When Studying Affective Responses to Exercise, the Definition of "Intensity" Must Reference Homeostatic Perturbations: A Retort to Vollaard et al.

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.

Improving reflective evaluations of sport through repeated experiences of fun-rationale, design, feasibility, and acceptability of the PlayFit Youth Sport Program.

INTRODUCTION: Adolescents who drop out of sport often report that it had become less 'fun' and 'enjoyable' over time. Although preadolescent sport typically emphasizes experiences of fun, emphases on competition and elite performance often dominate during adolescence. We theorized that adherence to adolescent sport might be improved if the overarching goal were to maximize repeated experiences of fun during sport and, subsequently, increase reflective evaluations of sport enjoyment. To that end, this manuscript reports on the rationale and design of the PlayFit Youth Sport Program (PYSP), as well as its preliminary feasibility and acceptability. The main objectives were to evaluate the feasibility of recruitment strategies and data collection procedures and the acceptability of the intervention. SETTING: An outdoor, multipurpose grass field at a south-central Pennsylvania middle school. METHODS: A mixed-methods, single-arm feasibility trial lasting for 8 weeks (August-October 2021) offered 3-times per week for 1-h per session. The equipment, ruleset, and psychosocial environment of the PYSP sport games were modified to reduce several of the constraints theorized to impair experiences of fun during sport and hamper reflective evaluations of enjoyment afterward. RESULTS: Eleven healthy, but sedentary adolescents in grades 5-7 completed the program. The median number of sessions attended (of 16 possible) was 12 (range = 6-13). Post-intervention, 9/10 respondents indicated that they 'looked forward' to the PYSP, 8/10 would recommend it to a friend, and 8/10 were interested in continuing the program. Ten of 11 participant guardians expressed interest in reenrolling their children if the PYSP were offered again. Some changes recommended were to improve recruitment via advertising the positive aspects of the program and "word of mouth" techniques, offering the program immediately following the school day, having contingencies for inclement weather, and minor changes to the sport equipment to improve the experience among the population the PYSP intends to attract. CONCLUSIONS: The adjustments recommended in this preliminary work could be used to further refine the PYSP. A future efficacy trial could explore whether the PYSP may reduce attrition for adolescents who experience existing sport programs negatively by offering an alternative that better matches their unique needs and preferences.

Accuracy of Self-Reported Physical Capacities as a Clinical Screening Test for Older Adults With Mobility Disability.

Background: Screening for poor physical performance has the potential to identify older adults at risk for loss of future independence, yet clinically feasible measures have yet to be identified. Methods: Using data from the National Health and Aging Trends Study, we evaluated the diagnostic utility of self-reported physical capacities of older adults (walking three blocks or six blocks, climbing 10 stairs or 20 stairs) compared to the objectively measured Short Physical Performance Battery (SPPB). Sensitivity, specificity, and likelihood ratio (LR) were calculated across three SPPB cut-points (≤8, ≤9, ≤10). Results: Sensitivity of single item-measures for detecting a low SBBP averaged 0.39 (range: 0.26-0.52), specific averaged 0.97 (range: 0.94-0.99) and likelihood ratio averaged 20.0 (range: 9.0-35.5). Among age and gender subgroups, all measures maintained clinically applicable LRs (minimum = 4.59). Conclusion: Single-item self-reported physical capacities are accurate for screening older adults with physical limitations, making them potentially useful in healthcare settings.

Fostering weight status understanding among exercise science and health students by simulating common physical activities with additional body mass.

Overweight and obesity rates continue to rise and appear unlikely to abate. While physical activity (PA) is an important contributor to health and successful weight maintenance, exercise science and health students (ESHS) often endorse negative weight status biases that could undermine PA promotion. This experiential learning activity was intended to help foster weight status understanding among ESHS. Nine ESHS completed the learning activity across two 75-minute class periods. During the initial didactic lesson, the instructor presented on psychophysiological responses to PA among normal and overweight individuals. During the second simulation lesson, the students first responded with their predictions of how the experience of four common physical activities, including shoe tying, brisk walking, running, and climbing and descending stairs, could differ with additional body mass. Next, students twice completed each of the four physical activities while first wearing a weighted vest that simulated 16 lb followed by 32 lb of additional mass. At the beginning, middle, and end of the stair climb and descent, the students provided ratings of affective valence (i.e., pleasure-displeasure). Following the PA simulations, the students wrote about their experiences and how their PA promotion strategies could be modified for overweight clients. The changes in student qualitative responses, particularly following the 32-lb simulations, suggested an increased understanding of the psychophysiological experience of PA while carrying additional mass. Learning activities like this one may be meaningful additions to ESHS curricula aiming to mitigate weight status bias and improve PA promotion among overweight clients.NEW & NOTEWORTHY Exercise science and health students (ESHS) often enter the field with the noble intention to help people become more physically active. However, many ESHS endorse negative weight status biases that could undermine health promotion efforts among overweight individuals. Experiential learning simulations that approximate the experiences of physical activity while overweight may be helpful tools to foster understanding and reduce bias. This article outlines a two-part didactic/simulation learning activity to promote weight status understanding among ESHS.

A Methodological Checklist for Studies of Pleasure and Enjoyment Responses to High-Intensity Interval Training: Part I. Participants and Measures.

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.

A Methodological Checklist for Studies of Pleasure and Enjoyment Responses to High-Intensity Interval Training: Part II. Intensity, Timing of Assessments, Data Modeling, and Interpretation.

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.

When American Adults Do Move, How Do They Do So? Trends in Physical Activity Intensity, Type, and Modality: 1988-2017.

BACKGROUND: Few Americans accumulate enough physical activity (PA) to realize its benefits. Understanding how and why individuals use their discretionary time for different forms of PA could help identify and rectify issues that drive individuals away from certain physical activities, and leverage successful strategies to increase participation in others. METHODS: The authors analyzed approximately 30 years of changes in PA behavior by intensity, type, and mode, using data from the Behavioral Risk Factor Surveillance System. RESULTS: Since 1988, the proportions of adults most frequently engaging in exercise, sport, or lifestyle physical activity have changed noticeably. The most apparent changes from 1988 to 2017 were the proportions most frequently engaging in Exercise and Sport. In addition, the proportion of time reportedly spent in vigorous-intensity PA decreased over time, particularly among male respondents. Moreover, the proportion of Americans reporting an "Other" PA mode increased substantially, suggesting a growing need for a greater variety of easily accessible options for adult PA. CONCLUSIONS: Over time, a smaller proportion of American adults reported participating in sport and exercise modalities and reported engaging more frequently in low-intensity physical activities.

Adult outdoor group sport play during a pandemic: Feasibility, acceptability, and program adherence results from a study of modifications to mitigate COVID-19 risk.

The purpose of this study was to investigate the feasibility, acceptability, and short-term adherence to an adult outdoor group sport play program designed to maximize enjoyment that was modified to incorporate COVID-19 risk mitigation strategies. We enrolled 17 healthy, but sedentary, central Pennsylvania adults (mean age = 31.6 ± 7.3) without obesity via mail advertisements to participate in four, 60-minute sessions of instructor-led modified sport games (e.g., handball, Ultimate Frisbee, soccer) over a two-week period in October 2020. Durign recrutiment and the study period, there were approximately 1000-2000 new cases of COVID-19 daily in central Pennsylvania . The overall adherence rate to the sessions was 91%, and no participants reported new or existing COVID-19 symptoms or diagnoses during the two-week study period or 10-days following the final session. Despite enforcing mandatory COVID-19 safety measures (e.g., universal masking, social distancing), the participants reported enjoying the program and feeling socially connected with one another, while perceiving the program to be safe. Additionally, all participants expressed a desire to participate again, if the program were offered in the future. These results suggest that an outdoor group sport play program for adults can be feasible, acceptable, and well-adhered to despite enforcing mandatory COVID-19 safety precautions. Physical activity programs similar to the one presented here may provide an easily-adaptable approach to outdoor physical activity during the current and potential future pandemics that have viral transmission characteristics similar to COVID-19.

Contactless differentiation of pleasant and unpleasant valence: Assessment of the acoustic startle eyeblink response with infrared reflectance oculography.

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.

Comparative effectiveness of an adult social physical play versus traditional group exercise program for adherence and fitness: Protocol for a randomized-controlled trial.

Despite the myriad benefits associated with regular physical activity (PA), few American adults accrue sufficient weekly PA. Although "lack of time" is often cited as a correlate of physical inactivity, a growing body of evidence suggests that, perhaps more importantly, people allocate their leisure-time to activities they find more enjoyable than PA. These findings underscore the need to devise physical activities that will be chosen over other enjoyable, but less healthy, behavioral alternatives. As a first step in this direction, we designed a group social PA play program for adults, known as PlayFit. The overarching philosophy of PlayFit is that fun and enjoyment are among the most important influences on PA adherence. In PlayFit, traditional sport games are modified to fulfill basic psychological needs, in a non-competitive, and non-contact environment. We will randomize 280 sedentary adults 18-50 years of age to 12-months of PlayFit or traditional group exercise, matching the groups on intensity, frequency, and duration. The primary outcomes include cardiorespiratory fitness (VO2peak), group adherence, and group enjoyment. We hypothesize that, at 6 months, cardiorespiratory fitness will have increased to the same extent in both groups, but at 12 months, only those randomized to PlayFit will have maintained their fitness through better adherence than Group Exercise - and this outcome will be mediated by enjoyment of the assigned group. Findings from this study could provide evidence that a focus on providing fun and enjoyable PA experiences for adults may be a viable route toward improving PA adherence. A simple, inexpensive PA intervention, such as PlayFit, may represent one such approach to do so.

Feasibility and impact of a 1-minute daily functional exercise regimen prescribed to older adults by their primary care physician.

Despite the inverse relationship between physical activity (PA) and physical function, few older adults achieve PA recommendations. In response to observations that "lack of time" underlies reduced PA among older adults, recent work suggests even short bouts of PA can improve health and fitness. In addition, because they are frequently visited by older adults, an important conduit for PA promotion could be the primary care physician (PCP). However, most PCPs receive little training related to PA, rendering it difficult for them to offer meaningful counseling. Therefore, we explored the feasibility and impact of a PCP-prescribed one-minute daily functional exercise program, consisting of 30 s each of bodyweight push-ups and squats, among 24 patients 60 years of age or older. 42% of patients who were contacted started the exercise prescription and, over 24-weeks, completed approximately 114 sessions, while 75% completed at least half of the possible daily exercise sessions. As a group, the patients demonstrated increases in both maximal push-up and squat performance, though these increases plateaued following week-12. These preliminary results suggest that a PCP prescription of one-minute of daily functional exercise among older adult patients was feasible, acceptable, and effective for improving functional physical fitness. Given these findings, formal controlled research with recruitment from multiple clinics, random assignment to treatment conditions, and blinded assessments of objective functional physical performance should be pursued.

Mass media representations of the evidence as a possible deterrent to recommending exercise for the treatment of depression: Lessons five years after the extraordinary case of TREAD-UK.

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.