Do High Levels of Physical Activity in Acute Anorexia Nervosa Associate with Worse Clinical Outcomes at Admission?

Research Paper Title

High levels of physical activity in female adolescents with anorexia nervosa: medical and psychopathological correlates.

Background

While overexercise is commonly described in patients who experience anorexia nervosa (AN), it represents a condition still underestimated, especially in the paediatric population.

Methods

The present study aims at assessing the possible associations between levels of physical activity (PA) and clinical features, endocrinological data and psychopathological traits in a sample of 244 female adolescents hospitalised for AN subdivided into two groups according to PA levels (high PA vs. no/low PA). The two groups were compared through multivariate analyses, while multiple regression analysis was conducted to determine whether physical activity predict specific outcomes.

Results

No significant differences were found between the two groups in terms of last Body Mass Index (BMI) before illness, BMI at admission and disease duration, while a difference emerged in delta BMI(rapidity of weight loss), significantly higher in high-PA group (p = 0.021). Significant differences were observed in Free triiodothyronine- (p < 0.001), Free thyroxine (p = 0.046), Follicle-stimulating hormone (p = 0.019), Luteinising hormone (p = 0.002) levels, with values remarkably lower in high-PA group. Concerning psychopathological scales, the high-PA group showed worst Children’s Global Assessment Scale (CGAS) scores (p = 0.035). Regression analyses revealed that higher PA predicts higher delta BMI (p = 0.021), presence of amenorrhea (p = 0.003), lower heart rate (p = 0.012), lower thyroid (Free triiodothyronine p < 0.001, Free thyroxine p = 0.029) and gynaecological hormones’ levels (Follicle-stimulating hormone p = 0.023, Luteinising hormone p = 0.003, 17-Beta estradiol p = 0.041). Concerning psychiatric measures, HPA predicts worst scores at CGAS (p = 0.019), and at scales for evaluation of alexithymia (p = 0.028) and depression (p = 0.004).

Conclusions

Results suggest that high levels of physical activity in acute AN associate with worst clinical conditions at admission, especially in terms of endocrinological and medical features.

Reference

Riva, A., Falbo, M., Passoni, P., Polizzi, S., Cattoni, A. & Nacinovich, R. (2021) High levels of physical activity in female adolescents with anorexia nervosa: medical and psychopathological correlates. Eating and Weight Disorders. doi: 10.1007/s40519-021-01126-3. Online ahead of print.

Book: Exercise-Based Interventions for Mental Illness

Book Title:

Exercise-Based Interventions for Mental Illness: Physical Activity as Part of Clinical Treatment.

Author(s): Brendon Stubbs and Simon Rosenbaum.

Year: 2018.

Edition: First (1st).

Publisher: Academic Press.

Type(s): Paperback, Audiobook, and Kindle.

Synopsis:

Exercise-Based Interventions for People with Mental Illness: A Clinical Guide to Physical Activity as Part of Treatment provides clinicians with detailed, practical strategies for developing, implementing and evaluating physical activity-based interventions for people with mental illness. The book covers exercise strategies specifically tailored for common mental illnesses, such as depression, schizophrenia, bipolar disorder, and more. Each chapter presents an overview of the basic psychopathology of each illness, a justification and rationale for using a physical activity intervention, an overview of the evidence base, and clear and concise instructions on practical implementation.

In addition, the book covers the use of mobile technology to increase physical activity in people with mental illness, discusses exercise programming for inpatients, and presents behavioural and psychological approaches to maximise exercise interventions. Final sections provide practical strategies to both implement and evaluate physical activity interventions.

Can Exercise & Physical Activity Induce Improvements for Mental Disorders?

Research Paper Title

Exercise and physical activity in mental disorders: clinical and experimental evidence.

Background

Several epidemiological studies have shown that exercise (EX) and physical activity (PA) can prevent or delay the onset of different mental disorders, and have therapeutic benefits when used as sole or adjunct treatment in mental disorders.

This review summarises studies that used EX interventions in patients with anxiety, affective, eating, and substance use disorders, as well as schizophrenia and dementia/mild cognitive impairment.

Despite several decades of clinical evidence with EX interventions, controlled studies are sparse in most disorder groups.

Preliminary evidence suggests that PA/EX can induce improvements in physical, subjective and disorder-specific clinical outcomes.

Potential mechanisms of action are discussed, as well as implications for psychiatric research and practice.

Reference

Zschucke, E., Gaudlitz, K. & Strohle, A. (2020) Exercise and physical activity in mental disorders: clinical and experimental evidence. Journal of Preventive Medicine and Public Health. 46 Suppl 1(Suppl 1), pp.S12-21. doi: 10.3961/jpmph.2013.46.S.S12. Epub 2013 Jan 30.

Research: Real-Time Data Collection to Examine Relations Between Physical Activity and Affect in Adults With Mental Illness

Research Paper Title:

Real-Time Data Collection to Examine Relations Between Physical Activity and Affect in Adults With Mental Illness.

Author(s): Danielle R. Madden, Chun Nok Lam, Brian Redline, Eldin Dzubur, Harmony Rhoades, Stephen S. Intille, Genevieve F. Dunton, and Benjamin Henwood.

Year: 2020.

Journal: Journ of Sport and Exercise Psychology, 6, pp.1-8.

DOI: doi: 10.1123/jsep.2019-0035. Online ahead of print.

Abstract:

Adults with serious mental illness engage in limited physical activity, which contributes to significant health disparities. This study explored the use of both ecological momentary assessments (EMAs) and activity trackers in adults with serious mental illness to examine the bidirectional relationship between activity and affect with multilevel modelling.

Affective states were assessed up to seven times per day using EMA across 4 days. The participants (n = 20) were equipped with a waist-worn accelerometer to measure moderate to vigorous physical activity.

The participants had a mean EMA compliance rate of 88.3%, and over 90% of completed EMAs were matched with 30-min windows of accelerometer wear. The participants who reported more positive affect than others had a higher probability of engaging in moderate to vigorous physical activity.

Engaging in more moderate to vigorous physical activity than one’s usual was associated with more negative affect. This study begins to address the effect of momentary mood on physical activity in a population of adults that is typically difficult to reach.

New Plank Record

A 62-Year-old former US Marine has set a world record for maintaining the plank.

On 15 February 2020, George Hood kept static for an incredible 8 hours 15 minutes and 15 seconds.

Hood, a former US Marine and retired Drug Enforcement Administration supervisory special agent, has broken the record for longest plank before, in 2011 when he held it for 1 hour and 20 minutes. But when he tried to set it again in 2016, he lost to Mao Weidong from China, who held a plank for 8 hours, 1 minute and 1 second.

A Guinness World Record official adjudicated at the event in Chicago, which raised money for an Illinois-based mental health counselling facility.

With his experience in the military and law enforcement, Hood said he knew mental illness is often stigmatized. So he completed the challenge at 515 Fitness, a gym that helps address mental illness through exercise and professional help.” (Lee, 2020).

The ultra-endurance athlete trained for seven hours a day for 18 months, completing around 2,100 hours of plank time, 270,000 push-ups and nearly 674,000 sit-ups.

“”It’s 4-5 hours a day in the plank pose,” Hood told CNN. “Then I do 700 pushups a day, 2,000 situps a day in sets of a hundred, 500 leg squats a day. For upper body and the arms, I do approximately 300 arm curls a day.”” (Lee, 2020).

To celebrate the reclaiming of his world record title, Hood finished off the event with a quick 75 push-ups/press-ups.

Hood has set the plank record a total of six times over the past eight years.

Hood said this will likely be his last time breaking the world record for planking, but his next goal is to set the Guinness World Record for most pushups completed in one hour, which currently stands at 2,806.

The female record is currently held by Dana Glowacka from Canada, who held a plank for 4 hours, 19 minutes and 55 seconds last year, according to Guinness World Records.

References

Lee, A. (2020) 62-year-old former Marine sets Guinness World Record by holding plank for over 8 hours. Available from World Wide Web: https://edition.cnn.com/2020/02/23/us/new-planking-world-record-trnd/index.html. [Accessed: 06 April, 2020].

Soldier. (2020) On His Toes. Soldier: Magazine of the British Army. April 2020, pp.16.

Mental Health: Exercise & Osteoarthritis in Older People

Research Paper Title

A Study on the Physical Activities, Mental Health, and Health-Related Quality of Life of Osteoarthritis Patients.

Background

The purpose of this study was to investigate the physical activities, mental health, and health-related quality of life (HRQOL) of osteoarthritis patients.

Methods

This study was conducted using data from the first year of the 7th Korea National Health and Nutritional Examination Survey.

There were 8,150 participants included in the survey, and 665 participants had been diagnosed with osteoarthritis.

This study analysed the measurements of physical activities, depression, and HRQOL in participants with osteoarthritis.

Results

The mean age of the participants was 67 ± 9.9 years and 83.1% were female.

Participants rarely engaged in work-related physical activity, and engaged in leisure-related physical activities infrequently.

Most of the participants (85.9%) did not do regular exercise, but 1/3 of the participants walked for over 10 minutes a day.

“Pain/discomfort” had the least impact upon HRQOL, and among the depression subcategories, “difficult to sleep and tiredness” had the most impact.

Multiple logistic regression analysis showed that an adverse HRQOL score was statistically significantly associated with “location changes/physical activities” (p < 0. 01), “depression” (p < 0.001) and “age” (p < 0.001).

Conclusions

Exercise programmes should be in place which are manageable in everyday life for the elderly (> 65 years).

Changes in daily routine so that patients become more active, should be supported by the family and community, together with assistance in managing psychological problems such as depression.

Reference

Kim, D.J. (2019) A Study on the Physical Activities, Mental Health, and Health-Related Quality of Life of Osteoarthritis Patients. Osong Public Health and Research Perspectives. 10(6), pp.368-375. doi: 10.24171/j.phrp.2019.10.6.07.