HSC316 Module 8 Final Exam
rating of perceived exertion (RPE) (77)
-The most commonly used scale to measure perception of effort is the Borg Scale, which measures a person's rating of perceived exertion (RPE) -The scale runs from 6 to 20 because it was originally designed to correspond to exercise HR, so that multiplying each level by 10 provided a rough guess of exercise HR. Be- cause exercise HR is highly variable, the scale does not reliably predict HR. But it works well as a tool to de- scribe exercise effort.
People's Perceptions of Effort Are Important 78
-Unless clients are very fit and athletic, it is usually a good idea to avoid exercise that is very high in intensity. Injuries are more likely to occur and people are more likely to drop out of exercise pro- grams that feel uncomfortable. -People may have some difficulty picking a number to represent their level of exertion at first but once they get used to the scale, they catch on quickly. Clients like to know you care how they are feeling, and you can use their response to adjust exercise intensity.
Mental Health Disorders and Your Scope of Practice 103
-do not slip into the role of therapist -never diagnosing illness or recommending treatment -You may discuss with them how studies have found that exercise may help reduce feelings of stress, anxiety, and depression for many people, keeping the focus on general research findings, rather than framing your remarks as your recommendations for their health problems -It is natural to want to be helpful, but realize you are not helping if you keep clients from getting professional help. Talk the situation over with your supervisor. And don't be afraid to discontinue your relationship with a troubled client if you are getting in over your head.
Maximal heart rate (77)
-is the highest HR a person can achieve and is measured while a person is exercising at maximal intensity. -maximal HR is often estimated with the formula 220 - age. For ex- ample, using this formula, someone who is 20 years old would be predicted to have a maximal HR of about 200 (220 - 20 = 200). This formula is only a rough estimate, however, as about a third of all people have maximal HRs that are at least 10 beats higher or lower than predicted.
Selecting Activities 90
Effective health and fitness professionals help clients select the best activities possible for their exercise programs. This may involve trading in faster improvements in measurable fitness for enjoyment. Professionals who work in fitness centers often keep their recommendations focused on the equipment and activities available in the fitness center. Clients have often paid to join the center and want to get their money's worth by coming as often as possible. In order to match exercise recommendations to client preferences, ask about previous experiences with exercise. What worked best in the past and why? What were the elements that helped your client stick to his or her program? What led to the client dropping out? Some clients are very forth coming about their preferences, whereas others may not have strong opinions. Listen carefully to the stories that clients tell about their lives and to their responses to your suggestions. Consider clients' preferences as much as possible rather than giving them a standard workout.
pedometers 78
Exercise studies may also have subjects wear pedometers, which count the number of steps people take during a given period of time
Bone and Joint Health 80
Exercise that applies optimal levels of stress, such as those that occur during weight-bearing exercise such as walking, skipping, and running, helps increase bone quality and density. Studies on aerobic exercise and joint health suggest that the best type of exercise depends on the current state of joint health. Healthy joints do not seem harmed, and are usually helped, by moderate amounts of aerobic activity. However, high impact activities such as running and jumping can worsen joint health and pain in joints that have sustained some level of damage, such as that which occurs with osteoarthritis
volume of oxygen consumed (VO2). (77)
For cardiovascular exercise of all intensity levels, exercise heart rate (HR) generally reflects exercise intensity. A more-precise measure of metabolic activity is obtained by measuring how much oxygen is used by the body to produce energy, a measure called volume of oxygen consumed (VO2). Oxygen is taken in from the air and exhaled by the person exercising. The difference between these two concentrations can be calculated and used to estimate the level of aerobic energy production. This method requires special equipment and is not readily available unless the exerciser has access to an exercise physiology laboratory
neuromotor exercise training or neuromuscular exercise training 83
Function fitness training is also called neuromotor exercise training or neuromuscular exercise training. Guidelines for functional fitness training generally recommend that people perform this type of training two to three times per week for 20 to 30 minutes per session
brain-derived neurotrophic factor (BDNF) 102
In the aerobic exercise group, the blood levels of an important protein called brain-derived neurotrophic factor (BDNF) were correlated with larger increases in hippocampal volume. BDNF plays a role in stimulating the formation of new brain cells, a process called neurogenesis, from stem cells or precursor cells in the brain. In the aerobic exercise group, increased hippocampal volume was also associated with better performance on the memory tests.
The Endorphin Theory 85
Interest in the runner's high led to a search for biological explanations for changes in mental state. This search led to formation of the hypothesis that intense physical activity may stimulate the body to produce chemicals similar to those in the opiate family. The Endorphin Theory proposed that the psychological changes experienced with exercise, such as the runner's high, are due to increased levels of endorphins in the brain. Many people jumped to the conclusion that endorphins explained everything about the psychological effects of exercise
Expectations and Cognitions Regarding the Exercise Experience 90
Just as people who expect to experience inebriation from a laboratory beverage get drunk on a placebo, so might people who expect exercise to feel good experience mood improvements with exercise. People learn from others how to think about exercise. When family and friends have continually told a story of how unpleasant exercise is, a person may come to believe this. Consequently, a person may focus on the unpleasant sensations that accompany exercise and ignore any positive effects.
The Effect of Exercise on Depression 106
Many people with depression experience significant improvement in their symptoms with exercise. And, because exercise generally improves physical health (which can itself make people feel better), advising people with depression to increase physical activity level makes sense. Exercise is often recommended as part of a comprehensive depression treatment program that may also include psychotherapy and possibly medication.
Does Muscle Turn Into Fat When People Stop Exercising? 82
Muscle cells and fat cells bear little resemblance to one another physiologically, and muscle tissue cannot "turn into" fat tissue.
Characteristics of the Exercise Experience 90
Not all exercise experiences are alike. An interesting study compared the response of women to a 10-minute walk at a self-selected intensity both in the laboratory and in an outdoor environment. Researchers measured affective state, enjoyment, and intention for future participation in walking exercise before, during, and after the 10-minute walks. Both in- door and outdoor walking sessions were associated with improvement in affective state. However, scores for the outdoor walking condition showed greater affective improvements, enjoyment, and intention to participate in future walking exercise
Calm Energy 89
Robert Thayer has proposed that people can learn to use exercise (along with eating habits, adequate sleep, and a balanced lifestyle) to regulate their moods to feel more energetic, engaged, and productive. Thayer's research led him to categorize moods on two dimensions. One is where mood sits on a continuum running from calmness to tension; the other dimension runs from tiredness to energy. Exercise can contribute to a pleasurable affective state that Thayer refers to as "calm energy," the title of his book summarizing his years of research on mood (Thayer, 2001). Calm energy is synonymous with feelings of enthusiasm, interest, and engagement. Sometimes people experience a sort of agitated tense energy, which can stimulate productivity but is often felt as anxiety and tension. Calm energy refers to more of a flow state of engagement without the nervous energy attached. Exercise is beneficial in reducing the anxious edge many people feel
Evaluating Mood 87
Several tools are available to evaluate mood. One of the most commonly used questionnaires in this area of research is the Profile of Mood States (POMS). The POMS scores individuals on several scales for common moods, including levels of anxiety and tension, anger and hostility, depression, fatigue, confusion, and vigor. The POMS is used for many different purposes, not just to measure mood associations with physical activity.
Exercise Recommendations for Improving Sleep Quality 100
Sleep quality improvement with exercise was observed in studies that administered exercise programs in line with current public health recommendations of at least 30 minutes of moderately vigorous exercise most days of the week, although some studies have used lower doses and still observed significant effects. Both strength training and aerobic exercise have been associated with improvements in sleep.
Exercise Recommendations for Improving Memory and Cognitive Function 102
Studies in humans have tended to focus on moderate amounts of aerobic exercise. It is likely that general public health guidelines are sufficient to promote good brain health by reducing inflammation, developing good artery health, and providing conditions that can enhance neurogenesis in the brain. For optimal brain health, exercise throughout life is important.
Exercise, Memory, and Cognitive Function 100
The adult brain contains about 100 billion nerve cells, or neurons, and 1,000 billion neuroglia, which are cells of the nervous system that perform a number of supportive functions. The cells of the brain communicate with each other and with the rest of the body by neurotransmitters sent from cell to cell and by hormones sent and received through the bloodstream and the cerebrospinal fluid.
How Much Exercise? 81
The amount of aerobic exercise that generates the many health benefits described above varies enormously from person to person, which is why exercise recommendations are best when they are individualized. In general, benefits begin to accrue with at least 30 minutes of aerobic activity per day. Metabolic and cardiovascular variables respond best to even larger amounts of exercise, up to 60 to 90 minutes of exercise per day.
Exercise Recommendations for the Reduction of Stress and Stress Reactivity 95
The exercise recommendations for stress reduction in humans echo those for mood improvement. Stress reactivity is often reduced with only a single session of exercise. Regular exercise sessions of at least 30 minutes duration at least 5 days a week, as recommended by public health organizations, are likely to help reduce stress reactivity.
anandamide 85
The molecule was named anandamide, after the Sanskrit word ananda, which means bliss or delight. Anandamide is one of a family of compounds called endocannabinoids, meaning cannabinoids produced endogenously. The endocannabinoids are neurotransmitters, binding to postsynaptic receptors on neurons. They reduce pain, enhance mood, and participate in many other important psychophysiological pathways. They appear to be involved in exercise behavior.
stress reactivity 94
The nature and strength of a person's stress response is known as stress reactivity. An appropriate level of arousal can improve an athletic performance, the quality of a presentation, or a job performance. Once the challenge or threat has passed, the body returns to normal, and no harm is done.
Moods are categorized along two dimensions known as valence and activation 87
Valence refers to how positive an emotional state feels to a person, and it runs from unpleasant to pleasant. Activation is the second dimension, and it refers to energy level, with deactivated meaning low energy level and activated meaning high energy level. Moods are categorized as follows: • Pleasant, activated—enthusiastic, excited, happy, alert • Pleasant, deactivated—calm, peaceful, relaxed, content • Unpleasant, activated—nervous, tense, upset, stressed • Unpleasant, deactivated—sluggish, bored, sad, depressed
state anxiety 102
When anxiety arises for a short period of time but then resolves, psychologists refer to this as state anxiety. Everyone experiences state anxiety from time to time. Health and fitness instructors often see clients who are anxious about exercise and can ease this anxiety with education, clear explanations, and programs that build success. However, health and fitness instructors must learn to recognize when clients have mental health disorders that require referral to a mental health specialist
trait anxiety 102
When anxiety is a part of a person's personality profile and is a fairly common and enduring characteristic, psychologists refer to this as trait anxiety. People with trait anxiety generally respond to challenges with feelings of anxiety and typical fight-or-flight symptoms such an increased HR, sweating, and muscle tension.
hypertrophy 82
When muscles hypertrophy, or increase in size, as a result of strength training, the increase in size occurs because muscle cells get larger. When training stops, the muscles atrophy, or become smaller, as the cells shrink.
nitric oxide (NO) 79
a compound that performs a variety of helpful roles in the body and is important for the normal function of arteries. Exercise increases the production of an enzyme called nitric oxide synthase. This enzyme stimulates the lining of arteries to release NO. NO, in turn, causes the little muscles lining the arteries to relax. This opens the arteries, allowing for greater blood flow and thus lowering blood pressure. NO enhances arterial function and slows the progression of artery disease in a number of ways, such as by preventing blood cells from sticking to the artery lining
ergometer (75)
a stationary piece of exercise equipment on which researchers can apply a very precise workload.
optimal dose of aerobic exercise for mood improvement 93
about 30 to 35 minutes of activity, performed 3 to 5 days per week at a low-to-moderate intensity regularly for a period of at least 10 to 12 weeks. Of course, regular participation in physical activity must continue, or benefits cease.
Active static stretching 82
adds contraction of the opposing muscle group to perform the stretching exercise
Accelerometers 78
are also used to give an indication of activity level. Accelerometers measure acceleration (changes in speed of movement) to estimate physical activity volume and can provide useful data for a variety of population groups
Opiates 85
are drugs that come from the poppy flower, including opium, heroin, morphine, and cocaine.
Self-confidence 97
refers to how much people feel likely to perform well in a given situation. Self-confidence is situation specific, although a general confidence in one's abilities contributes to a positive self-esteem. One of the interesting concepts that contributes to self-confidence, especially in the physical activity arena, is self-efficacy.
Exercise frequency (77)
refers to how often the exercise is performed and is usually expressed as number of exercise sessions per week. In the case of rehabilitation exercises, or exercise programs for people with a low tolerance for physical activity, frequency may be expressed as sessions per day.
Self-esteem 96
refers to people's evaluation and judgment about their self-concept. Self-esteem is a general sense of people's evaluations of their self-worth. People with high self-esteem tend to have a lower risk of developing depression and anxiety and to be less likely to develop self-destructive addictive behaviors such as smoking, alcohol and drug abuse, or practicing pathogenic weight-control methods such as overly re- strictive dieting or purging behaviors. Self-esteem may improve resistance to stress and be associated with a number of positive health variables, such as better cardiovascular and immune responses to acute stress
Executive function 101
refers to processes that are involved in future-oriented behavior, such as planning, multitasking, setting priorities, and coping with distractions. A study by Andel and colleagues examined the association between physical-activity level in midlife with the risk of dementia 30 years later. This study was particularly valuable because the investigators controlled for the effects of other variables known to affect risk for dementia, such as alcohol intake, smoking, diet, body mass index, age, and education. The researchers found that people who were exercising in midlife had a lower risk of developing dementia 30 years later.
Insomnia 99
refers to the inability to get an adequate amount of good-quality sleep. Insomnia is usually marked by difficulty falling asleep or waking during the night and being unable to get back to sleep
affect 87
refers to the nature of moods and emotions in terms of whether a person evaluates them as positive or negative
Flexibility training 82
refers to the performance of activities designed to increase flexibility, that is, the range of motion around joints. Because flexibility declines with age, sedentary lifestyle, injury, and immobilization, flexibility training helps reduce this loss, and preserve or increase range of motion. Flexibility training has been shown to increase joint range of motion in all age groups
Exercise mode (75)
refers to the type of activity. Examples of exercise modes are cycling, swimming, running, walking, and just about any exercise and sport activity.
Self-concept 96
refers to the way people perceive or define themselves. Self-concept includes the various roles people play in their family, community, and work lives. It includes people's ideas about their strengths and weaknesses, abilities, character, and all the stories built around what they have done in life.
Exercise duration (77)
refers to time—usually how long an activity lasts. Duration is measured in hours, minutes, and/or seconds, depending on what makes the most sense. The duration of a sprint interval might be 20 seconds, whereas the duration of the entire workout might be 2 hours and 20 minutes.
Proprioceptive neuromuscular facilitation (PNF) 82
sometimes called contract-relax stretching, has many variations, most of which involve first isometrically contracting the muscle group to be stretched, and then following the contraction with a static stretch for the same muscle group. Force is applied to enhance the stretch either by the person stretching or another person trained in this method
Intramuscular triglyceride 82
stores refer to adipocytes located within muscles. Thus, al- though muscle tissue does not "turn into" fat tissue, fat tissue can accumulate in muscles. Think of a nice juicy steak with streaks of fat. Endurance athletes like intramuscular triglyceride, since the muscle mitochondria break down these triglycerides to make energy
Exercise Recommendations for Reducing Anxiety 104
strength training and activities such as yoga and tai chi also appear to be effective in reducing anxiety. Because exercise performed at an individual's preferred pace may be best for improving positive affect, it makes sense for health and fitness professionals to work with individuals to establish the most effective exercise recommendations that not only work best to reduce feelings of anxiety but also improve exercise adherence
Ballistic stretching 82
uses a bouncing movement of the body to rapidly place intermittent force on the muscle group being stretched
Exercise-Induced Feeling Inventory (EFI) 87
was designed by researchers Gauvin and Rejeski (1993) as a quick and easy questionnaire to measure mood changes most commonly associated with physical activity. The EFI has subscales for feelings of positive engagement, revitalization, tranquility, and physical exhaustion—the mood descriptors that most commonly change in association with exercise. The EFI has been used to compare mood before and after exercise and also to compare general mood before and after weeks or months of regular exercise participation.
Feeling Scale (FS) 87
which is a one-item scale that is a sort of emotional RPE scale. People rate how they are feeling on a scale of -5 (very bad, unpleasant feeling) to +5 (very good, pleasant feeling), with 0 as a neutral midpoint. This simple scale is useful during an exercise session when people do not have the time or energy to focus on any- thing longer.
For over 40 years, psychologists have explored the associations between exercise and various psychological effects, including the following: 85
• Changes in mood • Reduced feelings of stress and psychophysiological responses to sources of stress • Changes in self-esteem • Altered perception of body image • Changes in sleep quality • Better memory and other markers of cognitive function • Reduction in symptoms of anxiety • Reduction in symptoms of depression
Passive static stretching 82
involves holding a stretching position for 10 seconds or more, gradually increasing the stretch placed on the muscle group
Dynamic stretching 82
involves slow movement from one stretching position to another
Interval training (76)
is a form of exercise where short bursts of high-intensity anaerobic exercise are combined with longer periods of aerobic exercise that allow the muscles time to recover.
Depression 105
is a mental health disorder marked by both mental and physical symptoms (Box 3-7). Symptoms of depression vary from person to person. In general, depression is diagnosed when people experience a number of symptoms, including prolonged feelings of sadness or anxiety, hopelessness, guilt, or worthless- ness; or loss of interest or pleasure in activities once enjoyed. Depression may be severe or mild and last for weeks or years. Many people suffer from a combination of both depression and anxiety. According to the National Institute of Mental Health (2010), in 2005-2008, over 6% of adults in the United States were diagnosed with major depressive disorder every year (12-month prevalence). An estimated 9.5% of U.S. adults were diagnosed with all forms of depression, which include major depressive disorder (also 12-month prevalence). Approximately 20% of adults in the United States will be diagnosed with a depressive disorder at some point during their lives. Depression rates are about 70% higher in women than men (NIMH, 2010). The prevalence of depressive disorders has doubled since the 1990s. This increase has occurred across all demo- graphic groups, including whites, blacks, and Hispanics, and for almost all age groups, including children and adolescents.
Exercise (75)
is a type of physical activity performed with the intention of improving physical fitness and/or sport performance.
Sport (75)
is generally defined as a physical activity that is performed according to rules and customs. Sports are usually highly structured and take the form of a contest between individuals or teams.
Self-efficacy 97
is the belief in one's ability to successfully accomplish a given task. Self-efficacy is situation specific. The stronger a person's self-efficacy, the more he or she persists at trying to succeed at a task in that area despite obstacles.
Many variables and mechanisms may help explain the effect of exercise on symptoms of depression. These include the following. 107
-Changes in activity patterns -Reductions in anxiety symptoms -Improved self-esteem, self-confidence, and body image -Improvement in mood -Better sleep quality -Changes in endorphin and endocannabinoid pathways -Changes in other neurotransmitter pathways -Increased neurogenesis -Reductions in inflammatory cytokines -Changes in endocrine response to stress
Exercise Recommendations for Reducing Depression 108
-Exercise seems to have the greatest depression-reducing effects in people with mild-to-moderate depression. -Exercise sessions lasting 20 to 29 minutes were more effective than longer sessions at reducing depression symptoms for nonclinical populations -On the other hand, for people already diagnosed with depression, more exercise was better. Sessions lasting 45 to 59 minutes were more effective than shorter sessions. -Among nonclinical subjects, exercise intensities representing 61% to 74% of maximal HR were more effective than lower or higher intensities
Characteristics of Common Anxiety Disorders 103
-Generalized Anxiety Disorder • Frequent experiences of fear most days, for at least 3 months • Excessive anxiety about a variety of situations • Feeling unable to control feelings of anxiety, which creates more anxiety • Physical and behavioral symptoms such as insomnia, muscle tension, and fatigue -Phobias • Excessive fear of something not regarded by most people as worthy of excessive fear, such as spiders, exams, or snakes • Changes in behavior, as people attempt to avoid encountering the object of their phobia • Distress because of worrying about the phobia or because behavior to avoid the phobia interferes with performance or quality of life • A phobia of exams or public speaking can occur in college students and block performance on these important tasks -Panic Disorder • Experience of panic attacks. A panic attack is a short, intense period of fear. People often feel they are dying. A panic attack is marked by a strong fight-or-flight response, with a rapid, pounding HR, sweating, trembling, and nausea. During a panic attack, people often feel the need for "flight" to escape a situation. • Preoccupation with worrying about having a panic attack, especially in public. • Changes in behavior because of worrying about panic attacks. People with panic disorder often develop -agoraphobia. • Panic disorder occurs in college student populations. Feelings of anxiety can lead to a fight-or-flight response, which leads to more anxiety and full-blown panic attacks. Feelings of fear snowball, as fear of fear feeds on itself to produce panic. -Agoraphobia • Fear of being in situations from which one cannot escape if a panic attack strikes, such as in public situations or in transportation situations (on airplanes, trains, buses, etc.). Students with agoraphobia may fear going to class and not being able to leave. • Changes in behavior as a result of anxiety, such as being unable to leave one's home. Students may stop attending class.
William P. Morgan 86
-He is known for his ability to see the "big picture" of sport and exercise psychology and exercise science -first contributions to sport psychology was the identification of the "iceberg profile" for the mood states of male and female elite athletes -The iceberg profile describes the results typically seen in these athletes' scores on the Profile of Mood States (POMS) questionnaire. The elite runners in Morgan's study sample scored below general popula- tions on the traits of tension, depression, anger, fatigue, and confusion. However, they scored higher than av- erage on the trait of vigor, which forms the tip of the iceberg. A later study in 15 older, elite, male marathon runners compared their POMS profiles from the 1990s with data gathered from the same runners about 20 years earlier. The older runners (average age of 50 years) showed the same iceberg profile on the POMS that they showed in their younger years
Sleep 99
-In general, adults need about 7 to 8 hours of sleep per night, and adolescents need an hour more. -Sleep deficits have deleterious effects on many cognitive functions, including memory, reasoning, and decision-making. -Sleeping problems also have a negative effect on emotional health because fatigue increases feelings of stress, irritability, depression, and other negative emotional states. Lack of sleep is associated with higher levels of the hormone ghrelin, which increases feelings of hunger, and may lead to overeating and risk of obesity.
When clients list stress and fatigue as factors contributing to nonadherence to exercise programs, how do I motivate them to exercise? 96
-Include emotional health goals in exercise program design -Encourage clients to tune into the psychological effects of physical activity -Adjust exercise recommendations if clients are experiencing fatigue or a decline in mood following exercise -Model positive thinking about exercise
Lower Stress Reactivity 90
-Over time, exercise training is associated with reduced arousal in response to psychosocial stressors. -When people have less sympathetic nervous system overactivation in response to daily stressors, they generally have a more-positive mood.
Most clients ask for my advice because they are dissatisfied with their bodies. How do I help? 98
-Provide a friendly atmosphere that welcomes a variety of body types. -Focus on positive reasons for exercising. -Help clients see progress. -Encourage positive thinking, but don't promise unrealistic results.
motor unit 81
includes a nerve fiber and the muscle fibers it innervates. With training, the nervous system becomes better at recruiting the right number of motor units of the right type of muscle fibers to produce the strength of contraction required by the strength exercise.
endorphins 85
As psychologists explored this hypothesis, neuroscientists such as Candace Pert, discussed in Chapter 2, discovered neurochemicals they dubbed endorphins, for "endogenous morphine." Endogenous means produced by the body. In the human body, endorphins reduce pain, but they have other roles in the brain and body as well, including important roles in memory, learning, and registering emotions
EXERCISE AND PHYSICAL HEALTH 79
Basically, as exercise stresses the body, the body responds to that stress by strengthening the systems being stressed. The response of the body to exercise varies somewhat with the type of exercise.
Cardiovascular/Aerobic Exercise 79
Beneficial health effects occur after even one session of aerobic exercise. For example, the cell membrane receptors for insulin become more sensitive to insulin for a day or two following exercise, enhancing the ability of cells to take up glucose from the bloodstream. This effect disappears rapidly, however, so regular activity is required to produce a significant change in blood glucose regulation.
Body image 97
Body image is all about perception. Body image refers to the way people see their bodies and to their subjective evaluations of their physical appearance. People's ideas and judgments about their bodies are influenced by many factors.
exercise intensity (77)
Conceptually, exercise intensity refers to the level of exertion and how hard a person is working. Exertion has both physical and psychological components, and both can be measured.
Adiposopathy 79
Dysfunction of adipose tissue that causes chronic inflammation and disease
Negative Psychological Consequences of Physical Activity 108
in addition to the exercise benefits presented above, exercise can become part of a compulsive behavior pattern for some people. Physical activity can become a way for people with eating disorders to purge calories. Compulsive exercise behavior and eating disorders are discussed in more detail in Chapter 11 in the context of addictions. Psychologists have noted that exercise, per se, is not really the problem. Rather, people struggling with stress and other difficult psychological issues may turn to exercise for a sense of stability and control
When Exercise Feels Like Panic 105
Occasionally, clients may report feeling anxious in response to exercise symptoms, such as elevations in HR. This is especially likely in patients who experience anxiety, panic disorder, or less- severe problems involving occasional feelings of panic. When examined closely, exercise does bear a resemblance to panic: higher HR and faster breathing rate, higher systolic blood pressure, in- creased muscle tension, and sweating. With panic, such symptoms are perceived to be problematic, which leads to fear and an even higher HR and other symptoms as clients struggle to maintain control. Clients who are sensitive to elevations in HR or other exercise symptoms may need to begin exercise programs using activities with a fairly low level of intensity until they can tolerate, and hopefully enjoy, activities with a higher intensity. Such clients may be fine with low-intensity strength training and low-intensity aerobic activities. They may enjoy walking, biking, or swimming at slower paces that do not result in high HRs or other problematic symptoms
telomeres 80
One of the most interesting effects at the cellular level is the effect of exercise on the length of telomeres. Telomeres are structures found on the ends of chromosomes. Nobel Prize winner Elizabeth Blackburn describes telomeres as being "like the tips of shoelaces. If you lose the tips, the ends start fraying."
The Effect of Exercise on Anxiety 103
Overall, exercise is generally helpful for reducing feelings of anxiety in most population groups.
Quality of Life 80
Quality of life reflects both physical and psychological levels of well-being
Cardiovascular and Metabolic Health 79
Regular physical activity: • Promotes artery health • Helps to lower high blood pressure • Improves blood lipid levels, raising HDL levels and lowering serum triglycerides • Helps to prevent obesity by contributing to energy balance • Improves insulin sensitivity • Slows progression of dementia
cross-stressor adaptation hypothesis 94
Researchers have suggested that people with higher fitness levels have a lower physiological response to laboratory stressors, a phenomenon known as the cross-stressor adaptation hypothesis. The basic idea is that people who become accustomed to the stress of exercise may become less reactive to other stressors, such as having to give a speech or perform a frustrating task.
Chromosomes 80
contain long chains of DNA that are found in cell nuclei. Each time a cell divides, some of the telomere material is lost, and the telomeres become shorter. Blackburn and colleagues found that stress accelerates telomere loss, whereas exercise increases concentration of an enzyme, telomerase, which helps restore telomere length
Anaerobic (76)
describes the body's energy production pathways that do not require the immediate presence of oxygen. The term anaerobic energy production is used for high-intensity exercise.
Functional fitness training 83
employs motor skills such as agility, balance, and coordination in exercises de- signed to improve daily functional ability. Functional fitness training employs a wide range of activities that often include strength and flexibility training. Activities such as tai chi, martial arts, group exercise classes, and many sports provide functional fitness training.
Anaerobic exercise (76)
generally refers to high-intensity exercise. Athletes and other very fit people engage in anaerobic training to improve energy production pathways and increase speed, strength, and power. Because anaerobic exercise involves high exercise intensities, it may not be appropriate for beginners or those with health risks.
Mihalyi Csikszentmihalyi and the Experience of Flow 92
has described his research on states of conscious- ness as beginning in his young adulthood in Hungary following the horror of World War II upon observing the adults around him. All were devastated as a result of the war, having lost social status, financial support, friends, family members, and especially hope. Csikszentmihalyi began a search to understand what makes life worth living. He interviewed people who seemed to find satisfaction in life—artists, musicians, and athletes—asking them to describe their lives, work, thoughts, and feelings. Later, he developed a data-collection procedure that he called the Experience Sampling Method. He and his col- leagues fitted volunteers with pagers that beeped at random times within every 2-hour period during the day. When the pager beeped, subjects completed a short questionnaire about what they were doing and how they were feeling. Data were collected on thousands of subjects. Csikszentmihalyi found that people report flow experiences most often when facing a challenge that elicits peak performance in some area. In other words, flow most commonly results from a good match between a task's level of challenge and the skill set of a given individual to perform that task. When the level of challenge is too high compared with people's perceptions of their skills, they feel anxious. If a task is too easy in an area where people's skills are high (an accomplished tennis athlete playing with a group of amateurs), people are bored. The skills-challenge balance is always task specific.
mood 87
how a person feels. Some researchers distinguish mood from emotion, using emotion to refer to shorter, often more-intense feelings experienced in response to a specific stimulus, such as something perceived to be disgusting, frightening, and so forth. Mood is generally used to refer to more-diffuse and longer-lasting feelings that may not be triggered by anything in particular.
Repetitions (reps) (76)
refer to the number of times a given exercise is performed. A strength training session is usually comprised of a number of different exercises for a variety of muscle groups. One series of exercises is called a set. The effect of a strength-training workout varies according to all variables discussed above: weight, repetitions, and number of sets
Exercise volume 78
refers to "how much" exercise is done. While this may sound like a simple thing to measure, exercise volume must take into account exercise frequency, intensity, and duration in order for exercise volume measures to be compared and evaluated.
Cardiovascular exercise or aerobic exercise (76)
refers to activities that involve movement of the large muscle groups at a moderately vigorous level, leading to sustained elevation in metabolic rate. Intensity level is submaximal, however, so that the activity can continue for at least 10 minutes and often longer.
Flow 91
refers to an enjoyable state of consciousness where people feel totally engaged and at one with the activity with which they are involved. People experiencing flow are alert, tuned into the present moment, and responding to an intense challenge, such as skiing, kayaking, playing a musical instrument, dancing, or playing chess.
Physical activity (75)
refers to any bodily movement, especially movement involving large muscle groups and an elevated (above resting) level of energy expenditure. Most of the time, when researchers use the term "physical activity," they are referring to activities such as walking, raking leaves, climbing stairs, dancing, and participating in sports, rather than lifting a forkful of food to one's mouth or walking from the couch to the refrigerator. In scientific studies, researchers must always define what they mean by physical activity because the term is so broad
Strength training (76)
refers to exercise performed to in- crease muscle strength. Strength refers to how much force muscles can exert against an object and is often measured by how much weight can be moved in various positions.
Stretching (76)
refers to exercise that pushes joints to the edge of their range of motion and thus improves range of motion, also known as flexibility
Euphoria 84
refers to feelings of intense happiness or well-being.
Anxiety 102
refers to feelings of worry, self-doubt, and fearful uncertainty about the future. Anxiety is a useful feeling when it motivates people to deal with problems causing anxiety. For example, anxiety about a physical symptom may motivate people to seek medical attention and receive treatment for medical conditions.
Csikszentmihalyi described seven characteristics of the flow experience as follows: 92
• Complete engagement in the activity; engagement requires total concentration • State of ecstasy, where one temporarily is so focused on the activity that one is not thinking about everyday life • Sense of inner clarity; one knows what to do and does it • Confidence, feeling that one's skills are adequate for the challenge at hand and that the challenge is doable • Serenity, perhaps because one's focus excludes the opportunity to worry • Sense of timelessness, not noticing the clock or being aware of time passing • Intrinsic motivation, which means feeling motivated to perform the task because of the inherent benefits of the task, not for gaining secondary benefits such as money, prestige, and so on. -Flow theory proposes that people feel most satisfied when they are both challenged and successful. Sport and exercise experiences that require total concentration are most frequently associated with flow experiences. While flow is more about states of consciousness, it does underscore the "feel good" potential of sport and exercise experiences.
The most frequently observed changes in mood include the following: 88
• Energy level: People often report feeling more energetic following a session of mild- to moderate-intensity exercise. They score higher on the POMS category of vigor and describe themselves as feeling more refreshed and invigorated. • Fatigue level: Not surprisingly, along with feeling more energy, people report feeling less fatigue. However, following high-intensity exercise, subjects with lower fitness levels may be more likely than highly fit subjects to report more, rather than less, fatigue • Negative mood: People report reductions in feelings of depression, anxiety, anger, tension, and irritability after a single exercise session as well as after participation in a regular exercise program.
In humans, anxiety is associated with many variables that also mediate the effect of exercise, including the following. 104
• Improvements in self-esteem, self-confidence, and self-efficacy. When people feel more capable of coping with sources of stress, they sometimes feel less generalized anxiety. • Changes in neurobiological pathways. The endorphin, endocannabinoid, and other neurotransmitter pathways discussed earlier in this chapter may be part of the explanation for the anxiolytic (anxiety-reducing) effects of physical activity. • Increased levels of BDNF. Studies in humans have found that BDNF levels are lower in those with anxiety and depressive disorders. One very interesting study compared BDNF levels in people who have panic disorder with levels in normal controls both before and after 30 minutes of exercise. BDNF levels were lower in people with panic disorder before exercise. Happily, following exercise their BDNF levels reached those of the normal controls. • Changes in epigenetic regulation of gene expression. Studies in rats suggest regular physical activity causes epigenetic changes that alter gene expression. Some of these may be responsible for changes in neurotransmitter pathways and regulation of BDNF, for example
Variables and Mechanisms Associated With Reduced Stress Reactivity 95
• Neurobiological changes: Described in the section above, animal research suggests that exercise may be associated with the way the brain responds to stress and the way that the brain tells the body to respond to stress. • Changes in sympathetic and parasympathetic nervous system response to stress: Lower HR parasympathetic tone in those accustomed to regular activity and possibly less sympathetic arousal. Animal models have shown a reduced norepinephrine response to stress following exercise. (Norepinephrine rises with activation of the sympathetic nervous system.) • Relaxed muscles: Relaxation and stress- reduction techniques often focus on the induction of muscular relaxation, which in turn contributes to feelings of psychological relaxation as well. Athletes often note a feeling of muscular relaxation following a good workout. It is possible that this muscle relaxation con- tributes to lower self-reported stress levels. • Improved mood: In everyday conversation, people use the term "feeling stressed" to refer to various negative mood states. If exercise increases positive affect and reduces negative mood states, as suggested in the preceding section, exercise would be associated with reduced feelings of stress.
Common symptoms of insomnia include the following: 99
• Trouble falling asleep • Waking frequently during the night • Difficulty getting back to sleep once awake • Waking too early in the morning • Daytime fatigue Insomnia may occur for many reasons. -It is often the side effect of medications, caffeine, nicotine, and other stimulants.
