Significant Effect Of Physical Activity Research Articles

Influence of Physical Exercise Program on Glycemic Status and Inflammatory Parameters in Type 2 Diabetes Mellitus

Introduction: Physical activity has a positive effect on the regulation of diabetes mellitus and has been shown to have benefits in improving health. Aim: Examine the effects of physical activity on changes in glycemic parameters (glucose, HbA1C) and inflammatory parameters (leukocyte count (WBC), CRP) before and one month after the exercise program. Material and Methods: The study was designed as a prospective, analytical, and observational study. Results: T-test of paired samples assessed the impact of physical activity on glycemic and inflammatory parameters in subjects with confirmed Diabetes mellitus type 2 and in subjects without confirmed diabetes mellitus type 2. In subjects with confirmed diabetes the value of eta squared (ɳ2 - eta sqared) is 95%, which indicates a significant impact of physical activity on the change in glucose values and on the change of HbA1C value was indicated by the value of eta square of 93%. When it comes to inflammatory parameters, the impact of physical activity was found in the reduced number of WBC (ɳ2 = 88%), and in CRP (ɳ2 = 90%). In subjects without confirmed diabetes mellitus, a significant effect of physical activity on the change in glucose (ɳ2 = 94%) and HbA1C (ɳ2 = 77%). The influence of physical activity on the reduction of leukocyte count was proven by ɳ2 - eta sqared test (ɳ2 = 66%), as well as a decrease in CRP (ɳ2 = 30%). Conclusion: This study showed a significant impact of physical activity on the reduction of elevated glycemic and inflammatory parameters.

Impact of Physical Activity-Based Interventions on Children and Adolescents’ Physical Self-Concept: A Meta-Analysis

ABSTRACT Background: Observational studies associate physical activity (PA) with improved perceptions of children and adolescents’ physical self-concept (PSC) and global self-concept (GSC). However, only a few PA-based interventions exist for improving PSC and their results have been inconclusive. Objective: To determine the effect of specific PA-based programmes on the PSC (including its sub-dimensions) and GSC of children and adolescents, and to assess possible moderators. Methods: The databases Web of Science, Scopus, SportDiscus, PubMed, CINAHL, and Cochrane Library were reviewed in February 2020. Only studies with pre-post measurements and control groups were included. The impact of PA-based interventions was explored through different meta-analyses and moderator analyses. Results: Altogether, 20 studies were included in the meta-analysis. Positive and significant effects of PA were determined on self-perceived physical appearance (g = 0.13; 95% CI = 0.03, 0.23), self-perceived sport competence (g = 0.30; 95% CI = 0.09, 0.51), self-perceived physical fitness (g = 0.19; 95% CI = 0.05, 0.32), PSC (g = 0.31; 95% CI = 0.10, 0.52), and GSC (g = 0.17; 95% CI = 0.01, 0.33). The existence of additional interventions in PA-based programmes (e.g., interventions focused on psychological factors or healthy habits) moderated the influence of PA on self-perceived sport competence and physical fitness. Moreover, environment and time were distinguished as moderators for self-perceived physical appearance and sport competence. Further, intervention type, gender, and frequency of intervention moderated the effects of PA on PSC. Conclusions: PA-based interventions, especially in school, seem to be beneficial for the development of positive physical self-perceptions.

Examining the Exercise and Self-Esteem Model Revised with Self-Compassion among Hong Kong Secondary School Students Using Structural Equation Modeling.

The association between physical activity in achieving mental health benefits and subjective well-being is consistently identified by empirical research. The causation of a positive self-concept created by physical exercise is empirically supported by Sonstroem and Morgan’s (1988) exercise and self-esteem model (EXSEM). However, various drawbacks of maintaining high self-esteem have been identified; thus, the concept of self-compassion was conjectured to be a form of “true self-esteem.” Hence, the current study aimed to investigate the relationship between physical activity and self-compassion by examining the exercise and self-esteem model revised with self-compassion (EXSEM-SC). This study recruited secondary school students from Hong Kong using convenience sampling. The structural equation modeling (SEM) approach, including path analysis and multiple indicators, multiple causes (MIMIC) modeling, were used to reveal the results of the study. The results (n = 1097) indicated that the relationship between physical activity and self-compassion could be demonstrated by the EXSEM-SC, with a satisfactory goodness-of-fit index in the SEMs. The SEM also demonstrated the direct paths from physical activity to self-compassion and mental well-being, indicating the significant effect of physical activity on self-compassion.

Factors contributing to distress among school and college-going adolescents during COVID-19 Lockdown: A cross-sectional study conducted in Sibi Balochistan, Pakistan.

BACKGROUND:Due to the COVID-19 pandemic, many countries have implemented nationwide lockdowns. While this leads to a decrease in disease transmission, there is a concurrent increase in the levels of psychological distress. To estimate the levels of psychological distress in school- and college-going adolescents currently under lockdown and to determine the factors associated with this psychological distress.MATERIALS AND METHODS:A cross-sectional study conducted in Army Public School and College (APSAC) Sibi, Balochistan province of Pakistan between March and May 2020. Students of APSAC Sibi were enrolled in this research. Modified Kuppuswamy Socioeconomic Scale, Godin Leisure-Time Exercise Questionnaire, and Kessler-10 were used for data acquisition. Chi-square and t-tests and univariate analysis (nonparametric test) were performed using the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM, Armonk, US).RESULTS:Out of 225 participants, 57.4% were studying at school. Sixty-four percent of the participants were likely to be suffering from psychological distress. There is a significant effect of physical activity, sleep duration, bedtime at night, screen-time duration, and COVID-19 positive family member on the levels of distress. A moderate positive correlation was between psychological distress and bed-time at night (rho[223] = 0.328, P < 0.001) and screen time duration (rho[223] = 0.541, P < 0.001). A moderate negative correlation of physical activity (rho[223] = −0.340, P < 0.001) and a weak negative correlation of sleep duration hours (rho[225] = −0.158, P = 0.018) was found with psychological distress levels.CONCLUSIONS:The COVID-19 lockdown and pandemic have had a considerable psychological impact on both school-going and college-going students, showing increased level of stress. A strong public health campaign along with mental and physical and social support programs are the need of the hour.

Physical activity counseling knowledge, attitudes and practices of healthcare providers in Kumasi, Ghana

Obesity, cardiovascular diseases, hypertension, diabetes, musculoskeletal pain and cancer mainly contribute to hospital admissions in Ghana. Although the significant effects of physical activity (PA) to ameliorate the burdens of these health conditions have been established, evidence of PA counseling knowledge, attitude and practice of Ghanaian healthcare providers (HCPs), who are mostly consulted, remain elusive. This cross-sectional survey examined PA counseling knowledge, attitudes and practices of 88 HCPs [doctors, nurses, and others; 37(42.0%) male and 51(58.0%) female, mean age = 34.36±9.91years] from tertiary, regional and district hospitals. PA counseling knowledge, attitude and practice questionnaire administered yielded the following findings: A significant proportion (59.2%, p <0.05) routinely counseled clients to accumulate 30 minutes of moderate-intensity of PA per session, while 92.1% (p <0.05) counseled clients on health benefits of PA at least once per year. The results further indicated that the HPCs had low (n=10, 11.36%), were somewhat knowledgeable (n=62, 70.45%), and had high knowledge and confidence (n=16; 18.18%) about clients’ PA and exercise assessment and counseling. A total of 58 (65.9%) doctors, nurses, and other HCPs received formal training related to PA benefits. A significant proportion of doctors, nurses, and others (n=78, 90.7%; p <0.05) were interested in obtaining training related to PA and exercise counseling. Thirty-six (40.9%) had light PA <3 METS/week and 47(53.4%) had received personal additional educational preparation in the field of counseling clients on PA. HCPs engage in some PA counseling within appreciable knowledge, attitude and practice. Policy-based PA and exercise counseling incorporated into existing medical education programmes is advocated.

Hubungan Aktivitas Fisik dan Perilaku Makan dengan Status Gizi Pelajar Sekolah Dasar Islam Al-Falaah Ciputat

Masalah gizi pada anak perlu mendapat perhatian karena pengaruhnya yang besar terhadap tumbuh kembang anak. Faktor-faktor yang memengaruhi status gizi antara lain aktivitas fisik, asupan energi yang berlebihan dan pengeluaran energi yang tidak seimbang yang menyebabkan kelebihan berat badan. Selain aktivitas fisik, perilaku makan turut berperan dalam terjadinya masalah gizi. Penelitian ini bertujuan untuk menganalisis hubungan aktivitas fisik dan perilaku makan dengan status gizi pada anak sekolah. Penelitian ini merupakan penelitian cross sectional dengan simple random sampling. Jumlah sampel yang digunakan dalam penelitian ini adalah 96 siswa sekolah SDI Al-Falaah Ciputat (usia 9-12 tahun). Kuesioner Baecke Physical Activities dan Child Eating Behavior yang telah divalidasi digunakan untuk pengumpulan data. Analisis bivariat digunakan untuk menganalisis pengaruh variabel bebas (aktivitas fisik dan perilaku makan) terhadap variabel terikat (status gizi). Hasil penelitian yang menyatakan bahwa terdapat korelasi positif antara aktivitas fisik dan status gizi. Siswa dengan aktivitas fisik rendah memiliki status gizi di atas normal. Siswa penghindar makanan cenderung memiliki status gizi yang lebih rendah, sedangkan siswa penyuka makanan berstatus obesitas. Analisis bivariat menunjukkan terdapat pengaruh yang signifikan aktivitas fisik dan perilaku makan terhadap status gizi anak SD Islam Al-Falaah Ciputat.

Association between Meeting Physical Activity Guidelines and Mortality in Korean Adults: An 8-year Prospective Study

[Purpose]Although previous studies have investigated the association between physical activity and various health outcomes, limited information is available on the effect of meeting new governmental guidelines for physical activity on the risk of mortality in Korean adults. This study aimed to examine the prospective association between meeting these guidelines and all-cause mortality during an 8-year follow-up using a large nationwide sample of middle-aged and older adults in Korea. [Methods]This prospective study was conducted based on the Korean Longitudinal Study of Ageing. The study participants included 9,177 adults aged 45 years or older at baseline, and all participants were monitored in a 2-year cycle during an 8-year period (70,873 person-years). The risk of mortality was analyzed by determining physical activity levels using the Cox proportional hazard models, and the hazard ratio (HR) and 95% confidence interval (CI) were estimated using Cox models. [Results]A statistically significant effect of physical activity on the reduced risk of mortality was observed in cases in which the participants met the guidelines compared to the inactive group (HR: 0.68, 95% CI: 0.58–0.81 vs. the inactive group). A strong association between meeting the recommended physical activity levels and the reduced risk of mortality was also found for non-smokers (HR: 0.62; 95% CI: 0.51–0.76 vs. the inactive group), but not for current smokers (HR: 0.93; 95% CI: 0.67–1.29 vs. the inactive group). [Conclusion]Meeting physical activity guidelines was associated with a decreased risk of all-cause mortality for Korean adults. Our results also suggest that smoking reduces the protective effect of physical activity on the risk of mortality.

(484) Physical activity and IL-6 related to capsaicin pain in healthy individuals

Participation in routine physical activity is associated with reduced clinical pain in chronic pain patients and a reduction in pain sensitivity in healthy participants. Proinflammatory cytokines, such as Interleuelkin-6 (IL-6), are associated with pain sensitivity and consistent exercise has been shown to reduce IL-6 levels. We examined the association between self-reported physical activity level (over a typical week), using the Godin Leisure-Time Exercise Questionnaire, IL-6 reactivity and response to capsaicin pain under saline and naloxone conditions. Naloxone (0.1mg/kg), an opioid antagonist, was utilized to probe endogenous opioid function and examine the effect on pain processing. Twenty-six healthy individuals (13 African American and 13 Non-Hispanic White) with complete data are included in these analyses. Blood was drawn before and after application of 10% topical capsaicin to the dorsum of the non-dominant hand. A thermode maintained a constant temperature of 40°Celsius for 90 minutes and pain ratings were obtained every five minutes. Participants who reported at least 15 minutes of strenuous (e.g., jogging) exercise >3x/week were categorized as high exercisers, and compared to low exercisers (<3x/wk). Analysis of variance (ANOVA), controlling for BMI, indicated a significant effect of physical activity on IL-6 reactivity (p=0.04), such that high exercisers showed reduced inflammatory reactivity to capsaicin pain. Repeated Measures ANOVA, controlling for BMI, race and sex (all factors known to influence pain) revealed a significant drug by time by group interaction (p=0.04) on pain ratings. High exercisers reported greater pain ratings over time in the naloxone drug condition. These results suggest that healthy individuals who report regular, strenuous bouts of exercise have improved endogenous opioid function and lower IL-6 inflammatory reactivity to capsaicin pain. Future studies should explore the effects of exercise in patients with chronic pain and the extent to which this may alter inflammatory responses such as IL-6 and pain perception. Participation in routine physical activity is associated with reduced clinical pain in chronic pain patients and a reduction in pain sensitivity in healthy participants. Proinflammatory cytokines, such as Interleuelkin-6 (IL-6), are associated with pain sensitivity and consistent exercise has been shown to reduce IL-6 levels. We examined the association between self-reported physical activity level (over a typical week), using the Godin Leisure-Time Exercise Questionnaire, IL-6 reactivity and response to capsaicin pain under saline and naloxone conditions. Naloxone (0.1mg/kg), an opioid antagonist, was utilized to probe endogenous opioid function and examine the effect on pain processing. Twenty-six healthy individuals (13 African American and 13 Non-Hispanic White) with complete data are included in these analyses. Blood was drawn before and after application of 10% topical capsaicin to the dorsum of the non-dominant hand. A thermode maintained a constant temperature of 40°Celsius for 90 minutes and pain ratings were obtained every five minutes. Participants who reported at least 15 minutes of strenuous (e.g., jogging) exercise >3x/week were categorized as high exercisers, and compared to low exercisers (<3x/wk). Analysis of variance (ANOVA), controlling for BMI, indicated a significant effect of physical activity on IL-6 reactivity (p=0.04), such that high exercisers showed reduced inflammatory reactivity to capsaicin pain. Repeated Measures ANOVA, controlling for BMI, race and sex (all factors known to influence pain) revealed a significant drug by time by group interaction (p=0.04) on pain ratings. High exercisers reported greater pain ratings over time in the naloxone drug condition. These results suggest that healthy individuals who report regular, strenuous bouts of exercise have improved endogenous opioid function and lower IL-6 inflammatory reactivity to capsaicin pain. Future studies should explore the effects of exercise in patients with chronic pain and the extent to which this may alter inflammatory responses such as IL-6 and pain perception.

Effect of Physical Activity on Nonmelanoma Skin Cancer Risk in Kidney, Liver, and Pancreatic Transplant Patients

Physical activity has been associated with a lower risk of cancer, including melanoma, but the effect has not yet been assessed for nonmelanoma skin cancer (NMSC). To determine whether the risk of skin cancer differs according to physical activity level in patients at high risk for NMSC. We conducted a retrospective cohort study in kidney, liver, and pancreatic transplant patients via telephone interview. Physical activity scores were calculated for each patient using a previously validated questionnaire. Sun exposure history and skin type were also recorded. The outcome of interest was a biopsy-proven diagnosis of at least one NMSC. Of 142 subjects, 45 (32%) developed NMSC. There was no significant effect of physical activity on the development of NMSC. Physical activity level may not be a major predictor of skin cancer risk in organ transplant patients. Controlled trials and population-based studies are needed to determine whether exercise can decrease the risk of NMSC in the general population. The authors have indicated no significant interest with commercial supporters.

Status of bone mineral content and body composition in boys engaged in intensive physical activity

It is well known that physical activity has an anabolic effect on bone tissue. But there is a lack of information about the effect of intensive physical activity in childhood, particularly at the prepubertal stage. To examine the influence of training on body composition and bone mineral density we have studied a group of prepubertal soccer players as well as a group of inactive prepubertal boys at the starting phase of their peak bone mass acquisition. A total of 62 healthy prepubertal boys took part in this study. They were divided into two groups. The first one consisted of 32 soccer players (aged 10.7 +/- 0.5 years), who had been playing football for at least 1 year (10-15 h per week). The second group a control group 30 boys (aged 11.2 +/- 0.7 years) doing 1.5 h per week physical activity at school. Body composition was assessed by a Body Fat Analyzer "BES 200 Z". Bone mineral density measurements of the left and the right calcaneus were done by using ultrasound densitometer "Sahara" (Hologic, Inc., MA, USA). There were significant differences between soccer players and the control group in fat mass (p = 0.01). Besides, a significant difference was determined between the group of athletes and the control group in bone mineral density of both calcaneal bones (p = 0.01). The results of this study confirm the significant effects of physical activity on reducing body mass and increasing bone density. Considering that football training can be very easily implemented in the broader population of children and young people, which does not apply to many other sports, it should be used more in the prevention of obesity and osteoporosis.

Physical Activity Level and Menopausal Symptoms

PURPOSE: To determine whether physical activity is associated with a reduction in menopausal symptoms (hot flashes, insomnia, numbness, fatigue, headaches, psychological symptoms, urogenital symptoms and physical symptoms). We assessed a homogenous group of inactive women, to identify the minimal level of physical activity necessary for relief of menopausal symptoms. METHODS: 401 women (58.2y) who were not taking hormone replacement therapy completed two questionnaires based on a 7-day recall of an average week for leisure time physical activity and menopausal symptoms. Women were divided into quintiles according to their physical activity scores and compared for menopausal symptoms using a MANCOVA with years since menopause and presence of a hysterectomy as co-factors. RESULTS: There was a significant group main effect of physical activity on menopausal symptoms (p < 0.05). Univariate results indicated significantly lower physical symptoms (i.e. weight gain, breast tenderness, aches and pains; by 22% p=0.01) and headache (by 44%; p=0.043) for women who were more physically active compared to inactive women. There were no statistically significant group differences for other menopausal symptoms. CONCLUSIONS: Based on the physical activity levels of our quintiles, a minimum of 5 bouts of 15 minutes of moderate intensity exercise in a week can reduce physical menopausal symptoms. To reduce the incidence of headache, between 2 to 4 bouts of 15 minutes of moderate intensity exercise in a week are recommended. There is no significant effect of physical activity level on hot flashes/night sweats, insomnia, limb numbness, fatigue, psychological symptoms or urogenital symptoms. Supported by the Canadian Institutes of Health Research

Physical activity and strength of the femoral neck during the adolescent growth spurt: A longitudinal analysis

Loading of the femoral neck (FN) is dominated by bending and compressive stresses. We hypothesize that adaptation of the FN to physical activity would be manifested in the cross-sectional area (CSA) and section modulus ( Z) of bone, indices of axial and bending strength, respectively. We investigated the influence of physical activity on bone strength during adolescence using 7 years of longitudinal data from 109 boys and 121 girls from the Saskatchewan Paediatric Bone and Mineral Accrual Study (PBMAS). Physical activity data (PAC-Q physical activity inventory) and anthropometric measurements were taken every 6 months and DXA bone scans were measured annually (Hologic QDR2000, array mode). We applied hip structural analysis to derive strength and geometric indices of the femoral neck using DXA scans. To control for maturation, we determined a biological maturity age defined as years from age at peak height velocity (APHV). To account for the repeated measures within individual nature of longitudinal data, multilevel random effects regression analyses were used to analyze the data. When biological maturity age and body size (height and weight) were controlled, in both boys and girls, physical activity was a significant positive independent predictor of CSA and Z of the narrow region of the femoral neck ( P < 0.05). There was no independent effect of physical activity on the subperiosteal width of the femoral neck. When leg length and leg lean mass were introduced into the random effects models to control for size and muscle mass of the leg (instead of height and weight), all significant effects of physical activity disappeared. Even among adolescents engaged in normal levels of physical activity, the statistically significant relationship between physical activity and indices of bone strength demonstrate that modifiable lifestyle factors like exercise play an important role in optimizing bone strength during the growing years. Physical activity differences were explained by the interdependence between activity and lean mass considerations. Physical activity is important for optimal development of bone strength.

Meta-analysis of the effectiveness of physical activity for the prevention of bone loss in postmenopausal women

A meta-analysis was done to measure the effect of physical activity on the bone mass of healthy postmenopausal women. All studies published between 1966 and 1996, in French or English, were reviewed for inclusion from Medline search, bibliographies of relevant studies, review articles and books. Studies had to be prospective intervention trials, randomized or not, evaluating the effectiveness of an exercise program of any duration, frequency and intensity, with a control group. Studies had to measure bone parameters and involve healthy postmenopausal women over 50 years of age who were free of symptomatic osteoporosis at the time of study entry. Effect sizes (ES) were calculated for each bone parameter and site measured in every eligible study according to Hedges and Olkin. DerSimonian and Laird's model was used to estimate overall effect sizes when combining studies. All analyses were bone parameter and site specific. Of 217 papers extracted from the literature, 187 did not meet eligibility criteria and 12 others were rejected. The two main reasons for rejection were that both genders were combined in the analyses and no exercise group without drug interaction was present. Eighteen studies were included for meta-analysis. Taking into account the frequency, duration, compliance rate and average age of the subjects, the programs were judged of moderate intensity and focused on walking, running, physical conditioning and aerobics. A significant effect of physical activity was detected on the bone mineral density at the L2-4 level of the lumbar column in studies published after 1991 (ES = 0.8745, p < 0.05). No effect could be seen, however, on forearm and femoral bone mass. Although applied to a small number of studies, this meta-analysis suggests that exercise programs in a population of postmenopausal women over 50 years of age are effective for preventing spinal bone mineral density loss at the L2-4 level. However, such programs do not have any effect on the forearm or femoral bone mass.

Differential effects of exercise and housing condition on murine natural killer cell activity and tumor growth.

Acute exercise and exercise conditioning have been shown to affect the activity of natural killer (NK) cells as well as the growth of experimentally induced tumors in animals. Since psychosocial factors are also known to alter NK activity and tumor growth, isolation, a known psychosocial stressor of mice, was also investigated to see if housing condition could alter exercise-induced changes in NK cell activity and tumor growth. NK cell activity and concentration of asialo GM1 (ASGM1) positive splenocytes were measured in male C3H mice inoculated i.v. with CIRAS 3 tumor cells. Mice were housed individually or in groups of four and trained to run for eight weeks on a rodent treadmill; controls remained sedentary throughout the experimental period. At four weeks into the training protocol, mice were injected with the tumor cells and continued to run for four weeks after tumor exposure. There was a significant effect of physical activity (p less than 0.019) but not of housing on splenic NK cytotoxicity against tumor targets in vitro. When the data were analyzed by presence or absence of lung metastases, only those animals without visible lung tumors had significantly higher NK activity as a function of exercise relative to sedentary controls. There were no significant differences in the frequency of ASGM1+ splenocytes between trained and untrained animals, irrespective of presence or absence of lung tumor colonies. There was a significant effect of housing (p less than 0.02), but not of physical activity, in mice with successful tumor takes with greater numbers of group housed animals (29/59) with tumor relative to individually housed animals (13/60).(ABSTRACT TRUNCATED AT 250 WORDS)

Geriatric benefits of exercise as an adult.

Associations between habitual physical activity and health were studied by retrospective questioning of 674 retirees aged 65-90. Within the limitations of the study (a volunteer sample and a simple questionnaire index of physical activity), the data show a decrease of activity in men, but not in women, from age 50 to the retirement years. The main factors influencing disability, and therefore health-care costs, were age (disability greater in older subjects) and sex (disability greater in women than in men). ANCOVA indicated that after allowing for these two variables, there was a possible small effect of physical activity at age 50 upon subsequent disability (p less than .094), together with a significant physical activity/sex interaction (p less than .030). However, a multivariate linear regression analysis of quality-adjusted health-care costs showed no significant effect of physical activity at age 50 upon subsequent disability. Nor did those surviving to the higher quintiles of the retirement years show a higher physical activity score at age 50 than those in the lower quintiles. While further research with more precise instruments remains desirable, the present results suggest that habitual physical activity at the age of 50 has only a weak association with lower levels of current physical disability and no relationship to resultant health-care costs during the years of retirement.

State anxiety, physical activity, and urinary 3-methoxy-4-hydroxyphenethylene glycol excretion.

Measurement of urinary 3-methoxy-4-hydroxyphenethylene glycol (MHPG) levels has been suggested as possibly being important in elucidating the role of central noradrenergic function in affective illnesses. The influence on urinary MHPG excretion of the state variables of physical activity and stress has not been clearly defined in previous studies. During a baseline medication-free period, 24 hospitalized depressed female patients underwent a five-day protocol including an eight-hour period of either enhanced or restricted activity. Throughout the protocol, independent measurements of telemetered mobility and stale anxiety were obtained. There were no significant effects of physical activity on urinary MHPG levels. Furthermore, baseline urinary MHPG levels and baseline state anxiety did not covary significantly. However, within-individual analyses yielded a highly significant relationship between changes in urinary MHPG levels and changes in state anxiety. The data suggested that those patients with lower baseline MHPG levels were those more prone to experience increased anxiety under environmentally "activating" circumstances.