Subscribe to RSS
DOI: 10.1055/a-2029-8337
The Assessment of Affective Responses within Exercise Prescription: A Narrative Review
Abstract
The assessment of affective responses (pleasure-displeasure) to exercise, is a useful tool for tailoring exercise prescription. Ideally, the proper prescription is a balance between minimizing risks, such as negative affect and dropout, and maximizing gains, such as improvements in health and fitness. Measuring affective responses to exercise facilitates the process of self-regulation. When individuals have the autonomy to select the exercise intensity, they are more likely to have a positive exercise experience and adhere to the program. The American College of Sports Medicine (ACSM) has put forth guidelines on how to incorporate affective responses within exercise prescription. The primary purpose of this review is to expand upon the techniques and recommendations provided by the ACSM on the topic of affective responses. Topics include an overview of the existing research of affective responses to exercise intensity, the impact of affective responses on motivation and exercise behaviors, and recommendations of specific techniques for measuring, monitoring, and evaluating affective responses within an exercise prescription.
Key words
affective responses - physical activity - exercise prescription - exercise adherence - behavior changePublication History
Received: 30 September 2022
Accepted: 01 February 2023
Accepted Manuscript online:
07 February 2023
Article published online:
02 May 2023
© 2023. Thieme. All rights reserved.
Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart,
Germany
-
References
- 1 Berryman JW. Exercise is medicine: A historical perspective. Curr Sports Med Rep 2010; 9: 195-201
- 2 Liguori G. ACSM’s Guidelines for Exercise Testing and Prescription. Eleventh Edition. Hong Kong: Wolters Kluwer; 2021
- 3 Fountaine C, Feito Y. General principles of exercise prescription. In: Liguori G (Ed). ACSM’s Guidelines for Exercise Testing and Prescription. Hong Kong: Wolters Kluwer; 2021: 142-166
- 4 Barreira T. Benefits and risks associated with physical activity. In: Liguori G (Ed). ACSM’s Guidelines for Exercise Testing and Prescription. Hong Kong: Wolters Kluwer; 2021: 1-28
- 5 Courtney M, Edwards H, Chang A. et al. Fewer emergency readmissions and better quality of life for older adults at risk of hospital readmission: A randomized controlled trial to determine the effectiveness of a 24-week exercise and telephone follow-up program. J Am Geriatr Soc 2009; 57: 395-402
- 6 Hoffmann TC, Maher CG, Briffa T. et al. Prescribing exercise interventions for patients with chronic conditions. CMAJ 2016; 188: 510-518
- 7 Marsden DL, Dunn A, Callister R. et al. Characteristics of exercise training interventions to improve cardiorespiratory fitness after stroke: A systematic review with meta-analysis. Neurorehabil Neural Repair 2013; 27: 775-788
- 8 Steinmetz H, Knappstein M, Ajzen I. et al. How effective are behavior change interventions based on the theory of planned behavior?. Z Psychol 2016; 224: 216-233
- 9 Marcus BH, Bock BC, Pinto BM. et al. Efficacy of an individualized, motivationally-tailored physical activity intervention. Ann Behav Med 1998; 20: 174-180
- 10 van Sluijs EMF, van Poppel MNM, Twisk JWR. et al. Effect of a tailored physical activity intervention delivered in general practice settings: Results of a randomized controlled trial. Am J Public Health 2005; 95: 1825-1831
- 11 Stoedefalke KG, Faulkner JA. Guidelines for Graded Exercise Testing and Exercise Prescription. Lea & Febiger;. 1975
- 12 Abbott RA. ACSM’s Guidelines for Exercise Testing and Prescription. Second Edition. Hong Kong: Wolters Kluwer; 1980
- 13 Blair SN. ACSM’s guidelines for Exercise Testing and Prescription. Third Edition. New York: Lippincott Williams & Wilkins; 1986
- 14 Borg G. Perceived exertion: A note on “history” and methods. Med Sci Sports Exerc 1973; 5: 90-93
- 15 Borg G. Subjective Effort in Relation to Physical Performance and Working Capacity. In: Psychology: From Research to Practice. Springer; 1978: 333-361
- 16 Ekkekakis P, Petruzzello SJ. Analysis of the affect measurement conundrum in exercise psychology: I. Fundamental issues. Psychol Sport Exerc 2000; 1: 71-88
- 17 Ekkekakis P, Petruzzello SJ. Acute aerobic exercise and affect: Current status, problems and prospects regarding dose-response. Sports Med 1999; 28: 337-374
- 18 Ekkekakis P. Pleasure and displeasure from the body: Perspectives from exercise. Cogn Emot 2003; 17: 213-239
- 19 Scherer KR. On the nature and function of emotion: A component process approach. In: Scherer KR, Ekman P (Eds.). Approaches to Emotion. 1st Edition. Psychology Press; Chapter 14. 1984
- 20 Pescatello LS, Arena R, Riebe D. et al. ACSM’s Guidelines for Exercise Testing and Prescription. Ninth Edition. Hong Kong: Lippincott Williams & Wilkins; 2013
- 21 Riebe D, Ehrman JK, Liguori G. et al. ACSM’s Guidelines for Exercise Testing and Prescription. Tenth Edition. Hong Kong: Wolters Kluwer; 2017
- 22 Bohlen LC. Behavioral theories and strategies for promoting exercise. In: Liguori G. ACSM’s guidelines for exercise testing and prescription. Hong Kong: Wolters Kluwer; 2021: 440-469
- 23 Barry VW, Baruth M, Beets MW. et al. Fitness vs. fatness on all-cause mortality: a meta-analysis. Prog Cardiovasc Dis 2014; 56: 382-390
- 24 Church TS, Thomas DM, Tudor-Locke C. et al. Trends over 5 decades in US occupation-related physical activity and their associations with obesity. PloS One 2011; 6: e19657
- 25 Troiano RP, Berrigan D, Dodd KW. et al. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 2008; 40: 181-188
- 26 Tudor-Locke C, Brashear MM, Johnson WD. et al. Accelerometer profiles of physical activity and inactivity in normal weight, overweight, and obese US men and women. Int J Behav Nutr Phys Act 2010; 7: 60-68
- 27 Trost SG, Loprinzi PD. Exercise – Promoting healthy lifestyles in children and adolescents. J Clin Lipidol 2008; 2: 162-168
- 28 Schneider M, Dunn A, Cooper D. Affect, exercise, and physical activity among healthy adolescents. J Sport Exerc Psychol 2009; 31: 706-723
- 29 Schutzer KA, Graves BS. Barriers and motivations to exercise in older adults. Prev Med 2004; 39: 1056-1061
- 30 Cohen-Mansfield J, Marx MS, Guralnik JM. Comparison of exercise models in an elderly population. Aging Clin Exp Res 2006; 18: 312-319
- 31 McAuley E, Blissmer B, Katula J. et al. Exercise environment, self-efficacy, and affective responses to acute exercise in older adults. Psychol Health 2000; 15: 341-355
- 32 Winett RA, Davy BM, Savla J. et al. Theory-based approach for maintaining resistance training in older adults with prediabetes: adherence, barriers, self-regulation strategies, treatment fidelity, costs. Transl Behav Med 2015; 5: 149-159
- 33 Cioe PA, Guthrie KM, Freiberg MS. et al. Cardiovascular risk reduction in persons living with HIV: Treatment development, feasibility, and preliminary results. J Assoc Nurses AIDS Care 2018; 29: 163-177
- 34 Cioe PA, Gordon RE, Williams DM. et al. The effect of increased physical activity on symptom burden in older persons living with HIV. AIDS Care 2019; 31: 1548-1554
- 35 Davy BM, Winett RA, Savla J. et al. Resist diabetes: a randomized clinical trial for resistance training maintenance in adults with prediabetes. PLoS One 2017; 12: e0172610
- 36 Pinto BM, Dunsiger S, Kindred MM. et al. Fatigue, affect and sedentary behavior among breast cancer survivors over time using ecological momentary assessments. Annals of Behavioral Medicine 2020; 243-243
- 37 Ekkekakis P, Zenko Z, Werstein KM. Exercise in obesity from the perspective of hedonic theory. In: Razon S, Sachs ML. Applied Exercise Psychology. New York, NY: Routledge; 2017: 289-315
- 38 Ladwig MA, Hartman ME, Ekkekakis P. Affect-based exercise prescription: An idea whose time has come?. ACSMs Health Fit J 2017; 21: 10-15
- 39 Box AG, Petruzzello SJ. Why do they do it? Differences in high-intensity exercise-affect between those with higher and lower intensity preference and tolerance. Psychol Sport Exerc 2019; 47: 101521
- 40 Courneya KS, Hellsten L-AM. Personality correlates of exercise behavior, motives, barriers and preferences: An application of the five-factor model. Personal Individ Differ 1998; 24: 625-633
- 41 Seguin RA, Economos CD, Palombo R. et al. Strength training and older women: A cross-sectional study examining factors related to exercise adherence. J Aging Phys Act 2010; 18: 201-218
- 42 Schreyer R, Lime DW, Williams DR. Characterizing the influence of past experience on recreation behavior. J Leis Res 1984; 16: 34-50
- 43 Godin G, Jobin J, Desharnais R. et al. The impact of physical fitness and health-age appraisal upon exercise intentions and behavior. J Behav Med 1987; 10: 241-250
- 44 Sibley BA, Bergman SM. Relationships among goal contents, exercise motivations, physical activity, and aerobic fitness in university physical education courses. Percept Mot Skills 2016; 122: 678-700
- 45 Rhodes RE, Kates A. Can the affective response to exercise predict future motives and physical activity behavior? A systematic review of published evidence. Ann Behav Med 2015; 49: 715-731
- 46 Schultz SJ. Educational and behavioral strategies related to knowledge of and participation in an exercise program after cardiac positron emission tomography. Patient Educ Couns 1993; 22: 47-57
- 47 Wilson K, Brookfield D. Effect of goal setting on motivation and adherence in a six-week exercise program. Int J Sport Exerc Psychol 2009; 7: 89-100
- 48 Annesi JJ. Goal-setting protocol in adherence to exercise by Italian adults. Percept Mot Skills 2002; 94: 453-458
- 49 Ekkekakis P, Hall EE, Petruzzello SJ. Practical markers of the transition from aerobic to anaerobic metabolism during exercise: Rationale and a case for affect-based exercise prescription. Prev Med 2004; 38: 149-159
- 50 Ekkekakis P, Hall EE, Petruzzello SJ. Variation and homogeneity in affective responses to physical activity of varying intensities: An alternative perspective on dose-response based on evolutionary considerations. J Sports Sci 2005; 23: 477-500
- 51 Ekkekakis P, Acevedo EO. Affective Responses to Acute Exercise: Toward a Psychobiological Dose-response Model. In: Psychobiology of Physical Activity. Champaign, IL: Human Kinetics; 2006: 91-109
- 52 Ekkekakis P, Parfitt G, Petruzzello SJ. The pleasure and displeasure people feel when they exercise at different intensities: Decennial update and progress towards a tripartite rationale for exercise intensity prescription. Sports Med 2011; 41: 641-671
- 53 Russell JA, Barrett LF. Core affect, prototypical emotional episodes, and other things called emotion: Dissecting the elephant. J Pers Soc Psychol 1999; 76: 805-819
- 54 Damasio A. Toward a neurobiology of emotion and feeling: Operational concepts and hypotheses. The Neuroscientist 1995; 1: 19-25
- 55 Västfjäll D, Slovic P, Burns WJ. et al. The arithmetic of emotion: Integration of incidental and integral affect in judgments and decisions. Front Psychol 2016; 7: 325
- 56 Ekkekakis P. The Dual-Mode Theory of affective responses to exercise in metatheoretical context: II. Bodiless heads, ethereal cognitive schemata, and other improbable dualistic creatures, exercising. Int Rev Sport Exerc Psychol 2009; 2: 139-160
- 57 Solomon RL, Corbit JD. An opponent-process theory of motivation: I. Temporal dynamics of affect. Psychol Rev 1974; 81: 119
- 58 Box AG, Feito Y, Zenko Z. et al. The affective interval: An investigation of the peaks and valleys during high- and moderate-intensity interval exercise in regular exercisers. Psychol Sport Exerc 2020; 49: 101686
- 59 Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 1988; 54: 1063
- 60 McNair D, Lorr M, Droppleman L. Revised Manual for the Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service; 1992
- 61 Lorr M, McNair D, Droppleman L. Manual: Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service;; 1971
- 62 Spielberger CD, Gorsuch RL, Lushene RE. The State-trait Anxiety Inventory (test manual). Palo Alto, CA: Consulting Psychologists Press; 1970
- 63 Ekkekakis P, Petruzzello SJ. Analysis of the affect measurement conundrum in exercise psychology: II. A conceptual and methodological critique of the Exercise-induced Feeling Inventory. Psychol Sport Exerc 2001; 2: 1-26
- 64 Ensari I, Greenlee TA, Motl RW. et al. Meta-analysis of acute exercise effects on state anxiety: An update of randomized controlled trials over the past 25 years. Depress Anxiety 2015; 32: 624-634
- 65 Hardy CJ, Rejeski WJ. Not what, but how one feels: The measurement of affect during exercise. J Sport Exerc Psychol 1989; 11: 304-317
- 66 Borg G. Borg’s Perceived Exertion and Pain Scales. Champaign, IL: Human kinetics;; 1998
- 67 Eston R. Use of ratings of perceived exertion in sports. Int J Sports Physiol Perform 2012; 7: 175-182
- 68 Ekkekakis P, Hall EE, Petruzzello SJ. Variation and homogeneity in affective responses to physical activity of varying intensities: An alternative perspective on dose-response based on evolutionary considerations. J Sports Sci 2005; 23: 477-500
- 69 Ekkekakis P, Lind E, Vazou S. Affective responses to increasing levels of exercise intensity in normal-weight, overweight, and obese middle-aged women. Obesity (Silver Spring) 2010; 18: 79-85
- 70 Hartman ME, Ekkekakis P, Dicks ND. et al. Dynamics of pleasure-displeasure at the limit of exercise tolerance: Conceptualizing the sense of exertional physical fatigue as an affective response. J Exp Biol 2019; 222: jeb186585
- 71 Roloff ZA, Dicks ND, Krynski LM. et al. Ratings of affective valence closely track changes in oxygen uptake: Application to high-intensity interval exercise. Perform Enhanc Health 2020; 7: 100158
- 72 Robertson CV, Marino FE. Cerebral responses to exercise and the influence of heat stress in human fatigue. J Therm Biol 2017; 63: 10-15
- 73 Butki BD, Baumstark J, Driver S. Effects of a carbohydrate-restricted diet on affective responses to acute exercise among physically active participants. Percept Mot Skills 2003; 96: 607-615
- 74 Gaesser GA, Poole DC. The slow component of oxygen uptake kinetics in humans. Exerc Sport Sci Rev 1996; 24: 35-71
- 75 Jones AM, Burnley M. Effect of Exercise Modality on VO2 Kinetics. In: Jones AM, Poole DC. Oxygen uptake kinetics in sport, exercise and medicine. New York, NY: Taylor & Francis Group; 2005: 103-106
- 76 Poole DC, Burnley M, Vanhatalo A. et al. Critical power: An important fatigue threshold in exercise physiology. Med Sci Sports Exerc 2016; 48: 2320-2334
- 77 Wasserman K, Whipp BJ, Koyl SN. et al. Anaerobic threshold and respiratory gas exchange during exercise. J Appl Physiol 1973; 35: 236-243
- 78 Binder RK, Wonisch M, Corra U. et al. Methodological approach to the first and second lactate threshold in incremental cardiopulmonary exercise testing. Eur J Prev Cardiol 2008; 15: 726-734
- 79 Cheng B, Kuipers H, Snyder AC. et al. A new approach for the determination of ventilatory and lactate thresholds. Int J Sports Med 1992; 13: 518-522
- 80 Svedahl K, MacIntosh BR. Anaerobic threshold: The concept and methods of measurement. Can J Appl Physiol 2003; 28: 299-323
- 81 Jones AM, Grassi B, Christensen PM. et al. Slow component of VO2 kinetics: Mechanistic bases and practical applications. Med Sci Sports Exerc 2011; 43: 2046-2062
- 82 Cottin F, Médigue C, Lopes P. et al. Ventilatory thresholds assessment from heart rate variability during an incremental exhaustive running test. Int J Sports Med 2007; 28: 287-294
- 83 Brickley G, Doust J, Williams C. Physiological responses during exercise to exhaustion at critical power. Eur J Appl Physiol 2002; 88: 146-151
- 84 Burnley M, Jones AM. Power-duration relationship: Physiology, fatigue, and the limits of human performance. Eur J Sport Sci 2018; 18: 1-12
- 85 Amann M. Significance of group III and IV muscle afferents for the endurance exercising human. Clin Exp Pharmacol Physiol 2012; 39: 831-835
- 86 Craig AD. Interoception: The sense of the physiological condition of the body. Curr Opin Neurobiol 2003; 13: 500-505
- 87 Ekkekakis P, Dafermos M. Exercise is a many-splendored thing, but for some it does not feel so splendid: Staging a resurgence of hedonistic ideas in the quest to understand exercise behavior. In: Acevedo EO (Ed.). The Oxford Handbook of Exercise Psychology. Oxford University Press; 2012: 295-333
- 88 Ekkekakis P, Lind E. Exercise does not feel the same when you are overweight: The impact of self-selected and imposed intensity on affect and exertion. Int J Obes 2006; 30: 652-660
- 89 Ekkekakis P, Hall EE, Petruzzello SJ. Some like it vigorous: Measuring individual differences in the preference for and tolerance of exercise intensity. J Sport Exerc Psychol 2005; 27: 350-374
- 90 Hall EE, Petruzzello SJ, Ekkekakis P. et al. Role of self-reported individual differences in preference for and tolerance of exercise intensity in fitness testing performance. J Strength Cond Res 2014; 28: 2443-2451
- 91 Acevedo EO, Ekkekakis P. The transactional psychobiological nature of cognitive appraisal during exercise in environmentally stressful conditions. Psychol Sport Exerc 2001; 2: 47-67
- 92 Giles GE, Cantelon JA, Eddy MD. et al. Cognitive reappraisal reduces perceived exertion during endurance exercise. Motiv Emot 2018; 42: 482-496
- 93 Ekkekakis P, Thome J, Petruzzello SJ. et al. The Preference for and Tolerance of the Intensity of Exercise Questionnaire: A psychometric evaluation among college women. J Sports Sci 2008; 26: 499-510
- 94 Broxterman RM, Ade CJ, Barker T. et al. Influence of pedal cadence on the respiratory compensation point and its relation to critical power. Respir Physiol Neurobiol 2015; 208: 1-7
- 95 Moritani T, Nagata A, Devries HA. et al. Critical power as a measure of physical work capacity and anaerobic threshold. Ergonomics 1981; 24: 339-350
- 96 Vanhatalo A, Doust JH, Burnley M. Determination of critical power using a 3-min all-out cycling test. Med Sci Sports Exerc 2007; 39: 548-555
- 97 Jamnick NA, Pettitt RW, Granata C. et al. An examination and critique of current methods to determine exercise intensity. Sports Med 2020; 50: 1729-1756
- 98 Jones AM, Vanhatalo A, Burnley M. et al. Critical power: Implications for determination of VO2max and exercise tolerance. Med Sci Sports Exerc 2010; 42: 1876-1890
- 99 Iannetta D, Inglis EC, Mattu AT. et al. A critical evaluation of current methods for exercise prescription in women and men. Med Sci Sports Exerc 2020; 52: 466-473
- 100 Vanhatalo A, Poole DC, DiMenna FJ. et al. Muscle fiber recruitment and the slow component of O2 uptake: Constant work rate vs. all-out sprint exercise. Am J Physiol Regul Integr Comp Physiol 2011; 300: R700-R707
- 101 Lind E, Ekkekakis P, Vazou S. The affective impact of exercise intensity that slightly exceeds the preferred level: Pain for no additional gain. J Health Psychol 2008; 13: 464-468
- 102 Rose EA, Parfitt G. Can the feeling scale be used to regulate exercise intensity?. Med Sci Sports Exerc 2008; 40: 1852-1860
- 103 Parfitt G, Alrumh A, Rowlands AV. Affect-regulated exercise intensity: Does training at an intensity that feels ‘good’ improve physical health?. J Sci Med Sport 2012; 15: 548-553
- 104 Brand R, Ekkekakis P. Affective-reflective theory of physical inactivity and exercise. Ger J Exerc Sport Res 2018; 48: 48-58
- 105 Ekkekakis P, Zenko Z. Escape from cognitivism: Exercise as hedonic experience. In: Raab M, Wylleman P, Seiler R, et al. (Eds.). Sport and Exercise Psychology Research: From Theory to Practice. Cambridge, MA: Academic Press; 2016: 389-414
- 106 Hamlyn-Williams CC, Tempest G, Coombs S. et al. Can previously sedentary females use the feeling scale to regulate exercise intensity in a gym environment? An observational study. BMC Sports Sci Med Rehabil 2015; 7: 30
- 107 Costa EC, de Sá JCF, Costa IBB. et al. Affect-regulated exercise: An alternative approach for lifestyle modification in overweight/obese women with polycystic ovary syndrome. Gynecol Endocrinol 2015; 31: 971-975
- 108 Evans JSB. In two minds: Dual-process accounts of reasoning. Trends Cogn Sci 2003; 7: 454-459
- 109 Pennycook G. A perspective on the theoretical foundation of dual process models. In: Dual Process Theory 2.0. Routledge; 2017: 5-27
- 110 Kahneman D. Thinking, Fast and Slow. Macmillan; 2011
- 111 Lang PJ, Bradley MM. Appetitive and defensive motivation: Goal-directed or goal-determined?. Emot Rev 2013; 5: 230-234
- 112 Williams DM. Exercise, affect, and adherence: An integrated model and a case for self-paced exercise. J Sport Exerc Psychol 2008; 30: 471-496
- 113 Bacon AP, Carter RE, Ogle EA. et al. VO2max trainability and high intensity interval training in humans: A meta-analysis. PLoS One 2013; 8: e73182
- 114 Batacan RB, Duncan MJ, Dalbo VJ. et al. Effects of high-intensity interval training on cardiometabolic health: A systematic review and meta-analysis of intervention studies. Br J Sports Med 2017; 51: 494-503
- 115 Sawyer BJ, Tucker WJ, Bhammar DM. et al. Effects of high-intensity interval training and moderate-intensity continuous training on endothelial function and cardiometabolic risk markers in obese adults. J Appl Physiol (1985) 2016; 121: 279-288
- 116 Decker ES, Ekkekakis P. More efficient, perhaps, but at what price? Pleasure and enjoyment responses to high-intensity interval exercise in low-active women with obesity. Psychol Sport Exerc 2017; 28: 1-10
- 117 Cabanac M. Sensory pleasure optimizes muscular work. Med Clin Exp 2006; 29: 110-116
- 118 Williams DM, Dunsiger S, Jennings EG. et al. Does affective valence during and immediately following a 10-min walk predict concurrent and future physical activity?. Ann Behav Med 2012; 44: 43-51
- 119 Russell JA. A circumplex model of affect. J Pers Soc Psychol 1980; 39: 1161-1178