David Wasley

Revisiting the Measurement of Exercise-Induced Feeling States: The Physical Activity Affect Scale (PAAS)

Interest in acute exercise-induced feeling states has intensified in recent years, signaling the need for development of domain-specific measures of these constructs. In response to this call, 2 exercise-specific measures of feeling states have been introduced-namely, the Exercise-Induced Feeling Inventory (EFI; Gauvin & Rejeski, 1993) and the Subjective Exercise Experiences Scale (SEES; McAuley & Courneya, 1994). Although certain subscales of the 2 instruments are unique, a number of similar constructs exist both within and between instruments. The purpose of this study, therefore, was to (a) combine the EFI and SEES scales into a single, more encompassing instrument and (b) investigate potential factor redundancy within and between the 2 instruments. Initial correlational analyses indicated that the Positive Well-Being subscale of the SEES and the revitalization and Positive Engagement subscales of the EFI were highly correlated. Similar results were obtained for the Fatigue (SEES) and Physical Exhaustion (EFI) subscales. These findings provided the impetus for the construction of the Physical Activity Affect Scale (PAAS), an instrument consisting of the Psychological Distress subscale of the SEES and the subscales of the EFI. Exploratory and confirmatory factor analyses demonstrated support for 4 components of exercise-induced affect that were subsequently labeled positive affect, negative affect, fatigue, and tranquility. The PAAS appears to be an improvement over the EFI and SEES in that it is a more encompassing measure of exercise-induced feeling states with less component redundancy than its predecessors.

A randomized feasibility study of a 12-week community-based exercise program for people with Huntington's Disease

Background and Purpose: The beneficial role of exercise as a treatment approach in Huntingtons disease (HD) has support from both preclinical work and small-scale studies; however, there have been no controlled studies of gym-based exercise in people with HD. This phase 2 randomized trial (ISRCTN 59910670) assessed feasibility, safety, acceptability, and benefit of a structured exercise program. Methods: Thirty-one participants (16 men; mean [SD] age = 50.4 [11.4] years) were randomly allocated to intervention (n = 16) or control group (usual care; n = 15). The intervention entailed a weekly supervised gym session of stationary cycling and resistance exercises, and a twice weekly independent home-based walking program. Retention and adherence rates and adverse events were recorded. Acceptability was determined from subjective reports of tolerability and physiological measures recorded during the gym sessions. Assessment of benefit included measures of physical abilities, disease severity, and quality of life (36-Item Short Form Health Survey). Analysis of covariance was used to test outcomes of interest. Results: The retention rate was 81% (9 of the 11 individuals who started the intervention completed it) and of the 9 who completed the program, 7 attended more than 75% (9/12) of the gym sessions. There were no related adverse events and the intervention was well tolerated by most participants. The between-group effect estimate for the Mental Component Summary score of the 36-Item Short Form Health Survey (n = 9; intervention, n = 13; control) was 7 (95% CI: 0.4–13.7) Moderate effect sizes for cognitive outcomes and measures of walking were also observed. Discussion and Conclusions: Observed effect sizes for clinical outcomes suggest the structured exercise program has benefit for persons with HD; larger scale trials are warranted. Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A60) for more insights from the authors.

Complexity of physiological responses decreases in high-stress musical performance.

For musicians, performing in front of an audience can cause considerable apprehension; indeed, performance anxiety is felt throughout the profession, with wide ranging symptoms arising irrespective of age, skill level and amount of practice. A key indicator of stress is frequency-specific fluctuations in the dynamics of heart rate known as heart rate variability (HRV). Recent developments in sensor technology have made possible the measurement of physiological parameters reflecting HRV non-invasively and outside of the laboratory, opening research avenues for real-time performer feedback to help improve stress management. However, the study of stress using standard algorithms has led to conflicting and inconsistent results. Here, we present an innovative and rigorous approach which combines: (i) a controlled and repeatable experiment in which the physiological response of an expert musician was evaluated in a low-stress performance and a high-stress recital for an audience of 400 people, (ii) a piece of music with varying physical and cognitive demands, and (iii) dynamic stress level assessment with standard and state-of-the-art HRV analysis algorithms such as those within the domain of complexity science which account for higher order stress signatures. We show that this offers new scope for interpreting the autonomic nervous system response to stress in real-world scenarios, with the evolution of stress levels being consistent with the difficulty of the music being played, superimposed on the stress caused by performing in front of an audience. For an emerging class of algorithms that can analyse HRV independent of absolute data scaling, it is shown that complexity science performs a more accurate assessment of average stress levels, thus providing greater insight into the degree of physiological change experienced by musicians when performing in public.

Physical and psychological predictors of exercise dosage in healthy adults.

PURPOSE The purpose of this study was to examine the exercise dose-response issue in a sample of 121 regular exercisers categorized as relatively low, moderate, or high dosage physical activity participants. METHODS Male and female students, faculty, and staff of a midwestern university, currently engaging in various exercise modalities at least two times per week, were assessed on a variety of factors hypothesized to impact ones degree of exercise involvement. RESULTS ANOVA procedures indicated that low and high dosage groups differed significantly on the variables of age, exercise history, positive affect, and the locus of causality and stability attributional dimensions. Groups did not differ significantly in terms of body mass index, exercise efficacy, perceptions of either personal or external control over exercise behavior, or negative affective reactions to exercise behavior. CONCLUSIONS Taken together, the findings of this study suggest that individuals who exercise at varying doses of physical activity may be differentiated by certain demographic, behavioral, physiological, and psychological variables.

Exploring autonomic nervous system dysfunction in patients with cancer cachexia: A pilot study

INTRODUCTION Abnormalities of the autonomic nervous system (ANS) have been associated with cachexia. METHODS In nine cancer patients who had lost weight and nine age-matched healthy volunteers heart rate variability (HRV) components were determined, together with serum cortisol and urinary catecholamines/metanephrines. RESULTS Compared to volunteers, patients exhibited a global reduction in HRV parameters, significantly so for high frequency, low frequency and total power (median values ms(2) 103 vs. 313, 62 vs. 148 and 316 vs. 736 respectively, P<0.05). Biochemical values did not differ. CONCLUSION Our results suggest the presence of ANS dysfunction in patients with cancer cachexia, with reduction in both sympathetic and parasympathetic components.

Exercise testing and training in people with Huntington’s disease

Objective: To explore exercise response in people with Huntington’s disease (HD). Design: Experimental observational study with a randomly allocated subgroup before/after interventional study. Setting: Community. Subjects: People with HD (n=30) and a healthy comparator group (n=20). Thirteen people from the HD group were randomly allocated to an exercise training program. Main measures: Heart rate (HR) and perceived exertion on the Borg-CR10 scale (RPE) during a submaximal cycle ergometer exercise test (three minute unloaded and nine minute 65%-75%HRmaximum phase). Expired air and lactate measures were available for 8 people with HD during the exercise. Intervention: A 12 week gym and home walking exercise programme (n=13). Results: People with HD achieved a lower work rate at nine minutes (82±42(0-195) v 107±35(50 -185) Watts (p<0.05)), but higher RPE at both three (3±2(0-7) v 1±1(0-4)) and nine minutes (7±3(1-10) v 5± 2(2-9)) both p<0.01, compared to the healthy group and did not achieve a steady state HR during unloaded cycling. People with HD also demonstrated higher than expected lactate at three 2.5±2.5(1.1-8)mmo.L-1 and nine 3.8±1.9(1.2-6.6)mmo.L-1 minutes and respiratory exchange ratio at three 0.78±0.03 (0.74-0.81) and nine minutes 0.94±0.11(0.81-1.15). After exercise training there were no changes observed in HR or RPE responses during the exercise test. Conclusions: There was a large variability in the observed metabolic and physiological responses to exercise in people with HD. The observed exercise responses suggest that altered exercise prescription parameters may be required for people with HD and that exercise response and factors’ affecting this requires further investigation.

The effect of a supported exercise programme in patients with newly diagnosed Type 2 diabetes: A pilot study

Abstract The aim of this study was to examine the effectiveness of either a standard care programme (n = 9) or a 12-week supported exercise programme (n = 10) on glycaemic control, β-cell responsiveness, insulin resistance, and lipid profiles in newly diagnosed Type 2 diabetes patients. The standard care programme consisted of advice to exercise at moderate to high intensity for 30 min five times a week; the supported exercise programme consisted of three 60-min supported plus two unsupported exercise sessions per week. Between-group analyses demonstrated a difference for changes in low-density lipoprotein cholesterol only (standard care programme 0.01 mmol · L−1, supported exercise programme –0.6 mmol · L−1; P = 0.04). Following the standard care programme, within-group analyses demonstrated a significant reduction in waist circumference, whereas following the supported exercise programme there were reductions in glycosylated haemoglobin (6.4 vs. 6.0%; P = 0.007), waist circumference (101.4 vs. 97.2 cm; P = 0.021), body mass (91.7 vs. 87.9 kg; P = 0.007), body mass index (30.0 vs. 28.7 kg · m−2; P = 0.006), total cholesterol (5.3 vs. 4.6 mmol · L−1; P = 0.046), low-density lipoprotein cholesterol (3.2 vs. 2.6 mmol · L−1; P = 0.028), fasting β-cell responsiveness (11.5 × 10−9 vs. 7.0 × 10−9 pmol · kg−1 · min−1; P = 0.009), and insulin resistance (3.0 vs. 2.1; P = 0.049). The supported exercise programme improved glycaemic control through enhanced β-cell function associated with decreased insulin resistance and improved lipid profile. This research highlights the need for research into unsupported and supported exercise programmes to establish more comprehensive lifestyle advice for Type 2 diabetes patients.

Stage call: cardiovascular reactivity to audition stress in musicians

Auditioning is at the very center of educational and professional life in music and is associated with significant psychophysical demands. Knowledge of how these demands affect cardiovascular responses to psychosocial pressure is essential for developing strategies to both manage stress and understand optimal performance states. To this end, we recorded the electrocardiograms (ECGs) of 16 musicians (11 violinists and 5 flutists) before and during performances in both low- and high-stress conditions: with no audience and in front of an audition panel, respectively. The analysis consisted of the detection of R-peaks in the ECGs to extract heart rate variability (HRV) from the notoriously noisy real-world ECGs. Our data analysis approach spanned both standard (temporal and spectral) and advanced (structural complexity) techniques. The complexity science approaches—namely, multiscale sample entropy and multiscale fuzzy entropy—indicated a statistically significant decrease in structural complexity in HRV from the low- to the high-stress condition and an increase in structural complexity from the pre-performance to performance period, thus confirming the complexity loss theory and a loss in degrees of freedom due to stress. Results from the spectral analyses also suggest that the stress responses in the female participants were more parasympathetically driven than those of the male participants. In conclusion, our findings suggest that interventions to manage stress are best targeted at the sensitive pre-performance period, before an audition begins.

Fit to Perform: An Investigation of Higher Education Music Students’ Perceptions, Attitudes, and Behaviors toward Health

Making music at the highest international standards can be rewarding, but it is also challenging, with research highlighting pernicious ways in which practicing and performing can affect performers’ health and wellbeing. Several studies indicate that music students’ perceptions, attitudes, and behaviors toward health and healthy living are less than optimal, especially considering the multiple physical and psychological demands of their day-to-day work. This article presents the results of a comprehensive screening protocol that investigated lifestyle and health-related attitudes and behaviors among 483 undergraduate and postgraduate students (mean age = 21.29 years ± 3.64; 59% women) from ten conservatoires. The protocol included questionnaires measuring wellbeing, general health, health-promoting behaviors, perfectionism, coping, sleep quality, and fatigue. On each measure, the data were compared with existing published data from similar age groups. The results indicate that music students have higher levels of wellbeing and lower fatigue than comparable samples outside of music. However, they also reveal potentially harmful perceptions, attitudes, and behaviors toward health. Specifically, engagement in health responsibility and stress management was low, which along with high perfectionistic strivings, limited use of coping strategies, poor sleep quality, and low self-rated health, paints a troubling picture both for the music students and for those who support their training. The findings point to the need for more (and more effective) health education and promotion initiatives within music education; in particular, musicians should be better equipped with mental skills to cope with constant pressure to excel and high stress levels. In part, this calls for musicians themselves to engage in healthier lifestyles, take greater responsibility for their own health, and be aware of and act upon health information in order to achieve and sustain successful practice and performance. For that to happen, however, music educators, administrators, and policy makers must play an active role in providing supportive environments where health and wellbeing is considered integral to expert music training.

Music regulators in two string quartets: A comparison of communicative behaviors between low- and high-stress performance conditions

In ensemble performances, group members use particular bodily behaviors as a sort of “language” to supplement the lack of verbal communication. This article focuses on music regulators, which are defined as signs to other group members for coordinating performance. The following two music regulators are considered: body gestures for articulating attacks (a set of movements externally directed that are used to signal entrances in performance) and eye contact. These regulators are recurring observable behaviors that play an important role in non-verbal communication among ensemble members. To understand how they are used by chamber musicians, video recordings of two string quartet performances (Quartet A performing Bartók and Quartet B performing Haydn) were analyzed under two conditions: a low stress performance (LSP), undertaken in a rehearsal setting, and a high stress performance (HSP) during a public recital. The results provide evidence for more emphasis in gestures for articulating attacks (i.e., the perceived strength of a performed attack-type body gesture) during HSP than LSP. Conversely, no significant differences were found for the frequency of eye contact between HSP and LSP. Moreover, there was variability in eye contact during HSP and LSP, showing that these behaviors are less standardized and may change according to idiosyncratic performance conditions. Educational implications are discussed for improving interpersonal communication skills during ensemble performance.