The effects of exercise training on mental well-being in the normal population: a controlled trial

This study was designed to compare the effects of two aerobic training programmes of differing intensities on mood and mental well-being with those of a credible attention-placebo condition. One hundred and nine sedentary adult volunteers from the local population were assigned to four conditions: high intensity aerobic training, moderate intensity aerobic training, attention-placebo and waiting list. Training was carried out over a 10 week period. Subjects were assessed before and after training with psychological measures and the 12 min walk-run test, and follow-up evaluations were undertaken after 3 months. Ninety-four subjects began the programme and the adherence rate averaged 80%, with no significant differences in number of drop-outs between conditions. Appropriate changes in estimated maximum oxygen consumption were observed in the three active conditions with the 12 min walk-run test. Psychological benefits were seen with the moderate exercise condition but not in the high exercise or attention-placebo conditions. These effects were manifest immediately after training on measures of tension/anxiety and confusion, and at follow-up on measures of perceived coping ability. The mechanisms underlying this pattern of results are discussed and the relative importance for health of vigorous activity and physical fitness is considered.     

Effects of aerobic exercise training and relaxation training on cardiovascular activity during psychological stress

Students who reported experiencing a high number of stressful life events were randomly assigned to: (a) an aerobic training condition, (b) a relaxation training condition, or (c) a no treatment control condition. Immediately before and after the 11 week training/control period, subjects' aerobic fitness and cardiovascular responses to acute psychological stress were assessed. Results indicated that: (1) subjects in the aerobic training condition showed significantly greater improvements in aerobic fitness than subjects in the other conditions, and (2) the subjects in the aerobic training condition showed significantly greater reductions in heart rate during all phases of the stress than subjects in the other conditions. Post-training differences between aerobic and control conditions during the moderate psychological stress were as great as 17 b.p.m. These results provide evidence for the utility of aerobic training for reducing cardiovascular activity during psychological stress, and they are consistent with earlier findings linking fitness to less illness following stress, reductions in depression and enhanced recovery in cardiac patients.     

Improving functional skills and physical fitness in children with Rett syndrome

Background To investigate the feasibility of a physical exercise programme with treadmill for persons with Rett syndrome (RS) in order to promote fitness and health. Methods A daily training programme on a treadmill was designed for four females with RS over a period of 2 months with tests performed in three intervals, at time 1, 2 and 3, 2 months apart with intervention taking place between tests 2 and 3. Participants were four girls with RS aged 8.5–11 years (mean: 10 years) attending the educational facility Beit Issie Shapiro, Raanana, Israel, all with independent mobility and with typical characteristics of RS stage III. The training took place at the educational facility, on a 1400 model treadmill (Trimline, capable of very low speeds < 0.5 k/h), with very long side rails. Special low side rails were adapted to the treadmill in order to fit the height of the children and velcro straps were added to assist in safely placing the hands. Pulse was monitored constantly during exercise by an A3 polar pulse belt. Pulse measurements at rest during training were considered as evaluators of aerobic physical condition. Functional measurement was based on a scale specially established for the present study. The scale was a 31‐item motor‐functioning tool that measures the ability of participants to knee walk and knee stand, to get up to a standing position, duration of walking different paths, and to go up and down stairs and slopes. Results The study showed that physical fitness of the children at the end of the training programme had improved considerably (P < 0.05). Tests showed that general functional abilities had improved considerably (P < 0.0001). Although all items of the functional ability measure showed impressive positive change, some of the 31 items on it showed statistically significant improvement (knee walking, going up and down stairs and speed of walking for 25 m. Pearson correlation showed high linkage (r = ?0.76) between functional improvement and change in physical fitness. Conclusions Physical fitness programme executed on a daily basis is capable of improving functional ability of children with RS. Nonprofessional personnel can execute such a programme under supervision of a qualified physical therapist.     

Aerobic capacity in early paraplegia: implications for rehabilitation

Both strength (ability to develop tension) and endurance (aerobic capacity as measured by VO2 max) contribute to overall functional capacity. In the rehabilitation of individuals with major neuromuscular deficits such as paraplegia, primary emphasis is generally placed on strength training to develop functional independence. However, endurance training may also be important. To clarify the influence of paraplegia on the VO2, we studied 10 paraplegics between 2 to 12 weeks after injury to determine whether or not a deficit in arm VO2 max was present before the inception of a conventional rehabilitation programme, and whether it persisted in three subjects after its completion. Cardiorespiratory responses to progressive multi-stage arm ergometry were measured using standard open circuit calorimetry. Ten paraplegic subjects demonstrated a low VO2 max compared to control subjects. This deficit persisted when selected subjects (n = 3) were tested after completion of a conventional rehabilitation programme which emphasised strengthening exercises. Further research is needed to study the effects of complementary endurance training on the aerobic capacity as measured by VO2 max, and to assess their value in the rehabilitation process.     

The Acute Effects of Aerobic Dance Exercise with and without Face Mask Use on Attention,Perceived Exertion and Mood States

The present study aimed to determine the effect of wearing a face mask during aerobic dance exercise on cognitive function, more specifically on attention, as well as on perceived exertion and mood states. Thirteen healthy college students (9 males and 4 females: mean age = 17.5 years, height = 1.72 m, weight = 71.00 kg) volunteered to participate in this study. They were randomized to perform aerobic dance exercise while wearing a cloth face mask or no mask or a control condition (sitting on a comfortable chair and reading information about the health benefits of aerobic dance exercise) on three separate occasions (with at least one week of interval). Rate of perceived exertion (RPE), the Brunel Mood Scale (BRUMS) and d2 Attention assessment were assessed before and immediately after each condition. The results demonstrated higher concentration performance for the aerobic dance exercise without face mask than the control condition (p = 0.05). Post RPE and BRUMS fatigue subscale values were significantly higher in the aerobic dance exercise with face mask as compared to the aerobic dance exercise without face mask and control condition (all, p < 0.05). BRUMS vigor subscale value significantly differed across conditions (F = 113.84, p < 0.001, ES = 0.86) and was significantly higher in the aerobic dance exercise group without face mask as compared to the aerobic dance exercise with face mask and the control conditions (both, p < 0.001). This study suggests that face mask use during aerobic dance exercise with moderate intensity did not affect attention. Practitioners, students and athletes should avoid wearing face mask while practicing physical activity or aerobic dance exercise with moderate intensity to improve its acute effect on cognitive function.     

Combined Aerobic and Resistance Training for Cardiorespiratory Fitness,Muscle Strength,and Walking Capacity after Stroke: A Systematic Review and Meta-Analysis

BackgroundCardiorespiratory fitness, measured as peak oxygen consumption, is a potent predictor of stroke risk. Muscle weakness is the most prominent impairment after stroke and is directly associated with reduced walking capacity. There is a lack of recommendations for optimal combined aerobic training and resistance training for those patients. The purpose of this study was to systematically review and quantify the effects of exercise training on cardiorespiratory fitness, muscle strength, and walking capacity after stroke.MethodsFive electronic databases were searched (until May 2019) for studies that met the following criteria: (1) adult humans with a history of stroke who ambulate independently; (2) structured exercise intervention based on combined aerobic training and resistance training; and (3) measured cardiorespiratory fitness, muscle strength, and/or walking capacity.ResultsEighteen studies (602 participants, average age 62 years) met the inclusion criteria. Exercise training significantly improved all 3 outcomes. In subgroup analyses for cardiorespiratory fitness, longer training duration was significantly associated with larger effect size. Likewise, for muscle strength, moderate weekly frequency and lower training volume were significantly associated with larger effect size. Furthermore, in walking capacity, moderate weekly frequency and longer training duration were significantly associated with larger effect size.ConclusionsThese results suggest that an exercise program consisting of moderate-intensity, 3 days per week, for 20 weeks should be considered for greater effect on cardiorespiratory fitness, muscle strength, and walking capacity in stroke patients.     

Examining the validity of exercise guidelines for the prevention of morbidity and all-cause mortality

Public health guidelines focus on increasing low to moderate physical activity levels in a largely sedentary population. While there is some evidence that inactivity is associated with increased risk of morbidity and mortality, there appears to be much stronger and consistent evidence for a graded inverse relationship between physical fitness and morbidity and mortality. However, epidemiological studies investigating physical fitness have often not directly measured aerobic capacity. This calls into question the specific recommendations that assume a direct relationship between aerobic capacity and risk. Performance on some test protocols can be favorably affected by increases in strength and musculoskeletal changes, in addition to aerobic capacity. Other public health recommendations assume that the volume of training, the total amount of work, or caloric expenditure is the key stimulus for health-protective adaptations. However, there is little evidence to support this long-held axiom. A balance of resistance training and aerobic training is recommended for decreasing morbidity and mortality. A threshold theory of adaptation and training is proposed that potentially can efficiently and effectively enhance aerobic capacity and strength in minimal time.     

The influence of aerobic fitness on cerebral white matter integrity and cognitive function in older adults: Results of a one‐year exercise intervention

Cerebral white matter (WM) degeneration occurs with increasing age and is associated with declining cognitive function. Research has shown that cardiorespiratory fitness and exercise are effective as protective, even restorative, agents against cognitive and neurobiological impairments in older adults. In this study, we investigated whether the beneficial impact of aerobic fitness would extend to WM integrity in the context of a one‐year exercise intervention. Further, we examined the pattern of diffusivity changes to better understand the underlying biological mechanisms. Finally, we assessed whether training‐induced changes in WM integrity would be associated with improvements in cognitive performance independent of aerobic fitness gains. Results showed that aerobic fitness training did not affect group‐level change in WM integrity, executive function, or short‐term memory, but that greater aerobic fitness derived from the walking program was associated with greater change in WM integrity in the frontal and temporal lobes, and greater improvement in short‐term memory. Increases in WM integrity, however, were not associated with short‐term memory improvement, independent of fitness improvements. Therefore, while not all findings are consistent with previous research, we provide novel evidence for correlated change in training‐induced aerobic fitness, WM integrity, and cognition among healthy older adults. Hum Brain Mapp 34:2972–2985, 2013. © 2012 Wiley Periodicals, Inc.     

Teaching sight words to children with moderate to mild mental retardation: comparison between instructional procedures

Differential effects of three training procedures to teach sight words to 13 children with moderate to mild mental retardation were investigated in an alternating treatments design. Number of correct responses was assessed during probe sessions in word-alone (word was presented without picture), integrated-picture (word was presented with integrated picture, no fading), and picture-fading (integrated picture was faded out) conditions. Results show that most children learned to identify sight words fastest in the word-alone condition. Effects were largely maintained during follow-up at 2 to 5 weeks after training.     

The effects of aerobic and anaerobic training on fitness, blood pressure, and psychological stress and well-being

To determine whether fitness alters psychological and physiological indices of well-being, male police officers were assigned to either an aerobic or anaerobic training condition or to a no treatment control group. The training groups met three times per week in 45 min sessions aimed at improving either cardiovascular endurance or muscle strength. Aerobic fitness level, heart rate, blood pressure and self-report of stress and well-being were measured prior to and following 10 weeks of training. Post-training fitness measures confirmed the effectiveness of training and between group differences for physiological and self-report measures were found. Subjects undergoing aerobic training evinced larger changes on the self-report measures of well-being and stress than the anaerobic trainers and both groups showed significant improvement when compared to controls. This experiment provides support for the hypothesis that exercise, and in particular aerobic exercise, has positive effects of well-being. It is suggested that future research might usefully explore the particular contribution of different aspects of the training situation to these effects.     

Feasibility of adapted aerobic cycle ergometry tasks to encourage paretic limb use after stroke: a case series

Cardiorespiratory fitness, along with sensorimotor recovery, is important for optimal function after stroke. Development of exercises that simultaneously address aerobic training and increase paretic limb involvement may improve outcomes and maximize productivity of therapy sessions. This case series assessed the feasibility of and characterized the cardiorespiratory and sensorimotor demands of adapted aerobic cycle ergometer activities hypothesized to increase paretic limb use. Mechanically loaded and electromyographic (EMG) feedback pedaling were compared to traditional pedaling in three poststroke case studies and a healthy control group. Submaximal oxygen uptake (Vo2), heart rate, perceived rate of exertion (RPE), and EMG of four leg muscles were assessed. Mechanically loaded ergometry increased RPE and altered muscle activity in healthy participants, while participants with stroke did not consistently increase paretic limb activation. EMG feedback pedaling increased target limb activity in healthy participants and decreased nonparetic activity in stroke participants. This paper highlights the challenges involved in adapting training tasks for individuals who are not able to walk at training intensities. Further work is necessary to refine adapted tasks for optimal effectiveness, and consideration of additional methods that permit differential interlimb loading may have additional value.     

Correlations between event-related potential components and nitric oxide in maximal anaerobic exercise among sportsmen trained at various levels

Physical exercise has influence on all organs except its effects on the central nervous system have not been fully elucidated. This study attempts to determine whether the degree of training could affect the response to physical stress by comparing the three groups of males in different levels of the physical fitness. Serum samples from high (n = 11), moderate (n = 10), and low physical activity sportsmen (n = 10) were collected to determine nitrite/nitrate levels before and after carrying out an anaerobic maximal exercise test. An "oddball paradigm" of auditory stimuli was used to evoke the N200 and P300 before and after the exercise. The amplitude of the N200 decreased significantly after anaerobic maximal exercise compared to the values of the recorded pre-exercise at Fz area in high physical activity group. There was a negative correlation between event-related potentials component and both nitrite/nitrate serum level changes and the heart rate changes in low physical activity subjects. However, in high and moderate physical activity groups, these relationships were positive.     

Individual responses to aerobic exercise: the role of the autonomic nervous system

It is well established that regular aerobic exercise training reduces all-cause mortality and improves a number of health outcomes. However, a marked heterogeneity in the training-induced changes, e.g. in terms of aerobic fitness, has been observed in healthy human subjects, even with highly standardized training programs. Mean improvements in aerobic fitness, expressed as maximal oxygen consumption, have been about 10-15% of the baseline values, but the training-induced changes have ranged from almost none to a 40% increase. The exact nature of the mechanisms responsible for this heterogeneity in response to regular aerobic exercise is not well known. In this review, we consider evidence of the association between the autonomic nervous system (ANS), aerobic fitness and aerobic training-induced changes in fitness. Results of recent studies support the hypothesis that assessment of ANS functioning includes important information concerning acute and chronic physiological processes before, during and after aerobic exercise training stimulus. Moreover, we show that daily assessment of ANS activity could serve as an indicator of appropriate physiological condition for aerobic training.     

Partial body-weight-supported treadmill training can improve walking in children with cerebral palsy: a clinical controlled trial

This matched-pairs, clinical controlled trial evaluated the effects of a school-based, partial body-weight-supported treadmill training (PBWSTT) programme, conducted twice a week for 6 weeks, on the walking speed and endurance of children with cerebral palsy (CP). Pairs of children (10 males, four females; mean age 8 y 10 mo [SD 2 y 6 mo], range 5-14 y) matched for sex, age, type of CP (athetoid quadriplegia, n=6; spastic quadriplegia, n=6; spastic diplegia, n=2), and Gross Motor Function Classification System level (10 at Level I V, four at Level III) were allocated to the experimental or control group. Compared with the control group, the seven treadmill-training participants increased their self-selected walking speed over 10 metres (Mann-Whitney U=9.00, z=-1.98, p=0.048; mean difference 4.21 m/min). A trend was also found for increased distance walked over ground in 10 minutes (t[12]=1.88, p=0.083; mean difference 19.81 m). A relatively short PBWSTT programme can improve the walking speed of children with CP and moderate to severe disabilities. Walking endurance might also improve in some children. Treadmill training seems to be a useful gait training option for children with C P, and it seems feasible to conduct such a programme within a school environment.     

Training reduces autonomic cardiovascular responses to both exercise-dependent and -independent stimuli in humans

Training attenuates the sympathetic pressor response to dynamic exercise. However, it is uncertain how training alters other patterns of cardiovascular autonomic activation. Therefore, we have quantified circulatory responses to a series of standard autonomic tests in highly fit and unfit subjects and examined the effects of a short-term training programme on these responses. Subjects were defined as either unfit (n = 8) or fit (n = 8) on the basis of training history and a maximal fitness test (VO2peak 54 +/- 2.3 cf. 68 +/- 2.8 (ml min(-1)) kg(-1), means + S.E.M., P < 0.05). On a separate day, the blood pressure, heart rate and forearm vascular conductance responses to a sustained handgrip to fatigue, 2 min mental arithmetic and 2 min of cold exposure were measured. All stimuli were associated with elevated blood pressures and heart rates, but these responses were significantly attenuated in the trained group. In the untrained subjects, forearm vascular conductance increased during exercise (from 0.032 +/- 0.004 to 0.05 +/- 0.007 (ml min(-1)) 100 ml(-1) mm Hg(-1), P < 0.05) and during mental arithmetic (from 0.028 +/- 0.003 to 0.04 +/- 0.006 (ml min(-1)) 100 ml(-1) mm Hg(-1) , p < 0.05), but trained subjects showed no rise in conductance during either test. All untrained subjects undertook a moderate intensity 5-week training programme, which significantly increased VO2peak (54 +/- 2.3 to 57 +/- 2 (ml min(-1)) kg(-1), p < 0.05). Qualitatively similar blunting of pressor, tachycardic and vasodilator responses were seen in this group post-training. These results demonstrate that the blunting of sympathetic vasomotor activation that follows training is not restricted to reflexes associated with exercise, and does not depend on training being prolonged or intense.     

Comparison of the influence of different rehabilitation programmes on clinical, spirometric and spiroergometric parameters in patients with multiple sclerosis

PURPOSE: The aim of this study was to compare the effect of four different programmes on spiroergometric, spirometric and clinical parameters in multiple sclerosis (MS) patients. METHODS: One hundred and twelve MS patients were divided into four groups. The first group underwent neurophysiologically based physiotherapy, the second aerobic training, the third combined therapy (neurophysiologically based physiotherapy and aerobic training) and the fourth did not change any habits. Seventeen patients did not finish the study. Patients were examined on impairment (Expanded Disability Status Scale), disability (Barthel Index), handicap (Environment Status Scale), quality of life (Multiple Sclerosis Quality of Life), fatigue (Modified Fatigue Impact Scale), depression (Beck Depression Inventory Score), respiratory function (spirometric parameters on spirometry) and physical fitness (spiroergometric parameters on a bicycle ergometer). RESULTS: The patients who participated in one of our training programmes showed a significant improvement of the examined parameters in comparison to those who did not change their present habits. Each of the four training programmes had a different impact on the parameters, which means that each of them had a different effect. The neurophysiologically based physiotherapy had the greatest impact on impairment, and the aerobic training on spirometric and spiroergometric parameters. All methods (the neurophysiologically based physiotherapy, the aerobic training and the combined programme) had an impact on fatigue.     

Aerobic endurance exercise benefits memory and affect in young adults

Exercise seems a simple and widely practised behaviour that activates molecular and cellular signalling cascades involved in various central nervous system processes. Despite impressive results obtained in animal studies, fitness interventions have produced less reliable effects in humans, particularly in young adults. In the present study we tested the hypothesis that an individually adapted exercise training consisting of three running sessions of 30 minutes per week for 6 weeks, has the potential to improve visuospatial and verbal memory, concentration performance, and affect in young and healthy adults. Twenty-eight students participated and underwent a graded fitness test to assess individual fitness. The experimental group took part in an aerobic running programme, whereas the control group were asked not to vary their everyday activities. We found a significant increase in visuospatial memory performance and a significant increase in positive affect on a .05 alpha level of significance. However, we observed no effects of running training on concentration performance and verbal memory. We conclude that physical activity can possibly serve as a means to improve positively valenced aspects of affect and benefit visuospatial but not verbal memory in young adults.     

Exercise intensity and reduction in neurotic symptoms. A controlled follow-up study

The psychological benefits of walking and jogging were compared in 52 symptomatic neurotics over an 8-week training period and subsequent 6-month follow-up. Both groups showed marked reduction of anxiety, depression and global symptoms. Joggers had greater aerobic gain, but no greater psychologic benefit. Significantly larger numbers of joggers dropped out of the study. There was no relationship between aerobic gain and reduction of symptoms at the end of the program. However, at 6 months' follow-up, those with greater aerobic fitness had much lower anxiety levels. Changes in exercise frequency and aerobic capacity were also maintained at follow-up. Depression levels were not associated with aerobic fitness at follow-up. High initial exercise intensity appears to inhibit the forming of new exercise habits.     

Aerobic endurance exercise benefits memory and affect in young adults

Exercise seems a simple and widely practised behaviour that activates molecular and cellular signalling cascades involved in various central nervous system processes. Despite impressive results obtained in animal studies, fitness interventions have produced less reliable effects in humans, particularly in young adults. In the present study we tested the hypothesis that an individually adapted exercise training consisting of three running sessions of 30 minutes per week for 6 weeks, has the potential to improve visuospatial and verbal memory, concentration performance, and affect in young and healthy adults. Twenty-eight students participated and underwent a graded fitness test to assess individual fitness. The experimental group took part in an aerobic running programme, whereas the control group were asked not to vary their everyday activities. We found a significant increase in visuospatial memory performance and a significant increase in positive affect on a .05 alpha level of significance. However, we observed no effects of running training on concentration performance and verbal memory. We conclude that physical activity can possibly serve as a means to improve positively valenced aspects of affect and benefit visuospatial but not verbal memory in young adults.     

Multiple sclerosis and brief moderate exercise. A randomised study

This is a randomised control study, to determine the effect of aerobic and strength exercise on physical fitness and quality of life in patients with mild multiple sclerosis (MS). Sixteen outpatients with definitive MS, aged 18-50, with an Expanded Disability Status Scale (EDSS) <4, completed the study. Every patient was evaluated according to physical fitness with peak oxygen consumption (V'O2peak), workload and anaerobic threshold; quality of life (SF-36); and degree of disability (EDSS). The patients were then randomised to an exercise group (EG) (n =6) or a control group (CG) (n = 10). The EG exercised three times a week for five weeks, and the CG did not change their habits regarding exercise. In the EG, the mean change in workload was 0.34 W/kg (95% confidence interval (CI): 0.09-0.58), the mean change in V'O2peak was 4.54 mL/kg per minute (95% CI: 1.65-7.44), and the mean change in anaerobic threshold was 0.32 L/min (95% CI: 0.08-0.57). There was a tendency towards improved quality of life, and no change was detected in the degree of disability. This study confirms that brief, moderate, aerobic exercise improves physical fitness in individuals with mild MS. No evidence was found for worsening of MS symptoms in association with exercises.