Publications by authors named "Kelli F Koltyn"

37 Publications

Exercise-induced increases in Anandamide and BDNF during extinction consolidation contribute to reduced threat following reinstatement: Preliminary evidence from a randomized controlled trial.

Psychoneuroendocrinology 2021 Oct 9;132:105355. Epub 2021 Jul 9.

University of Texas at Austin, Department of Psychiatry and Behavioral Sciences, 1601 Trinity St, Bldg B, Austin, TX 78712, United States.

Introduction: We recently demonstrated that moderate-intensity aerobic exercise delivered during the consolidation of fear extinction learning reduced threat expectancy during a test of extinction recall among women with posttraumatic stress disorder (PTSD). These findings suggest that exercise may be a potential candidate for improving the efficacy of exposure-based therapies, which are hypothesized to work via the mechanisms of fear extinction learning. The purpose of this secondary analysis was to examine whether exercise-induced increases in circulating concentrations of candidate biomarkers: endocannabinoids (anandamide [AEA]; 2-arachidonoylglycerol [2-AG], brain-derived neurotrophic factor (BDNF), and homovanillic acid (HVA), mediate the effects of exercise on extinction recall.

Methods: Participants (N = 35) completed a 3-day fear acquisition (day 1), extinction (day 2), and extinction recall (day 3) protocol, in which participants were randomly assigned to complete either moderate-intensity aerobic exercise (EX) or a light-intensity control (CON) condition following extinction training (day 2). Blood was obtained prior to and following EX or CON. Threat expectancy ratings during tests of extinction recall (i.e., initial fear recall and fear recall following reinstatement) were obtained 24 h following EX or CON. Mediation was tested using linear-mixed effects models and bootstrapping of the indirect effect.

Results: Circulating concentrations of AEA and BDNF (but not 2-AG and HVA) were found to mediate the relationship between moderate-intensity aerobic exercise and reduced threat expectancy ratings following reinstatement (AEA 95% CI: -0.623 to -0.005; BDNF 95% CI: -0.941 to -0.005).

Conclusions: Exercise-induced increases in peripheral AEA and BDNF appear to play a role in enhancing consolidation of fear extinction learning, thereby leading to reduced threat expectancies following reinstatement among women with PTSD. Future mechanistic research examining these and other biomarkers (e.g., brain-based biomarkers) is warranted.
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http://dx.doi.org/10.1016/j.psyneuen.2021.105355DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8487992PMC
October 2021

Aerobic exercise reduces anxiety and fear ratings to threat and increases circulating endocannabinoids in women with and without PTSD.

Ment Health Phys Act 2021 Mar 2;20. Epub 2020 Nov 2.

Department of Kinesiology at the University of Wisconsin-Madison, Madison, WI - USA.

Reductions in state anxiety have been reported following an acute bout of aerobic exercise. However, less is known regarding anxiety and fear ratings to specific threatening stimuli following an acute bout of aerobic exercise in women with PTSD. Moreover, the mechanisms responsible for the anxiolytic effects of exercise are not fully understood, although recent studies suggest a role for the endocannabinoid (eCB) system. Thus, this study utilized a randomized, counterbalanced approach to examine anxiety and fear ratings to predictable or unpredictable electric shock administration and circulating concentrations of eCBs and mood states immediately following moderate-intensity aerobic exercise (30 min on treadmill at 70-75% maximum heart rate) and a quiet rest control condition in women with and without a history of trauma, and in women with PTSD (N=42). Results revealed that anxiety and fear ratings to unpredictable and predictable threats were significantly (<.05) lower following exercise compared to quiet rest, with correlational analyses indicating those with greater increases in circulating eCBs had greater reductions in anxiety and fear ratings to unpredictable and predictable threats following exercise. Also, there were significant (<.05) reductions in fatigue, confusion, total mood disturbance, and increases in positive affect following exercise for the entire sample. Non-trauma controls and PTSD groups reported significant (<.05) increases in vigor, with additional mood improvements following exercise for the PTSD group (i.e., decreases in state anxiety, negative affect, tension, anger, and depression). Results from this study suggest that aerobic exercise exerts psychological benefits in women with PTSD, potentially due to exercise-induced increases in circulating concentrations of eCBs.
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http://dx.doi.org/10.1016/j.mhpa.2020.100366DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208522PMC
March 2021

Exercise and Neuropathic Pain: A General Overview of Preclinical and Clinical Research.

Sports Med Open 2021 Mar 22;7(1):21. Epub 2021 Mar 22.

Department of Kinesiology, University of Wisconsin-Madison, 1300 University Ave., Madison, WI, 53706, USA.

Neuropathic pain is a disease of the somatosensory system that is characterized by tingling, burning, and/or shooting pain. Medication is often the primary treatment, but it can be costly, thus there is an interest in understanding alternative low-cost treatments such as exercise. The following review includes an overview of the preclinical and clinical literature examining the influence of exercise on neuropathic pain. Preclinical studies support the hypothesis that exercise reduces hyperalgesia and allodynia in animal models of neuropathic pain. In human research, observational studies suggest that those who are more physically active have lower risk of developing neuropathic pain compared to those who are less active. Exercise studies suggest aerobic exercise training (e.g., 16 weeks); a combination of aerobic and resistance exercise training (e.g., 10-12 weeks); or high-intensity interval training (e.g., 15 weeks) reduces aspects of neuropathic pain such as worst pain over the past month, pain over the past 24 h, pain scores, or pain interference. However, not all measures of pain improve following exercise training (e.g., current pain, heat pain threshold). Potential mechanisms and future directions are also discussed to aid in the goal of understanding the role of exercise in the management of neuropathic pain. Future research using standardized methods to further understanding of the dose of exercise needed to manage neuropathic pain is warranted.
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http://dx.doi.org/10.1186/s40798-021-00307-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984211PMC
March 2021

The Feasibility and Effectiveness of a Community-Based Intervention to Reduce Sedentary Behavior in Older Adults.

J Appl Gerontol 2021 Jan 27:733464820987919. Epub 2021 Jan 27.

University of Wisconsin-Madison, USA.

The purpose of this study was to examine the effectiveness and feasibility of translating a 4-week "Stand Up and Move More" (SUMM) intervention by state aging units to older adults ( = 56, age = 74 years). A randomized controlled trial assessed sedentary behavior, physical function, and health-related quality of life (HRQoL) before and after the intervention. Participants included healthy community-dwelling, sedentary (sit > 6 hr/day) and aged ≥ 55 years adults. For the primary outcome, the SUMM group ( = 31) significantly ( < .05) reduced total sedentary time post-intervention by 68 min/day on average (Cohen's = -0.56) compared with no change in the wait-list control group ( = 25, Cohen's = 0.12). HRQoL and function also improved ( < .05) in the SUMM group post-intervention. Workshop facilitators indicated the intervention was easy to implement, and participants expressed high satisfaction. The SUMM intervention reduced sedentary time, improved physical function and HRQoL, and was feasible to implement in community settings.
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http://dx.doi.org/10.1177/0733464820987919DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313650PMC
January 2021

Psychological and endocannabinoid responses to aerobic exercise in substance use disorder patients.

Subst Abus 2021 15;42(3):272-283. Epub 2019 Nov 15.

Department of Kinesiology, University of Wisconsin, Madison, Wisconsin, USA.

Background: Exercise has been examined as an adjunctive treatment for substance use disorders (SUDs), yet few exercise interventions have been conducted among patients undergoing intensive outpatient (IOP) treatment, who may be the most vulnerable to relapse and for whom exercise could provide the most benefits. This study examined the effects of aerobic exercise, in addition to IOP treatment, on psychological variables and endocannabinoids in individuals with SUDs. : Twenty-one SUD patients (mean age 35 years) were recruited from local IOPs. Participants were randomized to either treatment-as-usual (TAU, at their outpatient clinic) or TAU plus aerobic exercise training (EX). EX participants engaged in supervised, moderate-intensity exercise for 30 min, 3 times/week for 6 weeks. TAU participants came into the laboratory once per week for assessments and a 30-min quiet rest session. Participants provided blood samples and completed questionnaires evaluating substance use, mood states, depression, anxiety, perceived stress, self-efficacy to abstain from substance use, and craving. Data were analyzed with Mann-Whitney tests or mixed model ANOVAs to determine group differences in outcomes acutely and over 6 weeks. : Over 6 weeks, there were reductions in perceived stress ( < 0.01) and craving ( < 0.05) for both groups. There were no group differences in abstinence rates or changes from baseline in self-efficacy, depression, or anxiety ( > 0.05). Acutely, both exercise and quiet rest sessions led to reductions in craving, tension, depression, anger, confusion, and total mood disturbance (all s < 0.05). In addition, the EX group experienced acute increases in vigor and circulating concentrations of the endocannabinoid, anandamide ( < 0.01). : An adjunctive aerobic exercise program during SUD treatment was associated with similar reductions in perceived stress and drug craving as standard care. Thirty minutes of exercise or quiet rest led to acute improvements in mood, but exercise produced the additional benefit of increases in vigor and circulating anandamide.
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http://dx.doi.org/10.1080/08897077.2019.1680480DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225058PMC
November 2019

Translating a "Stand Up and Move More" intervention by state aging units to older adults in underserved communities: Protocol for a randomized controlled trial.

Medicine (Baltimore) 2019 Jul;98(27):e16272

Department of Kinesiology, University of Wisconsin-Madison.

Introduction: As aging is associated with functional decline, preventing functional limitations and maintaining independence throughout later life has emerged as an important public health goal. Research indicates that sedentary behavior (prolonged sitting) is associated with functional loss and diminished ability to carry out activities of daily living. Despite many efforts to increase physical activity, which can be effective in countering functional loss, only an estimated 8% of older adults meet national physical activity guidelines. Thus, shifting the focus to reducing sitting time is emerging as a potential new intervention strategy but little research has been conducted in this area. With community support and funding, we developed and pilot tested a 4-week "Stand Up and Move More" intervention and found decreases in sedentary behavior, increases in physical activity, and improvements in mobility and vitality in a small sample of older adults. The purpose of this project is to expand upon these pilot results and examine the effectiveness and feasibility of translating a "Stand Up and Move More" intervention by State Aging Units to older adults in underserved communities. Eighty older adults from 4 counties across Wisconsin predominantly made up of rural older adults and older African American adults are randomly assigned to intervention (n = 40) or wait-list control (n = 40) groups. The intervention consists of 4 weekly sessions plus a refresher session at 8 weeks, and is delivered by community partners in each county. The sessions are designed to elicit ideas from older adults regarding how they can reduce their sitting time, help them set practical goals, develop action plans to reach their goals, and refine their plans across sessions to promote behavior change. Sedentary behavior, physical activity levels, functional performance, and health-related quality of life are assessed before and after the intervention to examine the effectiveness of the program. Feasibility of implementing the program by our community partners is assessed via semi-structured interviews. Strengths of this project include strong community collaborations and a high need given that the older adult population is projected to increase substantially in the next 15 years.

Conclusion: This project will provide an important step in developing effective strategies for maintaining independence in older adults through determining the feasibility and impact of a community-based intervention to break up sitting time.
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http://dx.doi.org/10.1097/MD.0000000000016272DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635154PMC
July 2019

Loss of exercise- and stress-induced increases in circulating 2-arachidonoylglycerol concentrations in adults with chronic PTSD.

Biol Psychol 2019 07 9;145:1-7. Epub 2019 Apr 9.

Department of Kinesiology, University of Wisconsin-Madison, 2000 Observatory Dr., Madison, WI, 53706, USA.

The endocannabinoid (eCB) system is a modulatory system that is both altered by stress and mediates the effects of acute stress, including contributing to restoration of homeostasis. Earlier studies suggest that circulating eCBs are dysregulated in adults with post-traumatic stress disorder (PTSD); however, it is not known whether circulating eCBs remain responsive to stress. The purpose of this study was to examine eCB and psychological responses to physical (exercise) and psychosocial (Trier Social Stress Test) stressors, using a randomized, counterbalanced procedure in adults with PTSD and healthy controls (N = 20, mean age = 24, SD = 7 yrs). Results from mixed-design, repeated measures ANOVAs revealed significant increases (p <  .05) in N-arachidonoylethanolamine (AEA) and oleoylethanolamide (OEA) following exercise and psychosocial stress in both groups. However, only the control group exhibited a significant increase (p < .05) in 2-arachidonoylglycerol (2-AG) following exercise and psychosocial stress exposure. These data extend our current understanding of circulating eCB responsiveness in PTSD, and provide preliminary evidence to suggest that the eCB system is hypoactive in PTSD following exposure to physical and psychosocial stressors.
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http://dx.doi.org/10.1016/j.biopsycho.2019.04.002DOI Listing
July 2019

Serum Endocannabinoid and Mood Changes after Exercise in Major Depressive Disorder.

Med Sci Sports Exerc 2019 09;51(9):1909-1917

Department of Kinesiology, University of Wisconsin-Madison, Madison WI.

The endocannabinoid (eCB) system is implicated in the pathophysiology of depression and is responsive to acute exercise in healthy adults.

Purpose: We aimed to describe acute changes in serum eCB across a prescribed moderate (MOD) and a self-selected/preferred (PREF) intensity exercise session in women with major depressive disorder (MDD) and determine relationships between changes in eCB and mood states.

Methods: Women with MDD (n = 17) exercised in separate sessions for 20 min on a cycle ergometer at both MOD or PREF in a within-subjects design. Blood was drawn before and within 10 min after exercise. Serum concentrations of eCB (anandamide [AEA], 2-arachidonoylglycerol) and related lipids (palmitoylethanolamine, oleoylethanolamine, 2-oleoylglycerol) were quantified using stable isotope-dilution, liquid chromatography/mass spectrometry/mass spectrometry. The profile of mood states and state-trait anxiety inventory (state only) were completed before, 10 min and 30 min postexercise.

Results: Significant elevations in AEA (P = 0.013) and oleoylethanolamine (P = 0.024) occurred for MOD (moderate effect sizes: Cohen's d = 0.58 and 0.41, respectively). Significant (P < 0.05) moderate negative associations existed between changes in AEA and mood states for MOD at 10 min (depression, confusion, fatigue, total mood disturbance [TMD] and state anxiety) and 30 min postexercise (confusion, TMD and state anxiety). Significant (P < 0.05) moderate negative associations existed between 2-arachidonoylglycerol and mood states at 10 min (depression and confusion) and 30 min postexercise (confusion and TMD). Changes in eCB or related lipids or eCB-mood relationships were not found for PREF.

Conclusion: Given the broad, moderate-strength relationships between improvements in mood states and eCB increases after MOD, it is plausible that the eCB system contributes to the mood-enhancing effects of prescribed acute exercise in MDD. Alternative mechanisms are likely involved in the positive mood state effects of preferred exercise.
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http://dx.doi.org/10.1249/MSS.0000000000002006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727944PMC
September 2019

Intervening to reduce sedentary behavior in older adults - pilot results.

Health Promot Perspect 2019 23;9(1):71-76. Epub 2019 Jan 23.

Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.

Older adults spend most of their day in sedentary behavior (SB) (i.e., prolonged sitting), increasing risk for negative health outcomes, functional loss, and diminished ability for activities of daily living. The purpose of this study was to develop and pilot test an intervention designed to reduce SB in older adults that could be translated to communities. Two pilot studies implementing a 4-week SB intervention were conducted. SB,physical function, and health-related quality of life were measured via self-report and objective measures. Participants (N=21) completed assessments pre- and post-intervention (studies 1 and 2) and at follow-up (4-weeks post-intervention; study 2). Due to the pilot nature of this research, data were analyzed with Cohen's d effect sizes to examine the magnitude of change in outcomes following the intervention. Results for study 1 indicated moderate (d=0.53) decreases in accelerometry-obtained total SB and increases (d=0.52) in light intensity physical activity post-intervention. In study 2,there was a moderate decrease (d=0.57) in SB evident at follow-up. On average SB decreased by approximately 60 min/d in both studies. Also, there were moderate-to-large improvements in vitality (d=0.74; study 1) and gait speed (d=1.15; study 2) following the intervention. Further,the intervention was found to be feasible for staff to implement in the community. These pilot results informed the design of an ongoing federally funded randomized controlled trial with a larger sample of older adults from underserved communities. Effective,feasible, and readily-accessible interventions have potential to improve the health and function of older adults.
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http://dx.doi.org/10.15171/hpp.2019.09DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377700PMC
January 2019

Psychobiological Responses to Aerobic Exercise in Individuals With Posttraumatic Stress Disorder.

J Trauma Stress 2018 02 1;31(1):134-145. Epub 2018 Feb 1.

Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Previous reports have shown improvements in mood and increases in endocannabinoids in healthy adults following a session of aerobic exercise, but it is unclear whether adults with posttraumatic stress disorder (PTSD) experience similar responses. The purpose of this study was to examine psychobiological responses (plasma endocannabinoids [eCBs], mood, and pain) to aerobic exercise in a sample of adults with a diagnosis of PTSD (n = 12) and healthy controls (n = 12). Participants engaged in an aerobic exercise session in which they ran on a treadmill for 30 min at a moderate intensity (70 to 75% maximum heart rate [MHR]). Results indicated improvements in mood states and reductions in pain for both groups following exercise, ds = 0.19 to 1.53. Circulating concentrations of N-arachidonylethanolamine (AEA), 2-arachidonoylglycerol (2-AG), and oleoylethanolamide (OEA) significantly increased (ps = .000 to .050) following the aerobic exercise session for both groups. There were no significant time, group, or interaction effects (ps = .062 to .846) for palmitoylethanolamide (PEA) and 2-oleoylglycerol (2-OG). Although eCBs increased significantly for both groups, within-group effect size calculations indicated the healthy controls experienced a greater magnitude of change for AEA when compared with adults with PTSD, d = 1.21 and d = 0.45, respectively; as well as for 2-AG, d = 0.43 and d = 0.21, respectively. The findings from this study indicated that adults with and without PTSD reported significant mood improvements following 30 min of moderate-intensity aerobic exercise. In addition, the endocannabinoid system was activated in adults with and without PTSD, although effect sizes suggest that adults with PTSD may have a blunted endocannabinoid response to exercise.
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http://dx.doi.org/10.1002/jts.22253DOI Listing
February 2018

Cerebral white matter structure is disrupted in Gulf War Veterans with chronic musculoskeletal pain.

Pain 2017 Dec;158(12):2364-2375

Department of Veterans Affairs, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.

Chronic musculoskeletal pain (CMP) affects ∼25% of the 700,000 Veterans deployed during the Persian Gulf War (1990-1991). The cause of their pain is unknown, and there are no efficacious treatments. A small body of literature suggests that brain abnormalities exist in Gulf War Veterans (GVs), yet relationships between brain abnormalities and disease symptoms remain largely unexplored. Our purpose was to compare white matter (WM) integrity between GVCMP and matched, healthy Veteran controls (GVCO) and investigate relationships between cerebral WM integrity and symptoms. Thirty GVCMP and 31 controls completed magnetic resonance imaging with diffusion tensor imaging. Tract-based spatial statistics estimated WM fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity over the whole brain (P < 0.05) and were corrected using threshold-free cluster enhancement. GVCMP had greater pain symptoms and mood disturbance and lower quality of life and physical function compared with GVCO (P < 0.05). GVCMP had lower WM integrity across several brain regions implicated in chronic pain (P < 0.05) including the middle and inferior frontal gyrus, corpus callosum, corona radiata, precentral gyrus, external capsule, and posterior thalamic radiation. For GVCMP, WM integrity was associated with pain and mood symptoms in widespread brain areas that were found to be different between groups (P < 0.05). Results indicate widespread WM microstructure disruption across brain regions implicated in pain processing and modulation in chronic pain. The observed relationships between WM microstructure and symptoms encourage the testing of treatments designed to improve the brain health of affected Veterans.
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http://dx.doi.org/10.1097/j.pain.0000000000001038DOI Listing
December 2017

Cognitive Resilience and Psychological Responses across a Collegiate Rowing Season.

Med Sci Sports Exerc 2017 Nov;49(11):2276-2285

1Department of Kinesiology, University of Wisconsin-Madison, Madison, WI; and 2Research Service, Department of Veterans Affairs, William S. Middleton Memorial Veterans Hospital, Madison, WI.

Introduction: Student-athletes face numerous challenges across their competitive season. Although mood states have been previously studied, little is known about adaptations in other psychological responses, specifically cognition. The purpose of this study was to characterize cognitive function, mood, sleep, and stress responses at select time points of a season in collegiate rowers. It was hypothesized that during baseline, typical training, and recovery, athletes would show positive mental health profiles, in contrast to decreases in cognition with increases in negative mood and measurements of stress during peak training.

Methods: Male and female Division I rowers (N = 43) and healthy controls (N = 23) were enrolled and assessed at baseline, typical training, peak training, and recovery. At each time point, measures of cognitive performance (Stroop color-naming task), academic and exercise load, perceived cognitive deficits, mood states, sleep, and stress (via self-report and salivary cortisol) were recorded.

Results: Repeated-measures ANOVA revealed significant group-time interactions for perceived exercise load, cognitive deficits, mood states, and perceived stress (P < 0.05). For athletes during peak training, the perception of cognitive deficits was positively correlated with mood disturbance (r = 0.54, P < 0.05) and perceived stress (r = 0.55, P < 0.05) and negatively correlated with response accuracy during incongruent Stroop trials (r = -0.38, P < 0.05). Cognitive performance did not change over the course of the season for either group. Cortisol and sleepiness changed over the course of the season but no significant interactions were observed.

Conclusion: These results demonstrate that various psychological responses change over the course of a season, but they also highlight adaptation indicative of cognitive resilience among student-athletes.
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http://dx.doi.org/10.1249/MSS.0000000000001363DOI Listing
November 2017

Endocannabinoid and Opioid System Interactions in Exercise-Induced Hypoalgesia.

Pain Med 2018 01;19(1):118-123

Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin.

Objective: The purpose of this study was to examine the interaction between the endogenous opioid and endocannabinoid (eCB) systems in a pain modulatory process known as exercise-induced hypoalgesia (EIH).

Design: Randomized controlled trial.

Setting: Clinical research unit in a hospital.

Subjects: Fifty-eight healthy men and women (mean age = 21 ± 3 years) participated in this study.

Methods: Participants were administered (randomized, double-blind, counterbalanced procedure) an opioid antagonist (i.e., naltrexone) and a placebo prior to performing pain testing and isometric exercise.

Results: Results indicated that 2-arachidonoylglycerol (2-AG) and 2-oleoylglycerol (2-OG) increased significantly (P < 0.05) following exercise in both placebo and naltrexone conditions. In comparison, N-arachidonylethanolamine (AEA) and oleoylethanolamine (OEA) increased significantly (P < 0.05) following exercise in the placebo condition but not the naltrexone condition. There were no significant (P > 0.05) differences in palmitolethanolamine (PEA) between the placebo and naltrexone conditions.

Conclusions: As reductions in pain (i.e., EIH) were observed following both conditions, these results suggest that the opioid system may not be the primary system involved in exercise-induced hypoalgesia and that 2-AG and 2-OG could contribute to nonopioid exercise-induced hypoalgesia. Moreover, as exercise-induced increases in AEA and OEA were blocked by naltrexone pretreatment, this suggests that the opioid system may be involved in the increase of AEA and OEA following exercise.
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http://dx.doi.org/10.1093/pm/pnx058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454785PMC
January 2018

Endocannabinoid and Mood Responses to Exercise in Adults with Varying Activity Levels.

Med Sci Sports Exerc 2017 08;49(8):1688-1696

1Department of Kinesiology, University of Wisconsin-Madison, Madison, WI; and 2Neuroscience Research Center and Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI.

Acute aerobic exercise improves mood and activates the endocannabinoid (eCB) system in physically active individuals; however, both mood and eCB responses to exercise may vary based on habitual levels of physical activity.

Purpose: This study aimed to examine eCB and mood responses to prescribed and preferred exercises among individuals with low, moderate, and high levels of physical activity.

Methods: Thirty-six healthy adults (21 ± 4 yr) were recruited from low (≤60 min moderate-vigorous physical activity [MVPA] per week), moderate (150-299 min MVPA per week), and high (≥300 MVPA per week) physical activity groups. Participants performed both prescribed (approximately 70%-75% max) and preferred (i.e., self-selected) aerobic exercise on separate days. Mood states and eCB concentrations were assessed before and after exercise conditions.

Results: Both preferred and prescribed exercise resulted in significant increases (P < 0.01) in circulating eCB (N-arachidonoylethanolamine [AEA] and 2-arachidonoylglycerol); however, increases in AEA (P < 0.05) were larger in the prescribed condition. Likewise, both preferred and prescribed exercise elicited positive mood improvements compared with preexercise values, but changes in state anxiety, total mood disturbance, and confusion were greater in the preferred condition (P < 0.05). Changes in 2-arachidonoylglycerol concentrations were found to negatively correlate with changes in depression, tension, and total mood disturbance in the preferred condition (P < 0.05), and changes in AEA were positively associated with changes in vigor in the prescribed condition (P < 0.05). There were no significant group differences for mood or eCB outcomes.

Conclusion: These results indicate that eCB and mood responses to exercise do not differ significantly between samples with varying physical activity levels. This study also demonstrates that in addition to prescribed exercise, preferred exercise activates the eCB system, and this activation may contribute to positive mood outcomes with exercise.
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http://dx.doi.org/10.1249/MSS.0000000000001276DOI Listing
August 2017

Psychosocial Influences on Exercise-Induced Hypoalgesia.

Pain Med 2017 03;18(3):538-550

Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Objective: The purpose of this study was to examine psychosocial influences on exercise-induced hypoalgesia (EIH).

Design: Randomized controlled trial.

Setting: Clinical research unit in a hospital.

Subjects: Fifty-eight healthy men and women (mean age = 21 ± 3 years) participated in this study.

Methods: Participants were first asked to complete a series of baseline demographic and psychological questionnaires including the Pain Catastrophizing Scale, the Fear of Pain Questionnaire, and the Family Environment Scale. Following this, they were familiarized with both temporal summation of heat pain and pressure pain testing protocols. During their next session, participants completed the Profile of Mood States, rated the intensity of heat pulses, and indicated their pressure pain thresholds and ratings before and after three minutes of submaximal, isometric exercise. Situational catastrophizing was assessed at the end of the experimental session.

Results: Results indicated that experimental pain sensitivity was significantly reduced after exercise ( P  < 0.05). Men and women did not differ on any of the measured psychosocial variables ( P  > 0.05). Positive family environments predicted attenuated pain sensitivity and greater EIH, whereas negative and chronic pain-present family environments predicted worse pain and EIH outcomes. Situational catastrophizing and negative mood state also predicted worse pain and EIH outcomes and were additionally associated with increased ratings of perceived exertion and muscle pain during exercise.

Conclusions: This study provides preliminary evidence that psychosocial variables, such as the family environment and mood states, can affect both pain sensitivity and the ability to modulate pain through exercise-induced hypoalgesia.
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http://dx.doi.org/10.1093/pm/pnw275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8491610PMC
March 2017

Psychobiological Responses to Preferred and Prescribed Intensity Exercise in Major Depressive Disorder.

Med Sci Sports Exerc 2016 11;48(11):2207-2215

1Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI; 2Department of Kinesiology, University of Wisconsin-Madison, Madison, WI; 3Department of Kinesiology, Iowa State University, Ames, IA; 4William S. Middleton Memorial Veterans Hospital, Madison, WI; and 5Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI.

Exercise acutely improves mood in major depressive disorder (MDD). However, it is unknown whether benefits differ depending on whether exercise intensity is self-selected or prescribed.

Purpose: This study aimed to compare psychological and biological responses to preferred and prescribed steady-state exercise intensities to a patient-selected preferred intensity.

Method: Female adults (N = 24, age = 38.6 ± 14.0 yr) diagnosed with MDD completed four 30-min sessions of cycling exercise at three prescribed intensities (RPE of 11, 13, and 15) and one session with a self-selected intensity (preferred). Order was randomized and counterbalanced. Depressed mood (DM) was evaluated before, 10 min, and 30 min postexercise using the Profile of Mood States. Serum brain-derived neurotrophic factor (BDNF) was measured before and within 10 min postexercise. Changes in BDNF and DM for the preferred session were compared with the following prescribed sessions: 1) performed at the most similar intensity (matched on RPE; closest) and 2) with the greatest improvement in DM (greatest).

Results: Compared with the preferred session, improvement in DM was significantly larger after the greatest session (30 min postexercise: -11.8 ± 7.4 vs -3.4 ± 4.8), and the BDNF response was significantly greater after the closest session (5.4 ± 6.9 vs -1.4 ± 9.8 ng·mL).

Conclusions: Permitting patients to select their own exercise intensity did not maximize improvements in mood. Further, preferred intensity exercise was also associated with a smaller BDNF response. Overall, the results suggest that exercise undertaken to improve mood should be prescribed on an individual basis in MDD and not necessarily based on the patient's preferred intensity. Clinicians, psychologists, and other practitioners should consider providing clear exercise intensity recommendations for symptom management in depression rather than allowing patients to self-select their intensity.
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http://dx.doi.org/10.1249/MSS.0000000000001022DOI Listing
November 2016

Relationships between serum BDNF and the antidepressant effect of acute exercise in depressed women.

Psychoneuroendocrinology 2016 12 28;74:286-294. Epub 2016 Sep 28.

William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA; Department of Kinesiology, University of Wisconsin-Madison, 2000 Observatory Drive, Madison, WI 53706, USA.

Objective: Brain-derived neurotrophic factor (BDNF) has recently emerged as one potential mechanism with which exercise improves mood in major depressive disorder (MDD). This study examined the relationship between changes in serum total BDNF and mood following acute exercise in MDD. It was hypothesized that acute exercise would increase BDNF in an intensity-dependent manner and that changes in BDNF would be significantly related to improvement in depressed mood post-exercise.

Methods: Twenty-four women (age: 38.6±14.0years) with MDD exercised for 30min on a stationary bicycle at light, moderate and hard exercise intensities and performed a quiet rest session using a within-subjects, randomized and counter-balanced design. Before, 10 and 30min after each session, participants completed the profile of mood states (POMS). Blood was drawn before and within 10min after completion of each session and serum total BDNF (sBDNF) was measured by enzyme-linked immunosorbent assay. Acute exercise-induced changes in POMS Depression and sBDNF were analyzed via 4 session (quiet rest, light, moderate, hard) by 2 measurement (pre, post) ANOVA. Secondary analyses examined the effects of baseline mood and antidepressant usage on sBDNF.

Results: Exercise resulted in an acute improvement in depressed mood that was not intensity dependent (p>0.05), resulting in significant acute increases in sBDNF (p=0.006) that were also not intensity-dependent (p>0.05). Acute changes in sBDNF were not significantly correlated to changes in POMS depression at 10m (r=-0.171, p=0.161) or 30m (r=-0.151, p=0.215) post-exercise. The fourteen participants taking antidepressant medications exhibited lower post-exercise sBDNF (p=0.015) than the participants not currently taking antidepressants, although mood responses were similar.

Conclusion: Acute exercise is an effective mood-enhancing stimulus, although sBDNF does not appear to play a role in this short-term response. Patients who are not currently taking antidepressant medications and those who have greater pre-exercise depression may experience a greater sBDNF response to exercise, but the clinical significance of this is currently unclear. Circulating BDNF levels are unlikely to be altered by steady-state acute exercise in a linear dose-dependent manner. This does not eliminate its potential relevance in the antidepressant response to chronic exercise training, but suggests that other mechanisms are involved in the acute affective response to exercise in depression.
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http://dx.doi.org/10.1016/j.psyneuen.2016.09.022DOI Listing
December 2016

Influence of Exercise Intensity for Improving Depressed Mood in Depression: A Dose-Response Study.

Behav Ther 2016 07 27;47(4):527-37. Epub 2016 Apr 27.

William S. Middleton Memorial Veterans Hospital, Madison, WI; University of Wisconsin-Madison.

Introduction: Exercise effectively improves mood in major depressive disorder (MDD), but the optimal exercise stimulus to improve depressed mood is unknown.

Purpose: To determine the dose-response relationship of acute exercise intensity with depressed mood responses to exercise in MDD. We hypothesized that the acute response to exercise would differ between light, moderate, and hard intensity exercise with higher intensities yielding more beneficial responses.

Methods: Once weekly, 24 women (age: 38.6±14.0) diagnosed with MDD underwent a 30-minute session at one of three steady-state exercise intensities (light, moderate, hard; rating of perceived exertion 11, 13 or 15) or quiet rest on a stationary bicycle. Depressed mood was evaluated with the Profile of Mood States before, 10 and 30 minutes post-exercise.

Results: Exercise reduced depressed mood 10 and 30 minutes following exercise, but this effect was not influenced by exercise intensity. Participants not currently taking antidepressants (n=10) had higher baseline depression scores, but did not demonstrate a different antidepressant response to exercise compared to those taking antidepressants.

Conclusions: To acutely improve depressed mood, exercise of any intensity significantly improved feelings of depression with no differential effect following light, moderate, or hard exercise. Pharmacological antidepressant usage did not limit the mood-enhancing effect of acute exercise. Acute exercise should be used as a symptom management tool to improve mood in depression, with even light exercise an effective recommendation. These results need to be replicated and extended to other components of exercise prescription (e.g., duration, frequency, mode) to optimize exercise guidelines for improving depression.
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http://dx.doi.org/10.1016/j.beth.2016.04.003DOI Listing
July 2016

Exercise as an adjunctive treatment for cannabis use disorder.

Am J Drug Alcohol Abuse 2016 09 17;42(5):481-489. Epub 2016 Jun 17.

a Department of Kinesiology , University of Wisconsin-Madison , Madison , WI , USA.

Background: Despite cannabis being the most widely used illicit substance in the United States, individuals diagnosed with cannabis use disorder (CUD) have few well-researched, affordable treatment options available to them. Although found to be effective for improving treatment outcomes in other drug populations, exercise is an affordable and highly accessible treatment approach that has not been routinely investigated in cannabis users.

Objectives: The aim of this paper is to inform the topic regarding exercise's potential as an adjunctive treatment for individuals with CUD.

Methods: We reviewed the evidence surrounding cannabis use and its current treatment in the United States, explored the rationale for including exercise in the treatment of substance use disorders (SUDs), and in particular, proposed a biological mechanism (i.e., endocannabinoids (eCBs)) that should be examined when utilizing exercise for the treatment of CUD.

Results: Cannabis use is widespread and increasing in the United States. Chronic, heavy cannabis use may dysregulate the endogenous cannabinoid system, which has implications for several psychobiological processes that interact with the eCB system such as reward processing and the stress response. Given that exercise is a potent activator of the eCB system, it is mechanistically plausible that exercise could be an optimal method to supplement cessation efforts by reducing psychophysical withdrawal, managing stress, and attenuating drug cravings.

Conclusion: We suggest there is a strong behavioral and physiological rationale to design studies which specifically assess the efficacy of exercise, in combination with other therapies, in treating CUD. Moreover, it will be especially important to include the investigation of psychobiological mechanisms (e.g., eCBs, hippocampal volume), which have been associated with both exercise and SUDs, to examine the broader impact of exercise on behavioral and physiological responses to treatment.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055462PMC
http://dx.doi.org/10.1080/00952990.2016.1185434DOI Listing
September 2016

Exercise Strengthens Central Nervous System Modulation of Pain in Fibromyalgia.

Brain Sci 2016 Feb 26;6(1). Epub 2016 Feb 26.

William S. Middleton Memorial Veterans Hospital, Madison, WI 53706, USA.

To begin to elucidate the mechanisms underlying the benefits of exercise for chronic pain, we assessed the influence of exercise on brain responses to pain in fibromyalgia (FM). Complete data were collected for nine female FM patients and nine pain-free controls (CO) who underwent two functional neuroimaging scans, following exercise (EX) and following quiet rest (QR). Brain responses and pain ratings to noxious heat stimuli were compared within and between groups. For pain ratings, there was a significant (p < 0.05) Condition by Run interaction characterized by moderately lower pain ratings post EX compared to QR (d = 0.39-0.41) for FM but similar to ratings in CO (d = 0.10-0.26), thereby demonstrating that exercise decreased pain sensitivity in FM patients to a level that was analogous to pain-free controls. Brain responses demonstrated a significant within-group difference in FM patients, characterized by less brain activity bilaterally in the anterior insula following QR as compared to EX. There was also a significant Group by Condition interaction with FM patients showing less activity in the left dorsolateral prefrontal cortex following QR as compared to post-EX and CO following both conditions. These results suggest that exercise appeared to stimulate brain regions involved in descending pain inhibition in FM patients, decreasing their sensitivity to pain. Thus, exercise may benefit patients with FM via improving the functional capacity of the pain modulatory system.
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http://dx.doi.org/10.3390/brainsci6010008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4810178PMC
February 2016

Inducing a blind spot: blinding data collectors in an investigation of experimental pain.

Pain Med 2015 Jun 3;16(6):1145-54. Epub 2015 Feb 3.

Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty Medicine, Aalborg University, Denmark.

Objective: Methods of blinding have been infrequently investigated. This study assessed data collector blinding within an investigation of endogenous pain modulation.

Design: Participants (N = 33; 52% women) were randomly assigned to an order of an exercise bout with intramuscular control injections, quiet rest with intramuscular algesic injections, and a control condition. Data collectors (N = 4; 50% women) recorded participants' pain responses and then left the room before the injection and exercise procedures were administered by other personnel. Immediately after the procedures, the data collectors returned to collect additional pain responses and record their suspicions regarding the assigned condition, their confidence level in their suspicions (0-100 mm scale), and the reason/s for their suspicions.

Results: Data collectors correctly identified control and algesic injections in 90.4 and 73.1% of the sessions, respectively, and quiet rest and exercise in 94.2 and 69.2% of the sessions, respectively. The confidence of the data collectors in their suspicions was 60.17 mm (SD = 34.54) for injections and 62.19 mm (SD = 34.95) for exercise. However, data collectors only had correct suspicions and confidence of at least 90 mm for 26.2% of the injections and 29.4% of the exercise bouts. Participants' pain responses were the primary reason for data collectors' suspicions. Neither the amount of experience nor the sexual composition of the participant-data collector dyad influenced the blinding.

Conclusions: Collection of participants' pain responses led to frequent episodes of unblinding. However, it may be misleading to only consider the frequency of correct suspicions as successful or unsuccessful blinding.
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http://dx.doi.org/10.1111/pme.12706DOI Listing
June 2015

Mechanisms of exercise-induced hypoalgesia.

J Pain 2014 Dec;15(12):1294-1304

University of Wisconsin–Madison, 2000 Observatory Dr, Madison, WI 53706-1121.

Unlabelled: The purpose of this study was to examine opioid and endocannabinoid mechanisms of exercise-induced hypoalgesia (EIH). Fifty-eight men and women (mean age = 21 years) completed 3 sessions. During the first session, participants were familiarized with the temporal summation of heat pain and pressure pain protocols. In the exercise sessions, following double-blind administration of either an opioid antagonist (50 mg naltrexone) or placebo, participants rated the intensity of heat pulses and indicated their pressure pain thresholds and pressure pain ratings before and after 3 minutes of submaximal isometric exercise. Blood was drawn before and after exercise. Results indicated that circulating concentrations of 2 endocannabinoids, N-arachidonylethanolamine and 2-arachidonoylglycerol, as well as related lipids oleoylethanolamide, palmitoylethanolamide, N-docosahexaenoylethanolamine, and 2-oleoylglycerol, increased significantly (P < .05) following exercise. Pressure pain thresholds increased significantly (P < .05), whereas pressure pain ratings decreased significantly (P < .05) following exercise. Also, temporal summation ratings were significantly lower (P < .05) following exercise. These changes in pain responses did not differ between the placebo and naltrexone conditions (P > .05). A significant association was found between EIH and docosahexaenoylethanolamine. These results suggest involvement of a nonopioid mechanism in EIH following isometric exercise.

Perspective: Currently, the mechanisms responsible for EIH are unknown. This study provides support for a potential endocannabinoid mechanism of EIH following isometric exercise.
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http://dx.doi.org/10.1016/j.jpain.2014.09.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302052PMC
December 2014

Pain during and within hours after exercise in healthy adults.

Sports Med 2014 Jul;44(7):921-42

Department of Physical Therapy, University of Missouri-Columbia, 801 Clark Hall, Columbia, MO, 65211-4250, USA,

Literature on the pain relieving effects of exercise has been reviewed several times. It is equally important to review the literature on the pain-inducing effects of exercise. Indeed, exercise professionals, health care providers, and exercisers must grapple with the fact that exercise can both induce and reduce pain. The objective of this review was to synthesize our current understanding of exercise-induced pain and inspire advanced research. We searched the PubMed database for publications since 2000 about healthy human participants. Disease-specific reviews of the effects of exercise are available elsewhere. The results of our literature review verified that many different modes, intensities, and durations of exercise can induce pain in healthy people. Another important point is that pain can occur within a few hours after eccentric contractions, which should be considered relative to the construct of delayed-onset muscle soreness. In addition, the studies supported that exercise can be painful in diverse muscle groups. Yet another point illuminated by the literature is that different pain measures do not always change in similar directions and magnitudes after exercise. Therefore, our review confirms that a wide variety of exercises can be painful--even for healthy people. We wonder how many exercise professionals and health care providers regularly and appropriately measure exercise-related pain or consider such pain in their exercise recommendations. We also question if exercise-related pain affects exercise behavior in healthy people as it has been shown to do in people with chronic illnesses. Additional research is needed to improve both exercise recommendations and exercise behavior.
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http://dx.doi.org/10.1007/s40279-014-0172-zDOI Listing
July 2014

Exercise-induced modulation of pain in adults with and without painful diabetic neuropathy.

J Pain 2014 Jun 13;15(6):656-63. Epub 2014 Mar 13.

Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin. Electronic address:

Unlabelled: The purpose of this study was to examine exercise-induced pain modulation in diabetic adults with painful diabetic neuropathy (PDN) compared to diabetic adults without PDN. Eighteen adults diagnosed with type 2 diabetes with and without PDN (mean age of 49 years) completed 2 sessions. During the familiarization session, participants completed questionnaires, were familiarized with the pain testing protocols, and completed maximal isometric contractions. During the exercise session, experimental pain testing was completed before and following exercise consisting of 3 minutes of isometric exercise performed at 25% maximal voluntary contraction. Ratings of perceived exertion and muscle pain were assessed every 30 seconds during exercise. Results indicated that ratings of perceived exertion and muscle pain during exercise were significantly higher (P < .05) for diabetic adults with PDN versus diabetic adults without PDN. Diabetic adults with PDN did not experience changes in thermal pain ratings following exercise, whereas diabetic adults without PDN reported significantly lower pain ratings following exercise. It is concluded that diabetic adults with PDN experienced high levels of muscle pain during exercise and a lack of exercise-induced hypoalgesia following exercise, in comparison to diabetic adults without PDN, who experienced lower levels of muscle pain during exercise and a hypoalgesic response following exercise.

Perspective: Very little research has been conducted examining the impact of exercise on pain modulation in diabetic adults with PDN. This study provides support that adults with PDN exhibit exercise-induced endogenous pain modulatory system dysfunction.
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http://dx.doi.org/10.1016/j.jpain.2014.02.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4496959PMC
June 2014

Does exercise induce hypoalgesia through conditioned pain modulation?

Psychophysiology 2014 Mar 20;51(3):267-76. Epub 2013 Dec 20.

William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA; Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Pain sensitivity decreases with exercise. The mechanisms that underlie this exercise-induced hypoalgesia (EIH) are unclear. Our purpose was to investigate conditioned pain modulation (CPM) as a potential mechanism of EIH. Sixteen women completed pain testing during three sessions: painful exercise, nonpainful exercise, and quiet rest. Intensity and unpleasantness ratings to noxious heat stimuli were assessed at baseline and during and following each session. Results showed that pain sensitivity decreased significantly during both exercise sessions (p < .05), but not during quiet rest. Effect size calculations showed that the size of the hypoalgesic response was greater following painful exercise than nonpainful exercise. Our results suggest that exercise-induced muscle pain may contribute to the magnitude of EIH. However, as pain sensitivity also decreased following nonpainful exercise, CPM is not likely the primary mechanism of EIH.
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http://dx.doi.org/10.1111/psyp.12168DOI Listing
March 2014

Dose-response relationships between physical activity, social participation, and health-related quality of life in colorectal cancer survivors.

J Cancer Surviv 2013 Sep 2;7(3):369-78. Epub 2013 Apr 2.

Department of Kinesiology, University of Wisconsin-Madison, 2000 Observatory Drive, Madison, WI 53706, USA.

Purpose: The purpose of this study was to examine the relationships between physical activity (PA), social participation, and health-related quality of life (HQOL) in older, long-term colorectal cancer survivors.

Methods: Male and female colorectal cancer survivors (n = 1,768), aged ≥65 and ≥5 years post-diagnosis, completed surveys on their current PA, social participation, HQOL, health history, and relevant covariates. Analysis of covariance was used to evaluate the cross-sectional relationship between PA and social participation with the SF-36 subscales, as well as the physical component summary score (PCS) and mental health component summary score (MCS).

Results: The final analytic sample (n = 832) was 81.5 ± 5.8 years and 8.2 ± 1.7 years post-diagnosis (mean ± SD). Meeting the current recommendation of 150 min/week of PA was associated with higher PCS (p < 0.001) but not MCS (p = 0.30). Engaging in any social participation, vs. none, was associated with MCS (p = 0.003), but not PCS (p = 0.13). There was a dose-response relationship between moderate-vigorous-intensity PA and PCS (p trend<0.001). Light-intensity PA was not associated with either summary score after adjustment for moderate-vigorous PA (p > 0.05), but in survivors performing no higher-intensity PA, it was associated with both (p < 0.01, p = 0.02, respectively). Participants reporting greater amounts of both planned exercise and non-exercise PA had significantly higher PCS (p trend<0.01, p trend < 0.01, respectively). Individuals participating in greater weekly hours of social participation had higher PCS and MCS (p trend<0.05) than those participating in less.

Conclusions: Among older, long-term colorectal cancer survivors, PA is related to their physical health, while social participation is predominantly related to their mental health.

Implications For Cancer Survivors: Older colorectal cancer survivors who participate socially and are engaged in PA, even non-exercise and light-intensity activities, have higher levels of physical and mental health.
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http://dx.doi.org/10.1007/s11764-013-0277-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3737238PMC
September 2013

Influence of preferred versus prescribed exercise on pain in fibromyalgia.

Med Sci Sports Exerc 2011 Jun;43(6):1106-13

Department of Kinesiology, University of Wisconsin-Madison, Madison, WI 53706-1121, USA.

Purpose: The purpose of this study was to examine the influence of a preferred- versus a prescribed-intensity exercise session on pain in women with fibromyalgia (FM).

Methods: Twenty-one women with FM (mean age = 44 yr) completed two randomly assigned exercise sessions consisting of 20 min of cycle ergometry at a self-selected intensity and a prescribed intensity. Experimental pain perception was assessed before and after aerobic exercise. During exercise, HR, watts, RPE, and muscle pain were assessed every 5 min. Clinical pain was assessed with the Short-Form McGill Pain Questionnaire (SF-MPQ) immediately and 24, 48, 72, and 96 h after exercise. Data were analyzed with repeated-measures ANOVA.

Results: Women with FM preferred a lower intensity of exercise than what was prescribed as indicated by significantly lower HR, watts, and RPE responses (P < 0.05). Muscle pain in the legs, however, was similar in the two conditions and significantly increased during exercise (P < 0.05). Pain thresholds and pain tolerances increased significantly after exercise, whereas peak pain ratings decreased after exercise (P < 0.05). Furthermore, pain (SF-MPQ) in the follow-up period was found to be lower than baseline (P < 0.05).

Conclusions: It is concluded that the women with FM who participated in this study experienced significant improvements in pain after exercise. The results from this study are novel and indicate that recommendations for exercise prescription for individuals with FM should consider the preferred-intensity exercise model as a strategy to reduce pain.
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http://dx.doi.org/10.1249/MSS.0b013e3182061b49DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598056PMC
June 2011

Examination of the dose-response relationship between pain perception and blood pressure elevations induced by isometric exercise in men and women.

Biol Psychol 2010 Sep 2;85(1):90-6. Epub 2010 Jun 2.

Department of Physical Medicine and Rehabilitation, University of Colorado-Denver, Aurora, CO, USA.

The purpose of this study was to examine exercise-induced hypoalgesia (EIH) in men and women, and whether different magnitudes of BP elevations induced by isometric exercise systematically influenced pain perception. Twenty-five men and 25 women performed isometric exercise at 25% MVC for 1-min, 3-min, and 5-min while BP and pain perception were assessed. Results indicated that BP was significantly elevated (p<0.05) by isometric exercise in a dose-response manner. Pain thresholds were found to be elevated while pain ratings were lower (p<0.05) immediately following isometric exercise but not in a dose-response manner. It was concluded that isometric exercise produced EIH in men and women, and there was not a dose-response relationship between BP and EIH.
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http://dx.doi.org/10.1016/j.biopsycho.2010.05.008DOI Listing
September 2010

Influence of blood pressure elevations by isometric exercise on pain perception in women.

Int J Psychophysiol 2009 Oct 17;74(1):45-52. Epub 2009 Jul 17.

Department of Physical Medicine and Rehabilitation, University of Colorado-Denver Anschutz Medical Campus, Aurora, CO, United States.

Very little research has been conducted examining the relationship between blood pressure (BP), exercise, and hypoalgesia especially in women, even though research indicates that there is an interaction between pain modulatory and cardiovascular systems. The purpose of this study was to examine if pain perception was altered shortly after brief isometric contractions that caused an associated transient prior elevation in BP. Twenty-three healthy women completed two randomly-assigned sessions consisting of isometric exercise (25% MVC for 1-min and 3-min) and quiet rest. A pressure stimulus was applied to the right forefinger for a maximum of 2-min following isometric exercise and quiet rest. The participants pressed a button indicating pain threshold (PT), and rated the intensity (PR-I) and the unpleasantness (PR-U) using pain rating scales. BP was assessed every 15-s during exercise, quiet rest, and during exposure to the pressure stimulus. Results indicated that systolic and diastolic BP were significantly elevated during exercise, with higher BP following 3-min vs 1-min of exercise. Patterns of responses for PT, however, differed with a small increase in PT following 3-min vs 1-min of isometric exercise (d=0.38) while there was a small decrease in PT following 3-min vs 1-min of quiet rest (d=0.20). PR-I and PR-U were not found to change significantly following isometric exercise or quiet rest. It was concluded that both durations of isometric exercise significantly elevated BP, but these elevations in BP were not associated with a consistent alteration in pain perception in this sample of normotensive women.
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http://dx.doi.org/10.1016/j.ijpsycho.2009.07.003DOI Listing
October 2009

Alterations in pain perception after resistance exercise performed in the morning and evening.

J Strength Cond Res 2009 May;23(3):891-7

Division of Health Behavior and Health Promotion and Section of Exercise and Health Science, The Ohio State University, Columbus, Ohio, USA.

The purpose of the present study was to examine whether changes in experimentally induced pain perception after acute resistance exercise (RE) are influenced by the time of day that RE is performed. Twenty-one recreationally trained (>1 year of regular recreational RE participation) young men (mean age = 21 years) completed 2 acute RE sessions at different times of day. One RE session was performed between 6:00 and 8:00 in the morning, and the other was performed between 6:00 and 8:00 in the evening. The RE sessions consisted of completing 3 sets of 10 repetitions for 4 different exercises at 75% of each individual's 1-repetition maximum. Assessments of pain threshold and pain ratings were obtained during exposure to an experimentally induced pressure pain stimulus before and after (1 and 15 minutes) each bout of RE. The results revealed that, irrespective of the time of day RE was performed, pain threshold increased significantly (p < 0.01) at 1 minute after exercise. Pain ratings were also found to be significantly (p < 0.01) lower at 1 minute after RE in both the morning and evening. It is concluded that acute RE results in alterations in the perception of experimentally induced pressure pain and that this hypoalgesic response is not influenced by the time of day that RE is performed.
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http://dx.doi.org/10.1519/JSC.0b013e3181a05564DOI Listing
May 2009
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