Prescribing or co-designing exercise in healthy adults? Effects on mental health and interoceptive awareness

Abstract

Universal exercise recommendations for adults neglect individual preferences, changing constraints, and their potential impact on associated health benefits. A recent proposal suggests replacing the standardized World Health Organisation (WHO) exercise recommendations for healthy adults by co-designed interventions where individuals participate actively in the decisions about the selected physical activities and the effort regulation. This study contrasts the effects on mental health and interoceptive awareness of a co-designed and co-adapted exercise intervention with an exercise program based on the WHO recommendations for healthy adults. Twenty healthy adults (10 men and 10 women, 40–55 y.o.) participated voluntarily in the research. They were randomly assigned to a co-designed exercise intervention (CoD group) and a prescribed exercise program (WHO group). Supervised online by specialized personal trainers, both programs lasted 9 weeks and were equivalent in volume and intensity. The effects of the exercise intervention were tested through personal interviews, questionnaires (DASS-21 and MAIA) and a cardiorespiratory exercise test. Intragroup differences (pre-post) were assessed using the Mann-Whitney Wilcoxon test and intergroup differences through Student’s t-tests. Effect sizes were calculated through Cohen’s d. Interviews were analyzed through thematic analysis. Eleven participants completed the intervention (CoD = 8, WHO = 5). Both groups improved, but non significantly, their cardiorespiratory testing results, and no differences were found between them post-intervention. Mental health was only enhanced in the CoD group (p < 0.001), and interoceptive awareness improved in seven of the eight scales in the CoD group (p < 0.001) and only in 3 scales in the WHO group (p < 0.01). In conclusion, the co-designed intervention was more effective for developing mental health, interoceptive awareness, autonomy, and exercise self-regulation than the WHO-based exercise program.

Sleep Quality and Interoception Are Associated with Generalized Anxiety in Baccalaureate Nursing Students: A Cross-Sectional Study

“…Similarly, a study conducted by Almarcha and colleagues found that participants involved in an exercise regime experienced increased mental health and interoceptive awareness scores. Interoceptive scores increased further for those who were able to co-design their exercise regime [ 39 ]. Finally, in a study assessing the impact of a time management training program on time management and anxiety among nursing undergraduate students, significant improvements were reported.…”

The relationship between mindfulness and athletes’ mental skills may be explained by emotion regulation and self-regulation

“…Interoceptive processes play a critical role in regulating physical exertion during physical activities and sports [43,49]. Previous research has demonstrated that a codesigned exercise intervention can improve interoceptive awareness and mental health in non-athletes [44]. Additionally, a moderate-vigorous physical activity-based intervention can increase cardiac interoceptive accuracy, and individuals with a higher sports background tend to benefit more than those who are physically inactive [47].…”

“…Interoception has recently gained recognition in physical activity and sports performance research as a means of improving physical and mental resilience (understood as a cognitive process focused on coping with difficult events and situations and recovering from them) by monitoring one's inner bodily sensations and making appropriate adjustments [43][44][45][46][47][48]. It plays a crucial role in shaping athletes' emotional experiences, decisionmaking processes, and well-being [43,47,49,50].…”

Validation of the shortened 24-item multidimensional assessment of interoceptive awareness, version 2 (Brief MAIA-2)

“…The present result is consistent with previous studies. Almrcha et al 9 showed that people engaged in co-designed exercise intervention (they decided about the selected physical activities and the effort regulation) scored higher in almost all MAIA scales (except Not Worrying). Also, interoceptive awareness improved in three MAIA scales (Emotional Awareness, Self Regulation, and Body Listening) among war veterans with post-traumatic stress disorder (PTSD) symptoms after participating in a 12-week integrative exercise intervention program 12 .…”

“…Interoceptive processes regulate physical exertion in physically active people, enhancing their physical and mental health and overall well-being 8 . Participating in the exercise intervention program can improve interoceptive awareness in healthy adults 9 , 10 , children 11 , and war veterans 12 . Research suggests that participating in sports also has a beneficial effect on interoceptive awareness 13 , 14 .…”