Verbal Encouragement and Between-Day Reliability During High-Intensity Functional Strength and Endurance Performance Testing

As verbal encouragement (VE) is used in high intensity functional exercise testing, this randomized controlled crossover study aimed at investigating whether VE affects high intensity functional strength and endurance performance testing. We further examined between-day variability of high intensity functional strength and endurance performance testing with and without VE. Nineteen experienced athletes (seven females and 12 males, age: 23.7 ± 4.3 years) performed a standardized one repetition maximum (1 RM) squat test and a 12-min high-intensity functional training (HIFT) workout [as many repetitions as possible (AMRAP)] on four different days over a 2-week period. Athletes randomly performed each test twice, either with VE or without (CON), with a minimum of 72 h rest between tests. Very good to excellent relative between-day reliability with slightly better values for strength testing (ICC: 0.99; CV: 3.5–4.1%) compared to endurance testing (ICC 0.87–0.95; CV: 3.9–7.3%) were observed. Interestingly, VE led to higher reliability during endurance testing. Mean squat strength depicted higher strength values with VE (107 ± 33 kg) compared to CON (105 ± 33 kg; p = 0.009, Cohen’s d: 0.06). AMRAP in the endurance test showed negligible differences between VE (182 ± 33 AMRAP) and CON (181 ± 35 AMRAP; p = 0.71, Cohen’s d: 0.03). In conclusion, the effects of VE do not notably exceed day-to-day variability during high intensity functional strength (CV: 3.5–4.1%) and endurance (CV: 3.9–7.3%) testing. However, high intensity functional strength and endurance testing with VE seems to be slightly more reliable, particularly during endurance testing

Long-term outcomes of physical activity counseling in in-patients with major depressive disorder: results from the PACINPAT randomized controlled trial.

Major depressive disorder (MDD) is an increasingly common psychiatric illness associated with a high risk of insufficient physical activity, which in turn is associated with negative mental and physical health outcomes. Theory-based, individually tailored, in-person and remote physical activity counseling has the potential to increase physical activity levels in various populations. Given this, the present study investigated the effect of such a physical activity intervention on the physical activity behavior of in-patients with MDD. This was a multi-center, two-arm randomized controlled trial including initially insufficiently physically active adult in-patients with MDD from four study sites in Switzerland. The sample consisted of 220 participants (Mage = 41 ± 12.6 years, 52% women), 113 of whom were randomized to the intervention group and 107 to the control group. The main outcome, moderate-to-vigorous physical activity (MVPA), was assessed at three time points via hip-worn accelerometer. According to accelerometer measures, there was no significant difference in minutes spent in MVPA over a 12-month intervention period when comparing the intervention with the control group (β = -1.02, 95% CI = -10.68 to 8.64). Higher baseline physical activity significantly predicted physical activity at post and follow-up. This study showed that it is feasible to deliver an individually tailored, theory-based physical activity counseling intervention to in-patients with MDD, however yielding no significant effects on accelerometer-based MVPA levels. Further efforts are warranted to identify efficacious approaches.Trial registration: ISRCTN, ISRCTN10469580, registered on 3rd September 2018, https://www.isrctn.com/ISRCTN10469580

Short-term outcomes of physical activity counseling in in-patients with Major Depressive Disorder: Results from the PACINPAT randomized controlled trial

IntroductionA physical activity counseling intervention based on a motivation-volition model was developed and delivered to in-patients with Major Depressive Disorders with the aim of increasing lifestyle physical activity. The aim of this study is to evaluate the short-term outcomes of this intervention.MethodsA multi-center randomized controlled trial was conducted in four Swiss psychiatric clinics. Adults who were initially insufficiently physically active and were diagnosed with Major Depressive Disorder according to ICD-10 were recruited. The sample consisted of 113 participants in the intervention group (Mage = 42 years, 56% women) and 107 in the control group (Mage = 40 years, 49% women). Motivation and volition determinants of physical activity were assessed with questionnaires. Implicit attitudes were assessed with an Implicit Association Test. Physical activity was self-reported and measured with hip-worn accelerometers over 7 consecutive days starting on the day following the data collection.ResultsAccording to accelerometer measures, step count decreased on average 1,323 steps less per day (95% CI = −2,215 to −431, p < 0.01) over time in the intervention group compared to the control group. A trend was recognized indicating that moderate-to-vigorous physical activity decreased on average 8.37 min less per day (95% CI = −16.98 to 0.23, p < 0.06) over time in the intervention group compared to the control group. The initial phase of the intervention does not seem to have affected motivational and volitional determinants of and implicit attitudes toward physical activity.ConclusionPhysical activity counseling may be considered an important factor in the transition from in-patient treatment. Methods to optimize the intervention during this period could be further explored to fulfill the potential of this opportunity.Clinical trial registrationhttps://www.isrctn.com/ISRCTN10469580, identifier ISRCTN10469580

Verbal encouragement and between-day reliability during high-intensity functional strength and endurance performance testing

As verbal encouragement (VE) is used in high intensity functional exercise testing, this randomized controlled crossover study aimed at investigating whether VE affects high intensity functional strength and endurance performance testing. We further examined between-day variability of high intensity functional strength and endurance performance testing with and without VE. Nineteen experienced athletes (seven females and 12 males, age: 23.7 ± 4.3 years) performed a standardized one repetition maximum (1 RM) squat test and a 12-min high-intensity functional training (HIFT) workout [as many repetitions as possible (AMRAP)] on four different days over a 2-week period. Athletes randomly performed each test twice, either with VE or without (CON), with a minimum of 72 h rest between tests. Very good to excellent relative between-day reliability with slightly better values for strength testing (ICC: 0.99; CV: 3.5-4.1%) compared to endurance testing (ICC 0.87-0.95; CV: 3.9-7.3%) were observed. Interestingly, VE led to higher reliability during endurance testing. Mean squat strength depicted higher strength values with VE (107 ± 33 kg) compared to CON (105 ± 33 kg; = 0.009, Cohen's d: 0.06). AMRAP in the endurance test showed negligible differences between VE (182 ± 33 AMRAP) and CON (181 ± 35 AMRAP; = 0.71, Cohen's d: 0.03). In conclusion, the effects of VE do not notably exceed day-to-day variability during high intensity functional strength (CV: 3.5-4.1%) and endurance (CV: 3.9-7.3%) testing. However, high intensity functional strength and endurance testing with VE seems to be slightly more reliable, particularly during endurance testing

Verbal encouragement and between-day reliability during high-intensity functional strength and endurance performance testing

As verbal encouragement (VE) is used in high intensity functional exercise testing, this randomized controlled crossover study aimed at investigating whether VE affects high intensity functional strength and endurance performance testing. We further examined between-day variability of high intensity functional strength and endurance performance testing with and without VE. Nineteen experienced athletes (seven females and 12 males, age: 23.7 $\pm$ 4.3 years) performed a standardized one repetition maximum (1 RM) squat test and a 12-min high-intensity functional training (HIFT) workout [as many repetitions as possible (AMRAP)] on four different days over a 2-week period. Athletes randomly performed each test twice, either with VE or without (CON), with a minimum of 72 h rest between tests. Very good to excellent relative between-day reliability with slightly better values for strength testing (ICC: 0.99; CV: 3.5–4.1%) compared to endurance testing (ICC 0.87–0.95; CV: 3.9–7.3%) were observed. Interestingly, VE led to higher reliability during endurance testing. Mean squat strength depicted higher strength values with VE (107 $\pm$ 33 kg) compared to CON (105 $\pm$ 33 kg; $\it p$ = 0.009, Cohen’s d: 0.06). AMRAP in the endurance test showed negligible differences between VE (182 $\pm$ 33 AMRAP) and CON (181 $\pm$ 35 AMRAP; $\it p$ = 0.71, Cohen’s d: 0.03). In conclusion, the effects of VE do not notably exceed day-to-day variability during high intensity functional strength (CV: 3.5–4.1%) and endurance (CV: 3.9–7.3%) testing. However, high intensity functional strength and endurance testing with VE seems to be slightly more reliable, particularly during endurance testing

Cardiorespiratory fitness, perceived fitness and autonomic function in in-patients with different depression severity compared with healthy controls.

Over 300 million individuals worldwide suffer from major depressive disorder (MDD). Individuals with MDD are less physically active than healthy people which results in lower cardiorespiratory fitness (CRF) and less favorable perceived fitness compared with healthy controls. Additionally, individuals with MDD may show autonomic system dysfunction. The purpose of the present study was to evaluate the CRF, perceived fitness and autonomic function in in-patients with MDD of different severity compared with healthy controls. We used data from 212 in-patients (age: 40.7 ± 12.6 y, 53% female) with MDD and from 141 healthy controls (age: 36.7 ± 12.7 y, 58% female). We assessed CRF with the Åstrand-Rhyming test, self-reported perceived fitness and autonomic function by heart rate variability (HRV). In specific, we used resting heart rate, time- and frequency-based parameters for HRV. In-patients completed the Beck Depression Inventory-II (BDI-II) to self-assess the subjectively rated severity of depression. Based on these scores, participants were grouped into mild, moderate and severe MDD. The main finding was an inverse association between depression severity and CRF as well as perceived fitness compared with healthy controls. Resting heart rate was elevated with increasing depression severity. The time-based but not the frequency-based autonomic function parameters showed an inverse association with depression severity. The pattern of results suggests that among in-patients with major depressive disorder, those with particularly high self-assessed severity scores show a lower CRF, less favorable perceived fitness and partial autonomic dysfunction compared to healthy controls. To counteract these conditions, physical activity interventions may be effective

An implementation evaluation of the physical activity counseling for in-patients with major depressive disorder (PACINPAT) intervention: a randomized controlled trial

Abstract Background The physical activity counseling for in-patients with major depression (PACINPAT) randomized controlled trial was launched to tackle physical inactivity for in-patients with major depressive disorder. Evidence shows that despite potential treatment effects, physical inactivity is prevalent in this population. To contribute to the assessment of how this in-person and remote, theory-based, individually tailored intervention was designed, received and effected behavior, the aim of this study was to evaluate its implementation. Methods This implementation evaluation was conducted within a multi-center randomized controlled trial according to the Process Evaluation Framework by the Medical Research Council including the analysis of reach, dose, fidelity and adaptation. Data were collected from the implementers and the participants randomized to the intervention group of the trial. Results The study sample comprised 95 physically inactive in-patients (mean age: 42 years, 53% women) with diagnosed major depressive disorder. The intervention reached the intended population (N = 95 in-patients enrolled in the study). The intervention dose varied between early dropouts (counseling sessions, M = 1.67) and study completers with some participants receiving a low dose (counseling sessions, M = 10.05) and high dose (counseling sessions, M = 25.37). Differences in the attendance groups were recognizable in the first two counseling sessions (duration of counseling session about 45 min in early dropouts versus 60 min for study completers). Fidelity of the in-person counseling content was partly achieved and adapted, whereas that of the remote counseling content was well achieved. Participants (86% at follow up) reported satisfaction with the implementers of the intervention. Adaptations were made to content, delivery mode and dose. Conclusion The PACINPAT trial was implemented in the intended population, in varying doses and with adaptations made to in-person counseling content and remote counseling dose. These findings are key to understanding outcome analyses within the PACINPAT trial, further developing interventions and contributing to implementation research among in-patients with depressive disorders. Trial registration ISRCTN, ISRCTN10469580 , registered on 3rd September 2018

The impact of lifestyle Physical Activity Counselling in IN-PATients with major depressive disorders on physical activity, cardiorespiratory fitness, depression, and cardiovascular health risk markers: study protocol for a randomized controlled trial

Major depressive disorder (MDD) is a widespread and burdensome psychiatric issue. Physical activity counselling may increase lifestyle physical activity and cardiorespiratory fitness in this specific and particularly vulnerable population, which often suffers from both mental and physical health problems. Therefore, this study will examine the impact of a lifestyle physical activity counselling intervention on physical activity, cardiorespiratory fitness, depression, and cardiovascular health risk markers among in-patients diagnosed with MDD compared to controls. Secondary purposes are to examine the acceptability and perceived usefulness of the intervention among these patients, to find out whether the effectiveness of the intervention is moderated by genetic factors, and to compare baseline values with an age- and gender-matched group of healthy controls.; The study is designed as a multi-centric two-arm randomized clinical trial including an intervention group and a placebo control group, allocation concealment, single-blinding, and intention-to-treat analysis. Participants (N = 334) will be continuously recruited from four clinics specialized in the treatment of MDD. The intervention builds on a standardized, theory-based, low-cost lifestyle physical activity counselling programme, which was specifically designed for an in-patient rehabilitation setting. The placebo control condition consists of general instructions about health-enhancing physical activity. Data assessments will take place 2-3 weeks after admission to in-patient treatment (baseline), and 6 weeks (post) and 12 months (follow-up) after discharge from in-patient treatment. The primary outcome is objectively assessed physical activity at follow-up.; Because regular physical activity has proven to be an important predictor of long-term response and remission in patients with major depression, we believe that our planned study may lay important groundwork by showing how individually tailored lifestyle physical activity counselling can be integrated into given clinical structures. Improving physical activity may have important implications for tackling metabolic and cardiovascular disease and increasing mood and cognitive functioning in this at-risk population, hence limiting the future burden of multiple chronic conditions. Increased physical activity may also reduce the likelihood of future depressive episodes. By moving towards the primary prevention of chronic physical conditions, much can be done to enhance the quality and quantity of life of people with MDD.; ISRCTN, ISRCTN10469580 . Registered on 3 September 2018