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Therapeutic Impact of Exercise on Psychiatric Diseases

Guidelines for Exercise Testing and Prescription

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Abstract

Aerobic exercise seems to be effective in improving general mood and symptoms of depression and anxiety in healthy individuals and psychiatric patients. This effect is not limited to aerobic forms of exercise. There are almost no contraindications for psychiatric patients to participate in exercise programmes, provided they are free from cardiovascular and acute infectious diseases. However, very little is known about the effects of exercise in psychiatric disease other than those in depression and anxiety disorders. A few reports indicate the need for controlled investigations in psychotic and personality disorders.

Unfortunately, no general concept for a therapeutic application of physical activity has been developed so far. Reliance on submaximal measures is highly recommended for fitness assessment. Monitoring of exercise intensity during training sessions is most easily done by measuring the heart rate using portable devices (whereas controlling the exact workload may be preferable for scientific purposes). Appropriate pre- and post-training testing is emphasised to enable adequate determinations of fitness gains and to eventually allow positive feedback to be given to patients in clinical settings.

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References

  1. Morgan WP, Pollock ML. Psychologic characterization of the elite distance runner. Ann N Y Acad Sci 1977; 301: 382–403

    Article  PubMed  CAS  Google Scholar 

  2. Francis KT, Carter R. Psychological characteristic of joggers. J Sports Med Phys Fitness 1982; 22: 386–91

    PubMed  CAS  Google Scholar 

  3. Lobstein DD, Ismail AH, Rasmussen CL. Beta-endorphin and components of emotionality discriminate between physically active and sedentary men. Biol Psychiatry 1989; 26: 3–14

    Article  PubMed  CAS  Google Scholar 

  4. Wilson VE, Morley NC, Bird EI. Mood profiles of marathon runners, joggers and non-exercisers. Percept Mot Skills 1980; 50: 117–8

    Article  PubMed  CAS  Google Scholar 

  5. Hayden RM, Allen GJ. Relationship between aerobic exercise, anxiety, and depression: convergent validation by knowledgeable informants. J Sports Med Phys Fitness 1984; 24: 69–74

    PubMed  CAS  Google Scholar 

  6. Nouri S, Beer J. Relations of moderate physical exercise to scores on hostility, aggression, and trait-anxiety. Percept Mot Skills 1989; 68: 1191–4

    Article  PubMed  CAS  Google Scholar 

  7. Brown JD, Lawton M. Stress and well-being in adolescence: the moderating role of physical exercise. J Hum Stress 1986; 12: 125–31

    CAS  Google Scholar 

  8. Farmer ME, Locke BZ, Moscicki EK, et al. Physical activity and depressive symptoms: the NHANES I epidemiologic follow-up study. Am J Epidemiol 1988; 128: 1340–51

    PubMed  CAS  Google Scholar 

  9. Perri S, Templer DI. The effects of an aerobic exercise program on psychological variables in older adults. Int J Aging Hum Dev 1984-85; 20: 167–72

    Article  PubMed  Google Scholar 

  10. Abele A, Brehm W. Befindlichkeitsveränderungen im Sport. Sportwissenschaft 1986; 16: 288–302

    Google Scholar 

  11. Blumenthal JA, Emery CF, Madden DJ, et al. Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women. J Gerontol 1989; 44: M147–57

    Article  PubMed  CAS  Google Scholar 

  12. Moses J, Steptoe A, Mathews A, et al. The effects of exercise training on mental well-being in the normal population: a controlled trial. J Psychosom Res 1989; 33: 47–61

    Article  PubMed  CAS  Google Scholar 

  13. King AC, Taylor CB, Haskell WL, et al. Influence of regular aerobic exercise on psychological health: a randomized, controlled trial of healthy middle-aged adults. Health Psychol 1989; 8: 305–24

    Article  PubMed  CAS  Google Scholar 

  14. White JR, Case DA, McWhirter D, et al. Enhanced sexual behavior in exercising men. Arch Sex Behav 1990; 19: 193–20

    Article  PubMed  CAS  Google Scholar 

  15. Norris R, Carroll D, Cochrane R. The effects of physical activity and exercise training on psychological stress and well-being in an adolescent population. J Psychosom Res 1992; 36: 55–65

    Article  PubMed  CAS  Google Scholar 

  16. Simons CW, Birkimer JC. An exploration of factors predicting the effects of aerobic conditioning on mood state. J Psychosom Res 1988; 32: 63–75

    Article  PubMed  CAS  Google Scholar 

  17. Steptoe A, Edwards S, Moses J, et al. The effects of exercise training on mood and perceived coping ability in anxious adults from the general population. J Psychosom Res 1989; 33: 537–47

    Article  PubMed  CAS  Google Scholar 

  18. Desharnais R, Jobin J, Caté C, et al. Aerobic exercise and the placebo effect: a controlled study. Psychosom Med 1993; 55: 149–54

    PubMed  CAS  Google Scholar 

  19. Greist JH, Klein MH, Eischens RR, et al. Running as treatment for depression. Compr Psychiatry 1979; 20: 41–54

    Article  PubMed  CAS  Google Scholar 

  20. McCann IL, Holmes DS. Influence of aerobic exercise on depression. J Pers Soc Psychol 1984; 46: 1142–7

    Article  PubMed  CAS  Google Scholar 

  21. Martinsen EW, Hoffart A, Solberg O. Comparing aerobic with anerobic forms of exercise in the treatment of clinical depression: a randomized trial. Compr Psychiatry 1989; 30: 324–31

    Article  PubMed  CAS  Google Scholar 

  22. Martinsen EW, Medhus A, Sandvik L. Effects of aerobic exercise on depression: a controlled study. BrMed J (Clin Res Ed) 1985; 291: 109

    Article  CAS  Google Scholar 

  23. Doyne EJ, Ossip-Klein DJ, Bowman ED, et al. Running versus weightlifting in the treatment of depression. J Consult Clin Psychol 1987; 55: 748–54

    Article  PubMed  CAS  Google Scholar 

  24. Pappas GP, Golin S, Meyer DL. Reducing symptoms of depression with exercise [letter]. Psychosomatics 1990; 31: 112–3

    Article  PubMed  CAS  Google Scholar 

  25. Williams JM, Getty D. Effect of levels of exercise on psychological mood states, physical fitness, and plasma beta-endorphin. Percept Mot Skills 1986; 63: 1099–105

    Article  PubMed  CAS  Google Scholar 

  26. Orwin A. Treatment of a situational phobia: a case for running. Br J Psychiatry 1974; 125: 95–8

    Article  PubMed  CAS  Google Scholar 

  27. Muller B, Armstrong Jr HE. A further note on the ‘running treatment’ for anxiety. Psychotherapy 1975; 12: 385–7

    Article  Google Scholar 

  28. McDaniel WW. Panic disorder and exercise [letter]. Am J Psychiatry 1988; 145: 269

    PubMed  CAS  Google Scholar 

  29. Sexton H, Maere A, Dahl NH. Exercise intensity and reduction in neurotic symptoms: a controlled follow-up study. Acta Psychiatr Scand 1989; 80: 231–5

    Article  PubMed  CAS  Google Scholar 

  30. Broocks A, Bandelow B, Pekrun G, et al. Comparison of aerobic exercise, clomipramine, and placebo in the treatment of panic disorder. Am J Psychiatry 1998; 155: 603–9

    PubMed  CAS  Google Scholar 

  31. Morgan WP. Physical activity and mental health. Washington, DC: Taylor & Francis, 1997

    Google Scholar 

  32. McDonald DG, Hodgdon JA. Psychological effects of aerobic fitness training: research and theory. New York (NY): Springer, 1991

    Book  Google Scholar 

  33. Jones M, Mellersh V. A comparison of the exercise response in anxiety states and normal controls. Psychosom Med 1946; 8: 180–7

    PubMed  CAS  Google Scholar 

  34. Martinsen EW. Physical fitness, anxiety and depression. Br J Hosp Med 1990; 43: 194–9

    PubMed  CAS  Google Scholar 

  35. Martinsen EW, Strand J, Paulsson G, et al. Physical fitness level in patients with anxiety and depressive disorders. Int J Sports Med 1989; 10: 58–61

    Article  PubMed  CAS  Google Scholar 

  36. Broocks A, Meyer TF, Bandelow B, et al. Exercise avoidance and impaired endurance capacity in patients with panic disorder. Neuropsychobiology 1997; 36: 182–7

    Article  PubMed  CAS  Google Scholar 

  37. Meyer T, Broocks A, Bandelow B, et al. Endurance training in panic patients: spiroergometric and clinical effects. Int J Sports Med 1998; 19: 496–502

    Article  PubMed  CAS  Google Scholar 

  38. Taylor CB, King R, Ehlers A, et al. Treadmill exercise test and ambulatory measures in panic attacks. Am J Cardiol 1987; 60: 48–52J

    Article  Google Scholar 

  39. Greist JH, Klein MH, Eischens RR, et al. Running through your mind. J Psychosom Res 1978; 22: 259–94

    Article  PubMed  CAS  Google Scholar 

  40. Doyne EJ, Chambless DL, Beutler LE. Aerobic exercise as a treatment for depression in women. Behav Ther 1983; 14: 434–40

    Article  Google Scholar 

  41. MacMahon JR, Gross RT. Physical and psychological effects of aerobic exercise in delinquent adolescent males. Am J Dis Child 1988; 142: 1361–6

    PubMed  CAS  Google Scholar 

  42. Martinsen EW, Raglin JS, Hoffart A, et al. Tolerance to intensive exercise and high levels of lactate in panic disorder. J Anxiety Disord 1998; 12: 333–42

    Article  PubMed  CAS  Google Scholar 

  43. Sinyor D, Brown T, Rostant L, et al. The role of a physical fitness program in the treatment of alcoholism. J Stud Alcohol 1982; 43: 380–6

    PubMed  CAS  Google Scholar 

  44. Weber A. Running as treatment option: an experimental trial in stationary alcoholics [in German]. Suchtgefahren 1984; 30: 160–7

    Google Scholar 

  45. Adams L. How exercise can help people with mental health problems. Nurs Times 1995; 91 (36): 37–9

    PubMed  CAS  Google Scholar 

  46. Martinsen EW. Physical activity and depression: clinical experience. Acta Psychiatr Scand Suppl 1994; 377: 23–7

    Article  PubMed  CAS  Google Scholar 

  47. Hannaford CP, Harrell EH. Psychophysiological effects of a running program on depression and anxiety in a psychiatric population. Psychol Rec 1988; 38: 37–48

    Google Scholar 

  48. Fulcher KY, White PD. Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome. BMJ 1997; 314: 1647–52

    Article  PubMed  CAS  Google Scholar 

  49. Buchfuhrer MJ, Hansen JE, Robinson TE, et al. Optimizing the exercise protocol for cardiopulmonary assessment. J Appl Physiol 1983; 55: 1558–64

    PubMed  CAS  Google Scholar 

  50. Carney RM, Templeton B, Hong BA, et al. Exercise training reduces depression and increases the performance of pleasant activities in hemodialyses patients. Nephron 1987; 47: 194–8

    Article  PubMed  CAS  Google Scholar 

  51. Gayle RC, Spitter DL, Karper WB, et al. Psychological changes in exercising COPD patients. Int J Rehabil Res 1988; 11: 335–42

    Article  PubMed  CAS  Google Scholar 

  52. Lennox SS, Bedell JR, Stone AA. The effect of exercise on normal mood. J Psychosom Res 1990; 34: 629–36

    Article  PubMed  CAS  Google Scholar 

  53. Morgan WP, Horstman DH. Anxiety reduction following acute physical activity [abstract]. Med Sci Sports 1976; 8: 62

    Google Scholar 

  54. Meyer T, Gabriel HHW, Kindermann W. Is determination of exercise intensities as percentages of V̇O2max or HRmax adequate? Med Sci Sports Exerc 1999; 31: 1342–5

    Article  PubMed  CAS  Google Scholar 

  55. Weltman A, Weltman J, Rutt R, et al. Percentages of maximal heart rate, heart rate reserve, and V̇O2peak for determining endurance training intensity in sedentary women. Int J Sports Med 1989; 10: 212–6

    Article  PubMed  CAS  Google Scholar 

  56. Weltman A, Snead D, Seip R, et al. Percentages of maximal heart rate, heart rate reserve, and V̇O2max for determining endurance training intensity in male runners. Int J Sports Med 1990; 11: 218–22

    Article  PubMed  CAS  Google Scholar 

  57. Katch V, Weltman A, Sady S, et al. Validity of the relative percent concept for equating training intensity. Eur J Appl Physiol 1978; 39: 219–27

    Article  CAS  Google Scholar 

  58. LaPerriere A, Fletcher MA, Antoni MH, et al. Aerobic exercise training in an AIDS risk group. Int J Sports Med 1991; 12: S53–7

    Article  PubMed  Google Scholar 

  59. Kindermann W, Schramm M, Keul J. Aerobic performance diagnostics with different experimental settings. Int J Sports Med 1980; 1: 110–4

    Article  Google Scholar 

  60. Cramer SR, Nieman DC, Lee JW. The effects of moderate exercise training on psychological well-being and mood state in women. J Psychosom Res 1991; 35: 437–49

    Article  PubMed  CAS  Google Scholar 

  61. Jacobs I, Schele R, Sjodin B. Blood lactate vs. exhaustive exercise to evaluate aerobic fitness. Eur J Appl Physiol 1985; 54: 151–5

    CAS  Google Scholar 

  62. Jacobs I. Blood lactate: implications for training and sports performance. Sports Med 1986; 3: 10–25

    Article  PubMed  CAS  Google Scholar 

  63. Kindermann W, Simon G, Keul J. The significance of the aerobic-anaerobic transition for the determination of work load intensities during endurance training. Eur J Appl Physiol 1979; 42: 25–34

    Article  CAS  Google Scholar 

  64. Urhausen A, Kindermann W. Biochemical monitoring of training. Clin J Sport Med 1992; 2: 52–61

    Article  Google Scholar 

  65. Aunola S, Rusko H. Comparison of two methods for aerobic threshold determination. Eur J Appl Physiol 1988; 57: 420–4

    Article  CAS  Google Scholar 

  66. Beaver WL, Wasserman K, Whipp BJ. A new method for detecting anaerobic threshold by gas exchange. J Appl Physiol 1986; 60: 2020–7

    PubMed  CAS  Google Scholar 

  67. Caiozzo VJ, Davis JA, Ellis JF, et al. A comparison of gas exchange indices used to detect the anaerobic threshold. J Appl Physiol 1982; 53: 1184–9

    PubMed  CAS  Google Scholar 

  68. Fukuba Y, Munaka M, Usui S, et al. Comparison of objective methods for determining ventilatory threshold. Jpn J Physiol 1988; 38: 133–44

    Article  PubMed  CAS  Google Scholar 

  69. Orr GW, Green HJ, Hughson RL, et al. A computer linear regression model to determine ventilatory anaerobic threshold. J Appl Physiol 1982; 52: 1349–52

    PubMed  CAS  Google Scholar 

  70. Wasserman K, Whipp BJ, Koyl SN, et al. Anaerobic threshold and respiratory gas exchange during exercise. J Appl Physiol 1973; 35: 236–43

    PubMed  CAS  Google Scholar 

  71. Yoshida T, Nagata A, Muro M, et al. The validity of anaerobic threshold determination by a Douglas bag method compared with arterial blood lactate concentration. Eur J Appl Physiol 1981; 46: 423–30

    Article  CAS  Google Scholar 

  72. Rusko H, Luhtanen P, Rahkila P, et al. Muscle metabolism, blood lactate and oxygen uptake in steady state exercise at aerobic and anaerobic thresholds. Eur J Appl Physiol 1986; 55: 181–6

    Article  CAS  Google Scholar 

  73. Simon J, Young JL, Gutin B, et al. Lactate accumulation relative to the anaerobic and respiratory compensation thresholds. J Appl Physiol 1983; 54: 13–7

    PubMed  CAS  Google Scholar 

  74. Stegmann H, Kindermann W, Schnabel A. Lactate kinetics and individual anaerobic threshold. Int J Sports Med 1981; 2: 160–5

    Article  PubMed  CAS  Google Scholar 

  75. Röcker K, Schotte O, Niess AM, et al. Predicting competition performance in long-distance running by means of a treadmill test. Med Sci Sports Exerc 1998; 30: 1552–7

    Article  Google Scholar 

  76. Conconi F, Ferrari M, Ziglio PG, et al. Determination of the anaerobic threshold by a noninvasive field test in runners. J Appl Physiol 1982; 52: 869–73

    PubMed  CAS  Google Scholar 

  77. Aunola S, Rusko H. Reproducibility of aerobic and anaerobic thresholds in 20-50 year old men. Eur J Appl Physiol 1984; 53: 260–6

    Article  CAS  Google Scholar 

  78. Bunc V, Heller J, Novack J, et al. Determination of the individual anaerobic threshold. Acta Univ Carol (Gymnica) 1985; 27: 73–81

    Google Scholar 

  79. Borg G, Noble B. Perceived exertion. Exerc Sports Sci Rev 1974; 2: 131–53

    Article  CAS  Google Scholar 

  80. Whaley MH, Brubaker PH, Kaminsky LA, et al. Validity of rating of perceived exertion during graded exercise testing in apparently healthy adults and cardiac patients. J Cardiopulm Rehabil 1997; 17: 261–7

    Article  PubMed  CAS  Google Scholar 

  81. Whaley MH, Woodall T, Kaminsky LA, et al. Reliability of perceived exertion during graded exercise testing in apparently healthy adults. J Cardiopulm Rehabil 1997; 17: 37–42

    Article  PubMed  CAS  Google Scholar 

  82. Mahon AD, Duncan GE, Howe CA, et al. Blood lactate and perceived exertion relative to ventilatory threshold: boys versus men. Med Sci Sports Exerc 1997; 29: 1332–7

    Article  PubMed  CAS  Google Scholar 

  83. Wasserman K, Hansen JE, Sue DY, et al. Principles of exercise testing and interpretation. Philadelphia (PA): Lea & Febiger, 1987

    Google Scholar 

  84. King CN, Senn MD. Exercise testing and prescription: practical recommendations for the sedentary. Sports Med 1996; 21: 326–36

    Article  PubMed  CAS  Google Scholar 

  85. Dunbar CC, Bursztyn DA. The slope method for prescribing exercise with ratings of perceived exertion (RPE). Percept Mot Skills 1996; 83: 91–7

    Article  PubMed  CAS  Google Scholar 

  86. O’Connor PJ, Raglin JS, Morgan WP. Psychometric correlates of perception during arm ergometry in males and females. Int J Sports Med 1996; 17: 462–6

    Article  PubMed  Google Scholar 

  87. MacKinnon SN. Relating heart rate and rate of perceived exertion in two simulated occupational tasks. Ergonomics 1999; 42: 761–6

    Article  PubMed  CAS  Google Scholar 

  88. Hollmann W, Rost R, Liesen H, et al. Assessment of different forms of physical activity with respect to preventive and rehabilitative cardiology. Int J Sports Med 1981; 2: 67–80

    Article  PubMed  CAS  Google Scholar 

  89. Tanaka H, Swensen T. Impact of resistance training on endurance performance: a new form of cross-training? Sports Med 1998; 25: 191–200

    Article  PubMed  CAS  Google Scholar 

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Meyer, T., Broocks, A. Therapeutic Impact of Exercise on Psychiatric Diseases. Sports Med 30, 269–279 (2000). https://doi.org/10.2165/00007256-200030040-00003

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