Inverse association between physical inactivity and mental health in men and women

Correlations of Physical and Psychological Health in Parents of Individuals With Autism Spectrum Disorder

BACKGROUND

Individuals with autism spectrum disorder (ASD) have social communication difficulties and restricted, repetitive, and/or sensory behaviors or interests. The prevalence of ASD is now 1 in 36 individuals. Parents of individuals with ASD face challenges that can affect their physical and psychological well-being.

OBJECTIVE

With the long-term goal to tailor an exercise program, the purpose of this study was 2-fold: (1) establish the baseline physical and mental health of parents of individuals with ASD and (2) estimate the relationship of physiologic variables with psychological variables of health for parents of individuals with ASD.

METHODS

This descriptive, cross-sectional study (N = 44) explored physical health measures and the correlation between physical and psychological health, using measures of anxiety, stress, parenting depression, and positive thinking for parents who care for individuals with ASD.

RESULTS

The common characteristics that these parents shared was high body fat and low physical activity. Body fat was negatively correlated to total step count (r = -0.428, P < .05), grip strength (r = -0.319, P < .5), and total distance walked in the week (r = -0.661, P < .01), and positively correlated to 5-times sit to stand (r = 0.337, P < .05). Low activity correlated to increased parenting stress of advocating for child's needs (r = -0.310, P = .043).

CONCLUSIONS

Understanding relationships between physical and psychological health informs effective interventions and support systems for parents. Parents need supports to be able to prioritize exercise. Future studies should include a larger sample to verify these effects.

Ten-Minute Physical Activity Breaks Improve Attention and Executive Functions in Healthcare Workers

Occupational health is a major problem in modern work environments. Physical activity breaks (PABs), short exercise periods delivered during working hours, incorporating exergames or outdoor activities, have emerged as a novel approach that could be used to improve work efficiency and workplace wellbeing. Therefore, this study aimed to investigate the impact of PABs on attention levels and executive functions in healthcare workers. A total of 27 healthcare workers (M = 14, W = 13; 49.55 ± 12.46 years), after 4 h of work, randomly performed one of three 10 min conditions weekly in a counterbalanced order: No Physical Activity Break (NPAB); Outdoor Physical Activity Break (OPAB); Physical Activity Break with Exergame (PABEx). After the conditions, executive functions and selective attention were assessed by the Stroop Color and Word Test (SCWT), and the Trail Making A,B test (TMT A,B), respectively. Significant differences between OPAB and NPAB as well as between PABEx and NPAB in the TMT-A test χ2(2) = 44.66 (p < 0.001) and TMT-B test χ2(2) = 48.67 (p < 0.001) were found, respectively. TMT-A and SCWT interference/time scores of the PABEx and OPAB conditions were significantly lower than those of NPAB (p < 0.001). In the SCWT interference/error score, no significant difference was found between the PABEx and NPAB (p > 0.05), but the score was statistically lower in the OPAB condition than PABEx (p = 0.001) and PABEx condition compared to OPAB for TMT-A (p = 0.001). Findings showed that the OPAB and PABEx conditions are effective in improving selective attention and executive functions in healthcare workers. Employers can foster a healthier and more productive workforce by promoting a culture of movement and prioritizing employee health, which in turn can enhance patient care outcomes.

Promoting physical activity and youth development in schools: the case for near-peer coaches

Background

Sports-based youth development (SBYD) programs provide an inclusive, supportive environment for promoting physical activity as well as nurturing the development of life skills which, in combination, promote physical, mental, and emotional health in youth. The Up2Us Sports SBYD program was implemented in six schools in New Orleans, Louisiana in 2020-2022, where near-peer coaches from the community were placed in schools and present throughout the school day. The intervention period straddled the COVID-19 pandemic as well as extreme weather events, modifying program delivery.

Process/methods

An exploratory case study was conducted to understand participant experience amid program disruptions and modifications, as well as their perceptions of program impact on physical activity and health. Interviews with coaches (n = 7), focus groups with youth (n = 14) and program observation data were triangulated to provide a description of the case.

Results

The major theme that emerged from the case study was the centrality of the near-peer mentorship relationships between coaches and youth. Participants believed near-peer relationships facilitated life skill development and increased opportunity for physical activity in schools, but pressures on coaches' time and external challenges in the community were limiting factors to the extent of program impact.

Conclusion

This community case study demonstrates the potential role for near-peer mentors in influencing the health and wellbeing of youth from under-resourced communities and highlights the opportunity for school-based SBYD programming to provide youth with a consistent source of both relational and physical activity support.

Impact of exercise training and diet therapy on the physical fitness, quality of life, and immune response of people living with HIV/AIDS: a randomized controlled trial

BACKGROUND

Exercise and dietary nutrition are considered crucial in human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS) treatment protocols and people living with HIV/AIDS (PLWHA) rehabilitation care. However, there is no well-studied research evaluating the effects of combined interventions on the fitness and immune systems of PLWHA. Therefore, this study aimed to analyze the effects of exercise and dietary intervention on physical fitness, quality of life and immune response in PLWHA.

METHODS

This was an experimental study, with a sample of 25 male PLWHA divided into two groups: the intervention group (IG: 12 participants) and the control group (CG: 13 participants). All participants have not had any exercise habits and nutritional supplements in the past six months. The participants in the IG completed 45 min of exercise (60-80% HRmax) 4 times per week for 4 weeks. The exercise was in the form of brisk walking or running. They were also given a nutritional dietary supplement 3 times a day for 4 weeks. The 13 individuals in the CG continued their normal daily life (physical activity and diet). The following parameters were evaluated before and after the intervention: body composition, physical fitness, immune response, quality of life (QoL), stress, dietary behavior, dietary habits, exercise motivation, and physical self-efficacy.

RESULTS

The significant changes were observed in burnout of stress variables and physical efficiency index (PEI) of physical fitness in the IG (p =.023). Moreover, in the saliva samples, sal-T levels significantly increased only after the intervention in the IG (p =.012). Additionally, regarding the analysis of the interaction (group × time), there was a significant improvement in the reaction speed (p =.001) and grip strength (left: p =.002, right: p =.030) and a significant difference in physical satisfaction in QoL (p =.001), stress burnout (p =.043), self-confidence in physical efficacy (p =.045), external display (p =.008), and fulfillment (p =.047) in exercise motivation. Moreover, the significant effect of the intervention on emotional eating in dietary behavior was shown in the comparison of the IG before and after intervention (p =.001) and in the comparison of the IG group with the CG after the experiment (p =.013). However, there was no significant effect of time or interaction between the condition and time on body composition.

CONCLUSIONS

In conclusion, exercise training and diet therapy caused changes in physical fitness and Sal-T levels, which had positive effects on the health promotion of PLWHA.

The impact of street greenery on active travel: a narrative systematic review

Background

Street greenery may have a profound effect on residents' active travel (AT), a mode of transportation involving walking and cycling. This study systematically reviewed the scientific evidence on the effects of street greenery on active travel.

Methods

A comprehensive search was performed using keywords and references in PubMed, Web of Science, Scopus, and Cochrane Library. The review included studies that met the following criteria: (1) Study design: experimental studies, cross sectional studies, (2) Participants: individuals of all ages, (3) Exposure variables: street greenery, including street vegetation (e.g., trees, shrubs, and lawns), (4) Outcomes: active travel behaviors (walking, cycling), (5) Article type: peer-reviewed articles, (6) Search time window: from the inception of relevant electronic literature database until 21 June 2023, (7) Geographic scope: worldwide; (8) Language: articles in English.

Results

Twenty-six cross-sectional studies met the inclusion criteria and were analyzed. These studies employed objective metrics for assessing street greenery and varied methodologies to measure AT, including 14 using subjective measurements (like self-reported surveys), 10 using objective data (such as mobile app analytics), and two studies combined both approaches. This review identifies a generally positive impact of street greenery on active travel in various aspects. However, the extent of this influence varies with factors such as temporal factors (weekdays vs. weekends), demographic segments (age and gender), proximity parameters (buffer distances), and green space quantification techniques. Street greenness promotes active travel by enhancing environmental esthetics, safety, and comfort, while also improving air quality, reducing noise, and fostering social interactions. In addition, the study suggests that variables like weather, seasonality, and cultural context may also correlate with the effectiveness of street greenery in encouraging active travel.

Conclusion

Street greenery positively influences active travel, contributing to public health and environmental sustainability. However, the findings also indicate the need for more granular, experimental, and longitudinal studies to better understand this relationship and the underlying mechanisms. These insights are pivotal for urban planners and policymakers in optimizing green infrastructure to promote active transportation, taking into account local demographics, socio-economic factors, and urban design.

Physical activity and depressive symptoms during the fifth wave of COVID-19 pandemic: Implication for public policy and administrators

Depression is a public mental health problem that can progress to suicidal ideation, literature suggests regular physical activity may ameliorate it. The study assessed the link between physical activity and depression symptoms during the fifth wave of the COVID-19 pandemic and the Academic Staff Union (ASU) strike among undergraduates. Four hundred and eighteen undergraduates were recruited and participated in the study. Participants completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and Patient Health Questionnaire-9 (PHQ-9) to measure depression severity. The result on PA showed that about one-third of the participants were inactive, above half were moderately active, while a few achieved high PA levels. Above one-fifth of the participants experienced minimal or no depression while a good percent had mild, moderate, moderately severe, and severe depression. Non-parametric tests between PA total score and depression total score with demographic variables were not significant. Spearman's correlation showed a strong negative relationship between PHQ-9 scores and IPAQ-SF scores. This suggests that a high PA level is associated with lower depression symptoms. The COVID-19 pandemic and the ASU strike experiences resulted in increased depression among undergraduates. The university administration needs to formulate an urgent policy to promote PA among undergraduates and provide treatment for the affected students.

Sporting Mind: The Interplay of Physical Activity and Psychological Health

The symbiotic relationship between sports practice and psychological well-being has, in recent times, surged to the forefront of academic and public attention. The aim of this narrative review is to comprehensively explore the intricate pathways linking physical engagement in sports to its subsequent impacts on mental health and synthesize the multifarious effects of sports on psychological health, offering insights for integrating physical and psychological strategies to enhance well-being. From neurobiological underpinnings to therapeutic applications, this comprehensive manuscript provides an in-depth dive into the multifaceted world of sports and psychology. Highlighting evidence-based interventions, this review aspires to offer actionable insights for practitioners, athletes, and individuals alike, advocating for a holistic approach to mental well-being. This manuscript highlights the profound impact of sports on mental health, emphasizing its role in emotional regulation, resilience, cognitive function, and treating psychological conditions. It details how sports induce neurochemical changes, enhance brain functions like memory and learning, and aid against cognitive decline. This review also notes the benefits of regular exercise in mood improvement, stress management, and social skill enhancement, particularly when combined with mindfulness practices. It underscores the importance of considering cultural and gender perspectives in sports psychology, advocating for an integrated physical-psychological approach to promote overall well-being.

The Impact of COVID-19 Health and Safety Measures on the Self-Reported Exercise Behaviors and Mental Health of College Students

The public-health restrictions (e.g., remote learning, restricted access to facilities and dining halls) put in place by colleges to reduce the spread of COVID-19 resulted in forced isolation and modifications to health-related behaviors. The restrictions and uncertainty associated with COVID-19 may have exacerbated the challenges of meeting exercise recommendations and mental-health concerns. The purpose of this study was to assess the impact of restrictions on students' exercise habits and their levels of anxiety, stress, and depression. Five-hundred and forty students completed a 29-question survey on individual demographics, living arrangements, exercise, sleep, diet, and mental health. Significant changes in weekly days of exercise and intensity were reported. Increases in anxiety, stress, and depression were reported. The two most frequently reported changes in exercise behavior were an increase in minutes of aerobic training (5%) and a combination of reduced minutes of aerobic and resistance training (3.9%), which could be reflective of an individual's ability and/or desire to maintain exercise behavior during the restrictions. Alternatively, for those students who reduced their exercise habits, aerobic training (11%) was the mode that suffered the most. Demographic factors such as ethnicity, regional residence, and gender were found to have significant effects on stress, anxiety, and depression. Amidst pandemics and future health emergencies, colleges should prioritize establishing opportunities for students to exercise, helping them meet physical activity recommendations and combat mental-health issues.

Relationship between Baseline Physical Activity and Generalized Anxiety Disorder and Major Depressive Disorder Treatment Outcomes

OBJECTIVES

Generalized anxiety disorder and major depressive disorder often benefit from medication and psychotherapy. Our aim was to determine whether a correlation exists between patient baseline physical activity and response to treatment.

METHODS

This was a retrospective study that included adult patients with anxiety and depression who received outpatient care for their conditions by providers in the Department of Psychiatry and Psychology of the Mayo Clinic in Jacksonville, Florida. Statistical analyses were used to analyze whether Rapid Assessment of Physical Activity scores as a measure of baseline exercise correlated to changes in Patient Health Questionnaire-9 (PHQ-9) scores or Generalized Anxiety Disorder-7-item scale (GAD-7) scores during treatment for anxiety or depression. Factors including age, sex, smoking status, and caffeine intake also were analyzed.

RESULTS

When comparing change in GAD-7 or PHQ-9 scores from baseline to follow-up during treatment for anxiety or depression, there was no significant difference based on Rapid Assessment of Physical Activity scores. Caffeine intake had a direct correlation with PHQ-9 scores from baseline to 12 to 24 weeks but no correlation with GAD-7 scores.

CONCLUSIONS

Overall, the amount of physical activity a patient participates in before anxiety or depression treatment does not appear to affect improvement outcomes. Caffeine intake may improve depression severity scores; however, further research is needed to assess whether this could be a part of future treatment plans.

The Relationship Between Psychological Distress and Physical Activity Is Non-linear and Differs by Domain: a Cross-Sectional Study

BACKGROUND

There is increasing evidence for the relationship between physical activity (PA), sedentary behaviour and mental health. Limited data exists on sex-specific associations. We aimed to identify associations between PA dose and domain and television time with psychological distress, including sex-stratified models.

METHODS

A total of 22,176 adults from the Melbourne Collaborative Cohort Study follow-up 2 cohort (2003-2007) participated in this cross-sectional study. Occupational, household, transport, leisure PA, hours watching television and psychological distress were assessed. Restricted cubic splines were used to examine the relationships between PA domains, television viewing time and psychological distress.

RESULTS

The relationships between PA and psychological distress were non-linear (p < 0.05) and differed by PA domain. There were dose-dependent, inverse associations between distress with transport (B[95% CI] = -0.39[-0.49, -0.30]) and leisure PA (B[95% CI] = -0.35[-0.46, -0.25]). The effect estimates for transport and leisure PA with distress were larger for women. For household domain, a U-shaped curve with an elongated tail was seen. Median PA was associated with lower distress compared with lower quantities (B[95% CI] = -0.12[-0.22, -0.03]); however, this association was not evident with increasing household PA. There were no clear associations between occupational PA and distress. Higher television viewing was associated with higher distress (B[95% CI] = 0.16[0.02, 0.30]).

CONCLUSIONS

Increasing PA and reducing television viewing may contribute to reduced psychological distress, particularly in women. Future interventions should incorporate leisure and transport PA and decrease television viewing to assess the impact on mental health.

The impacts of social restrictions during the COVID-19 pandemic on the physical activity levels of over 50-year olds: The CHARIOT COVID-19 Rapid Response (CCRR) cohort study

OBJECTIVES

To quantify the associations between shielding status and loneliness at the start of the COVID-19 pandemic, and physical activity (PA) levels throughout the pandemic.

METHODS

Demographic, health and lifestyle characteristics of 7748 cognitively healthy adults aged >50, and living in London, were surveyed from April 2020 to March 2021. The International Physical Activity Questionnaire (IPAQ) short-form assessed PA before COVID-19 restrictions, and up to 6 times over 11 months. Linear mixed models investigated associations between shielding status and loneliness at the onset of the pandemic, with PA over time.

RESULTS

Participants who felt 'often lonely' at the outset of the pandemic completed an average of 522 and 547 fewer Metabolic Equivalent of Task (MET) minutes/week during the pandemic (95% CI: -809, -236, p<0.001) (95% CI: -818, -275, p<0.001) than those who felt 'never lonely' in univariable and multivariable models adjusted for demographic factors respectively. Those who felt 'sometimes lonely' completed 112 fewer MET minutes/week (95% CI: -219, -5, p = 0.041) than those who felt 'never lonely' following adjustment for demographic factors. Participants who were shielding at the outset of the pandemic completed an average of 352 fewer MET minutes/week during the pandemic than those who were not (95% CI: -432, -273; p<0.001) in univariable models and 228 fewer MET minutes/week (95% CI: -307, -150, p<0.001) following adjustment for demographic factors. No significant associations were found after further adjustment for health and lifestyle factors.

CONCLUSIONS

Those shielding or lonely at pandemic onset were likely to have completed low levels of PA during the pandemic. These associations are influenced by co-morbidities and health status.

Coping with the COVID-19 pandemic by strengthening immunity as a nonpharmaceutical intervention: A major public health challenge

Background and Aims

The global Coronavirus-2 outbreak has emerged as a significant threat to majority of individuals around the world. The most effective solution for addressing this viral outbreak is through vaccination. Simultaneously, the virus's mutation capabilities pose a potential risk to the effectiveness of both vaccines and, in certain instances, newly developed drugs. Conversely, the human body's immune system exhibits a robust ability to combat viral outbreaks with substantial confidence, as evidenced by the ratio of fatalities to affected individuals worldwide. Hence, an alternative strategy to mitigate this pandemic could involve enhancing the immune system's resilience.

Methods

The research objective of the review is to acquire a comprehensive understanding of the role of inflammation and immunity in COVID-19. The pertinent literature concerning immune system functions, the impact of inflammation against viruses like SARS-CoV-2, and the connection between nutritional interventions, inflammation, and immunity was systematically explored.

Results

Enhancing immune function involves mitigating the impact of key factors that negatively influence the immune response. Strengthening the immune system against emerging diseases can be achieved through nonpharmaceutical measures such as maintaining a balanced nutrition, engaging in regular exercise, ensuring adequate sleep, and managing stress.

Conclusion

This review aims to convey the significance of and provide recommendations for immune-strengthening strategies amidst the ongoing COVID-19 pandemic.

The Impact of a Psychological Skills Training and Mindfulness-Based Intervention on the Mental Toughness, Competitive Anxiety, and Coping Skills of Futsal Players-A Longitudinal Convergent Mixed-Methods Design

Despite the sport's popularity, there is a paucity in futsal psychological interventional research. This study analysed the impact of a ten-session psychological skills training and mindfulness-based intervention (PSTMI) on the mental toughness, competitive anxiety, and athletic coping skills of national league futsal players (n = 13). It also analysed whether these variables were predicted by playing experience. Pre-/post-intervention questionnaires were filled in and analysed (Competitive State Anxiety Inventory-2, Sport Mental Toughness Questionnaire, and Athletic Coping Skills Inventory-28). Semi-structured interviews were also conducted with seven athletes; quantitative and qualitative data were integrated in a convergent parallel mixed-methods design. Results revealed significant medium-to-large improvements in mental toughness, cognitive anxiety, and coping skills following the PSTMI. Years of playing experience positively and significantly predicted better self-confidence and coping skills. Thematic analysis generated five themes: (1) post-intervention enhancement in athletic performance and well-being; (2) the non-athletic commitments of futsal players; (3) diverse views on how to improve the intervention; (4) instilling social identity through sport psychology sessions; and (5) the impact of years of experience on skill learning. Results mirrored those from other sporting disciplines. The PSTMI was well-received and equipped athletes with beneficial psychological skills, stressing the need for more sport psychology resources in futsal.

Joint effects of depressive status and body mass index on the risk of incident hypertension in aging population: evidence from a nationwide population-based cohort study

BACKGROUND

The impact of depressive status (DS) on hypertension incidence is still controversial and has not been studied in Chinese middle-aged and elderly population. This study aimed to explore the relationship between DS and incident hypertension and analyze the joint effects of DS and body mass index (BMI) on hypertension incidence.

METHODS

We conducted a prospective cohort study using data from the China Health and Retirement Longitudinal Study (CHARLS), a nationwide population-based study. In 2013, DS was identified using scores from the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) among eligible respondents from CHARLS, and hypertension occurrence was observed until 2018. The multiple Cox models were employed to calculate the associations between DS and hypertension incidence. In addition, we also computed the multiplicative interaction (MI) between DS and BMI of incident hypertension and assessed their additive interaction (AI) through relative excess risk due to interaction (RERI), attributable proportion (AP) or synthetic index (S). Positive AI was indicated by RERI > 0, AP > 0 or S > 1.

RESULTS

Over the 5-year follow-up, depressive symptoms increased the risk of hypertension incidence by 19% (hazard ratio (HR) = 1.19, 95% confidence interval (CI): (1.01, 1.41)), while depression was associated with a 24% increased risk (HR = 1.24; 95% CI: (1.03, 1.50)). Significant MIs between DS and overweight or obesity were observed and almost all of AI indexes showed positive joint effects on incident hypertension, of which the depression-obesity combination had the largest joint effect (RERI = 4.47, 95%CI: (0.28, 8.66); AP = 0.67, 95%CI: (0.50, 0.85); S = 4.86,95%CI: (2.66, 8.86)).

CONCLUSION

DS could lead to hypertension and this impact was amplified when coexisting with higher BMI. It highlighted a need for precise interventions targeting weight management and depression treatment in the aging population to prevent hypertension.

Sex-based differences in the association of leisure-time physical activity with the risk of depression: the Ansan and Ansung study of the Korean Genome and Epidemiology Study (KoGES)

Objective

Depression is a serious mental disorder which is the leading cause of suicide. This study investigated the association between incident depression and 4-year leisure-time physical activity (PA) levels and/or resistance training (RT).

Methods

This community-based Korean cohort included 3,967 participants without depression at baseline. The average PA-time (the total duration of moderate-intensity leisure-time PA) up to 4 years prior to baseline enrollment was calculated to evaluate the cumulative levels of PA. Participants were divided into four groups based on their average PA-time: "Non-PA," " <150 min/week," "150-299 min/week," and "≥300 min/week." Furthermore, based on compliance to PA guidelines (≥150 min/week of PA-time) and participation in RT, the participants were categorized into four subgroups: "Low-PA," "Low-PA+RT," "High-PA," and "High-PA+RT." A multivariate Cox proportional hazards regression model was used to assess the 4-year incidence of depression according to leisure-time PA levels and/or regularity of RT.

Results

During the mean 3.72 ± 0.69 years of follow-up, 432 participants (10.89%) developed depression. In women, performing 150-299 min/week of moderate-intensity leisure-time PA was associated with a 38% risk reduction for incident depression (HR, 0.62; CI, 0.43-0.89; p < 0.05), whereas more than 300 min/week of that was related to a 44% risk reduction for incident depression (HR, 0.56; CI, 0.35-0.89; p < 0.05) as compared to that in the Non-PA group. However, in men, there was no significant relationship between the amount of leisure-time PA per week and the risk of incident depression. Moreover, in both sexes, RT had no significant effect on depression in either the Low-PA or High-PA group.

Conclusions

There was an inverse dose-response association between leisure-time PA levels and incident depression only in women, whereas adding RT to high levels of PA had no significant effect on depression in either sex.

The Effects of Physical Activity on Academic Performance in School-Aged Children: A Systematic Review

Schools offer a unique environment to influence children's physical activity (PA) levels positively. This study aims to systematically review the evidence surrounding how PA affects academic performance by analysing how the frequency, intensity, time, and type of PA mediate academic performance outcomes. This review was conducted using the PRISMA framework. Keyword searches were conducted in Science Direct, PubMed, and SPORTDiscus. Children that were obese, typically developing, typical weight, disabled, with a developmental disability, from a low socio-economic background, or an ethnic minority were included. A total of 19 studies were included, with a total of 6788 participants, a mean age of 9.3 years (50.2% boys, and 49.8% girls). Overall, 63.2% were nondisabled, while 36.8% were diagnosed with a disability. Two authors met, reviewed papers with regard to the inclusion criteria, and agreed on outputs to be included. Evidence suggests that associations between PA and academic performance were primarily positive or nonsignificant. PA levels of 90 min plus per week were associated with improved academic performance, as was PA performed at moderate to vigorous intensity. The optimal duration of PA was 30-60 min per session, whilst various sports induced positive academic effects. Importantly, findings support that PA does not have a deleterious effect on academic performance but can enhance it.

Adaption of tele-behavioral activation to increase physical activity in depression: Protocol for iterative development and evaluation

Background

Poor treatment outcomes, disease recurrence, and medical co-morbidities contribute to the significant burden caused by depressive disorders. Increasing physical activity in persons with depression has the potential to improve both depression treatment outcomes and physical health. However, evidence for physical activity interventions that can be delivered as part of depression treatment remains limited. This study will examine a Behavioral Activation teletherapy intervention adapted to include a specific focus on increasing physical activity.

Methods

The two-phase study will include a preliminary pilot study (n = 15) to evaluate and refine the manualized intervention using a mixed-methods approach followed by a single-arm study to evaluate feasibility and preliminary efficacy of the adapted BA teletherapy. Participants will be adults, age 18-64, with moderate to severe depressive symptoms (defined as a PHQ-9 score ≥10) and who currently engage in 90 min or less of moderate-to-vigorous physical activity. Individuals will be excluded if they have a current or past manic or hypomanic episode, psychosis, schizophrenia or schizophreniform disorder, or active suicidal ideation, or if not medically-cleared to exercise. The BA intervention will consist of 8 weekly sessions, followed by 2 bi-weekly booster sessions. Feasibility outcomes will include metrics of screening, enrollment, intervention adherence and fidelity, and participant retention. Intervention preliminary efficacy will be evaluated through assessment of changes in depressive symptoms and moderate-to-vigorous physical activity.

Conclusion

Data from this trial will be used to support the conduct of a randomized controlled trial to evaluate the efficacy of the adapted BA intervention.

Use of new technologies for the promotion of physical activity in patients with mental illness: A systematic review

BACKGROUND

Physical exercise is an underutilized tool for the management of mental disorders. New technologies have made a breakthrough in health care, and one of its possible applications (apps) could be that of customizing exercise programs for special populations, such as patients with mental disorders. However, the app of the so-called e-health to mental health care is still limited.

AIM

To know the efficacy of apps to promote physical activity in patients with mental disorders.

METHODS

We conducted a systematic review of the PubMed and Embase databases with the aim of exploring the use of new technologies for the enhancement of physical exercise in patients with a psychiatric illness. Following the selection process, 10 articles were included in the review.

RESULTS

The most commonly used devices in this type of intervention are wearable devices and web platforms. Good results in terms of effectiveness and acceptability were obtained in most of the studies.

CONCLUSION

Our findings suggest that the use of new technologies in mental health represents a feasible strategy with great potential in clinical practice.

The Geography of Mental Health, Urbanicity, and Affluence

Residential location has been shown to significantly impact mental health, with individuals in rural communities experiencing poorer mental health compared to those in urban areas. However, the influence of an individual's social group on the relationship between residential location and mental health outcomes remains unclear. This study disaggregates the rural-urban binary and investigates how geography and social groupings interact to shape mental health outcomes. Merging data from PLACES and Claritas PRIZM, we conducted a hotspot analysis, generated bivariate choropleth maps, and applied multiscale geographically weighted regressions to examine the spatial distribution of mental health and social groupings. Our findings reveal that mental health is influenced by complex interactions, with social groups playing a critical role. Our study highlights that not all rural and urban areas are alike, and the extent to which social groups influence mental health outcomes varies within and across these areas. These results underscore the need for policies that are tailored to meet the unique mental health needs of individuals from different social groups in specific geographic locations to inform policy interventions that more effectively address mental health disparities across diverse communities.

First-year undergraduate students: depressed, distressed, and drained? Influence of depressive symptoms on markers of psychological well-being, sleep, and physical activity

Objective: This study examined depressive symptomatology (DS) across the academic year in first-year undergraduate students and the influence of DS on anxiety, stress, body esteem, physical activity, and sleep. Participants: Participants were first-year undergraduate students (N= 164). Methods: Participants completed validated self-report measures each quarter. A repeated measures ANCOVA was conducted to examine changes in DS over time. Students were categorized as reporting subclinical (SCD) or clinical (CD) depressive symptoms. A repeated measures MANCOVA was conducted to examine the effect of time and DS groups on primary outcomes. Results: No significant main effects of time were observed for outcomes. Significant between-subjects effects were observed with CD participants reporting significantly higher anxiety and stress and lower sleep than SCD participants. Conclusions: First-year undergraduates with CD may have increased risk for negative markers of psychological and physical health outcomes. Universities should prioritize the psychological and physical health of their first-year students.

Association between GHQ-12, Duke-UNC-11, Physical Activity, and Self-Perceived Health in Spanish Adults with Cancerous Tumours: A Cross-Sectional Study

Background: In Spain, people who have overcome some type of cancer have significantly worse self-perceived health (SPH) and higher rates of depression than people who have never suffered any type of cancer. Objective: to explore the relationships among physical activity levels (PAL), perceived social support (PSS), and SPH in terms of mental health and its dimensions in Spanish adults with cancerous tumours. Methods: A correlational study rooted in the National Health Survey 2017 for adults was carried out, including 627 Spanish residents who reported having malignant tumours. Results: A dependent association was found between PAL and SPH (p < 0.001). The mental health mean score decreased as PAL increased for the total sample and for both sexes, separately (p < 0.001). Low reverse associations were also observed between PAL and mental health (rho: −0.274; p < 0.001), successful coping (rho: −0.239; p < 0.001) and self-confidence (rho: −0.264; p <0.001). Moreover, PSS weakly and inversely correlates with mental health (r: −0.225; p < 0.001), successful coping (r: −0.218; p < 0.001) and self-confidence (r: −0.231; p < 0.001). A binary logistic model showed that active and very active people presented less threat of poor SPH, as did people with higher PSS (p < 0.001). Conclusions: Greater levels of physical activity are associated with larger mean scores in the three dimensions of mental health, perceived social support and self-perceived health in people with cancerous tumours.

Nigerian physiotherapists’ knowledge, attitude, and practice of digital physical therapy: a cross-sectional study

Background

The increasing demand for physical therapy services worldwide calls for innovations to be made to meet the challenges of service delivery. However, little is known about the knowledge, attitude, and practice (KAP) of digital physical therapy among Nigerian physiotherapists. Hence, this study aimed to evaluate the level of KAP of digital physical therapy among physiotherapists in Nigeria.

Methods

This cross-sectional study purposively recruited 150 Nigerian physiotherapists. Copies of modified and validated questionnaires on the KAP of digital physical therapy from a previous study were sent to registered and licensed physiotherapists via electronic survey to assess the KAP of digital physical therapy. Descriptive and inferential statistics were used to analyze the data. Alpha level was set at p < 0.05.

Results

The mean age of the respondents was 29.76 ± 6.95 years. Most participants (81.3%) have a knowledge level above average, while 18.7% have below average. Furthermore, most (76.0%) of the respondents had a positive attitude toward digital physical therapy. In addition, more than two-thirds, 69.3% uses digital physical therapy platforms for physical therapy practice. Knowledge, attitude, and practice were not significantly associated with sociodemographic characteristics (p > 0.05). Furthermore, there was no significant association between knowledge, attitude, and practice (p > 0.05).

Conclusion

Many Nigerian physiotherapists demonstrated adequate knowledge, positive attitude, and good practice of digital physical therapy. However, knowledge, attitude, and practice of digital physical therapy were not influenced by sociodemographic characteristics.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43161-022-00118-3.

Multi-Component Intervention to Promote Physical Activity in Japanese Office Workers: A Single-Arm Feasibility Study

This study investigated the feasibility of a multi-component intervention to promote physical activity (PA) among Japanese office workers. It was an 8-week single-arm trial conducted in Japan in 2021, in which 76 employees aged 20 or older, from an insurance company, participated. They received a multi-component PA intervention that comprised individual (lecture, print material, goal setting, and feedback), socio-cultural (team building and supportive atmosphere), physical (poster), and organizational (encouraging message from an executive) strategies. The primary outcome was change in objectively measured moderate-to-vigorous PA (MVPA). A paired t-test was used to compare the changes between weeks 0 and 8. We also conducted a subdomain analysis of PA divided into four domains (working, non-working, commuting working, and remote working). Excluding 26 participants who could not complete valid assessments, the MVPA among participants (n = 50, age 49.6 ± 9.7) significantly increased by +7.3 min/day [95% confidence interval (CI) 0.8 to 13.8]. We also identified significant changes in MVPA by +10.0 min/day [95% CI, 3.7 to 16.3] in working days (n = 40), and by +7.1 min/day [95% CI, 0.4 to 13.7] in remote working days (n = 34). We demonstrated that multi-component PA interventions might improve MVPA among Japanese office workers.

Telemedicine Interventions as an Attempt to Improve the Mental Health of Populations during the COVID-19 Pandemic-A Narrative Review

Published reports indicate the need for psychological interventions and the integration of psychiatric care into crisis management plans in people with mental health issues caused by the COVID-19 pandemic. It seems crucial to identify the root causes of the health-social-economic crisis and identify potential opportunities for widely implemented psychological assistance. This narrative literature review aims to identify the types of interventions deployed as telemedicine-based mental health support and their effectiveness. The PubMed and Web of Science electronic databases were searched. From a total of 48 articles, 46 were analysed after removing duplicates. From these, thirty-seven records were excluded according to the inclusion criteria and nine (eight RCT and one cross-over) were assessed as full texts. The included publications were randomised clinical trials or cross-over studies focused on remote mental support interventions. In all studies, participants represented both sexes and had an average age range of 6-64. Studies included participants from seven countries and the overall number of participants in the included studies was 687. The content of these intervention programmes includes both established psychotherapeutic programmes, as well as new interventions. Remote support was implemented through three approaches: phone/video calls, mobile applications, and internet-based programs. The results of the included studies indicate a higher or equal efficacy of telemedicine interventions compared to traditional forms. The review also revealed a relatively wide range of targeted research groups: from children with social anxiety through to their caregivers; adolescents with neurological disorders; and from college students to adults with psychiatric or orthopaedic disorders. Analysis of the included papers found that telemedicine interventions show promising results as an attempt to improve population mental health during the COVID-19 pandemic.

Mediation Effect of Musculoskeletal Pain on Burnout: Sex-Related Differences

Burnout occurs when people are exposed to emotionally demanding work situations over an extended period, resulting in physical, emotional, and mental exhaustion. This study adopted the personal burnout (PB) and work-related burnout (WB) scales of the Copenhagen Burnout Inventory to measure burnout levels. Musculoskeletal (MS) pain is one factor influencing burnout. Previous studies have demonstrated that male and female hormones may contribute to sex-related differences in MS pain. This was an observational and cross-sectional study conducted at a medical-university-affiliated hospital in Taichung, Taiwan, in 2021. Data were collected for demographic characteristics, family structure, living habits, occupation, physical health, Nordic Musculoskeletal Questionnaire score, and Copenhagen Burnout Inventory score. Of the 2531 questionnaires that were distributed, 1615 (63.81%) valid questionnaires remained after those with missing data were excluded. The results demonstrated neck and shoulder pain (NBSP) is commonly associated with burnout among healthcare workers, with a higher prevalence among women than among men. With confounders being controlled for, women were found to experience substantially higher levels of personal and work-related burnout than men did. NBSP is a mediating factor; therefore, it is a key reason why women are more likely than men to experience burnout.

Physical activity patterns among women during the postpartum period: an insight into the potential impact of perceived fatigue

Background

Regular participation in physical activity (PA) improves physical well-being and reduces the risk of contracting noncommunicable diseases. However, fatigue could negatively impact the PA participation of women in their postpartum period. This study delineated the levels of perceived fatigue and characterized the association between fatigue and the PA patterns of postpartum women.

Methods

A cross-sectional study was conducted using an online questionnaire distributed to postpartum women living in Saudi Arabia. Their perceived postpartum fatigue (PPF) was assessed using the fatigue severity scale; their PA, using the short form of the International Physical Activity Questionnaires; and their postpartum depression, using the Edinburgh Postnatal Depression Scale. Descriptive statistics were expressed as the mean ± standard deviation for normally distributed variables and as the median (interquartile range) for non-normally distributed variables. Between-group differences were tested using the Mann–Whitney U test for independent samples. To determine the relationship between the study variables, Spearman’s rho correlation coefficient was calculated. Multiple linear regression analysis was performed to explain the role of fatigue severity as an independent predictor of the variance of the PA level.

Results

A total of 499 postpartum women were divided into the PPF group (43%), who self-reported fatigue, and the non-PPF group (57%), who self-reported no fatigue. There was a significant difference in the median of vigorous PA, and moderate PA which were significantly higher in the non-PPF group than in the PPF group. The women with PPF reported less engagement in walking and a longer sitting duration than the women without PPF. High fatigue severity was associated with lower moderate PA (β = -10.90; p = .005; R² = .21) and vigorous PA (β = -04; p < .001; R² = .13). These associations remained significant in the regression model after adjustment for the mother’s depression score; age; number of children; body mass index (kg/m²); employment status; intake of vitamins B1 (thiamin), C, and D and of Omega-3; and walking metabolic equivalent.

Conclusion

PPF may reduce the PA of postpartum women. Strategies targeting PPF may buffer its harmful impacts, and thus, improve postpartum women’s health.

Associations of objectively measured movement behavior and cardiorespiratory fitness with mental health and quality of life in older adults with hypertension: an exploratory analysis during the COVID-19 pandemic

Objectives: Herein, we explored the associations of pre-pandemic COVID-19 physical activity (PA), sedentary behavior (SB) and cardiorespiratory fitness (CRF) with mental health and quality of life in older adults with hypertension.Method: Objectively measured PA and SB, perceived stress, depression symptoms, and quality of life were assessed before and during the pandemic in seventeen older adults with hypertension. CRF was assessed before the pandemic by cardiopulmonary exercise testing. Longitudinal and cross-sectional associations were analyzed using the mixed linear model.Results: Pre-pandemic light PA (positive association) and SB (negative association) were associated with quality of life during the pandemic. Higher pre-pandemic CRF was associated with less negative changes in perceived stress, depression symptoms, and quality of life during the pandemic.Conclusion: Our preliminary findings suggest that a healthier pre-pandemic movement behavior (more PA, less SB) and better CRF can mitigate the negative impact of the COVID-19 pandemic on mental health and quality of life in older adults with hypertension.

The roles of motivational interviewing and self-efficacy on outcomes and cost-effectiveness of a community-based exercise intervention for inactive middle-older aged adults

Increasing physical activity (PA) among inactive middle-older aged adults in rural communities is challenging. This study investigates the efficacy of a PA intervention supporting inactive adults in rural/semirural communities. Inactive participants enrolled on either a single signposting session (n =427) or a multisession pathway combining signposting with motivational interviewing (MI; n = 478). Pre-post outcomes data assessed activity levels (International Physical Activity Questionnaire-Short Form; Single Item Sport England Measure), self-efficacy (New General Self-Efficacy scale [NGSE]) and well-being (five-item World Health Organization Well-Being Index [WHO-5]). Measures were repeated at longitudinal time points (26, 52 weeks) for the MI pathway. Outcomes were contrasted with results from an unmatched comparison group receiving treatment as usual (TAU). Cost-utility (quality-adjusted life years [QALY]-incremental cost-effectiveness ratio) and return on investment (NHS-ROI; QALY-ROI) were estimated for short (5 years), medium (10 years) and long (25 years) time horizons. Both pathways significantly increased participants' PA. The MI pathway resulted in significantly greater increases in PA than signposting-only and TAU. Improvements in psychological outcomes (NGSE; WHO-5) were significantly greater in the MI pathway than TAU. Longitudinal results indicated MI pathway participants sustained increases in light-intensity PA at 52 weeks (p < 0.001; ηp2  = 0.16). Regression analyses found baseline self-efficacy predicted increased PA at 52 weeks, while baseline well-being did not. The relationship between self-efficacy and PA increased successively across time points. However, magnitude of participants' increased self-efficacy did not predict PA at any time point. Both pathways were cost-effective and cost -saving for participants aged ≥61 years from the short time horizon, with the MI pathway having greater ROI estimates. Overall, MI increased efficacy of a signposting PA intervention and was cost-saving for older adults.

Examining Anxiety, Sleep Quality, and Physical Activity as Predictors of Depression among University Students from Saudi Arabia during the Second Wave of the COVID-19 Pandemic

Conducted during the second wave of the pandemic, this cross-sectional study examined the link between sleep quality, physical activity, exposure, and the impact of COVID-19 as predictors of mental health in Saudi undergraduate students. A convenience sample of 207 participants were recruited, 89% of whom were females and 94% were single. The measures included questionnaires on the level of exposure and the perceived impact of COVID-19, a physical activity measure, GAD-7, PHQ-9, and PSQI. The results indicated that approximately 43% of participants exhibited moderate anxiety, and 50% were at risk of depression. Overall, 63.93% of students exposed to strict quarantine for at least 14 days (n = 39) exhibited a high risk of developing depression (χ2(1) = 6.49, p < 0.05, ϕ = 0.18). A higher risk of depression was also found in students whose loved ones lost their jobs (χ2(1) = 4.24, p < 0.05, ϕ = 0.14). Moreover, there was also a strong association between depression and anxiety (β = 0.33, p < 0.01), sleep quality (β = 0.32, p < 0.01), and the perceived negative impact of COVID-19 on socio-economic status (β = 0.26, p < 0.05), explaining 66.67% of depression variance. Our study highlights the socio-economic impact of this pandemic and the overwhelming prevalence of depression.

Injury-related psychological distress and the association with perceived running ability in injured runners

OBJECTIVE

Examine injury-related psychological distress and association with perceived running ability in injured runners.

DESIGN

Prospective longitudinal study.

PARTICIPANTS

Forty-three patients with a running-related injury.

MAIN OUTCOME MEASURES

Data collection at initial physical therapy visit and 12-16 weeks later included Optimal Screening for Prediction of Referral and Outcome - Yellow Flag (OSPRO-YF) and Athlete Fear Avoidance Questionnaire (AFAQ) for injury-related psychological distress, and University of Wisconsin Running and Recovery Index (UWRI) for perceived running ability. OSPRO-YF composite score, total yellow flags, and yellow flags in each domain (negative mood, fear-avoidance, positive affect/coping) were calculated.

RESULTS

UWRI score and OSPRO-YF composite score and yellow flags significantly improved over time, while AFAQ score and yellow flags in OSPRO-YF negative mood domain did not. AFAQ scores were significantly correlated with UWRI score at baseline, follow-up and change over time, while OSPRO-YF composite score and yellow flags were not. Baseline OSPRO-YF composite score and AFAQ score were not correlated with follow-up UWRI score.

CONCLUSIONS

Injury-related psychological distress is elevated when injured runners start rehabilitation, and generally improves; however, negative mood and athletic fear-avoidance may persist. Higher athletic fear-avoidance is associated with lower perceived running ability at the same time point or interval.

Increased Risks of Mental Disorders: Youth with Inactive Physical Activity

Before COVID-19, one of the most dangerous pandemics of the 21st century was physical inactivity (PI). Sedentary habits had increased in the last decades, reducing physical condition and increasing non-communicable diseases and mental disorders in the population. This study aimed to analyse the relationships between physical activity level (PAL) and the prevalence of anxiety, depression, and other mental disorders in Spanish young aged 15-35 years and to calculate the odd ratio (OR) of developing from these mental disorders in inactive young people, based on PAL.

METHODS

A cross-sectional study based on data from the Spanish National Health Survey 2017 with 4195 participants was conducted. A descriptive analysis was performed. Possible differences between groups were analysed using the non-parametric statistical tests. OR and relative risks for mental disorders in inactive versus others PAL were calculated.

RESULTS

Dependence relationships were found between PAL and the prevalence of anxiety, depression, and other mental disorders (p < 0.001). In addition, the risk of developing: anxiety (OR: 6.14. 95% CI: 3.28-11.50), depression (OR: 5.35. 95% CI: 2.40-11.96), and other mental disorders (OR: 8.52. 95% CI: 2.90-25.06) was higher in inactive young people.

CONCLUSIONS

PI is associated to high risk of mental disorders in Spanish young people.

Association between Agility, Health-Related Quality of Life, Depression, and Anthropometric Variables in Physically Active Older Adult Women with Depression

Introduction. Depressive disorders are mental disorders that last over time, and seriously affect the lives of the people who suffer from them, diminishing their quality of life, reducing their motor capacity, and incapacitating them in their daily lives. It is a major problem worldwide. Objective. To study the association between agility, health-related quality of life (hrqol), anthropometric status, and depression status in older adult women with depression. Design. Data collected from 685 physically active older women with depression were analyzed. Result. A moderate inverse correlation (r = −0.34) is shown between Time Up & Go (TUG) and EuroQol Five-Dimensional Three-Level Version (EQ-5D-3L). Between TUG and Geriatric Depression Scale (GDS), there is a small direct correlation (r = 0.14) between them. Between TUG and anthropometric data, all observed correlations are significant. Conclusions. There is a significant association between agility, health-related quality of life, depression, and anthropometric data in physically active older women with depression.

Winning The Game Against Depression: A Systematic Review of Video Games for the Treatment of Depressive Disorders

PURPOSE OF REVIEW

To review the evidence about video game-based therapeutic intervention for people diagnosed with depressive disorders.

RECENT FINDINGS

Psychotherapy has been proved to reduce depressive symptoms and is a key element in the treatment of depressive disorders. However, geographical, economical and stigmatized concerns are barriers to access to psychotherapy. New technologies and videos games can overcome some of these barriers by providing teleconferencing evidence-based therapy as time as they may offer an interactive entertainment. Overall, video game-based interventions were useful and effective in reducing symptoms of depressive disorders. Seven of the studies were published in the last 5 years, which reflects the increased research interest in video game-based interventions for depression. Overall, when adherence was reported, rates of acceptability and feasibility were high.

Effect of Neuromuscular Training Program on Quality of Life After COVID-19 Lockdown Among Young Healthy Participants: A Randomized Controlled Trial

Study in the period of coronavirus disease 2019 (COVID-19) lockdown and the effect of different exercise training programs on the quality of life (QoL) dimension are limited. This randomized control study as a part of which the impact of an 8-week neuromuscular training program on the 90 healthy young individuals' QoL after COVID-19 lockdown was assessed using a short form of the WHOQOL-BREF questionnaire comprising of four domains (physical health, psychological health, social relations, and the environment). The intervention group (NT) (n = 47) took part in a neuromuscular training program consisting of dynamic neuromuscular stabilization and whole-body vibration training. In contrast, the control group (CG) (n = 43) did not participate in any programmed physical activity. From pre- to post-intervention test, the NT group significantly and substantially improved [mean change (95% CI)] all the QoL domains, physical for 12.78 scores (8.89, 16.64), psychological for 13.12 scores (9.51, 16.74), social relationships for 20.57 scores (16.12, 25.02), and environmental for 24.40 scores (21.45, 27.35). These results suggest that the NT program could enhance QoL in young and healthy participants following COVID-19 lockdown.

The impact of physical fitness on resilience to modern life stress and the mediating role of general self-efficacy

Substantial evidence shows that physical activity and fitness play a protective role in the development of stress related disorders. However, the beneficial effects of fitness for resilience to modern life stress are not fully understood. Potentially protective effects may be attributed to enhanced resilience via underlying psychosocial mechanisms such as self-efficacy expectations. This study investigated whether physical activity and fitness contribute to prospectively measured resilience and examined the mediating effect of general self-efficacy. 431 initially healthy adults participated in fitness assessments as part of a longitudinal-prospective study, designed to identify mechanisms of resilience. Self-efficacy and habitual activity were assessed in parallel to cardiorespiratory and muscular fitness, which were determined by a submaximal step-test, hand strength and standing long jump test. Resilience was indexed by stressor reactivity: mental health problems in relation to reported life events and daily hassles, monitored quarterly for nine months. Hierarchical linear regression models and bootstrapped mediation analyses were applied. We could show that muscular and self-perceived fitness were positively associated with stress resilience. Extending this finding, the muscular fitness-resilience relationship was partly mediated by self-efficacy expectations. In this context, self-efficacy expectations may act as one underlying psychological mechanism, with complementary benefits for the promotion of mental health. While physical activity and cardiorespiratory fitness did not predict resilience prospectively, we found muscular and self-perceived fitness to be significant prognostic parameters for stress resilience. Although there is still more need to identify specific fitness parameters in light of stress resilience, our study underscores the general relevance of fitness for stress-related disorders prevention.

Prospective Associations of Leisure-Time Physical Activity With Psychological Distress and Well-Being: A 12-Year Cohort Study

OBJECTIVE

This study aimed to investigate the associations of leisure-time physical activity with psychological distress and well-being, and potential mediators.

METHODS

We used data from the 1970 British Cohort Study (n = 5197; 2688 men), including waves 34y (2004), 42y (2012), and 46y (2016). Participants reported leisure-time physical activity frequency and intensity (exposure) at age 34 years (baseline); cognition (vocabulary test), body mass index, disability, mobility and pain perception (potential mediators) at age 42 years; and psychological distress (Malaise Inventory) and well-being (Warwick-Edinburgh scale) at age 46 years. Baseline confounders included sex, country, education, employment status, alcohol use, tobacco smoking, and psychological distress. Main analyses included logistic regression and mediation models.

RESULTS

Higher leisure-time physical activity intensity at baseline was associated with lower psychological distress at 46y (β = -0.038 [95% confidence interval {CI} =-0.069 to -0.007]), but not leisure-time physical activity frequency. Baseline leisure-time physical activity frequency and intensity were associated with higher psychological well-being at 46y (frequency: β = 0.089 [95% CI = 0.002 to 0.176]; intensity: β = 0.262 [95% CI = 0.123 to 0.401]); and total: β = 0.041 [95% CI = 0.013 to 0.069]). Only body mass index at 42y partially mediated the association between leisure-time physical activity frequency (15.7%) and total leisure-time physical activity (6.2%) at 34y, with psychological well-being at 46y.

CONCLUSIONS

Our findings highlight the role of leisure-time physical activity in psychological distress and well-being, with greater effect sizes associated with higher frequency and intensity of leisure-time physical activity. Future interventions should consider examining potential mediators of the association of leisure-time physical activity with psychological well-being, such as body mass index.

[Impact of middle- and long-distance running on mental health in college students in Guangzhou during COVID-19 outbreak]

OBJECTIVE

To investigate the impact of middle- and long-distance running on mental health of students in a college in Guangzhou during the COVID-19 outbreak.

METHODS

We collected data using online questionnaires from the college students selected via snowball sampling. After exclusion of invalid questionnaires and matching the data of running exercise with physical test scores of the participants, 1022 questionnaires were deemed valid for analysis. Of the 1022 students, 869 completed at least a 60-km running distance each semester as required and 153 students did not complete the task. The mental health status of the students was evaluated using PTSD Checklist-Civilian Version (PCL-C), Zung Self-rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). The scale scores were compared between the students who completed the running task and those who did not, and the factors affecting anxiety and depression were analyzed using univariate analysis and binary logistic regression.

RESULTS

The students who completed the running task had significantly higher physical test scores than those who did not complete the task (P < 0.05). The PCL-C, SDS, SAS scale scores or the conditions of PTSD, anxiety, and depression did not differ significantly between two groups (P>0.05). Binary logistic regression analysis indicated that completing the running task or not did not affect the condition of PTSD, anxiety, or depression of the students; a higher physical test score was associated with a decreased risk of PTSD (OR=0.98, 95%CI: 0.97-0.99) and depression (OR=0.99, 95%CI: 0.97-1.00) but an increased risk of anxiety (OR=1.02, 95%CI: 1.01-1.04) during COVID-19 outbreak.

CONCLUSION

Regular middleand long-distance running exercise may enhance the physical health to indirectly promote the mental health of the college students during COVID-19 outbreak.

The Relationship Between Storey of Buildings and Fall Risk

Purpose: This study examined the association between storey of building and fall risk in older adults' residences and residents' level of fear of falling. Methods: The National Health and Ageing Trends Study (NHATS) collected information that would provide an understanding of basic trends people aged 65 years and older. Using a longitudinal survey, the present study employed the first round of NHATS data that was collected in 2011. In the first round, 12,411 participants were enrolled, and 8,077 interviews were completed. The study sample sizes for falling and worry about falling are 6,153 and 6,142, respectively. Results: Unadjusted analysis revealed that storey of building was a risk factor for fall and worry about falling. There was a higher prevalence for fall and worry about falling when subjects lived in single storey of building compared with the subjects live in multi-storey. Logistic regression analysis showed no highly significant between storey of building and the fall/fear of falling. Conclusion: Several clinical factors independently were indicated pertaining to the fall and worry about falling in older adult's residences.

Physical Exercise and Mental Health: The Routes of a Reciprocal Relation

Sport participation and exercise practice are considered to be beneficial for mental status, yielding an improved mood and better quality of life. On the other hand, good mental fitness is thought to lead to better physical status and sport performance. The key aim of this narrative review is to provide an unstructured overview on the topic with special considerations on the role of mental and physical health to summarize the evidence on their reciprocal influence. While very few papers describe the role of mental health measures in affecting physical performance, more evidence is available concerning the effect of exercise and sport in improving mental health outcomes. Furthermore, there is a consistent role of depressive and anxiety symptoms in influencing the risk of sport injury in either recreational or elite athletes. Moreover, the importance of investigating mental health issues in elite and retired athletes is highlighted. On the basis of the available literature, several biases were found to affect the provided evidence mainly because of the complexity of a proper study design in this field.

A Randomized Controlled Pilot Trial About the Influence of Kyusho Jitsu Exercise on Self-efficacy, Fear, Depression, and Distress of Breast Cancer Patients within Follow-up Care

Introduction

Breast cancer survivors are faced with several psychological issues. We report the influence on self-efficacy by a holistic orientated training schedule based on the “Kyusho Jitsu” martial art and explore the effects on self-efficacy, distress, fear, and depression.

Methods

Breast cancer survivors (N = 51) were randomly assigned to an intervention (n = 30) or control group (n = 21). The intervention group participated in a Kyusho Jitsu intervention twice a week over a period of 6 months, the control group received no intervention. Patients from both groups were measured at baseline, 3 and 6 months on level of self-efficacy (German General-Self-Efficacy Scale, SWE), stress (Perceived Stress Questionnaire, PSQ20), and fear and depression (Hospital Anxiety and Depression Scale, HADS).

Results

Analysis of the original data showed a significant difference between both groups regarding the subscale “joy” (P = .018). Several significant results within the intervention group were seen in self-efficacy (P = .014), fear (P = .009) and the overall score for fear and depression (P = .043). Both groups improved significantly within “worries” (intervention P = .006, control P = .019) and the PSQ20 overall score (both P = .005). The control group also significantly improved in the subscale for “demands” (P = .019).

Conclusion

To summarize, our pilot study showed that Kyusho Jitsu training is safe and feasible. Though, the intervention alone cannot be considered as being effective enough to help breast cancer survivors regarding relevant psychological issues, but might be an important supplement offer within follow-up care.

Social reward and support effects on exercise experiences and performance: Evidence from parkrun

There is growing academic, civic and policy interest in the public health benefits of community-based exercise events. Shifting the emphasis from competitive sport to communal activity, these events have wide appeal. In addition to physical health benefits, regular participation can reduce social isolation and loneliness through opportunities for social connection. Taking a broad evolutionary and social psychological perspective, we suggest that social factors warrant more attention in current approaches to physical (in)activity and exercise behavior. We develop and test the hypothesis that social reward and support in exercise are associated with positive exercise experiences and greater performance outputs. Using a repeated-measures design, we examine the influence of social perceptions and behavior on subjective enjoyment, energy, fatigue, effort, and objective performance (run times) among a UK sample of parkrun participants. Social factors were associated with greater subjective enjoyment and energy. Higher subjective energy, in turn, was associated with faster run times, without any corresponding increase in perceived effort. No significant main effects of social factors on fatigue, performance or effort were detected. The role of social structural factors has long been recognized in public health approaches to physical activity. Our results indicate that there should be greater research attention on how positive and rewarding social behaviors and experiences-particularly subjective enjoyment and energy, and perceptions of community social support and belonging-influence exercise-related behavior, psychology and physiology, and promote health through collective physical activity. The research also supplements traditional emphases on social facilitation and team sport that have dominated sport and exercise psychology and offers new avenues for understanding the deep connections among psychological, social and physical function in everyday health.

Factors associated with return musculoskeletal specialty visits

Introduction

Prior studies suggested that a greater number of return visits is associated with greater symptoms of depression and greater symptom intensity.

Methods

All new adult patients presenting for musculsoskeletal specialty care between October 2017 and October 2018 were included. Patients completed the PROMIS Global Health, the PHQ-2, and the GAD-7 as part of usual care.

Results

Accounting for confounders, having a return visit was associated with lower PROMIS Global Health, greater symptoms of depression, and greater symptoms of anxiety.

Conclusions

These findings provide support for the importance of 1) improved coordination with non-specialist referring clinicians, and 2) interdisciplinary care teams.

Level of evidence

Level II, Prognostic.

Physical activity patterns among adults population during the coronavirus pandemic: consideration of the role of resilience

BACKGROUND

This study aims to characterize patterns of physical activity (PA) and resilience levels, and to examine whether resilience contributes to PA participation among adults during COVID-19 pandemic.

METHODS

This cross-sectional study was conducted during the quarantine period. The International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Brief Resilience Scale (BRS) questionnaires were used to assess the study's outcomes. The Kruskal-Wallis test was used to examine the difference in PA across resilience levels. Spearman's correlation coefficient was used to assess the relationship between resilience and PA. Data were reported as medians and interquartile ranges.

RESULTS

A sample of 1859 were included in the study (40% aged 26-35 yrs). The findings show that 85% of the respondents engaged in PA and 15% were physically inactive. The majority participated in moderate-intensity PA (71%). The median score was 3.50(0.85), which indicates a medium level of resilience. The positive correlation coefficient was shown between the average score of resilience and both walking (rs =0.01, p<0.001) and vigorous- intensity PA (rs =0.08, p=.007). Data did not show a significant correlation between moderate-intensity PA and resilience score.

CONCLUSIONS

Greater emphasis on PA engagement after the period of quarantine is needed. Resilience may play an important role in buffering the deleterious impact of quarantine on PA. Key words: Exercise; Physical Activity; Rehabilitation; Mental Health; COVID-19.

Quality of Physical Activity Apps: Systematic Search in App Stores and Content Analysis

Background

Physical inactivity is a major contributor to the development and persistence of chronic diseases. Mobile health apps that foster physical activity have the potential to assist in behavior change. However, the quality of the mobile health apps available in app stores is hard to assess for making informed decisions by end users and health care providers.

Objective

This study aimed at systematically reviewing and analyzing the content and quality of physical activity apps available in the 2 major app stores (Google Play and App Store) by using the German version of the Mobile App Rating Scale (MARS-G). Moreover, the privacy and security measures were assessed.

Methods

A web crawler was used to systematically search for apps promoting physical activity in the Google Play store and App Store. Two independent raters used the MARS-G to assess app quality. Further, app characteristics, content and functions, and privacy and security measures were assessed. The correlation between user star ratings and MARS was calculated. Exploratory regression analysis was conducted to determine relevant predictors for the overall quality of physical activity apps.

Results

Of the 2231 identified apps, 312 met the inclusion criteria. The results indicated that the overall quality was moderate (mean 3.60 [SD 0.59], range 1-4.75). The scores of the subscales, that is, information (mean 3.24 [SD 0.56], range 1.17-4.4), engagement (mean 3.19 [SD 0.82], range 1.2-5), aesthetics (mean 3.65 [SD 0.79], range 1-5), and functionality (mean 4.35 [SD 0.58], range 1.88-5) were obtained. An efficacy study could not be identified for any of the included apps. The features of data security and privacy were mainly not applied. Average user ratings showed significant small correlations with the MARS ratings (r=0.22, 95% CI 0.08-0.35; P<.001). The amount of content and number of functions were predictive of the overall quality of these physical activity apps, whereas app store and price were not.

Conclusions

Apps for physical activity showed a broad range of quality ratings, with moderate overall quality ratings. Given the present privacy, security, and evidence concerns inherent to most rated apps, their medical use is questionable. There is a need for open-source databases of expert quality ratings to foster informed health care decisions by users and health care providers.

Home Confinement in Previously Active Older Adults: A Cross-Sectional Analysis of Physical Fitness and Physical Activity Behavior and Their Relationship With Depressive Symptoms

AIM

The aim of our study was to analyze physical activity levels, sitting time, physical fitness, and their relationship with depressive symptoms after home confinement in previously active older adults.

METHODS

This cross-sectional study sample comprised 68 older adults (74.24 ± 5.67 years) from a community-based exercise program conducted in Porto, Portugal. After home confinement, participants were assessed in person for lower-body strength (30-s chair stand test), cardiorespiratory fitness (6-min walking test), agility/dynamic balance (8-ft up-and-go test), handgrip strength, and anthropometry. Telephone interviews were performed to evaluate depressive symptoms with the Geriatric Depression Scale - 15 items (GDS-15) and physical activity levels through the International Physical Activity Questionnaire (IPAQ-SV). Individuals were also asked to self-report changes in their physical activity levels and time spent sitting.

RESULTS

Ninety percent of older adults self-reported a decrease in overall physical activity levels, and nearly 65% increased daily sitting time during the home confinement. However, previously active older adults still presented high levels of physical fitness (scores above 50th compared with Portuguese normative values) after 11 weeks of home confinement. Overall, 52.9% of participants scored 5 or more points on GDS-15, which is suggestive of depression. Higher levels of moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness were found in the non-depressed group compared with the depressed group. Finally, results from multiple regression analysis revealed that MVPA was negatively associated with depression. This model explained 16.4% of the variability seen in depression score, controlled for age, gender, and education.

CONCLUSION

Even reporting a decline in physical activity, older adults who previously participated in a formal exercise program, still presented high levels of physical fitness after 11 weeks of home confinement. However, MVPA, but not physical fitness, seems to be an associated depression score in previously active older adults. These results reinforce the importance of older adults to remain physically active, since higher levels of MVPA may have a protective effect on depressive symptoms and, therefore, mitigate the negative impact of home confinement on mental health. Future longitudinal research studies are needed to ascertain these results.

Systematic Review of Psychological and Behavioral Correlates of Recreational Running

Introduction: The aim of this review was to systematically synthesize the published literature describing the psychological and behavioral correlates of recreational running in adults, defined as running for leisure, with or without a competitive component. Methods: Quantitative research published in peer-reviewed journals until January 2021 were included. Studies were identified through MEDLINE, PsycINFO, SPORTDiscus, and Web of Science and were included in this review if they (1) were aimed at recreational running, (2) included general adult samples (18 years or older, without a diagnosed medical condition or metabolic disorder), and (3) assessed psychological or behavioral correlates of recreational running. Results: Fifty-six articles reporting 58 studies met the eligibility criteria and were included. There were 27 cross-sectional studies, 12 longitudinal studies, and 19 trials (8 non-controlled trials, 5 controlled trials, and 6 randomized controlled trials) (n = 37,501, 1877 years old, 43% women). Twenty-eight studies assessed antecedents of running behavior, and 25 studies used running behavior as treatment or predictor of a given effect or outcome. Four studies examined both predictors and outcomes of running. Thirty-one studies showed poor quality, while 20 had fair and 7 good quality. Motives were the most frequently studied antecedent of running behavior (k = 19), and results suggest that the highest-ranked or more prevalent motives were physical health, psychological motives, and personal achievement. Additionally, perceived control, attitude toward running, intention and subjective norms, self-efficacy, and social support may have also played a role in the adoption of recreational running. Moreover, improvements in mood (k = 10) and well-being (k = 10) were the most frequently reported positive outcomes of running. Reductions in depression, anxiety, and stress were also reported in included studies. Discussion: To our knowledge, this is the first systematic review on this topic. The identification of behavioral and psychological correlates of recreational running across populations can contribute to inform and guide a public policy agenda, focused on helping people sustain regular physical activity, through a modality they have chosen and appear to enjoy. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=68954, identifier: CRD42017068954.

The handgrip strength and risk of depressive symptoms: a meta-analysis of prospective cohort studies

PURPOSE

Many studies have investigated the association between handgrip strength (HGS) and depressive symptoms, but the conclusion remain controversial. We performed a meta-analysis to evaluate the longitudinal association between HGS and risk of depressive symptoms.

METHODS

PubMed, PSYCINFO and EMBASE databases were searched for eligible publications up to April 2020. Pooled relative risks (RRs) with 95% confidence intervals were calculated using random-effects model. Publication bias was estimated using Egger's test and the funnel plot. Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of eligible studies.

RESULTS

The present meta-analysis included 8 cohort studies with 30,727 participants. Overall, higher HGS was related to a decreased risk of depressive symptoms: the pooled risk ratio (RR) of 0.74 [95% confidence intervals (CI) 0.65-0.85] with a moderate heterogeneity (I² = 60.5%, P = 0.013). HGS was significantly associated with a reduced risk of depressive symptoms in males (RR = 0.69; 95% CI 0.50-0.94), but not in females.

CONCLUSIONS

Lower HGS was associated with an increased risk of depressive symptoms. Further studies are needed to confirm these findings and to investigate the sex differences.

The Relationship between Psychological Stress and Healthy Lifestyle Behaviors during COVID-19 among Students in a US Midwest University

The gripping coronavirus disease (COVID-19) has imposed dramatic changes to many areas of daily living in all sectors of society across the world. We examined the relationship between perceived stress and health behaviors among college students during the COVID-19 pandemic. An online survey with measures of psychological stress, physical activity and exercise, and sleep and social connectedness was distributed in June and July of 2020. The survey was completed by 550 college students (mean age: 21.3 ± 3.8 years, 74.2% female, 94.4% Caucasian). Being female and unemployed and having a lower annual income were significantly associated with higher levels of stress. In addition, regression analysis found that reduced exercise and sleep during the COVID-19 pandemic significantly predicted the levels of stress of participants after controlling for gender, employment status, and annual income. University officials should aim to implement health-promotion strategies directed at preventing reductions in exercise and sleep duration, especially in those at greater risk of increased perceived stress such as females and economically disadvantaged students.

The prevalence of uninvestigated dyspepsia and the association of physical exercise with quality of life of uninvestigated dyspepsia patients in Indonesia: An internet-based survey

BACKGROUND

Epidemiological data on the prevalence of uninvestigated dyspepsia (UD) and its impact on the health-related quality of life (HRQOL) in Indonesian population are still lacking. There is no study investigating the association between exercise and the HRQOL in UD patients. We aimed to investigate the prevalence of UD and its association with physical exercise, and its impact on HRQOL in Indonesian patients with UD.

METHODS

This was a population-based, cross-sectional study, conducted using an internet-based questionnaire which was randomly distributed throughout Indonesia using the social media. The questionnaire contained socio-demographic details, exercise levels, Rome III criteria for dyspepsia, and SF-NDI (Short Form-Nepean Dyspepsia Index). The frequency, duration, the intensity of exercise, and the classification of exercise according to ACSM (American College of Sports Medicine) were included in the assessment. The screening for UD was conducted using the Rome III criteria and the SF-NDI score was calculated to assess the HRQOL in patients with UD.

RESULTS

A total of 2725 valid responses were collected. The overall prevalence of UD in the study was 49.75%. Multiple logistic regression analysis showed that gender (female) and lack of exercise were independently associated with UD (OR 2.07, 95% CI 1.74-2.47, p < 0.001 and OR 1.72, 95% CI 1.42-2.07, p < 0.001). The median SF-NDI score among 1295 UD subjects in non-exercising and exercising groups was 21.00 and 18.00 (p < 0.001), respectively.

CONCLUSION

This study demonstrated the prevalence of UD and the association between exercise and HRQOL among UD patients in Indonesia.