Debate: How should doctors prescribe exercise to ensure compliance and engagement?

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Table 2. Neu­ro­bi­o­log­i­cal ben­e­fits of exercise.

How to Effec­tive­ly Pre­scribe Exer­cise (Psy­chi­atric Times):

Exer­cise can be a use­ful tool in man­ag­ing symp­toms of anx­i­ety and depres­sion. Learn how you can inte­grate exer­cise pre­scrip­tions into your treat­ment plans.

While most of us appre­ci­ate its impor­tance, we also rec­og­nize that avoid­ance is exceed­ing­ly com­mon. Too often patients hear the word exer­cise and devel­op an aver­sive reac­tion, as they antic­i­pate that it involves inten­sive train­ing reserved only for the ath­let­i­cal­ly elite. So how can one sim­ply and effec­tive­ly coun­sel a patient on exer­cise to increase their chances of engagement?

After con­dens­ing the infor­ma­tion in the lit­er­a­ture and comb­ing it with strate­gies for com­pli­ance, we feel it is pos­si­ble to come up with sam­ple exer­cise pre­scrip­tions. For exam­ple, a patient with low exer­cise tol­er­ance and moti­va­tion could be pre­scribed 30 min­utes of mod­er­ate walk­ing … Since the mood ben­e­fits of exer­cise have often been shown to be inten­si­ty inde­pen­dent, it is more than pos­si­ble to work with­in the patient’s exer­cise tol­er­ance and phys­i­cal limits.

In addi­tion, it can be ben­e­fi­cial to dis­cuss with patients the neu­ro­bi­o­log­i­cal changes seen dur­ing exer­cise that may con­tribute to ele­va­tion of mood and improved cognition…An exer­cise pre­scrip­tion is an impor­tant treat­ment option and a great adjunct to med­ica­tions. The key is pre­scrib­ing phys­i­cal activ­i­ty in a way that the patient will com­ply and remain engaged with.

Recent Study on Physical Activity, Neuroplasticity and Mood:

Ther­a­peu­tic ben­e­fits of phys­i­cal activ­i­ty for mood: A sys­tem­at­ic review on the effects of exer­cise inten­si­ty, dura­tion, and modal­i­ty (Jour­nal of Psychology):

  • Abstract: In con­tem­po­rary soci­ety, peo­ple expe­ri­ence con­sid­er­able stress in their dai­ly lives. There­fore, devel­op­ing effec­tive approach­es and con­ve­nient means to cope with their mood prob­lems is impor­tant nowa­days. Phys­i­cal activ­i­ty has been con­sis­tent­ly report­ed as a cost-effec­tive way to improve phys­i­cal fit­ness, pre­vent men­tal ill­ness­es, and alle­vi­ate mood prob­lems. In this sys­tem­at­ic review, the effects of exer­cise inten­si­ty, dura­tion, and modal­i­ty on mood change are dis­cussed. Results show that mod­er­ate-inten­si­ty anaer­o­bic exer­cise is asso­ci­at­ed with greater mood improve­ments. The rela­tion­ship between exer­cise dura­tion and mood change is non-lin­ear; A regime of 10- to 30-minute exer­cise is suf­fi­cient for mood improve­ments. For exer­cise modal­i­ty, anaer­o­bic exer­cise improves mood, but the effi­ca­cy of aer­o­bic and mind­ful­ness-relat­ed exer­cis­es remains to be fur­ther exam­ined. In addi­tion to the sys­tem­at­ic review of poten­tial mod­er­a­tors, a nar­ra­tive review of psy­cho­log­i­cal and neu­ro­phys­i­o­log­i­cal the­o­ries of exer­cise effects on mood is pro­vid­ed; we have high­light­ed the cen­tral role of neu­ro­plas­tic­i­ty in inte­grat­ing the two class­es of the­o­ries. An adop­tion of neu­roimag­ing tech­niques in future research is crit­i­cal to reveal the mech­a­nisms under­pin­ning the ther­a­peu­tic influ­ence of phys­i­cal activ­i­ty on affec­tive respons­es. Some future research direc­tions are also raised.

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