Exercise Sessions Research Articles

Validity of an Exercise Log for Measuring Duration of Exercise in Older Women With Knee Osteoarthritis.

To examine the validity and usability of a paper log for evaluating exercise duration in older women. Data from 23 females (mean age = 70.4 years) who completed an 8-week pilot randomized controlled trial investigating the effects of yoga and aerobic/strength training on knee osteoarthritis were included in this secondary analysis. Participants were asked to complete a paper log and video recording of their home exercise sessions. Concurrent validity was high between minutes reported on the paper logs and video recordings during Weeks 2 to 7 (r = 0.878). Usability was high, with participants completing 79% to 91% of paper logs and 74% to 100% of video diaries weekly. Overall minutes reported on the paper exercise logs and video diaries were positively correlated to Physical Activity Scale for the Elderly scores at 8 weeks. Exercise logs are a valid and useful method in assessing adherence to prescribed exercise duration in unsupervised home programs. [Research in Gerontological Nursing, 17(5), 219-225.].

Effects of Traditional Chinese Exercises on Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Currently, most studies on the health benefits of traditional Chinese exercises on type 2 diabetes mellitus have explored the effects of a single type of traditional Chinese exercise on type 2 diabetes. Although a previous study evaluated the combined clinical effects of traditional Chinese exercises on type 2 diabetes, the studies included in that review were deficient in their study design. In addition, previous studies have not explored the ideal exercise dose that should be taken by patients with type 2 diabetes when performing traditional Chinese exercises. To understand whether the findings of previous systematic reviews and meta-analyses are still applicable and to try to address the deficiencies in the previous review, this review conducted a meta-analysis of existing randomized controlled trials to investigate the impact of traditional Chinese exercises on glycemic control with type 2 diabetes. The literature was searched in seven Chinese and English databases. Randomized controlled trials published in English and Chinese, from database inception to March 2023, were included in this review. Two reviewers independently reviewed the search results, extracted the data, and assessed the risk of bias. A meta-analysis of the included studies was conducted using Rev Man 5.4 and Stata 15.1 software. Heterogeneity was investigated using a sensitivity analysis, a subgroup analysis, and a meta-regression analysis. Pre-determined subgroups included the duration of the intervention, frequency of exercise, and duration of the single exercise session. A total of 31 randomized controlled trials (2077 subjects) were selected in this review. The meta-analysis revealed that traditional Chinese exercises were more effective than control groups in lowering glycated hemoglobin (Z = 6.06; mean difference [MD] = - 0.64, 95% confidence interval [CI] - 0.85, - 0.44; P < 0.00001), fasting blood glucose (Z = 7.81; MD = - 0.82, 95% CI - 1.03, - 0.62; P < 0.00001), 2-h plasma glucose (Z = 5.61;MD = - 1.03, 95% CI - 1.39, - 0.67; P < 0.00001), total cholesterol (Z = 4.23; MD = - 0.37, 95% CI - 0.54, - 0.20; P < 0.0001), high-density lipoprotein cholesterol (Z = 5.94; MD = 0.12, 95% CI 0.08, 0.16; P < 0.00001), low-density lipoprotein cholesterol (Z = 6.20; MD = - 0.34, 95% CI - 0.44, - 0.23; P < 0.00001), and triglyceride levels (Z = 3.74; MD = - 0.44, 95% CI - 0.67, - 0.21; P = 0.0002) among patients with type 2 diabetes. Traditional Chinese exercises can significantly improve blood glucose and lipid levels in patients with type 2 diabetes. When performing traditional Chinese exercise interventions for type 2 diabetes, it is recommended that exercise programs are designed for 30-50min/session, 4-5 sessions/week for at least 3months.

Abstract P174: The endogenous circadian system modulates blood pressure reduction after an aerobic exercise session in healthy adults

Objective: To determine the role of the circadian system on blood pressure (BP) reduction promoted by exercise. Methods: Nine (4 male/5 female) healthy adults (aged 23±2 y) completed a 30-hour circadian protocol in a dim light laboratory (&lt;8 lux), where all behaviors and measurements were evenly distributed across the 24-hour cycle. Participants underwent five recurring 6-hour day-cycles of 2-hour sleep opportunities and 4-hour standardized wake episodes. Systolic, diastolic, and mean BPs, cardiac output (CO), and stroke volume were derived from beat-to-beat BP waveform (plethysmography). Heart rate (HR) was determined from an electrocardiogram (ECG), and systemic vascular resistance (SVR) was calculated (SVR = Mean BP/CO). Data were recorded for 10 minutes in supine at rest, before and after 30 minutes of moderate aerobic exercise (cycle ergometer, 30 min, 40% HR reserve). Circadian phases were calculated based on individual dim-light melatonin onsets. Mixed-model cosinor analyses tested if changes between before and postexercise had systematic rhythmicity with an underlying sinusoidal profile. Results: Systolic and mean BP change had a circadian rhythm (p&lt;0.05) with the greatest decrease (-12 and -9 mmHg) at ~1pm and an amplitude of 11 and 8 mmHg, respectively, from its blunted response at ~1am. SVR change had a circadian rhythm with a greater decrease ~10am (see figure). No other variables displayed a circadian variation. Conclusion: In young healthy adults, the circadian system potentiates the hypotensive effect of exercise in the afternoon. However, the absence of this ability during the night may represent cardiovascular vulnerability in those who stay awake at that time (e.g., shift workers).

Exercise and Acute Cognitive Enhancement.

Substantial research has explored the effects of a single session of exercise on cognitive performance. Meta-analytic reviews provide summary statistics relative to these effects when the cognitive task is performed while exercising and when performed after exercise. When performed concomitantly the effects of exercise are typically small or negative with the exception of moderate effects for speed of cognitive performance during moderate intensity exercise. When cognitive performance is assessed following the cessation of exercise, the effects are typically positive. When considering the effects following exercise, most studies have focused on executive function and episodic memory as the cognitive outcomes of interest with meta-analyses supporting small-to-moderate benefits. When potential moderators related to exercise parameters or participants characteristics are examined, results suggest that 20 minutes of moderate to vigorous intensity exercise consistently benefits performance with larger effects evident for executive function tasks with higher cognitive demands, for long-term memory tasks when exercise is performed prior to information encoding, and when considering individuals with lower initial cognitive performance levels. These observed benefits are likely due to the impacts acute exercise can have on physiological arousal, brain function, and brain neurotrophic factors. Advancements in our understanding of the potential of a single session of exercise to benefit cognitive performance are important for exercise prescription and to inform chronic exercise programs designed to benefit cognition.

Acute effects of exercise on gaze fixation and affective response inhibition in children with autism spectrum disorder: A randomized cross-over study.

Children with autism spectrum disorder (ASD) show impairments in response inhibition, especially in socio-emotional contexts. A single aerobic exercise session has the potential to temporarily reduce such impairments as findings from neurotypical children support acute benefits of this exercise type for inhibitory control and emotion recognition. In children with ASD, we therefore aimed to investigate the effects of an aerobic exercise bout on response inhibition in an emotional Go/NoGo task and gaze fixation as possible mechanism underlying changes in performance. Using a cross-over design, 29 patients completed a 20-min aerobic exercise bout at moderate intensity on a cycling ergometer and a control condition in a randomized order. An emotional Go/NoGo task was administered before and after both experimental conditions. Eye-tracking was performed during the cognitive task to assess the duration of gaze fixation of eyes and mouth parts of faces expressing happy or sad emotions. The results support no beneficial effect of exercise on performance on the emotional Go/NoGo task. Instead, patients showed a greater decrease in accuracy on Go trials displaying happy faces in the exercise compared to the control condition. This change was associated with a more pronounced decrease in the fixation duration of the eyes for faces expressing either happy or sad emotions. In conclusion, while a single session of moderately intense aerobic exercise does not affect response inhibition, it temporarily aggravates ASD-specific deficits in the processing of and response to facial emotions.

Moving an exercise referral scheme to remote delivery during the Covid-19 pandemic: an observational study examining the impact on uptake, adherence, and costs

BackgroundExercise Referral Schemes (ERSs) have been implemented across Western nations to stimulate an increase in adult physical activity but evidence of their effectiveness and cost-effectiveness is equivocal. Poor ERS uptake and adherence can have a negative impact on effectiveness and cost-effectiveness and, if patterned by socio-demographic factors, can also introduce or widen health inequalities. Different modes of ERS delivery have the potential to reduce costs and enhance uptake and adherence. The primary aim of this study was to examine the effect of different programmes of ERS delivery on scheme uptake and adherence. Secondary aims were to examine the effect of socio-demographic factors on scheme uptake and adherence, and the impact of delivery mode on the expected resource and corresponding costs of delivering core parts of the programme.MethodsThis was an observational cohort study with cost analysis. Routine monitoring data covering a three-year period (2019–2021) from one large UK ERS (number of patients = 28,917) were analysed. During this period three different programmes of delivery were operated in succession: standard (all sessions delivered face-to-face at a designated physical location), hybrid (sessions initially delivered face-to-face and then switched to remote delivery in response to the Covid-19 pandemic), and modified (sessions delivered face-to-face, remotely, or a combination of the two, as determined on a case-by-case basis according to Covid-19 risk and personal preferences). Multi-level binary logistic and linear regression were performed to examine the effect of programme of delivery and socio-demographic characteristics on uptake and adherence. Cost data were sourced from regional-level coordinators and through NERS audits supplied by national-level NERS managers and summarised using descriptive statistics.ResultsThere was no effect of programme of delivery on scheme uptake. In comparison to those on the standard programme (who attended a mean of 23.1 exercise sessions) those on the modified programme had higher adherence (mean attendance of 25.7 sessions) while those on the hybrid programme had lower adherence (mean attendance of 19.4 sessions). Being older, or coming from an area of lower deprivation, increased the likelihood of uptake and adherence. Being female increased the chance of uptake but was associated with lower adherence. Patients referred to the programme from secondary care were more likely to take up the programme than those referred from primary care for prevention purposes, however their attendance at exercise sessions was lower. The estimated cost per person for face-to-face delivery of a typical 16-week cycle of the scheme was £65.42. The same cycle of the scheme delivered virtually (outside of a pandemic context) was estimated to cost £201.71 per person.ConclusionsThis study contributes new evidence concerning the effect of programme of delivery on ERS uptake and adherence and strengthens existing evidence concerning the effect of socio-economic factors. The findings direct the attention of ERS providers towards specific patient sub-groups who, if inequalities are to be addressed, require additional intervention to support uptake and adherence. At a time when providers may be considering alternative programmes of delivery, these findings challenge expectations that implementing virtual delivery will necessarily lead to cost savings.

High Cognitive Effort Prior to Velocity-Based Training Sessions Reduces Rate of Force Development but Not Maximum Strength Gains in Untrained Male Adults.

This study aimed to analyze the chronic effect of high cognitive effort immediately before resistance exercise sessions on neuromuscular performance in untrained male adults. We used a mixed experimental design, with the group as between-participants factor and time as within-participants factor. Thirty-four participants were randomly assigned to two parallel groups: high cognitive effort (n = 17) and control (n = 17). Subjects in the control group were seated for 30 min before the resistance exercise sessions, while the high cognitive effort group completed incongruent trials of the Stroop task until subjective mental fatigue was present immediately before resistance exercise sessions. Participants attended 45 sessions over 15 weeks, consisting of three familiarizations, three baseline evaluations, 36 velocity-based training sessions, and three postexperiment evaluation sessions. Rate of force development (RFD) during the isometric mid-thigh pull, half back-squat 1-RM, and countermovement jump (CMJ) were measured before and after the 12-week intervention. A significant group × time interaction effect was found for the average RFD at 0-250 ms (p < 0.05), with greater improvements for the control group than for the high cognitive effort group. There was no group × time interaction for half back-squat 1-RM (p > 0.05). Also, there was no group × time interaction for CMJ (p > 0.05). In conclusion, repeated high cognitive effort immediately prior to resistance exercise sessions is a phenomenon that can induce greater early velocity loss and, consequently, impairs the improvements in RFD. However, this did not inhibit the increased performance for explosive strength and CMJ in male untrained adults. High cognitive effort before resistance exercise sessions should be avoided.

Predictors of post-exercise affect: A self-determination theory approach considering physical, social, and psychological factors.

Studies have shown increases in affect after acute exercise. However, the specific aspects of an exercise experience that predict or contribute to post-exercise affect remain relatively unknown. This study aimed to determine which physical (i.e., duration and intensity), contextual (i.e., social context and time of day), and psychological factors (i.e., motivation and need satisfaction) predicted post-exercise affect. In 2021, 296 gym users self-reported affect before and immediately after exercising at a gym facility. Participants also reported situational motivation towards exercise, need satisfaction (i.e., autonomy, competence, and relatedness), who they exercised with (social interaction), and the duration and perceived intensity of their exercise session. We first conducted a paired samples t-test to identify whether affect significantly increased from before to after exercise, and then a hierarchical regression model to determine which factors predicted post-exercise affect. Affect significantly increased from before to after exercise (t[291] = 8.116, p < .001). Autonomous motivation (β = .23, p = <.001), autonomy satisfaction (β = .15, p = <.05), and relatedness satisfaction (β = .19, p = <.01) significantly predicted post-exercise affect, whereas duration, perceived intensity, social interaction, and time of day did not. People should be encouraged to engage in activities that satisfy their need for autonomy and relatedness during leisure-time (i.e., not during the workday). SO WHAT?: This approach to physical activity promotion may lead to better affective outcomes and increased adherence compared to focusing on how long, how intense, or with whom people exercise.

Increasing participation in resistance training using outdoor gyms: A study protocol for the ecofit type III hybrid effectiveness implementation trial

BackgroundIn this paper we outline the protocol for an implementation-effectiveness trial of ecofit, a multi-component mHealth intervention aimed at increasing participation in resistance and aerobic physical activity using the outdoor built environment (i.e., outdoor gyms) and social support. We have previously demonstrated the efficacy and effectiveness of the ecofit program in insufficiently active people with (or at risk of) type 2 diabetes and community-dwelling adults, respectively. The objective of this trial is to compare the effects of two implementation support models (i.e., ‘Low’ versus ‘Moderate’) on the reach (primary outcome), uptake, dose received, impact and fidelity of the ecofit program. Research design and methodsThis hybrid type III implementation-effectiveness study will be evaluated using a two-arm randomized controlled trial, including 16 outdoor gym locations in two large regional municipalities in New South Wales, Australia. Outdoor gym locations will be pair-matched, based on an established socio-economic status consensus-based index (high versus low), and randomized to the ‘Low’ (i.e., ecofit app only) or ‘Moderate’ (i.e., ecofit app, face-to-face workout sessions and QR codes) implementation support group. The primary outcome of ‘reach’ will be measured using a modified version of the ‘System for Observing Play and Recreation in Communities’, capturing outdoor gym use amongst community members. ConclusionThis implementation-effectiveness trial will evaluate the effects of different levels of implementation support on participation in resistance-focused physical activity using mHealth and outdoor gyms across the broader community. This may guide widespread dissemination for councils (municipalities) nation-wide wanting to promote outdoor gym usage. Trial registryThis trial was preregistered with the Australian and New Zealand Clinical Trial Registry (ACTRN12624000261516).

Acceptability of a Portable Exercise Bike in Older Adults With Cardiovascular Diseases.

Ways to help older adults overcome barriers to performing regular exercise is a challenge to nurses. The study evaluated the acceptability of a portable exercise bike for arm/foot pedaling among older patients with cardiovascular diseases (CVDs). Participants reported their physical activity levels using the International Physical Activity Questionnaire (short form) and thereafter performed two 6-minute-long arm/foot pedal biking sessions using a portable exercise bike. Participants provided qualitative feedback (one open-ended question) on the bike while exercising and completed the quantitative Acceptability Use Questionnaire following the two exercise sessions. Twenty-five older adults (52% male and 48% female), with a mean (SD) age of 70 (6.4) years and a body mass index of 30 (7.4), completed the study. Most participants performed moderate to light physical activity at home with a daily mean (SD) sitting/sedentary time of 8 (3.4) hours. The mean scores from the Acceptability Use Questionnaire and the participants' comments alluded to the bike's multitasking utility and acceptability. Three broad themes derived from the qualitative analysis were: (1) the acceptability of the bike with participants who had musculoskeletal problems; (2) the ability to operate and use the bike for aerobic exercise engaging both arms and legs; and (3) the importance of overall utility, ease of use, and cost of the bike. The portable exercise bike was found acceptable in a group of older adults with CVDs. The bike has the potential to be applied in home-based exercise interventions.

Kinematic Responses to Water Treadmill Exercise When Used Regularly within a Sport Horse Training Programme: A Longitudinal, Observational Study.

Repeated exposure to water treadmill (WT) exercise could elicit kinematic responses reflecting adaptation to WT exercise. The study's aim was to compare the responses of a group of sport horses to a standardised WT exercise test (WTSET) carried out at three time points, week 0 (n = 48), week 20 (n = 38), and week 40 (n = 29), throughout a normal training programme incorporating WT exercise. Horses were recruited from the existing client populations of two commercial water treadmill venues for the purpose of this longitudinal, observational study. Limb, back, poll, wither, and pelvic kinematics were measured during the WTSET using videography, optical motion capture, and inertial motion sensors. Forelimb and hindlimb protraction increased (p < 0.001 for both), and forelimb and hindlimb retraction decreased (p < 0.001 for both) at week 40 compared to week 0. Caudal thoracic flexion-extension and lateral bend ranges of movement were greater at week 40 compared to week 0 (p < 0.001 and p = 0.009, respectively). Increased training speed was associated with increased craniocaudal poll movement (p = 0.021), decreased forelimb protraction (p = 0.008), and increased forelimb retraction (p = 0.021). In addition to characteristic changes in kinematics due to increasing water depth, regular WT exercise resulted in kinematic adaptation to movement in water. Factors such as the frequency of WT sessions and the type of session used with respect to depth and speed were seen to influence the nature of the adaptation. The results suggest that WT exercise sessions could be designed in accordance with specific training goals when used within a normal sport horse training programme.

Reconfigurable Robotic Exercising Companion

Regular exercise plays a crucial role in promoting overall well-being in today’s lifestyle. However, individuals often find it challenging to properly execute exercises, including maintaining correct postures and appropriate movement speeds. Robotic companions have emerged as potential solutions to assist and motivate users during exercise sessions. This research paper proposes a novel robot companion designed for exercise scenarios using a reconfigurable robot. In contrast to existing non-reconfigurable robotic companions, the use of a reconfigurable robot provides added flexibility in generating emotions. The system incorporates a module that utilizes fuzzy logic to evaluate the correctness of exercise performance based on posture variations and movement speeds. The robot generates emotions and provides feedback to users based on the exercise correctness score. The robot expresses emotions through reconfigurations, motion patterns, and variations in robot speed. This emotion-based feedback could be helpful for creating engaging and interactive exercise experiences. Apart from emotion generation, the robot utilizes vocal cues as feedback. Experimental results validate the effectiveness of the proposed system in evaluating exercise correctness and demonstrating meaningful emotion transitions. The findings of this work contribute to the development of innovative robotic companions for improving exercise adherence and overall well-being.

Knowledge, Prevalence, and Consequences of Dietary Supplements Intake among Iranian Bodybuilders

BackgroundThis study investigated the nutritional knowledge and prevalence of dietary supplements (DSs) among Iranian bodybuilders. MethodsThis cross-sectional research study involved sampling 648 bodybuilding clubs in Iran. A researcher distributed questionnaires among clubs in various regions and analyzed categorical variables, DS, nutritional knowledge, and sports nutrition data from 160 bodybuilders aged 18 and above in Iran. The analysis was conducted using the results obtained from a quantitative questionnaire. ResultsThere was a significant relationship between DS use and gender (P = 0.001, r = 0.330, males > females), bodybuilding history (P = 0.045; r = 0.158), and exercise sessions/wk (P = 0.050, r = 0.156). Whey protein (45.6%) and branched-chain amino acid (33.7%), vitamin D (50%), caffeine (34.3%), and generally vitamin C (56.2%) were the most common DS used. The most information sources for bodybuilders regarding DS were fitness coaches (35.6%) and registered dietitians/nutritionists (34.3%). Drug stores (36.7%) and fitness coaches (19.3%) were the most prominent sources for purchasing DS. Increasing performance (54.3%), increasing the need for DS through exercise (53.6%), preventing injury, and improving recovery (36.2%) were the most important reasons to consume DS. Skin problems (21.0%), increased liver enzymes (10.8%), and hair loss (9.4%) were the most common side effects of DS use. Total nutritional knowledge (macronutrients, micronutrients, and sports nutrition) was 58.6%. ConclusionsThis study concluded that fitness coaches and registered dietitians/nutritionists were the most common information sources for bodybuilders. It also revealed a moderate level of nutrition knowledge among bodybuilders. The most commonly used DS were vitamins C, D, and whey protein. Also, gender, bodybuilding history, and exercise sessions had a significant relationship with the prevalence of DS. However, the study also revealed some concerning findings; bodybuilders commonly experienced adverse side effects such as skin rashes, increased liver enzymes, and hair loss.

Do we really need this robot? Technology requirements for vestibular rehabilitation: Input from patients and clinicians

BackgroundA main challenge in many types of physical rehabilitation is patient adherence to recommended exercises. Vestibular rehabilitation is the most effective treatment for the symptoms of dizziness, vertigo, imbalance, and nausea caused by vestibular disorders, but adherence levels are particularly low as the rehabilitation program calls for many short exercise sets during the day, which can worsen symptoms and impair balance in the short term. Technological tools have the potential to increase adherence, but to date, there has been no comprehensive analysis, in the context of vestibular rehabilitation, of the specific needs from technology, of its limitations, and of concerns regarding its use. ObjectiveThe aim of the study is to identify the main features required from technology for vestibular rehabilitation, as perceived by patients with vestibular disorders and by vestibular physical therapists, using a socially assistive robot as a test case. We seek here to provide practical information for the development of future vestibular rehabilitation technologies which are based on human-computer interaction (HCI) and human-robot interaction (HRI). MethodsWe conducted a qualitative study with six focus groups (N = 39). Three groups of patients with vestibular disorders (N = 18) and three groups of physical therapists (N = 21) participated in this study. The participants answered structured questions on technologies for vestibular rehabilitation, watched a presentation of two videos of a socially assistive robot (SAR), and completed an online survey. Thematic analysis with a mixed deductive and inductive approach was used to analyze the data. ResultsParticipants preferred phone applications or virtual/augmented reality platforms over an embodied robotic platform. They wanted technology to be adaptive to the different stages of rehabilitation, gamified, easy to use, safe, reliable, portable, and accessible remotely by the therapist. They reported that the technology should provide feedback on the quality and quantity of exercise performance and monitor these factors while considering the tolerability of the ensuing disruptive symptoms. Participants expected that using technology as part of the rehabilitation process would shorten exercise sessions and improve clinical outcomes compared to standard care. SARs for vestibular rehabilitation were perceived as useful mostly for children and patients with chronic vestibular disorders, and their potential use for rehabilitation raised concerns regarding safety, ethics, and technical complexity. ConclusionsAlthough SARs can potentially be used to increase exercise adherence, a phone application appears to be a more suitable medium for this purpose, raising fewer notable concerns from users. We provide a summary of perceived advantages and disadvantages of technology for vestibular rehabilitation, as well as a set of specific requirements from it, which may inform the future development of specific supportive technologies. In addition, the focus group methodology employed demonstrates the importance of participatory design in the development of rehabilitation-supportive technology as participants were able to identify the likely inappropriateness of SARs for the specific case of vestibular rehabilitation.

Effects of Exercise on Cancer-Related Fatigue in Breast Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The primary objective of this study was to assess the influence of exercise interventions on cancer-related fatigue (CRF), specifically in breast cancer patients, with the ultimate goal of establishing an optimal exercise prescription for breast cancer patients. A comprehensive search was undertaken across multiple databases, including Embase, PubMed, Cochrane Library, Web of Science, and Scopus, covering data published up to 1 September 2023. A meta-analysis was conducted to calculate the standardized mean difference (SMD) along with its corresponding 95% confidence interval (CI), thereby quantifying the effectiveness of exercise in alleviating CRF in the breast cancer patient population. Twenty-six studies met the inclusion criteria. Aerobic exercise (SMD, -0.17, p = 0.02), resistance exercise (SMD, -0.37, p = 0.0009), and combined exercise (SMD, -0.53, p < 0.0001) significantly improved CRF in breast cancer patients. In addition, exercise intervention conducted ≥3 times per week (SMD, -0.47, p = 0.0001) for >60 min per session (SMD, -0.63, p < 0.0001) and ≥180 min per week (SMD, -0.79, p < 0.0001) had greater effects on improving CRF in breast cancer patients, especially middle-aged patients (SMD, -0.42, p < 0.0001). Exercise is an effective approach to improving CRF in breast cancer patients. When devising an exercise program, the primary consideration should be the incorporation of combined exercise as the principal intervention. This entails ensuring that participants engage in the program at least three times weekly, with each session lasting for more than 60 min. The ultimate aim is to achieve a total weekly exercise duration of 180 min by progressively increasing the frequency of exercise sessions.

Acute Affective Responses to Virtual Reality Exercise: A Crossover Randomized Clinical Trial.

Virtual reality (VR) exercise aims to offer positive affective and sensory experiences through an immersive experience rich in audiovisual stimuli. Notwithstanding, there is a paucity of large sample size studies comparing the acute effects of VR exercise compared with a matched exercise performed in a non-VR environment. The study compared the acute effects of a VR exercise session versus a matched non-VR exercise session in effect, pleasure, enjoyment, perceived exertion, and heart rate. This is a crossover randomized clinical trial. The time, difficulty, and exercise type of the non-VR exercise were matched to VR exercise. Before and immediately after each session, participants responded to the Borg's Perceived Exertion Scale, the Feeling Scale and the Felt Arousal Scale, and the Physical Activity Enjoyment Scale. The analyses were conducted with Generalized Linear Models, Wilcoxon's, and T-test for paired samples. A total of 83 adults (40 females) aged 35.46 years were included in the study. Participants in the VR condition had a greater increase in affect (mean change difference = 0.95, 95% confidence interval [CI] = 0.83-1.06, P < 0.001), arousal (mean change difference = 0.37, 95% CI = 0.23-9.50, P < 0.001). The pleasure and enjoyment median after the VR session were higher. In conclusion, the immersive VR exercise was more strenuous, but resulted in a better affective response, greater pleasure, and enjoyment.

Analysis of Factors Contributing to State Body Appreciation during Exercise.

This cross-sectional study aimed to analyse the factors contributing to state body appreciation (SBA) during exercise. After providing their informed consent, 200 study participants (mean age 30.0 ± 9.4 years, 72.0% were men) filled in an online questionnaire immediately after the completion of resistance training (n = 125), cardiovascular exercise (n = 55), or functional/interval group exercise (n = 20) sessions. The study measures included socio-demographic variables, body mass index (BMI), the duration of involvement in sports, SBA, state body surveillance (SBS), state mindfulness in physical activity, state intrinsic exercise regulation, and perceived pleasantness during exercise. The results showed that exercisers involved in sports for >2 years and those whose body weight was within a healthy range (<25.0 kg/m2) demonstrated higher SBA and mindfulness during exercise, lower SBS, more intrinsic exercise regulation, and higher satisfaction during physical activity compared to exercisers with less exercise experience (≤2 years) and a body weight higher than a healthy range (≥25.0 kg/m2). The negative effects of being overweight or obese were more pronounced in individuals with ≤2 years of sports participation, except regarding body surveillance and monitoring the mind. The factors significantly contributing to SBA during the exercise sessions were a longer duration of involvement in sports, a lower BMI and SBS, and greater mindful body acceptance and exercise pleasantness. Decreasing SBS and enhancing mindful body acceptance, pleasantness, and intrinsic motivation during exercise might significantly contribute to SBA in physical activity. These results can inform physical-activity-based programmes aiming to promote a positive body image. Also, these results show that it is important to increase education and develop competencies for fitness coaches to create inclusive and positive-body-image-promoting sports environments.

The Value of an Informal Before-School Exercise Opportunity for Adolescent Girls Living in a Low-Socioeconomic Community.

Physical activity is beneficial to physical, social, and emotional well-being, and schools are required to provide opportunities to engage in physical activity. While physical education and school sport have been extensively researched, little is known about the value of informal, unstructured, exercise opportunities. This study involved interviews with 19 adolescent girls who attended "extra" exercise opportunities provided by their school. The 3 opportunities were: (1) informal before-school exercise sessions at school, (2) before-school sport training, and (3) externally provided exercise sessions in a community setting during school hours. Students perceived all opportunities as valuable with benefits to confidence, social well-being, and emotional well-being. The informal exercise sessions held greater benefits to confidence as confidence transferred from the physical activity context into the academic classroom more so than for those participating in sport. Social benefits were greater for those exercising before school as this opportunity created new relationships with teachers and with students from other classes and year groups. The opportunity to engage in informal exercise with peers before school widened social networks, increased confidence, changed the overall school climate, and increased attendance.

Individualized pleasure-oriented exercise sessions, exercise frequency, and affective outcomes: a pragmatic randomized controlled trial

BackgroundAffective responses are increasingly recognized as potentially effective intervention targets that may facilitate exercise and physical activity behavior change. While emerging correlational evidence suggests that more pleasant affective responses are associated with higher participation and adherence, experimental evidence remains scarce. In light of this, we conducted a preregistered, pragmatic, single-blinded, superiority randomized controlled trial with two parallel groups, with the goal of determining the impact of an individualized exercise-intensity prescription targeting pleasure on exercise frequency.MethodsForty-seven non-regular exercisers were randomized into two groups. For both groups, the intervention consisted of three exercise sessions based on the Frequency-Intensity-Time-Type (FITT) principle. However, the experimental group also received an individualized intensity prescription based on prior assessment of preference for and tolerance of exercise intensity, as well as instructions emphasizing the promotion of pleasure as a basis for self-regulating exercise intensity. The primary outcome was gymnasium attendance over an eight-week follow-up period. Secondary outcomes were affective valence and arousal, post-exercise enjoyment, core affective exercise experiences, and anticipated and remembered affect.ResultsForty-six participants were retained for analysis (Mage = 32.00; SD = 8.62 years; 56.5% female). Compared to the control group, the experimental group exhibited 77% higher session attendance (14.35 vs. 8.13 sessions) over the eight-week follow-up period (group main effect p = 0.018, η2p = 0.120; Cohen’s d ranged from 0.28 to 0.91 during follow-up). Also, the experimental group reported higher levels of pleasure during the intervention sessions (for all group main effects, p < 0.001, η2p from 0.33 to 0.37) and higher levels of remembered pleasure (group main effect p = 0.021, η2p = 0.116) and anticipated pleasure (group main effect p = 0.022, η2p = 0.114). No harm was detected.ConclusionsThese results demonstrate the practicality and effectiveness of an intervention aimed at enhancing affective responses to exercise in improving short-term session attendance.Trial registrationClinicalTrial.gov NCT05416593.

Recovery of balance and walking in people with ataxia after acute cerebral stroke: study protocol for a prospective, monocentric, single-blinded, randomized controlled trial

IntroductionPosterior circulation stroke can lead to ataxia, manifesting in a loss of coordination and balance. Patients experience difficulty in activities of daily living and an increased risk of falling, both profoundly affecting quality of life. In individuals with neurodegenerative diseases, coordination exercises have been shown to lead to a reduction in ataxic symptoms. There is, however, limited evidence on the effect of physical therapy, specifically coordination exercises in patients with stroke-related ataxia. We therefore present a study protocol for a prospective trial.MethodsThe purpose of this trial is to investigate the effects of coordination exercises compared to standard physiotherapy on balance and walking in ataxic stroke patients. Therefore, a prospective, single-blinded randomized controlled trial is currently ongoing at the Clinical Department of Neurology, Medical University of Innsbruck, Austria, in collaboration with two local rehabilitation facilities in Austria, Hochzirl Hospital and the Clinic for Rehabilitation Münster. Balance is the primary outcome of the study as assessed using the Berg Balance Scale. Secondary outcomes are concerned with walking, risk and number of falls, independence in daily life, and quality of life, rated using appropriate scales and scores. Patients are allocated applying a 1:1 ratio and a stratified block randomization. In both groups recruited individuals undergo five 45-min treatment sessions per week, totaling 20 sessions of coordination exercises (IG) or standard physiotherapy (CG) over the course of 4 weeks. Data is collected at the baseline (T0), after the 4-week supervised practice (T1), and after another 8 weeks of independent home-based training (T2).DiscussionThis is the first randomized controlled trial investigating the effects of coordination exercises on balance and walking in people with stroke-related ataxia. As stroke guidelines emphasize the limited evidence of treatment for ataxic symptoms, this study aims to contribute further knowledge regarding tailored interventions for these patients.Clinical Trial RegistrationGerman Clinical Trials Registry (drks.de). Identifier: DRKS00020825.