Structured Exercise Sessions Research Articles

Factors Affecting Reproducibility of Change in Glucose During Exercise: Results From the Type 1 Diabetes and EXercise Initiative.

To evaluate factors affecting within-participant reproducibility in glycemic response to different forms of exercise. Structured exercise sessions ~30 minutes in length from the Type 1 Diabetes Exercise Initiative (T1DEXI) study were used to assess within-participant glycemic variability during and after exercise. The effect of several pre-exercise factors on the within-participant glycemic variability was evaluated. Data from 476 adults with type 1 diabetes were analyzed. A participant's change in glucose during exercise was reproducible within 15 mg/dL of the participant's other exercise sessions only 32% of the time. Participants who exercised with lower and more consistent glucose level, insulin on board (IOB), and carbohydrate intake at exercise start had less variability in glycemic change during exercise. Participants with lower mean glucose (P < .001), lower glucose coefficient of variation (CV) (P < .001), and lower % time <70 mg/dL (P = .005) on sedentary days had less variable 24-hour post-exercise mean glucose. Reproducibility of change in glucose during exercise was low in this cohort of adults with T1D, but more consistency in pre-exercise glucose levels, IOB, and carbohydrates may increase this reproducibility. Mean glucose variability in the 24 hours after exercise is influenced more by the participant's overall glycemic control than other modifiable factors.

Online Classification of Unstructured Free-Living Exercise Sessions in People with Type 1 Diabetes.

Background: Managing exercise in type 1 diabetes is challenging, in part, because different types of exercises can have diverging effects on glycemia. The aim of this work was to develop a classification model that can classify an exercise event (structured or unstructured) as aerobic, interval, or resistance for the purpose of incorporation into an automated insulin delivery (AID) system. Methods: A long short-term memory network model was developed with real-world data from 30-min structured sessions of at-home exercise (aerobic, resistance, or mixed) using triaxial accelerometer, heart rate, and activity duration information. The detection algorithm was used to classify 15 common free-living and unstructured activities and relate each to exercise-associated change in glucose. Results: A total of 1610 structured exercise sessions were used to train, validate, and test the model. The accuracy for the structured exercise sessions in the testing set was 72% for aerobic, 65% for interval, and 77% for resistance. In addition, we tested the classifier on 3328 unstructured sessions. We validated the session-associated change in glucose against the expected change during exercise for each type. Mean and standard deviation of the change in glucose of -20.8 (40.3) mg/dL were achieved for sessions classified as aerobic, -16.2 (39.0) mg/dL for sessions classified as interval, and -11.6 (38.8) mg/dL for sessions classified as resistance. Conclusions: The proposed algorithm reliably identified physical activity associated with expected change in glucose, which could be integrated into an AID system to manage the exercise disturbance in glycemia according to the predicted class.

16-Week Home- Based Exercise And Physical Activity Program Using Online Zoom On Health-Related Quality Of Life In Obese Children Aged 5-10 Years.

The aim of this research project was to implement a 16-week sports program for children with excessive obesity through online platforms, specifically using the Zoom platform, and evaluate its impact on the participants' physical health, psychological well-being, and overall satisfaction with the program. The study enrolled 30 children between the ages of 5 and 10 who had been diagnosed with excessive obesity by healthcare professionals. The program consisted of structured exercise sessions conducted remotely with qualified instructors providing guidance and supervision. Data regarding participants' health, physical fitness levels, and psychological well-being were collected through pre-program and post-program questionnaires completed by parents/guardians. The results indicated significant improvements in participants' physical health, with 53.3% showing improved physical fitness levels and 30% significantly improved physical health. Psychological well-being also improved, with 40% reporting fair to good mood and emotional well-being post-program compared to 23.3% pre-program. Overall satisfaction with the program was high, with 70% of parents expressing satisfaction or high satisfaction. These findings contribute to the growing body of evidence supporting the feasibility and effectiveness of online exercise interventions for children with excessive obesity. Further research is warranted to explore long-term outcomes and refine program delivery methods.

Effectiveness of a Community-Based Structured Physical Activity Program for Adults With Type 2 Diabetes

The efficacy of physical activity interventions among individuals with type 2 diabetes has been established; however, practical approaches to translate and extend these findings into community settings have not been well explored. To test the effectiveness of providing varying frequencies of weekly structured exercise sessions to improve diabetes control. The IMPACT (Initiate and Maintain Physical Activity in Communities Trial) study was a controlled randomized clinical trial (randomization occurred from October 2016 to April 2019) that included a 6-month, structured exercise intervention either once or thrice weekly vs usual care (UC; advice only). The exercise intervention was conducted at community-based fitness centers. Follow-up visits were conducted in a university research clinic. Participants included adults with type 2 diabetes (hemoglobin A1c [HbA1c] 6.5%-13.0%, not taking insulin, and no precluding health issues). Data analysis was performed from January to April 2022. A once-weekly structured exercise group, a thrice-weekly structured exercise group, or UC. The primary outcome was HbA1c at 6 months. A total of 357 participants (143 women [40.1%]) with a mean (SD) age of 57.4 (11.1) years were randomized (119 each to the UC, once-weekly exercise, and thrice-weekly exercise groups). There was no significant difference in HbA1c change by study group in the intention-to-treat analysis at 6 months. Specifically, HbA1c changed by -0.23% (95% CI, -0.48% to 0.01%) in the thrice-weekly exercise group and by -0.16% (95% CI, -0.41% to 0.09%) in the once-weekly exercise group. A total of 62 participants (52.1%) in the once-weekly exercise group and 56 participants (47.1%) in the thrice-weekly exercise group were at least 50% adherent to the assigned structured exercise regimen and were included in the per-protocol analysis. Per-protocol analysis showed that HbA1c changed by -0.35% (95% CI, -0.60% to -0.10%; P = .005) at 3 months and by -0.38% (95% CI, -0.65% to -0.12%; P = .005) at 6 months in the thrice-weekly exercise group compared with UC. There was no significant decrease in HbA1c in the once-weekly exercise group. The exercise intervention was effective in improving self-reported minutes of metabolic equivalent tasks per week for participants in the thrice-weekly exercise group (both overall and per protocol). Although the intervention was not effective in the intention-to-treat analysis, participants in the thrice-weekly exercise group who attended at least 50% of the sessions during the 6-month exercise intervention program improved HbA1c levels at 6 months. Future efforts should focus on improving adherence to thrice-weekly structured exercise programs to meet exercise guidelines. ClinicalTrials.gov Identifier: NCT02061579.

The legacy effect of a home walking exercise programme in kidney failure patients on dialysis.

The EXerCise Introduction To Enhance performance (EXCITE) trial (J Am Soc Nephrol 28: 1259-1268, 2017) in dialysis patients showed that a 6-month home walking exercise programme improves physical function and two dimensions of the Kidney Disease Quality of Life Short Form (KDQOLSF-SF™) questionnaire. Whether improvements in physical function achieved by exercise interventions are maintained in the long term has never been tested in the dialysis population. In this post-trial study embedded in the EXCITE trial, we tested the response to the 6 min walking test (6MWT) and the 5-time Sit-To-Stand (5STS) tests and the KDQOLSF-SF™ from the 6th month (end of the trial) to the 36th month. Among the 227 patients of the EXCITE trial cohort, 162 underwent at least three out of four testing visits (baseline, 6, 18 and/or 36 months) contemplated by the study protocol and 89 during all four testing visits. In the primary analysis by the linear mixed model, the gain in walking distance achieved in the 6th month in the exercise group [between-arms difference: +36 m, 95% confidence interval (CI): 22-51, P<.001] was maintained at the 18th month (between-arms difference: +37 m, 95% CI: 19-57, P<.001) and reduced to 23 m (95% CI: -4 to 49 meters, P=.10) at the 36th month. Overall, the post-trial difference in walking distance trajectories between the two study arms was highly significant (P=.004). Furthermore, the walking distance changes at the 6th (r=0.34, P=.018) and 18th month (r=0.30, P=.043) were directly related to the number of structured exercise sessions completed during the trial (i.e. the first 6 month). No such effect was registered in the response to the 5STS or in quality of life as measured by the KDQOLSF-SF™. In dialysis patients, the benefits of a 6-month structured walking programme outlast the duration of the intervention and postpone the loss of walking performance which naturally occurs in this population, but does not affect the quality of life (QoL) and the response to the STS test.

MO870: The Legacy Effect of a Home Walking Exercise Program in Kidney Failure Patients on Dialysis

Abstract BACKGROUND AND AIMS The EXCITE trial (JASN 28: 1259–1268, 2017) in dialysis patients showed that a 6-month home walking exercise program increases the walking distance covered during the 6 min walking test (6MWT), improves the response to the 5 times sit-to-stand test (5STS) and the cognitive function and quality of social interaction scores of the KDQOLSF-SF™ questionnaire. METHOD In this post-trial study embedded in the EXCITE trial, we tested the response to the 6MWT and the 5STS tests and the KDQOLSF-SF™ from the 6th month (end of the trial) to the 36th month. RESULTS Among the 227 patients of the EXCITE trial cohort, 162 underwent at least three out four testing visits (baseline, 6, 18 and/or 36 month) contemplated by the study protocol and 89 all four testing visits. In the primary analysis by the linear mixed model, the gain in walking distance achieved at 6th month in the exercise group {between-arms difference: +36 m, [95% confidence interval (95% CI): 22–51]; P &amp;lt; 0.001} was maintained at the 18th month (between-arms difference: +37 m, 95% CI: 19–57; P &amp;lt; 0.001) to reduce to 23 m (95% CI: –4 to 49 m; P = 0.10) at 36th month. Overall, the post-trial difference in walking distance trajectories between the two study arms was highly significant (P = 0.004). Furthermore, the walking distance changes at the 6th (r = 0.34; P = 0.018) and 18th month (r = 0.30; P = 0.043) were directly related with number of structured exercise sessions completed during the trial (i.e. the first 6 months). No such an effect was registered in the response to the 5STS or in quality of life as measured by the KDQOLSF-SF™. CONCLUSION In dialysis patients the benefits of a 6-months structured walking program outlast the duration of the intervention and postpone the loss of walking performance, which naturally occurs in this population.

Abstract 13107: Effectiveness Of The Outpatient Pritikin Intensive Cardiac Rehabilitation Program In Patients With Heart Failure

Introduction: The Pritikin intensive cardiac rehabilitation (ICR) program includes structured exercise sessions augmented by heart health education sessions for patients recovering from myocardial infarction, cardiac surgery, PCI, and stable angina. Medicare coverage for ICR expanded to include patients with heart failure (HF) with reduced ejection fraction (HFrEF, EF &lt;35%). However, the efficacy of outpatient ICR on improvement of cardiovascular disease (CVD) risk factors in all patients with HF, regardless of EF, is unknown. Hypothesis: Patients with HF who participate in the outpatient Pritikin ICR program will have improvements in several clinically significant CVD risk factors, including cardiorespiratory fitness, strength, body composition, and lipid profiles. Methods: We performed a prospective cohort study of patients with HF enrolled in the outpatient Pritikin ICR program at Barnes Jewish West County Hospital in St. Louis, MO. Patients referred for ICR since 1/1/2017 were invited to participate in assessments at baseline (BL) and after completing 24 ICR visits. Each visit included a monitored exercise session plus a Pritikin education session focusing on dietary changes (low-fat, low-sodium, high-fiber foods) and stress management through a series of videos, cooking classes, and workshops. We measured body composition using bioelectrical impedance, cardiorespiratory fitness using a 6-min walk test, hand grip strength by dynamometry, and lipids by venipuncture. Values are presented as median difference, and interquartile range (IQR) from BL to visit 24. Results: 84 patients with HF (68% HfrEF, 32% HfpEF; 70.2% also diagnosed with MI, CABG, or PCI; 40% women; mean age 69.9 [SD 9.6] y), completed BL and visit 24 assessments over an average of 9.9 weeks. Significant improvements (all P &lt;0.01) were observed for whole-body fat (-1.2%, IQR -2.4, 0.8), trunk fat (-1.3%, -3.2, 0.5), fat free mass (+0.6 kg, -0.3, 1.7), 6-min walk distance (+45.7 m, 17.9, 68.9), hand grip strength (+1.0 kg, -0.4, 2.9), and LDL cholesterol (-3 mg/dL, -14, 6). Conclusion: Outpatient Pritikin ICR results in significant cardiovascular benefits in patients with HF by enhancing exercise capacity and strength, reducing adiposity, and improving lipid profiles.

The impact of 2weeks of detraining on phase angle, BIVA patterns, and muscle strength in trained older adults.

An intermission in the training routine, in which older adults refrain from regular structured exercise, may have deleterious effects on muscle performance and bioelectric phase angle (PhA), which is a predictive marker for cellular integrity. To determine the effects of a 2-week detraining period on PhA and muscular strength (MS) in trained older adults. A total of 14 trained older adults (6 females) aged ≥65years (77.2±6.6) were assessed at baseline (i.e. trained condition) and after 2weeks of detraining, where they refrained from their usual participation in structured exercise sessions. Whole-body resistance (R), reactance (Xc), and PhA were assessed using bioelectrical impedance analysis (BIA, single frequency, 50kHz±1%, NutriLab, Akern). MS was assessed on both lower and upper limbs under isometric conditions. Differences between moments were examined using ANOVA for repeated measures, while adjusting for sex. Bioimpedance vector analysis (BIVA) was performed to evaluate changes in cellular function and body fluid content. Detraining resulted in declines in PhA (-4.34%) (p=0.017). There was a significant difference in the mean impedance vectors from baseline to post-detraining (p<0.05), which were driven by decreases in reactance (Xc) relative to height (Xc/H) with little change in resistance (R) relative to height (R/H) for both males and females. No differences were found in MS for both the leg press (p=0.992) and bench press (p=0.166) tests. A detraining period as short as 2-weeks is enough to cause alterations in the bodies bioelectrical properties, resulting in detrimental changes in PhA, due to alterations in cellular integrity, but not in MS. These results highlight the importance of maintaining structured exercise sessions in older adults, and reinforce the potential role of PhA as a sensitive predictor to detect acute changes in muscle cell integrity following alterations in exercise training.

COVID-19-Related Home Confinement in Adults: Weight Gain Risks and Opportunities.

As the global COVID-19 pandemic unfolds, over 90% of U.S. adult residents are confined to their homes, with restaurants, shops, schools, and workplaces shut down to prevent disease spread. While it is a priority to mitigate the immediate impact, one area of great concern is the long-term effects of this pandemic on weight management in adults. As evident from previous research, small changes in body weight in relatively short time periods can become permanent and lead to substantial weight gain over time(1). Considering that the current situation could last a total of several months, this extended home confinement could exacerbate the problem of obesity in adults by substantially contributing to or exceeding annual weight gain.

Effectiveness Of The Foreverfit Weight Loss Program

INTRODUCTION: Overweight and obesity is an increasing health concern amongst US adults, as 68% of the adult population are currently classified as such. Several health issues, including cardiovascular health, are associated with increased adiposity. The ForeverFit Program was designed to promote weight loss and cardiovascular fitness via behavior change and structured exercise sessions. Programs that demonstrate weight loss and improved health variables are essential for societal health. PURPOSE: The purpose of the current study was to assess the effectiveness of the ForeverFit Weight Loss Program. METHODS: Ten overweight and obese (BMI= 31.4 kg/m2 ± 4.8) women (49.4 years ± 11.4) were assessed for body composition, cardiovascular health, and exercise and nutrition self-efficacy prior to and following the ten week program. Bioelectrical impedance analysis (InBody 270, California, USA) measured body composition and weight, VO2 max was estimated via the Ebbeling treadmill protocol, and resting heart rate and blood pressure were measured by an oscillometric automated device (Omron 10 series, Illinois, USA). Self-efficacy was measured via Eating and Exercise Habits Confidence Surveys. The participants underwent a ten week exercise and education program in which they exercised in small groups led by a personal trainer twice each week and given weekly behavior challenges. Variables were analyzed pre and post via paired t-test (p < .05). RESULTS: Participants showed significantly decreased body weight (-2.54 kg ± 3.36, p=0.041), BMI (-0.84 kg/m2 ± 1.11, p= 0.040), fat mass (-2.47 kg ± 0.02, p= 0.024), and water weight (-0.72 kg ± 0.17, p= 0.002). Diet (0.70 ± 0.58, p=0.025) and exercise (0.66 ± 0.87, p=0.040) self-efficacy demonstrated significant increases on the 5-point Likert scale. Percent body fat approached significance (-1.59% ± 2.36, p =0.059). Skeletal muscle mass, resting heart rate, blood pressure, and VO2 max did not change significantly. CONCLUSION: Twice weekly exercise sessions combined with weekly behavior change challenges were effective at reducing body weight and improving self-efficacy in overweight and obese individuals. Future iterations of the ForeverFit Weight Loss Program should augment the supervised exercise sessions to more effectively target cardiovascular changes.

Weighing the Impact of Diet and Lifestyle on Female Reproductive Function.

In the last years, several scientific societies and expert groups focused on the role played by nutritional factors, lifestyle and excess of body fat in interfering with female reproduction and fertility. In many studies a confounding factor is represented by polycystic ovary syndrome (PCOS) which is one of the major causes of infertility where genetic and family history are certainly playing a role, together with lifestyle and nutritional factors. In an attempt to define "the optimal fertility diet", we consider the role played by Mediterranean lifestyle and some macronutrients (animal and vegetable proteins) on ovulatory disorders and female fertility also considering some new visions derived from randomized trials of lifestyle programs in obese infertile women asking for in vitro fertilization or alternative assisted reproduction technologies. Several reports are in favor of an increased consumption of either proteins or low-glycemic index carbohydrates to improve ovulatory disorders and female fertility. In studies concerning infertile women undergoing assisted reproduction, either structured exercise sessions and dietary intervention programs seem to be effective in improving menstrual cycles and fertility as demonstrated by the increased rate of natural conceptions. The findings of this review confirm the important impact of Mediterranean diet and lifestyle in preserving and improving fertility. However, epigenetic factors are very important in determining fertility rate, but genetic background and ethnicity are also playing crucial roles.

The Park Prescription Study: Development of a community-based physical activity intervention for a multi-ethnic Asian population.

This mixed-methods study aims to inform the development of a ‘Park Prescription’ intervention, including face-to-face counseling on physical activity and park use and providing weekly structured exercise sessions in the park to promote physical activity. Participants aged 40–65 years were recruited from regional health screening events in Singapore where they completed a questionnaire (N = 97) and consented to focus group (FG) participation (N = 16). The questionnaire assessed current park use, and the type, duration, and intensity of park-based activities that would be of interest. FGs explored the barriers and facilitators of physical activity (in parks). Short interviews (N = 16) with ‘doers’, i.e., people already engaging in park-based physical activity, identified motivational factors and ways to overcome common barriers. Participants acknowledged the health benefits of parks and valued them because of their pleasant landscapes, greenery and facilities. However, few participants engaged in physical activity at the parks, because they were too busy or too tired. Participants mostly indicated doing informal activities, such as walking, cycling or playing traditional Asian games when using the parks for exercise. A variety of low-to-moderate intensity park-based activities such as walking, cycling or aerobics were of interest to participants who expressed the willingness to engage in structured exercise sessions on weekday evenings or weekend mornings. Strategies to increase physical activity in parks included: encourage planning, create social support, identify alternatives for bad weather, improve proximity/accessibility to parks and park safety. The effectiveness of the Park Prescription intervention in promoting physical activity, park use, as well as physical and mental well-being will be tested in a one-year Randomized Controlled Trial.

Use of apps for physical activity in type 1 diabetes: current status and requirements for future development.

Smartphone technologies, and the applications (apps) that they host, are developing rapidly mainly with regard to communication, information processing, design, features and connectivity with other devices. Technologies used in modern treatment modalities and monitoring of type 1 diabetes are also rapidly evolving and can communicate with smartphones and apps. Therefore, numerous web-based and smartphone apps aim to provide information and various patient data metrics (e.g. caloric intake, activity levels, glucose monitoring) that can be accessed and processed for decision support by smartphone apps. In this narrative review, we highlight current information about the effectiveness of interventions through smartphone apps with a focus on apps designed to give guidance to patients with type 1 diabetes on physical activity monitoring and glucose control during and after structured exercise sessions, as these patients are experiencing huge therapeutic challenges during exercise. Furthermore, we propose a number of critical elements for future apps designed for people with type 1 diabetes.

Effect of structured exercise sessions on post-operative problems related to immobility in post-caesarean patients

As the well-being of maternal and child health occupies a paramount place in the healthcare delivery system, caesarean section (CS) has become the most common intervention in obstetrics care, in many countries. Although the indicated and timely CS has tremendous advantages for the mother and the baby, there are several consequences of caesarean delivery in comparison to normal delivery. Being one of the major abdominal surgeries, it also carries the risk associated with general surgeries. Non-probability sampling design was used to recruit 500 participants, who were allotted to experimental and control groups. With the routine post-caesarean care as per hospital routine, the planned structured exercise session was initiated for the experimental group on the day of lower segment caesarean section and was followed twice a day for the first 5 post-caesarean days. The study participants of the control group were given the routine care only. At the end of each day, the selected data for the presence of post-operative complications were collected by structured observation and self-report techniques. It was evident that the selected post-operative problems related to immobility were less in the experimental group as compared to that of the control group. The study concluded that structured post-operative exercise sessions are effective in reducing the potential post-operative problems associated with immobility in post-caesarean period. It can be implemented effectively to enhance the recovery of women after CS.

Effectiveness of high-intensity interval training combined with resistance training versus continuous moderate-intensity training combined with resistance training in patients with type 2 diabetes: A one-year randomized controlled trial.

To evaluate the impact of one-year high intensity interval training (HIIT) combined with resistance training (RT) vs continuous moderate intensity training (MCT) combined with RT on glycaemic control, body composition and cardiorespiratory fitness (CRF) in patients with type 2 diabetes. A randomized controlled trial included 96 participants with type 2 diabetes for a one-year supervised exercise intervention with three groups: Control, HIIT with RT and MCT with RT). The control group received standard counseling regarding general PA guidelines, with no structured exercise sessions. The main outcome variable was HbA1c (%). Secondary outcomes were other glycaemic variables, body composition, anthropometry measurements, CRF and enjoyment of exercise. Generalized estimating equations (GEE) were used to model outcomes. Among the 96 participants enrolled in the intervention, 80 were randomized, with a mean (SD) age of 58.5 years (7.7) and a mean HbA1c of 7.2% (1.6). After adjusting the model for sex and total moderate-to-vigorous physical activity (MVPA), we found that both the MCT with RT (β, 0.003; P, 0.921) and the HIIT with RT (β, 0.025; P, 0.385) groups had no effect on HbA1c. A favourable effect was observed in the MCT with RT group, with a reduction in whole body fat index (β, -0.062; P, 0.022), android fat index (β, -0.010; P, 0.010) and gynoid fat index (β, -0.013; P, 0.014). Additionally, CRF increased during the intervention, but only in the MCT with RT group (β, 0.185; P, 0.019). The results from this study suggest that there was no effect of either MCT with RT or HIIT with RT on glycaemic control in individuals with type 2 diabetes. However, the combination of MCT and RT improved body composition and CRF following a one-year intervention.

A physical activity intervention in a Bingo club: Significance of the setting

Objective: A Bingo club was selected for the design and delivery of a health intervention (Well!Bingo) in order to engage with older women living in areas of socio-economic disadvantage. In the light of our experience, we discuss the significance of the setting in relation to a typology of health promotion settings. Design and Setting: The Well!Bingo physical activity intervention was piloted in a Bingo club in Scotland. Methods: In a pilot feasibility study, women were recruited face-to-face at a Bingo club over 2 weeks. The 12-week intervention consisted of three different structured exercise sessions per week, followed by refreshments, with trained instructors delivering a schedule of simple pre-defined health messages. Participants completed a baseline questionnaire, and in-depth qualitative interviews were carried out with participants and instructors post-intervention. For this paper, using the framework method, we retrieved and analysed the data coded as relating to the setting. Results: Eighteen women (55-92 years) took part in intervention sessions. Half lived in areas of socio-economic deprivation. Practical and social familiarity with the setting (a sense of belonging and being with people like themselves) encouraged them to take part, and implicit features of the setting may have enhanced recruitment and effectiveness. Discussion: In settings-based health promotion, a Bingo club could be seen as a ‘passive’ setting, simply facilitating access to a target population. It cannot be an ‘active setting’, because health promotion will never be a core activity and features cannot be drawn upon to influence change. However, calling it a passive setting overlooks the importance of characteristics that may enhance recruitment and effectiveness. This highlights the need to extend current concepts of ‘passive’ health promotion settings.

Acute Effects of Aerobic Exercise on Affect and Smoking Craving in the Weeks Before and After a Cessation Attempt.

Aerobic exercise may improve smoking abstinence via reductions in craving and negative affect and increases in positive moods. Acute changes in craving and affect before and after structured exercise sessions have not been examined during the weeks prior to and following quit attempts nor has smoking status been examined in relation to these effects. Given that regular cigarette smoking can be perceived as affect enhancing and craving reducing, it is not known whether exercise could contribute additional affective benefit beyond these effects. Participants (N = 57; 68.4% women) were low-active daily smokers randomized to cessation treatments plus either group-based aerobic exercise (AE) or a health-education control (HEC). Mood, anxiety, and craving were assessed before and after each intervention session for each of the 12 weeks. Carbon monoxide (CO) breath samples ≤ 5ppm indicated smoking abstinence. During the prequit sessions, significantly greater decreases in anxiety following AE sessions relative to HEC sessions were observed. Changes in mood and craving were similar after AE and HEC sessions prior to quitting. Postquit attempt, significant reductions in craving and anxiety were observed after AE sessions but not following HEC. During the postquit period, positive mood increased following AE sessions relative to HEC only among individuals who were abstinence on that day. AE may be effective in acutely reducing anxiety prior to a quit attempt and both anxiety and craving following the quit attempt regardless of abstinence status. The mood-enhancing effects of AE may occur only in the context of smoking abstinence. The current findings underscore the importance of examining the acute effects of aerobic exercise prior to and after a cessation attempt and as a function of smoking status. Given the equivocal results from previous studies on the efficacy of exercise for smoking cessation, increasing our understanding of how aerobic exercise produces its reinforcing benefits for smokers attempting to quit could potentially inform the refinement (e.g., timing/sequencing) of exercise interventions within smoking cessation programs.

1. The Effects of an Aerobic Exercise Intervention on Daily Activity Patterns

The purpose of this study was to examine the effects of participation in an aerobic exercise intervention on daily activity occurring outside of the structured exercise sessions. Participants were randomized into one of the following 4 conditions: 1) No-exercise, 2) Low volume, low intensity exercise (LVLI), 3) High volume, low intensity exercise (HVLI), 4) Low volume, high intensity (LVHI). Physical activity was measured over 7 days with an accelerometer at baseline and during week 8 of the intervention. Activity was defined as: sedentary behaviour (SED; &lt; 100 counts/minute), light physical activity (LPA; 100 to 1951 counts/minute), moderate-to-vigorous physical activity (MVPA; ≥1952 counts/minute), and total physical activity (TPA; LPA + MVPA). Activity was quantified as average total minutes per day of each SED, LPA, MVPA, and TPA. A one-way ANOVA was used to determine if time spent in SED, LPA, MVPA, and TPA changed from baseline to week 8. Seventy-one participants (No-exercise; n=12, LVLI n=17, HVLI n=24, LVHI; n=18,) with a mean age of 54 y and waist circumference of 110 cm completed 8 weeks of the intervention. There were no significant differences in SED, LPA, MVPA, or TPA between groups at baseline. There was no significant change in SED, LPA, MVPA, or TPA at week 8 compared to baseline (p&gt;0.05). Similarly, there were no significant differences in activity variables between exercise conditions. Our observations suggest that daily activity patterns do not change with the implementation of an exercise intervention in men and women.

Long-term outcomes from Healthy Eating and Exercise Lifestyle Program for overweight people with heart disease and diabetes.

The benefits of exercise and weight reduction for overweight or obese people with coronary heart disease and/or diabetes mellitus are well recognised. The Healthy Eating and Exercise Lifestyle Program demonstrated these outcomes at 4 months, but longer-term outcomes are not yet reported. To determine whether positive weight, body mass index, waist and exercise duration outcomes were sustained in the long term (12 months) and to identify the independent predictors of these outcomes at 4 and 12 months. Longitudinal design, combining data of all Healthy Eating and Exercise Lifestyle Program participants (intervention and wait-list control, n = 134). Participants had a body mass index between 27 and 39 kg/m(2) and had completed cardiac rehabilitation and/or diabetes education programmes. Healthy Eating and Exercise Lifestyle Program intervention included an active phase of two 1-hour group-based supervised structured exercise sessions every week for 4 months and four 90-minute group information and support sessions. The maintenance phase included one 90-minute group-based booster information session and three 15-minute goal-focused telephone follow-up calls over 8 months. Participants had statistically significant reductions from baseline in weight, body mass index and waist circumference and improvements in exercise duration and capacity at 4 and 12 months. Time, self-efficacy, depressive symptoms and male gender were independent predictors for body mass index, waist and/or exercise duration (p < 0.05). The Healthy Eating and Exercise Lifestyle Program was an effective programme to achieve and sustain weight loss and increase exercise participation over 1 year.

Physical activity interventions differentially affect exercise task and barrier self-efficacy: A meta-analysis.

Researchers have yet to establish how interventions to increase physical activity influence specific self-efficacy beliefs. The current study sought to quantify the effect of interventions to increase physical activity among healthy adults on exercise task (EXSE) and barrier self-efficacy (BSE) via meta-analysis. Intervention characteristics associated with self-efficacy and physical activity changes were also identified. A systematic database search and manual searches through reference lists of related publications were conducted for articles on randomized, controlled physical activity interventions. Published intervention studies reporting changes in physical activity behavior and either EXSE or BSE in healthy adults were eligible for inclusion. Of the 1,080 studies identified, 20 were included in the meta-analyses. Interventions had a significant effect of g = 0.208, 95% confidence interval (CI) [0.027, 0.388], p < .05, on EXSE; g = 0.128, 95% CI [0.05, 0.20], p < .05 on BSE; and g = 0.335 95% CI [0.196, 0.475], p < .001, on physical activity. Moderator analyses indicated shorter interventions that did not include structured exercise sessions effectively increased EXSE and physical activity, whereas long interventions improved BSE. Interventions that did not provide support increased BSE and physical activity levels. Further, interventions that did not require the use of daily exercise logs improved EXSE and physical activity behavior. Interventions designed to increase physical activity differentially influenced EXSE and BSE. EXSE appeared to play a more significant role during exercise adoption, whereas BSE was involved in the maintenance of exercise behavior. Recommendations are offered for the design of future interventions.