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Brown F, Hill M, Renshaw D, Pedlar C, Hill J, van Someren K, Howatson G, Tallis J. The effect of medical grade compression garments on the repeated-bout effect in non-resistance-trained men. Exp Physiol 2023; 108:1490-1499. [PMID: 37768013 PMCID: PMC10988506 DOI: 10.1113/ep091399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
NEW FINDINGS What is the central question of this study? What are the effects of compression garments on recovery from unaccustomed damaging exercise and subsequent protective adaptations? What is the main finding and its importance? Compression did not influence recovery, but was associated with blunted protective adaptations for isokinetic performance, which were completely absent at high velocities. Based on these findings, the use of compression garments for recovery would not be recommended following unaccustomed exercise, particularly if the maintenance of high-velocity performance following exercise-induced muscle damage is desirable. ABSTRACT Whilst compression garments (CG) may enhance recovery from exercise-induced muscle damage (EIMD), many recovery strategies can attenuate adaptative responses. Therefore, the effects of CG on recovery from EIMD, and the rapid protective adaptations known as the repeated bout effect (RBE) were investigated. Thirty-four non-resistance-trained males (18-45 years) randomly received class II medical-grade CG or placebo for 72 h following eccentrically-focused lower-body exercise, in a double-blind, randomised controlled trial. Indices of EIMD were assessed at baseline, 0, 24, 48 and 72 h post-exercise, before exercise and testing were repeated after 14 days. Results were analysed using a three-way (time × condition × bout) linear mixed-effects model. Exercise impaired isometric and isokinetic strength, with soreness and thigh circumference elevated for 72 h (P < 0.001). Compression did not enhance recovery (P > 0.05), despite small to moderate effect sizes (ES, reported alongside 90% confidence intervals) for isokinetic strength (ES from 0.2 [-0.41, 0.82] to 0.65 [0.03, 1.28]). All variables recovered faster after the repeated bout (P < 0.005). However, RBE for peak isokinetic force was impaired in CG at 60° s-1 (group × bout interaction: χ2 = 4.24, P = 0.0395; ES = -0.56 [-1.18, 0.07]) and completely absent at 120° s-1 (χ2 = 16.2, P < 0.001, ES = -0.96 [-1.61, -0.32]) and 180° s-1 (χ2 = 10.4, P = 0.001, ES = -0.72 [-1.35, -0.09]). Compression blunted RBE at higher isokinetic velocities without improving recovery in non-resistance-trained males, potentially contraindicating their use following unaccustomed exercise in this population.
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Affiliation(s)
- Freddy Brown
- School of Life SciencesCoventry UniversityCoventryUK
- Research Centre for Physical Activity, Sport and Exercise ScienceCoventry UniversityCoventryUK
| | - Matt Hill
- Research Centre for Physical Activity, Sport and Exercise ScienceCoventry UniversityCoventryUK
| | - Derek Renshaw
- Centre for Health and Life SciencesCoventry UniversityCoventryUK
| | - Charles Pedlar
- Faculty of Sport, Health and Applied ScienceSt Mary's UniversityTwickenhamUK
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional ScienceUniversity College LondonLondonUK
| | - Jessica Hill
- Faculty of Sport, Health and Applied ScienceSt Mary's UniversityTwickenhamUK
| | - Ken van Someren
- Sports Lab NorthwestAtlantic Technological UniversityDonegalIreland
| | - Glyn Howatson
- Faculty of Health and Life of SciencesNorthumbria UniversityNewcastle Upon TyneUK
- Water Research GroupNorthwest UniversityPotchefstroomSouth Africa
| | - Jason Tallis
- Research Centre for Physical Activity, Sport and Exercise ScienceCoventry UniversityCoventryUK
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2
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Biondolillo MJ, Carr KA, Wojcik K, Curry DC, Epstein LH. Effects of Episodic Memory Recall on Reinforcing Value of Physical Activity. Psychol Rep 2023:332941231210213. [PMID: 37890092 DOI: 10.1177/00332941231210213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
OBJECTIVE Many people prefer a sedentary versus an active lifestyle and have difficulty completing sufficient physical activity to improve health. While exercise can be a powerful reinforcer for some people, many prefer to be sedentary. The relative reinforcing value of physical activity (RRVPA) is influenced by a person's learning history with positive experiences strengthening the motivation to be active. Episodic memories may be critical to determining RRVPA, or RRV of different types of positive behaviors. METHOD As a potential way to increase RRVPA we examined if recalling a positive episodic memory would affect RRVPA. One hundred and thirty seven adult participants completed measures of reinforcement history and memory functions and then recalled a single positive episode of either a physical activity or of a cognitively enriching activity, rated subjective memory qualities, and completed tasks to measure the RRV of both types of activity. RESULTS Recalling a positive episodic memory increased RRV for the respective activity, and changes in RRVPA were moderated by how much the memory satisfies a basic psychological need. CONCLUSIONS This research demonstrates the impact of episodic memory on RRVPA, which could be leveraged to aid behavior change efforts.
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Affiliation(s)
- Mathew J Biondolillo
- Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Katelyn A Carr
- Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Kathleen Wojcik
- Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Damante C Curry
- Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Leonard H Epstein
- Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
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Maharaj A, Jefferies JL, Mulrooney DA, Armstrong GT, Brinkman TM, O'Neil ST, Terrell S, Partin RE, Srivastava DK, Hudson MM, Wang Z, Ness KK. Design and methods of a randomized telehealth-based intervention to improve fitness in survivors of childhood cancer with exercise intolerance. Contemp Clin Trials 2023; 133:107339. [PMID: 37730199 PMCID: PMC10591872 DOI: 10.1016/j.cct.2023.107339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/01/2023] [Accepted: 09/15/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Exercise intolerance among childhood cancer survivors substantially increases risk for early mortality, reduced cognitive function, poor quality of life, emotional distress, and sub-optimal participation in social roles. Fortunately, exercise intolerance is modifiable, even among individuals with impaired cardiopulmonary and neuromuscular health. This study aims to evaluate the impact of tailored exercise intervention remotely supervised by fitness professionals in survivors with exercise intolerance. Telehealth-based delivery of the intervention aims to enhance uptake by removing the burden of travel and allowing participants to gain confidence with exercise and physical activity at home. METHODS This is an ongoing single-blind, two-arm, prospective, clinical trial that will randomize 160 participants 1:1 to intervention (n = 80) and attention control (n = 80) groups. The intervention group receives an individually tailored exercise prescription based on results from baseline assessments performed remotely via a Health Insurance Portability and Accountability Act-compliant virtual platform and personal preferences for aerobic exercise. Each prescription includes aerobic and strengthening components designed to progress gradually to 150-300-min of moderate aerobic activity and twice weekly strengthening exercises over 20-weeks. The first two weeks are supervised for 6 sessions, tapering to twice/week for weeks 3-4, once/week for weeks 5-8, every other week for weeks 9-16 and once midway between weeks 17-20. The schedule is modifiable depending on participant need, adherence, and response to exercise. Each session is approximately one hour. CONCLUSION This study tests the efficacy of an individually prescribed, virtually supervised exercise intervention on exercise intolerant childhood cancer survivors. CLINICALTRIALS gov registration: NCT04714840.
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Affiliation(s)
- Arun Maharaj
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN 38105, USA.
| | - John L Jefferies
- Department of Medicine, University of Tennessee Health Science Center, 920 Madison Avenue, Memphis, TN 38163, USA.
| | - Daniel A Mulrooney
- Department of Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-260, Memphis, TN 38105, USA.
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN 38105, USA.
| | - Tara M Brinkman
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-740, Memphis, TN 38105, USA.
| | - Sean T O'Neil
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN 38105, USA.
| | - Sarah Terrell
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN 38105, USA.
| | - Robyn E Partin
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN 38105, USA.
| | - Deo Kumar Srivastava
- Department of Biostatistics, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-768, Memphis, TN 38105, USA.
| | - Melissa M Hudson
- Departments of Oncology and Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN 38105, USA.
| | - Zhaoming Wang
- Departments of Epidemiology and Cancer Control and Computational Biology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN 38105, USA.
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN 38105, USA.
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4
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Flack KD, Stults-Kolehmainen MA, Creasy SA, Khullar S, Boullosa D, Catenacci VA, King N. Altered motivation states for physical activity and 'appetite' for movement as compensatory mechanisms limiting the efficacy of exercise training for weight loss. Front Psychol 2023; 14:1098394. [PMID: 37187558 PMCID: PMC10176969 DOI: 10.3389/fpsyg.2023.1098394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/23/2023] [Indexed: 05/17/2023] Open
Abstract
Weight loss is a major motive for engaging in exercise, despite substantial evidence that exercise training results in compensatory responses that inhibit significant weight loss. According to the Laws of Thermodynamics and the CICO (Calories in, Calories out) model, increased exercise-induced energy expenditure (EE), in the absence of any compensatory increase in energy intake, should result in an energy deficit leading to reductions of body mass. However, the expected negative energy balance is met with both volitional and non-volitional (metabolic and behavioral) compensatory responses. A commonly reported compensatory response to exercise is increased food intake (i.e., Calories in) due to increased hunger, increased desire for certain foods, and/or changes in health beliefs. On the other side of the CICO model, exercise training can instigate compensatory reductions in EE that resist the maintenance of an energy deficit. This may be due to decreases in non-exercise activity thermogenesis (NEAT), increases in sedentary behavior, or alterations in sleep. Related to this EE compensation, the motivational states associated with the desire to be active tend to be overlooked when considering compensatory changes in non-exercise activity. For example, exercise-induced alterations in the wanting of physical activity could be a mechanism promoting compensatory reductions in EE. Thus, one's desires, urges or cravings for movement-also known as "motivation states" or "appetence for activity"-are thought to be proximal instigators of movement. Motivation states for activity may be influenced by genetic, metabolic, and psychological drives for activity (and inactivity), and such states are susceptible to fatigue-or reward-induced responses, which may account for reductions in NEAT in response to exercise training. Further, although the current data are limited, recent investigations have demonstrated that motivation states for physical activity are dampened by exercise and increase after periods of sedentarism. Collectively, this evidence points to additional compensatory mechanisms, associated with motivational states, by which impositions in exercise-induced changes in energy balance may be met with resistance, thus resulting in attenuated weight loss.
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Affiliation(s)
- Kyle D. Flack
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY, United States
| | - Matthew A. Stults-Kolehmainen
- Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
- *Correspondence: Matthew A. Stults-Kolehmainen,
| | - Seth A. Creasy
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Saumya Khullar
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Daniel Boullosa
- Faculty of Physical Activity and Sports Sciences, Universidad de León, León, Spain
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
- Graduate Program in Movement Sciences, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Victoria A. Catenacci
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Neil King
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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Foxx RK, Jake-Schoffman DE, Mathews AE, Cheong J, Yurasek AM. Relative reinforcement from physical activity in real-world environments: a novel application of behavioral economics. J Behav Med 2022; 45:914-924. [PMID: 36116081 PMCID: PMC9483365 DOI: 10.1007/s10865-022-00363-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 09/29/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Ricarda K Foxx
- Department of Health Education and Behavior, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA.
| | - Danielle E Jake-Schoffman
- Department of Health Education and Behavior, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
| | - Anne E Mathews
- Food Science and Human Nutrition Department, University of Florida, P.O. Box 110370, Gainesville, FL, USA
| | - JeeWon Cheong
- Department of Health Education and Behavior, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
| | - Ali M Yurasek
- Department of Health Education and Behavior, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
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6
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Brown FCW, Hill JA, Pedlar CR. Compression Garments for Recovery from Muscle Damage: Evidence and Implications of Dose Responses. Curr Sports Med Rep 2022; 21:45-52. [PMID: 35120050 DOI: 10.1249/jsr.0000000000000933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT The use of compression garments (CG) has been associated with improved recovery following exercise-induced muscle damage. The mechanisms responsible are not well established, and no consensus exists regarding the effects of compression pressure (i.e., the "dose"), which until recently was seldom reported. With the increasing prevalence of studies reporting directly measured pressures, the present review aims to consolidate current evidence on optimal pressures for recovery from exercise-induced muscle damage. In addition, recent findings suggesting that custom-fitted garments provide greater precision and experimental control are discussed. Finally, biochemical data from human trials are presented to support a theoretical mechanism by which CG enhance recovery, with recommendations for future research. The effects of compression on adaptation remain unexplored. More studies are required to investigate the relationship between compression pressure and the recovery of performance and physiological outcomes. Furthermore, improved mechanistic understanding may help elucidate the optimal conditions by which CG enhance recovery.
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Affiliation(s)
| | - Jessica A Hill
- Faculty of Sport, Health and Applied Science, St. Mary's University, Twickenham, United Kingdom
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7
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Malone SK, Patterson F, Grunin L, Melkus GD, Riegel B, Punjabi N, Yu G, Urbanek J, Crainiceanu C, Pack A. Habitual physical activity patterns in a nationally representative sample of U.S. adults. Transl Behav Med 2021; 11:332-341. [PMID: 31985811 DOI: 10.1093/tbm/ibaa002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Physical inactivity is a leading determinant of noncommunicable diseases. Yet, many adults remain physically inactive. Physical activity guidelines do not account for the multidimensionality of physical activity, such as the type or variety of physical activity behaviors. This study identified patterns of physical activity across multiple dimensions (e.g., frequency, duration, and variety) using a nationally representative sample of adults. Sociodemographic characteristics, health behaviors, and clinical characteristics associated with each physical activity pattern were defined. Multivariate finite mixture modeling was used to identify patterns of physical activity among 2003-2004 and 2005-2006 adult National Health and Nutrition Examination Survey participants. Chi-square tests were used to identify sociodemographic differences within each physical activity cluster and test associations between the physical activity clusters with health behaviors and clinical characteristics. Five clusters of physical activity patterns were identified: (a) low frequency, short duration (n = 730, 13%); (b) low frequency, long duration (n = 392, 7%); (c) daily frequency, short duration (n = 3,011, 55%); (d) daily frequency, long duration (n = 373, 7%); and (e) high frequency, average duration (n = 964, 18%). Walking was the most common form of activity; highly active adults engaged in more varied types of activity. High-activity clusters were comprised of a greater proportion of younger, White, nonsmoking adult men reporting moderate alcohol use without mobility problems or chronic health conditions. Active females engaged in frequent short bouts of activity. Data-driven approaches are useful for identifying clusters of physical activity that encompass multiple dimensions of activity. These activity clusters vary across sociodemographic and clinical subgroups.
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Affiliation(s)
- Susan K Malone
- Rory Myers College of Nursing, New York University, New York, NY, USA
| | - Freda Patterson
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE, USA
| | - Laura Grunin
- Rory Myers College of Nursing, New York University, New York, NY, USA
| | - Gail D Melkus
- Rory Myers College of Nursing, New York University, New York, NY, USA
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Naresh Punjabi
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Gary Yu
- Rory Myers College of Nursing, New York University, New York, NY, USA
| | - Jacek Urbanek
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Ciprian Crainiceanu
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Allan Pack
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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8
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Epstein LH, O'Donnell S, Biondolillo MJ, Hostler D, Roemmich JN. Comparing the reinforcing value of high intensity interval training versus moderate intensity aerobic exercise in sedentary adults. Physiol Behav 2021; 238:113468. [PMID: 34033846 DOI: 10.1016/j.physbeh.2021.113468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022]
Abstract
Exercise is a reinforcer for both animals and humans, as they will work progressively harder to gain access for the opportunity to exercise. Exercise activates brain reward pathways similar to drugs of abuse, and the magnitude of the reinforcing value of exercise is a predictor of exercise behavior. The majority of research on exercise reinforcement has studied moderate intensity aerobic exercise (MIAE) or resistance training. There is limited research on the relative reinforcing value (RRV) of high intensity interval training (HIIT), which is often reported to be a preferred form of exercise in comparison to MIAE. Experiment 1 was a pilot study of 20 sedentary females designed to compare the reliability of differences in RRVHIIT vs RRVMIAE over two sessions, assess protocols comparing different volumes of HIIT in comparison to MIAE, and estimate sample sizes needed for a fully powered study to assess which type of exercise protocol was a better substitute for a highly liked sedentary activity. Experiment 2 studied 44 participants to assess whether HIIT or MIAE would be better substitutes for highly liked sedentary activities. Experiment 1 showed that measures of RRVHIIT or RRVMIAE were reliable, and that volume of HIIT did not influence RRVHIIT, even if it was of equal amount or duration to MIAE. Experiment 2 showed that HIIT was a more preferred substitute for sedentary behaviors than MIAE. Predictors of RRVMIAE were liking of MIAE and pleasantness of affect post MIAE. These results suggest inactive people may find interval training to be more reinforcing than MIAE, and may be more likely to adopt and maintain an exercise program involving HIIT rather than MIAE. The next stage of research should be to understand how to sensitize the RRV of exercise to motivate sedentary people to be more active.
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Affiliation(s)
- Leonard H Epstein
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York.
| | - Sara O'Donnell
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
| | - Mathew J Biondolillo
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
| | - David Hostler
- Department of Exercise and Nutrition Sciences, University at Buffalo School of Public Health and Health Sciences, Buffalo, New York
| | - James N Roemmich
- Grand Forks Human Nutrition Research Center, USDA Agricultural Research Service, Grand Forks, North Dakota
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Clark-Sienkiewicz SM, Caño A, Zeman LL, Lumley MA, Gothe N. Development of a Multicomponent Intervention to Initiate Health Behavior Change in Primary Care: The Kickstart Health Program. J Clin Psychol Med Settings 2021; 28:694-705. [PMID: 33398641 DOI: 10.1007/s10880-020-09755-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 11/25/2022]
Abstract
There is a growing movement to integrate behavioral health specialists into primary care settings in order to better manage patients' health behaviors. Group interventions in healthcare settings can provide services to multiple individuals simultaneously; however, the participants' experiences taking part in these activities and the logistics of integrating them into clinical settings are largely under-studied. This article describes the development and implementation of a novel group intervention for health behavior change, The Kickstart Health Program, which integrates components of cognitive, behavioral, acceptance, and experiential therapies. Participant feasibility, acceptability, experiences, and treatment course were assessed. Acceptability among a small sample of attendees was high, and initial data on behavior change suggest there were benefits to patients who attended the program. Increases in mindfulness practice and decreases in exercise barriers from baseline to 10-week follow-up were detected as were improvements in overall perceived health and well-being. Participants expressed that the program was acceptable and successful at helping them reach their individual health goals; however, enrollment barriers negatively impacted the feasibility of the program in regard to attendance. Modification to the enrollment process such as embedding referrals into the electronic medical record, encouraging spouse or family co-enrollment, and peer coaching may address these barriers. The Kickstart Health Program has the potential to improve health behaviors and paves the way for unique studies of dissemination and implementation of efficacious behavioral health interventions into real-world healthcare settings.
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Affiliation(s)
- Shannon M Clark-Sienkiewicz
- Department of Psychology, Wayne State University, Detroit, MI, USA. .,Beaumont Health, Sterling Heights, MI, USA. .,Huntsman Cancer Institute, University of Utah, 2000 Cir of Hope Dr, #1950, Salt Lake City, UT, 84112, USA.
| | - Annmarie Caño
- Department of Psychology, Wayne State University, Detroit, MI, USA.,College of Arts and Sciences, Gonzaga University, Spokane, WA, USA
| | | | - Mark A Lumley
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Neha Gothe
- Department of Kinesiology & Community Health, University of Illinois At Urbana-Champaign, Champaign, IL, USA
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10
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Flack KD, Hays HM, Moreland J. Incentive sensitization for exercise reinforcement to increase exercise behaviors. J Health Psychol 2020; 26:2487-2504. [PMID: 32338538 DOI: 10.1177/1359105320914073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Individuals can be sensitized to the reinforcing effects of exercise, although it is unknown if this process increases habitual exercise behavior. Sedentary men and women (body mass index: 25-35 kg/m2, N = 52) participated in a 12-week aerobic exercise intervention. Exercise reinforcement was determined by how much work was performed for exercise relative to a sedentary alternative in a progressive ratio schedule task. Habitual physical activity was assessed via accelerometry. Post-intervention increases in exercise reinforcement predicted increases in physical activity bouts among those who expended over 2000 kcal per week in exercise and who compensated for less than 50 percent of their exercise energy expenditure.
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Affiliation(s)
- Kyle D Flack
- Department of Deitetics and Human Nutrition, University of Kentucky, USA
| | - Harry M Hays
- Department of Deitetics and Human Nutrition, University of Kentucky, USA
| | - Jack Moreland
- Department of Deitetics and Human Nutrition, University of Kentucky, USA
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11
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Flack KD, Ufholz K, Johnson L, Roemmich JN. Increasing the Reinforcing Value of Exercise in Overweight Adults. Front Behav Neurosci 2019; 13:265. [PMID: 31849625 PMCID: PMC6902083 DOI: 10.3389/fnbeh.2019.00265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/20/2019] [Indexed: 12/21/2022] Open
Abstract
Objectives: This study determined whether a moderate- or high-dose exercise program increases exercise reinforcement. Increasing the relative reinforcing value of exercise (RRVexercise; i.e., incentive sensitization of exercise) may increase the usual physical activity (PA) participation. Preference and/or tolerance for the intensity of exercise was also assessed. Design: Sedentary men and women (body mass index, BMI: 25–35 kg/m2) were randomized into parallel exercise training groups expending either 300 (n = 18) or 600 (n = 18) kcal/exercise session, five sessions/week, for 12 weeks. Methods: The RRVexercise was determined by how much work was performed for exercise relative to a sedentary alternative in a progressive ratio schedule task. Preference and tolerance for exercise intensity were determined by questionnaire. Results: RRVexercise increased (P < 0.05) in both groups. Exercise reinforcement, defined as the amount of work completed for exercise without taking sedentary activity into account, increased (P < 0.01) in the 600 kcal group only. Preference and tolerance for exercise intensity increased (P < 0.01) in both groups, which predicted increases in RRVexercise. Conclusion: Expending 300 or 600 kcal, 5 days/week increases RRVexercise, while 600 kcal, 5 days/week may be needed to increase exercise reinforcement.
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Affiliation(s)
- Kyle D Flack
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY, United States
| | - Kelsey Ufholz
- United States Department of Agriculture-Agricultural Research Service (USDA-ARS), Grand Forks Human Nutrition Research Center, Grand Forks, ND, United States
| | - LuAnn Johnson
- United States Department of Agriculture-Agricultural Research Service (USDA-ARS), Grand Forks Human Nutrition Research Center, Grand Forks, ND, United States
| | - James N Roemmich
- United States Department of Agriculture-Agricultural Research Service (USDA-ARS), Grand Forks Human Nutrition Research Center, Grand Forks, ND, United States
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12
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Ufholz K, Flack KD, Johnson L, Roemmich JN. Active Videogames to Promote Traditional Active Play: Increasing the Reinforcing Value of Active Play Among Low-Active Children. Games Health J 2019; 9:208-214. [PMID: 31800323 DOI: 10.1089/g4h.2019.0040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: Exercise reinforcement predicts physical activity of children. Repeated exposures of physical activity may increase physical activity reinforcement (incentive sensitization). Active videogame (AVG) play produces light-to-moderate-intensity physical activity. Ideally, AVG play would transition to nonscreen-based active play through incentive sensitization of traditional active play (TAP), providing AVG does not increase sedentary videogame (SVG) reinforcement. Greater autonomy increases motivation toward traditional physical activity, but whether autonomy enhances incentive sensitization has not been studied. Objectives: To determine whether autonomy over AVG play promotes incentive sensitization of TAP or SVG. Methods: Inactive children (ages 8-12; 5th-97th body mass index percentile) were provided with AVG and SVG for 6 weeks and assigned to either a high autonomy (n = 25) or low autonomy (n = 24) group, differentiated by AVG choice and more freedom over amount of play. Both groups played AVG 3 days per week. SVG were played ad libitum. Participants completed an operant responding task to measure the relative reinforcing value (RRV) of AVG versus SVG (RRVAVG vs. SVG) and AVG versus TAP (RRVAVG vs. TAP) at baseline, 6 weeks, and 10 weeks. Results: RRVAVG vs. SVG increased over time (P = 0.056) but did not differ by autonomy or autonomy × time (P = 0.184). RRVAVG vs. TAP decreased over time (P = 0.033) but did not differ by autonomy or autonomy × time (P = 0.73). Conclusion: AVG play does not increase motivation toward SVG and increases motivation to play AVG relative to TAP. Providing higher autonomy did not promote incentive sensitization of play.
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Affiliation(s)
- Kelsey Ufholz
- United States Department of Agriculture, Agricultural Research Service, Grand Forks, North Dakota
| | - Kyle D Flack
- United States Department of Agriculture, Agricultural Research Service, Grand Forks, North Dakota
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky
| | - LuAnn Johnson
- United States Department of Agriculture, Agricultural Research Service, Grand Forks, North Dakota
| | - James N Roemmich
- United States Department of Agriculture, Agricultural Research Service, Grand Forks, North Dakota
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Flack K, Pankey C, Ufholz K, Johnson L, Roemmich JN. Genetic variations in the dopamine reward system influence exercise reinforcement and tolerance for exercise intensity. Behav Brain Res 2019; 375:112148. [PMID: 31404557 DOI: 10.1016/j.bbr.2019.112148] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/08/2019] [Accepted: 08/08/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Exercise is a reinforcing behavior and finding exercise highly reinforcing is characteristic of habitual exercisers. Genotypes related to dopamine metabolism moderate the reinforcing value of behaviors, but genetic moderators of exercise reinforcement have not been established. PURPOSE Determine whether singular nucleotide polymorphisms (SNPs) that moderate central reward pathways and pain neurotransmission are associated with exercise reinforcement, tolerance for exercise intensity, and usual physical activity. METHODS Adults (n = 178) were measured for the reinforcing value of exercise relative to sedentary activities (RRVexercise), minutes of moderate-to-vigorous physical activity (MVPA) and completed the Preference for and Tolerance of the Intensity of Exercise Questionnaire. Genotyping of 23 SNPs known to influence central dopamine tone, pain, or physical activity was performed. ANOVA tested differences in RRVexercise, tolerance, and MVPA among genotype groups. Linear regression controlling for BMI, sex, and liking of exercise was used to further predict the association of genotype on RRVexercise, tolerance, and MVPA. RESULTS Having at least one copy of the G allele for the DRD2/ANKK1 polymorphism (rs1800497) conferred greater RRVexercise. Greater tolerance for exercise intensity was observed among those homozygous for the T allele for the CNR1 polymorphism (rs6454672), had at least one copy of the G allele for the GABRG3 polymorphism (rs8036270), or had at least one copy of the T allele for the LPR polymorphism (rs12405556). Homozygous individuals for the T allele at rs6454672 exhibited greater MVPA. CONCLUSION Similar to other reinforcing behaviors, there is a genetic contribution to exercise reinforcement, tolerance for exercise intensity, and MVPA.
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Affiliation(s)
- Kyle Flack
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY, USA; USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, 2420 2ndAve N., Grand Forks, ND, USA.
| | - Christopher Pankey
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, 2420 2ndAve N., Grand Forks, ND, USA; Department of Biomedical Sciences, West Virginia School of Osteopathic Medicine, Lewisburg, WV, USA
| | - Kelsey Ufholz
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, 2420 2ndAve N., Grand Forks, ND, USA
| | - LuAnn Johnson
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, 2420 2ndAve N., Grand Forks, ND, USA
| | - James N Roemmich
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, 2420 2ndAve N., Grand Forks, ND, USA
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Decreasing the Consumption of Foods with Sugar Increases Their Reinforcing Value: A Potential Barrier for Dietary Behavior Change. J Acad Nutr Diet 2019; 119:1099-1108. [DOI: 10.1016/j.jand.2018.12.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 12/18/2018] [Accepted: 12/22/2018] [Indexed: 12/13/2022]
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Inducing incentive sensitization of exercise reinforcement among adults who do not regularly exercise-A randomized controlled trial. PLoS One 2019; 14:e0216355. [PMID: 31063478 PMCID: PMC6504040 DOI: 10.1371/journal.pone.0216355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/17/2019] [Indexed: 12/13/2022] Open
Abstract
Background Increasing exercise reinforcement, or decreasing sedentary reinforcement, may reduce sedentary activity and promote habitual exercise. Repeated exposures to a reinforcer may increase its reinforcing value (i.e., incentive sensitization). It is not yet known whether incentive sensitization occurs for exercise or factors associated with incentive sensitization for exercise reinforcement. The purpose was to determine whether exercise exposures increase exercise reinforcement relative to a sedentary alternative and whether this sensitization of exercise reinforcement would alter physical or sedentary behavior. This work also determined whether exercise dose, intensity, and preference and tolerance for exercise intensity were associated with incentive sensitization of exercise. Methods 104 sedentary men and women were randomized to exercise training groups with 89 completing the study. Groups included exercise exposures of 150 (n = 35) or 300 kcal/session (n = 34), 3 sessions/week for 6 weeks, or a non-exercise control group (n = 35). Assessments for exercise and sedentary behavior reinforcement (primary dependent variables) and activity and tolerance for exercise intensity were performed at baseline (week 0), post training (week 6), and post washout (week 10). Results The control group reduced (P = 0.022) relative reinforcing value of exercise, such that the 150 kcal group had a greater relative reinforcing value of exercise after the exercise treatment 150 kcal: 0.69 ± 0.07 to 0.74 ± 0.07; 300 kcal: 0.72 ± 0.07 to 0.63 ± 0.08, control: 0.72 ± 0.07 to 0.57 ± 0.08 mean ± SE. Increases in tolerance for exercise intensity discomfort were associated with increases in relative reinforcing value of exercise. Sedentary behavior reinforcement decreased in both exercise groups (150 kcal: 5.4 ± 4.3 to 1.8 ± 1.3; 300 kcal: 5.4 ± 4.3 to 3.1 ± 2.4, P<0.05), but remained unchanged in the control group (5.1 ± 4.0 to 6.1 ± 4.9, P>0.05). Sedentary activity decreased baseline to post-training in the 300 kcal group (546.5 ± 10.7 to 503.8 ± 11.8 minutes, P<0.01). Conclusion Small amounts of regular exercise may reduce the reinforcing value sedentary behavior. The process of incentive sensitization of exercise may include reducing the reinforcing value of competing sedentary activities. Developing tolerance to exercise discomfort of exercise may be critical to increasing exercise reinforcement.
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Fredslund EK, Leppin A. Can the Easter break induce a long-term break of exercise routines? An analysis of Danish gym data using a regression discontinuity design. BMJ Open 2019; 9:e024043. [PMID: 30765400 PMCID: PMC6398681 DOI: 10.1136/bmjopen-2018-024043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES Many sedentary individuals are aware of the health benefits of regular physical activity and start becoming more physically active. Yet, despite good intentions, many struggle to keep up initial exercise levels and experience a decline in exercise frequency. A possible explanation is that it is hard to establish habits or routines, and that such routines-once established-might be easy to break. In this paper, we analyse whether a break in habitual/routine behaviour-induced by the Easter holidays-results in individuals exercising less after the break. METHODS The study included a sample of 1210 members of a Danish chain of fitness centres who were gym members at least since the preceding New Year's Day. Participants granted access to gym attendance data, which were automatically recorded when entering the gym. We use a regression discontinuity design encompassing a time period of 10 weeks prior to and 10 weeks after Easter. RESULTS We found a significant and relevant discretionary drop in exercise frequency right after the Easter holidays of 0.24 times per week (p=0.001) corresponding to a fall of 12.25% compared with the week prior to the Easter holidays. The effect was especially profound for individuals below retirement age and for individuals who had attended the gym with a higher frequency (twice a week or more) in the 6 weeks prior to the Easter break. DISCUSSION This information is potentially relevant for helping individuals maintain an exercise habit. Motivational support should focus on the time period after normative breaks, such as Easter or other holidays.
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Affiliation(s)
- Eskild Klausen Fredslund
- Department of Public Health, Syddansk Universitet Det Sundhedsvidenskabelige Fakultet, Odense, Denmark
- VIVE - The Danish Center for Social Science Research, Aarhus, Denmark
| | - Anja Leppin
- Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
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The reinforcing value and liking of resistance training and aerobic exercise as predictors of adult's physical activity. Physiol Behav 2017; 179:284-289. [DOI: 10.1016/j.physbeh.2017.06.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 06/11/2017] [Accepted: 06/25/2017] [Indexed: 12/12/2022]
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Bryan AD, Jakicic JM, Hunter CM, Evans ME, Yanovski SZ, Epstein LH. Behavioral and Psychological Phenotyping of Physical Activity and Sedentary Behavior: Implications for Weight Management. Obesity (Silver Spring) 2017; 25:1653-1659. [PMID: 28948719 PMCID: PMC5657446 DOI: 10.1002/oby.21924] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/07/2017] [Accepted: 06/08/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Risk for obesity is determined by a complex mix of genetics and lifetime exposures at multiple levels, from the metabolic milieu to psychosocial and environmental influences. These phenotypic differences underlie the variability in risk for obesity and response to weight management interventions, including differences in physical activity and sedentary behavior. METHODS As part of a broader effort focused on behavioral and psychological phenotyping in obesity research, the National Institutes of Health convened a multidisciplinary workshop to explore the state of the science in behavioral and psychological phenotyping in humans to explain individual differences in physical activity, both as a risk factor for obesity development and in response to activity-enhancing interventions. RESULTS Understanding the behavioral and psychological phenotypes that contribute to differences in physical activity and sedentary behavior could allow for improved treatment matching and inform new targets for tailored, innovative, and effective weight management interventions. CONCLUSIONS This summary provides the rationale for identifying psychological and behavioral phenotypes relevant to physical activity and identifies opportunities for future research to better understand, define, measure, and validate putative phenotypic factors and characterize emerging phenotypes that are empirically associated with initiation of physical activity, response to intervention, and sustained changes in physical activity.
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Affiliation(s)
| | | | - Christine M. Hunter
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Mary E. Evans
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Susan Z. Yanovski
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Leonard H. Epstein
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
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