Influence of Aerobic Exercise Training and Relaxation
Influence of Aerobic Exercise Training and Relaxation
The amount of stressful life change that erate stress and thereby avoid developing
persons report experiencing over a recent stress-related health problems.
time period has been repeatedly found to One variable that has been proposed as
be associated with the amount of physical a moderator of the stress-illness relation-
and psychologic health problems they re- ship is aerobic fitness. The results of a re-
port over a subsequent time period (1-5). cent study revealed that following stress-
Currently, there is a great deal of interest ful life events, those subjects with high
in determining the ways in which the del- levels of aerobic fitness reported fewer
eterious effects of stress can be reduced. physical health problems and tended to
Because it is not always practical or even report less depression than did those with
possible to avoid many stressful life events, lower levels of fitness (4). Other compar-
it seems that one of the most effective ways isons of high- and low-fit persons have
to reduce the impact of stress on health indicated that a high level of fitness is
would be to enhance one's ability to tol- associated with reduced physiologic re-
sponses to laboratory stressors requiring
active coping or cognitive processing (6-9).
Physiologic responses to stressors requir-
Address reprint requests to: David L. Roth, Ph.D., ing passive coping (e.g., viewing a stress-
Department of Psychology, Campbell Hall, Univer- ful film, cold pressor task) have not been
sity of Alabama at Birmingham, Birmingham, AL
35294. reliably different for high- and low-fit per-
Received for publication August 1985; revision re- sons (7, 8), although high-fit persons have
ceived October 22, 1986. been found to show quicker physiologic
From the Department of Psychology, University of
Kansas, Lawrence, Kansas. recovery from stressors requiring either
active or passive coping responses (10-12). this variability may have prevented the
However, because these studies did not emergence of between-group differences.
utilize experimental manipulations of fit- Moreover, individual differences in fitness
ness, inferences concerning causation must improvement were found to be signifi-
be considered tentative. cantly correlated with quicker heart rate
There are a few experiments that do pro- recovery for those in the exercise group,
vide some evidence concerning the role providing some support for the hypothesis
that fitness may play in the response to that fitness training alters responses to
stress. In one experiment, subjects who psychologic stress.
participated in an exercise training class The present investigation was designed
showed quicker autonomic recovery, as to experimentally test the influence of
measured by electrodermal response, from aerobic exercise training on the physical
laboratory stressors requiring active cog- and psychological health of a group of col-
nitive processing than subjects who par- lege students who reported experiencing
ticipated in meditation training or music high levels of life stress. On the basis of
appreciation classes (13). An experiment previous prospective studies (1, 3, 4), these
conducted on cardiac patients revealed that students were considered to be at risk for
those assigned to an exercise condition developing more health problems over the
showed greater improvements in cardiac next few months than less stressed stu-
functioning and self-concept than those dents. Subjects assigned to the aerobic ex-
assigned to a routine care condition (14). ercise training condition were compared
An experiment conducted on moderately on measures of self-reported physical and
depressed college women revealed that psychologic health to subjects assigned to
those who were assigned to participate in participate in a progressive relaxation
an aerobic dance class showed greater de- training condition and to subjects as-
clines in depression than those who were signed to a no-treatment control condi-
assigned to a program of self-monitored tion. The exercise training condition con-
relaxation activities or to a no-treatment sisted of running and brisk walking when
condition (15). These investigators pointed necessary, whereas the relaxation training
out, however, that because the women in condition consisted of progressive muscle
the exercise condition participated in relaxation and guided imagery techniques.
groups and those in the relaxation con-
dition participated individually, social
contact and support may have contributed METHODS
to the effects achieved in the exercise con-
dition. Finally, a recent experiment com- Subjects
paring subjects assigned to 10-week aero-
bic training, anaerobic training (weight- The subjects in this investigation were college stu-
dents enrolled in General Psychology classes at the
lifting), or wait-list control conditions re- University of Kansas. A total of 1051 students indi-
vealed no reliable group differences on cated which events on the Life Experiences Survey
heart rate or self-report responses to lab- (LES) (17) they had experienced over the past year,
oratory stressors (16). However, these in- and they rated each experienced event as being either
vestigators reported large variability in the "good" or "bad" when it happened. Those students
degree of fitness improvement in the aero- who reported experiencing a high number of negative
life events and who indicated that they were not
bic training group, and they suggested that currently participating in either a regular aerobic ex-
ercise training or structured relaxation training pro- no effect, 1 = slight effect, 2 = moderate effect, 3
gram were invited to participate in the experiment. = great effect), in addition to indicating whether
The subjects who agreed to participate were ran- each event experienced was "good" or "bad" when
domly assigned to the aerobic exercise training con- it happened. Finally, to provide measures of psy-
dition, the progressive relaxation training condition, chologic health, each subject completed the Beck
or the no-treatment control condition. Initially, 23, Depression Inventory (BDI) (18), the Spielberger Trait
21, and 21 subjects were assigned to the three con- Anxiety Inventory (STAI) (19), and the Hopkins
ditions, respectively, but 10 subjects dropped out of Symptom Checklist (SCL-90) (20).
the study within the first few weeks, leaving 18 sub- Each subject also participated in an individual ses-
jects in the exercise training condition (9 males, 9 sion in which his or her preintervention level of aero-
females), 19 subjects in the relaxation training con- bic fitness was assessed using a Balke treadmill test
dition (10 males, 9 females), and 18 subjects in the (21). After weighing the subject on an electronic scale,
no-treatment control condition [8 males, 10 females). three electrodes were attached to the subject's chest
The ages of the subjects did not differ reliably across to provide a modified Lead II monitoring of the sub-
the groups. Overall, the subjects had a mean age of ject's cardiac activity. The subject was then in-
18.9 years (SD = 1.3). structed to begin walking on a motorized treadmill
for which the speed was set at 3.4 miles per hour.
The elevation of the treadmill was increased by 1%
Procedures and Measures after each minute until the subject's heart rate reached
90% of the maximum heart rate that would be pre-
dicted for a person of that age (e.g., 220 minus age).
Preintervention Assessments. In initial meet- The grade at which this heart rate was reached was
ings, the procedures to be used in the experiment used to provide an estimate of aerobic capacity in
were explained, and then each subject signed an in- milliliters per kilogram per minute according to the
formed consent statement specific to the particular conversion tables reported by Londeree (22). In ad-
condition to which he or she had been assigned. Next, dition, each subject's heart rate at the 10% grade was
each subject was given a Health Record Form (4) to recorded.
take home and use to record all health problems that
occurred between the preintervention and midinter- Midintervention Assessments. After approxi-
vention sessions. On these forms, each subject was mately 5 weeks of the intervention conditions, each
to indicate the date(s) of each health problem, pro- subject participated in a midintervention question-
vide a brief description of the problem, indicate naire session. Subjects first turned in the Health Re-
whether a doctor was consulted about the problem, cord Forms that were distributed during the prein-
indicate whether medications were used, and rate tervention session, and then they were given blank
the severity of each problem in terms of the degree Health Record Forms to use to record any health
to which it interfered with normal daily activities (1 problems that occurred between the midintervention
= not at all, 2 = a little, 3 = somewhat, 4 = a lot, and postintervention sessions. The subjects then
5 = very much). Subjects were instructed to record completed the Health Survey, BDI, STAI, and SCL-
all physical health problems that occurred including 90 again. In addition, the subjects in the exercise and
minor diseases (e.g., head colds) and transient ail- relaxation training conditions responded to ques-
ments (e.g., headaches). Next, each subject com- tions regarding a) how effective they had found their
pleted a Health Survey that provided a retrospective training classes to have been up to that point for
measure of physical health problems. On this mea- handling stressful situations, b) how effective they
sure, the subjects were provided with a list of com- expected their training would be for assisting them
mon physical health problems, and they indicated in handling the effects of stress in the future, and c)
which problems they had experienced over the past how likely they were to continue to use their training
month and rated each problem experienced in terms activity after the class ended. All responses were made
of how much it interfered with normal daily activi- on 7-point scales (e.g., 1 = not at all effective, 7 =
ties on the same scale used on the Health Record very effective).
Form. Next, each subject completed the LES to ex-
amine the replicability of the high-life-stress classi-
Postintervention Assessments. Immediately af-
fication from the initial screening. On this admin-
istration of the LES, the subjects also rated the impact ter the conclusion of the 11-week training (and con-
of each event experienced on a 4-point scale (0 = trol) period, all subjects participated in sessions in
which they turned in the Health Record Forms and
completed the Health Survey, BDI, STAI, and SCL- 28). Subjects were encouraged to exercise on their
90 again. In individual sessions, the subjects were own to make up for holidays and absences in order
also administered the Balke treadmill test again, with to maintain a frequency of three exercise sessions per
the same procedures and predicted maximum heart week.
rates used.
Progressive Relaxation Training. Subjects in the
Follow-up Assessments and Debriefing. Ap- progressive relaxation training condition met in a
proximately 2 months after the postintervention as- classroom. During the first several meetings, the sub-
sessments, most of the subjects were met a final time jects were taught an abbreviated version of Jacobson's
during which they completed the Health Survey, BDI, (23) progressive muscle relaxation training proce-
and STAI once again. (Two subjects from the exercise dure (24). Later in the class, other techniques, such
condition, two from the relaxation condition, and six as mental imagery procedures (25), were introduced
from the no-treatment condition were not available and practiced. Toward the end of the class, very few
to participate at follow-up, but comparisons on the explicit instructions were provided, and individual
data collected up to that point indicated that they flexibility in the utilization of the various techniques
did not differ systematically from the other subjects.) taught was encouraged. The relaxation training sub-
After the questionnaires were completed, each sub- jects were taught how to monitor their heart rates so
ject was given a thorough and elaborate debriefing. that they could evaluate the effects of their training
Subjects in both the no-treatment condition and re- on their physiologic arousal.
laxation training condition were offered a program The subjects in the relaxation training class were
of exercise training similar to the one provided to informed that daily practice of these techniques is
the subjects in the exercise training condition. sometimes recommended by clinical practitioners,
and they were encouraged to practice these tech-
Intervention Conditions niques at home on days that the class did not meet.
A total of 29 relaxation class meetings were held, and
The exercise and relaxation training programs were the mean attendance was 24.8 (SD = 2.4, range =
conducted in very comparable ways. Both were 18-28).
structured as 1 credit-hour college courses that met
for one half-hour each day, 3 days per week, over an No-Treatment Controi. The subjects in the no-
11-week period. Both courses were taught by the same treatment control condition were not seen except
instructor who had been trained in both clinical psy- during the sessions when the dependent measures
chology and exercise physiology. were collected.
p = 0.0005 (adjusted Ms = 49.6,45.8, and ment session revealed that the subjects in
45.3 ml/kg/min for the subjects in the ex- the relaxation training condition rated their
ercise, relaxation, and control conditions, training as being more beneficial up to that
respectively, collapsed across subject gen- point, F(l,34) = 4.69, p = 0.04, as ex-
der). The relaxation and control condi- pected to provide more benefits in the fu-
tions did not differ reliably, F(l,43) = 0.22. ture, F(l,34) = 6.00, p = 0.02, and as
Analyses on subject gender effects indi- something they were more likely to con-
cated that similar improvements in fitness tinue using, F(l,34) = 5.00, p = 0.03, than
occurred for both the males and females the subjects in the exercise training con-
in the exercise training condition. (It might dition rated their training experience (Ms
be noted that male and female subjects were [SDs] = 3.9 [1.4], 4.4 [1.4], and 4.6 [0.9]
not found to show any statistically reliable for the exercise condition and 4.7 [0.9], 5.4
differences in the amount of change ob- [1.0], and 5.4 [1.1] for the relaxation con-
served from preintervention levels on any dition, respectively). These results indi-
of the measures examined. Males and fe- cate that after participating in the training
males were therefore both included to- conditions for approximately 5 weeks, the
gether in all reported statistical analyses.) subjects in the relaxation training condi-
Similar results were obtained from the tion had higher subjective impressions and
analysis of covariance conducted on the expectations for the effectiveness of their
10% grade heart rate data. A reliable dif- training than did the subjects in the ex-
ference among the conditions was ob- ercise training class.
tained, F(2,43) = 6.66, p = 0.003, and
pairwise comparisons indicated that this Influence of Interventions on Self-
heart rate decreased more for the subjects Reported Physical and
in the exercise condition than for subjects Psychologic Health
in the relaxation condition, F(1,43) = 10.59, Table 2 contains the means and stan-
p = 0.002, or in the no-treatment condi- dard deviations for the three groups on the
tion, F(l,43) = 6.99, p = 0.011 (adjusted self-reported measures of physical and
Ms = 135.2, 146.0, and 144.0 bpm, re- psychologic health. To examine group dif-
spectively). Overall, these results indicate ferences in the changes observed across
that the exercise training condition led to time, analyses of covariance were per-
reliable improvements in cardiovascular formed on the scores obtained at each
fitness. The aerobic capacity estimates administration, with the respective prein-
suggested that the subjects in the exercise tervention scores serving as the covariate.
training condition showed approximately The Health Record Form and the Health
a 10% improvement in fitness compared Survey were used to provide measures of
to changes of less than 1% for the other physical health. Total scores were ob-
two conditions. tained for each administration of each
measure by simply adding the severity rat-
ings of all reported problems. The analyses
Subjective Impressions and of covariance did not reveal reliable dif-
Expectations about Interventions ferences among the conditions (all ps >
One-way analyses of variance on the 0.10), and therefore it appears that neither
subjective ratings of the training classes training program had a systematic effect
made during the midintervention assess- on general physical health.
(16) in suggesting that a relatively brief present study. They were not seeking any
aerobic training program has no system- treatment on their own. In addition to at-
atic effect on the psychologic symptoma- tempting to replicate these results using
tology assessed by the SCL-90. clinical samples, future research might also
It is noteworthy that the patterning of be directed towards examining the possi-
results concerning depression that were ble mechanisms responsible for the anti-
found in this experiment are similar to those depressant effects of exercise. For exam-
found in an earlier study (15). In both stud- ple, aerobic exercise training may affect
ies, exercise training was found to be more mood through either biochemical (32, 33)
effective than relaxation training for re- or psychologic (e.,g., enhanced self-con-
ducing depression. Furthermore, in both cept related to improvements in fitness)
studies the full effect of this finding was means or both. If the mechanism(s) re-
apparent after only 5 weeks of participa- sponsible can be specified, then more spe-
tion. The methodologic improvements cific exercise prescriptions aimed at pro-
introduced in this experiment (e.g., an ducing optimal effects can be developed.
alternative training program involving Contrary to the expectations based on
comparable amounts of time and contact) previous correlational research (4), the ex-
and the consistency of the findings across ercise training did not have a reliable in-
the two experiments provide strong sup- fluence on subjects' self-reported physical
port for the suggestion that regular aerobic health. One possibility is that the general
exercise is effective for reducing mild to improvement in health reported by most
moderate levels of depression. It is also subjects over the course of the experiment
noteworthy that in the present investiga- may have obviated the effects of the treat-
tion the exercise training had the greatest ments. Another possibility is that aerobic
effect despite the fact that the subjects in fitness may serve more of a prophylactic
the relaxation training condition per- role rather than a corrective one with re-
ceived and expected their training to be gard to the influence of life stress on phys-
more effective for dealing with stressful ical illness. The results of the previous re-
situations. In light of these findings, it ap- search are consistent with the prophylactic
pears that the effects of exercise training role because in that research it was found
on depression observed in the present study that subjects who were already high in fit-
cannot be attributed to placebo or expec- ness experienced fewer physical health
tancy effects. problems following life stress than did
Although it has been suggested by oth- subjects who were low in fitness. In the
ers that frequent aerobic exercise may be present experiment, improvements in fit-
an effective treatment for depression in ness were introduced after the onset of the
clinical settings (28-30), there appears to stressors and therefore may have come too
be no adequately controlled experimental late.
demonstration of this effect on a patient In summary, the results of this investi-
sample (15, 31). The results of the present gation indicated that aerobic exercise
investigation should only be generalized training was more effective than relaxa-
to a population of college students who tion training or no treatment for reducing
are experiencing high levels of life stress. depression following exposure to high lev-
It should be emphasized that these sub- els of life stress. This beneficial effect ap-
jects were recruited to participate in the peared after only 5 weeks of periodic ex-
ercise. In contrast, neither exercise training The authors would like to thank Tom
nor relaxation training was superior to a R- Thomas and Wayne Osness for making
no-treatment condition for reducing phys- possible the aerobic fitness testing and ex-
ical illnesses following life stress. It is pos- ercise training condition. Appreciation is
sible that frequent aerobic exercise pro- QJso due to B. Kent Houston and Douglas
vides an assortment of prophylactic and R- Denney for their comments. This pro-
therapeutic effects with regard to the ef- J e c t WQs supported in part by a disserta-
fects of life stress on physical and psy- tion fellowship awarded to the first author
chologic health, and additional research by the Graduate School of the University
seems necessary to further delineate the °f Kansas,
nature of these effects.
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