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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.
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.
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).
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.
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.
The general purpose of this systematic review was to summarize, structure and evaluate the findings on automatic evaluations of exercising. Studies were eligible for inclusion if they reported measuring automatic evaluations of exercising with an implicit measure and assessed some kind of exercise variable. Fourteen nonexperimental and six experimental studies (out of a total N = 1,928) were identified and rated by two independent reviewers. The main study characteristics were extracted and the grade of evidence for each study evaluated. First, results revealed a large heterogeneity in the applied measures to assess automatic evaluations of exercising and the exercise variables. Generally, small to large-sized significant relations between automatic evaluations of exercising and exercise variables were identified in the vast majority of studies. The review offers a systematization of the various examined exercise variables and prompts to differentiate more carefully between actually observed exercise behavior (proximal exercise indicator) and associated physiological or psychological variables (distal exercise indicator). Second, a lack of transparent reported reflections on the differing theoretical basis leading to the use of specific implicit measures was observed. Implicit measures should be applied purposefully, taking into consideration the individual advantages or disadvantages of the measures. Third, 12 studies were rated as providing first-grade evidence (lowest grade of evidence), five represent second-grade and three were rated as third-grade evidence. There is a dramatic lack of experimental studies, which are essential for illustrating the cause-effect relation between automatic evaluations of exercising and exercise and investigating under which conditions automatic evaluations of exercising influence behavior. Conclusions about the necessity of exercise interventions targeted at the alteration of automatic evaluations of exercising should therefore not be drawn too hastily.
The general purpose of this systematic review was to summarize, structure and evaluate the findings on automatic evaluations of exercising. Studies were eligible for inclusion if they reported measuring automatic evaluations of exercising with an implicit measure and assessed some kind of exercise variable. Fourteen nonexperimental and six experimental studies (out of a total N = 1,928) were identified and rated by two independent reviewers. The main study characteristics were extracted and the grade of evidence for each study evaluated. First, results revealed a large heterogeneity in the applied measures to assess automatic evaluations of exercising and the exercise variables. Generally, small to large-sized significant relations between automatic evaluations of exercising and exercise variables were identified in the vast majority of studies. The review offers a systematization of the various examined exercise variables and prompts to differentiate more carefully between actually observed exercise behavior (proximal exercise indicator) and associated physiological or psychological variables (distal exercise indicator). Second, a lack of transparent reported reflections on the differing theoretical basis leading to the use of specific implicit measures was observed. Implicit measures should be applied purposefully, taking into consideration the individual advantages or disadvantages of the measures. Third, 12 studies were rated as providing first-grade evidence (lowest grade of evidence), five represent second-grade and three were rated as third-grade evidence. There is a dramatic lack of experimental studies, which are essential for illustrating the cause-effect relation between automatic evaluations of exercising and exercise and investigating under which conditions automatic evaluations of exercising influence behavior. Conclusions about the necessity of exercise interventions targeted at the alteration of automatic evaluations of exercising should therefore not be drawn too hastily.
Doping use in recreational sports is an emerging issue that has received limited attention so far in the psychological literature. The present study assessed the lifetime prevalence of controlled performance and appearance enhancing substances ( PAES), and used behavioral reasoning theory to identify the reasons for using and for avoiding using controlled PAES in young exercisers across five European countries, in the context of the "SAFE YOU" Project. Participants were 915 young amateur athletes and exercisers (M = 21.62; SD = 2.62) from Cyprus, Germany, Greece, Italy, and UK who completed an anonymous questionnaire that included measures of self-reported use of controlled PAES, as well as reasons for using and not using controlled PAES. The results of the descriptive analyses demonstrated that almost one out five exercisers in the sample had a previous experience with controlled PAES. Higher prevalence rates were found in Greece and Cyprus and lower in Italy. The most frequently reported reasons for using controlled PAES included achieving the desired results faster; pushing the self to the (physical) limits; and recovering faster after exercise/training. Furthermore, the most frequently reported reasons for not using controlled PAES involved worry about any possible adverse health effects; not feeling the need for using them; and wanting to see what can be achieved naturally without using any controlled PAES. The findings of the present study indicate that the use of controlled PAES is fast becoming a crisis in amateur sports and exercise settings and highlight the need for preventive action and concerted anti-doping education efforts.
The genesis of chronic pain is explained by a biopsychosocial model. It hypothesizes an interdependency between environmental and genetic factors provoking aberrant long-term changes in biological and psychological regulatory systems. Physiological effects of psychological and physical stressors may play a crucial role in these maladaptive processes. Specifically, long-term demands on the stress response system may moderate central pain processing and influence descending serotonergic and noradrenergic signals from the brainstem, regulating nociceptive processing at the spinal level. However, the underlying mechanisms of this pathophysiological interplay still remain unclear. This paper aims to shed light on possible pathways between physical (exercise) and psychological stress and the potential neurobiological consequences in the genesis and treatment of chronic pain, highlighting evolving concepts and promising research directions in the treatment of chronic pain. Two treatment forms (exercise and mindfulness-based stress reduction as exemplary therapies), their interaction, and the dose-response will be discussed in more detail, which might pave the way to a better understanding of alterations in the pain matrix and help to develop future prevention and therapeutic concepts
Physical activity protects from incident anxiety: A meta-analysis of prospective cohort studies
(2019)
Background Prospective cohorts have suggested that physical activity (PA) can decrease the risk of incident anxiety. However, no meta-analysis has been conducted. Aims To examine the prospective relationship between PA and incident anxiety and explore potential moderators. Methods Searches were conducted on major databases from inception to October 10, 2018 for prospective studies (at least 1 year of follow-up) that calculated the odds ratio (OR) of incident anxiety in people with high PA against people with low PA. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was conducted and heterogeneity was explored using subgroup and meta-regression analysis. Results Across 14 cohorts of 13 unique prospective studies (N = 75,831, median males = 50.1%) followed for 357,424 person-years, people with high self-reported PA (versus low PA) were at reduced odds of developing anxiety (adjusted odds ratio [AOR] = 0.74; 95% confidence level [95% CI] = 0.62, 0.88; crude OR = 0.80; 95% CI = 0.69, 0.92). High self-reported PA was protective against the emergence of agoraphobia (AOR = 0.42; 95% CI = 0.18, 0.98) and posttraumatic stress disorder (AOR = 0.57; 95% CI = 0.39, 0.85). The protective effects for anxiety were evident in Asia (AOR = 0.31; 95% CI = 0.10, 0.96) and Europe (AOR = 0.82; 95% CI = 0.69, 0.97); for children/adolescents (AOR = 0.52; 95% CI = 0.29, 0.90) and adults (AOR = 0.81; 95% CI = 0.69, 0.95). Results remained robust when adjusting for confounding factors. Overall study quality was moderate to high (mean NOS = 6.7 out of 9). Conclusion Evidence supports the notion that self-reported PA can confer protection against the emergence of anxiety regardless of demographic factors. In particular, higher PA levels protects from agoraphobia and posttraumatic disorder.
The clinical benefits of rehabilitation in cardiovascular disease are well established. Among cardiovascular disease patients, however, patients with type 2 diabetes mellitus require a distinct approach. Specific challenges to clinicians and healthcare professionals in patients with type 2 diabetes include the prevalence of peripheral and autonomic neuropathy, retinopathy, nephropathy, but also the intake of glucose-lowering medication. In addition, the psychosocial wellbeing, driving ability and/or occupational status can be affected by type 2 diabetes. As a result, the target parameters of cardiovascular rehabilitation and the characteristics of the cardiovascular rehabilitation programme in patients with type 2 diabetes often require significant reconsideration and a multidisciplinary approach. This review explains how to deal with diabetes-associated comorbidities in the intake screening of patients with type 2 diabetes entering a cardiovascular rehabilitation programme. Furthermore, we discuss diabetes-specific target parameters and characteristics of cardiovascular rehabilitation programmes for patients with type 2 diabetes in a multidisciplinary context, including the implementation of guideline-directed medical therapy.
I Can See It in Your Face.
(2019)
The purpose of this study was to illustrate that people’s affective valuation of exercise can be identified in their faces. The study was conducted with a software for automatic facial expression analysis and it involved testing the hypothesis that positive or negative affective valuation occurs spontaneously when people are reminded of exercise. We created a task similar to an emotional Stroop task, in which participants responded to exercise-related and control stimuli with a positive or negative facial expression (smile or frown) depending on whether the photo was presented upright or tilted. We further asked participants how much time they would normally spend for physical exercise, because we assumed that the affective valuation of those who exercise more would be more positive. Based on the data of 86 participants, regression analysis revealed that those who reported less exercise and a more negative reflective evaluation of exercise initiated negative facial expressions on exercise-related stimuli significantly faster than those who reported exercising more often. No significant effect was observed for smile responses. We suspect that responding with a smile to exercise-related stimuli was the congruent response for the majority of our participants, so that for them no Stroop interference occurred in the exercise-related condition. This study suggests that immediate negative affective reactions to exercise-related stimuli result from a postconscious automatic process and can be detected in the study participants’ faces. It furthermore illustrates how methodological paradigms from social–cognition research (here: the emotional Stroop paradigm) can be adapted to collect and analyze biometric data for the investigation of exercisers’ and non-exercisers’ automatic valuations of exercise.
Objectives
The aims of this study were to investigate the effects of a six-week in-season period of soccer training and games (congested period) on plasma volume variations (PV), hematological parameters, and physical fitness in elite players. In addition, we analyzed relationships between training load, hematological parameters and players’ physical fitness.
Methods
Eighteen elite players were evaluated before (T1) and after (T2) a six-week in-season period interspersed with 10 soccer matches. At T1 and T2, players performed the Yo-Yo intermittent recovery test level 1 (YYIR1), the repeated shuttle sprint ability test (RSSA), the countermovement jump test (CMJ), and the squat jump test (SJ). In addition, PV and hematological parameters (erythrocytes [M/mm3], hematocrit [%], hemoglobin [g/dl], mean corpuscular volume [fl], mean corpuscular hemoglobin content [pg], and mean hemoglobin concentration [%]) were assessed. Daily ratings of perceived exertion (RPE) were monitored in order to quantify the internal training load.
Results
From T1 to T2, significant performance declines were found for the YYIR1 (p<0.001, effect size [ES] = 0.5), RSSA (p<0.01, ES = 0.6) and SJ tests (p< 0.046, ES = 0.7). However, no significant changes were found for the CMJ (p = 0.86, ES = 0.1). Post-exercise, RSSA blood lactate (p<0.012, ES = 0.2) and PV (p<0.01, ES = 0.7) increased significantly from T1 to T2. A significant decrease was found from T1 to T2 for the erythrocyte value (p<0.002, ES = 0.5) and the hemoglobin concentration (p<0.018, ES = 0.8). The hematocrit percentage rate was also significantly lower (p<0.001, ES = 0.6) at T2. The mean corpuscular volume, mean corpuscular hemoglobin content and the mean hemoglobin content values were not statistically different from T1 to T2. No significant relationships were detected between training load parameters and percentage changes of hematological parameters. However, a significant relationship was observed between training load and changes in RSSA performance (r = -0.60; p<0.003).
Conclusions
An intensive period of “congested match play” over 6 weeks significantly compromised players’ physical fitness. These changes were not related to hematological parameters, even though significant alterations were detected for selected measures.
Objectives:
The prevalence rates for mental health (MH) problems in cancer patients is high, although reduced uptake of services may be influenced by mental health literacy (MHL). The objective of this study was to investigate the MHL for depression and panic disorder (PD), including treatment preferences in Australian adults who had been diagnosed and treated for cancer, and whether MHL and treatment preferences was influenced by sex, age, and individuals' lived MH experience.
Method:
A total of 421 cancer survivors (n = 378 females) completed a self-report survey. Participants were asked to specify whether they had a lived experience with anxiety and/or depression, and to indicate treatment preferences for managing cancer-related distress. Two vignettes were administered to assess MHL for depression and PD.
Results:
The MHL accuracy for depression was higher than PD. Accuracy rates were higher for females with a lived experience with anxiety and/or depression; although the accuracy rate for PD was significantly lower in males. A high proportion of individuals preferred exercise and in-person counselling to manage depression and PD. Internet-based therapies were not strongly preferred for managing MH problems.
Conclusions:
The MHL for depression and PD is moderate for adult cancer survivors, with higher levels indicated for individuals with a personal lived experience with anxiety and/or depression. Public health campaigns for enhancing MHL should broaden to include individuals experiencing comorbid physical health conditions. Health providers also need to take into account client preferences for evidence-based therapies.
Objective: We investigated the effects of combined balance and strength training on measures of balance and muscle strength in older women with a history of falls.
Methods: Twenty-seven older women aged 70.4 ± 4.1 years (age range: 65 to 75 years) were randomly allocated to either an intervention (IG, n = 12) or an active control (CG, n = 15) group. The IG completed 8 weeks combined balance and strength training program with three sessions per week including visual biofeedback using force plates. The CG received physical therapy and gait training at a rehabilitation center. Training volumes were similar between the groups. Pre and post training, tests were applied for the assessment of muscle strength (weight-bearing squat [WBS] by measuring the percentage of body mass borne by each leg at different knee flexions [0°, 30°, 60°, and 90°], sit-to-stand test [STS]), and balance. Balance tests used the modified clinical test of sensory interaction (mCTSIB) with eyes closed (EC) and opened (EO), on stable (firm) and unstable (foam) surfaces as well as spatial parameters of gait such as step width and length (cm) and walking speed (cm/s).
Results: Significant group × time interactions were found for different degrees of knee flexion during WBS (0.0001 < p < 0.013, 0.441 < d < 0.762). Post hoc tests revealed significant pre-to-post improvements for both legs and for all degrees of flexion (0.0001 < p < 0.002, 0.697 < d < 1.875) for IG compared to CG. Significant group × time interactions were found for firm EO, foam EO, firm EC, and foam EC (0.006 < p < 0.029; 0.302 < d < 0.518). Post hoc tests showed significant pre-to-post improvements for both legs and for all degrees of oscillations (0.0001 < p < 0.004, 0.753 < d < 2.097) for IG compared to CG. This study indicates that combined balance and strength training improved percentage distribution of body weight between legs at different conditions of knee flexion (0°, 30°, 60°, and 90°) and also decreased the sway oscillation on a firm surface with eyes closed, and on foam surface (with eyes opened or closed) in the IG.
Conclusion: The higher positive effects of training seen in standing balance tests, compared with dynamic tests, suggests that balance training exercises including lateral, forward, and backward exercises improved static balance to a greater extent in older women.
Eccentric exercise is discussed as a treatment option for clinical populations, but specific responses in terms of muscle damage and systemic inflammation after repeated loading of large muscle groups have not been conclusively characterized. Therefore, this study tested the feasibility of an isokinetic protocol for repeated maximum eccentric loading of the trunk muscles. Nine asymptomatic participants (5 f/4 m; 34±6 yrs; 175±13 cm; 76±17 kg) performed three isokinetic 2-minute all-out trunk strength tests (1x concentric (CON), 2x eccentric (ECC1, ECC2), 2 weeks apart; flexion/extension, 60°/s, ROM 55°). Outcomes were peak torque, torque decline, total work, and indicators of muscle damage and inflammation (over 168 h). Statistics were done using the Friedman test (Dunn’s post-test). For ECC1 and ECC2, peak torque and total work were increased and torque decline reduced compared to CON. Repeated ECC bouts yielded unaltered torque and work outcomes. Muscle damage markers were highest after ECC1 (soreness 48 h, creatine kinase 72 h; p<0.05). Their overall responses (area under the curve) were abolished post-ECC2 compared to post-ECC1 (p<0.05). Interleukin-6 was higher post-ECC1 than CON, and attenuated post-ECC2 (p>0.05). Interleukin-10 and tumor necrosis factor-α were not detectable. All markers showed high inter-individual variability. The protocol was feasible to induce muscle damage indicators after exercising a large muscle group, but the pilot results indicated only weak systemic inflammatory responses in asymptomatic adults.
Hintergrund. Personen, die mit der chronischen Erkrankung HIV leben (PWH), müssen ihr Leben lang die sog. antiretrovirale Therapie (ART) einnehmen, um einen Ausbruch der Erkrankung in das Vollbild AIDS (Akquiriertes Immun-Defizienz-Syndrom) zu vermeiden. Gleichzeitig ist die ART und HIV selbst assoziiert mit dem Auftreten zusätzlicher Erkrankungen (Komorbiditäten) kardiovaskulärer oder psychologischer Natur. Die Prävalenz von Komorbiditäten und schlechter Lebensqualität ist im Vergleich zu HIV-negativen Personen deutlich höher.
Methoden. Es wurden zwei Metaanalysen zu sportlicher Betätigung, PWH und (1) kardiovaskulären und (2) psychologischen Parametern sowie eine Querschnittsstudie (HIBES-Studie, HIV-Begleiterkrankungen und Sport) durchgeführt. Für die Auswertung der metaanalytischen Daten wurde der Review Manager 5.3, für die Auswertung der Daten der HIBES-Studie das Analyseprogramm „R“ verwendet. In den Metaanalysen wurden, neben den Hauptanalysen verschiedener Parameter, erstmals spezifische Subgruppenanalysen durchgeführt. Die HIBES-Studie untersuchte Unterschiede zwischen kumulativen (2-3 verschiedenen Sportarten pro Woche) und einfachen (eine Sportart pro Woche) Freizeitsport und analysiert die Zusammenhänge von Parametern des Freizeitsports (Trainingshäufigkeit, -Minuten und –Intensität), Komorbiditäten und der Lebensqualität.
Ergebnisse. Ausdauer- und Krafttraining haben einen mittel-starken bis starken positiven Effekt auf die maximale Sauerstoffaufnahme (SMD= 0.66, p< .00001), den 6-Minuten-Walk-Test (6MWT) (SMD= 0.59, p= .02), die maximale Watt Zahl (SMD= 0.80, p= .009). Kein Effekt wurde bei der maximalen Herzfrequenz und dem systolischen sowie diastolischen Blutdruck gefunden. Subgruppenanalysen zu ≥3 Einheiten/Woche, ≥150 Min./Woche ergaben hohe Effektstärken in der maximalen Watt Zahl und 6MWT. Ausdauer- und Krafttraining zusammen mit Yoga haben einen starken Effekt auf Symptome der Depression (SMD= -0.84, p= .02) und Angststörungen (SMD= -1.23, p= .04). Die Subanalyse der Depression zu professioneller Supervision und sportlicher Betätigung wiesen einen sehr starken Effekt (SMD= -1.40, p= .03). Die HIBES-Studie wies ein sehr differenziertes Bild im Sportverhalten von PWH in Deutschland auf. 49% der Teilnehmer übten mehr als eine Sportart pro Woche aus. Es wurden keine Unterschiede zwischen kumuliertem (CTE) und einfachem Sport (STE) in der Lebensqualität gefunden. Die Freizeitsportparameter (Häufigkeiten/Woche, Minuten/Woche, Intensität/Woche) waren in der CTE-Gruppe deutlich höher als in der STE-Gruppe. Trainingsminuten und die -Intensität zeigten beim Vorhandensein einer Komorbidität einen großen Zusammenhang mit der Lebensqualität. Die Minuten und die Intensität des durchgeführten Sportes zeigten einen prädiktiven Zusammenhang mit der Lebensqualität.
Konklusion: Sportliche Betätigung verbessert die maximale Sauerstoffaufnahme und Symptome der Depression und Angststörungen. Die Aussagekraft der Subanalysen ist aufgrund der geringen Studienzahl, vorsichtig zu interpretieren. Erhöhte Trainingsparameter finden sich eher bei PWH, die mehr als eine Sportart pro Woche treiben. Daher kann kumulierter Sport als mediierender Faktor zur Steigerung der Lebensqualität interpretiert werden; zumindest bei PWH mit einer psychologischen Komorbidität.