Effect of Menstrual Cycle Phase on Perceived Exertion During Aerobic Exercise in Eumenorrheic Women: A Systematic Review and Meta-analysis.

Background: The rating of perceived exertion (RPE) is a readily available and practical tool widely used in exercise science to monitor exercise load, but a rigorous review of the effect of menstrual cycle (MC) phases on RPE within continuous aerobic exercise has not yet been completed. Objective: This study investigated the effects of the MC phase on RPE during aerobic exercise. Study Design: This was a systematic review and meta-analysis. Methods: The search strategy was carried out using the 5 most common scientific databases. While qualitative analyses were performed in all included studies, random effects to standard mean difference were calculated and meta-analysis was performed where possible. This study addresses comparison for RPE at the beginning, middle, and end of the exercise adopting 2 mains analysis. The first adopted early cycle (first session of the cycle) as control compared with the subsequent phases, and the second adopted days 1 to 5 (early follicular) as control compared with the subsequent phases. Results: A total of 17 studies (n = 160) were included in the qualitative synthesis. The meta-analysis showed that MC phases did not impact RPE (P > .05). Conclusions: The current meta-analysis showed that MC does not impact RPE. Although acute RPE is not impacted by MC phases, future studies and practitioners should pay attention to the impact of RPE session by session throughout the MC.

Examining the effects of increasing then decreasing exercise intensity within a session of aerobic exercise.

Recent studies have examined the relations between the slope of pleasure experienced during exercise and remembered pleasure, forecasted pleasure, and enjoyment. OBJECTIVES: This study advances this line of research by examining the effects of exposing participants to exercise that increases in intensity and then decreases in intensity. METHODS: In a within-subjects design, participants completed three exercise sessions matched for total and average work. One session steadily increased in intensity, another steadily decreased in intensity, and a third increased-then-decreased in intensity. Remembered pleasure, forecasted pleasure, and exercise enjoyment served as primary outcome variables. RESULTS: Remembered pleasure, forecasted pleasure, and enjoyment did not differ between conditions. Remembered pleasure was positively associated with mean experienced pleasure, the overall slope of pleasure during the exercise session, affect experienced at the end of exercise, forecasted pleasure, accomplishment, and enjoyment. CONCLUSIONS: These data add to a growing literature on the effects of patterns of exercise intensity on affective responses to exercise. The results are discussed in context of previous and more recent research.

Psychophysiological Responses to High-Intensity Interval Training Exercise over Menstrual Cycle Phases: An Exploratory Study.

INTRODUCTION: Although there is potential for the menstrual cycle to impact psychophysiological responses to exercise, there has been a paucity of studies investigating this aspect, specifically in the context of high-intensity interval training (HIIT). PURPOSE: This exploratory study aimed to examine the psychophysiological responses to HIIT over the menstrual cycle. METHODS: Twenty-three healthy and physically active young women were recruited. Each woman completed a cycle ergometer HIIT session in the menstrual, follicular, and luteal phases of the menstrual cycle in a random order. Psychophysiological variables of interest were collected at baseline, and during and after exercise. Primary variables of interest were anxiety, mood, motivation, enjoyment, arousal, affect, and menstrual distress. RESULTS: Higher pain, water retention, behavior change (related to social interactions, eating habits, and self-performance), and autonomic reactions (consisting of nausea, dizziness, hot flashes, and cold sweats) were observed before HIIT during the menstrual phase compared to the follicular phase (p < 0.05). Participants exhibited worse psychological responses to HIIT sessions during the menstrual phase, followed by the luteal phase. Findings also noted participants arrived to the laboratory with lower motivation to initiate HIIT sessions during the luteal and menstrual phases compared to the follicular phase. This difference was observed before and during HIIT. Motivation and depressive symptoms showed a significant reduction from pre-HIIT to post-HIIT (p < 0.05), regardless of menstrual phase. CONCLUSIONS: The findings revealed that the menstrual cycle had a significant impact on psychophysiological responses. Moreover, HIIT could be adopted to improve motivation and depressive symptoms, however, further research is needed to explore the effects of HIIT across the menstrual cycle in women with clinical depression.

Exercise Prescription Practices Among Mental Health Professionals on College Campuses: Testing the Information-Motivation-Behavioral Skills Model.

BACKGROUND: The co-occurrence of physical inactivity and poor mental health in the college student population can lead to chronic health issues that have negative short-term effects (e.g., academic success). Poor mental health is associated with long-term conditions (e.g., obesity, serious mental illness) that are linked to premature mortality. The purpose of this study was to examine the information-motivation-behavioral (IMB) skills model and evaluate its ability to explain the variance in the use of exercise prescription in mental health treatment. METHOD: Mental health professionals (MHPs) (n = 255) were recruited from college counseling centers in the USA. Structural equation modeling was used to examine the relationship between the predictor variables of information (exercise knowledge and benefits of exercise), motivation (personal beliefs, perceived barriers, and organizational support), and behavioral skills (self-efficacy), and the outcome variable of exercise prescription (i.e., brief counseling and referral for exercise). RESULTS: The predictors accounted for 23% of the variance in exercise prescription (p = .001). Organizational support had a significant direct effect on exercise prescription (ß = 0.27, p = .05). Personal beliefs (ß = 0.96, p = .05) and organizational support (ß = 0.31, p = .04) had significant direct effects on self-efficacy for prescribing exercise. MHP personal exercise behavior was associated with exercise prescription. CONCLUSION: MHPs may be willing to support physical activity promotion and exercise prescription, but organizational structures are critical to enhance and sustain the delivery of this adjunctive therapy. The personal exercise history of MHPs may be an important consideration for behavior change interventions. The development and validation of scales are important considerations for future intervention study design.

Psychophysiological Responses to Self-Selected Exercise Intensity Over the Menstrual Cycle: A Randomized Crossover Phase Trial.

Purpose: This study investigated the psychophysiological responses during self-selected exercise intensity over the course of the menstrual cycle (MC). Methods: Seventeen healthy women with regular MCs completed three randomized treadmill bouts of 30 min of self-selected exercise intensity during menstruation, mid-follicular, and late luteal phases. Anxiety, menstrual distress (i.e., pain, behavior change, autonomic reaction, fluid retention, and negative affect) and profile of mood (i.e., tension, depression, and anger) were measured before exercise. Arousal, heart rate (HR), motivation, rating of perceived exertion and affective valence were measured before, during and after each exercise session. Results: Anger, anxiety, behavior change, pain, and negative affect were significantly greater (p < .05) during menstruation compared to the mid-follicular phase, whereas fluid retention, anger, behavior change, and autonomic reaction were greater (p < .05) during the late luteal phase compared with the mid-follicular phase. Participants felt more negative affective valence and less motivation to start exercise during menstruation compared with other MC phases. Average treadmill speed (5.8 ± 1.1 vs 6.0 ± 0.7 vs 5.9 ± 0.7 km/h-1, p = .36) and %HRmax (74.9 ± 3.2 vs 77.8 ± 5.4 vs 77.4 ± 7.1%, p = .40) did not differ between menstruation, mid-follicular, and late luteal phases. Also, noteworthy is that participants self-selected an intensity that exceeded the minimum levels recommended for health and cardiorespiratory fitness promotion (64-70% HRmax). Conclusions: Results of this study indicate that psychophysiological responses are negatively impacted mainly during menstruation and the late luteal phase of the MC. These findings may be helpful for professionals who work to promote the initiation and maintenance of exercise in women.

Patient reported physical and mental health changes associated with a comprehensive cardiovascular risk reduction program for women with breast cancer receiving potentially cardiotoxic chemotherapy.

OBJECTIVE: Women with breast cancer (BCA) and cardiovascular disease (CVD) risk factors are at increased risk of developing cardiovascular complications when exposed to potentially cardiotoxic cancer therapy. The benefit of aggressive CVD risk factor modification to reduce adverse treatment-related psychologic and biologic effects is not well established. METHODS: Using a single group pre-test, post-test design, 33 women with BCA receiving anthracycline and/or trastuzumab therapy participated in a 6-month comprehensive CVD risk reduction program involving formal cardio-oncology evaluation along with regular motivational counseling for improved nutrition and physical activity. Study parameters were assessed at baseline and 6 months with paired t-tests used to evaluate changes after the intervention. RESULTS: The mental component summary score assessed by SF-36V2 improved significantly after program completion (45.0 to 48.8, effect size 0.37, p = 0.017), however the physical component summary score declined (46.2 to 40.9, effect size - 0.53, p = 0.004). Despite this decline in perceived physical health, markers of health-related fitness and nutritional status were maintained or improved. Systolic and diastolic blood pressure also improved after the intervention (136.7 to 124.1 mmHg, p = 0.001 and 84.0 to 78.7 mmHg, p = 0.031, respectively). No significant change in resting heart rate, body mass index, lipids, hemoglobin A1C, or left ventricular ejection fraction was observed. CONCLUSIONS: Patient-reported mental health improved significantly in women with BCA enrolled in a comprehensive CVD risk reduction program despite exposure to potentially cardiotoxic therapies. This study provides preliminary data for future randomized controlled trials evaluating the effects CVD risk reduction program in high-risk breast cancer cohorts.

The effect of menstrual cycle and exercise intensity on psychological and physiological responses in healthy eumenorrheic women.

Psychological responses such as affect, mood, motivation, anxiety are important considerations for exercise adherence. A large body of evidence indicates that exercise intensity is a controllable variable capable of increasing positive feelings. Investigations thus far, however, have not considered that the higher incidence of negative psychological responses in women could be due to physiological particularities of the menstrual cycle (MC). This project investigates the effect of MC phases and exercise intensity on psychophysiological responses in fourteen healthy, eumenorrheic and physically active women. Measuring psychophysiological responses before, during and after exercise, participants completed two exercise bouts of 15 min above and below the anaerobic threshold in the follicular phase (FP) and the luteal phase (LP) of the MC. Lower levels of depression and hostility and higher levels of vigor, affect and motivation were observed during exercise in the FP. Exercise at moderate intensity elicited more positive psychological responses compared to high-intensity exercise, highlighted by findings that affect and rating of perceived exertion were worse in the LP without changes in physiological responses. These findings suggest no effect of MC on physiological responses, but psychological responses are impaired in the LP, worsening particularly during exercise at high intensity.

Psychological Responses to High-Intensity Interval Training: A Comparison of Graded Walking and Ungraded Running at Equivalent Metabolic Loads.

High-intensity interval training (HIIT) is highly beneficial for health and fitness and is well tolerated. Treadmill-based HIIT normally includes running interspersed with walking. The purpose of this study was to compare ungraded running and graded walking HIIT on perceived exertion, affective valence, and enjoyment. Thirty-four active, healthy adults completed maximal testing and two 20-min HIIT trials alternating between 85% of VO2peak and a comfortable walking speed. Affective valence, enjoyment, and perceived exertion, both overall (ratings of perceived exertion [RPE]-O) and legs only (RPE-L), were measured. RPE-O and affective valence were similar between HIIT trials (p > .05), RPE-L was higher for walk HIIT (p < .05), and enjoyment was higher for run HIIT (p < .05). Findings indicate that both walk and run HIIT produce exertion, affective, and enjoyment responses that are positive and possibly supportive of exercise behavior. Walk HIIT may be desirable for individuals who are unable or do not want to run.

Affective and enjoyment responses in high intensity interval training and continuous training: A systematic review and meta-analysis.

Previous studies investigating the effects of high intensity interval training (HIIT) and moderate intensity continuous training (MICT) showed controversial results. The aim of the present study was to systematically review the literature on the effects of HIIT and MICT on affective and enjoyment responses. The PRISMA Statement and the Cochrane recommendation were used to perform this systematic review and the database search was performed using PubMed, Scopus, ISI Web of Knowledge, PsycINFO, and SPORTDiscus. Eight studies investigating the acute affective and enjoyment responses on HIIT and MICT were included in the present systematic review. The standardized mean difference (SMD) was calculated for Feeling Scale (FS), Physical Activity Enjoyment Scale (PACES) and Exercise Enjoyment Scale (EES). The MICT was used as the reference condition. The overall results showed similar beneficial effects of HIIT on PACES and EES responses compared to MICT with SMDs classified as small (PACES-SMD = 0.49, I2 = 69.3%, p = 0.001; EES-SMD = 0.48, I2 = 24.1%, p = 0.245) while for FS, the overall result showed a trivial effect (FS-SMD = 0.19, I2 = 78.9%, p<0.001). Most of the comparisons performed presented positive effects for HIIT. For the FS, six of 12 comparisons showed beneficial effects for HIIT involving normal weight and overweight-to-obese populations. For PACES, six of 10 comparisons showed beneficial effects for HIIT involving normal weight and overweight-to-obese populations. For EES, six of seven comparisons showed beneficial effects for HIIT also involving normal weight and overweight-to-obese populations. Based on the results of the present study, it is possible to conclude that HIIT exercise may be a viable strategy for obtaining positive psychological responses. Although HIIT exercise may be recommended for obtaining positive psychological responses, chronic studies should clarify the applicability of HIIT for exercise adherence.

Randomized, clinical trial of RT001: Early signals of efficacy in Friedreich's ataxia.

BACKGROUND: RT001 is a deuterated ethyl linoleate that inhibits lipid peroxidation and is hypothesized to reduce cellular damage and recover mitochondrial function in degenerative diseases such as Friedreich's ataxia. OBJECTIVE: To evaluate the safety, pharmacokinetics, and preliminary efficacy of RT001 in Friedreich's ataxia patients. DESIGN/METHODS: We conducted a phase I/II double-blind, comparator-controlled trial with 2 doses of RT001 in Friedreich's ataxia patients (9 subjects each cohort). Subjects were randomized 2:1 to receive either RT001 (1.8 or 9.0 g/day), or a matching dose of nondeuterated ethyl linoleate as comparator for 28 days. The primary endpoints were safety, tolerability, and pharmacokinetic analysis. Secondary endpoints included cardiopulmonary exercise testing and timed 25-foot walk. RESULTS: Nineteen patients enrolled in the trial, and 18 completed all safety and efficacy measurements. RT001 was found to be safe and tolerable, with plasma levels approaching saturation by 28 days. One subject with a low body mass index experienced steatorrhea taking a high dose and discontinued the study. Deuterated arachidonic acid (a brain-penetrant metabolite of RT001) was found to be present in plasma on day 28. There was an improvement in peak workload in the drug group compared to placebo (0.16 watts/kg; P = 0.008), as well as an improvement trend in peak oxygen consumption (change of 0.16 L/min; P = 0.116), and in stride speed (P = 0.15). CONCLUSIONS: RT001 was found to be safe and tolerable over 28 days, and improved peak workload. Further research into the effect of RT001 in Friedreich's ataxia is warranted. © 2018 International Parkinson and Movement Disorder Society.

Exergame Grading Scheme: Concept Development and Preliminary Psychometric Evaluations in Cancer Survivors.

The challenge of using exergames to promote physical activity among cancer survivors lies in the selection of the exergames that match their fitness level. There is a need for a standardized grading scheme by which to judge an exergame's capacity to address specific physical fitness attributes with different levels of physical engagement. The study aimed to develop an Exergame Grading Scheme and preliminarily evaluate its psychometric properties. Fourteen (14) items were created from the human movement and exergame literature. The content validity index (CVI) was rated by content experts with two consecutive rounds (N = 5 and N = 3 independently). The interrater reliability (IRR) was determined by two raters who used the Exergame Grading Scheme to determine the grading score of the five exergames performed by two cancer survivors (N = 10). Each item had a score of 1 for item-level CVI and 1 for k. For IRR, 9 items had rho values of 1, 1 item had 0.93, and 4 items had between 0.80 and 0.89. This valid and reliable Exergame Grading Scheme makes it possible to develop a personalized physical activity program using any type of exergame or fitness mobile application in rehabilitation practice to meet the needs of cancer survivors.

Comparison of Powerlifting Performance in Trained Men Using Traditional and Flexible Daily Undulating Periodization.

Colquhoun, RJ, Gai, CM, Walters, J, Brannon, AR, Kilpatrick, MW, D'Agostino, DP, and Campbell, WI. Comparison of powerlifting performance in trained men using traditional and flexible daily undulating periodization. J Strength Cond Res 31(2): 283-291, 2017-Daily undulating periodization (DUP) is a growing trend, both in practice and in the scientific literature. A new form of DUP, flexible daily undulating periodization (FDUP), allows for athletes to have some autonomy by choosing the order of their training. The purpose of this study was to compare an FDUP model to a traditional model of DUP on powerlifting performance in resistance-trained men. Twenty-five resistance-trained men were randomly assigned to one of 2 groups: FDUP (N = 14) or DUP (N = 11). All participants possessed a minimum of 6 months of resistance training experience and were required to squat, bench press, and deadlift 125, 100, and 150% of their body mass, respectively. Dependent variables assessed at baseline and after the 9-week training program included bench press 1 repetition maximum (1RM), squat 1RM, deadlift 1RM, powerlifting total, Wilks Coefficient, fat mass, and fat-free mass (FFM). Dependent variables assessed during each individual training session were motivation to train, Session Rating of Perceived Exertion (Session RPE), and satisfaction with training session. After the 9-week training program, no significant differences in intensity or volume were found between groups. Both groups significantly improved bench press 1RM (FDUP: +6.5 kg; DUP: +8.8 kg), squat 1RM (FDUP: +15.6 kg; DUP: +18.0 kg), deadlift 1RM (FDUP: +14.8 kg; DUP: +13.6 kg), powerlifting total (FDUP: +36.8 kg; DUP: +40.4 kg), and Wilks Coefficient (FDUP: +24.8; DUP: +26.0) over the course of study (p = <0.001 for each variable). There was also a significant increase in FFM (FDUP: +0.8 kg; DUP: +0.8 kg) for both groups (p = 0.003). There were no differences in motivation to train, session RPE, or satisfaction with training session measurements between groups (p = 0.369-0.702, respectively). In conclusion, FDUP seems to offer similar resistance training adaptations when compared with a traditional DUP in resistance-trained men.

Daily Physical Activity and Cognitive Function Variability in Older Adults.

Physical activity (PA) is believed to preserve cognitive function in older adulthood, though little is known about these relationships within the context of daily life. The present microlongitudinal pilot study explored within- and between-person relationships between daily PA and cognitive function and also examined within-person effect sizes in a sample of community-dwelling older adults. Fifty-one healthy participants (mean age = 70.1 years) wore an accelerometer and completed a cognitive assessment battery for five days. There were no significant associations between cognitive task performance and participants' daily or average PA over the study period. Effect size estimates indicated that PA explained 0-24% of within-person variability in cognitive function, depending on cognitive task and PA dose. Results indicate that PA may have near-term cognitive effects and should be explored as a possible strategy to enhance older adults' ability to perform cognitively complex activities within the context of daily living.

A comparison of the impacts of continuous and interval cycle exercise on perceived exertion.

Ratings of perceived exertion (RPE) were developed to assess exertion during exercise testing. However, assessments of RPE prior to and after exercise have become common and potentially important in understanding exercise behaviour. The purpose of this project was to compare RPE taken before, during and after interval and continuous exercise sessions. Twenty-four participants (12 men, 12 women, body mass index = 24, VO2peak = 41 mL · kg · min(-1)) completed a maximal cycle ergometer test used to prescribe experimental trials: (1) moderate continuous (MC), (2) vigorous continuous (VC), (3) vigorous interval and (4) severe interval. All trials were 20 minutes in length and all intervals utilised 60-second segments and a 1:1 work-to-rest ratio. Predicted exertion was highest in the continuous vigorous trial (p < .05). Exertion increased from beginning to end in all trials (p < .05). Session RPE values were highest for the continuous vigorous trial (p < .05). Findings suggest that interval protocols produce perceptions of effort that are lower than VC exercise but similar to MC exercise. These results help describe the perceptions of effort associated with continuous and interval exercise and suggest that interval exercise can be performed with lower perceived work, which may encourage increased participation.

Affective and Enjoyment Responses to High-Intensity Interval Training in Overweight-to-Obese and Insufficiently Active Adults.

High-intensity interval training (HIIT) has many known physiological benefits, but research investigating the psychological aspects of this training is limited. The purpose of the current study is to investigate the affective and enjoyment responses to continuous and high-intensity interval exercise sessions. Twenty overweight-to-obese, insufficiently active adults completed four counterbalanced trials: a 20-min trial of heavy continuous exercise and three 24-min HIIT trials that used 30-s, 60-s, and 120-s intervals. Affect declined during all trials (p < .05), but affect at the completion of trials was more positive in the shorter interval trials (p < .05). Enjoyment declined in the 120-s interval and heavy continuous conditions only (p < .05). Postexercise enjoyment was higher in the 60-s trial than in the 120-s trial and heavy continuous condition (p < .05). Findings suggest that pleasure and enjoyment are higher during shorter interval trials than during a longer interval or heavy continuous exercise.

The Impact of Continuous and Interval Cycle Exercise on Affect and Enjoyment.

UNLABELLED: Rates of physical activity remain low despite public health efforts. One form of physical activity that provides significant physiological benefit but has not been evaluated in terms of affective and enjoyment responses is interval exercise. PURPOSE: The purpose of this study was to compare affect and enjoyment assessed before, during, and after interval and continuous exercise sessions. METHOD: Twenty-four participants (12 men, 12 women; body mass index = 24 ± 4, maximal oxygen consumption = 41 ± 5 mL/kg/min) completed a maximal cycle ergometer test used to prescribe experimental trials: (a) moderate continuous, (b) heavy continuous, (c) heavy interval, and (d) severe interval. All trials were 20 min in length, and all intervals utilized 60-s segments and a 1:1 work-to-rest ratio. RESULTS: Affective and enjoyment responses were significantly less positive for the heavy continuous trials in comparison with all other trials during exercise (p < .05; ES = .2-.8). Additionally, both severe and heavy interval exercise were more enjoyable than heavy continuous exercise (p > .05). CONCLUSION: Findings suggest that interval protocols produce affective and enjoyment responses that are equal to moderate continuous exercise and more positive than heavy continuous exercise. These results indicate that interval-based exercise may be a viable alternative to continuous exercise in the promotion of health and fitness.

Differential impact of acute high-intensity exercise on circulating endothelial microparticles and insulin resistance between overweight/obese males and females.

BACKGROUND: An acute bout of exercise can improve endothelial function and insulin sensitivity when measured on the day following exercise. Our aim was to compare acute high-intensity continuous exercise (HICE) to high-intensity interval exercise (HIIE) on circulating endothelial microparticles (EMPs) and insulin sensitivity in overweight/obese men and women. METHODS: Inactive males (BMI = 30 ± 3, 25 ± 6 yr, n = 6) and females (BMI = 28 ± 2, 21 ± 3 yr, n = 7) participated in three experimental trials in a randomized counterbalanced crossover design: 1) No exercise control (Control); 2) HICE (20 min cycling @ just above ventilatory threshold); 3) HIIE (10 X 1-min @ ∼ 90% peak aerobic power). Exercise conditions were matched for external work and diet was controlled post-exercise. Fasting blood samples were obtained ∼ 18 hr after each condition. CD62E(+) and CD31(+)/CD42b- EMPs were assessed by flow cytometry and insulin resistance (IR) was estimated by homeostasis model assessment (HOMA-IR). RESULTS: There was a significant sex X exercise interaction for CD62E(+) EMPs, CD31(+)/CD42b- EMPs, and HOMA-IR (all P < 0.05). In males, both HICE and HIIE reduced EMPs compared to Control (P ≤ 0.05). In females, HICE increased CD62E(+) EMPs (P < 0.05 vs. Control) whereas CD31(+)/CD42b- EMPs were unaltered by either exercise type. There was a significant increase in HOMA-IR in males but a decrease in females following HIIE compared to Control (P<0.05). CONCLUSIONS: Overweight/obese males and females appear to respond differently to acute bouts of high-intensity exercise. A single session of HICE and HIIE reduced circulating EMPs measured on the morning following exercise in males but in females CD62E(+) EMPs were increased following HICE. Next day HOMA-IR paradoxically increased in males but was reduced in females following HIIE. Future research is needed to investigate mechanisms responsible for potential differential responses between males and females.