Effects of Exercise Testing and Cardiac Rehabilitation in Patients with Coronary Heart Disease on Fear and Self-Efficacy of Exercise: A Pilot Study.

BACKGROUND: Exercise fear and low exercise self-efficacy are common in patients attending cardiac rehabilitation (CR). This study tested whether exercise prescription methods influence exercise fear and exercise self-efficacy. We hypothesized that the use of graded exercise testing (GXT) with a target heart rate range exercise prescription, relative to standard exercise prescription using rating of perceived exertion (RPE), would produce greater reductions in exercise fear and increase self-efficacy during CR. METHOD: Patients in CR (N = 32) were randomized to an exercise prescription using either RPE or a target heart rate range. Exercise fear and self-efficacy were assessed with questionnaires at three time points: baseline; after the GXT in target heart rate range group; and at session 6 for the RPE group and CR completion. Items were scored on a five-point Likert-type scale with higher mean scores reflecting higher fear of exercise and higher self-efficacy. To analyze mean differences, a mixed effects analysis was run. RESULTS: There were no significant changes in exercise self-efficacy between baseline and discharge from CR; these were not statistically significant (mean differences baseline - 0.63; end - 0.27 (p = 0.13)). Similarly, there was no change in fear between groups (baseline 0.30; end 0.51 (p = 0.37)). CONCLUSION: Patients in the RPE and target heart rate groups had non-significant changes in exercise self-efficacy over the course of CR. Contrary to our hypothesis, the use of GXT and target heart rate range did not reduce fear, and we noted sustained or increases in fear of exercise among patients with elevated baseline fear. A more targeted psychological intervention seems warranted to reduce exercise fear and self-efficacy in CR.

Affective Responses to Increasing- and Decreasing-Intensity Resistance Training Protocols.

This study compared the effects of an increasing-intensity (UP) and a decreasing-intensity (DOWN) resistance training protocol on affective responses across six training sessions. Novice participants (Mage 43.5 ± 13.7 years) were randomly assigned to UP (n = 18) or DOWN (n = 17) resistance training groups. Linear mixed-effects models showed that the evolution of affective valence within each training session was significantly moderated by the group (b = -0.45, p ≤ .001), with participants in the UP group reporting a decline in pleasure during each session (b = -0.82) and the DOWN group reporting an improvement (b = 0.97; ps < .001). Remembered pleasure was significantly higher in the DOWN group compared to the UP group (b = 0.57, p = .004). These findings indicate that a pattern of decreasing intensity throughout a resistance exercise session can elicit more positive affective responses and retrospective affective evaluations of resistance training.

Listening to Fast-Tempo Music Improves Physical Performance in Recreational Swimmers.

Purpose: To determine whether swimming while listening to fast (140 bpm) or moderate tempo (120 bpm) music enhances physical performance compared to a non-music condition. Methods: Sixteen healthy university students (21.5 ± 2.3 years) with a minimum of one year of experience swimming front crawl were recruited. All completed four testing sessions. In the first session, a graded exercise treadmill test was performed to establish baseline fitness. The next three visits were at the swimming pool and participants were asked to swim as far as possible in 12-minutes (i.e., Swimming Cooper Test) under each of three randomly assigned conditions: 120 bpm (M120), 140 bpm (M140) and a non-music condition (NM). Results: No significant differences were found between conditions for either heart rate (p > .05) or rating of perceived exertion (p > .05). However, differences were found on distance covered (p = .014) between M120 (305.7 ± 19.7 m) and M140 (321.2 ± 19.4 m; p = .035), and on stroke frequency (p = .009) between M120 (48.4 ± 1.8) and M140 (51.6 ± 1.9; p = .028). Conclusion: These results suggest that distance covered and the frequency of strokes per minute were greater when participants were exposed to fast tempo music (M140) compared to moderate tempo music (M120) and a non-music condition (NM) in a 12-minute swimming test.

The Influence of Affective Priming on the Affective Response During Exercise: A Replication Study.

The affective response during exercise is an important factor for long-term exercise adherence. Pottratz et al. suggested affective priming as a behavioral intervention for the enhancement of exercise-related affect. The present paper aims to replicate and extend upon these findings. We conducted a close replication with 53 participants completing a brisk walking task in two conditions (prime vs. no prime). Affective valence was assessed during exercise, and exercise enjoyment and remembered/forecasted pleasure were assessed postexercise. We could not replicate the findings of Pottratz et al., finding no evidence for positive changes in psychological responses in the priming condition. However, linear mixed models demonstrated significant interindividual differences in how participants responded to priming. These results demonstrate that affective priming during exercise does not work for everyone under every circumstance and, thus, provide an important contribution to the understanding of boundary conditions and moderating factors for priming in exercise psychology.

Exercise Prescription Methods and Attitudes in Cardiac Rehabilitation: A NATIONAL SURVEY.

PURPOSE: High-quality exercise training improves outcomes in cardiac rehabilitation (CR), but little is known about how most programs prescribe exercise. Thus, the aim was to describe how current CR programs prescribe exercise. METHODS: We conducted a 33-item anonymous survey of CR program directors registered with the American Association of Cardiovascular and Pulmonary Rehabilitation. We assessed the time, mode, and intensity of exercise prescribed, as well as attitudes about maximal exercise testing and exercise prescription. Results were summarized using descriptive statistics. Open-ended responses were coded and quantitated thematically. RESULTS: Of 1470 program directors, 246 (16.7%) completed the survey. In a typical session of CR, a median of 5, 35, 10, and 5 min was spent on warm-up, aerobic exercise, resistance training, and cooldown, respectively. The primary aerobic modality was the treadmill (55%) or seated dual-action step machine (40%). Maximal exercise testing and high-intensity interval training (HIIT) were infrequently reported (17 and 8% of patients, respectively). The most common method to prescribe exercise intensity was ratings of perceived exertion followed by resting heart rate +20-30 bpm, although 55 unique formulas for establishing a target heart rate or range (THRR) were reported. Moreover, variation in exercise prescription between staff members in the same program was reported in 40% of programs. Program directors reported both strongly favorable and unfavorable opinions toward maximal exercise testing, HIIT, and use of THRR. CONCLUSIONS: Cardiac rehabilitation program directors reported generally consistent exercise time and modes, but widely divergent methods and opinions toward prescribing exercise intensity. Our results suggest a need to better study and standardize exercise intensity in CR.

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.

Prime Movers: Effects of Subliminal Primes, Music, and Music Video on Psychological Responses to Exercise.

BACKGROUND: Priming is a process in which exposure to a stimulus activates relevant mental representations that are given increased weight in subsequent judgment tasks. Affective primes can influence affective evaluations and associations. Such influence has meaningful implications for the promotion of exercise behavior, yet there is scant research on priming effects in exercise settings. PURPOSE: The purpose of the present pair of studies was to examine the efficacy of music (M), music video (MV), and music video with affective primes (PRIME) in modulating psychological responses during and immediately following an exercise bout among two distinct populations. METHODS: In Study 1, physically active participants completed a brisk walking task on a treadmill under four conditions: M, MV, PRIME, and control. Affective valence and rating of perceived exertion (RPE) were assessed during exercise and remembered/forecasted pleasure was measured immediately following each exercise bout. In Study 2, largely inactive and overweight participants completed a brisk walking task on a treadmill under two conditions: MV and PRIME. Affective valence was assessed during exercise, while exercise enjoyment and remembered/forecasted pleasure were assessed postexercise. RESULTS: In Study 1, PRIME yielded more positively valenced affect, remembered/forecasted pleasure, and lower RPE when compared to the other conditions (MCohen's d for all DVs = 0.91). In Study 2, PRIME elicited more positively valenced affect, greater enjoyment, and enhanced remembered/forecasted pleasure when compared to MV (MCohen's d for all DVs = 0.64). CONCLUSIONS: Subliminal primes embedded in music video can elicit positive changes in psychological responses during and immediately following exercise.

The effects of 16-weeks of prebiotic supplementation and aerobic exercise training on inflammatory markers, oxidative stress, uremic toxins, and the microbiota in pre-dialysis kidney patients: a randomized controlled trial-protocol paper.

BACKGROUND: Chronic kidney disease (CKD) is characterized by dysbiosis, elevated levels of uremic toxins, systemic inflammation, and increased markers of oxidative stress. These factors lead to an increased risk of cardiovascular disease (CVD) which is common among CKD patients. Supplementation with high amylose maize resistant starch type 2 (RS-2) can change the composition of the gut microbiota, and reduce markers of inflammation and oxidative stress in patients with end-stage renal disease. However, the impact of RS-2 supplementation has not been extensively studied in CKD patients not on dialysis. Aerobic exercise training lowers certain markers of inflammation in CKD patients. Whether combining aerobic training along with RS-2 supplementation has an additive effect on the aforementioned biomarkers in predialysis CKD patients has not been previously investigated. METHODS: The study is being conducted as a 16-week, double-blind, placebo controlled, parallel arm, randomized controlled trial. Sixty stage 3-4 CKD patients (ages of 30-75 years) are being randomized to one of four groups: RS-2 & usual care, RS-2 & aerobic exercise, placebo (cornstarch) & usual care and placebo & exercise. Patients attend four testing sessions: Two baseline (BL) sessions with follow up visits 8 (wk8) and 16 weeks (wk16) later. Fasting blood samples, resting brachial and central blood pressures, and arterial stiffness are collected at BL, wk8 and wk16. A stool sample is collected for analysis of microbial composition and peak oxygen uptake is assessed at BL and wk16. Blood samples will be assayed for p-cresyl sulphate and indoxyl sulphate, c-reactive protein, tumor necrosis factor α, interleukin 6, interleukin 10, monocyte chemoattractant protein 1, malondialdehyde, 8-isoprostanes F2a, endothelin-1 and nitrate/nitrite. Following BL, subjects are randomized to their group. Individuals randomized to conditions involving exercise will attend three supervised moderate intensity (55-65% peak oxygen uptake) aerobic training sessions (treadmills, bikes or elliptical machine) per week for 16 weeks. DISCUSSION: This study has the potential to yield information about the effect of RS-2 supplementation on key biomarkers believed to impact upon the development of CVD in patients with CKD. We are examining whether there is an additive effect of exercise training and RS-2 supplementation on these key variables. TRIAL REGISTRATION: Clinicaltrials.gov Trial registration# NCT03689569 . 9/28/2018, retrospectively registered.

Increasing the Pleasure and Enjoyment of Exercise: A Novel Resistance-Training Protocol.

This study was designed to test the effect of an increasing- (UP) or decreasing-intensity (DOWN) resistance-training (RT) protocol on the pleasure and enjoyment of RT. The participants (N = 40; mean age = 35.0 ± 9.2 years) completed two RT sessions comprising 3 × 10 repetitions of six exercises. In the UP condition, load progressively increased from 55% to 75% of 1-repetition maximum, while in the DOWN condition, this pattern was reversed (i.e., 75-55% 1-repetition maximum). The DOWN condition resulted in more overall pleasure compared with UP and a slope of increasing pleasure, while the UP condition resulted in decreasing pleasure. Enjoyment of RT, postexercise pleasure, and remembered pleasure were all significantly greater for DOWN compared with UP (all ps > .01). These findings suggest that decreasing RT intensity throughout an exercise bout can elicit a positive slope of pleasure and enhance affective evaluations of exercise.

A Qualitative Investigation of Music Use among Amateur and Semi-Professional Golfers.

Music use in golf receives minimal attention from both applied and empirical perspectives. Golfers, coaches, and sport psychology practitioners alike may benefit from understanding and utilizing music within their work. Since music use in golf has become an increasingly common practice, the purpose of the current study was to investigate current music use among golfers using a qualitative approach. Researchers aimed to identify potential psychological and physiological effects derived from music use during golf practice and pre-performance, given the limited empirical research in this area to date. Semi-structured interviews were conducted with ten amateur and semi-professional golfers (five male, five female, Mage = 22.9 years, SD = 5.04 years). Consensual qualitative research (CQR) methodology was used to analyze the interview data. Six domains emerged from the CQR analysis regarding participants' self-reported music use in golf: tempo, attention, physiological regulation, psychological regulation, effects of music on performance perceptions, and context (to use or not to use). Given the capacity of carefully selected music to elicit profound affective, neurophysiological, and behavioral responses, there is clear potential for mental performance consultants to utilize music in working with golfers in training contexts. Implications, caveats, and future research recommendations are provided.

Should We Scale-Up? A Mixed Methods Process Evaluation of an Intervention Targeting Sedentary Office Workers Using the RE-AIM QuEST Framework.

Background: Interventions targeting a reduction in sedentary behaviour in office workers need to be scaled-up to have impact. In this study, the RE-AIM QuEST framework was used to evaluate the potential for further implementation and scale-up of a consultation based workplace intervention which targeted both the reduction, and breaking up of sitting time. Methods: To evaluate the Springfield College sedentary behaviour intervention across multiple RE-AIM QuEST indicators; intervention participant, non-participant (employees who did not participate) and key informant (consultation delivery team; members of the research team and stakeholders in workplace health promotion) data were collected using interviews, focus groups and questionnaires. Questionnaires were summarized using descriptive statistics and interviews and focus groups were transcribed verbatim, and thematically analysed. Results: Barriers to scale-up were: participant burden of activity monitoring; lack of management support; influence of policy; flexibility (scheduling/locations); time and cost. Facilitators to scale up were: visible leadership; social and cultural changes in the workplace; high acceptability; existing health and wellbeing programmes; culture and philosophy of the participating college. Conclusions: There is potential for scale-up, however adaptations will need to be made to address the barriers to scale-up. Future interventions in office workers should evaluate for scalability during the pilot phases of research.

In the Zone: An Exploration of Personal Characteristics Underlying Affective Responses to Heavy Exercise.

Positive affective responses to exercise have been linked to longer-term adherence. The dual-mode model indicates that affective responses during heavy exercise (between the ventilatory threshold and the respiratory compensation point) are subject to interindividual variability (zone of response variability). Participants (N = 48) completed measures to assess personal characteristics prior to a graded exercise test. Responses to the Feeling Scale were recorded during the graded exercise test and subsequently used to group participants as either negative responders or neutral/positive responders to heavy exercise. Discriminant function analysis was applied, and a significant weighted linear composite predicted affective response. Preference for exercise intensity and sex were significant predictors (p = .003). Negative responders had lower preference scores and were more likely to be men. The combination of these two variables successfully predicted group membership 71% of the time. Individual differences appear relevant when examining affective responses to heavy exercise.

Subjective and objective assessment of sedentary behavior among college employees.

BACKGROUND: High levels of sedentary behavior are linked to increased mortality. In the United States, individuals spend 55-70% of their waking day being sedentary. Since most individuals spend large portions of their daily lives at work, quantifying the time engaged in sedentary behavior at work is emerging as an important health determinant. Studies profiling academic institutions, where a variety of personnel with diverse job descriptions are employed, are limited. Available studies focus mostly on subjective methods, with few using objective approaches. Therefore, the purpose of the current study was to assess sedentary behavior among all occupational groups of a college in the Northeastern United States utilizing both a subjective and an objective method. METHODS: College employees (n = 367) completed the Occupational Sitting and Physical Activity Questionnaire (OSPAQ). A sub-sample of these employees (n = 127) subsequently wore an activPAL3 accelerometer 24 h per day for seven consecutive days. Outcome variables were time spent sitting, standing, stepping, and total number of steps. To assess fragmentation of sedentary behavior, the average duration of a sitting bout and sitting bouts/sitting hour were calculated. Differences between administrators, faculty, and staff, were analyzed using multivariate and univariate analyses of variance. RESULTS: The OSPAQ results indicated that administrators spent more of their working day sedentary (73.2 ± 17.7%) than faculty members (58.5 ± 19.6%, p < 0.05). For the objective phase of the study, complete data were analyzed from 86 participants. During a waking day, administrators (64.0 ± 8.1%) were more sedentary than faculty (56.0 ± 7.9%, p < 0.05) and fragmented their sitting less than staff (3.7 ± 0.7 and 4.5 ± 7.9 bouts of sitting/sitting hour, respectively; p < 0.05). This pattern was also seen during working hours, with administrators (4.9 ± 2.1) taking fewer breaks per hour than staff (6.9 ± 3.0, p < 0.05). CONCLUSIONS: Administrators are the most sedentary members of the campus community. However, overall, the level of sedentary behavior among employees was high. This study highlights the need for sedentary behavior interventions in the college/university environment.

Changes in Sitting Time and Sitting Fragmentation after a Workplace Sedentary Behaviour Intervention.

Prolonged sedentary behaviour (SB) has shown to be detrimental to health. Nevertheless, population levels of SB are high and interventions to decrease SB are needed. This study aimed to explore the effect of a personalized intervention aimed at reducing SB and increasing breaks in SB among college employees. A pre-experimental study design was used. Participants (n = 36) were recruited at a college in Massachusetts, USA. SB was measured over 7 consecutive days using an activPAL3 accelerometer. Following baseline measures, all participants received a personalized SB consultation which focused on limiting bouts of SB >30 min, participants also received weekly follow-up e-mails. Post-intervention measures were taken after 16 weeks. Primary outcome variables were sedentary minutes/day and SB bouts >30 min. Differences between baseline and follow-up were analyzed using paired t-tests. The intervention did not change daily sedentary time (-0.48%; p > 0.05). The number of sedentary bouts >30 min decreased significantly by 0.52 bouts/day (p = 0.010). In this study, a personalized SB intervention was successful in reducing number of bouts >30 min of SB. However, daily sedentary time did not reduce significantly. These results indicate that personalized, consultation-based interventions may be effective if focused on a specific component of SB.

The Diabeates Project: Perceptual, Affective and Psychophysiological Effects of Music and Music-Video in a Clinical Exercise Setting.

OBJECTIVES: The purpose of this study was to examine the effects of music and music-video on perceptual (attentional focus, rated perceived exertion), affective (affective valence and enjoyment) and psychophysiological (blood glucose, heart rate) variables in outpatients attending a diabetes exercise clinic. METHODS: Participants were 24 females (age = 66.0 ± 8.5 years) enrolled in a supervised exercise program for people with diabetes. They engaged in mixed-modality exercise sessions that included a standardized combination of flexibility, aerobic and resistance activities under conditions of music, music-video and control. RESULTS: Analyses revealed a main effect of condition on attentional focus and affect during aerobic exercise only. The music-video condition elicited the highest level of attentional dissociation, while affective valence was more positive in the 2 experimental conditions when compared to control. Rated perceived exertion and heart rate did not differ across conditions. Measures of exercise enjoyment indicated a main effect of condition wherein scores were higher with the music-video condition when compared to control. There was an acute glucose-lowering effect of exercise in all conditions. CONCLUSIONS: Results lend support to the notion that auditory and visual stimuli can enhance affective responses to exercise in a clinical setting. This may have meaningful implications for adherence, given the link between affective judgements and future behaviour in an exercise context.

The Effects of Mental Imagery with Video-Modeling on Self-Efficacy and Maximal Front Squat Ability.

This study was designed to assess the effectiveness of mental imagery supplemented with video-modeling on self-efficacy and front squat strength (three repetition maximum; 3RM). Subjects (13 male, 7 female) who had at least 6 months of front squat experience were assigned to either an experimental (n = 10) or a control (n = 10) group. Subjects' 3RM and self-efficacy for the 3RM were measured at baseline. Following this, subjects in the experimental group followed a structured imagery protocol, incorporating video recordings of both their own 3RM performance and a model lifter with excellent technique, twice a day for three days. Subjects in the control group spent the same amount of time viewing a placebo video. Following three days with no physical training, measurements of front squat 3RM and self-efficacy for the 3RM were repeated. Subjects in the experimental group increased in self-efficacy following the intervention, and showed greater 3RM improvement than those in the control group. Self-efficacy was found to significantly mediate the relationship between imagery and front squat 3RM. These findings point to the importance of mental skills training for the enhancement of self-efficacy and front squat performance.

See hear: psychological effects of music and music-video during treadmill running.

BACKGROUND: There is a paucity of work addressing the distractive, affect-enhancing, and motivational influences of music and video in combination during exercise. PURPOSE: We examined the effects of music and music-and-video on a range of psychological and psychophysical variables during treadmill running at intensities above and below ventilatory threshold (VT). METHODS: Participants (N = 24) exercised at 10 % of maximal capacity below VT and 10 % above under music-only, music-and-video, and control conditions. RESULTS: There was a condition × intensity × time interaction for perceived activation and state motivation, and an intensity × time interaction for state attention, perceived exertion (RPE), and affective valence. The music-and-video condition elicited the highest levels of dissociation, lowest RPE, and most positive affective responses regardless of exercise intensity. CONCLUSIONS: Attentional manipulations influence psychological and psychophysical variables at exercise intensities above and below VT, and this effect is enhanced by the combined presentation of auditory and visual stimuli.

Moderating influence of dominant attentional style and exercise intensity on responses to asynchronous music.

We examined independent and combined influences of asynchronous music and dominant attentional style (DAS) on psychological and psychophysical variables during exercise using mixed methods. Participants (N = 34) were grouped according to DAS and completed treadmill runs at three intensities (low, moderate, high) crossed with three music conditions (motivational, oudeterous, no-music control). State attentional focus shifted from dissociative to associative with increasing intensity and was most aligned with DAS during moderate-intensity exercise. Both music conditions facilitated dissociation at low-to-moderate intensities. At high exercise intensity, both music conditions were associated with reduced RPE among participants with an associative DAS. Dissociators reported higher RPE overall during moderate and high intensities. Psychological responses were most positive in the motivational condition, followed by oudeterous and control. Findings illustrate the relevance of individual differences in DAS as well as task intensity and duration when selecting music for exercise.