Exploring the Impact of Individualized Pleasure-Oriented Exercise Sessions in a Health Club Setting
Condition: Affect
Study type: Interventional

Summary: 
      A call for an exercise prescription aiming at pleasure promotion has been proposed by several
      authors. This entails that current exercise prescription guidelines are heavily focused on a
      dose-response relation derived from an effectiveness (e.g., fitness gains) and safety of the
      prescription (e.g., reduced risk of injury for the general population) standpoint. Despite
      its relevance, this bipartite or biomedical approach (e.g., rationale for a given dose of a
      drug and expected outcome) tends to overlook other relevant variables that are needed for,
      for example, behavior maintenance, or individual preferences. Although some flexibility of
      this rationale may account for personal differences, how to adequately adjust the training
      variables to individual characteristics is still poorly explored or even expressed.

      The call for a tripartite exercise prescription reflects the bout of evidence that supports
      the relevance of pleasurable experiences in exercise and their impact on adherence. Thus,
      besides an effective and safe program, contemplating how to assess and promote
      exercise-related pleasurable experiences are paramount. As stated in 2011 on the ACSM
      position stand, affect-regulation did not behold the necessary evidence to be a primary
      method of exercise prescription, although affect assessment (e.g., through the feeling scale)
      was proposed to be relevant for exercise intensity self-regulation. A decennial look at the
      ACSM exercise guidelines shows that although presenting an advancement in affect-related
      behavioral strategies and theories, no clear indications on operational instruments for
      assessment and admeasurement of affect are presented depicts a barrier to an adequate
      advancement in this matter. This can be seen, for example, in ACSM principles for exercise
      prescription (Frequency, Intensity, Time, and Type; FITT). Although supporting the use of
      affect regulation for exercise promotion and maintenance, the FITT is not based on a previous
      (e.g., preexercise evaluation) or in-session affective assessment, and more importantly, does
      not address how to adjust exercise prescription/supervision aiming to improve the
      pleasure/displeasure relation.
    

Detailed description: 
      Background and rationale From a public health standpoint, gyms and health clubs are one of
      the most relevant contexts of supervised exercise practice, targeting millions of individuals
      worldwide. However, exercise adherence has proven to be a challenge in the last 20 years.
      Several indicators show high attrition rates (i.e., clients' dropout in a given period) in
      these contexts, particularly in the first 6 months.

      Individual physical activity promotion can be challenging as it reflects several aspects of a
      complex human behavior. Many psychological theories and strategies have been used to address
      this issue, albeit with differentiated results. These are usually based on cognitivist
      assumptions and have shown small to moderate effects on exercise adherence. However, in
      recent years, exercise psychology started to shift attention to other constructs that can
      help expand the predictive value of current theoretical models. Particularly, affective
      processes (e.g., emotions, mood) have been highlighted as relevant when trying to understand
      or predict behavior, and a call for a new era - the affectivism - is emerging. This reflects
      a new parading resulting from decades of evidence in which affective processes can be seen as
      outcomes, but also as relevant constructs that can expand the understanding of current
      behavioral strategies and theories.

      For example, the latest edition of the American College of Sports Medicine (ACSM) guidelines
      presented an expanded chapter addressing behavioral theories for increasing physical
      activity, which, besides the most commonly used (e.g., self-efficacy, self-determination
      theory, theory of planned behavior), now explores affect regulation as a product of
      non-conscious motivational processes (e.g., dual-process theories), and the automatic
      associations between behavior and previous affective response (i.e., remembered affect).

      Affective determinants in exercise and the role of exercise intensity

      Affect can be understood as an umbrella term that encompasses (1) the most general valenced
      experiential responses (e.g., pleasure/displeasure; good/bad), termed basic affect or core
      affect, and (2) emotion and mood, which reflects appraisal processes of basic affect, and are
      usually called distinct affective states. Several theories and models have been developed in
      recent years that reflect this conceptualization and the evidence of affect-related
      constructs, as is the case, for example, of the Affective-Reflective Theory of physical
      inactivity and exercise (ART); the Physical Activity Adoption and Maintenance (PAAM) model;
      the Theory of Effort Minimization in Physical Activity (TEMPA), and the Affect and Health
      Behavior Framework (AHBF).

      In the broader look given by the AHBF, the affective response (i.e., how one feels while
      performing an activity or immediately after completing the activity; core affect), triggers a
      set of influences that can, via an automatic or reflective affect processing, influence
      motivation, goals, behavioral intentions and, ultimately, the exercise behavior. As shown in
      some research, the affective response during exercise has demonstrated to be a determinant of
      future behavior, and core affective valence and activation the most relevant aspects in this
      matter. This seems to be grounded in hedonic assumptions (i.e., pursuing pleasure and
      avoiding displeasure or pain), in which positive (and regular) shifts in affective valence
      and/or activation tend to increase the likelihood of future exercise behavior, and a negative
      shift may have an opposite influence.

      Regarding exercise characteristics that may influence the affective response, exercise
      intensity stand out as the most relevant. Current evidence suggests that people present
      distinct responses as intensity increases. Generally, aerobic activities intensities below
      the ventilator threshold depict similar patterns among exercisers, given that an increase in
      intensity usually corresponds to an increase in the pleasurable response. After the
      ventilator threshold, inter-individual variability marks how soon or accentuated the pleasure
      decline will be manifested. For resistance training, some evidence also indicates that
      increases in intensity (e.g., Repetition Maximum (RM) %) are positively associated with
      pleasure until the 70-80 RM% interval, a moment from which individual characteristics will
      reflect, albeit unclear at this point at which rate or magnitude, an inverted association
      with pleasure. Thus, targeting the intensity-pleasure/displeasure relation individually may
      be of particular relevance for the exercise domain when aiming to promote adherence.

      Exercise prescription - a tripartite approach

      A call for an exercise prescription aiming pleasure promotion has been proposed by several
      authors. This entails that current exercise prescription guidelines are heavily focused on a
      dose-response relation derived from an effectiveness (e.g., fitness gains) and safety of the
      prescription (e.g., reduced risk of injury for the general population) standpoint. Despite
      its relevance, this bipartite or biomedical approach (e.g., rationale for a given dose of a
      drug and expected outcome) tends to overlook other relevant variables needed for, for
      example, behavior maintenance or individual preferences. Although some flexibility of this
      rationale may account for personal differences, how to adequately adjust the training
      variables to individual characteristics is still poorly explored or even expressed.

      The call for a tripartite exercise prescription reflects the bout of evidence that supports
      the relevance of pleasurable experiences in exercise and their impact on adherence. Thus,
      besides an effective and safe program, contemplating how to assess and promote
      exercise-related pleasurable experiences are paramount. As stated in 2011 on the ACSM
      position stand, affect-regulation did not behold the necessary evidence to be a primary
      method of exercise prescription, although affect assessment (e.g., through the feeling scale)
      was proposed to be relevant for exercise intensity self-regulation. A decennial look at the
      ACSM exercise guidelines shows, and although presenting an advancement in affect-related
      behavioral strategies and theories, that no clear indications on operational instruments for
      assessment and admeasurement of affect are presented, which depicts a barrier to an adequate
      advancement in this matter. This can be seen, for example, in ACSM principles for exercise
      prescription (Frequency, Intensity, Time, and Type; FITT). Although supporting the use of
      affect regulation for exercise promotion and maintenance, the FITT is not based on a previous
      (e.g., preexercise evaluation) or in-session affective assessment, and more importantly, does
      not address how to adjust exercise prescription/supervision aiming to improve the
      pleasure/displeasure relation.
    

Intervention name(s): General exercise prescription (FITT); Affective regulation (AFFECT)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The (1) control group (FITT) will receive a preexercise evaluation and 3 individualized training sessions based on the ACSM and FITT principles (ACSM, 2021). These are the procedures commonly used for apparently healthy individuals that start to exercise in health clubs.; As for the (2) experimental group (AFFECT), the focus will be given to exercise intensity assessment and manipulation. The same preexercise evaluation, number of individualized sessions, and methodological approach (i.e., FITT) will be made. However, individual preferences and experiences regarding exercise intensity will be assessed in the preexercise evaluation. These will be used to select the exercise sessions' initial intensity. Moreover, intensity self-selection guidance and affective response assessments will be made throughout the session for continuous intensity adjustments (aiming for pleasurable feelings).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Other
Keywords: Affect; Affective response; Exercise; Affective determinants; Circumplex model