A syndemics approach to exercise is medicine

Association of physical activity and sedentary behaviour with depressive symptoms in Chinese adults

This study aims to examine the independent and joint associations of physical activity (PA) and sedentary behaviour with depressive symptoms. A population-based cross-sectional study conducted in China included 17,861 adults. PA and sedentary behaviour were assessed using the International Physical Activity Questionnaire. Depressive symptoms were determined by the 9-item Patient Health Questionnaire score ≥10. Logistic regression models were used to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs). The prevalence of depressive symptoms among all participants was 20.6% (3679/17861). Higher levels of PA were inversely associated with depressive symptoms, whereas prolonged sedentary behaviour was associated with increased odds of depressive symptoms. The positive associations between sedentary behaviour and depressive symptoms remained significant, regardless of PA levels. In joint analyses, the depressive symptoms OR comparing adults who reported low level of PA with the highest tertile of sedentary behaviour to those reporting high level of PA with the lowest tertile of sedentary behaviour was 1.99 (95% CI 1.64 to 2.40). This study indicated that high level of PA may not offset the increased risk of depressive symptoms associated with high amounts of sedentary behaviour, and therefore these behaviours should be considered jointly to obtain optimal prevention effects.

Results of the MOVE MS Program: A Feasibility Study on Group Exercise for Individuals with Multiple Sclerosis

Exercise improves a wide range of symptoms experienced by those living with multiple sclerosis (MS) and may foster community and a positive sense of disability identity. However, exercise rates remain low. Sustained exercise participation has the greatest likelihood of improving symptoms and requires a theory-based approach accounting for the barriers faced by people with MS that impede exercise participation long-term. MOVE MS is a once weekly group exercise program based on Social Cognitive Theory supporting long-term exercise participation through peer instruction, behavior change education, multiple exercise modalities, and seated instruction. This feasibility study evaluated MOVE MS with a 7-month trial. The primary scientific outcome was exercise participation and the secondary outcomes were MS symptoms/impact, self-efficacy, depression, anxiety, disability identity, and quality of life, among others. We further conducted semi-structured formative interviews post-intervention. Thirty-three participants began the program. The onset of COVID-19 necessitated a shift toward online delivery. Seventeen participants completed the program. There were non-significant improvements in exercise participation (Godin Leisure-Time Exercise Questionnaire, baseline mean = 14.2 (SD = 11.8), post-intervention mean = 16.6 (SD = 11.2), F-value = 0.53 (Partial Eta2 = 0.08), and several secondary outcomes (including the MS Impact Scale, MS Walking Scale, and the Leeds MS Quality of Life Scale). Sixteen participants were interviewed, and analysis yielded five themes on program components and feedback. MOVE MS-delivered in-person or online-may be a feasible option for long-term exercise programming for people with MS.

Medicalization of Exercise Through Vigilance, Productivity, and Self-Care: A Secondary Data Analysis of Qualitative Interviews Among Those With Multiple Sclerosis

Exercise is becoming more integrated into the management of multiple sclerosis (MS) and is promoted to manage impairments and symptoms. Whereas extensive research outlines factors impacting participation, less is known regarding how medicalized exercise promotion might impact views of exercise and self. We conducted a secondary data analysis to understand how medicalized exercise-promotion paradigms impact the meaning and roles of exercise among those with MS. Twenty-two interviews were selected for reanalysis with an interpretative phenomenological analysis methodology and a critical disability studies lens. Three themes were identified: Constant Vigilance (worry about exercise), Productivity and Social Engagement (exercise to feel productive, engage socially, and enhance self-worth), and Exercise as Medicine/Self-Care (exercise to manage MS, relax, improve mental well-being, prevent/reverse disability, and stay healthy). This research underscores that exercise occupies many contradictory roles reflecting a medicalized exercise-promotion paradigm for those with MS, and this should inform exercise promotion practices.