Cardiovascular reactivity to acute psychological stress is associated with generalized self-efficacy and self-efficacy outcomes during adventure challenges.

Outdoor adventure challenges are commonly used to enhance self-efficacy, but the physiological mechanisms involved remain unexplored. Additionally, while studies have documented the influence of self-efficacy on stress management, general self-efficacy has yet to be fully understood in the context of cardiovascular stress reactivity (CVR). This study investigated the influence of self-efficacy beliefs on CVR during acute psychological stress tasks. Additionally, it explored whether CVR serves as a novel mechanism underlying the outcomes of outdoor adventure challenges. As part of a wider randomized controlled trial, participants (n = 55) were invited to complete a laboratory session to assess CVR to an active (paced auditory serial addition test (PASAT)) and a passive (cold pressor test (CPT)) stress task. Randomized participants (n = 33) to the experimental condition also engaged in a high ropes challenge course after the laboratory session. It was found that greater self-reported self-efficacy was associated with larger CVR during the CPT and positively associated with perceived engagement and performance during the PASAT. Secondly, participants reporting positive change in self-efficacy post-intervention were associated with greater CVR and greater CVR was associated with higher ratings of intervention engagement and perceived challenge. This study provides preliminary evidence suggesting that greater efficacy beliefs may heighten CVR to passive acute psychological stressors. Habitual stress reactivity may represent a novel mechanism involved in outdoor and adventure-based interventions. Future research should continue to explore the impact of psychological variables on stress physiology and examine CVR as a potential mechanism in adventure experiences.

Evaluation of the MOVE online exercise programme for young people aged 13-30.

PURPOSE: To evaluate the MOVE exercise programme in supporting the recovery of young people affected by cancer. METHODS: Participants in an 8-week exercise rehabilitation programme delivered online by cancer rehabilitation specialists completed self-reported questionnaires at baseline and after programme completion. Assessments included cancer-related fatigue (FACIT fatigue scale) and health-related quality of life (EORTC-QLC-30). Qualitative data were provided through written accounts of participant experiences and underwent content analysis. RESULTS: Seventy-one participants commenced the exercise rehabilitation programme and 57 completed the programme and provided data for analysis (63% female; median age 22 years). Statistically significant improvements were observed in post-programme scores for all measured outcomes (cancer-related fatigue, quality of life, physical functioning, role functioning, emotional functioning). Content analysis of written experiences generated ten unique codes. The highest frequency codes were enjoyment (n = 34), motivation (n = 14) and fitness (n = 13). CONCLUSIONS: These findings indicate feasibility of delivery, acceptability to patients and physical and psychological benefits of a personalised online exercise rehabilitation programme for young people living with and beyond cancer. Further research involving a control arm and long-term follow-up would be beneficial. IMPLICATIONS FOR CANCER SURVIVORS: These results support the inclusion of a personalised exercise programme as part of cancer rehabilitation for young people living with and beyond cancer.

Effects of engaging in mass participation sporting events on physical activity behaviour,: a systematic review.

Mass participation sports event (MPSE)s have been identified as a potential referral pathway for engaging inactive patients in regular physical activity. This study aimed to review evidence of physical activity behaviour and associated health-related outcomes of engaging in MPSEs among the general population. A systematic review was performed of quantitative studies that examined the relationship between MPSEs and physical activity behaviour or secondary outcomes (e.g. physical activity motivation or confidence, physical or mental health) or any intervention to maintain physical activity following MPSEs. Search methods included searching five electronic databases and checking reference lists. Methodological quality was assessed using the Mixed Methods Appraisal Tool. A total of 2079 papers were identified, 142 were independently assessed for eligibility and 39 were included. Data from prospective cohort studies suggested that levels of physical activity achieved in training for MPSEs tended to drop in the months after, but increases were reported in some studies of novice participants. Interventions involving health promotion materials provided post-event led to small increases in physical activity. Perceived benefits of participating in MPSEs included physical and mental health, fitness, self-efficacy and social connections. Existing evidence suggests that MPSEs can act as a motivator to initiate exercise in preparation for the event, but there is limited evidence on how best to sustain physical activity post-event. Given the short duration of most studies, longer prospective analyses are needed to delineate patterns of habitual and event-related activity and account for seasonal effects.

Mass participation sporting events can be attractive to low-active participants as well as regular exercisers, with a notable proportion identified as low active (one-fifth). Overall levels of physical activity tend to decline after event completion, suggesting that training in preparation for events was not maintained. There is some evidence of increased exercise post-event reported among novice participants, though evidence is limited on effective ways to sustain exercise after event completion. Regularly held events such as parkrun or booster interventions following events helped maintain exercise levels over 12 months.

Perceptions and Experiences of High-Intensity Interval Training in Kidney Transplant Recipients: A Big HIIT?

High-intensity interval training (HIIT) is considered a novel and time-efficient method to reduce cardiovascular disease risk, a leading cause of mortality in kidney transplant recipients. However, research in this population is severely limited. The aim of this study was to understand kidney transplant recipients' perceptions and experiences of HIIT and their readiness to participate in HIIT. Individual, semi-structured interviews were conducted in adults with a kidney transplant (n = 13; 53±13 years). Interviews were audiorecorded, transcribed verbatim, and subjected to framework analysis. Overall, participants had a good knowledge of HIIT and were open to participation. Acknowledgment of the superior benefits to cardiovascular, mental, and general health, as well as the lower time commitment, were all motivators for participation. There were some heightened concerns around damaging the kidney and 'knowing your limits. Personalization, physician's approval, and supervision were all important factors in participation. This study provides evidence that HIIT would be, in principle, largely accepted by recipients of a kidney transplant. However, several considerations are also identified in the present study, which would be essential to the success of any future efficacy trial or rehabilitation program.

Perceived barriers and facilitators to exercise in kidney transplant recipients: A qualitative study.

BACKGROUND: Exercise has the potential to attenuate the high levels of cardiovascular morbidity and mortality present in kidney transplant recipients (KTRs). Despite this, activity levels in KTRs remain low. The aim of this qualitative study was to explore the barriers and facilitators of exercise in KTRs. METHODS: Thirteen KTRs (eight males; mean ± SD; age 53 ± 13 years; estimated glomerular filtration rate 53 ± 21 ml/min/1.73 m2 ) were recruited and completed semistructured one-to-one interviews at University Hospitals of Leicester NHS Trust. All KTRs were eligible if their kidney transplant was completed >12 weeks before interview and their consultant considered them to have no major contraindications to exercise. All interviews were audio recorded, transcribed verbatim and subject to framework analysis to identify and report themes. RESULTS: Themes were organized into personal, behavioural and environmental factors based on social cognitive theory. Facilitators of exercise were largely internal: enjoyment, exercise for general health and health of the transplanted kidney and desire to maintain normality. Social interaction, support and guidance of healthcare professionals and goal setting were perceived as motivational. Harming the kidney, a lack of guidance, self-motivation and accessibility were barriers to exercise. CONCLUSION: These results provide detailed insight into the development of interventions designed to increase physical activity in KTRs. They provide strong evidence that specific exercise guidelines are required for this population and that the healthcare system could have a key role in supporting KTRs to become more physically active. Interventions need to be multifaceted to appeal to the differing levels of support desired by KTRs. PATIENT OR PUBLIC CONTRIBUTION: KTRs were involved in the development of the interview topic guide to ensure all relevant topics were explored.

Prospective study of beginner running groups: psychological predictors and outcomes of participation.

Running is an example of vigorous activity that leads to important health benefits if maintained. Beginner running groups provide supportive training programs to help people progress from walking to sustained running. This study explored the characteristics of individuals joining beginner running groups and the outcomes they achieve. New members of beginner running groups (n = 141; mean age 43 years, 122 female) completed online assessments at the start of their group program with 63 participants (45%) also completing a follow-up assessment at the end of the program. Validated scales were used to assess exercise behavior, mental wellbeing, self-efficacy, running identity and social physique anxiety. The majority of participants had low exercise levels at the start of the program (63%, n = 89). By the program end, 47 participants (75% of those completing the follow-up assessment) reported meeting the training goal (running for 30 minutes continuously) with self-efficacy, program adherence and younger age representing significant predictors of success. Significant improvements in exercise levels, mental wellbeing, self-efficacy, running identity and social physique anxiety were observed by the end of the program. In conclusion, beginner running programs attract low active individuals and may lead to improved levels of exercise and psychological outcomes. Additional research is needed to examine the extent to which improvements are sustained longer term.

Exploring the benefits of participation in community-based running and walking events: a cross-sectional survey of parkrun participants.

BACKGROUND: Whilst the benefits of physical activity for health and wellbeing are recognised, population levels of activity remain low. Significant inequalities exist, with socioeconomically disadvantaged populations being less physically active and less likely to participate in community events. We investigated the perceived benefits from participation in a weekly running/walking event called parkrun by those living in the most socioeconomically deprived areas and doing the least physical activity. METHODS: A cross-sectional online survey was emailed to 2,318,135 parkrun participants in the UK. Demographic and self-reported data was collected on life satisfaction, happiness, health status, physical activity, motives, and the perceived benefits of parkrun. Motivation, health status and benefits were compared for sub-groups defined by physical activity level at parkrun registration and residential Index of Multiple Deprivation. RESULTS: 60,000 completed surveys were received (2.7% of those contacted). Respondents were more recently registered with parkrun (3.1 v. 3.5 years) than the parkrun population and had a higher frequency of parkrun participation (14.5 v. 3.7 parkruns per year). Those inactive at registration and from deprived areas reported lower happiness, lower life satisfaction and poorer health compared to the full sample. They were more likely to want to improve their physical health, rather than get fit or for competition. Of those reporting less than one bout of activity per week at registration, 88% (87% in the most deprived areas) increased their physical activity level and 52% (65% in the most deprived areas) reported improvements to overall health behaviours. When compared to the full sample, a greater proportion of previously inactive respondents from the most deprived areas reported improvements to fitness (92% v. 89%), physical health (90% v. 85%), happiness (84% v. 79%) and mental health (76% v. 69%). CONCLUSION: The least active respondents from the most socioeconomically deprived areas reported increases to their activity levels and benefits to health and wellbeing since participating in parkrun. Whilst the challenge of identifying how community initiatives like parkrun can better engage with underrepresented populations remains, if this can be achieved they could have a critical public health role in addressing inequalities in benefits associated with recreational physical activity.

Psychomotor Performance Decrements following a Successful Physical Activity Intervention for Insomnia.

Objectives: Evidence supports the view that reductions in cognitive hyperarousal contribute substantially to improved sleep outcomes following cognitive and behavioral interventions for insomnia disorder. Assuming an inverted-u relationship between arousal and performance, a theoretical possibility, supported by limited empirical data, is that the same mediating processes could negatively impact aspects of psychomotor performance, reducing speed on tests of reaction time. Participants: Sedentary participants (mean age = 59.8; SD = 9.46) meeting research diagnostic criteria for insomnia were randomized to either an exercise intervention of ≥150 min of moderate-intensity activity per week (n = 20), or a wait-list control group (n = 21). Of these, n = 17 intervention and n = 18 control participants completed 6-month follow-up assessments. Methods: Digit span, and simple and complex vigilance task performance was assessed using a computerized protocol at baseline and 6-month follow-up. Dependent variables included digit span, simple reaction time (SRT), complex reaction time (CRT), false positive responses, number of lapses, and SRT/CRT ratio (indicative of the magnitude of difference between simple and complex RT performance). The primary clinical outcome was Insomnia Severity Index (ISI) score. Results: In comparisons of baseline to follow-up change, ISI scores showed clinically significant improvement in the intervention group at 6-month follow-up (F (8,26) = 5.16; P = 0.03). Baseline vigilance performance was equivalent in both groups. At 6-month follow-up, however, the intervention group showed significantly slower simple reaction time F(4,30) = 10.25, p < 0.01, and a significantly decreased SRT/CRT ratio (F(4,30) = 13.22, p < 0.01). Conclusions: Among people meeting diagnostic criteria for insomnia, beneficial sleep outcomes following successful behavioral interventions may, under some circumstances, come at the cost of slower psychomotor performance.

Intervention development for exercise promotion at active charity events in the UK.

This study used the Intervention Mapping protocol to design an evidence-based intervention package for organizers of active charity events to support their participants in remaining or becoming regular exercisers. A mixed-methods approach following the Intervention Mapping protocol was used to develop intervention components. A needs assessment was initially performed to identify the behavioural and environmental determinants of exercise for charity event participants (Step 1). Next, the intended intervention outcomes, and performance and change objectives were specified (Step 2). Theory-based change methods were selected and matched with practical strategies (Step 3). This resulted in the design of the first iteration of the intervention which underwent pre-testing with former event participants and feasibility testing at an active charity event (Step 4). The evidence-based interventions included components to implement at events (e.g. an activity and information zone, and exercise planner), along with elements pre- and post-event (e.g. social media). Pre-testing indicated high acceptability of the planned components, but feasibility testing suggested low engagement with the intervention. Despite developing the intervention package through the systematic process of Intervention Mapping, preliminary data suggest that further development and testing is needed to refine the intervention before implementation.

Exploring parkrun as a social context for collective health practices: running with and against the moral imperatives of health responsibilisation.

Critiques of public health policies to reduce physical inactivity have led to calls for practice-led research and the need to reduce the individualising effects of health promotion discourse. The purpose of this paper is to examine how parkrun - an increasingly popular, regular, community-based 5 km running event - comes to be understood as a 'health practice' that allows individuals to enact contemporary desires for better health in a collective social context. Taking a reflexive analytical approach, we use interview data from a geographically diverse sample of previously inactive parkrun participants (N = 19) to explore two themes. First, we argue that parkrun offers a space for 'collective bodywork' whereby participants simultaneously enact personal body projects while they also experience a sense of being 'all in this together' which works to ameliorate certain individualising effects of health responsibilisation. Second, we examine how parkrun figures as a health practice that makes available the subject position of the 'parkrunner'. In doing so, parkrun enables newly active participants to negotiate discourses of embodied risk to reconcile the otherwise paradoxical experience of being an 'unfit-runner'. Findings contribute to sociological understandings of health and illness through new insights into the relation between health practices and emerging physical cultures, such as parkrun.

Affective outcomes during and after high-intensity exercise in outdoor green and indoor gym settings.

Outdoor exercise settings promote greater psychological well-being than synthetic equivalents, although the influence of the exercise context has not been investigated at high exercise intensities. This study compared the psychological effects of high-intensity exercise in outdoor green and indoor gym settings in 22 adult runners using a randomized repeated measures design. Affect and perceived exertion were assessed before, during, and after a 6000-m run with the second half completed at maximum effort. Perceived exertion and activation increased in a progressive manner from baseline to 6000 m, and decreased during the 10-min recovery post-run. Non-significant reductions in affective valence were observed between 3000 and 6000 m, followed by a significant increase post-run. Outcomes did not differ at any time point between the settings. This study suggested that regular runners experience positive affective responses during and after high-intensity exercise in both a natural outdoor environment and an indoor gym.

Strategies designed to help healthcare professionals to recruit participants to research studies.

BACKGROUND: Identifying and approaching eligible participants for recruitment to research studies usually relies on healthcare professionals. This process is sometimes hampered by deliberate or inadvertent gatekeeping that can introduce bias into patient selection. OBJECTIVES: Our primary objective was to identify and assess the effect of strategies designed to help healthcare professionals to recruit participants to research studies. SEARCH METHODS: We performed searches on 5 January 2015 in the following electronic databases: Cochrane Methodology Register, CENTRAL, MEDLINE, EMBASE, CINAHL, British Nursing Index, PsycINFO, ASSIA and Web of Science (SSCI, SCI-EXPANDED) from 1985 onwards. We checked the reference lists of all included studies and relevant review articles and did citation tracking through Web of Science for all included studies. SELECTION CRITERIA: We selected all studies that evaluated a strategy to identify and recruit participants for research via healthcare professionals and provided pre-post comparison data on recruitment rates. DATA COLLECTION AND ANALYSIS: Two review authors independently screened search results for potential eligibility, read full papers, applied the selection criteria and extracted data. We calculated risk ratios for each study to indicate the effect of each strategy. MAIN RESULTS: Eleven studies met our eligibility criteria and all were at medium or high risk of bias. Only five studies gave the total number of participants (totalling 7372 participants). Three studies used a randomised design, with the others using pre-post comparisons. Several different strategies were investigated. Four studies examined the impact of additional visits or information for the study site, with no increases in recruitment demonstrated. Increased recruitment rates were reported in two studies that used a dedicated clinical recruiter, and five studies that introduced an automated alert system for identifying eligible participants. The studies were embedded into trials evaluating care in oncology mainly but also in emergency departments, diabetes and lower back pain. AUTHORS' CONCLUSIONS: There is no strong evidence for any single strategy to help healthcare professionals to recruit participants in research studies. Additional visits or information did not appear to increase recruitment by healthcare professionals. The most promising strategies appear to be those with a dedicated resource (e.g. a clinical recruiter or automated alert system) for identifying suitable participants that reduced the demand on healthcare professionals, but these were assessed in studies at high risk of bias.

Sleep Quality and Recommended Levels of Physical Activity in Older People.

A minimum level of activity likely to improve sleep outcomes among older people has not previously been explored. In a representative UK sample aged 65+ (n = 926), cross-sectional regressions controlling for appropriate confounders showed that walking at or above the internationally recommended threshold of ≥ 150 min per week was significantly associated with a lower likelihood of reporting insomnia symptoms (OR = 0.67, 95% CI = 0.45-0.91, p < .05). At a 4-year follow-up (n = 577), higher walking levels at baseline significantly predicted a lower likelihood of reporting sleep onset (OR = 0.64, 95% CI = 0.42-0.97, p < .05) or sleep maintenance (OR = 0.63, 95% CI = 0.41-0.95, p < .05) problems. These results are consistent with the conclusion that current physical activity guidelines can support sleep quality in older adults.

Increased physical activity improves sleep and mood outcomes in inactive people with insomnia: a randomized controlled trial.

While high levels of activity and exercise training have been associated with improvements in sleep quality, minimum levels of activity likely to improve sleep outcomes have not been explored. A two-armed parallel randomized controlled trial (N=41; 30 females) was designed to assess whether increasing physical activity to the level recommended in public health guidelines can improve sleep quality among inactive adults meeting research diagnostic criteria for insomnia. The intervention consisted of a monitored program of ≥150 min of moderate- to vigorous-intensity physical activity per week, for 6 months. The principal end-point was the Insomnia Severity Index at 6 months post-baseline. Secondary outcomes included measures of mood, fatigue and daytime sleepiness. Activity and light exposure were monitored throughout the trial using accelerometry and actigraphy. At 6 months post-baseline, the physical activity group showed significantly reduced insomnia symptom severity (F(8,26) = 5.16, P = 0.03), with an average reduction of four points on the Insomnia Severity Index; and significantly reduced depression and anxiety scores (F(6,28) = 5.61, P = 0.02; and F(6,28) = 4.41, P = 0.05, respectively). All of the changes were independent of daily light exposure. Daytime fatigue showed no significant effect of the intervention (F(8,26) = 1.84, P = 0.18). Adherence and retention were high. Internationally recommended minimum levels of physical activity improve daytime and night-time symptoms of chronic insomnia independent of daily light exposure levels.

Facilitating participation in health-enhancing physical activity: a qualitative study of parkrun.

BACKGROUND: Public health guidelines emphasise the value of vigorous intensity physical activity, but participation levels are low. PURPOSE: This study was aimed at identifying factors contributing to initial and sustained engagement in parkrun in the UK, to inform the design of community-based interventions promoting health-enhancing physical activity. METHODS: Semi-structured interviews were conducted by telephone with 48 adult participants of parkrun, a national network of weekly, free, volunteer-led, timed 5 km runs in public spaces. The framework approach was used for thematic analysis of transcripts. RESULTS: Two overarching themes emerged: freedom and reciprocity. Freedom referred to the accessibility and inclusivity of events, both of which contributed to initial attendance and sustained involvement. Reciprocity related to the dual opportunity for personal gain and for helping others. Anticipation of fitness and health benefits were important for initial motivation. However, additional aspects motivating continued involvement included achievement of time or attendance goals, social cohesion, and contributing to the community. CONCLUSIONS: Specific features of the parkrun experience encouraged participation including the accessible, inclusive ethos, achievement opportunities, and inherent social support, along with the outdoor natural settings, and integrated volunteer system. The inclusion of these elements in community-based interventions may increase success in initiating and maintaining health-enhancing physical activity.

Effects of outdoor recreational physical challenges on general self-efficacy: A randomized controlled trial.

Outdoor programs involving recreational physical challenges are becoming increasingly popular for training and development purposes among adults, but rigorous studies investigating their effectiveness remain scarce. A randomized controlled trial was conducted to evaluate the effects of an outdoor adventure-based program on measures of self-efficacy, resilience, risk-taking propensity, and perceived stress. Participants were randomly assigned either to an intervention condition (half-day high ropes course) or a wait-list control group. Measures were taken at baseline and four days post-intervention and on the day to measure intervention perceptions. Significant increases in self-efficacy and risk-taking propensity were observed for the intervention arm compared to the control arm. Greater intervention engagement and affective valence ratings were associated with self-efficacy change. These findings highlight the practical relevance of adventure-based experiences for organizations and educational institutions seeking to enhance young adults' self-confidence. Additionally, they emphasize the importance of tailoring interventions to individual needs and ensuring positive participant experiences to achieve desired outcomes.

Effect of a Single Light-intensity Walking Session on Sleep Quality of Patients with Bladder Cancer: A Randomized Cross-Over Study.

OBJECTIVES: Exercise has been recommended to enhance sleep. However, there is a paucity of studies investigating the relationships between exercise and sleep problems in patients with bladder cancer. The authors explored the effects of a single bout of light-intensity walking on the sleep quality of patients with bladder cancer who have sleep disorders. DATA SOURCES: A total of 14 patients with bladder cancer with sleep disorders were recruited for this trial. The participants were randomly assigned to the walking or control condition in a cross-over design to explore the effects of a single light-intensity walking session on objectively measured sleep quality. A two-way repeated measures analysis of variance and a nonparametric permutation test were used to examine intervention effects. Twelve participants (85.7%) completed the trial. A significant group × time interaction for sleep latency (P = .023) was identified. The pairwise comparison showed significant results (P = .012) for the difference between the post-test sleep latency and the pre-test. No significant group × time interactions were observed for the remaining seven sleep parameters. Additionally, only the main effects of time on length of awakening and time in bed were significant (P < .001). CONCLUSION: A single bout of light-intensity walking has a positive effect on shortening the sleep latency of patients with bladder cancer who have sleep disorders. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses can encourage patients with bladder cancer to exercise, even light-intensity walking, which may improve sleep quality.

Exercise Promotion in Saudi Arabia: Understanding Personal, Environmental, and Social Determinants of Physical Activity Participation and Well-Being.

Physical activity promotion has received increasing attention globally due to the considerable benefits of regular activity for population health and well-being. In Saudi Arabia, government strategy explicitly aims to increase physical activity participation among residents. This study assessed the barriers to physical activity among the general Saudi population including any age and gender differences and examined the contribution of contextual factors and nature relatedness to health and well-being. A representative sample of 1046 Saudi adults (aged 18 years and above) completed an online survey that included four validated scales: the International Physical Activity Questionnaire-short form, the Exercise Benefits/Barriers Scale, the World Health Organization Five Well-Being Index and the Nature Relatedness Scale. Analyses indicated that young Saudi adults perceived more barriers than middle-aged and older adults, but few gender differences were observed. Furthermore, exercising outdoors, with other people and via sport predicted higher levels of mental well-being, as did nature relatedness. Therefore, developing a comprehensive strategy package that includes the development of outdoor environments for all age groups across regions and fostering a connection with nature may be particularly effective to improve the health and well-being of Saudi adults.

Predictors of follow-up exercise behavior 6 months after a randomized trial of supervised exercise training in lymphoma patients.

OBJECTIVES: Supervised exercise is beneficial for lymphoma patients, but it needs to be maintained to optimize long-term benefits. Here, we report the predictors of follow-up exercise behavior 6 months after a randomized controlled trial in lymphoma patients. METHODS: Lymphoma patients were randomly assigned to 12 weeks of supervised aerobic exercise (n = 60) or usual care (n = 62). At baseline and post-intervention, data were collected on demographic, medical, health-related fitness, quality of life, and motivational variables. At 6-month follow-up, participants were mailed a questionnaire that assessed exercise behavior and were categorized as meeting or not meeting public health exercise guidelines. RESULTS: At 6-month follow-up, 110 participants (90.2%) responded, of which 61 (55.5%) were meeting public health exercise guidelines. In univariate analyses, 16 variables predicted 6-month follow-up exercise behavior. In a stepwise regression analysis, five variables entered the model and explained 38% (p < 0.001) of the variance including the following: accepting a post-intervention exercise prescription (ß = 0.33; p < 0.001), achieving a higher peak power output at post-intervention (ß = 0.28; p = 0.001), experiencing a larger positive change in perceived behavioral control (ß = 0.18; p = 0.028), having Hodgkin lymphoma (ß = 0.19; p = 0.025), and having a stronger post-intervention intention (ß = 0.18; p = 0.034). CONCLUSION: Exercise behavior in lymphoma patients 6 months after a randomized trial was predicted by a wide range of demographic, medical, health-related fitness, quality of life, and motivational variables. These findings may help facilitate the uptake of self-directed exercise after short-term supervised exercise in lymphoma patients.

Relationships of leisure-time and non-leisure-time physical activity with depressive symptoms: a population-based study of Taiwanese older adults.

BACKGROUND: Limited research has explored the relationship between non-leisure-time physical activity (NLTPA), including domestic and work-related physical activities, with depressive symptoms. This study was designed to elucidate independent associations between leisure-time physical activity (LTPA), NLTPA, and specific parameters of physical activity (frequency, duration and intensity) with depressive symptoms in older adults. METHODS: A total of 2,727 persons aged ≥ 65 years participating in the 2005 Taiwan National Health Interview Survey were studied. Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale. Information regarding energy parameters for each type of LTPA and NLTPA during the past 2-week period was analyzed. After adjusting for socio-demographic variables, lifestyle behaviors and health status, multivariate logistic regression models were used to compute adjusted odds ratios (AOR) for LTPA and NLTPA for predicting depressive symptoms. RESULTS: LTPA but not NLTPA was significantly associated with depressive symptoms. Compared with participants expending 2000+ kcal/week through LTPA, the risk of experiencing depressive symptoms was significantly higher for those expending 1-999 kcal/week (AOR = 2.06, 95% CI: 1.25-3.39), and those who expending 0 kcal/week (AOR = 3.72, 95%CI: 2.28-6.06). Among the three parameters of LTPA (intensity, duration and frequency) examined, only intensity was independently associated with depressive symptoms. CONCLUSIONS: These findings imply that exercise recommendations for older adults should emphasize the importance of higher intensity activity, rather than frequency or duration, for improved mental well-being. However, well-designed prospective cohort studies or intervention trials are needed to confirm these findings.