Mindful Walking Research Articles

A controlled trial comparing the impact of guided forest bathing or a mindful urban walk on heart rate, blood pressure, and mood in young Thai adults

Abstract In Thailand, cardiovascular disease and mental health cause a large health and economic burden, with 10% of Thai adults and 32% of adolescents reporting depression. Forest bathing (FB) (mindful nature walking) is growing in popularity globally as a preventative health intervention. Most FB research compares FB with a non‐active control of unguided urban walking, finding improved health and well‐being in FB but not the urban condition. This controlled trial offers a unique and robust comparison of guided FB with an active control of guided mindful urban walking. This is also the first study testing the acceptability and effectiveness of guided FB in Thailand. In a crossover design, heart rate, heart rate variability, blood pressure, and mood in 30 participants were compared before and after 1 h of guided FB and a guided mindful urban walk. MANOVA and t‐test analyses revealed that heart rate and blood pressure reduced in both conditions, but more in the mindful urban condition. Whilst negative mood was reduced in the FB condition but increased in the mindful urban condition. The study offers evidence for the promising health and well‐being benefits of both guided FB and mindful urban walking. Poor mental health and health inequalities are of increasing global concern, hence further research into the effectiveness of alleviating these difficulties through inexpensive interventions such as guided FB and mindful walking are encouraged. The study also offers the first data indicating that FB was acceptable and effective in a Thai population. Read the free Plain Language Summary for this article on the Journal blog.

The Effect Of Mindful Walking On Perceived Stress

The Effect Of Mindful Walking On Perceived Stress

Golden steps: A nursing approach for vitality, agility, and rumination in geriatric clients with depressive disorders through mindful walking

BackgroundDepression is a prevalent issue among older adults and can significantly impact their overall quality of life. While traditional treatments may not always be sufficient or suitable for all individuals, the potential of alternative interventions, such as mindful walking, offers a ray of hope. This study aimed to evaluate the impact of mindful walking on rumination, agility, vitality, and mindfulness in geriatric patients with depressive disorders. MethodA prospective quasi-experimental design was employed with a purposive sample of 35 clients in the intervention group and 33 in the control group. This study utilized the Ruminative Responses Scale – Short Form (RRS-SF) and Five Facet Mindfulness Questionnaire (FFMQ) to measure the primary outcome. The Timed Up and Go Test (TUG) and State-Level Version of the Subjective Vitality Scale (SVS) were used to measure the secondary outcomes. ResultsMindful walking significantly affected vitality, mindfulness, and rumination, with effect sizes (ղ2 = 0.168, 0.137, and 0.127), respectively. On the other hand, the intervention had a less significant effect on agility, with an effect size (ղ2 = 0.047). ConclusionThis study revealed that geriatric clients with depressive disorders showed more significant improvements in vitality, followed by improvement in rumination and agility. Integrating mindful walking as a part of care plans for those clients would promote their physical activity and mental well-being.

Implementation and evaluation of a community-based mindful walking randomized controlled trial to sustain cognitive health in older African Americans at risk for dementia

BackgroundWith an increasing proportion of older adults and the associated risk of Alzheimer’s Disease and Related Dementias (ADRD) around the globe, there is an urgent need to engage in ADRD risk reduction efforts. African American (AA) older adults in the U.S. are disproportionally impacted by ADRD compared to other races and ethnicities. Mindful walking integrates two potentially protective factors of ADRD by elevating mindfulness and physical activity (i.e., walking), resulting in a synergistic behavioral strategy that is feasible and safe for older adults. However, the efficacy of applying this intervention for cognitive health outcomes has not been evaluated using experimental designs.MethodsThis paper documents the goal and protocol of a community-based, mindful walking randomized controlled trial to examine the short- and longer-term efficacy on cognitive and other health-related outcomes in ADRD at-risk AA older adults. The study outcomes include various brain health determinants, including cognitive function, quality of life, psychological well-being, physical activity, mindfulness, sleep, and overall health status. In addition, the estimated costs of program implementation are also collected throughout the study period. This study will recruit 114 older adults (ages 60+ years) with elevated ADRD risk from the Midlands region of South Carolina. Older adults are randomly assigned to participate in 24 sessions of outdoor mindful walking over three months or a delayed mindful walking group (n=57 in each group). Participants in both groups follow identical measurement protocols at baseline, after 12 weeks, after 18 weeks, and after 24 weeks from baseline. The outcome measures are administered in the lab and in everyday settings. Costs per participant are calculated using micro-costing methods. The eliciting participant costs for mindful walking engagement with expected results are reported using the payer and the societal perspectives.DiscussionThis study will generate evidence regarding the efficacy of mindful walking on sustaining cognitive health in vulnerable older adults. The results can inform future large-scale effectiveness trials to support our study findings. If successful, this mindful walking program can be scaled up as a low-cost and viable lifestyle strategy to promote healthy cognitive aging in diverse older adult populations, including those at greatest risk.Trial registrationClinicalTrials.gov number NCT06085196 (retrospectively registered on 10/08/2023).

Yoga in Schools: Self-Care for Administrators and Teachers

Since early 20th century, yoga is applied as a therapeutic intervention to provide various psychophysiological benefits. It has been positioned as an effective tool to combat compassion fatigue of professionals. School based yoga is usually integrated in Physical Education curriculum or department. Yoga’s development in China has become the prevalent fitness choice founded by imported knowledge and traditional interpretation of body technique. School administrators can equally have emotional concerns, similar internal struggles and external conflicts with others but minimal literature on self-care is studied about them. The purpose of this study was to assess the yoga in schools and examine the self-care of administrators and supervisors. This study was anchored on Mindful-Based Supervision Framework by Haberlin (2020) which involves Mindful walking, Deep listening, Mindful notetaking, and Meditation. The latter was the focus of the study that uses yoga to achieve self-care among school administrators in China. The study involved mostly male respondents between 31-36 years old with permanent employment as teachers who served as administrators or supervisors for one year. Using quantitative descriptive correlational design, respondents agreed in all attributes in yoga in school such as objectives, content, and impact and occasionally practiced all attributes of self-care in terms of physical, psychological, emotional, spiritual, and balanced self-care practices. To strengthen and intensify the yoga program for teachers and school administrators, self-care strategies were recommended to be integrated as the output of the study.

Impact of Religion-Based Mindful Walking Meditation on Cardiometabolic and Mental Health.

Walking meditation or mindful walking is a widely performed form of Buddhist practice that focuses on mind-body interactions. We have found that this particular form of exercise was highly effective in eliciting improvements in cardiometabolic and functional fitness measures in a number of clinical populations. In some key measures, the magnitudes of benefits were greater than the traditional walking program.

Implementation of a Mindful Walking Intervention in Breast Cancer Patients After Their Primary Oncologic Treatment: Results of a Qualitative Study Within a Randomized Controlled Trial.

Breast cancer survivors often suffer from diagnosis- and therapy-related long-term side effects, such as cancer related fatigue, restricted stress resilience and quality of life. Walking as a physical activity and mindfulness practice have been shown to be helpful in studies. The aim of this study was to compare the individual experiences and subjectively perceived effects of walking in combination with mindfulness practice with moderate walking alone in breast cancer patients. This paper focuses on the qualitative results of a mixed-methods pilot study. Breast cancer patients who had finished their primary oncologic treatment at least 6 months ago were randomized to an 8-week group intervention program of either mindful walking or moderate walking. Within the qualitative study part, semi-structured focus group interviews (2 interviews per study arm) were conducted and analyzed using a qualitative content analysis approach. Audio recorded interviews were transcribed verbatim and pseudonymized. The subsequent data analysis was performed by using MAXQDA®. A total of 51 women (mean age 55.8 [SD 10.9] years) were included in the RCT, among these 20 (mean age 56.7 [SD 12.0] years) participated in the focus group interviews (n = 11 patients of the mindful walking group; n = 9 patients of the walking group). Breast cancer patients in both groups described different effects in the complex areas of self-efficacy, coping, body awareness and self-reflection. While mindful walking primarily promoted body awareness and inner strength by mindfulness in breast cancer patients, moderate walking promoted self-efficacy by a confidence of their body and an easily integrated and accepted way of physical activity. Study interventions and the study setting triggered processes and reflections on one's own health and situation. However, mindful walking and moderate walking seem to address different resources. This important knowledge may help oncologists and other therapists to assess what type of interventions can best meet the needs and requirements of individual patients. DKRS00011521; prospectively registered 21.12.2016; https://drks.de/search/de/trial/DRKS00011521.

Pemberdayaan Kesehatan Ibu Hamil dengan Aplikasi Mindfulness Pregnancy

Mental health problems during pregnancy can cause complications in pregnancy. In Bandar Lor Village there are still many pregnant women who experience psychological problems. The purpose of this community service is to increase the understanding and skills of pregnancy mindfulness in pregnant women independently through online mindfulness pregnancy applications and hands-on exercises to increase self-empowerment in optimizing their mental health during pregnancy. Community service activities are carried out in 2x meetings with a distance of 2 weeks. Each meeting was held for 4 hours. Training was also given to 50 pregnant women. The skills provided are on how to use the application, and then train pregnant women in practicing mindfulness/meditation which includes mindful breathing awareness, mindfulness eating, loving-kindness meditation, prenatal yoga, body scanning with baby, sitting meditation, mindful walking, and silent meditation. The results of the interviews and post-tests obtained an increase in the understanding and skills of pregnant women regarding the use of mindfulness pregnancy applications, skills in meditation/mindfulness, and improving mental health. Suggestions for further community service activities are to develop wider community empowerment according to health problems that are currently developing in Indonesia.

PE augmented mindfulness: A neurocognitive framework for research and future healthcare.

Various well-controlled studies have suggested that practitioners in mindfulness can be prone to patient drop-out (e.g., due to chronic stress, pathology, cognitive reactivity), despite researchers having identified the underlying mechanisms that link mindfulness to mental health. In this article, a framework for physical exercise (PE) augmented mindfulness is proposed, which posits that consistently practiced PE before meditation can support (early-stage) mindfulness. Neurocognitive research shows PE (aerobic exercises or yoga) and mindfulness to impact similar pathways of stress regulation that involve cognitive control and stress regulation, thereby supporting the proposed synergistic potential of PE augmented mindfulness. Research focused on the psychophysiological impact of PE, showed its practice to promote short-term neurocognitive changes that can promote both cognitive control and the attainment of mindful awareness (MA). In order to chart dose responses required for protocol development, further research will be presented. Together these findings are discussed in light of future research on this multidisciplinary topic, protocol development, mindful walking, and further application in healthcare and beyond.

Effectiveness of a mindful nature walking intervention on sleep quality and mood in university students during Covid-19: A randomised control study

ObjectiveThe aim of this project was to conduct a randomised control study to examine whether outdoor mindful walking in nature can effectively improve university students’ sleep quality, mood, and mindfulness during the Covid-19 pandemic in the U.K. MethodsParticipants were measured at T0 (pre-study baseline), T1 (pre-intervention), T2 (post-intervention), and T3 (follow-up). A total of 104 participants (female = 94) who were experiencing sleep difficulties were randomly allocated to either an experimental (i.e., nature) or control (i.e., urban) walking environment. Participants in each walking condition independently undertook a daily 35-minute walk for a week (7 days). Subjective sleep quality, total mood disturbance, mindfulness, and degree of nature connectedness, and participants’ perspectives on the intervention, were collected. ResultsFindings suggest that both groups resulted in significant improvements in participants' trait mindfulness, sleep quality and mood after the intervention. However, mindful walking in nature did not bring additional mental health benefits to participants relative to those who walked an urban environment. Participants provided their perspectives about the intervention, which will assist with future intervention development. ConclusionsFindings contribute to the evidence-base on the effectiveness of outdoor mindful walking interventions for enhancing mental health. These findings contribute new knowledge on how mindful walking outdoors reduces university students’ mood disturbances and improves sleep quality and mindfulness level.

Adaptations to mindfulness-based interventions for neurological impairment: The SMALL PROMPTS approach.

Standardized mindfulness-based interventions (MBIs), used for the management of physical and psychological symptoms associated with neurological impairment/injury (NI), have been problematized as lacking accessibility due to their focus on sensory presence and mindful walking. Research is needed to generate formalized recommendations regarding how MBIs may be best adapted to enhance their suitability for people with NI. A two-phase qualitative study was completed. First, semistructured interviews were undertaken with eight accredited mindfulness teachers with NI. Interviews reviewed the adaptations participants made in their personal and teaching practice, using thematic analysis, and generated recommendations for adaptations to MBIs specific to people with NI. Second, using the DELPHI method, the adapted practice recommendations were reviewed and revised via three rounds, following cognitive interviews with an expert panel (N = 5 trained mindfulness teachers with NI). Ten core areas for adaptation are proposed and validated, acting as SMALL PROMPTS which can be used to adapt mindfulness-based teaching techniques to the specific requirements of people with NI: (a) Skin/bladder/bowel management; (b) mindful Movement; (c) Accessible training; (d) Language Leadership; (e) Permissive pRactice; (f) Optimizing timelines; (g) Management of posture; (h) inclusion of Pacing; (i) Teaching from experience; and (j) body Scanning. Mindfulness is a highly applicable approach for people with sensory loss, however significant, specific adaptations are required to improve inclusivity and accessibility. The SMALL PROMPTS adaptations increase the accessibility, applicability, and utility of MBIs for populations living with NI, enhancing effective management of physical and psychological wellbeing, and optimizing MBI delivery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Mindful Walking in Patients with Chronic Low Back Pain: A Randomized Controlled Trial

Aim:The objective of this study was to investigate the effectiveness of a mindful walking program (MWP) in patients with chronic low back pain (CLBP).Methods:The trial was a two-armed, randomized, controlled single-center open clinical trial. The study was performed in the Outpatient Clinic for Integrative Medicine of the Charité–Universitätsmedizin Berlin. The participants were adults aged 18–65 years with CLBP (≥3 months) and an average low back pain within the past 7 days measured on a visual analog scale (VAS, 0 = no pain, 100 = worst imaginable pain) of at least 40 mm. The patients received either eight weekly MWP sessions or no intervention (control). The primary outcome was the perceived pain intensity assessed with a VAS (0–100 mm) after 8 weeks. The secondary outcomes included back function assessed by the Hannover Functional Questionnaire Backache (FFbH-R) and perceived stress assessed by the 14-item Cohen's Perceived Stress Scale (PSS-14). The results were obtained by analysis of covariance adjusted for the respective baseline values.Results:In total, 55 patients were randomized (MWP: n = 29, 82.8% female, mean (±standard deviation) age: 52.5 ± 8.6 years, pain: 56.4 ± 14.1 mm; control: n = 26, 84.6% female, 54.8 ± 7.5 years, pain: 55.4 ± 13.1 mm). After 8 weeks, compared with the control conditions, the MWP was not associated with a statistically significant benefit for pain (VAS), adjusted mean − 9.6 [−22.3 to 3.1], p = 0.136, clinical benefits for back function (FFbH-R), adjusted mean 2.2 [−4.2 to 8.6], p = 0.493, or stress (PSS-14), adjusted mean − 1.6 [−4.8 to 1.6], p = 0.326.Conclusion:In conclusion, compared with no intervention, mindful walking did not significantly improve pain, back function, or perceived stress in patients with CLBP.Clinical Trial registration:ClinicalTrials.gov (NCT01893073).

MINDFUL WALKING IN KNEE OSTEOARTHRITIS: A FEASIBILITY RANDOMIZED CONTROLLED TRIAL

Purpose: Current walking interventions for people with knee osteoarthritis (OA) focus on either reducing knee joint loading or on increasing physical activity. There is a need for interventions that could address both quality and quantity of walking for people with knee OA. The goal of this randomized controlled trial (clinicaltrials.gov # NCT03064139) was to determine the feasibility of a mindful walking intervention to improve quality and quantity of walking in people with knee OA.

Feasibility and Possible Effects of Mindful Walking and Moderate Walking in Breast Cancer Survivors: A Randomized Controlled Pilot Study With a Nested Qualitative Study Part.

Introduction:Breast cancer (BC) survivors often suffer from disease- and therapy-related long-term side-effects. The study aim was to explore the feasibility, adherence, and individual experiences as well as possible effects of 2 different walking interventions in BC patients.Methods:This randomized controlled, pragmatic pilot trial included a qualitative study component. BC patients were randomized to either mindful walking (MFW) with mindfulness exercises and walking or moderate walking (MW) alone in weekly group sessions over 8 weeks. After 8 and 16 weeks, satisfaction, and self-perceived effectiveness as well as different health-related outcomes including health-related (WHOQOL-BREF) and disease-specific quality of life (FACT-G), perceived stress (PSQ) and cancer-related fatigue (CFS-D) were assessed. ANCOVA was used to evaluate differences in study outcomes. Qualitative data included 4 focus group interviews including 20 patients and were analyzed using a directed qualitative content analysis approach.Results:Altogether, 51 women (mean age 55.8 years (SD 10.9)) were randomized (n = 24 MFW; n = 27 MW). Both groups would recommend the course to other BC patients (MFW 88.9%; MW 95.2%) and showed possible improvements from baseline to week 8, without statistically significant difference between groups: WHOQOL-BREF (MFW: adjusted mean 65.4 (95% confidence interval (CI), 57.1-73.7); MW: 61.6 (53.6-69.6)); FACT-G (MFW: 76.0 (71.5-80.5); MW: 73.0 (68.5-77.4)); PSQ (MFW: 45.3 (40.5-50.1); MW: 45.4 (40.8-50.0)); CFS-D (MFW: 24.3 (20.8-27.8); MW: 25.5 (22.1-28.8)). Improvements lasted until the 16-weeks follow-up. The qualitative analysis suggested that MFW primarily promoted mindfulness, self-care, and acceptability in BC patients, whereas MW activated and empowered the patients as a result of the physical exercise.Conclusion:Both study interventions were positively evaluated by patients and showed possible pre-post effects in disease-specific health-related outcomes without differences between groups. The qualitative analysis results indicate that different resources and coping strategies were addressed by the 2 study interventions.Trial registration:DKRS00011521; prospectively registered 21.12.2016; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011521.

A protocol and novel tool for systematically reviewing the effects of mindful walking on mental and cardiovascular health.

To our knowledge, no published systematic review has described the effects of mindful walking on mental and cardiovascular health. We have aimed to fill this gap by first establishing our systematic review protocol. Our protocol was adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and is registered in PROSPERO (Registration Number: CRD42021241180). The protocol is described step-by-step in this paper, which we wrote to achieve three objectives: to adhere to the best practices stated in the PRISMA guidelines, to ensure procedural transparency, and to enable readers to co-opt our protocol for future systematic reviews on mindful walking and related topics. To achieve our third objective, we provide and explain a novel tool we created to track the sources we will find and screen for our review. Ultimately, the protocol and novel tool will lead to the first published systematic review about mindful walking and will also facilitate future systematic reviews.

The role of place attachment in recreation experience and outcome preferences among forest bathers

Forest bathing or forest therapy encompasses slow mindful walking and deep immersion in nature while utilizing all sensory systems, which can occur during multiple recreation activities. This study examined differences in demographic and visit characteristics, recreation experience preferences (i.e., experiential on-site benefits sought), and improved well-being outcome preferences (i.e., long-term off-site outcomes) based on forest bathers’ varying levels of place attachment. The study was framed by immersion in nature benefits-related theories and an Outcomes-Focused Management approach. Using a convenience sample and several forest bathing criteria, responses (N = 247) were voluntarily and anonymously collected with an exit survey of forest bathing participants at national, county, and metropolitan/municipal forests in South Korea from late July to mid-September in 2014. Cluster analysis segmented forest bathing participants into three place attachment groups (Low-Medium-High). Results revealed that forest bathers experiencing higher levels of place attachment were more likely to be non-local, repeat visitors who partake in water-based immersion and mindful forest walking activities. More highly attached forest bathing participants considered various on-site recreation benefits (e.g., social connection, nature enjoyment, physical and mental health) to be more important than less attached forest bathing participants. Also, more highly attached forest bathing participants rated preferences for various improved well-being outcomes, including psychophysiological, psychological, social, economic, and environmental factors significantly higher. Results suggest that forest bathing participation has a significant role in enhancing positive well-being benefits. ∙ Forest therapy known as ‘forest bathing’ is a globally emerging and increasingly popular recreational activity in natural areas. ∙Forest bathing participants with higher levels of attachment to a natural area report stronger preferences for achieving not only on-site personal, health and social benefits but also off-site personal, social, economic, and environmental benefits. ∙Managers can prepare maps indicating sitting places to reflect on natural features and engage with notable natural elements during their forest bathing experience. ∙Forest bathing participants often develop a high sense of attachment to and desire diverse benefit opportunities in the natural area so managers are advised to offer several forest bathing trails of varying lengths with various natural features, so that the more attached forest bathers can achieve the higher levels of experience outcomes they seek. These opportunities should be clearly communicated through websites and trailhead displays to ensure that first-time and long-term visitors are aware of the diverse opportunities available. ∙Since forest bathers are shown to be more highly attached to their natural area, this can benefit managers by having visitors who are more likely to be advocates and supporters of their natural areas when threats emerge or additional funding is needed.

Mindful walking and cognition in older adults: A proof of concept study using in-lab and ambulatory cognitive measures

Mindfulness practice and walking have been linked individually to sustain cognition in older adults. This early-phase study aimed to establish proof-of-concept by evaluating whether an intervention that integrates light-intensity walking with mindfulness practices shows promising signs of improving cognition in older adults. Participants (N = 25, Mage = 72.4 ± 6.45) were community-dwelling older adults who engaged in a supervised mindful walking program over one month (8 sessions total, 2 sessions per week, 30-minute slow walking containing mindfulness skills). They completed performance-based and subjective ratings of cognitive measures in field before and after two mindful walking bouts using a smartphone app. They also completed in-lab performance-based and self-report cognitive measures at baseline and after the entire program. Controlling for demographics, potential covariates, and time trends, short-term improvements in perceived cognition and processing speed were observed from pre- to post-mindful walking sessions (i.e., 30 min) across multiple ambulatory cognitive measures (Cohen’s ds range = 0.46–0.66). Longer-term improvements in processing speed and executive function were observed between baseline and end of the program (i.e., one month) across various performance-based cognitive measures (ds range = 0.43–1.28). No significant changes were observed for other cognitive domains. This early-phase study (Phase IIa) provides preliminary support that mindful walking activity is promising for sustaining cognition in older adults. Our promising findings form the building blocks of evidence needed to advance this intervention to a fully powered randomized controlled trial that examines program efficacy with a comparator. Favorable outcomes will inform the development of this lifestyle behavioral strategy for promoting healthy brain aging in late adulthood.

Gateways to New Learnings: Walking to Re/Vision an International Practicum

We engage in a creative exploration of the ways in which a walk provided us with insights into how we might enhance the curriculum for a teacher education international practicum in Italy. Drawing from a currere framework, we shifted to mindful walking, and we tell our story in three parts that represent the various stages of our mindful engagement: intention; attention; and attitude. Walking in this way provided the impetus for us to re-examine the curriculum of the international practicum. We argue that mindful walking has the potential to increase observation skills and open up ways to develop deeper cultural connections in an international practicum. We consider what those connections could do to enhance the practicum and our teacher candidates’ experience.

Walking and mindfulness improve the exercise capacity of patients with chronic obstructive pulmonary disease: A randomised controlled trial

Objective: To evaluate the effects of mindful walking practice on the exercise capacity of patients with chronic obstructive pulmonary disease (COPD). Design: A randomised controlled trial with four repeated measurements. Setting: Outpatient departments of a medical centre in northern Taiwan. Participants: Patients with mild to severe COPD. Intervention: The control group received usual care, whereas the mindful walking group received usual care plus undertook a mindful walking practice. Outcome measures: The main outcome was the six-minute walk distance. And the Global Initiative for Chronic Obstructive Lung Disease classification, dyspnoea, heart rate variability and interoceptive awareness were control factors. Results: Compared with the control group (n = 40), the mindful walking group (n = 38) achieved a significantly longer six-minute walk distance (longer by 45.57 m; P = 0.04). The interaction effect of the six-minute walk distance significantly increased on Week 4 (P = 0.01), Week 8 (P = 0.002) and Week 12 (P = 0.02). Participants in Global Initiative for Chronic Obstructive Lung Disease class A exhibited significantly improved six-minute walk distance compared with those in class D (P = 0.001). Moreover, scores on the emotional awareness scale of interoceptive awareness were significantly associated with the six-minute walk distance (P = 0.02). Conclusion: The eight-week mindful walking practice improved the exercise capacity of patients with COPD, and its effect was sustained for at least four weeks after the end of the practice. This study suggest that this practice improved COPD symptoms, reduced COPD risk and increased the interoceptive awareness of this population.

The effect of acceptance and commitment training on improving physical activity during the COVID-19 pandemic

This study aimed to assess whether applied behavior analysis (ABA) procedures such as feedback, goal setting and stimulus control, combined with acceptance and commitment training (ACTr) interventions implemented digitally improve levels of physical activity, consistency with self-care values and psychological flexibility during the COVID-19 pandemic. A nonconcurrent multiple baseline design across five participants was used in this study. Participants included five women with BMI's in the overweight or obese range. All participants were exposed to two intervention phases. In the first phase, feedback, goal setting and stimulus control procedures were implemented to improve physical activity. In the next phase, these procedures were combined with mindful walking exercises and values clarification exercises. In addition, psychological flexibility related to physical activity and values consistency were measured throughout the study. Results indicated that step count improved with the implementation of ABA + ACTr across all participants. Furthermore, psychological flexibility and self-care value scores improved after the intervention and maintained at 1-week follow-up. Lastly, the impact of physical activity during COVID-19, effectiveness and efficiency of ABA + ACT interventions are discussed.