Theoretical Derivation of a Telephone-Based Health Coaching Intervention for Promoting Physical Activity and Healthy Nutrition.

Present research regarding interventions to change behavior suffers from insufficient communication of their theoretical derivation. This insufficient communication is caused by the restrictions imposed by most of the relevant scientific journals. This impedes further intervention development. In this article, a telephone-based health coaching (TBHC) intervention is introduced using a format outside these restrictions. This intervention is seen as a combination of (1) the activities performed with the target persons, i.e., its core, and (2) measures to ensure the quality of the intervention. The theoretical derivation of the core is presented. The core is seen to consist of (1) the style of coach-patient interaction and (2) the contents of this interaction. The style of coach-patient interaction was derived from self-determination theory and was concretized using motivational interviewing techniques. The contents of the coach-patient interaction were derived from the health action process approach and were concretized using behavior-change techniques. The derivation led to (1) a set of 16 coaching tools referring to the different states in which a patient might be and containing state-specific recommendations for performing the coaching session, and (2) guidelines for selecting the appropriate coaching tool for each session. To ensure the quality of the intervention, a coach-training program before and supervision sessions during the TBHC were added.

Social compensation of performance drops in dyadic exercises-Two experiments testing the role of relationship quality.

The purpose of this study was to analyze whether the social compensation of performance drops in a team setting depends on the relationship quality. Two experiments were conducted. Experiment 1: In a team-building condition, the relationship quality between subject and confederate was manipulated. The performance situation consisted of an isometric strength task. A joint team result had to be achieved in a second run, whereby the subject received manipulated feedback on the confederate's performance, hence suggesting a sudden drop. The results showed no compensation effect. Experiment 2: Given that one potential reason for the lack of effect appeared to be the isometric holding task, the study design was maintained, but the task was modified into a dynamic one. Performance drops were compensated for. However, the relationship quality did not affect compensation behavior. It is possible that implicit team building through the necessary joint agreement on goals interfered with the effect in both conditions.

Gaze behavior in social interactions between beach volleyball players-An exploratory approach.

Previous research has indicated that social interactions and gaze behavior analyses in a group setting could be essential tools in accomplishing group objectives. However, only a few studies have examined the impact of social interactions on group dynamics in team sports and their influence on team performance. This study aimed to investigate the effects of game performance pressure on the gaze behavior within social interactions between beach volleyball players during game-like situations. Therefore, 18 expert beach volleyball players conducted a high and a low game performance pressure condition while wearing an eye tracking system. The results indicate that higher game performance pressure leads to more and longer fixation on teammates' faces. A higher need for communication without misunderstandings could explain this adaptation. The longer and more frequent look at the face could improve the receiving of verbal and non-verbal information of the teammate's face. Further, players showed inter-individual strategies to cope with high game performance pressure regarding their gaze behavior, for example, increasing the number of fixations and the fixation duration on the teammate's face. Thereby, this study opens a new avenue for research on social interaction and how it is influenced in/through sport.

Effects of an Impulse on the Sterno-Cleido-Mastoid Muscle on Back Pain, Discomfort, and Well-Being: A Randomized Controlled Trial in People with Low Back Pain.

INTRODUCTION: In the treatment of low back pain (LBP), passive regimens (e.g., relaxation) as opposed to active regimens (e.g., muscle training) may be a useful adjunct or, in certain cases, the only possible approach. Passive relaxation may be particularly useful for individuals who have lost the ability to adequately perceive relaxed muscles. The aim of the randomized controlled trial presented here was to investigate a specific and novel treatment for passive relaxation, namely, the Vitametik impulse (VI). METHODS: Participants (n = 135; 73.3% women; 26.7% men) were individuals with mild to moderate LBP aged from 19 to 76 years (M = 48.8). The participants were randomly assigned to one of four different groups (three different 8-week interventions, one control group). Pain, discomfort, and well-being were measured before and after the intervention period and at an 8-week follow-up. RESULTS: In the VI group, the decrease in various pain variables and discomfort was higher compared to the control group and compared to an education program (EP). There were no differences between the VI group and a combined VI/EP group. The effects remained stable until follow-up. CONCLUSION: VI appears to be an effective approach in the treatment of LBP, although the underlying mechanism remains unproven. Future studies should compare VI treatment with specific relaxation techniques or active muscle training. In addition, the results of the study need to be replicated.

A pragmatic randomised controlled trial referring to a Personalised Self-management SUPport Programme (P-SUP) for persons enrolled in a disease management programme for type 2 diabetes mellitus and/or for coronary heart disease.

BACKGROUND: Type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD) are two chronic diseases that cause a tremendous burden. To reduce this burden, several programmes for optimising the care for these diseases have been developed. In Germany, so-called disease management programmes (DMPs), which combine components of Disease Management and the Chronic Care Model, are applied. These DMPs have proven effective. Nevertheless, there are opportunities for improvement. Current DMPs rarely address self-management of the disease, make no use of peer support, and provide no special assistance for persons with low health literacy and/or low patient activation. The study protocol presented here is for the evaluation of a programme that addresses these possible shortcomings and can be combined with current German DMPs for T2DM and CHD. This programme consists of four components: 1) Meetings of peer support groups 2) Personalised telephone-based health coaching for patients with low literacy and/or low patient activation 3) Personalised patient feedback 4) A browser-based web portal METHODS: Study participants will be adults enrolled in a DMP for T2DM and/or CHD and living in North Rhine-Westphalia, a state of the Federal Republic of Germany. Study participants will be recruited with the assistance of their general practitioners by the end of June 2021. Evaluation will be performed as a pragmatic randomised controlled trial with one intervention group and one waiting control group. The intervention group will receive the intervention for 18 months. During this time, the waiting control group will continue with usual care and the usual measures of their DMPs. After 18 months, the waiting control group will also receive a shortened intervention. The primary outcome is number of hospital days. In addition, the effects on self-reported health-state, physical activity, nutrition, and eight different psychological variables will be investigated. Differences between values at month 18 and at the beginning will be compared to judge the effectiveness of the intervention. DISCUSSION: If the intervention proves effective, it may be included into the DMPs for T2DM and CHD. TRIAL REGISTRATION: The study was registered in the German Clinical Trials Registry (Deutsches Register Klinischer Studien (DRKS)) in early 2019 under the number 00020592. This registry has been affiliated with the WHO Clinical Trials Network ( https://www.drks.de/drks_web/setLocale_EN.do ) since 2008. It is based on the WHO template, but contains some additional categories for which information has to be given ( https://www.drks.de/drks_web/navigate.do?navigationId=entryfields&messageDE=Beschreibung%20der%20Eingabefelder&messageEN=Description%20of%20entry%20fields ). A release and subsequent number assignment only take place when information for all categories has been given.

Motivational contagion during exercise and the role of interpersonal relationships: An experimental study.

The present research focused on the phenomenon of motivational contagion while being physically active. It can be assumed that communication with significant others impacts upon a person's behavior in situations where communication or interaction is not explicitly intended to change behavior. Specifically, the purpose of the two present studies was to examine the effect of positive (i.e., intrinsically connoted) and negative (i.e., extrinsically connoted) self-disclosure from a confederate on the motivational state of an individual simultaneously exercising with the confederate. These studies sought to replicate the experimental study of Scarapicchia, Andersen, & Bengoechea (2013). In addition, to test the further assumption that the relationship impacts upon contagion processes, we included a short team-building intervention involving our confederate and the participant in order to manipulate the relationship quality (Study 1) and to compare friends with strangers (Study 2). Our results show that the participants who were exposed to the intrinsic cues (e.g., "I enjoy riding the bike, it's great that there is a study about it") reported greater interest and enjoyment while exercising on the bicycle ergometer than those who were exposed to extrinsic cues (e.g., "I don't enjoy cycling at all. I'm only participating because my teacher told me to do so"). The relationship between the confederate and participant was not found to affect the main effect.

Effects of two types of dynamic office workstations (DOWs) used at two intensities on cognitive performance and office work in tasks with various complexity.

This study examines the possible effects on objective work performance while using two types of dynamic office workstations (DOWs). 20 participants each used one type with three intensities (seated, light, moderate) and completed a task battery assessing cognitive performance and office work with two levels of complexity. Repeated measures MANOVA showed a significant interaction effect for work performance between the type of workstation and intensity for the simple level and a significant main effect for intensity for the complex level. Comparing the types of DOWs to each other, accuracy of text processing differed when working sedentary. Using both devices with light and moderate intensity had a significant detrimental effect on mouse tasks compared to working sedentary, but none comparing the intensities. No further results indicated neither a detrimental nor an enhancing effect of using DOWs on cognitive performance and office-work related tasks, regardless of the intensity of use or the task complexity. Practitioner Summary: By using DOWs, light physical activity can be integrated while working at a desk. Results showed that using different types of DOWs with different intensities does have a detrimental effect on tasks requiring a high motor control, but not on cognitive or further office work-related tasks of various complexity. Abbreviations: DOW: dynamic office workstation; aLT: activeLife Trainer; DB: deskbike; RPE: rated perceived exertion; MANOVA: multivariate analysis of variance; ANOVA: analysis of variance.

Body Image in Athletes and Nonathletes With Low Back Pain: Avoidance-Endurance-Related Subgroups and Sports Status Play a Role.

CONTEXT: Low back pain (LBP) is a serious health problem, both in the general population as well as in athletes. Research has shown that psychosocial aspects, such as dysfunctional pain responses, play a significant role in the chronification of LBP. Recent research supports the relevance of the multidisciplinary concept of body image in the interpretation of LBP. OBJECTIVE: To examine the differences in 2 psychosocial aspects, body image and pain responses, between athletes and nonathletes with LBP. DESIGN: Cross-sectional design. SETTING: The questionnaires were distributed in the course of LBP treatment. PARTICIPANTS: Data from 163 athletes (mean age = 28.69 [9.6] y) and 75 nonathletes (mean age = 39.34 [12.63] y) were collected. INTERVENTIONS: Data were collected by questionnaires assessing body image, pain behavior, training activity, and LBP. MAIN OUTCOME MEASURES: To examine group differences between athletes and nonathletes regarding body image and pain behavior, the authors performed 2-way analyses of variance with Bonferroni post hoc tests. RESULTS: The results showed (1) a significant main effect regarding pain responses and body image, showing that participants with eustress endurance or adaptive pain behavior revealed a more positive body image in both groups compared with participants with distress endurance or fear-avoidance behavior, and (2) a significant main effect for the factor group in the body image dimension of physical efficacy, indicating a more positive body image for athletes. CONCLUSION: These results suggest that considering multiple risk factors for LBP, such as body image and dysfunctional pain behavior, as well as subgrouping, might be valuable for research and for broadening therapy options.

Cohesion and adherence in exercise groups of patients with chronic heart diseases - a prospective study.

Objective: In cardiac rehabilitation, long-term adherence to exercise prescription is an important prerequisite to reduce mortality and the risk of recurrent cardiac events. Cohesion seems to be an important predictor of adherence when exercise is conducted in prevention settings, but in clinical settings, this relationship is currently unknown. To address this gap, the goal of this study was to determine the relationship between group cohesion and adherence in cardiac rehabilitation programs considering the duration of membership as a moderator.Design: The study was conducted with 474 participants (21.7% women), in three rehabilitation centres in North Rhine Westphalia, Germany, assessing cohesion, adherence and group membership in outpatient cardiac exercise groups.Main Outcome Measures: Cohesion was assessed using the KIT-FG and adherence was operationalized as the total number of sessions attended over a 7-week period.Results: Moderated hierarchical stepwise regression analyses revealed that perceptions of the social dimension of group cohesion significantly predicted adherence behaviour only for members with a rather long duration of membership.Conclusion: Our findings suggest that cohesion might have a differential effect on an individual's decision to regularly participate in exercise, depending on the duration of membership in the group.

Stress in Physical Education Teachers: A Systematic Review of Sources, Consequences, and Moderators of Stress.

Purpose: The purpose of this systematic review was to identify sources of stress, consequences of chronic stress and moderators of stress in physical education teachers and to formulate implications for future research and teacher education. Methods: The initial search identified 2483 publications, including 47 that met the inclusion criteria. Results: The most important sources of stress in physical education teachers were the curriculum, inadequate facilities/equipment, the low status of PE and students´ discipline problems. Regarding the consequences of chronic stress, the majority of studies assessed burnout and reported low to moderate levels of burnout in general. However, of the studies that reported percentages, 20-25% of physical education teachers indicated high levels of burnout. Conclusions: Regarding the relationship between sources of stress and consequences of chronic stress in physical education teachers, future studies should (a) take into account the whole stress process (b) use more adequate measures for stress and (c) address potential moderators of stress. In terms of practical implications, PE teachers should receive an adequate pre- and in-service training that aims at being aware of the main sources of stress in PE teachers and building up adequate coping strategies. In addition, PE teacher education should consider interventions to prevent health consequences of stress such as voice disorders.

Psychological pain responses in athletes and non-athletes with low back pain: Avoidance and endurance matter.

BACKGROUND: Dysfunctional psychological pain responses, namely fear-avoidance (FAR), including catastrophizing and helplessness, as well as endurance-related responses (ER), including thought suppression and overactivity, have been shown to be risk factors for persistent low back pain (LBP). Literature suggests that athletes may differ from non-athletes regarding psychological responses to pain. OBJECTIVES: This study set out to compare FAR and ER between athletes and non-athletes with LBP. It was hypothesized that athletes would report less frequent FAR and more frequent ER, and that both FAR and ER are associated with LBP intensity and disability. METHODS: The 173 athletes and 93 non-athletes cross-sectionally reported how frequently they employ FAR and ER on the Avoidance-Endurance Questionnaire (AEQ), as well as LBP intensity and disability on the Chronic Pain Grade Questionnaire (CPGS). MANOVA was applied to compare FAR and ER between athletes and non-athletes. Hierarchical multiple linear regression models were used to determine the unique associations between FAR and ER with LBP intensity and disability. RESULTS: Athletes reported lower frequencies of behavioural avoidance than non-athletes, but no other FAR variables differed between the groups. Frequencies of ER did not differ between athletes and non-athletes. Regression analysis indicated substantial associations of FAR with LBP intensity, as well as of FAR and ER with disability in athletes and non-athletes. CONCLUSIONS: The results of the present study suggest that athletes and non-athletes with LBP differ regarding behavioural avoidance, but overall, differences regarding pain responses are marginal. FAR and ER are both reported in athletes and non-athletes and contribute to disability in both groups. SIGNIFICANCE: Athletes train to endure pain in the course of athletic socialization, at least in the context of exercise. However, there is sparsity of knowledge about psychological pain responses in athletes with low back pain and whether they differ from those in non-athletes. The results of this comparative study suggest that endurance responses are more frequent than avoidance responses among athletes and non-athletes alike. However, both types of responses seem relevant to clinical pain management in athletes as well as non-athletes.

Early Risk Detection of Burnout: Development of the Burnout Prevention Questionnaire for Coaches.

Introduction: Previous research has shown that burnout develops as the result of a continuous imbalance between chronic stress and appropriate coping resources. Hence, the essential factors to measure burnout encompassed the factors stress and recovery within our studies. However, the Burnout Prevention Questionnaire for Coaches (BPQ-C) does not represent a new questionnaire from scratch, but rather a re-evaluated, condensed, and subsequently combined instrument with scales derived from validated psychometric instruments. Methods: The objective of study 1 (N = 233) was to create and evaluate the psychometric structure of the BPQ-C. The aim of study 2 (N = 473) consisted in the validation of the BPQ-C via a Confirmatory Factor Analysis. Results: The Exploratory Factor Analysis resulted in a model with three dimensions (Pre-Burnout, Resources, and Burnout). Via the subsequent Confirmatory Factor Analysis, the model could be confirmed with good fit indices (χ2 = 96.898, df = 19, p < 0.001, CFI = 0.973, SRMR = 0.044, RMSEA = 0.093, LO90 = 0.075, HI90 = 0.112). Conclusion: The BPQ-C includes a number of previously established risk and protective factors within a single psychometric instrument. The systematic application of the BPQ-C can help to detect critical conditions at an early stage in order to derive individualized and beneficial interventions for the respective coaches.

Depression and suicidal ideation in high-performance athletes suffering from low back pain: The role of stress and pain-related thought suppression.

BACKGROUND: Depression and suicidal ideation are important health problems in athletes suffering from pain. Dysfunctional pain cognitions, that is, pain-related thought suppression (PTS), may play an important role in their aetiology. Thought suppression was shown to increase depressive mood, particularly in highly stressed individuals. This cross-sectional study examines the relationship between PTS and stress on depression and suicidal ideation in athletes with pain. METHODS: A total of 159 athletes with non-specific low back pain completed a set of questionnaires to measure PTS, depression and stress. Participants were split into groups with high and low stress, and high and low PTS. Two-way ANOVA calculated main effects for PTS, stress and a PTS*stress interaction, with depressive symptoms as dependent. Subsequently, distribution tests were calculated, investigating if the presence of clinically relevant depression and suicidal ideation is dependent of conditions of high/low PTS and stress. RESULTS: A main effect of stress demonstrated higher depression scores in highly stressed athletes. Further, a significant PTS*stress interaction showed elevated depression scores in athletes with high PTS and high stress. Distribution analysis revealed positive associations between PTS, stress and depression, with depression being most frequent among athletes with high PTS and high stress. Suicidal ideation was not significantly associated with PTS and only weakly correlated with stress. CONCLUSIONS: Our findings show that PTS is the most common pain response in athletes with pain. The results indicate a higher prevalence of depression and elevated depressive symptoms in athletes experiencing high stress, seemingly more pronounced when highly engaging in PTS. SIGNIFICANCE: This study contributes to the understanding of depression in athletes with pain, suggesting stress and pain-related thought suppression to increase symptoms and prevalence of depression. As athletes often experience acute or chronic pain, understanding the impact of pain cognitions on health outcomes is an important step in the optimization of treatments.

Examining the Presence of Back Pain in Competitive Athletes: A Focus on Stress and Recovery.

CONTEXT: Explanatory approaches for back pain (BP) in athletes focus on biomechanical factors while neglecting psychological perspectives. Psychological factors have gained importance in the prediction of injuries in athletes and BP in the general population, with stress and recovery emerging as central risk factors. However, scarce evidence exists regarding the role of these aspects for the prevalent burden of BP. OBJECTIVE: To investigate the association between stress and recovery parameters and the presence of BP. DESIGN: Cross-sectional design. SETTING: The questionnaires were distributed after the training sessions. PARTICIPANTS: A total of 345 competitive athletes (mean age = 18.31 y [SD = 5.40]) were investigated. The classification of the athletes' competitive status was based on performance level. INTERVENTIONS: Data were collected using questionnaires for the assessment of stress, recovery, and BP. MAIN OUTCOME MEASURES: The authors performed a multiple logistic regression to obtain odds ratios for stress and recovery parameters with regard to the outcome variable BP status. RESULTS: For stress, the dimension "overall stress" (odds ratio = 1.83; 95% confidence interval, 1.30-2.59; P = .001) and the scale "physical complaints" (odds ratio = 1.68; 95% confidence interval, 1.25-2.25; P = .001) of the general version of the Recovery-Stress Questionnaire resulted to be significantly associated with BP. None of the recovery-related scales displayed a statistically significant relationship with BP. CONCLUSION: The outcomes of this study imply a modest association between stress and the presence of BP in competitive athletes. Practitioners may take these findings into account regarding the conception of training and for monitoring purposes.

Body image is more negative in patients with chronic low back pain than in patients with subacute low back pain and healthy controls.

Background and aims Body image as an increasing research field has been integrated into pain research within the last years. However, research on cognitive-affective dimensions of body image dependent on different pain groups like acute/subacute and chronic pain patients, and healthy controls is still lacking. Therefore, this study aims to explore three dimensions of body image, namely self-acceptance, physical efficacy, and health in patients with low back pain and healthy controls. The present study is the first to distinguish between patients with low back pain in different stages of pain with regard to the concept of body image. In a second step we investigated the differences in exercise frequency between the three groups. Methods Seventy seven patients (53.2% female) suffering from low back pain and 57 healthy controls (42.1% female) filled in a battery of questionnaires in terms of body image, pain parameters and exercise frequency. Results Main results indicate first that patients suffering from chronic low back pain revealed a more negative body image in all three body image-dimensions than healthy controls. Second, patients suffering from subacute pain revealed a more negative body image of physical efficacy compared to the healthy controls. Conclusions Our results suggest that body image is relevant for the treatment of low back pain, because patients suffering from low back pain revealed a more negative body image than healthy controls. Implications To investigate the cognitive-affective dimensions of body image in different patient groups suffering from low back pain seems to be an important aspect for future research to improve therapy options and prevention of low back pain. Future research should also focus on improvements or on positive aspects of body image in patients with low back pain.

Dynamic Office Workstations: Initial Insights into User Usability Evaluations and Motivation.

Dynamic office workstations present a promising way to address the problem of inactivity at work, as they combine light physical activity with office tasks. In order to overcome the lack of structured implementation of such devices in office environments and the difficulty of stimulating employees to engage in healthy behaviors, the aim of this study was to investigate employees' motivation and perceived usability (e.g. operability) regarding the use of dynamic office workstations. Two different types of devices were made available to 30 employees (13 females, 17 males, mean ± SD = 43 ± 11.51 years) for 6 weeks. Motivation to the use of the workstations was assessed pre- and post-intervention, and usability was assessed post-intervention. Descriptive statistics and Wilcoxon tests were conducted. Employees reported the usability of the workstations to be acceptable, as they did not impede their work activities, whilst they were autonomously motivated towards using either workstation. Dynamic office workstations are suitable for daily use, although a flexible use of such devices should be guaranteed, depending on the task at hand.

Introducing a Dynamic Workstation in the Office: Insights in Characteristics of Use and Short-Term Changes of Well-Being in a 12 Week Observational Study.

The present field study evaluates the use of dynamic workstations (cycling devices) in a real-life office environment. Specific characteristics of use were recorded and possible relationships with short-term changes in well-being were investigated. For a period of 12 weeks, 36 employees were given free access to eight devices. Frequency, duration and speed of use were self-determined but registered objectively for every event of use. Immediately before and after using a cycling device, employees rated their well-being with a modified version of the EZ-scale from Nitsch to assess changes in the short-term. In total, 817 events of use were registered. On each day of the intervention period one of the devices was used. Participants used the devices between one day to all days present at the office, for 21.09 (SD 0.58) to 31.58 (SD 2.19) minutes on average per event of use per day. Comparing the pre- and post-measurements, a significant increase in well-being after using a cycling device was found. Results of a Generalized Estimating Equations (GEE) analysis showed mixed effects for the duration of use, the speed and variation of speed on the probability of reporting positive changes in recovery, calmness and mood. Therefore, using cycling devices in the office might improve short-term well-being.

Use and physiological responses of portable dynamic office workstations in an occupational setting - A field study.

OBJECTIVE: The aim of this study was to investigate the use of two types of dynamic workstations (Deskbike, activeLife Trainer) and their effects on physiological activation in an occupational setting. METHODS: 30 employees were given access to the devices for 28 days. Frequency and duration of borrowing and use was recorded by a Chipcard-system. Physiological activation (energy expenditure, heart rate) while working in a seated position and using the workstations was measured with the activity tracker Fitbit Charge HR. RESULTS: Participants used dynamic workstations on 40% of their working days for an average of 54.3 ±â€¯23.9 min per day. Energy expenditure and heart rate increased significantly while using the workstations compared to working seated. The Deskbike was used more frequently and resulted in greater heart rate elevation. CONCLUSION: Both types of dynamic workstations were used by the employees and had positive effects on physiological activation. The implementation of either type can be recommended.

Stress and risk for depression in competitive athletes suffering from back pain - Do age and gender matter?

Back pain (BP), a prominent problem for competitive athletes, is a primary reason for limitations in athletic performance and daily life restrictions. As studies on the relationship between psychological variables and BP in athletes are scarce, the aim of this study was to investigate stress and depression in competitive athletes with BP. In a cross-sectional design, data of 154 competitive athletes (51% female; Mage = 18.81 years, SDage = 5.05 years) were collected, assessing Performance stress, Socio-emotional stress, Risk for depression and Psychological well-being and the two BP parameters BP Intensity and Disability. Two multiple linear regressions were conducted to predict (1) BP Intensity and (2) Disability from Performance stress, Socio-emotional stress, Risk for depression and Psychological well-being. Multiple linear regressions demonstrated that Performance stress (ß = .21, p = .01) was the only significant predictor of BP Intensity (F1,142 = 6.68, p = .01, R2 = .05), whilst Risk for depression (ß = .24, p = .01) was the only significant predictor of Disability (F1,142 = 8.46, p = .01, R2 = .06). Neither gender nor age explained a significant amount of variance in the models. Study results showed that, as in the general population, the variables stress and depression are related to BP in competitive athletes. In particular, BP intensity was found to be associated with stress and BP-related disability was associated with depression, whereas age and gender showed no association with the BP parameters. A longitudinal investigation is warranted to determine the direction of the observed relationships.