Affective Responses to Both Climbing and Nordic Walking Exercise Are Associated With Intermediate-Term Increases in Physical Activity in Patients With Anxiety and Posttraumatic Stress Disorder - A Randomized Longitudinal Controlled Clinical Pilot Trial

Carina S Bichler, Martin Niedermeier, Katharina Hüfner, Mátyás Gálffy, Barbara Sperner-Unterweger, Martin Kopp, Carina S Bichler, Martin Niedermeier, Katharina Hüfner, Mátyás Gálffy, Barbara Sperner-Unterweger, Martin Kopp

Abstract

Background: Exercise programs have shown anxiolytic effects in psychiatric patients. Adherence to exercise programs and subsequent long-term lifestyle change is influenced by acute affective responses of the exercise programs. This research aimed to assess acute affective responses of two different exercise modalities compared to a non-exercise control program and its effects on persisting physical activity behavior change.

Methods: Sixty-six outpatients diagnosed with an anxiety disorder or posttraumatic stress disorder were randomly allocated to one of three groups in a randomized longitudinal controlled clinical pilot trial: climbing (n = 26), nordic walking (n = 19), social contact control (n = 21). Affective responses were assessed pre, during, and post activity. General physical activity behavior was recorded prior to participation in the program, post program, and at follow-ups three and six months after the program.

Results: Multilevel modeling analyzes of 1,066 individual data points revealed increases in affective valence in the exercise sessions compared to the social contact sessions. State anxiety decreased in the climbing group compared to the social contact group. Physical activity behavior was increased immediately following the program as well as at six months follow-up in both exercise groups. A larger increase in affective valence during and after the sessions was associated with higher physical activity post program.

Conclusions: Climbing and conventional nordic walking exercise sessions revealed positive affective changes in outpatients indicating therapeutic potential of both modalities for acute emotion regulation. In accordance with theoretical models of human behavior change, it was judged that the experience of a more pleasant affective state following the exercise sessions induced more persisting effects on physical activity behavior after the exercise programs.

Trial registration: https://www.clinicaltrials.gov/ct2/show/NCT03758599, identifier: NCT03758599.

Keywords: affective valence; anxiety; climbing therapy; exercise intervention; posttraumatic stress disorder; psychiatric disorder.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Bichler, Niedermeier, Hüfner, Gálffy, Sperner-Unterweger and Kopp.

Figures

Figure 1
Figure 1
Schedule of the complete project. Measurement of physical activity (PA) and Body Mass Index (BMI) at 4 timepoints (t1–t4). Procedure of measurement for affective responses from session 2–8. Set A Feeling Scale (FS) and Felt Arousal Scale (FAS) were recorded in all sessions. Set B was recorded in sessions 3 and 6 and additionally included the State-Trait-Anxiety Inventory (STAI).
Figure 2
Figure 2
Participant flow.
Figure 3
Figure 3
Dimensional affective responses, affective valence, and perceived activation over time separated by climbing group (left panel, filled gray circles), nordic walking group (middle panel, filled black circles), and social contact group (right panel, empty black circles). Circles represent mean values and error bars indicate standard deviations. *Indicates a significant time-by-group interaction both for affective valence and perceived activation.
Figure 4
Figure 4
State anxiety over time separated by groups. Circles represent mean values and error bars indicate standard deviations. *Indicates a significant time-by-group interaction.
Figure 5
Figure 5
Physical activity pre program (t1), post program (t2, n = 54), at follow-up 3 months post program (t3, n = 50), and at follow-up 6 months post program (t4, n = 49) separated by groups. Circles represent mean values and error bars indicate standard deviations. *Indicates a significant group difference in the analysis adjusted by physical activity pre program.

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