title: Efficacy of Tai Chi, brisk walking, meditation, and reading in reducing mental and emotional stress. Mindful Walking in Psychologically Distressed Individuals: A Randomized Controlled Trial A Web-Based Intervention to Encourage Walking (StepWise): Pilot Randomized Controlled Trial Affective responses in mountain hiking—A randomized crossover trial focusing on differences between indoor and outdoor activity Regular exercise is associated with emotional resilience to acute stress in healthy adults Exercise and Self-Esteem in Menopausal Women: A Randomized Controlled Trial Involving Walking and Yoga Physical activity, self-esteem, and self-efficacy relationships in older adults: A randomized controlled trial Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomized controlled MRS study. Combining walking and relaxation for stress reduction—A randomized cross‐over trial in healthy adults The Effect of the More Active MuMs in Stirling Trial on Body Composition and Psychological Well-Being among Postnatal Women Effects of intervention using a community-based walking program for prevention of mental decline: a randomized controlled trial. Trajectories of change in self-esteem in older adults: exercise intervention effects Increasing older adults’ walking through primary care: results of a pilot randomized controlled trial Promoting walking as an adjunct intervention to group cognitive behavioral therapy for anxiety disorders--a pilot group randomized trial. Dose–response relationships between physical activity, walking and health-related quality of life in mid-age and older women Effect of walking distance on 8-year incident depressive symptoms in elderly men with and without chronic disease: the Honolulu-Asia Aging Study. Relation between clinical depression risk and physical activity and time spent watching television in older women: a 10-year prospective follow-up study. Improving the health behaviours of elderly people: randomised controlled trial of a general practice education programme Accumulating brisk walking for fitness, cardiovascular risk, and psychological health. Walking toward a new me: the impact of prescribed walking 10,000 steps/day on physical and psychological well-being. Customary physical activity and psychological wellbeing: a longitudinal study. Effects of a Walking Program on Attributional Style, Depression, and Self-Esteem in Women Social relations, physical activity, and well-being in older adults. Walking in (Affective) Circles: Can Short Walks Enhance Affect? Relationship between regular walking, physical activity, and health-related quality of life. The effects of moderate exercise training on psychological well-being and mood state in women. The feasibility and effectiveness of pram walking groups for postpartum women in western Sydney. The effects of a pedometer-based intervention on first-year university students: A randomized control trial Chronic psychological effects of exercise and exercise plus cognitive strategies. Effect of pedometer-based walking on depression, anxiety and insomnia among postmenopausal women Self-rated walking pace and all-cause, cardiovascular disease and cancer mortality: individual participant pooled analysis of 50 225 walkers from 11 population British cohorts
abstract: Tai Chi , a moving meditation , is examined for its efficacy in post-stressor recovery . Forty-eight male and 48 female Tai Chi practitioners were r and omly assigned to four treatment groups : Tai Chi , brisk walking , mediation and neutral reading . Mental arithmetic and other difficult tests were chosen as mental challenges , and a stressful film was used to produce emotional disturbance . Tai Chi and the other treatments were applied after these stressors . After all treatments , the salivary cortisol level dropped significantly , and the mood states were also improved . In general the stress-reduction effect of Tai Chi characterized moderate physical exercise . Heart rate , blood pressure , and urinary catecholamine changes for Tai Chi were found to be similar to those for walking at a speed of 6 km/hr . Although Tai Chi appeared to be superior to neutral reading in the reduction of state anxiety and the enhancement of vigour , this effect could be partially accounted for by the subjects ' high expectations about gains from Tai Chi . Approaches controlling for expectancy level are recommended for further assessment Background . The aim of this r and omized , controlled study was to investigate the effectiveness of a mindful walking program in patients with high levels of perceived psychological distress . Methods . Participants aged between 18 and 65 years with moderate to high levels of perceived psychological distress were r and omized to 8 sessions of mindful walking in 4 weeks ( each 40 minutes walking , 10 minutes mindful walking , 10 minutes discussion ) or to no study intervention ( waiting group ) . Primary outcome parameter was the difference to baseline on Cohen 's Perceived Stress Scale ( CPSS ) after 4 weeks between intervention and control . Results . Seventy-four participants were r and omized in the study ; 36 ( 32 female , 52.3 ± 8.6 years ) were allocated to the intervention and 38 ( 35 female , 49.5 ± 8.8 years ) to the control group . Adjusted CPSS differences after 4 weeks were −8.8 [ 95 % CI : −10.8 ; −6.8 ] ( mean 24.2 [ 22.2 ; 26.2 ] ) in the intervention group and −1.0 [ −2.9 ; 0.9 ] ( mean 32.0 [ 30.1 ; 33.9 ] ) in the control group , result ing in a highly significant group difference ( P < 0.001 ) . Conclusion . Patients participating in a mindful walking program  showed reduced psychological stress symptoms and improved quality of life compared to no study intervention . Further studies should include an active treatment group and a long-term follow-up Background Despite Internet-based interventions that incorporate pedometers with appropriate goal - setting processes and other theoretically-based behavior change strategies being proposed as a means of increasing walking behavior , few have incorporated all of these key features or assessed maintenance of behavior change . Objective The objective of our study was to investigate the effect of a 12-week pedometer step goal walking program individually tailored to baseline step counts , combined with an interactive support website for step counts , health parameters and motivation over 12 and 24 weeks . Methods Low active participants ( mean [ SD ] 46.2 [ 11.2 ] years ) were r and omly assigned to the  Stepwise ( SW ) intervention group ( n=49 ) or a  comparison ( CP ) group ( n=48 ) . SW received a pedometer , step goal walking program and access to the SW website ( containing interactive self-monitoring and goal feedback tools , motivational messages and action and coping planning strategies ) . CP received a pedometer and locally available physical activity information . Step counts , BMI , resting heart rate , blood pressure and glucose , cholesterol and triglyceride levels , psychological well-being , perceived health , self-efficacy and self-determined motivation were measured at baseline , 12 and 24 weeks . Results Linear mixed model analysis found that both groups ’ step counts increased from baseline to week 12 ( β = 11,002 , CI 5739 - 16,266 , P<.001 ) and 24 ( β = 6810 , CI 1190 - 12,431 ; P=.02 ) . Group step counts were significantly different at week 24 with SW taking 8939 ( CI 274 - 17604 , P=.04 ) more steps compared to CP . Compared to baseline , both groups had improved triglyceride levels ( 0.14 mmol/L , CI -0.25 to -0.02 , P=.02 ) at week 12 , decreased diastolic blood pressure ( 4.22 mmHg , CI -6.73 to -1.72 ) at weeks 12 and 24 ( 3.17 mmHg , CI -5.55 to -0.78 ) , improved positive ( β = .21 , CI 0.03 - 0.38 , P=.02 ) and negative affect ( β = -.15 , CI -0.28 to -0.03 , P=.02 ) at week 12 , and perceived health at week 12 ( β = 6.37 , CI 2.10 - 10.65 , P=.004 ) and 24 ( β = 8.52 , CI 3.98 - 13.06 , P<.001 ) . Total cholesterol increased at week 12 ( 0.26 mmol/L , CI 0.099 - 0.423 , P=.006 ) and week 24 ( 0.38 mmol/L , CI 0.20 - 0.56 , P<.001 ) . Repeated measures ANOVA found motivation for walking improved from baseline with higher task self-efficacy ( P<.001 , η2 = .13 ) and autonomous motivation ( P<.001 , η2=.14 ) at weeks 12 and 24 and decreased controlled motivation ( P=.004 , η2=.08 ) at week 24 . Conclusions Both groups had similar improvements in step counts and physical and psychological health after 12 weeks but only the SW group successfully maintained the increased step-counts 24 weeks post-intervention . This suggests the step- goal based walking program combined with Internet-based behavior change tools were important for sustained behavior change Introduction Affective responses during physical activity ( PA ) are important for engagement in PA programs and for adherence to a physically active lifestyle . Little is known about the affective responses to PA bouts lasting longer than 45 minutes . Therefore , the aims of the present study were to analyse acute effects on affective responses of a three-hour outdoor PA intervention ( mountain hiking ) compared to a sedentary control situation and to an indoor treadmill condition . Methods Using a r and omized crossover design , 42 healthy participants were r and omly exposed to three different conditions : outdoor mountain hiking , indoor treadmill walking , and sedentary control situation ( approximately three hours each ) . Measures included the Feeling Scale , Felt Arousal Scale and a Mood Survey Scale . Repeated measures ANOVAs were used to analyse differences between the conditions . Results Compared to the control situation , the participants showed a significant increase in affective valence ( d = 1.21 , p < .001 ) , activation ( d = 0.81 , p = .004 ) , elation ( d = 1.07 , p < .001 ) , and calmness ( d = 0.84 , p = .004 ) , and a significant decrease in fatigue ( d = -1.19 , p < .001 ) and anxiety ( d = -.79 , p < .001 ) after mountain hiking . Outdoor mountain hiking showed significantly greater positive effects on affective valence , activation , and fatigue compared to indoor treadmill walking . Discussion The results indicate that a three-hour PA intervention ( mountain hiking ) elicits higher positive and lower negative affective responses compared to a sedentary control situation and to an indoor PA condition . Outdoor mountain hiking can be recommended by health professionals as a form of PA with the potential to positively influence affective responses . Trial registration Clinical Trials.gov NCT02853760 . https:// clinical trials.gov/. Date of registration : 08/02/2016 ( retrospectively registered ) . Date of enrolment of the first participant to the trial : 05/01/2014 Physical activity has long been considered beneficial to health and regular exercise is purported to relieve stress . However empirical evidence demonstrating these effects is limited . In this study , we compared psychophysiological responses to an acute psychosocial stressor between individuals who did , or did not , report regular physical exercise . Healthy men and women ( N = 111 ) participated in two experimental sessions , one with the Trier Social Stress Test ( TSST ) and one with a non-stressful control task . We measured heart rate , blood pressure , cortisol , and self-reported mood before and at repeated times after the tasks . Individuals who reported physical exercise at least once per week exhibited lower heart rate at rest than non-exercisers , but the groups did not differ in their cardiovascular responses to the TSST . Level of habitual exercise did not influence self-reported mood before the tasks , but non-exercisers reported a greater decline in positive affect after the TSST in comparison to exercisers . These findings provide modest support for cl aims that regular exercise protects against the negative emotional consequences of stress , and suggest that exercise has beneficial effects in healthy individuals . These findings are limited by their correlational nature , and future prospect i ve controlled studies on the effects of regular exercise on response to acute stress are needed Purpose . To examine the effects of walking and yoga on multidimensional self-esteem and roles played by self-efficacy , body composition , and physical activity ( PA ) in changes in esteem . Design . Four-month r and omized controlled exercise trial with three arms : walking , yoga , and control . Subjects . Previously low-active middle-aged women ( n = 164 ; M age = 49.9 ; SD = 3.6 ) . Intervention . Structured and supervised walking program meeting three times per week for 1 hour and supervised yoga program meeting twice per week for 90 minutes . Measures . Body composition , fitness assessment , and battery of psychologic measures . Analysis . Panel analysis within a structural equation modeling framework using Mplus 3.0 . Results . The walking and yoga interventions failed to enhance global or physical self-esteem but improved subdomain esteem relative to physical condition and strength ( for walking ) and body attractiveness ( for both walking and yoga ) . Over time the effects of PA , self-efficacy , and body fat on changes in physical self-esteem and global esteem were mediated by changes in physical condition and body attractiveness subdomain esteem . Women reporting greater levels of self-efficacy and PA with lower body fat also reported greater enhancements in subdomain esteem . Conclusion . These results provide support for the hierarchic and multidimensional nature of self-esteem and indicate that middle-aged women may enhance certain aspects of physical self-esteem by participating in PA A r and omized controlled trial examined the growth and form of multidimensional self-esteem over a 12-month period ( 6-month exercise intervention and 6-month follow-up ) in 174 older adults engaged in either a walking or stretching/toning program .  The extent to which changes in physical fitness parameters and physical self-efficacy were related to changes in perceptions of attractive body , strength , physical conditioning , and physical self-worth was also determined . Latent growth curve analyses showed a curvilinear pattern of growth in esteem with significant increases at all levels of self-esteem upon completion of the intervention followed by significant declines at 6 months poistintervention in both groups . Frequency of activity and changes in physical fitness , body fat , and self-efficacy were related to improvements in esteem perceptions relative to attractive body , strength , and physical condition . Model fitting procedures suggested that the best fit of the data was to a model in which the influence of changes in efficacy and physical parameters on physical self-worth were mediated by perceptions of attractive body and physical conditions OBJECTIVES Yoga and exercise have beneficial effects on  mood and anxiety .  γ-Aminobutyric acid (GABA)-ergic activity is reduced in mood and anxiety disorders . The practice of yoga postures is associated with increased brain GABA levels . This study addresses the question of whether changes in mood , anxiety , and GABA levels are specific to yoga or related to physical activity . METHODS Healthy subjects with no significant medical/psychiatric disorders were r and omized to yoga or a metabolically matched walking intervention for 60 minutes 3 times a week for 12 weeks . Mood and anxiety scales were taken at weeks 0 , 4 , 8 , 12 , and before each magnetic resonance spectroscopy scan . Scan 1 was at baseline . Scan 2 , obtained after the 12-week intervention , was followed by a 60-minute yoga or walking intervention , which was immediately followed by Scan 3 . RESULTS The  yoga subjects ( n = 19 ) reported greater improvement in mood and greater decreases in anxiety than the walking group ( n = 15 ) . There were positive correlations between improved mood and decreased anxiety and thalamic GABA levels . The yoga group had positive correlations between changes in mood scales and changes in GABA levels . CONCLUSIONS The 12-week yoga intervention was associated with greater improvements in mood and anxiety than a metabolically matched walking exercise . This is the first study to demonstrate that increased thalamic GABA levels are associated with improved mood and decreased anxiety . It is also the first time that a behavioral intervention ( i.e. , yoga postures ) has been associated with a positive correlation between acute increases in thalamic GABA levels and improvements in mood and anxiety scales . Given that pharmacologic agents that increase the activity of the GABA system are prescribed to improve mood and decrease anxiety , the reported correlations are in the expected direction . The possible role of GABA in mediating the beneficial effects of yoga  on mood and anxiety warrants further study Both physical activity and relaxation have stress-relieving potential . This study investigates their combined impact on the relaxation response while considering participants ' initial stress level . In a r and omized cross-over trial , 81 healthy adults completed 4 types of short-term interventions for stress reduction , each lasting for 1 hr : ( 1 ) physical activity ( walking ) combined with resting , ( 2 ) walking combined with balneotherapy , ( 3 ) combined resting and balneotherapy , and ( 4 ) resting only .  Saliva cortisol , blood pressure , state of mood , and relaxation were measured preintervention and postintervention . Stress levels were determined by vali date d question naires . All interventions were associated with relaxation responses in the variables saliva cortisol , blood pressure , state of mood , and subjective relaxation . No significant differences were found regarding the reduction of salivary cortisol ( F = 1.30 ; p = .281 ) . The systolic blood pressure was reduced best when walking was combined with balneotherapy or resting ( F = 7.34 ; p < .001 ) . Participants with high stress levels ( n = 25 ) felt more alert after interventions including balneotherapy , whereas they reported an increase of tiredness when walking was combined with resting ( F = 3.20 ; p = .044 ) . Results suggest that combining physical activity and relaxation ( resting or balneotherapy ) is an advantageous short-term strategy for stress reduction as systolic blood pressure is reduced best while similar levels of relaxation can be obtained Introduction . Physical activity is important for health and well-being ; however , rates of postnatal physical activity can be low . This paper reports the secondary outcomes of a trial aim ed at increasing physical activity among postnatal women . Methods . More Active MuMs in Stirling ( MAMMiS ) was a r and omised controlled trial testing the effect of physical activity consultation and pram walking group intervention among inactive postnatal women . Data were collected on postnatal weight , body composition , general well-being , and fatigue . Participants were also interviewed regarding motivations and perceived benefits of participating in the trial . Results . There was no significant effect of the intervention on any weight/body composition outcome or on general well-being at three or six months of follow-up . There was a significant but inconsistent difference in fatigue between groups . Qualitative data highlighted a number of perceived benefits to weight , body composition , and particularly well-being ( including improved fatigue ) which were not borne out by objective data . Discussion . The MAMMiS study found no impact of the physical activity intervention on body composition and psychological well-being and indicates that further research is required to identify successful approaches to increase physical activity and improve health and well-being among postnatal women OBJECTIVES To evaluate the efficacy of a municipality-led walking program  under the Japanese public Long-Term Care Insurance Act to prevent mental decline . DESIGN R and omized controlled trial . SETTING The city of Takasaki . PARTICIPANTS One hundred fifty community members aged 72.0 ± 4.0 were r and omly divided into intervention ( n = 75 ) and control ( n = 75 ) groups . INTERVENTION A walking program was conducted once a week for 90 minutes for 3 months . The program encouraged participants to walk on a regular basis and to increase their steps per day gradually . The intervention was conducted in small groups of approximately six , so combined benefits of exercise and social interaction were expected . MEASUREMENTS Cognitive function was evaluated focusing on nine tests in five domains : memory , executive function , word fluency , visuospatial abilities , and sustained attention . Quality of life ( QOL ) , depressive state , functional capacity , range of activities , and social network were assessed using question naires , and motor function was evaluated . RESULTS Significant differences between the intervention and control groups were shown in word fluency related to frontal lobe function ( F(1 , 128 ) = 6.833 , P = .01 ) , QOL ( F(1,128 ) = 9.751 , P = .002 ) , functional capacity including social interaction ( F(1,128 ) = 13.055 , P < .001 ) , and motor function ( Timed Up and Go Test : F(1,127 ) = 10.117 , P = .002 ) . No significant differences were observed in other cognitive tests . CONCLUSION Walking programs may provide benefits in some aspects of cognition , QOL , and functional capacity including social interaction in elderly community members . This study could serve as the basis for implementation of a community-based intervention to prevent mental decline This 12-month , 2 arm , single blind r and omized controlled exercise trial examined relationships among changes in multidimensional self-esteem as a function of intervention mode ( i.e. , walking vs. flexibility-toning-balance ) . Data were collected on three equidistant occasions ( baseline , 6 and 12 months ) . One-hundred seventy-nine older adults ( Mage = 66.38 ) began the study and 145 completed assessment s at all time points . Participants completed measures of physical and global self-esteem as well as demographic information . There were no significant group differences at baseline on these demographic indicators or esteem variables . Data were analyzed using linear and parallel process growth modeling procedures . Results supported the position that across both groups , domain-level ( i.e. , physical self-worth ) was dependent upon sub-domain-level ( i.e. , perceived attractiveness , strength , and condition ) esteem change . Furthermore , greater improvements were observed in the flexibility-toning-balance group , in terms of perceived strength and attractiveness esteem , compared to the walking group . Our findings support theoretically-based predictions and extend the literature showing unique psychological responses conditional on specific types of physical activities Background . Physical activity can positively influence health for older adults . Primary care is a good setting for physical activity promotion . Objective . To assess the feasibility of a pedometer-based walking programme in combination with physical activity consultations . Methods . Design : Two-arm ( intervention/control ) 12-week r and omized controlled trial with a 12-week follow-up for the intervention group . Setting : One general practice in Glasgow , UK . Participants : Participants were aged ≥65 years . The intervention group received two 30-minute physical activity consultations from a trained practice nurse , a pedometer and a walking programme . The control group continued as normal for 12 weeks and then received the intervention . Both groups were followed up at 12 and 24 weeks . Outcome measures : Step counts were measured by sealed pedometers and an activPALTM monitor . Psychosocial variables were assessed and focus groups conducted . Results . The response rate was 66 % ( 187/284 ) , and 90 % of those r and omized ( 37/41 ) completed the study . Qualitative data suggested that the pedometer and nurse were helpful to the intervention . Step counts ( activPAL ) showed a significant increase from baseline to week 12 for the intervention group , while the control group showed no change . Between weeks 12 and 24 , step counts were maintained in the intervention group , and increased for the control group after receiving the intervention . The intervention was associated with improved quality of life and reduced sedentary time . Conclusions . It is feasible to recruit and retain older adults from primary care and help them increase walking . A larger trial is necessary to confirm findings and consider cost-effectiveness A group r and omized trial of adding a home-based walking program to a st and ard group cognitive behavioral therapy ( GCBT+EX ) was compared with groups receiving GCBT and educational sessions ( GCBT+ED ) . The study was implemented in an outpatient clinic providing GCBT for clients diagnosed with panic disorder , generalized anxiety disorder or social phobia . Pre- and post-treatment measures included the self-report depression , anxiety , and stress scale ( DASS-21 ) and measures of physical activity .  From January 2004 to May 2005 , six groups were allocated to GCBT+EX ( n=38 ) and five to GCBT+ED ( n=36 ) . Analysis of covariance for completed cases ( GCBT+EX , n=21 ; GCBT+ED , n=20 ) , adjusting for the group design , baseline DASS-21 scores , and anxiety diagnosis showed significant effect for GCBT+EX on depression , anxiety , and stress ( regression coefficients=-6.21 , -3.41 , and -5.14 , respectively , p<0.05 ) compared to the GCBT+ED . The potential of exercise interventions as adjunct to GCBT for anxiety disorder needs to be further explored Background Although physical activity is associated with health-related quality of life ( HRQL ) , the nature of the dose – response relationship remains unclear . Objectives To examine the concurrent and prospect i ve dose – response relationships between total physical activity ( TPA ) and ( only ) walking with HRQL in two age cohorts of women . Methods Participants were 10 698 women born in 1946–1951 and 7646 born in 1921–1926 , who completed three mailed surveys for the Australian Longitudinal Study on Women 's Health . They reported weekly TPA minutes ( sum of walking , moderate and vigorous minutes ) . HRQL was measured with the Medical Outcomes Study Short-Form 36 Health Status Survey ( SF-36 ) . Linear mixed models , adjusted for socio-demographic and health-related variables , were used to examine associations between TPA level ( none , very low , low , intermediate , sufficient , high and very high ) and SF-36 scores . For women who reported walking as their only physical activity , associations between walking and SF-36 scores were also examined . Results Curvilinear trends were observed between TPA and walking with SF-36 scores . Concurrently , HRQL scores increased significantly with increasing TPA and walking , in both cohorts , with increases less marked above sufficient activity levels . Prospect ively , associations were attenuated although significant and meaningful improvements in physical functioning and vitality were observed across most TPA and walking categories above the low category . Conclusion For women in their 50s–80s without clinical depression , greater amounts of TPA are associated with better current and future HRQL , particularly physical functioning and vitality . Even if walking is their only activity , women , particularly those in their 70s–80s , have better HRQL OBJECTIVES To determine the effect of walking on incident depressive symptoms in elderly Japanese-American men with and without chronic disease . DESIGN Prospect i ve cohort study . SETTING The Honolulu-Asia Aging Study . PARTICIPANTS Japanese-American men aged 71 to 93 at baseline . MEASUREMENTS  Physical activity was assessed according to self-reported distance walked per day . Depressive symptoms were measured using an 11- question version of the Centers for Epidemiologic Studies Depression Scale ( CES-D 11 ) at the fourth examination ( n=3,196 ) and at the seventh examination 8 years later ( 1999/00 , n=1,417 ) . Presence of incident depressive symptoms was defined as a CES-D 11 score of 9 or greater or taking antidepressants at Examination 7 . Subjects with prevalent depressive symptoms at baseline were excluded . RESULTS Age-adjusted 8-year incident depressive symptoms were 13.6 % , 7.6 % , and 8.5 % for low ( < 0.25 miles/day ) , intermediate ( 0.25 - 1.5 miles/day ) , and high ( > 1.5 miles/day ) walking groups at baseline ( P=0.008 ) . Multiple logistic regression analyses , adjusted for age , education , marital status , cardiovascular risk factors , prevalent diseases , and functional impairment , showed that those in the intermediate and highest walking groups had significantly lower odds of developing 8-year incident depressive symptoms ( odds ratio (OR)=0.52 , 95 % confidence interval (CI)=0.32 - 0.83 , P=.006 and OR=0.61 , 95 % CI= 0.39 - 0.97 , P=.04 , respectively ) . Analysis found that this association was significant only in participants without chronic diseases ( coronary heart disease , cerebrovascular accident , cancer , Parkinson 's disease , dementia , or cognitive impairment ) at baseline . CONCLUSION Daily physical activity ( ≥0.25 mile/day ) is significantly associated with lower risk of 8-year incident depressive symptoms in elderly Japanese-American men without chronic disease at baseline Although  physical activity ( PA ) has been inversely associated with depressive symptoms , it is not clear whether regular PA and television watching are associated with clinical depression risk . The authors conducted a prospect i ve analysis involving 49,821 US women from the Nurses ' Health Study who were free from depressive symptoms at baseline ( 1996 ) . Information on PA was obtained from vali date d question naires completed in 1992 , 1994 , 1996 , 1998 , and 2000 ; analyses were conducted using the cumulative average of PA ( minutes/day ) with a 2-year latency period applied . Participants were asked about television-watching habits in 1992 . Cox proportional hazards regression models adjusted for multiple risk factors were used to estimate relative risks of clinical depression ( self-reported physician-diagnosed depression or use of antidepressants ) . During 10 years of follow-up ( 1996 - 2006 ) , 6,505 incident cases of depression were documented . Higher  levels of PA  were associated with lower depression risk . The multivariate relative risk comparing the highest level of PA  ( ≥ 90 minutes/day ) with the lowest ( < 10 minutes/day ) was 0.80 ( 95 % confidence interval : 0.70 , 0.92 ; P(trend ) < 0.001 ) . In contrast , the risk of depression increased with increasing television-watching time . The multivariate relative risk comparing women who spent 21 hours/week or more watching television with those who spent 0 - 1 hour/week was 1.13 ( 95 % confidence interval : 1.00 , 1.27 ; P(trend ) = 0.01 ) . Analyses simultaneously  considering PA and television watching suggested that both contributed independently to depression risk Abstract Objectives : To establish the effect of an educational intervention for general practitioners on the health behaviours and wellbeing of elderly patients . Design : R and omised controlled trial with 1 year follow up . Setting : Metropolitan general practice s in Melbourne , Australia . Subjects : 42 general practitioners and 267 of their patients aged over 65 years . Intervention : Educational and clinical practice audit programme for general practitioners on health promotion for elderly people . Main outcome measures : Patients ' physical activity , functional status , self rated health , immunisation status , social contacts , psychological wellbeing , drug usage , and rate of influenza vaccination .  Primary efficacy variables were changes in outcome measures over 1 year period . Results : Patients in the intervention group had increased ( a ) walking by an average of 88 minutes per fortnight , ( b ) frequency of pleasurable activities , and ( c ) self rated health compared with the control group . No change was seen in drug usage , rate of influenza vaccination , functional status , or psychological wellbeing as a result of the intervention . Extrapolations of the known effect of these changes in behaviour suggest mortality could be reduced by 22 % if activity was sustained for 5 years . Conclusions : Education of the general practitioners had a positive effect on health outcomes of their elderly patients . General practitioners may have considerable public health impact in promotion of health for elderly patients . Key messages Few educational interventions for doctors have shown benefit to the health of patients Elderly people were identified in the UK health initiatives as in need of additional attention , and levels of health protective behaviours were low in community surveys A multifaceted educational intervention for general practitioners was effective in improving walking behaviour , self rated health status , and the frequency of social contacts in elderly patients General practitioners are effective in improving health and health behaviours in their elderly PURPOSE To compare the effects of different patterns of regular brisk walking on fitness , risk factors for cardiovascular disease , and psychological well-being in previously sedentary adults . METHODS Twenty-one subjects ( 14 women ) , aged 44.5 + /- 6.1 yr ( mean + /- SD ) were r and omly assigned to two different , 6-wk programs of brisk walking in a cross-over design , with an interval of 2 wk . One program comprised one 30-min walk per day , 5 d.wk(-1 ) ( long bout ) and the other three 10-min walks per day , also 5 d.wk(-1 ) ( short bouts ) . All walking was at 70 - 80 % of predicted maximal heart rate . Maximal oxygen uptake ( (.)VO(2max ) ) , body composition , resting arterial blood pressure , fasting plasma lipoprotein variables , and psychological parameters were assessed before and after each program . RESULTS Overall , subjects completed 88.2 + /- 1.1 % and 91.3 + /- 4.1 % of prescribed total walking time in the short- and long-bout programs , respectively . Both programs increased plasma concentrations of high-density lipoprotein cholesterol , and decreased concentrations of triacylglycerol and total cholesterol ( all < 0.05 ) . There were no changes in body mass , but the sum of four skinfolds , waist circumference , and hip circumference were decreased after both walking programs ( all P<0.05 ) . Predicted (.)VO(2max ) increased with both programs ( P<0.05 ) , but this increase was greater with the program based on short bouts ( P<0.05 ) . Both walking patterns result ed in similar decreases in tension/anxiety ( P<0.05 ) . CONCLUSION These findings suggest that three short bouts ( 10 min ) of brisk walking accumulated throughout the day are at least as effective as one continuous bout of equal total duration in reducing cardiovascular risk and improving aspects of mood in previously sedentary individuals PURPOSE To determine whether individuals participating in a program design ed to accumulate 10,000 steps/ day demonstrate health , fitness and psychological benefits . METHODS Sedentary individuals ( 22 F , 7 M ; age 59.8 + /- 5.78 yr ) were r and omly assigned into a walking ( W , n = 14 ) or control ( C , n = 15 ) group . Following baseline assessment , the W group was given a daily plan to reach 10,000 steps/day within 3 weeks and asked to maintain this level for 12 weeks ; the C group was asked to maintain their current activity . Participants were evaluated for cardiovascular endurance , resting and postexercise HR , functional ability , cholesterol , psychological well-being , and exercise self-efficacy before and following the 15-week program . RESULTS Significant changes over time were noted between groups ( G x T ; P < .05 ) with the W group demonstrating improvements in postexercise HR ( -6.51 % ) , total cholesterol ( TC : -7.74 % ) , and personal growth ( 2.53 % ) . While not statistically significant , the W group also demonstrated improvements in 6 min walk distance ( 2.32 % ) , total/HDL ratio ( -10.09 % ) , 8 foot up- and -go time ( -3.35 % ) , chair st and s ( 6.17 % ) , flexibility ( 128 % ) , and environmental mastery ( 4.54 % ) . CONCLUSION A 15-week program aim ed at accumulating 10,000 steps/day improves cardiovascular performance and personal growth and also positively influences many variables that are indicators of health , fitness and psychological well-being OBJECTIVES to assess longitudinal relationships between habitual levels of physical activity and indices of psychological wellbeing in older people . DESIGN baseline assessment with 4- and 8-year follow-ups . SUBJECTS 1042 people originally aged 65 and over r and omly sample d from general practitioner lists in Nottingham , UK . METHODS logistic regression analysis of selected T1 ( 1985 ) and T2 ( 1989 ) variables , with depression at T2 as dependent ; multiple regression analyses of selected T1 , T2 and T3 ( 1993 ) variables , with life satisfaction at T2 ( model 1 ) or T3 ( model 2 ) as dependent . MAIN OUTCOME MEASURES question naire-assessed  levels of physical activity ; 14-item Symptoms of Anxiety and Depression scale ; 13-item Life Satisfaction Index ; health , demographic and social activity variables . RESULTS in the logistic regression model , depression at T2 was most strongly associated with depression [ odds ratio ( OR ) = 7.13 ; 95 % confidence interval ( CI ) = 3.25 - 15.64 ; P < 0.001 ] and lower physical health status ( OR = 1.26 per unit change in score ; 95 % CI = 1.17 - 1.42 ; P < 0.001 ) at T1 . Lower levels of outdoor/leisure activities at T1 were also associated with some increased risk of depression 4 years later ( OR = 0.92 per hour of activity ; 95 % CI = 0.85 - 0.99 ; P < 0.05 ) . Similar predictive patterns emerged from the multiple regression analyses where , in both models , earlier levels of life satisfaction , social engagement and health accounted for most of the explained variance in life satisfaction ( R2 = 0.42 for model 1 ; R2 = 0.35 for model 2 ) . Again , however , earlier levels of physical activity ( as walking and housework ) did contribute significantly , although modestly , to longitudinal changes in morale . CONCLUSIONS while the results provide some support for the conclusion that physical activity contributes independently to the promotion and maintenance of psychological wellbeing in later life , this contribution is , at best , extremely modest Few controlled studies describe the psychological effects of a walking program on non clinical , premenopausal women . This experiment measured the effects of an 8–wk . walking program on female volunteers ( N = 27 ) age 29 to 50 years ( M = 37.4 ) r and omly assigned to a supervised walking group vs a nonwalking group . A repeated- measures , multivariate design was used to analyze blood pressure , resting heart rate , timed mile walk , and scores on self-esteem , depression , and attributional style . The walking group showed significant improvement in the timed mile walk , diastolic blood pressure , and rated self-esteem BACKGROUND A r and omized controlled trial was conducted to examine : ( a ) the effect of two physical activity modes on changes in subjective well-being ( SWB ) over the course of a 12-month period in older , formerly sedentary adults ( N = 174 , M age = 65.5 years ) and ( b ) the role played by physical activity participation and social support in changes in SWB over time . METHOD Participants were r and omized into either an aerobic activity group or a stretching and toning group . Structural equation modeling was employed to conduct multiple sample latent growth curve analyses of individual growth in measures of SWB ( happiness , satisfaction with life , and loneliness ) over time . RESULTS A curvilinear growth pattern was revealed with well-being significantly improving over the course of the intervention followed by significant declines at the 6-month follow-up . Subsequent structural analyses were conducted showing that frequency of exercise participation was a significant predictor of improvement in satisfaction with life , whereas social relations were related to increases in satisfaction with life and reductions in loneliness . Improvements in social relations and exercise frequency also helped to buffer the declines in satisfaction with life at follow-up . CONCLUSIONS It appears that social relations integral to the exercise environment are significant determinants of subjective well-being in older adults . Findings are discussed in terms of how physical activity environments might be structured to maximize improvements in more global well-being constructs such as satisfaction with life Recent physical activity recommendations call for activities that are of moderate intensity and can be performed intermittently during the day , such as walking . These proclamations were based partly on the assumption that moderate activities are generally more enjoyable than physically dem and ing ones , and they are , therefore , also more likely to be continued over the long haul . However , little is actually known about the affective outcomes of short bouts of walking and extant findings are equivocal . Four experimental studies examined the affective responses associated with short ( 10- to 15-min ) bouts of walking using a dimensional conceptual model of affect , namely , the circumplex . Results consistently showed that walking was associated with shifts toward increased activation and more positive affective valence . Recovery from walking for 10–15 min was associated with a return toward calmness and relaxation . This pattern was robust across different self-report measures of the circumplex affective dimensions , across ecological setting s ( field and laboratory ) , across time , and across sample BACKGROUND The current physical activity ( PA ) and  health-related quality of life ( HRQoL ) literature warrants further investigation with general population sample s. The exploratory-focused purpose of this study was to compare total PA-HRQoL and walking-HRQoL relations , include a measure of general happiness , and to evaluate potential activity-HRQoL demographic moderators . METHODS A r and om sample of 351 adults completed an adapted Godin Leisure Time Question naire , the SF-36 , and the Satisfaction with Life Scale .  RESULTS Partial correlations revealed small-to-moderate associations between walking/total PA and general health , vitality , and social functioning after controlling for key demographics ( P < 0.05 ) . A dependent t-test determined  walking and PA  as equally related to vitality and social functioning . Multiple regression revealed annual income as a moderator of the total PA/walking-social functioning relationship [ F(3,315 ) = 9.71 and F(3,316 ) = 12.03 , P < 0.01 , respectively ] . CONCLUSIONS HRQoL may be considered with walking interventions and annual income . The contribution of PA to overall happiness appears to be minor The relationship between moderate exercise training ( five 45 min sessions/week , brisk walking at 62 beta + /- 2 % VO2max for 15 weeks , psychological well-being and mood state was investigated in a group of 35 sedentary , mildly obese women . A 2 ( exercise ( EX ) ( N = 18 ) , and nonexercise ( NEX ) ( N = 17 ) groups ) x 3 ( baseline , 6-week , 15-week testing sessions ) factorial design was used with data analyzed using repeated measures ANOVA . Four psychological tests were administered : Daily Hassles Scale ( DHS ) , General Well-being Schedule ( GWB ) , Spielberger State Anxiety Inventory ( S-Anxiety ) , and Profile of Mood States ( POMS ) . The EX and NEX groups had significantly different patterns of change over time for GWB total scores [ F(2,66 ) = 5.72 , p = 0.005 ] and the GWB subscales ' energy level ' and ' freedom from health concern or worry ' . Scores for the EX group were elevated at both 6 and 15 weeks . General well-being total scores and subscale ' energy level ' scores were significantly correlated with improvement in submaximal cardiorespiratory fitness ( r = -0.41 , p = 0.014 ; r = -0.40 , p = 0.017 , respectively ) . Exercise training also had a significant effect on frequency but not intensity of DHS scores , and S-Anxiety , with a significant decrease seen in the EX group at 6 weeks but not 15 weeks . Profile of Mood States scores were not significantly related to exercise training . These data support the results of other studies that have reported improvement in general psychological well-being with exercise training ISSUE ADDRESSED Women with children under five are the least physically active population group . We provided postpartum women living in western Sydney with the opportunity to participate in weekly pram walking groups and evaluated the effect of the intervention on self-reported physical activity , mental health and social indicators . METHODS Mothers living in the intervention area ( Blacktown LGA ) and control area ( Holroyd and Parramatta LGAs ) completed a baseline question naire . Women in the intervention community were invited to participate in a pram walking group starting in the next month . The control group ( n = 60 ) were also invited to participate in a pram walking group starting six months later . A follow-up question naire was completed by all mothers . RESULTS There was no significant increase in the proportion of mothers in the intervention or control groups engaging in adequate physical activity from baseline to follow-up . However , intervention mothers increased their sessions of vigorous exercise and control mothers increased the amount of time spent walking . There were no significant differences at baseline or follow-up between the intervention and control groups in frequency of social contact or size of social networks . Nor was there a significant difference in satisfaction with social contact at baseline between the two groups . However , at follow-up women in the intervention group were more satisfied with the quality of their social contacts than the controls . CONCLUSIONS Providing organised , community-based pram walking was not sufficient to increase overall physical activity levels among this group of postpartum women . The results suggest that the friendships formed in the pram walking group boosted mothers ' satisfaction with social contact and possibly their mental health ABSTRACT Objectives : To assess the effects of a 12-week pedometer-based intervention on the physical activity behavior , health-related quality of life ( HRQOL ) , and psychological well-being of first-year university students . Participants : First-year university students ( N = 184 ) were recruited during September 2012 and r and omly assigned to an intervention or a control group . Methods : Intervention participants were provided with a pedometer , monthly tracking logs , and follow-up e-mails . Control participants received no intervention .  Physical activity , HRQOL , and psychological well-being were measured at baseline and post intervention . Data were analyzed using multivariate/univariate analysis of variance ( MANOVA/ANOVA ) . Results : All participants experienced an increase in mild physical activity ( p < .01 ) from baseline to follow-up . The intervention failed to produce significant differences between groups for physical activity ( p = .28 ) , HRQOL ( p = .80 ) , or psychological well-being ( p = .72 ) . Psychological well-being ( p < .001 ) , vigorous physical activity ( p = .04 ) , and mental health status ( p < .001 ) decreased across the duration of the study . Conclusions : More intensive interventions may be required to elicit physical activity behavior change Psychological changes associated with 16-wk moderate and low intensity exercise training programs , two of which possessed a cognitive component , were evaluated . Subjects were healthy , sedentary adults , 69 women ( mean age = 54.8 + /- 8.3 yr ) and 66 men ( mean age = 50.6 + /- 8.0 yr ) . Participants were r and omly assigned to a control group ( C ) , moderate intensity walking group ( MW ) , low intensity walking group ( LW ) , low intensity walking plus relaxation response group ( LWR ) , or mindful exercise ( ME ) group-a Tai Chi type program . Women in the ME group experienced reductions in mood disturbance ( tension , P < 0.01 ; depression , P < 0.05 ; anger , P < 0.008 ; confusion , P < 0.02 ; and total mood disturbance , P < 0.006 ) and an improvement in general mood ( P < 0.04 ) . Women in the MW group noted greater satisfaction with physical attributes ( body cathexis , P < 0.03 ) , and men in MW reported increased positive affect ( P < 0.006 ) . No other differences were observed between groups on measures of mood , self-esteem , personality , or life satisfaction . Equivocal support is provided for the hypothesis that exercise plus cognitive strategy training programs are more effective than exercise programs lacking a structured cognitive component in promoting psychological benefits Objective Insomnia , anxiety , and depression are some psychological symptoms associated with menopause . The aim of this study was to evaluate the effect of pedometer-based walking on anxiety , insomnia , and depression  among postmenopausal women . Methods In this r and omized , controlled trial , 106 postmenopausal women were r and omly assigned to two groups ( n = 53 in each group ) . Their anxiety , insomnia , and depression levels were assessed using the GHQ-28 and  Beck question naires in the 4th , 8th , and 12th weeks of intervention . The depression level was assessed in the beginning , and in the 12th week of the trial . The members of the intervention group each received a pedometer and were asked to increase their steps by 500 per week . Data were analyzed using the independent t-test , χ2 and repeated- measures tests . Results The levels of anxiety and insomnia decreased in the 8th ( 4.2 ± 2.1 vs. 5.4 ± 2.3 , p = 0.007 ) and 12th week ( 4.3 ± 2.8 vs. 7.2 ± 2.6 , p < 0.001 ) in the intervention group , compared with the control group . The depression intensity decreased in the intervention group , compared with the control group , after 12 weeks ( 13.7 ± 5 vs. 19.6 ± 4.79 , p < 0.001 ) . The intervention group increased their step count from 76 377 steps per month in the first month , to 106 398 in the 3rd month ( p < 0.001 ) . Conclusion This study showed that pedometer-based walking had a positive effect on depression , insomnia and anxiety among postmenopausal women . A walking training program can be considered for postmenopausal women in Iran Background / objectives Walking pace is associated with risk of premature mortality . However , whether this relationship is independent of total volume of physical activity and highest physical activity intensity remains unclear . We examined the associations between  walking pace  and cause-specific mortality , investigating the potential modifying effect of factors such as total physical activity volume , highest physical activity intensity , age , sex and body mass index ( BMI ) . Methods Prospect i ve pooled analysis of 11 population -based baseline surveys in Engl and and Scotl and between 1994 and 2008 that were linked with mortality records . Multivariate-adjusted Cox proportional hazards models examined associations between  walking pace  ( slow , average , brisk/fast ) and all-cause , cancer and cardiovascular disease ( CVD ) mortality . Results 50 225 walkers were entered in the core analyses . Among participants who did not experience an event in the first 2 years of follow-up ( n=49 731 ) , walking at an average or brisk/fast pace was associated with a reduced risk of all-cause ( 20 % ( 95 % CI 12 % to 28 % ) and 24 % ( 95 % CI 13 % to 33 % ) , respectively ) and CVD mortality ( 24 % ( 95 % CI 9 % to 36 % ) and 21 % ( 95 % CI 1 % to 38 % ) , respectively ) , compared with reporting walking at a slow pace . In stratified analyses , such associations were evident among those over 50 years , those not meeting the physical activity recommendations and those who did not undertake vigorous-intensity activity . There were no interactions by sex or BMI . No associations were seen between pace and cancer mortality . Conclusion Walking benefits health . Assuming causality , these analyses suggest that increasing walking pace could reduce risk for all-cause and CVD mortality .  Walking pace could be emphasised in public health messages , especially in situations when increase in walking volume or frequency is less feasible
target: Evidence for anxiety , psychological stress , psychological well-being , subjective well-being and social isolation and loneliness varied in volume and effectiveness , but no harmful effects were identified .
  The setting and context of walking seems to be important variables .
background: Background / objectives Walking has well-established positive relationships with , and effects on , physical health .
  In contrast , while poor mental health contributes substantially to global health burden , an overview of the benefits from walking has not previously been published .
  We aim ed to scope the literature and present what is known , and highlight what is not known , about walking and mental health .