Exercise Behavior Change Research Articles

Comparing exercise determinants between Black and White older adults with heart failure

BackgroundHeart Failure is a leading cause of mortality among older adults. Engaging in regular exercise at moderate-to-vigorous intensity has been shown to improve survival rates. Theory-informed methodologies have been recommended to promote exercise, but limited application of theoretical framework has been conducted for understanding racial disparities among older adults with heart failure. This study aimed to use the Health Belief Model to compare exercise behavior determinants between Black and White older adults diagnosed with heart failure.MethodsThe HF-ACTION Trial is a multi-site study designed to promote exercise among individuals with heart failure that randomized participants to an experimental (three months of group exercise sessions followed by home-based training) or control arm. The present study used structural equation modeling to test the change in Health Belief Model constructs and exercise behavior across 12 months among older adults.ResultsParticipants (n = 671) were older adults, 72.28 (SD = 5.41) years old, (Black: n = 230; White, n = 441) diagnosed with heart failure and reduced ejection fraction. The model found perceived benefits, self-efficacy, perceived threats, and perceived barriers to predict exercise behavior among Black and White older adults. However, among these constructs, only perceived benefits and self-efficacy were facilitated via intervention for both races. Additionally, the intervention was effective for addressing perceived barriers to exercise only among White participants. Finally, the intervention did not result in a change of perceived threats for both races.ConclusionsAmong health belief model constructs, perceived threats and barriers were not facilitated for both races in the experimental arm, and the intervention did not resolve barriers among Black older adults. Racial differences need to be considered when designing interventions for clinical populations as future studies are warranted to address barriers to exercise among Black older adults with heart failure.

Exercise Behavior Changes And Qualitative Factors In Elderly Women Two Years Post Resistance Exercise Classes

Exercise Behavior Changes And Qualitative Factors In Elderly Women Two Years Post Resistance Exercise Classes

Telemedicine-based inspiratory muscle training and walking promotion with lung cancer survivors following curative intent therapy: a parallel-group pilot randomized trial

PurposeFollowing curative-intent therapy of lung cancer, many survivors experience dyspnea and physical inactivity. We investigated the feasibility, acceptability, safety, and potential efficacy of inspiratory muscle training (IMT) and walking promotion to disrupt a postulated “dyspnea-inactivity” spiral.MethodsBetween January and December 2022, we recruited lung cancer survivors from Kaiser Permanente Colorado who completed curative-intent therapy within 1–6 months into a phase-IIb, parallel-group, pilot randomized trial (1:1 allocation). The 12-week intervention, delivered via telemedicine, consisted of exercise training (IMT + walking), education, and behavior change support. Control participants received educational materials on general exercise. We determined feasibility a priori: enrollment of ≥ 20% eligible patients, ≥ 75% retention, study measure completion, and adherence. We assessed acceptability using the Telemedicine-Satisfaction-and-Usefulness-Questionnaire and safety events that included emergency department visits or hospitalizations. Patient-centered outcome measures (PCOMs) included dyspnea (University-of-California-San-Diego-Shortness-of-Breath-Questionnaire), physical activity (activPAL™ steps/day), functional exercise capacity (mobile-based-six-minute-walk-test), and health-related quality of life (HRQL, St.-George’s-Respiratory-Questionnaire). We used linear mixed-effects models to assess potential efficacy.ResultsWe screened 751 patients, identified 124 eligible, and consented 31 (25%) participants. Among 28 participants randomized (14/group), 22 (11/group) completed the study (79% retention). Intervention participants returned > 90% of self-reported activity logs, completed > 90% of PCOMs, and attended > 90% of tele-visits; 75% of participants performed IMT at the recommended dose. Participants had high satisfaction with tele-visits and found the intervention useful. There was no statistically significant difference in safety events between groups. Compared to control participants from baseline to follow-up, intervention participants had statistically significant and clinically meaningful improved HRQL (SGRQ total, symptom, and impact scores) (standardized effect size: -1.03 to -1.30).ConclusionsAmong lung cancer survivors following curative-intent therapy, telemedicine-based IMT + walking was feasible, acceptable, safe, and had potential to disrupt the “dyspnea-inactivity” spiral. Future efficacy/effectiveness trials are warranted and should incorporate IMT and walking promotion to improve HRQL.Trial Registration: ClinicalTrials.gov NCT05059132.

Feasibility Meets Implementation Science: Narrowing the Research-To-Practice Gap for Exercise Activity in Multiple Sclerosis

Background There is a need to identify why multiple sclerosis exercise research is not translating into real-world participation. To lay the foundations of strong clinical research, considering the translational element of implementation science at the feasibility phase of a trial is vital. Methods Document analysis was used to examine document sources on exercise activity interventions designed for people living with multiple sclerosis. Document sources focused on multiple sclerosis research that incorporated exercise prescription elements and behaviour change and were feasibility studies incorporating aspects of implementation science. Results Implementation science should come much earlier than the efficacy or effectiveness research pipeline. An alternate view is outlined where feasibility and implementation science should meet based on case examples that have not yet shown strong efficacy or effectiveness. Findings from our key themes indicate a need for a cyclical iterative approach to the translational process. Multiple aspects of feasibility and how it can be assessed using an implementation science lens to support more successful interventions are provided. The determination of feasibility in behaviour change should involve implementation science as feasibility is drawn on for theory development, optimising the intervention design and quality of implementation strategies, and identifying those delivering the intervention before conducting efficacy and effectiveness research. Conclusions Document analysis methodology is underused in qualitative research and was appropriate to use as it was a very resource, time-efficient and an unobtrusive process that could track change and development to explore the integration of implementation science at the feasibility phase, with the findings indicating the earlier implementation science is introduced into multiple sclerosis exercise interventions the better.

Transtheoretical model of behavior change and motivational profiles among University of Baguio students using fitness applications

Introduction: This study aims to determine how the motivational profile affects the behavior change of fitness application users in terms of adopting regular physical activity. Methods: The study utilized a descriptive correlation method design to determine the variations of the motivational regulations of fitness application users. A total of 204 college students were respondents, wherein 57 were male, and 147 were female. Respondents were of legal age, undergraduates, and have used or are using physical fitness applications. Respondents answered the questionnaire online in their free time. Data collected were subjected to tabulation, averaging, and Fisher’s Exact Test. Results: The study found no noticeable difference between genders in terms of the motivational regulations comprising their motivational profile and the distribution of users along the stages of the Transtheoretical Model of Behavior Change. Intrinsic and identified regulations were found to be high amongst the respondents (Intrinsic = 5.62; Identified = 5.31), while their external regulation was low (External = 2.51). Data suggest that the motivational profile of fitness application users is found to be autonomous. Moreover, there is a highly significant relationship between identified regulation and exercise behavior change along the preparation or action stages (p = 0.001). A significant relationship between intrinsic regulation and the preparation or action stage of exercise behavior change is also established (Fisher’s Exact Test, p = 0.016). Discussion: The motivational profiles of fitness application users are favorable in adopting regular physical activity. Promotion and encouragement of the established autonomous motivational profile can help people seriously consider starting exercise as it increases one’s likelihood of sustaining interest and motivation to achieve and maintain higher stages of exercise behavior.

Dynamic changes in clinical biomarkers of cardiometabolic diseases by changes in exercise behavior, and network comparisons: a community-based prospective cohort study in Korea.

Lifestyles, including exercise behaviors, change continually over time. This study examined whether the clinical biomarkers (CBs) related to cardiometabolic diseases (CMDs) and their relationships differed with changes in exercise behavior. The Ansan-Ansung cohort study (third to fifth phases; n=2,668) was used in the current study. Regular exercise behavior was investigated using a yes/no questionnaire. Changes in exercise behavior were classified into 4 groups: Y-N, N-Y, Y-Y, and N-N, with "Y" indicating that a participant regularly engaged in exercise at a given time point and "N" indicating that he or she did not. Fourteen CBs related to CMDs were used, and the associations between changes in exercise behavior and relative changes in CBs were examined. CB networks were constructed and topological comparisons were conducted. Y-N was associated with increases in fasting blood sugar and insulin levels in men, and increased total cholesterol and low-density lipoprotein cholesterol levels in women. Meanwhile, N-Y was inversely associated with body fat percentage, visceral fat percentage, fasting insulin, and triglyceride level. Waist circumference played a central role in most networks. In men, more edges were found in the N-Y and Y-Y groups than in the N-N and Y-N groups, whereas women in the N-Y and Y-Y groups had more edges than those in the N-N and Y-N groups. Consistent exercise or starting to engage in regular exercise had favorable effects on CBs related to CMDs, although their network patterns differed between the sexes.

THE ROLE OF THE EXERCISE PROFESSIONAL IN THE SUPERVISED VERSUS TELEREHABILITATION EXERCISE PROGRAMS FOR MULTIPLE SCLEROSIS (STEP FOR MS) TRIAL

https://youtu.be/itqMuZmn70Q BACKGROUND The STEP for MS trial was designed and delivered by a team of medical and rehabilitation professionals with a key player being the exercise professional (EP). Our purpose is to showcase the role of the EP and methods for standardized, safe and effective exercise and behavior change intervention. DESIGN Site principal investigators who designed the intervention and implementation plan were physical medicine and rehabilitation doctors, physical therapists and kinesiologists with expertise in MS and exercise programming. The interventional EP were site staff members with varied backgrounds in delivering exercise programming to people with MS. Professional titles include personal trainer, exercise specialist, clinical exercise physiologist, graduate teaching assistant, research associate, clinical integration and research coordinator. Interventionalists had little to no prior experience using the theory-based behavior change strategies employed in the trial. METHODS To accommodate differences in EP backgrounds and expertise, standardized training on behavior change principles and exercise prescription was required. Weekly booster meetings were held via Zoom to discuss participant progress, challenges and identify solutions and modifications to the intervention while maintaining trial fidelity. Supporting materials like exercise training manuals, scripts, newsletters, logbooks and calendars were used by EPs to deliver the intervention. EPs deployed their unique skills and training to provide guidance on exercise program progression, exercise technique modification and behavior change strategies to participants. EPs and participants mutually decided on the trajectory of exercise progression based on experiences during the first 2 standardized weeks. The trajectories differed in the rate of progression with all participants meeting the exercise guidelines of 30 minutes of aerobic exercise and 5–10 strength exercises consisting of 1–2 sets, 10–15 repetitions targeting lower body, upper body, and core musculature 2 days a week, by week 10 of the program. Outcome measures were transcribed by EPs in a research database. CONCLUSION There was a varied skillset among principal investigators and interventionalists in the STEP for MS trial which provided a well-rounded intervention to people with MS. Standardized training, trial-issued supporting materials and weekly booster meetings enabled successful and standardized program implementation across 8 sites.

Using the TIDieR checklist to describe development and integration of a web-based intervention promoting healthy eating and regular exercise among older cancer survivors.

To facilitate replication and future intervention design of web-based multibehavior lifestyle interventions, we describe the rationale, development, and content of the AiM, Plan, and act on LIFestYles (AMPLIFY) Survivor Health intervention which provides healthy eating and exercise behavior change support for older cancer survivors. The intervention promotes weight loss, improvements in diet quality, and meeting exercise recommendations. The Template for Intervention Description and Replication (TIDieR) checklist was used to provide a comprehensive description of the AMPLIFY intervention, consistent with CONSORT recommendations. A social cognitive theory web-based intervention founded on the core components of efficacious print and in-person interventions was conceptualized and developed through an iterative collaboration involving cancer survivors, web design experts, and a multidisciplinary investigative team. The intervention includes the AMPLIFY website, text and/or email messaging, and a private Facebook group. The website consists of: (1) Sessions (weekly interactive e-learning tutorials); (2) My Progress (logging current behavior, receiving feedback, setting goals); (3) Tools (additional information and resources); (4) Support (social support resources, frequently asked questions); and (5) Home page. Algorithms were used to generate fresh content daily and weekly, tailor information, and personalize goal recommendations. An a priori rubric was used to facilitate intervention delivery as healthy eating only (24 weeks), exercise only (24 weeks), or both behaviors concurrently over 48 weeks. Our TIDieR-guided AMPLIFY description provides pragmatic information helpful for researchers designing multibehavior web-based interventions and enhances potential opportunities to improve such interventions.

Outcome Expectations and Older Adults with Knee Osteoarthritis: Their Exercise Outcome Expectations in Relation to Perceived Health, Self-Efficacy, and Fear of Falling.

Outcome expectations are a determinant of exercise engagement and adherence. However, the factors that influence outcome expectations for exercise remain poorly understood for people with knee osteoarthritis. In this paper, a cross-sectional study was conducted by recruiting 211 older adults from three clinics in Southern Taiwan. This study explored older adults with knee osteoarthritis exercise outcome expectations and perceived health, self- efficacy, and fear of falling. The older adults completed the Outcome Expectations for Exercise Scale (OEES), the pain and physical function subscales of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Perceived Health Status Scale, the Self-Efficacy for Exercise scale (SEE- C), the Activities-Specific Balance Confidence Scale (ABC), the Geriatric Depression Scale (GDS). Multiple logistic regression models were used to determine associations between outcome expectations for exercise and physical and psychosocial outcomes in the knee OA population. Among the participants of the cross-sectional study, the mean age was 72.04 (SD = 5.53) years, and 71.6% were female. Higher outcome expectations for exercise were associated with higher physical function (OR = 0.98; 95% CI [0.96−1.99]; p = 0.007), better perceived health (OR = 1.30; 95% CI [1.12−1.51]; p < 0.001), greater self-efficacy (OR =1.03; 95% CI [1.01−1.04]; p = 0.006), and less fear of falling (OR = 3.33; 95% CI [1.21−9.19]; p = 0.020). Thus, the results indicated that outcome expectations for exercise among the participants were significantly associated with physical function, perceived health, self-efficacy, and fear of falling. These findings suggest the importance of personal factors in the design of interventions to promote exercise behavior changes among elderly patients with Knee Osteoarthritis.

Using a Motivational Paradigm to Develop an Exercise Program for Nurses with High Risk of Metabolic Syndrome.

Nurses are frontline care providers whose health is vital to providing good quality of care to patients. The purpose of this study was to develop an exercise program for high-risk metabolic syndrome nurses based on the transtheoretical model. The transtheoretical model was used in this study due to its popular use in exercise behavior change and it can clearly identify the stage of exercise so as to plan an effective program to promote health. This was a quasi-experimental pilot study with a total of 40 participants who met the inclusion criteria. Exercise programs were developed for three groups distinguished by their commitment to exercising for health. Sixteen (40%) nurses moved one step forward, six (15%) nurses moved backward, and eighteen (45%) nurses maintained at the same stage over time (stable sedentary, 40%; stable active, 5%). Bowker’s test of symmetry, χ2 = 14.00 (p < 0.01), revealed that the population exercising increased significantly after the intervention. After the program, the perceived benefits from exercise in the decisional balance significantly increased to 1.53 (t = 2.223, p < 0.05), perceived exercise barriers significantly decreased to 3.10 (t = −3.075, p < 0.05), and self-efficacy significantly increased to 2.90 (t = 3.251, p < 0.01), respectively. Applying the transtheoretical model to health behavior enables significant change. The benefits of applying the transtheoretical model for promoting exercise include increasing perceived exercise benefits and self-efficacy, decreasing perceived exercise barriers, and increasing physical activity levels.

An Irish Multi-Centre Study of Behaviours, Attitudes and Barriers to Exercise in Inflammatory Bowel Disease, a Survey from the Patient’s Perspective

Background: Physical activity (PA) in inflammatory bowel disease (IBD) has many potential favourable outcomes including anti-inflammatory effects, improvement in quality of life and improvements in patient body composition. It is recognised that patients with IBD have a significantly decreased exercise tolerance. Aim: 1. To assess physical activity levels, behaviours and barriers to PA in IBD. 2. To assess the likelihood of patients with IBD to engage in a community-based exercise programme. 3. To examine the presence of body image concerns in IBD. Method: Patient surveys were distributed in Beaumont and Connolly Hospitals between October and December 2021. Descriptive statistics, Chi-squared testing and Pearson’s correlations were completed using Minitab. p &lt; 0.05 denoted statistical significance. Results: Data were recorded for a total of 203 patients. Out of all patients, 62% (n = 126) had Crohn’s disease (CD). Over half of the cohort were male (n = 115). Mean weight among females was 75 kg and 83 kg among males. Exercise behaviours: Out of all patients, 71% exercise regularly, on average for 59 min, 3.2 days/week. Walking was the most common form of PA (74%). A post-diagnosis change in exercise behaviour was found in 66% with three-quarters exercising less. The primary barrier to exercise was fatigue (54%). Female gender (p = 0.007) and age &lt; 45 years (p = 0.02) were associated with body image dissatisfaction reported in 62% of patients. Conclusion: These data demonstrate the patient-reported impact of IBD on patient participation in PA. Concerns regarding body image were common and associated with gender and age. A feasibility study of a physician-derived exercise programme in patients with active IBD is underway in Beaumont Hospital to determine the effect on patient response to therapy, inflammation and body composition outcomes (NCT05174754).

Sex differences in the change of exercise behavior leading to incident metabolic syndrome reduction: A community-based prospective study

This study was undertaken to assess the role of sex differences in the effects of exercise behavior change on incident metabolic syndrome (MetS) in Changhua County, Taiwan. Using data derived from the Changhua Community-based Integrated Screening (CHCIS), 22,594 eligible residents aged 40 years or older had the screening at least twice from 2005 to 2018. A prospective cohort study was designed to follow up the normal cohort without MetS at baseline to ascertain incident MetS in the light of the criteria of the Epidemiology Task Force Consensus Group. We then evaluated whether there was a sex difference in the outcome of incident MetS attributed to the change in exercise behavior from three (no, irregular, and regular exercise) maintained patterns already defined at baseline to either the enhanced pattern or the reduced pattern by the end of follow-up. We applied Cox proportional hazards regression model stratified by sex for estimating the hazard ratio of any two-group comparison. After adjustment for sociodemographic factors, the number of screenings attended, personal disease history, and other health behaviors, the influence of change in exercise behavior on incident MetS was statistically significant only in men. Specifically, maintaining no exercise showed a lower risk of MetS than maintaining regular exercise 21 % in men. Regarding the change in exercise behavior, men with the enhanced pattern reduced the risk of MetS by 15 % compared with those maintaining regular exercise. The findings suggest that positive changes in exercise behavior reduce the incidence of MetS in men but not in women.

Investigation of Attitudes Towards Exercise Behavior Changes of Adults Registered with Fitness and Activity Centers under the COVID-19 Lockdown

In this article, the authors aim to examine the attitudes towards exercise behavior changes of adults who are registered to Fitness and Activity Centers under the COVID-19 Quarantine and cannot routinely go to gyms due to quarantine. Method; It consisted of a total of 120 individuals, 40 women and 80 men, between the ages of 18-55, registered to fitness and activity centers. The participants were selected from those who went to the gym for at least 45 minutes a day, 3 days a week for at least 6 months, and did fitness exercises for at least 6 months before the quarantine. The experiential and behavioral attitudes of the participants regarding the benefits of exercise were determined by the Exercise Change Processes Scale (EDSS). The components of experiential and behavioral processes are determined with a 5-point Likert-type scale consisting of 28 questions. According to the findings; There was no significant difference between men and women in the experiential sub-dimension and the behavioral sub-dimension, which includes helping relationships and empowering management processes (P&gt;0.05). On the other hand, it was determined that there was a significant difference between the behavioral sub-dimension components of opposite and opposite situation, self-liberation and stimulus control, and total awareness levels between men and women (P&lt;0.05, P&lt;0.01). As a result, it can be argued that unlike the months-long quarantine effectively controlling the spread of the COVID-19 pandemic, it does not have a positive contribution to the exercise behavior change process. Keywords: COVID-19, Fitness, Exercise Behavior , lockdown

Long-term efficacy of exercise across diagnostically heterogenous mental disorders and the mediating role of affect regulation skills

BackgroundExercise interventions are efficacious in reducing disorder-specific symptoms in various mental disorders. However, little is known about long-term transdiagnostic efficacy of exercise across heterogenous mental disorders and the potential mechanisms underlying treatment effects. MethodsPhysically inactive outpatients, with depressive disorders, anxiety disorders, insomnia or attention deficit hyperactivity disorder were randomized to a standardized 12-week exercise intervention, combining moderate exercise with behavior change techniques (BCTs) (n = 38), or a passive control group (n = 36). Primary outcome was global symptom severity (Symptom Checklist-90, SCL-90-R) and secondary outcomes were self-reported exercise (Physical Activity, Exercise, and Sport Questionnaire), exercise-specific affect regulation (Physical Activity-related Health Competence Questionnaire) and depression (SCL-90-R) assessed at baseline (T1), post-treatment (T2) and one year after post-treatment (T3). Intention-to-treat analyses were conducted using linear mixed models and structural equations modeling. ResultsFrom T1 to T3, the intervention group significantly improved on global symptom severity (d = −0.43, p = .031), depression among a depressed subsample (d = −0.62, p = .014), exercise (d = 0.45, p = .011) and exercise-specific affect regulation (d = 0.44, p = .028) relative to the control group. The intervention group was more likely to reveal clinically significant changes from T1 to T3 (p = .033). Increases in exercise-specific affect regulation mediated intervention effects on global symptom severity (ß = −0.28, p = .037) and clinically significant changes (ß = −0.24, p = .042). ConclusionsThe exercise intervention showed long-term efficacy among a diagnostically heterogeneous outpatient sample and led to long-lasting exercise behavior change. Long-term increases in exercise-specific affect regulation within exercise interventions seem to be essential for long-lasting symptom reduction.

Association between the Health Belief Model, Exercise, and Nutrition Behaviors during the COVID-19 Pandemic.

The COVID-19 pandemic has affected our nation's health further than the infection it causes. Physical activity levels and dietary intake have suffered while individuals grapple with the changes in behavior to reduce viral transmission. With unique nuances regarding the access to physical activity and nutrition during the pandemic, the constructs of Health Belief Model (HBM) may present themselves differently in nutrition and exercise behaviors compared to precautions implemented to reduce viral transmission studied in previous research. The purpose of this study was to investigate the extent of exercise and nutritional behavior change during the COVID-19 pandemic and explain the reason for and extent of this change using HBM constructs (perceived susceptibility, severity, benefit of action, and barriers to action). This study used a cross-sectional design to collect 206 surveys. This survey collected information on self-reported exercise and nutrition changes during the pandemic and self-reported levels of the HBM constructs. Findings showed individuals with medium or high exercise behavior change had greater odds of increased HBM score than individuals with little to no exercise behavior change (OR = 1.117, 95% CI: 1.020-1.223, SE: 0.0464, p = 0.0175). There was no association between nutritional behavior change and HBM score (OR = 1.011, 95% CI: 0.895-1.142, p = 08646). Individuals who reported a more drastic change in either exercise had greater odds of increased feelings of perceived susceptibility and severity related to COVID-19 and decreased perceived benefits and increased barriers to exercise. This relationship was not found regarding nutrition behavior change. These results encourage public health practitioners to understand how an individual's perceived feelings about a threat may affect exercise and nutritional behaviors.

Physical activity in 9–15 year-old pediatric cancer survivors compared to a nationwide sample

IntroductionSufficient physical activity (PA) has the potential to mitigate late effects of cancer, but objective data of PA levels in adolescents are scarce. The aim of this study was to investigate differences in PA behavior between childhood cancer survivors (CCS) and healthy peers.MethodsPA levels of n = 74 CCS and n = 1304 healthy peers from the MoMo study aged 9–15 years were assessed with validated objective accelerometry and group means were compared. A binary multiple logistic regression was performed to investigate the potential predictors of PA.ResultsCCS spent significantly more time sedentary (p < 0.001) and less time in moderate-to-vigorous physical activity (p = 0.002) compared to the healthy cohort. Subgroup analysis revealed the largest deviations of PA levels for CCS aged 9–11 years who fulfilled international PA recommendations on significantly fewer days than MoMo (p < 0.01). Health conditions seem to be a predictor concerning the fulfillment of international PA recommendations by the WHO (p = 0.015).ConclusionsOur study identified vulnerable groups which seem to require targeted exercise and health behavior change programs to increase physical activity and reduce sedentary time. The presence of treatment sequelae as a significant predictor of insufficient physical activity underlines the need of multidisciplinary supportive care approaches.

COVID-19: Social Distancing and Physical Activity in United Kingdom Residents With Visual Impairments.

Introduction: The introduction of the COVID-19 lockdown and social distancing policy has the potential to restrict access to physical activity, change exercise behavior, and to increase sedentary behavior. This study was conducted with the support of British Blind Sport and evaluates the effect of the lockdown policy on adults with visual impairments in the United Kingdom (UK). Methods: An online survey based on the World Health Organization’s Global Physical Activity Questionnaire was completed by 73 participants (median age 35–44 years, 59% female) to gain information on how the implementation of the lockdown policy by the UK government has affected physical activity and sedentary behavior in adults that are visually impaired. Paired sample t-tests and Wilcoxon signed rank tests were used to analyze continuous and Likert scale data, respectively. Results: The majority of participants continued to exercise during lockdown, but the nature of this activity altered with a significant change to exercising in a private indoor space (+190% (always), z = −3.871, p < 0.001), and those exercising alone (+118% (always), z = −2.595, p = 0.009). The volume of activity reduced in all cases, between −11% and −52%, with significant changes in duration of vigorous day-to-day activity, moderate day-to-day activity, travel by foot or cycle, and vigorous recreational activity. Sedentary behavior increased on average by 21% (t(59) = −2.050, p = 0.045), with a greater effect seen in females (+36%, t(35) = −2.525, p = 0.016). Discussion: Reductions in physical activity volume and increases in sedentary behavior are consequences of the UK lockdown for those with visual impairments. The health and well-being implications of these data to this specific population are of particular concern. Implications for Practitioners: Lockdown measures should be designed with consideration of the needs of people with disabilities. Innovative ways to engage these populations in physical activity are strongly encouraged.

Effects of supervised high-intensity interval training on motivational outcomes in men with prostate cancer undergoing active surveillance: results from a randomized controlled trial

BackgroundUnderstanding the motivational effects of supervised aerobic high-intensity interval training (HIIT) may help men with prostate cancer undergoing active surveillance initiate and maintain exercise behavior, however, few studies have addressed this question. This report explored exercise motivation in men with prostate cancer undergoing active surveillance participating in a randomized exercise trial.MethodsThe Exercise during Active Surveillance for Prostate Cancer (ERASE) trial randomized 52 men with prostate cancer on active surveillance to the HIIT exercise group or the usual care (UC) group. The exercise program was supervised aerobic HIIT conducted three times per week for 12 weeks. The motivation questions were developed using the Theory of Planned Behavior and included motivational constructs, anticipated and experienced outcomes, and barriers to HIIT during active surveillance.ResultsThe HIIT group attended 96% of the planned exercise sessions with 100% compliance to the exercise protocol. Motivation outcome data were obtained in 25/26 (96%) participants in the HIIT group and 25/26 (96%) participants in the UC group. At baseline, study participants were generally motivated to perform HIIT. After the intervention, the HIIT group reported that HIIT was even more enjoyable (p < 0.001; d = 1.38), more motivating (p = 0.001; d = 0.89), more controllable (p < 0.001; d = 0.85), and instilled more confidence (p = 0.004; d = 0.66) than they had anticipated. Moreover, compared to UC, HIIT participants reported significantly higher perceived control (p = 0.006; d = 0.68) and a more specific plan (p = 0.032; d = 0.67) for performing HIIT over the next 6 months. No significant differences were found in anticipated versus experienced outcomes. Exercise barriers were minimal, however, the most often reported barriers included pain or soreness (56%), traveling to the fitness center (40%), and being too busy and having limited time (36%).ConclusionMen with prostate cancer on active surveillance were largely motivated and expected significant benefits from a supervised HIIT program. Moreover, the men assigned to the HIIT program experienced few barriers and achieved high adherence, which further improved their motivation. Future research is needed to understand long-term exercise motivation and behavior change in this setting.Trial registrationClinicaltrials.gov, NCT03203460. Registered on June 29, 2017.

Exploring Temporal Changes In Exercise Behavior, Perceived Fitness, And Identity In Former High School Athletes

While exercise promotion is recommended to preserve athletes’ post-sport transition quality, specific understanding of behavioral changes after retirement is unknown and necessary for program development. PURPOSE: Document temporal changes to exercise behavior, perceived fitness, and identity in former high school athletes (FHSAs) entering college, understand their exercise experiences, and explain why observed changes occurred using mixed methods. METHODS: Over their freshman year, FHSAs completed 8 online surveys assessing bodyweight, perceived fitness (Likert scale 1-5), self-reported exercise, perceived barriers (Likert scale 1-5), and identity (Likert scale 1-7). Responses were analyzed using hierarchical mixed modeling procedures, idiographic visual analysis, and intraclass correlation coefficients (ICC). A subsample completed semi-structured interviews incorporating their survey data, which underwent thematic analysis. RESULTS: As a group, FHSAs (N=35, 7 men, 18±0 years) exhibited no statistically significant changes in any primary outcomes, but idiographic analyses revealed substantial intra-individual variation. Most variables demonstrated “poor”-“fair” consistency (ICC .271-.654); only bodyweight (ICC=.987), athlete identity (ICC=.788), and exercise identity (ICC=.898) exhibited “good”-“excellent” consistency. Interviews (n=14) yielded 5 themes: adapting to transition, from “athlete” to “athletic exerciser”, motivational determinants to exercise, within-person pre-condition, and environment. CONCLUSION: FHSAs maintained relatively high levels of exercise, identity, and ‘good’ fitness perceptions as a group. However, noted variability from participants’ time devoted to schoolwork, exercise-specific social supports, and COVID-19 restrictions suggests individual responses were not represented by average values. FHSAs’ sports backgrounds provided exercise-related competence and self-regulatory abilities, but made balancing fitness expectations and losses difficult. Future directions should explore other former athlete populations’ behavior, ways of nurturing FHSA’s exercise-related competence and self-regulation, and the cyclical relationship conceptualized from interviews between participants’ exercise and identity.

Effect of combined exercise training and behaviour change counselling versus usual care on physical activity in patients awaiting hip and knee arthroplasty: A randomised controlled trial

ObjectiveThis study aimed to determine if a novel intervention that combined individualised exercise training with behaviour change counselling based on Health Action Process Approach (HAPA) constructs could elicit long-term increase in physical activity (PA) and reduce comorbidity development among people requiring hip or knee arthroplasty. MethodA pre-registered two arm, parallel group, randomised controlled trial comparing the effect of a 12-week individualised exercise program combined with behavioural counselling delivered by accredited exercise physiologists, versus usual care to Osteoarthritis (OA) patients on public surgery waitlists. Participants were followed up at 6 months after baseline (pre-surgery) and again at 6 months post-surgery. Within and between group differences in post-surgery PA (as measured by ActivPal accelerometer), pain, function, quality of life, HAPA-based behavioural and psychological constructs, and health risk factors were analysed. Results63 participants (34 Female; Mean age ​= ​66.4 ​± ​7.2 ​yrs) consented to participate in this study. At 6 months post baseline and 6 months post-surgery there were significant improvements in PA, pain, function, and quality of life, however there were no significant differences in the between group responses. Significant between group changes were observed in several psychological constructs related to volition at 6 months post baseline; however, these had disappeared by 6 months post-surgery. ConclusionsAn exercise program and HAPA guided counselling intervention can improve psychological constructs related to exercise behaviour; however, these did not result in significant between group changes in PA at the timepoints measured. Further research with larger sample size is required.Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN 12617000357358) Date of registration: 08/03/2017.