Cardiorespiratory fitness moderates the effect of an affect-guided physical activity prescription: a pilot randomized controlled trial

Abstract

Physical activity (PA) interventions have a clear role in promoting mental health. Current PA guidelines directed toward specific PA intensities may have negative effects on affective response to exercise, and affective response is an important determinant of PA adherence. In this randomized trial of 67 previously inactive adults, we compared the effects of a PA prescription emphasizing the maintenance of positive affect to one emphasizing a target heart rate, and tested the extent to which the effect of the affect-guided prescription on PA is moderated by cardiorespiratory fitness (CRF). We found the effect of an affect-guided prescription was significantly moderated by CRF. At one week, for participants with lower CRF (i.e. poor conditioning), the affect-guided prescription resulted in significantly greater change in PA minutes (M = 240.8) than the heart rate-guided prescription (M = 165.7), reflecting a moderate-sized effect (d = .55). For those with higher CRF (i.e. good conditioning), the means were in the opposite direction but not significantly different. At one month, the same pattern emerged but the interaction was not significant. We discuss the implications of these findings for the type of PA prescriptions offered to individuals in need.

Physical activity as a model for health neuroscience

“…For example, higher depressive symptoms and perceived barriers to PA has been linked with both lower habitual PA levels over time 62 and smaller effects on PA levels during the intervention. 59,63 Depressive symptoms are also associated with poorer cognitive performance, particularly in the domains of memory and executive functioning. [64][65][66][67] In fact, depression-related cognitive impairment has been shown to persist, particularly for executive functions, even after successful treatment and remission of the affective symptoms.…”

Anxiety sensitivity predicts increased perceived exertion during a 1-mile walk test among treatment-seeking smokers

“…The current results extend existing prior findings that examined the link between anxiety sensitivity and lower levels of cardiorespiratory fitness in a separate sample of sedentary treatment-seeking smokers (Farris et al, 2016), and parallel findings non-specific to smokers that indicate anxiety sensitivity predicts increased negative affect (i.e., fear) during exercise, particularly among individuals with higher body mass index (Smits et al, 2010). Of note, RPE is a subjective rating of exertion and effort, including breathlessness and fatigue during exercise, and while is distinct from the affective response to exercise, they may certainly influence one another (Baldwin et al, 2016). …”

“…There is evidence that “prescribing” an affect-based exercise program to guide the intensity of activity (i.e., how one feels to determine intensity), versus a HR-based exercise-intensity prescription, results in greater uptake in moderate-to-vigorous intensity exercise, greater positive affective response to exercise, and higher average HR during exercise, particularly among individual with low level of cardiorespiratory fitness levels (Baldwin et al, 2016). Thus, it is possible that tailoring exercise prescription to maximize the affective response to bouts of physical activity for smokers with elevated anxiety sensitivity, who have lower cardiorespiratory fitness levels (Farris et al, 2016), could result in greater uptake in exercise.…”

Potential Utility of Self-Report Measures of Affect to Optimise Exercise Adherence in People with Type 2 Diabetes

“…injury) [70], each of which can impact exercise adherence. Such studies have typically included athletes [41,42,[70][71][72][73], otherwise healthy active or inactive adults [74][75][76][77][78][79][80] and adolescents/children [81][82][83][84], rather than focussing on clinical populations such as T2D.…”

“…Allowing participants to choose the intensity at which they exercise based on their affective response results in increased perceived autonomy and control [74,92]. This in turn promotes adherence as indicated by a significant improvement in weekly PA levels [66,79,82], compared to heart rate-guided prescription.…”