Download PDF
CC BY-NC-ND 4.0 · Sports Med Int Open 2019; 03(02): E48-E57
DOI: 10.1055/a-0900-7501
Training & Testing
Eigentümer und Copyright ©Georg Thieme Verlag KG 2019

Behavioral Modification Enhances the Benefits from Structured Aerobic and Resistance Training

Brett A. Dolezal
1   David Geffen School of Medicine at UCLA, Medicine, Physiology, Los Angeles, United States
,
David M. Boland
1   David Geffen School of Medicine at UCLA, Medicine, Physiology, Los Angeles, United States
2   Army-Baylor University Doctoral Program, Physical Therapy, San Antonio, United States
,
Eric V. Neufeld
1   David Geffen School of Medicine at UCLA, Medicine, Physiology, Los Angeles, United States
,
Jennifer L. Martin
3   David Geffen School of Medicine at UCLA, Medicine, Los Angeles, United States
4   VA Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center, Los Angeles, United States
,
Christopher B. Cooper
1   David Geffen School of Medicine at UCLA, Medicine, Physiology, Los Angeles, United States
› Author Affiliations
Further Information

Publication History

received 24 October 2018
revised 14 March 2019

accepted 25 April 2019

Publication Date:
15 July 2019 (online)

   Permissions and Reprints

Abstract

Behavioral modification (BM) is a strategy designed to sustain or restore well-being through effects such as enhanced relaxation, reduced stress, and improved sleep. Few studies have explored the role of BM delivered in the context of fitness programs for healthy adults. Thus, the purpose of this investigation was to examine whether BM combined with aerobic and resistance training programs would improve health and fitness measures more than the exercise training alone. Thirty-two healthy fitness club members (19 men) were randomized to receive a BM program (n=15) or an equal-attention (EA) control (n=17). BM consisted of twelve, 10-min education sessions between a trained fitness professional and the participant, coupled with weekly, individualized relaxation, stress reduction, and sleep improvement assignments. All participants engaged in 1 h of coached resistance training and remotely guided aerobic exercise thrice weekly for 12 weeks. Fitness measures (aerobic performance, body composition, muscle strength and endurance, lower-body power), sleep characteristics, and heart rate variability (HRV) were obtained at baseline and after the 12-week program. BM resulted in greater improvements in aerobic performance (increased maximum oxygen uptake, metabolic (lactate) threshold, and percent of maximum oxygen uptake at which metabolic threshold occurred), peak and average lower-body power, and body composition (decreased body fat percentage and fat mass) compared to EA. BM also positively influenced parasympathetic tone through increased High-frequency HRV. BM resulted in greater improvements in fitness measures, body composition, and heart rate variability compared with EA. These findings have intriguing implications regarding the role of BM in augmenting health and physical performance.

Key words

behavioral modification - physical fitness - exercise - maximum oxygen uptake - heart rate variability - sleep intervention
 

  • References

  • 1 Adams R. Revised physical activity readiness questionnaire. Can Fam Physician 1999; 45 992, 995 1004-1005
    PubMedGoogle Scholar
  • 2 Aiello KD, Caughey WG, Nelluri B, Sharma A, Mookadam F, Mookadam M. Effect of exercise training on sleep apnea: A systematic review and meta-analysis. Respir Med 2016; 116: 85-92
    CrossrefPubMedGoogle Scholar
  • 3 National Strength & Conditioning Association. Baechle TR, Earle RW. eds Essentials of Strength Training and Conditioning. 3rd ed Champaign, IL: Human Kinetics; 2008
    Google Scholar
  • 4 Baron KG, Reid KJ. Circadian misalignment and health. Int Rev Psychiatry 2014; 26: 139-154
    CrossrefPubMedGoogle Scholar
  • 5 Batalin M, Yuen E, Dolezal B, Smith D, Cooper C, Mapar J. PHASER: Physiological Health Assessment System for Emergency Responders. IEEE International Conference on Body Sensor Networks; Cambridge, Massachusetts: 2013
    Google Scholar
  • 6 Borbely AA. A two process model of sleep regulation. Hum Neurobiol 1982; 1: 195-204
    PubMedGoogle Scholar
  • 7 Burgess E, Hassmen P, Welvaert M, Pumpa KL. Behavioural treatment strategies improve adherence to lifestyle intervention programmes in adults with obesity: A systematic review and meta-analysis. Clin Obes 2017; 7: 105-114
    CrossrefPubMedGoogle Scholar
  • 8 Burton AR, Rahman K, Kadota Y, Lloyd A, Vollmer-Conna U. Reduced heart rate variability predicts poor sleep quality in a case-control study of chronic fatigue syndrome. Exp Brain Res 2010; 204: 71-78
    CrossrefPubMedGoogle Scholar
  • 9 Buysse DJ, Reynolds 3rd CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res 1989; 28: 193-213
    CrossrefPubMedGoogle Scholar
  • 10 Carney CE, Buysse DJ, Ancoli-Israel S, Edinger JD, Krystal AD, Lichstein KL, Morin CM. The consensus sleep diary: Standardizing prospective sleep self-monitoring. Sleep 2012; 35: 287-302
    CrossrefPubMedGoogle Scholar
  • 11 Deka P, Pozehl B, Williams MA, Yates B. Adherence to recommended exercise guidelines in patients with heart failure. Heart Fail Rev 2017; 22: 41-53
    CrossrefPubMedGoogle Scholar
  • 12 Dekker JM, Crow RS, Folsom AR, Hannan PJ, Liao D, Swenne CA, Schouten EG. Low heart rate variability in a 2 min rhythm strip predicts risk of coronary heart disease and mortality from several causes: The ARIC Study. Atherosclerosis Risk In Communities. Circulation 2000; 102: 1239-1244
    CrossrefPubMedGoogle Scholar
  • 13 Dolezal BA, Lau MJ, Abrazado M, Storer TW, Cooper CB. Validity of two commercial-grade bioelectrical impedance analyzers for measurement of body fat percentage. J Exerc Physiol Online 2013; 16: 74-83
    PubMedGoogle Scholar
  • 14 Dolezal BA, Storer TW, Neufeld EV, Smooke S, Tseng CH, Cooper CB. A systematic method to detect the metabolic threshold from gas exchange during incremental exercise. J Sports Sci Med 2017; 16: 396-406
    PubMedGoogle Scholar
  • 15 Dolezal BA, Waite JG, Neufeld EV, Boland DM, Cooper CB. Remotely guided feedback enhances exercise training adherence and physical performance in firefighters. Int J Sports Sci 2015; 5: 221-227
    PubMedGoogle Scholar
  • 16 Duffield R, Murphy A, Kellett A, Reid M. Recovery from repeated on-court tennis sessions: Combining cold-water immersion, compression, and sleep recovery interventions. Int J Sports Physiol Perform 2014; 9: 273-282
    CrossrefPubMedGoogle Scholar
  • 17 Farnsworth JL, Kim Y, Kang M. Sleep disorders, physical activity, and sedentary behavior among U.S. adults: National Health and Nutrition Examination Survey. J Phys Act Health 2015; 12: 1567-1575
    CrossrefPubMedGoogle Scholar
  • 18 Farrell TC, Keeping-Burke L. The primary prevention of cardiovascular disease: nurse practitioners using behaviour modification strategies. Can J Cardiovasc Nurs 2014; 24: 8-15
    PubMedGoogle Scholar
  • 19 Fowler P, Duffield R, Vaile J. Effects of simulated domestic and international air travel on sleep, performance, and recovery for team sports. Scand J Med Sci Sports 2015; 25: 441-451
    CrossrefPubMedGoogle Scholar
  • 20 Fullagar HH, Skorski S, Duffield R, Hammes D, Coutts AJ, Meyer T. Sleep and athletic performance: the effects of sleep loss on exercise performance, and physiological and cognitive responses to exercise. Sports Med 2015; 45: 161-186
    CrossrefPubMedGoogle Scholar
  • 21 Harman EA, Rosenstein MT, Frykman PN, Rosenstein RM, Kraemer WJ. Estimation of human power output from vertical jump. J Strength Cond Res 1991; 5: 116-120
    PubMedGoogle Scholar
  • 22 Harriss DJ, Macsween A, Atkinson G. Standards for ethics in sport and exercise science research: 2018 update. Int J Sports Med 2017; 38: 1126-1131
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Horne JA, Ostberg O. A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int J Chronobiol 1976; 4: 97-110
    PubMedGoogle Scholar
  • 24 Huikuri HV, Jokinen V, Syvanne M, Nieminen MS, Airaksinen KE, Ikaheimo MJ, Koistinen JM, Kauma H, Kesaniemi AY, Majahalme S, Niemela KO, Frick MH. Heart rate variability and progression of coronary atherosclerosis. Arterioscler Thromb Vasc Biol 1999; 19: 1979-1985
    CrossrefPubMedGoogle Scholar
  • 25 Institute of Medicine (US) Committee on Sleep Medicine and Research. Colten HR, Altevogt BM. eds Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: National Academies Press (US); 2006
    Google Scholar
  • 26 Kim K, Shin D, Jung GU, Lee D, Park SM. Association between sleep duration, fat mass, lean mass and obesity in Korean adults: The fourth and fifth Korea National Health and Nutrition Examination Surveys. J Sleep Res 2017; 26: 453-460
    CrossrefPubMedGoogle Scholar
  • 27 Kredlow MA, Capozzoli MC, Hearon BA, Calkins AW, Otto MW. The effects of physical activity on sleep: A meta-analytic review. J Behav Med 2015; 38: 427-449
    CrossrefPubMedGoogle Scholar
  • 28 Leard JS, Cirillo MA, Katsnelson E, Kimiatek DA, Miller TW, Trebincevic K, Garbalosa JC. Validity of two alternative systems for measuring vertical jump height. J Strength Cond Res 2007; 21: 1296-1299
    PubMedGoogle Scholar
  • 29 Leproult R, Holmback U, Van Cauter E. Circadian misalignment augments markers of insulin resistance and inflammation, independently of sleep loss. Diabetes 2014; 63: 1860-1869
    CrossrefPubMedGoogle Scholar
  • 30 Liu Y, Wheaton AG, Chapman DP, Cunningham TJ, Lu H, Croft JB. Prevalence of healthy sleep duration among adults–United States, 2014. MMWR Morb Mortal Wkly Rep 2016; 65: 137-141
    CrossrefPubMedGoogle Scholar
  • 31 Mah CD, Mah KE, Kezirian EJ, Dement WC. The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep 2011; 34: 943-950
    CrossrefPubMedGoogle Scholar
  • 32 Mastin DF, Bryson J, Corwyn R. Assessment of sleep hygiene using the Sleep Hygiene Index. J Behav Med 2006; 29: 223-227
    CrossrefPubMedGoogle Scholar
  • 33 Miller WR, Rollnick S. Motivational Interviewing: Preparing People for Change. 3rd ed New York: Guilford Press; 2012
    Google Scholar
  • 34 Minton O, Jo F, Jane M. The role of behavioural modification and exercise in the management of cancer-related fatigue to reduce its impact during and after cancer treatment. Acta Oncol 2015; 54: 581-586
    CrossrefPubMedGoogle Scholar
  • 35 Morgenthaler T, Kramer M, Alessi C, Friedman L, Boehlecke B, Brown T, Coleman J, Kapur V, Lee-Chiong T, Owens J, Pancer J, Swick T. Practice parameters for the psychological and behavioral treatment of insomnia: An update. An American Academy of Sleep Medicine report. Sleep 2006; 29: 1415-1419
    CrossrefPubMedGoogle Scholar
  • 36 Mougin F, Simon-Rigaud ML, Davenne D, Renaud A, Garnier A, Kantelip JP, Magnin P. Effects of sleep disturbances on subsequent physical performance. Eur J Appl Physiol Occup Physiol 1991; 63: 77-82
    CrossrefPubMedGoogle Scholar
  • 37 Mullington JM, Haack M, Toth M, Serrador JM, Meier-Ewert HK. Cardiovascular, inflammatory, and metabolic consequences of sleep deprivation. Prog Cardiovasc Dis 2009; 51: 294-302
    CrossrefPubMedGoogle Scholar
  • 38 Nedelec M, Halson S, Delecroix B, Abaidia AE, Ahmaidi S, Dupont G. Sleep hygiene and recovery strategies in elite soccer players. Sports Med 2015; 45: 1547-1559
    CrossrefPubMedGoogle Scholar
  • 39 Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 1999; 131: 485-491
    CrossrefPubMedGoogle Scholar
  • 40 Prentice C, Stannard SR, Barnes MJ. Effects of heavy episodic drinking on physical performance in club level rugby union players. J Sci Med Sport 2015; 18: 268-271
    CrossrefPubMedGoogle Scholar
  • 41 Roemer L, Orsillo SM, Salters-Pedneault K. Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: Evaluation in a randomized controlled trial. J Consult Clin Psychol 2008; 76: 1083-1089
    CrossrefPubMedGoogle Scholar
  • 42 Sack RL, Auckley D, Auger RR, Carskadon MA, Wright Jr. KP, Vitiello MV, Zhdanova IV. Circadian rhythm sleep disorders: Part I, basic principles, shift work and jet lag disorders. An American Academy of Sleep Medicine review. Sleep 2007; 30: 1460-1483
    CrossrefPubMedGoogle Scholar
  • 43 Storer TW, Dolezal BA, Berenc MN, Timmins JE, Cooper CB. Effect of supervised, periodized exercise training vs. self-directed training on lean body mass and other fitness variables in health club members. J Strength Cond Res 2014; 28: 1995-2006
    CrossrefPubMedGoogle Scholar
  • 44 Stults-Kolehmainen MA, Sinha R. The effects of stress on physical activity and exercise. Sports Med 2014; 44: 81-121
    CrossrefPubMedGoogle Scholar
  • 45 Tobaldini E, Costantino G, Solbiati M, Cogliati C, Kara T, Nobili L, Montano N. Sleep, sleep deprivation, autonomic nervous system and cardiovascular diseases. Neurosci Biobehav Rev 2017; 74: 321-329
    CrossrefPubMedGoogle Scholar
  • 46 Van Ryswyk E, Weeks R, Bandick L, O’Keefe M, Vakulin A, Catcheside P, Barger L, Potter A, Poulos N, Wallace J, Antic NA. A novel sleep optimisation programme to improve athletes’ well-being and performance. Eur J Sport Sci 2017; 17: 144-151
    CrossrefPubMedGoogle Scholar
  • 47 Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion. Sleep 2015; 38: 1161-1183
    CrossrefPubMedGoogle Scholar
  • 48 Werner GG, Ford BQ, Mauss IB, Schabus M, Blechert J, Wilhelm FH. High cardiac vagal control is related to better subjective and objective sleep quality. Biol Psychol 2015; 106: 79-85
    CrossrefPubMedGoogle Scholar
  • 49 Wu Y, Zhai L, Zhang D. Sleep duration and obesity among adults: A meta-analysis of prospective studies. Sleep Med 2014; 15: 1456-1462
    CrossrefPubMedGoogle Scholar