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1.
J Sport Exerc Psychol ; 46(2): 66-72, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38580300

ABSTRACT

In articles on the methodology of studies investigating affective and enjoyment responses to high-intensity interval training, we noted that, occasionally, exercise conditions described as involving "high" intensity exhibited heart rates that were only as high as, or even lower than, heart rates recorded during comparator conditions described as being of "moderate" intensity. Drs. Vollaard, Metcalfe, Kinghorn, Jung, and Little suggest instead that exercise intensity in high-intensity interval-training studies can be defined in terms of percentages of peak workload. Although we maintain that defining exercise intensity in terms of percentages of maximal heart rate is a suboptimal way to quantify the degree of homeostatic perturbations in response to exercise, we are unconvinced that definitions of intensity relying solely on workload are appropriate for studies investigating affective and enjoyment responses to exercise. The reason is that affect is theorized to have evolved to relay information about homeostatic perturbations to consciousness.


Subject(s)
Exercise , High-Intensity Interval Training , Humans , Exercise/psychology , Pleasure/physiology , Happiness , High-Intensity Interval Training/methods , High-Intensity Interval Training/psychology , Heart Rate/physiology , Oxygen Consumption/physiology
2.
Psychol Sport Exerc ; 64: 102295, 2023 01.
Article in English | MEDLINE | ID: mdl-37665824

ABSTRACT

Nonadherence to and dropout from regular exercise and physical activity are important reasons why the field of exercise science has yet to fulfill its promise of improving public health on a global scale. Researchers have claimed that High-Intensity Interval Training (HIIT) is a feasible and sustainable exercise modality that may result in higher long-term adherence than moderate-intensity continuous exercise. If true, this would be a breakthrough discovery that could unlock the potential of exercise as a health-promoting intervention. We performed a systematic search of the literature and identified eight trials comparing HIIT to moderate-intensity continuous exercise, all of which involved follow-up periods of at least 12 months (i.e., SWIFT, Small Steps for Big Changes, SAINTEX-CAD, SMARTEX-HF, Generation 100, FITR, OptimEx-Clin, HITTS). Findings from these trials demonstrate that, while unsupervised, individuals initially assigned to HIIT tend to exercise at lower-than-prescribed intensities and HIIT groups demonstrate no advantage in long-term adherence.


Subject(s)
High-Intensity Interval Training , Humans , Exercise , Public Health , Research Personnel
3.
Psychol Sport Exerc ; 66: 102399, 2023 05.
Article in English | MEDLINE | ID: mdl-37665861

ABSTRACT

Kinesiology aspires to be an integrated, interdisciplinary field that studies human movement from multiple perspectives. However, the main societal deliverables of the field, namely exercise prescriptions and physical activity recommendations, still reflect fragmentation, placing more emphasis on physiological outcomes than on behavioral and other considerations. Recently, researchers have called for the introduction of High-Intensity Interval Training (HIIT) to the domain of public health, based on the argument that HIIT can maximize fitness and health benefits for a fraction of the time recommended by the prevailing model of physical activity in public-health guidelines. Here, we show that an unintended side-effect of arguments underpinning the implementation of HIIT in the domain of public health might have been the exacerbation of segmentation. To highlight the value of interdisciplinarity, four foundational claims in support of HIIT are critiqued by tapping into cognate literatures: (1) the primary reason people do not exercise is lack of time, (2) HIIT is relevant to public health, (3) HIIT is being proposed as merely another option, so there is no basis for controversy, and (4) HIIT is safe and well tolerated. These claims are contradicted by credible lines of evidence. To improve the accuracy and effectiveness of its public claims, kinesiology should remain committed to the ideals of integration and interdisciplinarity.


Subject(s)
Drug-Related Side Effects and Adverse Reactions , High-Intensity Interval Training , Lens, Crystalline , Lenses , Unionidae , Humans , Animals , Dissent and Disputes
4.
Psychol Sport Exerc ; 67: 102424, 2023 07.
Article in English | MEDLINE | ID: mdl-37665877

ABSTRACT

Research on the relationship between exercise-induced affect and exercise or physical activity behavior has gained momentum in recent years, yielding several observational and longitudinal studies. However, experimental tests demonstrating a causal role of affective responses on exercise adherence are lacking. Given the need to devise exercise prescriptions that can facilitate adherence and promote regular physical activity, a Randomized Controlled Trial targeting individual pleasurable responses in a health-club setting will be conducted. The experimental protocol will compare two individualized evaluation, prescription, and supervision methods, adjusted for intensity, with the aim to explore their impact on behavioral, affective, and motivational outcomes. The planned study will be a pragmatic randomized, single-blinded, controlled superiority trial with two parallel groups and an allocation ratio of 1:1. Apparently healthy volunteer participants (N = 46) between 18 and 45 years old, who are not regularly active, will be randomly allocated to a control or experimental group. The control group will follow a general American College of Sports Medicine exercise prescription; the experimental group will follow the same prescription but with enhancements aimed at promoting pleasure: (1) individualization based on individual differences in preference for and tolerance of exercise intensity; (2) self-regulation of intensity; and (3) repeated assessments of core affect. The primary outcome will be post-intervention exercise-session attendance. Affective and motivational variables will be examined as secondary outcomes. The results are expected to advance exercise prescriptions by promoting affective regulation, thus helping to improve exercise adherence and related outcomes. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT05416593.


Subject(s)
Fitness Centers , Sports , Humans , Adolescent , Young Adult , Adult , Middle Aged , Pleasure , Exercise , Exercise Therapy , Randomized Controlled Trials as Topic
5.
Psychol Sport Exerc ; 69: 102490, 2023 11.
Article in English | MEDLINE | ID: mdl-37665925

ABSTRACT

Affective responses during exercise have been identified as a predictor of exercise adherence. However, research has been mostly limited to aerobic and resistance exercise. Considering that stretching activities are also an important component of physical fitness, this quasi-experimental study was designed to: 1) compare affective responses during and immediately after stretching exercises in apparently healthy adults, and 2) assess the consistency and repeatability of affect ratings obtained one week apart. For this purpose, we analyzed the Feeling Scale (FS) and Felt Arousal Scale (FAS) ratings using Time (during and after stretching) x Intensity (light, moderate, vigorous) x Stretched Muscle Group (quadriceps, hamstrings, glutes, latissimus dorsi, triceps) with repeated measures analysis of variance (ANCOVA) in 34 participants (21 males; aged 32.8 ± 8.6 years). The repeatability of FS and FAS ratings was assessed using two-way random-effects models, Intraclass Correlation Coefficients (ICC), and Bland-Altman plots. FS scores were higher following the stretching exercises, whereas FAS scores were lower, particularly in the vigorous intensity. In general, the inter-day repeatability for FS and FAS measurements was good across muscle groups. ICC tended to be higher at vigorous intensities. Ratings of core affect can be collected during static passive stretches using the FAS and FAS in ecologically valid settings. These results suggest that an adequate assessment of core affective responses to stretching activities should be performed during the exercises.


Subject(s)
Exercise Therapy , Exercise , Adult , Male , Humans , Physical Fitness , Arousal , Correlation of Data
6.
Sports Med ; 53(10): 1865-1890, 2023 10.
Article in English | MEDLINE | ID: mdl-37561389

ABSTRACT

The literature on high-intensity interval training (HIIT) contains claims that, if true, could revolutionize the science and practice of exercise. This critical analysis examines two varieties of claims: (i) HIIT is effective in improving various indices of fitness and health, and (ii) HIIT is as effective as more time-consuming moderate-intensity continuous exercise. Using data from two recent systematic reviews as working examples, we show that studies in both categories exhibit considerable weaknesses when judged through the prism of fundamental statistical principles. Predominantly, small-to-medium effects are investigated in severely underpowered studies, thus greatly increasing the risk of both type I and type II errors of statistical inference. Studies in the first category combine the volatility of estimates associated with small samples with numerous dependent variables analyzed without consideration of the inflation of the type I error rate. Studies in the second category inappropriately use the p > 0.05 criterion from small studies to support claims of 'similar' or 'comparable' effects. It is concluded that the situation in the HIIT literature is reminiscent of the research climate that led to the replication crisis in psychology. As in psychology, this could be an opportunity to reform statistical practices in exercise science.


Subject(s)
High-Intensity Interval Training , Humans , Exercise
7.
J Sport Exerc Psychol ; 45(3): 121-137, 2023 Jun 01.
Article in English | MEDLINE | ID: mdl-36889325

ABSTRACT

This study compared the effects of an increasing-intensity (UP) and a decreasing-intensity (DOWN) resistance training protocol on affective responses across six training sessions. Novice participants (Mage 43.5 ± 13.7 years) were randomly assigned to UP (n = 18) or DOWN (n = 17) resistance training groups. Linear mixed-effects models showed that the evolution of affective valence within each training session was significantly moderated by the group (b = -0.45, p ≤ .001), with participants in the UP group reporting a decline in pleasure during each session (b = -0.82) and the DOWN group reporting an improvement (b = 0.97; ps < .001). Remembered pleasure was significantly higher in the DOWN group compared to the UP group (b = 0.57, p = .004). These findings indicate that a pattern of decreasing intensity throughout a resistance exercise session can elicit more positive affective responses and retrospective affective evaluations of resistance training.


Subject(s)
Resistance Training , Humans , Retrospective Studies , Affect , Exercise/psychology , Pleasure , Randomized Controlled Trials as Topic
8.
J Sport Exerc Psychol ; 45(2): 77-91, 2023 Apr 01.
Article in English | MEDLINE | ID: mdl-36898385

ABSTRACT

For decades, the exercise psychology research literature echoed the conclusion that exercise makes most people feel better, with no clear evidence that this "feel-better effect" is moderated by intensity. An overhaul of the methodological approach subsequently showed that high-intensity exercise is experienced as unpleasant, and the "feel-better effect," although possible, is conditional and therefore not as robust or prevalent as initially thought. Recently, several studies investigating high-intensity interval training (HIIT) have concluded that HIIT is pleasant and enjoyable, despite the high intensity. Considering that HIIT is emerging as an option in physical activity recommendations and exercise prescription guidelines, in part due to these claims, a methodological checklist is presented to aid researchers, peer reviewers, editors, and other readers in critically appraising studies examining the effects of HIIT on affect and enjoyment. This first part addresses the characteristics and number of participants, as well as the selection of measures of affect and enjoyment.


Subject(s)
High-Intensity Interval Training , Pleasure , Humans , High-Intensity Interval Training/psychology , Checklist , Happiness , Exercise/psychology
9.
J Sport Exerc Psychol ; 45(2): 92-109, 2023 Apr 01.
Article in English | MEDLINE | ID: mdl-36898386

ABSTRACT

Recent studies have concluded that high-intensity interval training should be seen as a "viable alternative" to, and may be more enjoyable than, moderate-intensity continuous exercise. If true, these claims have the potential to revolutionize the science and practice of exercise, establishing high-intensity interval training as not only a physiologically effective exercise modality but also a potentially sustainable one. However, these claims stand in contrast to voluminous evidence according to which high levels of exercise intensity are typically experienced as less pleasant than moderate levels. To help researchers, peer reviewers, editors, and critical readers appreciate possible reasons for the apparently conflicting results, we present a checklist that identifies crucial methodological elements in studies investigating the effects of high-intensity interval training on affect and enjoyment. This second installment covers how "high-intensity" and "moderate-intensity" experimental conditions are defined, the timing of assessments of affect, the modeling of affective responses, and data interpretation.


Subject(s)
High-Intensity Interval Training , Pleasure , Humans , High-Intensity Interval Training/psychology , Checklist , Oxygen Consumption/physiology , Happiness
10.
Sports Med ; 53(1): 1-5, 2023 01.
Article in English | MEDLINE | ID: mdl-35687251

ABSTRACT

The global health and wellness industry has an estimated value of US$4 trillion. Profits derive from heath club memberships, exercise classes, diets, supplements, alternative 'therapies', and thousands of other products and services that are purported to improve health, recovery, and/or sports performance. The industry has expanded at an alarming rate, far outstripping the capacity of federal bodies to regulate the market and protect consumer interests. As a result, many products are sold on baseless or exaggerated claims, feigned scientific legitimacy, and questionable evidence of safety and efficacy. This article is a consciousness raiser. Herein, the implications of the mismatch between extraordinary health and performance claims and the unextraordinary scientific evidence are discussed. Specifically, we explore how pseudoscience and so-called 'quick fix' interventions undermine initiatives aimed at evoking long-term behavior change, impede the ongoing pursuit of sports performance, and lead to serious downstream consequences for clinical practice. Moreover, pseudoscience in health and wellness, if left unchecked and unchallenged, may have profound implications for the reputation of exercise science as a discipline. This is a call to action to unify exercise scientists around the world to more proactively challenge baseless claims and pseudoscience in the commercial health and wellness industry. Furthermore, we must shoulder the burden of ensuring that the next generation of exercise scientists are sufficiently skilled to distinguish science from pseudoscience, and information from mis- and disinformation. Better population health, sports performance, and the very reputation of the discipline may depend on it.


Subject(s)
Athletic Performance , Pseudoscience , Humans , Exercise , Dietary Supplements , Diet
11.
Health Psychol Rev ; 17(2): 211-226, 2023 06.
Article in English | MEDLINE | ID: mdl-35094640

ABSTRACT

The SMART acronym (e.g., Specific, Measurable, Achievable, Realistic, Timebound) is a highly prominent strategy for setting physical activity goals. While it is intuitive, and its practical value has been recognised, the scientific underpinnings of the SMART acronym are less clear. Therefore, we aimed to narratively review and critically examine the scientific underpinnings of the SMART acronym and its application in physical activity promotion. Specifically, our review suggests that the SMART acronym: is not based on scientific theory; is not consistent with empirical evidence; does not consider what type of goal is set; is not applied consistently; is lacking detailed guidance; has redundancy in its criteria; is not being used as originally intended; and has a risk of potentially harmful effects. These issues are likely leading to sub-optimal outcomes, confusion, and inconsistency. Recommendations are provided to guide the field towards better practice and, ultimately, more effective goal setting interventions to help individuals become physically active.


Subject(s)
Exercise , Goals , Humans
12.
Behav Res Methods ; 53(5): 2092-2104, 2021 10.
Article in English | MEDLINE | ID: mdl-33754323

ABSTRACT

The ability to distinguish between discrete emotions by monitoring autonomic or facial features has been an elusive "holy grail" for fields such as psychophysiology, affective computing, and human-computer interface design. However, cross-validated models are lacking, and contemporary theory suggests that emotions may lack distinct physiological or facial "signatures." Therefore, in this study, we propose a reorientation toward distinguishing between pleasant and unpleasant affective valence. We focus on the acoustic eyeblink response, which exhibits affective modulation but remains underutilized. The movement of the eyelid was monitored in a contactless manner via infrared reflectance oculography at 1 kHz while 36 participants viewed normatively pleasant, neutral, and unpleasant images, and 50-ms bursts of white noise were presented binaurally via headphones. Startle responses while viewing pleasant images exhibited significantly smaller amplitudes than those while viewing unpleasant images, with a large effect size (d = 1.56). The affective modulation of the eyeblink startle response is a robust phenomenon that can be assessed in a contactless manner. As research continues on whether systems based on psychophysiological or facial features can distinguish between discrete emotions, the eyeblink startle response offers a relatively simple way to distinguish between pleasant and unpleasant affective valence.


Subject(s)
Blinking , Reflex, Startle , Acoustics , Electromyography , Emotions , Humans , Photic Stimulation
13.
Health Psychol Rev ; 15(1): 34-50, 2021 03.
Article in English | MEDLINE | ID: mdl-31900043

ABSTRACT

Goal-setting is a widely used and accepted strategy for promoting physical activity. Locke and Latham's goal-setting theory is the primary theoretical framework for setting goals in psychology and plays a prominent role in physical activity promotion. Recently, however, there have been calls to reconsider current goal-setting practice in this field. Therefore, we aimed to critically review and update the application of goal-setting theory in physical activity promotion, by examining core developments in this theory since 1990. Current practice relies on setting specific 'performance' goals as a means of increasing physical activity (e.g., 10,000 steps; national physical activity guidelines). This approach was initially consistent with key tenets of goal-setting theory. However, since 1990 this theory has evolved to differentiate between performance and learning goals. Both goal types are context-dependent and it is now recognised that, in some cases, performance goals can even be detrimental to the achievement of desired outcomes. Consequently, current practice may be theoretically appropriate for physically active individuals but a different approach (e.g., learning goals) may be preferable for inactive individuals who are new to physical activity (i.e., most of the population). We conclude by discussing implications for policy, research, and practice in goal-setting for physical activity promotion.


Subject(s)
Exercise , Goals , Humans , Learning , Motivation , Sedentary Behavior
14.
Int J Psychophysiol ; 158: 114-122, 2020 12.
Article in English | MEDLINE | ID: mdl-33080298

ABSTRACT

OBJECTIVE: Interest in automatic associations of exercise and physical activity as potential contributors to behavior is rising. However, the measurement of these associations presents a challenge, since the reliability and validity of behavioral tests (despite their widespread usage) is unsatisfactory by most accounts. As a possible alternative, an electroencephalographic (EEG) index (i.e., P3b amplitude) was examined in the present study. DESIGN: We used a mixed-factor design, with one group of insufficiently and one group of sufficiently physically active participants being compared across different experimental conditions. METHODS: Thirty-seven insufficiently and thirty-six sufficiently active participants viewed exercise-related images presented within series of negative, neutral, or positive images and rated all images as negative (unpleasant) or positive (pleasant) while EEG recordings were obtained. The amplitude of the P3b component of the EEG-derived event-related potential, time-locked to the onset of exercise images in each context (series), was extracted as the dependent variable. RESULTS: Insufficiently active participants rated the exercise-related images as neutral-to-positive, whereas sufficiently active participants rated the images as positive. However, all participants exhibited the smallest P3b amplitude when the images were presented in the neutral context, suggesting that the images were registering as neutral. CONCLUSION: Exercise-related images may evoke neutral automatic associations, but these associations may differ from how individuals reflectively rate the same images. P3b amplitude may be useful in detecting such discrepancies and potentially a promising (evidence-based) option for assessing automatic associations of exercise stimuli.


Subject(s)
Electroencephalography , Emotions , Evoked Potentials , Exercise , Humans , Reproducibility of Results
15.
J Sport Exerc Psychol ; 41(5): 271-288, 2019 Oct 01.
Article in English | MEDLINE | ID: mdl-31469367

ABSTRACT

Studies of automatic associations of sedentary behavior, physical activity, and exercise are proliferating, but the lack of information on the psychometric properties of relevant measures is a potential impediment to progress. The purpose of this review was to critically summarize measurement practices in studies examining automatic associations related to sedentary behavior, physical activity, and exercise. Of 37 studies, 27 (73%) did not include a justification for the measure chosen to assess automatic associations. Additional problems have been noted, including the nonreporting of psychometric information (validity, internal consistency, test-retest reliability) and the lack of standardization of procedures (e.g., number, type of stimuli). The authors emphasize the need to select measures based on conceptual arguments and psychometric evidence and to standardize measurement procedures. To facilitate progress, the review concludes with a proposal for conceptually appropriate validation criteria to be used in future studies.

16.
J Sport Health Sci ; 8(4): 325-338, 2019 Jul.
Article in English | MEDLINE | ID: mdl-31333885

ABSTRACT

OBJECTIVE: Research on methods of improving the affective experience of exercise remains limited, especially for low-active overweight adults. We investigated the effectiveness of a virtual-reality headset and headphones in improving affective responses over conventionally delivered audiovisual stimulation. METHODS: Low-active, overweight adults (16 women, 5 men; age: 34.67 ± 9.62 years; body mass index: 28.56 ± 4.95 kg/m²; peak oxygen uptake for men: 29.14 ± 6.56 mL/kg/min, for women: 22.67 ± 4.52 mL/kg/min, mean ± SD) completed 15-min sessions of recumbent cycling at the ventilatory threshold: (a) high immersion (HI, virtual reality headset and headphones), (b) low immersion (LI, television screen and speakers), and (c) Control. During-exercise pleasure and post-exercise enjoyment were self-reported. Oxygenation of the right dorsolateral prefrontal cortex (dlPFC) was assessed with near infrared spectroscopy. RESULTS: Higher pleasure was reported during HI than during LI and Control (Condition × Time interaction; p < 0.001, η p 2 = 0.43). Participants who reported a preference for low exercise intensity showed higher dlPFC oxygenation during Control, but this difference diminished during LI and HI (Condition × Time × Preference interaction; p = 0.036, ηp 2 = 0.10). CONCLUSION: Compared with conventionally delivered audiovisual stimulation, using a virtual-reality headset strengthens the dissociative effect, further improving affective responses to exercise at the ventilatory threshold among overweight, low-active adults. Presumably by competing with interoceptive afferents at the level of sensory input, audiovisual stimulation may lessen reliance on cognitive efforts to attenuate declining affect, as indicated by lower right dlPFC activity, particularly among participants disinclined toward high exercise intensity.

17.
J Exp Biol ; 222(Pt 3)2019 02 04.
Article in English | MEDLINE | ID: mdl-30559299

ABSTRACT

The search for variables involved in the regulation and termination of exercise performance has led to integrative models that attribute a central role to the brain and utilize an array of psychological terms (e.g. sensation, perception, discomfort, tolerance). We propose that theorizing about exercise regulation would benefit from establishing cross-disciplinary bridges to research fields, such as affective psychology and neuroscience, in which changes along the dimension of pleasure-displeasure are considered the main channel via which homeostatic perturbations enter consciousness and dictate corrective action (slowing down or stopping). We hypothesized that ratings of pleasure-displeasure would respond to the severity of homeostatic perturbation and would be related to time to exhaustion during exercise performed at an unsustainable intensity. In a within-subjects experiment (N=15, 13 men and 2 women, age 23.4±2.2 years; maximal oxygen uptake 46.0±8.0 ml kg-1 min-1), we compared the slope of ratings of pleasure-displeasure (acquired every 1 min) during cycling exercise at a power output 10% above critical power until volitional termination under glycogen-loaded and glycogen-depleted conditions. As hypothesized, ratings of pleasure-displeasure declined more steeply under glycogen depletion (P=0.009, d=0.70) and correlated closely with time to exhaustion under both glycogen-loaded (r=0.85; P<0.001) and glycogen-depleted conditions (r=0.83; P<0.001). We conclude that in exercise, as in other domains, changes in pleasure-displeasure may be the main channel via which homeostatic perturbations enter consciousness. This proposal may have important implications for conceptualizing and identifying the neurobiological mechanisms of the sense of exertional physical fatigue.


Subject(s)
Exercise Tolerance , Fatigue/psychology , Physical Exertion , Pleasure , Adult , Female , Humans , Male , Young Adult
18.
J Sports Sci ; 36(16): 1860-1871, 2018 Aug.
Article in English | MEDLINE | ID: mdl-29350586

ABSTRACT

Exercise or physical activity are recommended options within stepped-care treatment models for depression. However, few physicians present these options to patients, in part because of the impression that the supporting evidence is weak or inconsistent. We speculate that the coocurrence of "counter-messaging" and deficient critical appraisal may lead to such impressions. We focus on TREAD-UK (ISRCTN16900744), the largest trial to investigate "whether physical activity can be an effective treatment for depression within primary care". In media statements, researchers declared that exercise was ineffective in lowering depression. We examined (a) the results of the trial, critiques, and rejoinders, (b) the impact on internet searches, and (c) whether TREAD-UK was critically appraised, as reflected in citing articles. We show that the results of TREAD-UK were misrepresented. The media campaign resulted in a fourfold increase in relevant internet searches. Of articles characterising the results, 57% adopted the interpretation that exercise failed to lower depression, whereas only 17% were critiques. We identify similarities to media portrayals of the OPERA (ISRCTN43769277), DEMO (NCT00103415), and DEMO-II trials (NCT00695552). We note a disconcerting trend of media campaigns that misrepresent the effects of exercise on depression and call for increased scrutiny in peer reviewing both pre- and post-publication.


Subject(s)
Depression/therapy , Exercise Therapy , Information Dissemination , Mass Media , Randomized Controlled Trials as Topic , Evidence-Based Medicine/standards , Humans , Randomized Controlled Trials as Topic/standards , Research Design/standards , Treatment Failure , United Kingdom
19.
Front Psychiatry ; 9: 762, 2018.
Article in English | MEDLINE | ID: mdl-30687141

ABSTRACT

Major depression shortens life while the effectiveness of frontline treatments remains modest. Exercise has been shown to be effective both in reducing mortality and in treating symptoms of major depression, but it is still underutilized in clinical practice, possibly due to prevalent misperceptions. For instance, a common misperception is that exercise is beneficial for depression mostly because of its positive effects on the body ("from the neck down"), whereas its effectiveness in treating core features of depression ("from the neck up") is underappreciated. Other long-held misperceptions are that patients suffering from depression will not engage in exercise even if physicians prescribe it, and that only vigorous exercise is effective. Lastly, a false assumption is that exercise may be more harmful than beneficial in old age, and therefore should only be recommended to younger patients. This narrative review summarizes relevant literature to address the aforementioned misperceptions and to provide practical recommendations for prescribing exercise to individuals with major depression.

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