Benefits Of Exercise Research Articles

Implementing exercise recommendations into clinical practice—new findings from mental health professionals' and patients' perspectives in a university psychiatric setting

IntroductionTo date, concrete recommendations for physical activity in psychiatric treatments are limited. Thus, we evaluated knowledge, barriers and beliefs associated with exercise prescription of mental health professionals (MHP) to people with mental illnesses. We aimed to identify patients' barriers to exercise participation and to work out options addressing these barriers.MethodsIn our cross-sectional and questionnaire-based investigation, we recruited medical, nursing and therapeutic staff and patients of a psychiatric clinic by email and personal contact. Questionnaires contained the German versions of The Exercise in Mental Illness Questionnaire (EMIQ-G) and the International Physical Activity Questionnaires (IPAQ).ResultsWe included 100 MHP and 100 patients. MHP had significantly more knowledge regarding positive effects of exercise on general health than patients. Exercise was prescribed mostly (48.4%) or always (37.9%) by MHP. The data showed missing education in exercise prescriptions and different recommendation behavior. Male patients seemed to experience exercise more often as a positive distraction and had lower physical health barriers than females.DiscussionPhysical activity needs to be more integrated in psychiatric treatments. Some strategies as educating MHP and patients regarding potential benefits of exercise via psychoeducative brochures and adapting recommendations to individual symptoms could improve exercise behavior in psychiatric patients.

Investigation of the Relationship Between Exercise Barriers, Quality of Life, Physical Performance, and Range of Motion in Patients with Total Hip Arthroplasty

Aim: This study aimed to demonstrate the relationship between exercise barriers-benefits with joint range of motion (ROM), quality of life, and physical performance in individuals with total hip arthroplasty (THA). Material and Method: A cross-sectional observational study was conducted with fifty older individuals with THA. Patients were evaluated with the 5-Times Sit and Stand Test (5TSTS), Exercise Benefits and Barriers Scale (EBBS), and EuroQol (EQ-5D-5L) Quality of Life Scale. In addition, the patient's active ROM was measured with a universal goniometer. Results: There was a significant low correlation between body mass index (BMI) and EBBS-Benefits sub-score (r=-0.286 p

The effect of forest-environment construction on the physical activity among Chinese adults

The Chinese government attaches great importance to the construction of the National Forest City (NFC), aiming at creating a pleasant living environment beneficial for people’s health and well-being. This study aimed to estimate the effect of the NFC policy on the frequency of physical activity (PA) for people in mainland China. Using the nationally representative data from the China Family Panel Studies in 2010 and its follow-up in 2018, 17 704 participants aged 18 and older were analyzed in our study. We employed the two-way fixed estimator in the difference in difference setting to analyze the PA of the adults in the cohort with different development levels of the forest-environment construction measured by the number of NFCs, and explore the relative differences before and after the construction of NFC. Subgroup analysis of age group, gender and living areas and a series of robustness tests were further conducted. The mean age of 17 704 participants in 2010 was (45.03 ± 13.67) years old, 51.74% of which were female and 48.26% were male. DID results showed that after the construction of NFC, the frequency of PA increased by 1.35 (β = 1.35, 95% CI:0.73–1.98) per week compared to those in provinces without NFC after adjusting covariates. And the improving effect of the forest-environment construction on PA frequency was intensified in middle-aged and older adults aged 45 and above (β = 2.03, 95% CI:1.09–2.96), males (β = 1.26, 95% CI:0.39–2.12) and females (β = 1.49, 95% CI:0.58–2.40) and those living in urban areas (β = 1.29, 95% CI:0.57–2.00). Our findings showed that the forest-environment construction under the NFC strategy has a positive role in the PA of older adults, indicating the health-promoting effects of the national green low-carbon environmental strategy. Considering the heterogeneity, it is essential to promote the benefits of green exercise for young and rural adults.

Exercise-induced cortical disinhibition mediates the relationship between fitness and memory in older adults.

Regular exercise benefits learning and memory in older adults, but the neural mechanisms mediating these effects remain unclear. Evidence in young adults indicates that acute exercise creates a favourable environment for synaptic plasticity by enhancing cortical disinhibition. As such, we investigated whether plasticity-related disinhibition mediated the relationship between cardiorespiratory fitness and memory function in healthy older adults (n=16, mean age=66.06). Participants completed a graded maximal exercise test and assessments of visual and verbal memory, followed by two counterbalanced sessions involving 20min of either high-intensity interval training exercise or rest. Disinhibition was measured following intermittent theta burst stimulation via paired-pulse transcranial magnetic stimulation. In line with our hypotheses, we observed a positive correlation between cardiorespiratory fitness and verbal memory, which was mediated by plasticity-related cortical disinhibition. Our novel finding implicates cortical disinhibition as a mechanism through which the effects of acute bouts of exercise may translate to improved memory in older adults. This finding extends current understanding of the physiological mechanisms underlying the positive influence of cardiorespiratory fitness for memory function in older adults, and further highlights the importance of promoting exercise engagement to maintain cognitive health in later life. KEY POINTS: There are well established benefits of regular exercise for memory function in older adults, but the mechanisms are unclear. Cortical disinhibition is important for laying down new memories, and is enhanced following acute exercise in young adults, suggesting it is a potential mechanism underlying these benefits in ageing. Older adults completed a fitness test and assessments of memory, followed by two sessions involving either 20min of exercise or rest. Disinhibition was measured following intermittent theta burst stimulation via paired-pulse transcranial magnetic stimulation. Cardiorespiratory fitness was positively associated with memory performance. Higher fitness was associated with enhanced cortical disinhibition following acute exercise. Cortical disinhibition completely mediated the relationship between fitness and memory. This novel finding provides a mechanistic account for the positive influence of cardiorespiratory fitness on memory in later life, and emphasises the importance of regular exercise for cognitive health in older populations.

Acute Vigorous Exercise Decreases Subsequent Non-Exercise Physical Activity and Body Temperature Linked to Weight Gain.

Exercise benefits the body and mind, but its weight loss effect is less than generally expected. Although this phenomenon is likely due to an exercise intensity-dependent decrease in non-exercise physical activity (NEPA), resulting in a decrease in non-exercise activity thermogenesis, the underlying mechanisms and effects of exercise intensity remain unknown. Here we show that acute vigorous exercise decreases subsequent NEPA and body temperature (BT) in association with body weight gain. Adult male C57BL/6 J mice were categorized into three groups: sedentary, moderate exercise, and vigorous exercise, with exercise groups undergoing a 30 min treadmill session. Using an intraperitoneally implanted activity monitor, NEPA and BT were monitored for two days before and three days after exercise. The daily synchrony between NEPA and BT was evaluated using a cross-correlation function. Plasma corticosterone was also detected 6 and 24 h after exercise. Notably, Only the vigorous exercise group exhibited a decline in both NEPA and BT, resulting in body weight gain the following day, despite no observed changes in food intake. Furthermore, vigorous exercise induces a distinct delay in the daily dynamics of NEPA compared to BT. A positive correlation was observed between plasma corticosterone levels and changes in NEPA levels before and after exercise across all exercise groups. Our findings provide evidence for vigorous exercise-specific reduction in subsequent NEPA, BT, and their synchrony linked to weight gain, likely due to the disturbed circadian rhythm of corticosterone. This is an initial investigation redefining the significance of exercise intensity in beneficial effects beyond the energy expenditure of the exercise itself.

Psychometric validation of the short version of the Information Needs in Cardiac Rehabilitation scale through a first global assessment.

Tailored education is recommended for cardiac patients, yet little is known about information needs in areas of the world where it is most needed. This study aims to assess (i) the measurement properties of the Information Needs in Cardiac Rehabilitation short version (INCR-S) scale and (ii) patient's information needs globally. In this cross-sectional study, English, simplified Chinese, Portuguese, or Korean versions of the INCR-S were administered to in- or out-patients via Qualtrics (January 2022-November 2023). Members of the International Council of Cardiovascular Prevention and Rehabilitation community facilitated recruitment. Importance and knowledge sufficiency of 36 items were rated. Links to evidence-based lay education were provided where warranted. A total of 1601 patients from 19 middle- and high-income countries across the world participated. Structural validity was supported upon factor analysis, with five subscales extracted: symptom response/medication, heart diseases/diagnostic tests/treatments, exercise and return-to-life roles/programmes to support, risk factors, and healthy eating/psychosocial management. Cronbach's alpha was 0.97. Construct validity was supported through significantly higher knowledge sufficiency ratings for all items and information importance ratings for all subscales in cardiac rehabilitation (CR) enrolees vs. non-enrolees (all P < 0.001). All items were rated as very important-particularly regarding cardiac events, nutrition, exercise benefits, medications, symptom response, risk factor control, and CR-but more so in high-income countries in the Americas and Western Pacific. Knowledge sufficiency ranged from 30.0 to 67.4%, varying by region and income class. Ratings were highest for medications and lowest for support groups, resistance training, and alternative medicine. Identification of information needs using the valid and reliable INCR-S can inform educational approaches to optimize patients' health outcomes across the globe.

Study protocol to examine the effects of acute exercise on motor learning and brain activity in children with developmental coordination disorder (ExLe-Brain-DCD)

Introduction Developmental coordination disorder (DCD) is one of the most prevalent pediatric chronic conditions. Without proper intervention, significant delays in motor skill performance and learning may persist until adulthood. Moderate-to-vigorous physical exercise has been proven to improve motor learning (adaptation and consolidation) in children with or without disorders. However, the effect of a short bout of physical exercise on motor adaptation and consolidation in children with DCD has not been examined. Furthermore, the role of perceptual-motor integration and attention as mediators of learning has not been examined via neuroimaging in this population. Objectives Therefore, the primary aims of this project will be to compare children with and without DCD to (a) examine the effect of acute exercise on motor learning (adaptation and consolidation) while performing a rotational visuo-motor adaptation task (rVMA), and (b) explore cortical activation in the dorsolateral- and ventrolateral-prefrontal cortex areas while learning the rVMA task under rest or post-exercise conditions. Methods One hundred twenty children will be recruited (60 DCD, 60 controls) and within-cohort randomly assigned to either exercise (13-minute shuttle run task) or rest prior to performing the rVMA task. Adaptation and consolidation will be evaluated via two error variables and three retention tests (1h, 24h and 7 days post adaptation). Cortical activation will be registered via functional near-infrared spectroscopy (fNIRS) during the baseline, adaptation, and consolidation. Discussion We expect to find exercise benefits on motor learning and attention so that children with DCD profiles will be closer to those of children with typical development. The results of this project will provide further evidence to: (a) better characterize children with DCD for the design of educational materials, and (b) establish acute exercise as a potential intervention to improve motor learning and attention.

Intermittent Hypoxic Training Increases and Prolongs Exercise Benefits in Adult Untrained Women.

Alba Camacho-Cardenosa, Marta Camacho-Cardenosa, Johannes Burtscher, Pedro R. Olivares, Guillermo Olcina, and Javier Brazo-Sayavera. Intermittent hypoxic training increases and prolongs exercise benefits in adult untrained women. High Alt Med Biol. 00:00-00, 2024. Background: Exercising in hypoxia may confer multiple health benefits, but the evidence for specific benefits is scarce. Methods: We investigated effects of intermittent hypoxic training (IHT) on the quality of life and functional fitness of healthy adult women, in a double-blind, randomized, placebo-controlled study. Subjects performed 36 sessions of IHT (experimental group, n = 41; fraction of inspired oxygen [FIO2]: 0.17) or the same training in normoxia (control group, n = 41; FIO2: 0.21). Health-related quality of life, fitness tests, and hemoglobin levels were assessed before (T1), directly after (T2), and 4 weeks after (T3) cessation. Results: At T2, upper body strength (+14.96%), lower body strength (+26.20%), and agility (-4.94%) increased significantly in the experimental group compared to baseline but not in controls.The experimental group improved lower body strength more (by 9.85%) than controls at T2 and performed significantly better in walking (by 2.92%) and upper body strength testing (by 16.03%), and agility (by 4.54%) at T3. Perceived general health and vitality was significantly greater in the experimental group at T2 and T3 compared with T1. None of these improvements were observed in the control group. Conclusions: IHT is a promising strategy to induce long-lasting fitness benefits in healthy adult women.

A co-designed mixed methods study on community-based gym exercise for non-ambulant adults with childhood onset disability

Purpose Explore community-based gym exercise for non-ambulant adults with childhood-onset disability. Materials and methods Non-ambulant adults with childhood-onset disability participated in four, weekly gym sessions co-facilitated by physiotherapists and exercise professionals. Practicalities of participating in the sessions were recorded via uptake and attrition, weekly surveys, and focus groups. Perspectives of those who designed/delivered the study were gathered via weekly debrief meetings. Quantitative data were analysed descriptively, qualitative data were analysed thematically. Results Ten non-ambulant adults with childhood-onset disability participated; 70% completed all exercise sessions. Focus groups identified three themes. “I wouldn’t be able to exercise…there’s no option for a community-based setting” described the lack of opportunities for exercise in gyms. “You don’t realise the benefit of coming here” highlighted benefits of exercise. “We can do better” had two sub-themes: problem solving and ingredients for community-based gym exercise. Weekly feedback and debrief meetings identified practicalities related to equipment, exercises, and collaborative working between facilitators. Conclusions Whilst there is an interest in community-based gym exercise for non-ambulant adults with childhood-onset disability, there remains a lack of inclusive gyms. Co-design of inclusive gym guidelines and condition-specific physical activity referral scheme may enhance opportunities for participation in gym exercise for adults with childhood-onset disability.

The effects of neck exercise in comparison to passive or no intervention on quantitative sensory testing measurements in adults with chronic neck pain: A systematic review.

Previous systematic reviews have identified the benefits of exercise for chronic neck pain on subjective reports of pain, but not with objective measures such as quantitative sensory testing (QST). A systematic review was conducted to identify the effects of neck specific exercise on QST measures in adults with chronic neck pain to synthesise existing literature and provide clinical recommendations. The study protocol was registered prospectively with PROSPERO (PROSPERO CRD42021297383). For both randomised and non-randomised trials, the following databases and trial registries were searched: AMED, CINAHL, Embase, Google Scholar, Medline, PEDro, PubMed, Scopus, SPORTDiscus, Science Citation Index and Social Science Citation Index from Web of Science Core Collection, clinicaltrials.gov, GreyOpen, and ISRCTN registry. These searches were conducted from inception to February 2022 and were updated until September 2023. Reference lists of eligible studies were screened. Study selection was performed independently by two reviewers, with data extraction and quality appraisal completed by one reviewer and independently ratified by a second reviewer. Due to high heterogeneity, narrative synthesis was performed with results grouped by exercise type. Three trials were included. Risk of bias was rated as moderate and the certainty of evidence as low or moderate for all studies. All exercise groups demonstrated statistically significant improvement at an intermediate-term follow-up, with progressive resistance training combined with graded physical training demonstrating the highest certainty of evidence. Fixed resistance training demonstrated statistically significant improvement in QST measures at a short-term assessment. Fixed resistance training is effective for short-term changes in pain sensitivity based on low-quality evidence, whilst moderate-quality evidence supports progressive resistance training combined with graded physical training for intermediate-term changes in pain sensitivity.

Abstract PO3-27-06: Investigating The Association Between Exercise and Quality of Life Among Breast Cancer Survivors in The Black Women’s Health Study

Abstract Background: Black breast cancer survivors (BCS) experience suboptimal quality of life (QoL) compared to White BCS. QoL is a multi-dimensional concept focused on different aspects of wellbeing. Exercise (a subset of physical activity) has been shown to improve QoL in cancer survivors. However, there is limited evidence on the benefits of exercise in relation to QoL among Black BCS and warrants further investigation. Purpose: To examine the association between exercise intensity (e.g., moderate activity) and multiple domains of QoL (e.g., physical wellbeing) among BCS in the Black Women’s Health Study (BWHS). Methods: The BWHS is the largest prospective cohort study following 59,000 Black women in the United States since 1995. Self-reported questionnaires are distributed every two years to obtain current health information, including lifestyle factors and disease occurrence. The 2019 survey data, completed by 3,608 Black BCS, were used to address the primary aim. Of the 3,608 Black BCS, 1,085 females were eligible to participate in this cross-sectional study. The primary predictors were moderate and vigorous exercise intensity. The outcomes (physical, mental, functional, social functioning, and financial wellbeing) were categorized as excellent, very good or good, and fair or poor health. The covariates were marital status, occupation, education, age, body mass index, time since diagnosis, breast cancer stage, and general health. Adjusted multinomial logistic regressions were performed to estimate the odds ratios and 95% confidence intervals for the associations with each predictor. Multiple imputation was used to address missing data. Results: At baseline, the majority of the BCS were 64 years or younger (99%), premenopausal (69%), employed (95%), and had more than a high school degree (86%). About 50% of the participants were married or living as married. There were significant and positive associations between exercise intensity and QoL (p&amp;lt; .05). Compared to BCS who reported little or no exercise (&amp;lt; 60 minutes/week), those who reported at least 60 minutes/week of vigorous exercise had greater odds of experiencing excellent QoL including financial wellbeing (OR=1.70, 95% CI: 1.08-2.67), functional wellbeing (OR=3.64, 95% CI: 1.56-8.49), social functioning (OR=4.56, 95% CI: 2.42-8.60), and physical wellbeing (OR=4.26, 95% CI: 2.12-8.52). Similarly, BCS who engaged in at least 150 minutes of moderate exercise/week had increased odds of reporting excellent social functioning (OR=2.59, 95% CI: 1.41-4.76) and functional wellbeing (OR=4.40, 95% CI: 1.89-10.24) than those who engaged in less than 150 minutes/week of moderate exercise. Conclusions: Black BCS who engage in certain durations (e.g., 150 minutes/week) and exercise intensities (e.g., moderate activity) tend to have better QoL. These findings may help to build upon the relevance of exercise in the context of supportive care for racial and ethnic minority cancer survivors and encourage healthcare professionals to assess the frequency, intensity, time, and type of exercise during routine or follow-up care. Future longitudinal studies are needed to examine the proposed associations among Black BCS and to compare the current study findings. Citation Format: Natasha Burse, Chris Wiesen, Todd Schwartz, Shawn Kneipp, Ashley Leak Bryant. Investigating The Association Between Exercise and Quality of Life Among Breast Cancer Survivors in The Black Women’s Health Study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-27-06.

Mechanisms and benefits of cardiac rehabilitation in individuals with stroke: emerging role of its impact on improving cardiovascular and neurovascular health.

Human and animal studies have demonstrated the mechanisms and benefits of aerobic exercise for both cardiovascular and neurovascular health. Aerobic exercise induces neuroplasticity and neurophysiologic reorganization of brain networks, improves cerebral blood flow, and increases whole-body VO2peak (peak oxygen consumption). The effectiveness of a structured cardiac rehabilitation (CR) program is well established and a vital part of the continuum of care for people with cardiovascular disease. Individuals post stroke exhibit decreased cardiovascular capacity which impacts their neurologic recovery and extends disability. Stroke survivors share the same risk factors as patients with cardiac disease and can therefore benefit significantly from a comprehensive CR program in addition to neurorehabilitation to address their cardiovascular health. The inclusion of individuals with stroke into a CR program, with appropriate adaptations, can significantly improve their cardiovascular health, promote functional recovery, and reduce future cardiovascular and cerebrovascular events thereby reducing the economic burden of stroke.

Train in Pain: A Review of Exercise Benefits and Application for Individuals With Musculoskeletal Pain

ABSTRACT Exercise is a safe and recommended treatment for individuals experiencing chronic musculoskeletal pain. After receiving medical clearance, strength and conditioning practitioners and clinicians may prescribe exercise for clients with comorbid pain conditions, representing a unique challenge in determining the appropriate exercise prescription. Although exercise is a recommended intervention for pain, pain can also act as a key barrier to exercise participation because of associated increases in pain intensity or location during activity. In addition, biopsychosocial factors integral to the pain experience may affect response to exercise and should be considered when developing an exercise plan of care for this population. Strength and conditioning professionals may also consider the role of contextual factors in the delivery of exercise, such as expectations for pain relief and therapeutic alliance. This narrative review provides an overview of the current evidence regarding exercise for individuals with musculoskeletal pain.

Exploring Temporal and Intensity Effects of Resistance Exercise on Inhibition: A Four-Arm Crossover Randomized Controlled Trial.

Given the recognized benefits of resistance exercise on both physical and cognitive domains, elucidating how to maximize its benefit is pivotal. This study aims to evaluate these effects in terms of their timing and intensity on cognitive performance. This was a four-arm, crossover randomized controlled trial. Healthy college-aged male adults with recreational resistance training experience participated in this study. Participants completed three separate sessions of circuit barbell resistance exercises, including back squat, press, and deadlift. Each session corresponded to a different intensity level: 65% 1RM, 72% 1RM, and 78% 1RM. Each session consisted of 5 repetitions across 3 sets, with a 3-minute rest between exercises and sets. For the control condition, participants engaged in a reading activity for the same duration. The subjective exercise intensity was measured using the rating of perceived exertion and repetitions in reserve immediately after each set. The primary outcome was the temporal effect of acute resistance exercise on inhibition, measured by the Stroop color-word task. The secondary outcome was the effect of different intensities. 30 out of 31 recruited participants were randomized, with 28 completing all experiment sessions. Using repeated measures correlation (rrm), a linear temporal effect was observed on accuracy-adjusted congruent reaction time: rrm = 0.114, p = 0.045, 95% CI [0.002, 0.223]. Participants responded 19.1 ms faster than the control condition approximately 10 minutes post-intervention. This advantage, however, gradually declined at a rate of 4.3 ms every 15 minutes between 10-55 minutes post-intervention. In contrast, no significant effects were detected for incongruent trials or the Stroop effect. When examining the linear relationship across exercise intensities, no significant correlations emerged for congruent trials. Resistance exercise demonstrates a temporal effect on cognitive performance, particularly in reaction speed for congruent trials, without significant changes in incongruent trials or the overall Stroop effect. The findings highlight the importance of timing in leveraging the cognitive benefits of acute resistance exercise, suggesting a window of enhanced cognitive performance following exercise. However, this study has a limitation regarding Type I error inflation, due to multiple measurements of cognitive performance being undertaken, suggesting caution in interpreting the observed temporal effects. Practically, scheduling crucial, cognitively demanding tasks within 10-60 minutes post-exercise may maximize benefits, as positive effects diminish after this period.

Using Semi-Occluded Vocal Tract Exercises as a Vocal Tract "Reset"

Abstract: For decades, the benefits of semi-occluded vocal tract exercises (SOVTEs) in voice training and rehabilitation have been extolled, most especially how SOVTEs impact phonation. However, a second important, yet neglected aspect of SOVTEs identified in numerous research studies is how they affect the shape of the vocal tract. This article highlights how SOVTEs can passively expand the airway, alleviating unintended constrictions, freeing singers from attempting to "open the throat" through direct muscular activation. This expansion can serve as a vocal tract "reset," allowing singers to selectively shape the vocal tract, facilitatating the wide-narrow contrasts needed for singing in a variety of musical genres.

Therapeutic benefit of laughter yoga and deep breathing exercises with oral doses of Withania somnifera root extracts in Parkinson's disease patients.

Therapeutic benefit of laughter yoga and deep breathing exercises with oral doses of Withania somnifera root extracts in Parkinson's disease patients.

ADHERENCE TO PRESCRIBED EXERCISE AND CLINICAL OUTCOMES IN PEOPLE WITH CHRONIC NONSPECIFIC LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS

BACKGROUND Exercise is widely accepted as a first-line treatment for chronic non-specific low back pain (CNSLBP). However, the benefits of exercise diminish over time, as does adherence to exercise. It is unclear whether greater exercise adherence is associated with improvements in pain intensity (PI) and functional limitation (FL). We explored the relationship between exercise adherence and patient-reported outcomes in people with CNSLBP. METHODS We conducted a secondary analysis of the Cochrane systematic review, ‘Exercise therapy for chronic low back pain’, using a subset of 24 trials that measured exercise adherence compared to usual care. Random-effects meta-analysis was performed in R for PI and FL at the closest time point post-intervention. We used predefined subgroups of exercise adherence of ‘Good’ (90-100%), ‘Moderate’ (70-89%), or ‘Poor’ (14-69%) adherence. We used the risk of bias judgements provided by Cochrane. RESULTS All trials included were deemed low risk of bias. Compared to usual care, ‘Good’ adherence was associated with reduced PI by 17.83 points on a 100-point scale (95% CI -26.23 to -9.43; I2 = 81.7%) and FL by 9.69 points on a 100-point scale (95% CI -12.64 to -6.74; I2 = 18.9%). ‘Moderate’ adherence was associated with reduced PI by 6.93 points (95% CI -10.43 to -3.44; I2 = 18.3%) and FL by 3.80 points (95% CI -6.10 to -1.49; I2 = 0%). ‘Low’ adherence was associated with reduced PI by 7.50 points (95% CI -19.83 to -4.84; I2 = 89.7%) and FL by 3.35 points (95% CI -10.45 to -3.74; I2 = 82.7%). CONCLUSIONS Greater adherence to exercise is associated with greater improvements in PI and FL in adults with CNSLBP. Further research is needed to understand the causal effect of adherence on patient-reported outcomes. Better reporting of this potentially important exercise parameter in randomised trials is also needed.

EFFECT OF PRE-EXERCISE EDUCATION ON PAIN RESPONSES TO A SINGLE EXERCISE SESSION IN PEOPLE WITH KNEE OSTEOARTHRITIS: A RANDOMISED CONTROLLED TRIAL

INTRODUCTION &amp; AIMS In pain-free individuals, pre-exercise education about exercise-induced hypoalgesia (EIH) reduces experimental pain following a single exercise session. However, its effect in people with chronic pain remains unexplored. This study aimed to determine if EIH education influences pain during and following exercise in people with knee osteoarthritis (OA). METHODS Participants were randomised into an intervention group (INT) who received 15-minutes of explicit EIH education or a control group (CON) who received 15-minutes of general information about knee OA. Following education, participants’ knowledge and beliefs about exercise and pain were assessed using five questions scored on a Likert scale. Participants then undertook a single 15-minute, low-moderate intensity home-based strength exercise session delivered online. Pain was assessed on a 0-10 scale before, during, and immediately following exercise. RESULTS 40 people with knee OA (67 ± 10.8 years old; BMI: 27.6 ± 6.5) completed the study. Education did not significantly influence participants’ knowledge or beliefs about exercise and pain. Pain reduced during exercise in both groups (mean difference [95% CI]; INT = -0.50 [-1.39 to 0.39]; CON = -1.58 [-2.55 to -0.62]), with a moderate effect (Cohen’s d) in favour of CON (-1.08 [-2.35 to 0.18], d = 0.54). Pain also reduced following exercise in both groups (INT = -0.95 [-1.77 to -0.12]; CON = -0.98 [-1.74 to -0.22]), with no difference between groups (0.03 [-1.06 to 1.12], d = 0.02). CONCLUSION A single exercise session reduces pain in people with knee OA, but this was not influenced by pre-exercise education about EIH. Given the chronic nature of OA pain, any intervention that can potentiate the benefits of exercise, even if marginal, may be beneficial. Therefore, further research is needed to understand if and how EIH can be modulated in people with knee OA.

CALL FOR ACTION: GUIDELINES FOR PHYSICAL ACTIVITY BASED INTERVENTIONS IN ADDICTION

With the evidence supporting the extensive benefits of exercise for people experiencing substance use disorders (SUD) rapidly growing, the demand for clinical exercise interventions in SUD services is expanding through Australia. However, at present there are no clear safety considerations or guidelines specific to SUD, leaving exercise physiologists falling to broader guidelines when working with SUD, often using those developed for severe mental illness (SMI). When working with SUD, many considerations differ to those being treated with SMI. This includes differences in the common comorbidities seen in SUD compared to SMI, as well as considerations relating to withdrawal and craving management. Furthermore, the different impacts and considerations of each substance class in relation to exercise needs to be elucidated. Therefore, standardised safety considerations and contraindications need to be developed to allow Exercise Physiologists to provide safe and effective interventions for those in the withdrawal and recovery phase of SUD. This call for action proposes the development of a multidisciplinary informed clinical exercise guideline for safety protocols, considerations and contraindications for physical activity-based interventions within substance use disorder treatment.

Exercise does not cause post-exertional malaise in Veterans with Gulf War Illness: A randomized, controlled, dose–response, crossover study

Chronic multisymptom illnesses (CMI) such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, long-COVID, and Gulf War Illness (GWI) are associated with an elevated risk of post-exertional malaise (PEM), an acute exacerbation of symptoms and other related outcomes following exercise. These individuals may benefit from personalized exercise prescriptions which prioritize risk minimization, necessitating a better understanding of dose–response effects of exercise intensity on PEM. MethodsVeterans with GWI (n = 40) completed a randomized controlled crossover experiment comparing 20 min of seated rest to light-, moderate-, and vigorous-intensity cycling conditions over four separate study visits. Symptoms, pain sensitivity, cognitive performance, inflammatory markers (C-reactive protein and plasma cytokines) were measured before and within 1 h after exercise and seated rest. Physical activity behavior was measured ≥ 7 days following each study visit via actigraphy. Linear mixed effects regression models tested the central hypothesis that higher intensity exercise would elicit greater exacerbation of negative outcomes, as indicated by a significant condition-by-time interaction for symptom, pain sensitivity, cognitive performance, and inflammatory marker models and a significant main effect of condition for physical activity models. ResultsSignificant condition-by-time interactions were not observed for primary or secondary measures of symptoms, pain sensitivity, cognitive performance, and a majority of inflammatory markers. Similarly, a significant effect of condition was not observed for primary or secondary measures of physical activity. ConclusionsUndesirable effects such as symptom exacerbation were observed for some participants, but the group-level risk of PEM following light-, moderate-, or vigorous-intensity exercise was no greater than seated rest. These findings challenge several prior views about PEM and lend support to a broader body of literature showing that the benefits of exercise outweigh the risks.