessed pre- and post-intervention in both groups via the Trail Making Test. Self-rated feelings of energy were also recorded pre- and post-intervention. Only completion time for the TMT-A significantly improved from pre- to post-intervention in participants who exercised compared with participants who practiced relaxation/concentration. No Group × Time interaction was found with regard to the other TMT variables. Finally, changes in feelings of energy were found to fully mediate the relationship between exercise and perceptual speed/visual attentional control. Taken together, our data suggest that a brief bout of moderate intensity exercise can improve the efficiency of certain cognitive processes through increases in feelings of energy, but further research is required to evaluate the duration of benefits and to determine whether these apply to other populations.

Acute Effects of Aerobic Exercise on Feelings of Energy in Relation to Age and Sex.

A crossover experiment was performed to determine whether age and sex, or their interaction, affect the impact of acute aerobic exercise on vigor-activity (VA). We also tested whether changes in VA mediated exercise effects on performance on various cognitive tasks. Sixty-eight physically inactive volunteers participated in exercise and TV-watching control conditions. They completed the VA subscale of the Profile of Mood States immediately before and 2 min after the intervention in each condition. They also performed the Trail Making Test 3 min after the intervention in each condition. Statistical analyses produced a condition . age . sex interaction characterized by a higher mean VA gain value in the exercise condition (compared with the VA gain value in the TV-watching condition) for young female participants only. In addition, the mediational analyses revealed that changes in VA fully mediated the effects of exercise on TMT-Part A performance.

Efficacy of exercise as an adjunct treatment for clinically depressed inpatients during the initial stages of antidepressant pharmacotherapy: An open randomized controlled trial.

BACKGROUND: Physical exercise as adjunctive treatment for hospitalized patients with major depressive disorder (MDD) has been of increasing interest in the past few years. While preliminary findings are promising, these prior studies have been plagued by inclusion of participants at different stages of medication use at study entry. The present study evaluates the effects of a short (10-days) add-on endurance-training intervention in hospitalized MDD patients on antidepressant medication for less than two weeks. METHOD: Thirty-five participants were randomly assigned to one of three study groups: aerobic exercise (n=14), placebo (stretching) exercise (n=11), or no intervention (control; n=10). The study outcome was the change in the Beck Depression Inventory (BDI-II) total score from baseline to the end of the study period. RESULTS: The intent-to-treat analysis showed significant improvements in BDI-II scores for both the aerobic and the stretching groups. However, comparing pre- to post-study depression changes in these two groups, we found a large effect size in favor of aerobic exercise (Cohen's d=-1.06). No significant change in depressive symptoms was found in the control group. LIMITATIONS: The nature of the intervention (i.e., exercise) meant blinding participants to treatments was not possible. Precise information on medication dosage was not available, and the short duration of interventions and lack of follow-up assessment were all limitations. CONCLUSIONS: Endurance-training can be a helpful adjunct treatment for hospitalized patients with severe affective disorders in the initial stages of pharmacotherapy.

Do Changes in Tympanic Temperature Predict Changes in Affective Valence During High-Intensity Exercise?

PURPOSE: Increased core (brain or body) temperature that accompanies exercise has been posited to play an influential role in affective responses to exercise. However, findings in support of this hypothesis have been equivocal, and most of the performed studies have been done in relation to anxiety. The aim of the present study was to investigate the effects of tympanic temperature on basic affect (i.e., pleasure-displeasure) in the course of a high-intensity exercise session. METHOD: One hundred seventy students performed a 10-min cycling exercise at an intensity of 80% to 85% of maximal heart rate. Heart rate, tympanic temperature, and self-reported pleasure (using the Feeling Scale [FS]) were measured twice during exercise at the end of the first minute (Min 1:00) and beginning of the last minute (Min 9:00). RESULTS: Small increases in tympanic temperature were noted from Min 1:00 to Min 9:00 (mean change value = +0.2°C). Meanwhile, the FS scores changed in the opposite direction (mean change value = - 0.2 units). However, changes in temperature only poorly predicted changes in pleasure-displeasure (R(2) = .05 for the linear regression, R(2) = .08 for the curvilinear regression). CONCLUSIONS: Slight elevated tympanic temperature occurred during the 10-min cycling exercise, but it had a negligible effect on changes in pleasure ratings. The possibility that tympanic temperature is not a valid indicator of core temperature during exercise is discussed.

Relationships between facial temperature changes, end-exercise affect and during-exercise changes in affect: a preliminary study.

The present study was performed as an evaluation of the relationships between changes in facial temperature and self-reported pleasure-displeasure during an acute aerobic exercise bout. Ninety-two students performed a 10-minute long session of cycle ergometry at 80-85% of age-predicted maximal heart rate. Using infrared thermography and a single-item measure of pleasure-displeasure (the Feeling Scale, FS), facial temperature and the FS score were sampled at the beginning (Min1:00) and at the end of the exercise session (Min9:00). Statistical analyses revealed that cheek (but not forehead) temperature was higher at the end of the exercise bout compared to Min1:00 (it increased by about 5%). Change in cheek temperature was negatively related to end-exercise affect (ß = -0.28, P < 0.001) and to during-exercise affective changes (ß = -0.35, P < 0.001). No significant relationship with forehead temperature was found. Some of the possible reasons for this differential effect as well as theoretical and practical implications of our findings are discussed.

Effects of exercise on physical self-concept, global self-esteem, and depression in women of low socioeconomic status with elevated depressive symptoms.

We examined the possible mediating role of physical self-perceptions, physical self-esteem, and global self-esteem in the relationships between exercise and depression in a group of socioeconomically disadvantaged women with elevated symptoms of depression. Forty-four female residents of a low-income housing complex were randomized into a 7-week-long exercise-training group or a wait-list group. Depression, physical self-perceptions and self-esteem were measured repeatedly. Significant changes were found for depression, self-esteem, physical self-worth, and self-perceived physical condition in the exercise-training group. Intent-to-treat analyses did not alter the results. Most of the reduction in depression occurred between Week 2 and Week 4 while initial improvement in physical self-worth and self-perceived physical condition was observed between baseline and Week 2. These variables can be seen as plausible mechanisms for effects of exercise on depression.

Acute mood responses to a 15-minute long walking session at self-selected intensity: effects of an experimentally-induced telic or paratelic state.

In the present controlled experiment, we examine the influence of opposite states of mind (the "telic" vs. "paratelic" state) on mood response to a 15 min long walk at self-selected pace. Fifty-five first-year students were randomized to a telic (n = 22) or paratelic (n = 33) motivational environment. These opposed motivational environments were created using established reversal theory based procedures to induce the telic versus paratelic state. More than 90% of participants walked within a motivational state corresponding to the environment they were allocated. No significant mood changes (neither positive, nor negative) occurred pre- to postexercise in participants who walked with the telic state operative (p > .05). This has important implications when considering the use of exercise to relieve depression in clinical populations. Also, our findings shed new light on the reasons why not all individuals respond in the same way to moderate exercise. Practically, these results suggest that motivational state should be considered to optimize the mood enhancing effects of aerobic exercise.

Stress responses during aerobic exercise in relation to motivational dominance and state.

We examined the hypothesis that congruence between motivational dominance and state results in optimal psychological responses and performance during exercise. Twenty participants (10 telic dominant and 10 paratelic dominant) rated their stress at 5 min intervals as they cycled on an ergometer at gas exchange threshold for 30 min in both telic and paratelic state manipulated conditions. Participants then performed a test to exhaustion at a resistance equivalent to 110% of VO(2max). The hypothesized interaction between condition and dominance was significant for internal tension stress, as paratelic dominants were more stressed than telic dominants when exercising in the telic state and telic dominants were more stressed than paratelic dominants when exercising in the paratelic state. Similarly, the condition × dominance interaction for internal stress discrepancy was significant, as paratelic dominants reported greater internal stress discrepancy exercising in the telic compared with the paratelic state. Findings are discussed in relation to the application of reversal theory for understanding stress responses during aerobic exercise.

Telic dominance influences affective response to a heavy-intensity 10-min treadmill running session.

In this paper, we examine the hypothesis that telic dominance is one of the psychological variables that may influence the exercise-affect relationship according to the dual-mode model of exercise and affect (Ekkekakis, 2003). Thirty-three participants with high or low telic dominance rated their affect at 3-min intervals as they ran on a treadmill while the speed was adjusted to maintain their respiratory exchange ratio at a target value of 1.00 +/- 0.02 for a period of 10 min. Compared with baseline scores (which were not statistically different between the two groups), the mean decline in pleasure at the end of the run was twofold greater in participants with high telic dominance. This was observed after having controlled for individual differences in aerobic fitness (as measured by [Vdot]O(2max)). We also detected an earlier onset of decreases in pleasure in high telic dominant participants. Our data extend the burgeoning research on variables influencing one's ability to continue exercising at an imposed intensity that can produce pain or discomfort (i.e. tolerance of exercise intensity). Additionally, results from this study support continued promotion of tailor-made prescriptions for maximizing positive affective outcomes during exercise, which ultimately may lead to increased adherence to an exercise programme.

Why do people perform thrilling activities? A study based on reversal theory.

The present study was aimed at testing the assumption based on reversal theory, according to which people perform frightening activities to induce high anxiety, which in turn can give rise to pleasant excitement, provided that a metamotivational reversal occurs. The Tension and Effort Stress Inventory was administered to 46 individuals just before and just after a frightening ride on a cable (Fantasticable). A 30-subject control group was given the same inventory in a safe context, with a 2-min. rest between the two periods of completion. Ratings of Tension Stress, Anxiety, and overall Unpleasant Emotions were significantly decreased after the ride for the Fantasticable group. Conversely, significant increases in Preferred Arousal, Excitement, Transactional Emotions, and overall Pleasant Emotions were found after the ride. Also, pre-activity anxiety correlated with postactivity excitement (r = .79) for the Fantasticable group only. This supports the reversal theory contention about how one's involvement in arousal-seeking leisure may improve one's emotional state. No time effect was noted in the ratings for the control group, suggesting an association of participation in a frightening activity and emotional enhancement.