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Illuminating the Black Box: Investigating Prefrontal Cortical Hemodynamics during Exercise with Near-Infrared Spectroscopy

Panteleimon Ekkekakis

Near-infrared spectroscopy (NIRS) presents an appealing option for investigating hemodynamic changes in the cerebral cortex during exercise. This review examines the physical basis of NIRS and the types of available instruments. Emphasis is placed on the physiological interpretation of NIRS signals. Theories from affective neuroscience and exercise psychobiology, including Davidson's prefrontal asymmetry hypothesis, Dietrich's transient hypofrontality hypothesis, and Ekkekakis's dual-mode model, are reviewed, highlighting the potential for designing NIRS-based tests in the context of exercise. Findings from 28 studies involving acute bouts of exercise are summarized. These studies suggest that the oxygenation of the prefrontal cortex increases during mild-to-moderate exercise and decreases during strenuous exercise, possibly proximally to the respiratory compensation threshold. Future studies designed to test hypotheses informed by psychological theories should help elucidate the significance of these changes for such important concepts as cognition, affect, exertion, and central fatigue.

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Why Is Exercise Underutilized in Clinical Practice Despite Evidence It Is Effective? Lessons in Pragmatism From the Inclusion of Exercise in Guidelines for the Treatment of Depression in the British National Health Service

Panteleimon Ekkekakis

Exercise remains greatly underutilized in clinical practice for reasons that are only partly understood. This critical review situates the problem within the broader political and economic context. It focuses on depression, the leading cause of disability worldwide, and the processes that followed the inclusion of exercise as a treatment option in clinical practice guidelines in the British National Health Service. The review highlights previously unaddressed phenomena, including antiexercise lobbying by primary care physicians and efforts to present the evidence for the antidepressant effects of exercise as weak, nonexistent, or methodologically flawed. Notably, the field of kinesiology remained silent while these processes unfolded. This information suggests that the path from research evidence to implementation in clinical settings remains dependent on factors beyond the amount and quality of research evidence. The review underscores the need to vigilantly monitor, critically appraise, and actively participate in the clinical research literature and the development of guidelines.

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Critical Review of Measurement Practices in the Study of Automatic Associations of Sedentary Behavior, Physical Activity, and Exercise

Zachary Zenko and Panteleimon Ekkekakis

Studies of automatic associations of sedentary behavior, physical activity, and exercise are proliferating, but the lack of information on the psychometric properties of relevant measures is a potential impediment to progress. The purpose of this review was to critically summarize measurement practices in studies examining automatic associations related to sedentary behavior, physical activity, and exercise. Of 37 studies, 27 (73%) did not include a justification for the measure chosen to assess automatic associations. Additional problems have been noted, including the nonreporting of psychometric information (validity, internal consistency, test–retest reliability) and the lack of standardization of procedures (e.g., number, type of stimuli). The authors emphasize the need to select measures based on conceptual arguments and psychometric evidence and to standardize measurement procedures. To facilitate progress, the review concludes with a proposal for conceptually appropriate validation criteria to be used in future studies.

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Extraordinary Claims in the Literature on High-Intensity Interval Training: II. Are the Extraordinary Claims Supported by Extraordinary Evidence?

Panteleimon Ekkekakis and Nicholas B. Tiller

Dishman challenged kinesiologists to seek a compromise between “the ideal physiological prescription and a manageable behavioral prescription.” High-intensity interval training (HIIT) is the first exercise modality that has been claimed to meet this challenge, combining substantial benefits for fitness and health with pleasure and enjoyment. If true, these claims may revolutionize the science and practice of exercise. In this paper, four claims are critically appraised: (a) HIIT lowers the risk of mortality more than moderate-intensity continuous exercise, (b) HIIT doubles endurance performance after only 15 min of training over 2 weeks, (c) 1 min of HIIT is equivalent to 45 min of moderate-intensity continuous exercise, and (d) HIIT is more pleasant and enjoyable than moderate-intensity continuous exercise. The evidence for these claims appears questionable. Kinesiology should heed the principle endorsed by Hume, Laplace, and Sagan, namely that extraordinary claims should be supported by commensurate evidence.

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Can You Have Your Vigorous Exercise and Enjoy It Too? Ramping Intensity Down Increases Postexercise, Remembered, and Forecasted Pleasure

Zachary Zenko, Panteleimon Ekkekakis, and Dan Ariely

There is a paucity of methods for improving the affective experience of exercise. We tested a novel method based on discoveries about the relation between exercise intensity and pleasure, and lessons from behavioral economics. We examined the effect of reversing the slope of pleasure during exercise from negative to positive on pleasure and enjoyment, remembered pleasure, and forecasted pleasure. Forty-six adults were randomly assigned to a 15-min bout of recumbent cycling of either increasing intensity (0–120% of watts corresponding to the ventilatory threshold) or decreasing intensity (120–0%). Ramping intensity down, thereby eliciting apositive slope of pleasure during exercise, improved postexercise pleasure and enjoyment, remembered pleasure, and forecasted pleasure. The slope of pleasure accounted for 35–46% of the variance in remembered and forecasted pleasure from 15 min to 7 days postexercise. Ramping intensity down makes it possible to combine exposure to vigorous and moderate intensities with a pleasant affective experience.

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Can High-Intensity Exercise Be More Pleasant? Attentional Dissociation Using Music and Video

Leighton Jones, Costas I. Karageorghis, and Panteleimon Ekkekakis

Theories suggest that external stimuli (e.g., auditory and visual) may be rendered ineffective in modulating attention when exercise intensity is high. We examined the effects of music and parkland video footage on psychological measures during and after stationary cycling at two intensities: 10% of maximal capacity below ventilatory threshold and 5% above. Participants (N = 34) were exposed to four conditions at each intensity: music only, video only, music and video, and control. Analyses revealed main effects of condition and exercise intensity for affective valence and perceived activation (p < .001), state attention (p < .05), and exercise enjoyment (p < .001). The music-only and music-and-video conditions led to the highest valence and enjoyment scores during and after exercise regardless of intensity. Findings indicate that attentional manipulations can exert a salient influence on affect and enjoyment even at intensities slightly above ventilatory threshold.

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Overcoming the “Ostrich Effect”: A Narrative Review on the Incentives and Consequences of Questionable Research Practices in Kinesiology

Nicholas B. Tiller and Panteleimon Ekkekakis

Increasing transparency and openness in science is an ongoing endeavor, one that has stimulated self-reflection and reform in many fields. However, kinesiology and its related disciplines are among those exhibiting an “ostrich effect” and a reluctance to acknowledge their methodological shortcomings. Notwithstanding several high-profile cases of scientific misconduct, scholars in the field are frequently engaged in questionable research practices (QRPs) such as biased experimental designs, inappropriate statistics, and dishonest/inexplicit reporting. To advance their careers, researchers are also “gaming the system” by manipulating citation metrics and publishing in predatory and/or pay-to-publish journals that lack robust peer review. The consequences of QRPs in the discipline may be profound: from increasing the false positivity rate to eroding public trust in the very institutions tasked with informing public health policy. But what are the incentives underpinning misconduct and QRPs? And what are the solutions? This narrative review is a consciousness raiser that explores (a) the manifestations of QRPs in kinesiology; (b) the excessive publication pressures, funding pressures, and performance incentives that are likely responsible; and (c) possible solutions for reform.

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Physical Activity, Stress, and Metabolic Risk Score in 8- to 18-Year-Old Boys

Megan E. Holmes, Joey C. Eisenmann, Panteleimon Ekkekakis, and Douglas Gentile

Background:

We examined whether physical activity modifies the relationship between stress and the metabolic risk score in 8- to 18-year-old males (n = 37).

Methods:

Physical activity (PA) and television (TV)/videogame (VG) use were assessed via accelerometer and questionnaire, respectively. Stress was determined from self-report measures. A metabolic risk score (MRS) was created by summing age-standardized residuals for waist circumference, mean arterial pressure, glycosylated hemoglobin, and high-density lipoprotein cholesterol.

Results:

Correlations between PA and MRS were low (r < –.13), and TV and VG were moderately associated with MRS (r = .39 and .43, respectively). Correlations between stress-related variables and MRS ranged from r = .19 to .64. After partitioning by PA, significant correlations were observed in the low PA group between school- and sports-related self-esteem and anxiety with the MRS.

Conclusions:

The results provide suggestive evidence that PA might modify the relationship between stress and MRS in male adolescents.

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Some like It Vigorous: Measuring Individual Differences in the Preference for and Tolerance of Exercise Intensity

Panteleimon Ekkekakis, Eric E. Hall, and Steven J. Petruzzello

Individuals differ in the intensity of exercise they prefer and the intensity they can tolerate. The purpose of this project was to develop a measure of individual differences in the preference for and tolerance of exercise intensity. The steps involved in (a) item generation and face validation, (b) exploratory factor analysis and item selection, (c) structural validation, (d) examination of the internal consistency and test-retest reliability, (e) concurrent validation, and (f) construct validation are described. The Preference for and Tolerance of the Intensity of Exercise Questionnaire (PRETIE-Q) is a 16-item, 2-factor measure that exhibits acceptable psychometric properties and can be used in research aimed at understanding individual differences in responses to exercise and thus the psychological processes involved in the public health problem of exercise dropout.

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Measuring State Anxiety in the Context of Acute Exercise Using the State Anxiety Inventory: An Attempt to Resolve the Brouhaha

Panteleimon Ekkekakis, Eric E. Hall, and Steven J. Petruzzello

Two studies were conducted to examine the internal consistency and validity of the state anxiety subscale of the State-Trait Anxiety Inventory (SAI) in the context of acute exercise. SAI responses typically found in the exercise literature were replicated. Analysis at the item level revealed divergent response patterns, confounding the total SAI score. During moderate and immediately after vigorous exercise, scores on items referring to cognitive antecedents of anxiety decreased, whereas scores on items assessing perceived activation increased. Indices of internal showed exercise-associated decreases. A principal-components analysis of responses immediately postexercise revealed a multidimensional structure, distinguishing “cognitive” and “activation” items. By failing to discern exercise-induced and anxiety-related increases in activation from anxiety-antecedent appraisals, the SAI exhibits compromised internal consistency and validity in the context of acute exercise.