Healthy body, healthy mind?

The field of psychosomatic medicine has clearly established the idea that how we think and feel will affect the functioning of the body. What we do with our bodies may also affect how we think and feel, but this somatopsychic approach is less well established. This article aims to review what is known about the effects of physical activity on psychological function, and raise awareness of this research amongst psychologists

Maintaining physical activity in cardiac rehabilitation

This chapter describes an intervention that has been used to encourage individuals to remain regularly physically active in exercise-based CR in phases III and IV.The principles of this intervention are also appropriate for allphases of CR.This intervention, called the exercise consultation (EC), is based on the Transtheoretical Model of behaviour change and Relapse Prevention Model (pp.197-205), and uses cognitive and behavioural strategies to increaseand maintain physical activity (Loughlan and Mutrie,1995,1997). The strategies used in this EC include: assessing stage of change, decisional balance, overcoming barriers to activity, social support, goal setting, self-monitoring and relapse prevention. It involves a client-centred, one-to-one counselling approach and encourages individuals to develop an activity plan, tailored to their needs, readiness to change and lifestyle. The EC aims to encourage accumulated physical activity accumulating at least 30 minutes ofmoderate intensity activity on five days per week (Pate, et al., 1995, stage one, as discussed in Chapter 4). In addition, this level of physical activity may be easier for cardiac patients to incorporate into their daily routine and to sustainin the long term. Thus, the exercise consultation encourages individuals to integrate moderate intensity activity into their daily lives. In addition, EC can help maintain involvement in structured exercise in phases III and IV (SIGN, 2002)

Using pedometers as motivational tools : are goals set in steps more effective than goals set in minutes for increasing walking?

Background Pedometers are popular devices that measure walking steps. There has been a recent surge in promoting the pedometer as a motivational tool to increase walking. However, little empirical evidence exists to support this suggestion. This study examined the effectiveness of a pedometer as a motivational tool to increase walking. 50 participants (7 men and 43 women, mean age (SD) 40.16 (8.81) years, range 25-61 years) were randomly assigned to either an intervention group who followed a four-week walking programme with goals set in steps (using an open pedometer for feedback) or a comparison group who followed an equivalent four-week walking programme with goals set in minutes. Participants had step-counts recorded at baseline, weeks 1, 2, 3, 4, and at weeks 16 and 52 for follow-up. Both groups significantly increased step-counts from baseline to week 4 with no significant difference between groups. However, a significantly greater number of participants in the intervention group (77%) compared with the comparison group (54%) achieved their week 4 goals (p=0.03). There was no significant change in step-counts from week 4 to week 16. There was a significant decrease from week 16 to week 52. In the short term, both goals set in minutes and goals set in steps using a pedometer may be effective at promoting walking. In the long term, additional support may be required to sustain increases in walking

Motivations and barriers to participation in sport and exercise : a review of the literature

In considering a strategy for research development at the National Centre for Prosthetics and Orthotics, the importance of making accessibility and involvement in sport to those athletically inclined has become apparent. Preparation for the 2012 Paralympic Games in London and the 2014 Commonwealth Games in Glasgow highlights a need to champion sport for people with lower limb deficiency and empower those who might never have participated to become involved (Gold & Gold, 2007). We are all athletes in our own way; each individual has the right to fulfil their exercise potential. The White Paper on Sport (2007) by the Commission of European Communities stated that 'Sport has a greater influence than any social movement as a tool for health enhancing physical activity'. Importantly, the UK population with limb deficiency is predominantly elderly and has a sedentary lifestyle (Davies and Datta, 2003). Although there has been an increase in opportunities for these people to participate in sports due to better prosthetic components, the number of sports prostheses users remain relatively low. This appears to be linked to limited skills specific to disability sport within the rehabilitation and sports professional communities. The objective was to investigate the motivations and barriers to participation in physical activity and sports in a group of people with lower limb deficiency. A review was carried out by examining literature from a number of different sources. Articles were limited to those written in, or translated into English, and which focused on established users of lower limb prostheses. In future, the review will underpin ongoing doctoral research into how exercise and sport participation can be increased for our patients and how exercise concepts and knowledge can be enhanced in the undergraduate curriculum and professional communities. The work examines the motivations and barriers to exercise within the normal population, and how these issues might be compounded within the prostheses user population. The work also examines the type of psychological benefit the user can derive from physical activity and how patients can be encouraged to implement a healthy lifestyle change. In conclusion and because of its dynamic nature, increasing physical activity in all populations is challenging. The challenges of lower limb loss can seem insurmountable when compounded by an alteration in body image. Factors such as self-efficacy, social support, and perceived health benefits are all mutable and show potential for an increase in the chance of individual behaviour change in people with lower limb amputation. Integrating an achievable, realistic exercise regime into hospital based rehabilitation and importantly continuing this into community based sports initiatives for people with limb loss would capitalise on the clear relationship between physical activity and improved health and well-being

Alternative research strategies in the exercise - mental health relationship

From the numerous investigations available, there is cautious support for the proposition that exercise is associated with enhanced emotion and mood in mental illness, but the strength of the conclusions derived from the empirical findings available will largely depend on the strength of the designs applied. In applied research, such as the investigation of the exercise - mental health relationship, this relationship depends on population, environmental and individual characteristics and a number of difficulties will certainly hinder progress in this area of inquiry. Randomised controlled trials are important but have the disadvantage of deemphasizing the importance of the individual. Single-case designs on the other hand have considerable potential to adequately unravel the mechanisms at work in the exercise - mental health relationship. From a clinical perspective however, research findings should be viewed based on the support of earlier epidemiological evidence, suggesting that mental illness indeed might be associated with low activity/fitness and that those who maintain activity are less likely to develop mental illness

Encouraging stair walking

A motivational poster placed at a choice point between escalator and stair use, in a city centre underground station, doubled stair use. The study also showed that men and boys used the stairs more than women and girls both before and after the poster intervention, but there was no obvious explanation of this finding. Follow up interviews with 200 stair users or escalator users showed that motivational posters can change the behaviour of people who are not very active as not all those using the stairs were regularly active. The barriers to stair use were time, laziness, and effort, while the motivations for stair use were saving time and improving health. Women cited laziness as the key barrier to stair climbing and in comparison with men perceived stair climbing as requiring more effort

Better movers and thinkers (BMT):A quasi-experimental study into the impact of physical education on children's cognition—A study protocol

This study will extend on a pilot study and will evaluate the impact of a novel approach to PE, Better Movers and Thinkers (BMT), on students' cognition, physical activity habits, and gross motor coordination (GMC). The study will involve six mainstream state schools with students aged 9-11. years. Three schools will be allocated as the intervention condition and three as the control condition. The design of the study is a 16-week intervention with pre-, post- and 6. month follow-up measurements taken using the 'Cognitive Assessment System (CAS)' GMC tests, and the 'Physical Activity Habits Questionnaire for Children (PAQ-C).' Qualitative data will be gathered using student focus groups and class teacher interviews in each of the six schools. ANCOVA will be used to evaluate any effect of intervention comparing pre-test scores with post-test scores and then pre-test scores with 6. month follow-up scores. Qualitative data will be analysed through an iterative process using grounded theory. This protocol provides the details of the rationale and design of the study and details of the intervention, outcome measures, and the recruitment process. The study will address gaps within current research by evaluating if a change of approach in the delivery of PE within schools has an effect on children's cognition, PA habits, and GMC within a Scottish setting

Physical Activity Behaviour of Paediatric Patients with Type 1 Diabetes

Type 1 diabetes is a common chronic condition in children and young people and its prevalence is increasing worldwide. Paediatric patients with Type 1 diabetes can have poorer health and overall quality of life than their non-diabetic peers and some studies suggest that they may be less active than their non-diabetic peers. Regular physical activity has many potential health benefits for any young person but can also benefit areas of health specifically important for those with Type 1 diabetes. In addition being regularly active can reduce the risk of developing diabetic complications. Promoting physical activity participation in this population is important due to the potential health benefits that can be gained. Limited research has investigated the effectiveness of physical activity intervention in this group. It is therefore necessary for physical activity interventions targeting this group to be developed

Recruiting hard-to-reach populations to physical activity studies : evidence and experiences

Most researchers who are conducting research with a public health focus face difficulties in recruiting the segments of the population that they really want to reach. This symposium presented evidence and experiences on recruiting participants to physical activity research, including both epidemiological and intervention based studies. Results from a systematic review of recruitment strategies suggested that we know little about how best to recruit and highlighted the need for researchers to report this in more detail, including metrics of reach into the target population such as number, proportion, and representativeness of participants. Specific strategies used to optimise responses to a population-based mail survey were presented such as study promotion, survey design, multiple mailings, and personal engagement. Finally, using place based recruiting via schools or places of worship to target ethnic minority youth were discussed. Overall the symposium presenters suggested that we need to learn more about how best to recruit participants, in particular those typically under-represented, and that researchers need to apportion a similar amount of planning effort to their recruitment strategies as they do the their research design. Finally we made a plea for researchers to report their recruitment processes in detail