Exercise Sessions Research Articles

Efficacy of the mHealth-Based Exercise Intervention re.flex for Patients With Knee Osteoarthritis: Pilot Randomized Controlled Trial.

Exercise therapy is recommended by international guidelines as a core treatment for patients with knee osteoarthritis. However, there is a significant gap between recommendations and practice in health care. Digital exercise apps are promising to help solve this undersupply. This study aims to evaluate the efficacy of a 12-week fully automated app-based exercise intervention with and without a supporting knee brace on health-related outcomes, performance measures, and adherence in patients with knee osteoarthritis. This closed user group trial included participants with moderate to severe unicondylar painful knee osteoarthritis. Randomization was 1:1:2 into an intervention group (IG) with 2 subgroups (app-based training [IG A] and app-based training and a supportive knee brace [IG AB]) and a control group (CG). The intervention included a 12-week home exercise program with 3 sessions per week. Instructions for the exercises were given via the app and monitored using 2 accelerometers placed below and above the affected knee joint. Participants in the CG did not receive any study intervention but were allowed to make use of usual care. Osteoarthritis-specific pain (Knee Injury and Osteoarthritis Outcome Score) was defined as the primary outcome, and secondary outcomes included all other Knee Injury and Osteoarthritis Outcome Score subscales, general health-related quality of life (Veterans RAND 12-item Health Survey), psychological measures (eg, exercise self-efficacy), performance measures (strength and postural control), and the monitoring of adherence and safety. Outcomes were assessed at baseline and after 12 weeks. Intervention effects were calculated using baseline-adjusted analysis of covariance for the joint comparison of IG A and IG AB versus the CG using a per-protocol approach. Subgroup analyses were conducted for each IG separately. A total of 61 participants were included (IG: n=30, 49%; CG: n=31, 51%; male: n=31, 51%; female: n=30, 49%; mean age 62.9, SD 8.5 years; mean BMI 27.7, SD 4.5 kg/m2). Analysis revealed statistically significant effects in favor of the IG for pain reduction (P<.001; effect size [ES]=0.76), improvements in physical function (P<.001; ES=0.64), improvements in symptoms (P=.01; ES=0.53), improvements in sport and recreation activities (P=.02; ES=0.47), improvements in knee-related quality of life (P<.001; ES=0.76), and improvements in the physical component of general health-related quality of life (P<.001; ES=0.74). Mean differences ranged from 6.0 to 13.2 points (scale range 0-100). ESs indicated small to medium effects. No effects were found for psychological and performance measures. Participants adhered to 92.5% (899/972) of all scheduled exercise sessions. Individuals with knee osteoarthritis undergoing a 12-week sensor-assisted app-based exercise intervention with or without an additional knee brace experienced clinically meaningful treatment effects regarding pain relief and improvements in physical function as well as other osteoarthritis-specific concerns compared to controls. German Clinical Trials Register (DRKS) DRKS00023269; https://drks.de/search/de/trial/DRKS00023269.

Systematic review of adherence to technology-based falls prevention programs for community-dwelling older adults: Reimagining future interventions.

Prevention programs, and specifically exercise, can reduce falls among community-dwelling older adults, but low adherence limits the benefits of effective interventions. Technology may overcome some barriers to improve uptake and engagement in prevention programs, although less is known on adherence for providing them via this delivery mode. We aimed to synthesize evidence for adherence to technology-based falls prevention programs in community-dwelling older adults 60 years and older. We conducted a systematic review following standard guidelines to identify randomized controlled trials for remote delivered (i.e., no or limited in-person sessions) technology-based falls prevention programs for community-dwelling older adults. We searched nine sources using Medical Subject Headings (MeSH) terms and keywords (2007-present). The initial search was conducted in June 2023 and updated in December 2023. We also conducted a forward and backward citation search of included studies. Two reviewers independently conducted screening and study assessment; one author extracted data and a second author confirmed findings. We conducted a random effects meta-analysis for adherence, operationalized as participants' completion of program components, and aimed to conduct meta-regressions to examine factors related to program adherence and the association between adherence and functional mobility. We included 11 studies with 569 intervention participants (average mean age 74.5 years). Studies used a variety of technology, such as apps, exergames, or virtual synchronous classes. Risk of bias was low for eight studies. Five interventions automatically collected data for monitoring and completion of exercise sessions, two studies collected participants' online attendance, and four studies used self-reported diaries or attendance sheets. Studies included some behavior change techniques or strategies alongside the technology. There was substantial variability in the way adherence data were reported. The mean (range) percent of participants who did not complete planned sessions (i.e., dropped out or lost to follow-up) was 14% (0-32%). The pooled estimate of the proportion of participants who were adherent to a technology-based falls prevention program was 0.82 (95% CI 0.68, 0.93) for studies that reported the mean number of completed exercise sessions. Many studies needed to provide access to the internet, training, and/or resources (e.g., tablets) to support participants to take part in the intervention. We were unable to conduct the meta-regression for adherence and functional mobility due to an insufficient number of studies. There were no serious adverse events for studies reporting this information (n = 8). The use of technology may confer some benefits for program delivery and data collection. But better reporting of adherence data is needed, as well as routine integration and measurement of training and skill development to use technology, and behavior change strategies within interventions. There may be an opportunity to rethink or reimagine how technology can be used to support people's adoption and integration of physical activity into daily life routines.

Acute effect of different types of moderate intensity physical exercise on affective response and mood state in individuals with substance use disorder

Substance use disorder (SUD) affects a significant percentage of people around the world, negatively influencing aspects of physical and mental health. Physical exercise can promote acute and chronic effects on the affective response and mood of individuals and has shown promising effects in all phases of rehabilitation. The objective of this study was to verify the acute effects of two types of physical exercises at moderate intensity on the mood state and on the affective response of individuals hospitalized for the treatment of SUD. For this purpose, 43 individuals (31 men and 12 women) underwent two physical exercise sessions (one aerobic and one functional) and a control session. Before and immediately after the sessions, subjects answered questionnaires about mood, affective valence, and perceived arousal. Generalized estimating equations (GEE) followed by the Bonferroni post hoc test were used to assess the effect of timing and session on the variables. The results showed significant improvements after both physical exercise sessions in mood (reduction in levels of tension, depression, anger, fatigue, and confusion) and in affective valences (feeling of pleasure and arousal perception), with no changes after the control session. It is observed that different types of physical exercises can positively impact the mental health of individuals undergoing treatment for SUD and should be used as a non-pharmacological strategy in the rehabilitation process.

Aerobic exercise elevates perceived appetite but does not modify energy intake over a 3-day postexercise period: A pilot study.

While a low degree of energy compensation is typically reported over the 24 h following a session of exercise, the prolonged impact of a bout of exercise on energy intake remains unclear. To overcome the challenge associated with accurately measuring energy intake in a free-living environment, this study employed the use of a meal replacement beverage to assess the 3 day impact of an exercise session on energy intake. In a randomized, crossover study, 14 participants (8 male, 6 female) completed two trials: (1) EX: 75 min exercise on a motorized treadmill (75% VO2peak); and (2) SED: 75 min sedentary control session. Each condition was followed by 3 days of exclusive adlibitum consumption of a meal replacement beverage. Appetite-regulating hormones, subjective appetite, energy intake, and energy expenditure were assessed. Exercise transiently suppressed the orexigenic hormone acyl-ghrelin (p < 0.05) and elevated the appetite-supressing hepatokine GDF-15 (p < 0.05). Despite these acute changes, overall perceived appetite was elevated over the 3 day assessment period with exercise (p < 0.05). No increase in energy intake or change in postexercise physical activity patterns were observed. One acute session of moderate to vigorous exercise is unlikely to affect short-term, three-day energy balance in healthy individuals.

The Release of Lipolytic Hormones during Various High-Intensity Interval and Moderate-Intensity Continuous Training Regimens and Their Effects on Fat Loss.

To investigate the release of lipolytic hormones during various high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), and their effects on fat loss. 39 young women categorized as obese (with a body fat percentage (BFP) ≥30%) were randomly allocated to one of the following groups: all-out sprint interval training (SIT, n =10); supramaximal HIIT (HIIT120, 120%V̇O2peak, n = 10); HIIT (HIIT90, 90%V̇O2peak, n = 10), or MICT, (60%V̇O2peak, n = 9) for a twelve-week observation period consisting of 3 to 4 exercise sessions per week. Serum epinephrine (EPI) and growth hormone (GH) were measured during the 1st, 20th, and 44th training sessions. Body weight (BW), body mass index (BMI), whole-body fat mass (FM) and BFP were assessed pre- and post-intervention. Following the 1st and 20th sessions, significant increases in EPI (p < 0.05) were observed post-exercise in HIIT120 and HIIT90, but not in SIT and MICT. In the 44th session, the increased EPI was found in SIT, HIIT120, and HIIT90, but not in MICT (p < 0.05). For the GH, a significant increase was observed post-exercise in all groups in the three sessions. The increased EPI and GH returned to baselines 3 hours post-exercise. After the 12-week intervention, significant reductions in FM and BFP were found in all groups, while reductions in BW and BMI were only found in the SIT and HIIT groups. Greater reductions in FM and BFP, in comparison to MICT, were observed in the SIT and HIIT groups (p < 0.05). 12-week SIT, HIIT120, and HIIT90, in comparison to MICT, were more efficacious in fat reduction in obese women, partly benefiting from the greater release of lipolytic hormones during training sessions.

Segmental multi-frequency bioelectrical impedance analysis indicates dehydration status after exercise

AimHydration status monitoring is critical to help those in exercise training to avoid serious dehydration. Bioelectrical impedance analysis (BIA) is a convenient and timely method to monitor body composition in resting conditions. The study obtained bioelectrical impedance (BI) from different segments at multi-frequency before and after exercise aiming to evaluate whether segmental multi-frequency (SMF)-BIA can indicate exercise dehydration in humans. MethodsA total of 43 young adults were recruited. Body weight (BW) and segmental BI at frequencies of 1, 5, 50, 250, 500, and 1000 kHz from each subject were measured before and after each bout of exercise. Hydration status was assessed by body weight loss (BWL), indicated by changes in body weight (ΔBW) and the percentage of body weight change (ΔBW%). Each subject participated in 3 to 4 exercise sessions on different days. ResultsA total of 143 pieces of data were collected with various degrees of dehydration: BWL ranging from 0.2–4.2 kg (0.4 %–5.8 %) in participants (aged 24.40 ± 6.47). Correlation analysis revealed that the changes of BI (ΔZ) in arms and legs during exercise were correlated with the BWL. Multivariate regression and machine learning analysis showed that predicted values of dehydration were correlated with true values of dehydration (ΔBW: R2 = 0.4471, R2 = 0.5502; ΔBW%: R2 = 0.4469, R2 = 0.5073). When the diagnosis of dehydration is based on BWL > 1 %: the AUC of the SMF-BIA regression model was 0.7262 (p < 0.001) and the specificity and sensitivity were 85.19 %, 60 %. When the diagnosis of dehydration is based on BWL > 2 %: the AUC of the SMF-BIA regression model was 0.8757 (p < 0.0001) and the specificity and sensitivity were 77.22 %, 81 %. ConclusionThese results suggested that SMF-BIA can indicate exercise dehydration in humans.

Molecular Transducers of Physical Activity Consortium (MoTrPAC): human studies design and protocol.

Physical activity, including structured exercise, is associated with favorable health-related chronic disease outcomes. Although there is evidence of various molecular pathways that affect these responses, a comprehensive molecular map of these molecular responses to exercise has not been developed. The Molecular Transducers of Physical Activity Consortium (MoTrPAC) is a multicenter study designed to isolate the effects of structured exercise training on the molecular mechanisms underlying the health benefits of exercise and physical activity. MoTrPAC contains both a preclinical and human component. The details of the human studies component of MoTrPAC that include the design and methods are presented here. The human studies contain both an adult and pediatric component. In the adult component, sedentary participants are randomized to 12 wk of Control, Endurance Exercise Training, or Resistance Exercise Training with outcomes measures completed before and following the 12 wk. The adult component also includes recruitment of highly active endurance-trained or resistance-trained participants who only complete measures once. A similar design is used for the pediatric component; however, only endurance exercise is examined. Phenotyping measures include weight, body composition, vital signs, cardiorespiratory fitness, muscular strength, physical activity and diet, and other questionnaires. Participants also complete an acute rest period (adults only) or exercise session (adults, pediatrics) with collection of biospecimens (blood only for pediatrics) to allow for examination of the molecular responses. The design and methods of MoTrPAC may inform other studies. Moreover, MoTrPAC will provide a repository of data that can be used broadly across the scientific community.NEW & NOTEWORTHY The Molecular Transducers of Physical Activity Consortium (MoTrPAC) will be the first large trial to isolate the effects of structured exercise training on the molecular mechanisms underlying the health benefits of exercise and physical activity. By generating a compendium of the molecular responses to exercise, MoTrPAC will lay the foundation for a new era of biomedical research on Precision Exercise Medicine. Presented here is the design, protocols, and procedures for the MoTrPAC human studies.

P212 COMPARISON OF COLLEGE STUDENTS’ HEALTH METRICS DURING TRADITIONAL AND VIRTUAL REALITY BASED CYCLING

Background: Most college students do not meet the recommended physical activity guidelines. Novel technology such as virtual reality (VR) may be used to promote physical activity among sedentary students. Purpose: To investigate physiological changes in heart rate (HR), blood-pressure (BP) and rating of perceived exertion (RPE) among college students during stationary cycling with and without VR. Methods: Twenty-two college-students (7 M/15F; 18-30years) were recruited on campus. Students separately &amp; randomly completed 2 separate cycling-sessions (with and without VR). The VZFit Ring Racer application with Meta Quest 2 VR Headset synced to a RENPHO smart AI bike was used for the VR session. HR, BP and RPE were assessed at 5-min intervals. Results: Only, RPE at 5-min interval was significant (p=0.032) between the non-VR and VR groups, which may be attributed to the fact that participants were focused more on the VR environment rather than the exercise session, potentially lowering their RPE. Conclusions: In this preliminary data, college students HR, BP &amp; RPE were influenced during the VR session with RPE being lower. This suggests that VR may reduce the perception of effort for a given exercise intensity, and it could be used as a tool to engage students and promote physical activity, in an otherwise sedentary student population.

O93 BRIGHT LIGHT EXPOSURE ATTENUATES BLOOD PRESSURE REDUCTION POSTEXERCISE

Background and objective: A single session of aerobic exercise lowers blood pressure (BP), known as postexercise hypotension (PEH). Bright light (BL) exposure increases BP at rest compared to dim light (DL). However, whether BL exposure can attenuate PEH remains unknown, and this hypothesis was tested in the current study. Methods: Twenty healthy men (27±5 years) underwent two experimental sessions: one under BL (5000 lux) and another under dim light (DL ≤8 lux), performed in random order. In each session, subjects executed an aerobic exercise session on a cycle ergometer for 30 min at 50-60-% heart rate (HR) reserve. BP (oscillometric) and HR (HR monitor) were measured, and rate-pressure-product (RPP) was calculated (systolic BP * HR) pre- and postexercise. Additionally, subjects wore an ambulatory BP monitor (ABPM) for 24 hours after postexercise measurements. Results: Systolic BP decreased similarly postexercise in both sessions, but its levels were higher in BL than DL throughout the experimental session (Figure 1A). Diastolic and mean BPs decreased postexercise only in DL at 30 min, while they increased in BL at 60 and 90 min (Figure 1B and 1C, respectively). HR and RPP increased in both sessions postexercise, but RPP levels were higher throughout the experimental session in BL than DL (Figure 1D and 1E, respectively) and for the first three hours of ABPM. Conclusions: In healthy adult men, BL exposure increased systolic BP and cardiac work and attenuated PEH on diastolic and mean BPs.

Effects of postprandial exercise timing on blood glucose and fluctuations in patients with type 2 diabetes mellitus.

The aim of this study was to assess how moderate-intensity aerobic exercise performed 45 minutes and 90 minutes after a meal affects blood glucose levels and fluctuations in individuals diagnosed with type 2 diabetes mellitus (T2DM). Twenty-two patients with T2DM, who were solely receiving oral hypoglycemic medication, were enrolled and divided randomly into two categories: those exercising 45 minutes after a meal (45-minute postprandial exercise group) and those exercising 90 minutes post-meal (90-minute postprandial exercise group). Both groups engaged in a 30-minute session of moderate-intensity aerobic stationary bike exercise following breakfast. This aerobic exercise regimen consisted of two stages, with the groups switching exercise timings after the initial phase. Continuous glucose monitoring (CGM) was utilized to evaluate the blood glucose levels and fluctuations in the participants. After breakfast, both overall daily blood glucose levels and the area under the curve for blood glucose following breakfast were reduced in the 45-minute postprandial exercise group compared to the 90-minute postprandial exercise group. The 45-minute postprandial exercise group demonstrated greater time spent within the target glucose range and less time above the target range than the 90-minute postprandial exercise group. Additionally, measures such as standard deviation, mean amplitude of glycemic excursions, largest amplitude of glycemic excursions, and postprandial glucose excursion for breakfast, peak postprandial glucose levels, and duration of elevated glucose levels were all lower in the 45-minute postprandial exercise group compared to the 90-minute postprandial exercise group. Moderate-intensity aerobic exercise lasting 45 minutes after meals was found to be more efficient in decreasing blood glucose levels and minimizing fluctuations compared to exercising 90 minutes after meals in patients with T2DM. Additionally, it notably reduced the peak in blood glucose levels after meals.

Skimmed, Lactose-Free Milk Ingestion Postexercise: Rehydration Effectiveness and Gastrointestinal Disturbances Versus Water and a Sports Drink in Physically Active People.

Postexercise hydration is fundamental to replace fluid loss from sweat. This study evaluated rehydration and gastrointestinal (GI) symptoms for each of three beverages: water (W), sports drink (SD), and skimmed, lactose-free milk (SLM) after moderate-intensity cycling in the heat. Sixteen college students completed three exercise sessions each to lose ≈2% of their body mass. They drank 150% of body mass loss of the drink assigned in randomized order; net fluid balance, diuresis, and GI symptoms were measured and followed up for 3hr after completion of fluid intake. SLM showed higher fluid retention (∼69%) versus W (∼40%; p < .001); SD (∼56%) was not different from SLM or W (p > .05). Net fluid balance was higher for SLM (-0.26kg) and SD (-0.42kg) than W (-0.67kg) after 3hr (p < .001), resulting from a significantly lower diuresis with SLM. Reported GI disturbances were mild and showed no difference among drinks (p > .05) despite ingestion of W (1,992 ± 425ml), SD (1,999 ± 429ml), and SLM (1,993 ± 426ml) in 90min. In conclusion, SLM was more effective than W for postexercise rehydration, showing greater fluid retention for the 3-hr follow-up and presenting with low-intensity GI symptoms similar to those with W and SD. These results confirm that SLM is an effective option for hydration after exercise in the heat.

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).

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.