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Models employed in exercise psychology highlight the role of reflective processes for explaining behavior change. However, as discussed in social cognition literature, information-processing models also consider automatic processes (dual-process models). To examine the relevance of automatic processing in exercise psychology, we used a priming task to assess the automatic evaluations of exercise stimuli in physically active sport and exercise majors (n = 32), physically active nonsport majors (n = 31), and inactive students (n = 31). Results showed that physically active students responded faster to positive words after exercise primes, whereas inactive students responded more rapidly to negative words. Priming task reaction times were successfully used to predict reported amounts of exercise in an ordinal regression model. Findings were obtained only with experiential items reflecting negative and positive consequences of exercise. The results illustrate the potential importance of dual-process models in exercise psychology.
The goals of this study were to test whether exercise-related stimuli can elicit automatic evaluative responses and whether automatic evaluations reflect exercise setting preference in highly active exercisers. An adapted version of the Affect Misattribution Procedure was employed. Seventy-two highly active exercisers (26 years +/- 9.03; 43% female) were subliminally primed (7 ms) with pictures depicting typical fitness center scenarios or gray rectangles (control primes). After each prime, participants consciously evaluated the "pleasantness" of a Chinese symbol. Controlled evaluations were measured with a questionnaire and were more positive in participants who regularly visited fitness centers than in those who reported avoiding this exercise setting. Only center exercisers gave automatic positive evaluations of the fitness center setting (partial eta squared = .08). It is proposed that a subliminal Affect Misattribution Procedure paradigm can detect automatic evaluations to exercising and that, in highly active exercisers, these evaluations play a role in decisions about the exercise setting rather than the amounts of physical exercise. Findings are interpreted in terms of a dual systems theory of social information processing and behavior.
Objective: Demographic changes are increasing the pressure to improve therapeutic strategies against cognitive decline in Alzheimer disease (AD) and mild cognitive impairment (MCI). Besides drug treatment, physical activity seems to be a promising intervention target as epidemiological and clinical studies suggest beneficial effects of exercise training on cognition. Using comparable inclusion and exclusion criteria, we analyzed the efficacy of drug therapy (cholinesterase inhibitors, memantine, and Ginkgo biloba) and exercise interventions for improving cognition in AD and MCI populations. Methods: We searched The Cochrane Library, EBSCO, OVID, Web of Science, and U.S Food and Drug Administration data from inception through October 30, 2013. Randomized controlled trials in which at least one treatment arm consisted of an exercise or a pharmacological intervention for AD or MCI patients, and which had either a non-exposed control condition or a control condition that received another intervention. Treatment discontinuation rates and Standardized Mean Change score using Raw score standardization (SMCR) of cognitive performance were calculated. Results: Discontinuation rates varied substantially and ranged between 0% and 49% with a median of 18%. Significantly increased discontinuation rates were found for galantamine and rivastigmine as compared to placebo in AD studies. Drug treatments resulted in a small pooled effect on cognition (SMCR: 0.23, 95% CI: 0.20 to 0.25) in AD studies (N = 45, 18,434 patients) and no effect in any of the MCI studies (N = 5, 3,693 patients; SMCR: 0.03, 95% CI: 0.00 to 0.005). Exercise interventions had a moderate to strong pooled effect size (SMCR: 0.83, 95% CI: 0.59 to 1.07) in AD studies (N = 4, 119 patients), and a small effect size (SMCR: 0.20, 95% CI: 0.11 to 0.28) in MCI (N = 6, 443 patients). Conclusions: Drug treatments have a small but significant impact on cognitive functioning in AD and exercise has the potential to improve cognition in AD and MCI. Head-to-head trials with sufficient statistical power are necessary to directly compare efficacy, safety, and acceptability. Combining these two approaches might further increase the efficacy of each individual intervention. Identifier: PROSPERO (2013:CRD42013003910).
Depression is the most prevalent psychiatric disorder in the general population. Despite a large demand for efficient treatment options, the majority of older depressed adults does not receive adequate treatment: Additional low-threshold treatments are needed for this age group. Over the past two decades, a growing number of randomized controlled trials (RCT) have been conducted, testing the efficacy of physical exercise in the alleviation of depression in older adults. This meta-analysis systematically reviews and evaluates these studies; some subanalyses testing specific effects of different types of exercise and settings are also performed. In order to be included, exercise programs of the RCTs had to fulfill the criteria of exercise according to the American College of Sports Medicine, including a sample mean age of 60 or above and an increased level of depressive symptoms. Eighteen trials with 1,063 participants fulfilled our inclusion criteria. A comparison of the posttreatment depression scores between the exercise and control groups revealed a moderate effect size in favor of the exercise groups (standardized mean difference (SMD) of –0.68, p < .001). The effect was comparable to the results achieved when only the eleven trials with low risk of bias were included (SMD = –0.63, p < .001). The subanalyses showed significant effects for all types of exercise and for supervised interventions. The results of this meta-analysis suggest that physical exercise may serve as a feasible, additional intervention to fight depression in older adults. However, because of small sample sizes of the majority of individual trials and high statistical heterogeneity, results must be interpreted carefully.
Purpose
We quantified the acute and chronic effects of whole body vibration on athletic performance or its proxy measures in competitive and/or elite athletes.
Methods
Systematic literature review and meta-analysis.
Results
Whole body vibration combined with exercise had an overall 0.3 % acute effect on maximal voluntary leg force (−6.4 %, effect size = −0.43, 1 study), leg power (4.7 %, weighted mean effect size = 0.30, 6 studies), flexibility (4.6 %, effect size = −0.12 to 0.22, 2 studies), and athletic performance (−1.9 %, weighted mean effect size = 0.26, 6 studies) in 191 (103 male, 88 female) athletes representing eight sports (overall effect size = 0.28). Whole body vibration combined with exercise had an overall 10.2 % chronic effect on maximal voluntary leg force (14.6 %, weighted mean effect size = 0.44, 5 studies), leg power (10.7 %, weighted mean effect size = 0.42, 9 studies), flexibility (16.5 %, effect size = 0.57 to 0.61, 2 studies), and athletic performance (−1.2 %, weighted mean effect size = 0.45, 5 studies) in 437 (169 male, 268 female) athletes (overall effect size = 0.44).
Conclusions
Whole body vibration has small and inconsistent acute and chronic effects on athletic performance in competitive and/or elite athletes. These findings lead to the hypothesis that neuromuscular adaptive processes following whole body vibration are not specific enough to enhance athletic performance. Thus, other types of exercise programs (e.g., resistance training) are recommended if the goal is to improve athletic performance.
Continuous exercise (CON) and high-intensity interval exercise (HIIE) can be safely performed with type 1 diabetes mellitus (T1DM). Additionally, continuous glucose monitoring (CGM) systems may serve as a tool to reduce the risk of exercise-induced hypoglycemia. It is unclear if CGM is accurate during CON and HIIE at different mean workloads. Seven T1DM patients performed CON and HIIE at 5% below (L) and above (M) the first lactate turn point (LTP1), and 5% below the second lactate turn point (LTP2) (H) on a cycle ergometer. Glucose was measured via CGM and in capillary blood (BG). Differences were found in comparison of CGM vs. BG in three out of the six tests (p < 0.05). In CON, bias and levels of agreement for L, M, and H were found at: 0.85 (-3.44, 5.15) mmol.L-1, -0.45 (-3.95, 3.05) mmol.L-1, -0.31 (-8.83, 8.20) mmol.L-1 and at 1.17 (-2.06, 4.40) mmol.L-1, 0.11 (-5.79, 6.01) mmol.L-1, 1.48 (-2.60, 5.57) mmol.L-1 in HIIE for the same intensities. Clinically-acceptable results (except for CON H) were found. CGM estimated BG to be clinically acceptable, except for CON H. Additionally, using CGM may increase avoidance of exercise-induced hypoglycemia, but usual BG control should be performed during intense exercise.
Changing the perspective sometimes offers completely new insights to an already well-known phenomenon. Exercising behavior, defined as planned, structured and repeated bodily movements with the intention to maintain or increase the physical fitness (Caspersen, Powell, & Christenson, 1985), can be thought of as such a well-known phenomenon that has been in the scientific focus for many decades (Dishman & O’Connor, 2005). Within these decades a perspective that assumes rational and controlled evaluations as the basis for decision making, was predominantly used to understand why some people engage in physical activity and others do not (Ekkekakis & Zenko, 2015).
Dual-process theories (Ekkekakis & Zenko, 2015; Payne & Gawronski, 2010) provide another perspective, that is not exclusively influenced by rational reasoning. These theories differentiate two different processes that guide behavior “depending on whether they operate automatically or in a controlled fashion“ (Gawronski & Creighton, 2012, p. 282). Following this line of thought, exercise behavior is not solely influenced by thoughtful deliberations (e.g. concluding that exercising is healthy) but also by spontaneous affective reactions (e.g. disliking being sweaty while exercising). The theoretical frameworks of dual-process models are not new in psychology (Chaiken & Trope, 1999) and have already been used for the explanation of numerous behaviors (e.g. Hofmann, Friese, & Wiers, 2008; Huijding, de Jong, Wiers, & Verkooijen, 2005). However, they have only rarely been used for the explanation of exercise behavior (e.g. Bluemke, Brand, Schweizer, & Kahlert, 2010; Conroy, Hyde, Doerksen, & Ribeiro, 2010; Hyde, Doerksen, Ribeiro, & Conroy, 2010). The assumption of two dissimilar behavior influencing processes, differs fundamentally from previous theories and thus from the research that has been conducted in the last decades in exercise psychology. Research mainly concentrated on predictors of the controlled processes and addressed the identified predictors in exercise interventions (Ekkekakis & Zenko, 2015; Hagger, Chatzisarantis, & Biddle, 2002).
Predictors arising from the described automatic processes, for example automatic evaluations for exercising (AEE), have been neglected in exercise psychology for many years. Until now, only a few researchers investigated the influence of these AEE for exercising behavior (Bluemke et al., 2010; Brand & Schweizer, 2015; Markland, Hall, Duncan, & Simatovic, 2015). Marginally more researchers focused on the impact of AEE for physical activity behavior (Calitri, Lowe, Eves, & Bennett, 2009; Conroy et al., 2010; Hyde et al., 2010; Hyde, Elavsky, Doerksen, & Conroy, 2012). The extant studies mainly focused on the quality of AEE and the associated quantity of exercise (exercise much or little; Bluemke et al., 2010; Calitri et al., 2009; Conroy et al., 2010; Hyde et al., 2012). In sum, there is still a dramatic lack of empirical knowledge, when applying dual-process theories to exercising behavior, even though these theories have proven to be successful in explaining behavior in many other health-relevant domains like eating, drinking or smoking behavior (e.g. Hofmann et al., 2008).
The main goal of the present dissertation was to collect empirical evidence for the influence of AEE on exercise behavior and to expand the so far exclusively correlational studies by experimentally controlled studies. By doing so, the ongoing debate on a paradigm shift from controlled and deliberative influences of exercise behavior towards approaches that consider automatic and affective influences (Ekkekakis & Zenko, 2015) should be encouraged. All three conducted publications are embedded in dual-process theorizing (Gawronski & Bodenhausen, 2006, 2014; Strack & Deutsch, 2004). These theories offer a theoretical framework that could integrate the established controlled variables of exercise behavior explanation and additionally consider automatic factors for exercise behavior like AEE.
Taken together, the empirical findings collected suggest that AEE play an important and diverse role for exercise behavior. They represent exercise setting preferences, are a cause for short-term exercise decisions and are decisive for long-term exercise adherence. Adding to the few already present studies in this field, the influence of (positive) AEE for exercise behavior was confirmed in all three presented publications. Even though the available set of studies needs to be extended in prospectively studies, first steps towards a more complete picture have been taken. Closing with the beginning of the synopsis: I think that time is right for a change of perspectives! This means a careful extension of the present theories with controlled evaluations explaining exercise behavior. Dual-process theories including controlled and automatic evaluations could provide such a basis for future research endeavors in exercise psychology.
Background:
Arising from the relevance of sensorimotor training in the therapy of nonspecific low back pain patients and from the value of individualized therapy, the present trial aims to test the feasibility and efficacy of individualized sensorimotor training interventions in patients suffering from nonspecific low back pain.
Methods and study design:
A multicentre, single-blind two-armed randomized controlled trial to evaluate the
effects of a 12-week (3 weeks supervised centre-based and 9 weeks home-based) individualized sensorimotor exercise program is performed. The control group stays inactive during this period. Outcomes are pain, and pain-associated function as well as motor function in adults with nonspecific low back pain. Each participant is scheduled to five measurement dates: baseline (M1), following centre-based training (M2), following home-based training (M3) and at two follow-up time points 6 months (M4) and 12 months (M5) after M1. All investigations and the assessment of the primary and secondary outcomes are performed in a standardized order: questionnaires – clinical examination – biomechanics (motor function). Subsequent statistical procedures are executed after the examination of underlying assumptions for parametric or rather non-parametric testing.
Discussion:
The results and practical relevance of the study will be of clinical and practical relevance not only for researchers and policy makers but also for the general population suffering from nonspecific low back pain.
Trial registration:
Identification number DRKS00010129. German Clinical Trial registered on 3 March 2016.
Decades of research have demonstrated that physical stress (PS) stimulates bone remodeling and affects bone structure and function through complex mechanotransduction mechanisms. Recent research has laid ground to the hypothesis that mental stress (MS) also influences bone biology, eventually leading to osteoporosis and increased bone fracture risk. These effects are likely exerted by modulation of hypothalamic–pituitary–adrenal axis activity, resulting in an altered release of growth hormones, glucocorticoids and cytokines, as demonstrated in human and animal studies. Furthermore, molecular cross talk between mental and PS is thought to exist, with either synergistic or preventative effects on bone disease progression depending on the characteristics of the applied stressor. This mini review will explain the emerging concept of MS as an important player in bone adaptation and its potential cross talk with PS by summarizing the current state of knowledge, highlighting newly evolving notions (such as intergenerational transmission of stress and its epigenetic modifications affecting bone) and proposing new research directions.
Decades of research have demonstrated that physical stress (PS) stimulates bone remodeling and affects bone structure and function through complex mechanotransduction mechanisms. Recent research has laid ground to the hypothesis that mental stress (MS) also influences bone biology, eventually leading to osteoporosis and increased bone fracture risk. These effects are likely exerted by modulation of hypothalamic–pituitary–adrenal axis activity, resulting in an altered release of growth hormones, glucocorticoids and cytokines, as demonstrated in human and animal studies. Furthermore, molecular cross talk between mental and PS is thought to exist, with either synergistic or preventative effects on bone disease progression depending on the characteristics of the applied stressor. This mini review will explain the emerging concept of MS as an important player in bone adaptation and its potential cross talk with PS by summarizing the current state of knowledge, highlighting newly evolving notions (such as intergenerational transmission of stress and its epigenetic modifications affecting bone) and proposing new research directions.