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sustainability
Article
Physical Activity Is Related to Mood States, Anxiety State and
Self-Rated Health in COVID-19 Lockdown
Rafael E. Reigal 1 , José A. Páez-Maldonado 2 , José L. Pastrana-Brincones 3 , Juan P. Morillo-Baro 1 ,
Antonio Hernández-Mendo 1 and Verónica Morales-Sánchez 1, *
1
2
3
*
Faculty of Psychology, University of Malaga, Teatinos Campus, 29071 Malaga, Spain;
rafareigal@uma.es (R.E.R.); juanpablo.morillo@gmail.com (J.P.M.-B.); mendo@uma.es (A.H.-M.)
Departamento de Informática y Deporte, Pablo de Olavide University, Utrera Road, 41013 Sevilla, Spain;
J.a.paezmaldonado@gmail.com
School of Computer Science and Engineering, University of Malaga, 29071 Malaga, Spain;
pastrana@lcc.uma.es
Correspondence: vomorales@uma.es
10.3390/su13105444
Abstract: The main goal of this research is to study the relationships between physical activity, mood
states and self-rated health in the Spanish lockdown (March 2020–April 2020) due to the state of alarm
caused by COVID-19. The participants were 328 people aged between 19 and 59 years (M = 37.06;
SD = 10.82). Females comprised 63.70% of the participants, and 36.30% were male. An associative,
comparative and predictive design was used in this research. The International Physical Activity
Questionnaire (IPAQ), the Profile of Mood State (POMS), the state anxiety scale of the State-Trait
Anxiety Questionnaire (STAI) and the General Health Questionnaire GHQ 12 were applied in order
to measure the study variables. Both correlation and linear regression analyses were performed,
showing that physical activity is positively related to health perception and mood. Similarly, data
have shown that moderate physical practice predicts better health perceptions and positive mood
states than vigorous physical activity. Specifically, moderate physical activity is the only variable
that predicts the anxiety state (R = 0.22; R2 adjusted = 0.05; F = 15.51; p < 0.001). In addition, it has
been detected that mood is related to the perception of the state of health. Outcomes suggest that
practicing moderate physical activity during these types of situations could amortize its negative
effects on psychological health and benefit a more positive mental state. Future studies should
consider the employment status of the sample to detect possible differences based on this variable.
Academic Editor: José
Keywords: physical activity; moods; self-rated health; state anxiety; COVID-19
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Citation: Reigal, R.E.;
Páez-Maldonado, J.A.;
Pastrana-Brincones, J.L.; Morillo-Baro,
J.P.; Hernández-Mendo, A.;
Morales-Sánchez, V. Physical Activity
Is Related to Mood States, Anxiety
State and Self-Rated Health in
COVID-19 Lockdown. Sustainability
2021, 13, 5444. https://doi.org/
Carmelo Adsuar
Received: 10 April 2021
Accepted: 8 May 2021
Published: 13 May 2021
Publisher’s Note: MDPI stays neutral
with regard to jurisdictional claims in
published maps and institutional affiliations.
Copyright: © 2021 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
1. Introduction
In 2020, the SARS-CoV-2 virus (COVID-19) generated an exceptional situation in many
countries, causing worldwide distress [1,2]. In Spain, a state of alarm was declared on 14
March 2020 by Royal Decree and was published in the Official State Bulletin. This entailed
restrictions on people’s mobility and many limitations on the development of activities,
both professional and recreational. Non-essential activities were stopped, schools and
universities taught classes online and sports competitions were canceled, among other
examples [3,4]. Overall, it caused a radical change in the way of living, changing habits
and social routines [5–8].
COVID-19 has severely affected people’s health [9,10]. Among other consequences,
problems such as muscle weakness, respiratory problems, cough, coronary involvement, joint
pain, fatigue, loss of smell or taste, cognitive alterations, etc., have been described [11–14].
The damage may be transient, although alterations with uncertain prognoses that may remain
over time have also been described [15,16]. This has generated multiple scientific studies,
with the aim of determining how harmful they could be to humans [17,18].
Overall, the COVID-19 pandemic has impacted people’s well-being and quality of
life [19,20]. Even among those not suffering from the disease directly, the level of stress
Sustainability 2021, 13, 5444. https://doi.org/10.3390/su13105444
https://www.mdpi.com/journal/sustainability
Sustainability 2021, 13, 5444
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that people are currently living with is high [21]. The imposed mobility restrictions, the use
of masks and disinfectant gels, economic uncertainty, working problems, the way people
are in contact with each other, etc., all demand a change in the way of living and a great
adaptive capacity. There is some evidence pointing to the impact that the pandemic is
having on mental health, increasing the number of anxiety and depression cases [22,23].
Lin, Hu, Alias and Wong [24] have observed that anxiety has increased in the Chinese
population due to the pandemic caused by COVID-19.
The pandemic caused by COVID-19 has made many people feel fear and worry because of the uncertainty currently being experienced [25]. Certainly, there is much evidence
highlighting how the pandemic has impacted factors affecting people’s psychological wellbeing [26,27]. Distortions in mood states have been described due to COVID-19, which
have suggested in all likelihood more severe mental health problems [28,29]. Likewise,
it has been observed that social restrictions, getting food and the distress caused by this
situation are associated with worse health perceptions by people [30,31]. This is a relevant
fact, given the known relationship between self-perception of health and the development
of physical or mental illness [32,33].
Promoting the growth of an active lifestyle is an essential goal for health improvements [34]. Specifically, there are many studies that have shown a positive relationship
between physical practice and mental health [35,36]. Among others, it has been observed
that physical practice has a positive impact on mood [37,38], it decreases anxiety and
depression symptoms [39,40] and it improves self-perceived health appraisal [41,42]. This
phenomenon has been observed both after a single session of physical activity and after a
physical exercise program [43], indicating the broad potential such behaviors have in order
to improve people’s health and well-being.
It has been observed that during the pandemic, mobility restrictions have generated
some changes in people’s physical activity behaviors [44]. These changes have caused
some people to quit their active behaviors or modify their habits, adapting them to the
existing options in such phases of the pandemic [45,46]. Given the benefits of activity on
physical and mental health, it would be advisable that people do not stop their physical
activity and continue practicing within the given circumstances, adapting them to the
protocols in place [47]. Studies such as that by Lesser and Nienhuis [48] have highlighted
that the practice of physical activity during those months has been related to a lower level
of anxiety and a better perception of mental health. Other studies analyzing the effects
of physical activity on mental health levels have highlighted a lower level in anxiety and
depression symptoms, as well as a better perception of well-being for those who were
more active.
Given the relationship between physical exercise and mental health, as well as to
explore whether this issue has occurred during the coronavirus lockdown, the aim of
this study is to analyze the relationships between the level of physical activity and mood,
anxiety state and health perception in a group of adults in the COVID-19 pandemic.
2. Materials and Methods
2.1. Design
An associative, comparative and predictive design was carried out in this research
in order to analyze the relationships between the studied variables, as well as to explore
whether physical activity has predicted mood, anxiety and self-rated health.
2.2. Participants
A total of 328 people aged between 19 and 59 years (M = 37.06; SD = 10.82) from
the de Andalusia region (Spain) participated in the study. Females comprised 63.70% of
the participants, while 36.30% were male. The sampling was non-probabilistic, and was
selected from March 2020 to April 2020. Specifically, participants were recruited through
snowball sampling using social networks. Participants completed questionnaires using an
online survey software (Google Forms). People who had suffered from COVID-19 or were
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infected at that moment were excluded from the study because they could be conditioned
by several sequelae of the disease. Within the whole sample, when the study was taken,
59.45% did not know anyone who had had the disease, 8.23% had friends who had had the
disease, 3.05% had a co-worker who had had it, 12.63% had a family member who had had
the disease and 16.63% knew someone who was not a friend, co-worker or family member
but had had it.
2.3. Measurements and Instruments
(a)
(b)
(c)
(d)
Physical activity in the last seven days. Physical activity was assessed using the
short form of the International Physical Activity Questionnaire (IPAQ) [49]. The
questionnaire consists of seven items (e.g., How much time did you usually spend doing
vigorous physical activities on one of those days?), asking about how many days and
minutes were spent in the last week doing intense, moderate and low-intensity
physical activity, as well as how many hours were spent sitting. In this study, we
multiplied the days and minutes taken in the last week by each level of physical
activity, obtaining the number of minutes per week in each case. In addition, the
number of hours spent sitting was also used.
Mood. Mood was evaluated using a short, 30-item version of the Profile of Mood
States questionnaire (POMS) [50]. This version is made up of 30 adjectives and
six factors. In this research, the dimensions of anger (e.g., Upset), depression (e.g.,
Melancholic), vigor (e.g., Full of energy) and tension (e.g., Nervous) were evaluated.
Questions have been answered on a Likert scale from 1 (a little) to 5 (a lot). The
internal consistency analyses were adequate (Cronbach’s alpha), showing values
between 0.81 and 0.90.
State anxiety. State anxiety was evaluated using the state anxiety scale of the State-Trait
Anxiety questionnaire (STAI) [51]. This scale consists of 20 items (e.g., I feel uncomfortable)
scored on a Likert scale from 0 (low anxiety) to 3 (high anxiety). The internal consistency
analyses were adequate (Cronbach’s alpha), showing a value a = 0.91.
Self-rated health. The 12-item version of the General Health Questionnaire [52,53],
was used in order to assess health perception. This questionnaire focuses on the
psychological components that identify negative health (e.g., Feeling unhappy and
depressed). A Likert response scale was used, from 0 (no problems) to 3 (presence of
problems). Internal consistency analyses were adequate (Cronbach’s alpha), showing
a value a = 0.81.
2.4. Procedure
Data were gathered via online surveys. The evaluation tools were implemented
in such a way that they could be carried out via computer, cell phone or tablet. The
questionnaires offered a description of the study as well as requests for informed consent
for the participants.. The data were gathered between March 2020 and April 2020, when
the COVID-19 lockdown at home was effective in Spain.
The estimated time for completing the questionnaires was approximately 45 min. The
investigators’ contact information was provided just in case respondents had any questions.
The ethical principles of the Declaration of Helsinki [54] were respected throughout the
research process, and the research was approved by the Ethics Committee of the University
of Malaga.
2.5. Data Analysis
The data were subjected to descriptive and inferential analyses. The normality of the
data (Kolmogorov–Smirnov) and the internal consistency of the scales (Cronbach’s alpha)
were checked. Pearson’s bivariate coefficient was used in order to analyze the correlations
between variables. The predictive capacity of weekly physical activity time on the variables
of mood, anxiety-state and health perception was evaluated by linear regression analysis
(successive steps). SPSS version 23.0 has been used for the statistical processing of the data.
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3. Results
Table 1 shows the descriptive statistics of the variables under study for the whole sample, as well as by gender and age. Furthermore, the Kolmogorov–Smirnov test has shown
that the variables were distributed, fulfilling the assumption of normality. Asymmetry
values ranged from 0.19 to 1.26, and kurtosis values ranged from 0.63 to 1.29.
Table 1. Descriptive statistics and normality analysis.
Total Sample
min/week of intense PA
min/week of moderate PA
min/week of low PA
Hours/day sitting
Cholera
Depression
Vigor
Tension
Anxiety state
Self-rated health
Male
Female
19 to 39 Years
40 to 59 Years
M
SD
M
SD
M
SD
M
SD
M
SD
234.53
194.34
168.27
6.90
2.49
2.29
3.21
2.62
1.03
1.07
208.04
223.14
161.79
3.50
0.98
0.92
0.81
1.05
0.63
0.49
248.00
197.52
177.65
7.17
2.35
2.07
3.34
2.35
1.03
0.96
220.15
228.64
169.79
3.57
1.00
0.87
0.77
0.94
0.60
0.43
226.87
192.52
162.93
6.75
2.58
2.41
3.13
2.77
1.03
1.13
200.96
220.48
157.22
3.47
0.96
0.92
0.82
1.08
0.65
0.51
246.56
197.95
169.03
7.38
2.53
2.32
3.14
2.65
1.02
1.08
212.21
237.36
165.36
3.67
0.94
0.94
0.79
1.05
0.63
0.48
217.97
189.36
167.23
6.24
2.44
2.24
3.31
2.57
1.04
1.05
201.75
202.67
157.34
3.16
1.03
0.88
0.82
1.05
0.63
0.51
NOTE: M = Mean; min/week = Minutes/week; PA = Physical Activity.
Table 2 shows the Pearson bivariate correlation coefficients for the whole sample.
As can be seen, there were significant relationships between the studied variables. The
most relevant associations (p < 0.001) occurred between vigor and the different parameters
of physical activity, between weekly minutes walking with health perception, as well as
between weekly minutes of moderate physical activity with anxiety status and health
perception. In general terms, weekly minutes of moderate physical activity is the type of
physical practice most strongly related to the different parameters of psychological health.
Table 2. Correlation analysis (Pearson) (whole sample).
Cholera
Depression
Vigor
Tension
Anxiety-state
Self-rated health
Minutes/Week
of Intense PA
Minutes/Week
of Moderate PA
Minutes/Week
of Low PA
Hours/Day
Sitting
0.10
0.13 *
0.22 ***
0.14 *
0.11 *
0.17 **
0.12 *
0.14 *
0.20 ***
0.15 **
0.19 ***
0.25 ***
0.13 *
0.13 *
0.19 ***
0.12 *
0.15 **
0.19 ***
0.03
0.11 *
0.21 ***
0.05
0.04
0.16 **
NOTE: PA= Physical Activity. * p < 0.05; ** p < 0.01; *** p < 0.001.
Tables 3 and 4 show the Pearson bivariate correlation coefficients by gender and age.
There were significant relationships between the studied variables, although the results
indicate that men and the younger age group (from 19 to 39 years old) present more robust
statistically significant correlations between intense physical activity and the psychological
variables analyzed. However, women and the older group (from 40 to 59 years old) show
higher statistically significant correlations between moderate physical activity and the
psychological variables under study.
Table 5 shows the linear regression models (successive steps) generated. The predictor
variables were physical activity (intense, moderate and low) during the last seven days, as
well as how long they were sitting. Variables excluded in the various cases are not present
due to lack of significance (p > 0.05). The data meet the assumptions of linearity in the
relationship between predictor variables and criterion, as well as homoscedasticity and
normal distribution of the residuals, whose mean value is 0 and standard deviation is near
1 (0.99). In addition, the Durbin–Watson values are satisfactory since they are in a range
between 1.53 and 1.91 [55].
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Table 3. Correlation analysis (Pearson) (by gender).
Minutes/Week of Intense PA
Cholera
Depression
Vigor
Tension
Anxiety-state
Self-rated health
Minutes/Week of Moderate PA
Minutes/Week of Low PA
Hours/Day Sitting
Male
Female
Male
Female
Male
Female
Male
0.21 *
0.21 *
0.20 *
0.18 *
0.13
0.25 **
0.05
0.08
0.22 **
0.07
0.17 *
0.16*
0.24 **
0.18 *
0.14
0.19 *
0.09
0.23 *
0.14 *
0.15 *
0.22 **
0.21 **
0.23 **
0.25 ***
0.08
0.12
0.16
0.04
0.13
0.26 **
0.03
0.08
0.20 **
0.10
0.09
0.11
0.12
0.25 **
0.26 **
0.06
0.13
0.28 **
Female
0.03
0.05
0.17 *
0.07
0.01
0.10
NOTE: PA = Physical Activity. * p < 0.05; ** p < 0.01; *** p < 0.001.
Table 4. Correlation analysis (Pearson) (by age).
Minutes/Week of Intense PA
Cholera
Depression
Vigor
Tension
Anxiety-state
Self-rated health
Minutes/Week of Moderate PA
19 to 39
Years
40 to 59
Years
19 to 39
Years
0.16 *
0.17 *
0.25 **
0.18 *
0.01
0.16 *
0.03
0.08
0.20 *
0.09
0.25 **
0.19 *
0.07
0.14
0.18 *
0.12
0.15 *
0.22 **
40 to 59
Years
Minutes/Week of Low PA
19 to 39
Years
0.18 *
0.13
0.23 **
0.21 *
0.25 **
0.29 ***
Hours/Day Sitting
40 to 59
Years
0.11
0.14
0.16 *
0.10
0.13
0.23 **
19 to 39
Years
0.16
0.11
0.24 **
0.13
0.17
0.14
0.05
0.14 *
0.28 ***
0.09
0.13
0.21 **
40 to 59
Years
0.02
0.05
0.06
0.03
0.10
0.07
NOTE: PA = Physical Activity. * p < 0.05; ** p < 0.01; *** p < 0.001.
Table 5. Linear regression analysis.
Criteria
M
R
R2
D-W
Predictors
Cholera
1
0.17
0.03
1.53
Depression
1
0.18
0.03
1.68
2
0.23
0.05
1.68
1
0.22
0.04
1.65
2
0.27
0.07
1.65
3
0.30
0.08
1.65
1
0.19
0.03
1.58
2
0.23
0.05
1.58
Anxiety state
1
0.22
0.05
2.05
Self-rated health
1
0.24
0.06
1.73
2
0.30
0.09
1.73
3
0.32
0.10
1.73
4
0.34
0.11
1.73
(Constant)
Low PA
(Constant)
Moderate PA
(Constant)
Moderate PA
Sitting time
(Constant)
Intense PA
(Constant)
Intense PA
Sitting time
(Constant)
Intense PA
Sitting time
Moderate PA
(Constant)
Moderate PA
(Constant)
Moderate PA
Low PA
(Constant)
Moderate PA
(Constant)
Moderate PA
(Constant)
Moderate PA
Sitting time
(Constant)
Moderate PA
Sitting time
Intense PA
(Constant)
Moderate PA
Sitting time
Intense PA
Low PA
Vigor
Tension
B
T
0.17
0.18
0.16
0.13
0.22
0.18
0.17
0.14
0.16
0.14
0.19
0.15
0.13
0.22
0.24
0.21
0.17
0.17
0.15
0.13
0.14
0.14
0.13
0.12
35.74 ***
2.99 **
38.01 ***
3.34 ***
18.21 ***
2.96 **
2.40 *
45.82 ***
3.99 ***
28.67 ***
3.37 ***
3.16 **
27.08 ***
2.85*
2.91**
2.42 *
38.14 ***
3.48 ***
34.29 ***
2.47 *
2.24 *
25.13 ***
3.94 ***
34.96 ***
4.38 ***
15.88 ***
3.82 ***
3.14 **
15.38 ***
2.95 **
2.79 **
2.21 **
15.21 ***
2.26 *
2.55 *
2.22 *
2.12 *
T
IVF
1.00
1.00
1.00
1.00
0.98
0.98
1.02
1.02
1.00
1.00
0.96
0.96
1.04
1.04
0.87
0.95
0.88
1.15
1.05
1.13
1.00
1.00
0.87
0.87
1.15
1.15
1.00
1.00
1.00
1.00
0.97
0.97
1.03
1.03
0.87
0.95
0.87
1.15
1.06
1.16
0.81
0.94
0.86
0.89
1.24
1.07
1.16
1.12
Note: D-W = Durbin–Watson; T = Tolerance Index; IVF = Variance Inflation Factor. * p < 0.05; ** p < 0.01; *** p < 0.001.
The regression model for anger status showed that this variable was predicted by the
practice of low-intensity physical activity (R = 0.17; R2 adjusted = 0.03; F = 8.99; p < 0.001). For
the depression status variable, the regression model generated included moderate physical
activity and sedentary behavior time (R = 0.23; R2 adjusted = 0.05; F = 8.53; p < 0.001). The
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prediction model for vigor status included intense physical activity, sitting time and
moderate physical activity (R = 0.30; R2 adjusted = 0.08; F = 10.88; p < 0.001). On the other
hand, the factors of moderate and low physical activity were predictors of state stress
(R = 0.23; R2 adjusted = 0.05; F = 12.17; p < 0.001). The model for state anxiety showed one
predictor variable, moderate weekly physical activity (R = 0.22; R2 adjusted = 0.05; F = 15.51;
p < 0.001). For health perception, the linear regression model included heavy, moderate and
low physical activity, as well as sitting time (R = 0.34; R2 adjusted = 0.10; F = 9.92; p < 0.001).
4. Discussion
The aim of this study is to analyze the relationships between the level of physical
activity and mood, state anxiety and health perception in a group of adults during the
COVID-19 pandemic. Results showed statistically significant relationships between the
different parameters of weekly physical activity analyzed and the psychological variables
under study.
The data show relationships between the practice of physical activity during the
COVID-19 lockdown period and the different psychological parameters analyzed. These
results satisfy the objective of the work and show that the practice of physical activity is
related to better mental health states, as has also been supported by the scientific literature
in recent years [35,36]. Moreover, the results are consistent with the outcomes of other
research that have revealed a positive relationship between the practice of physical activity
and a better mood, lower anxiety symptoms and better self-perceived health [37–42].
There are studies on physical activity versus mental disorder vulnerability that conclude that daily physical activity decreases the risk of mental illness compared to inactive
people [56]. According to recent research, physical activity is considered to be an element
that can contribute to the improvement of symptoms of depression and anxiety [57]. In
addition, several studies have indicated that physical activity is related to strengthening
the immune system, as well as certain parameters of cardiovascular and respiratory system functioning, which have an impact on the psychological perception of health and
well-being [57].
According to a recent study, it has been indicated that performing moderate to vigorous aerobic physical activity and muscular strength exercises is associated with a lower
likelihood of developing symptoms related to mental disorders [58]. Some authors claim
that physical exercise is a useful tool for recovery from disorders related to depression
and anxiety [59]. In another recent study, it was observed that the existing relationship
between physical activity and mental health is defined as the improvement of mood
by increasing blood circulation in the brain area, which influences the hypothalamus–
hypophysis–adrenal as well as the physiological response to stress [60]. Finally, another
research study showed that patients with severe depression who underwent an aerobic
physical activity program experienced significant improvements compared to patients who
only received psychotropic treatment [61].
The results reveal slight differences by gender and age, although in general terms, the
data are similar. However, the younger age group and men showed a stronger relationship
between intense physical activity and the different psychological variables studied. However, statistically significant relationships were more important for women and the older
group, in which moderate physical activity was related to psychological variables. This
could be because female sports culture has been characterized by lower-intensity practice
and is also focused on activities aimed to maintain a physical fitness related to health, while
there has been greater use of outdoor spaces and a greater diversification of the activities in
males [62]. In addition, younger adults are associated to a greater extent with an intensive,
competitive and federated practice, which presents better performance in competitive
sports [63]. Regular and non-recreational practice has been associated with older people,
who usually practice sports sporadically for well-being and health reasons [64].
This research has been contextualized in a global pandemic caused by COVID-19,
specifically in a period when there have been home lockdowns and mobility restrictions,
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increasing the interest of these results. In these months, people have suffered high and
sustained levels of stress, which can leave an important long-term psychological imprint [65,66]. In fact, these circumstances have increased the predisposition to suffer
negative emotional and cognitive responses due to the stress suffered, such as fear, worry
or discouragement [25,67]. Moreover, in the first months of the pandemic, ambiguous information has been a common denominator, causing great uncertainty and bewilderment [68]
and potentially having consequences of a negative nature on people’s well-being [69,70].
Therefore, the results obtained by this research suggest that the practice of physical activity
could relieve the negative effects caused by this situation, preserving more adequate levels
of mental health.
In a social isolation situation such as the one experienced during quarantine, behaviors
such as the practice of physical activity could play a fundamental role in the preservation of
health. Even when habits and the type of physical activity performed have to be modified,
they can be adapted to be performed at home, thus encouraging benefits in relation to
mental health by decreasing anxiety symptoms [71,72]. Psychological distress is greater
the longer a person is exposed to a social isolation situation [73]. The observed relationship
between mental health and physical activity throughout the COVID-19 pandemic is also
conditioned by the impact of physical exercise on self-esteem [74] and also reduces some
inflammatory processes buffered by physical activity [75].
This research has several limitations. On the one hand, the cross-sectional design of
the present work does not allow for confirmation of whether there are causal relationships
between the study variables. The only thing that can be highlighted is the associations
found between these variables. However, the existing literature suggests that physical
exercise can help to preserve levels of mental health during this period. In addition, even
though the residual change score method is comparable to the analysis of covariance when
groups are randomly assigned, as shown in Kisbu-Sakarya et al. [76], future research could
calculate the residual change score method because it is frequently adopted by researchers
to test whether groups differ in the amount of change from pre-test to post-test, estimating
the initially predicted post-test scores by regressing the post-test scores on the pre-test
scores and ignoring group assignment. On the other hand, the sample is not representative
of the whole Spanish population. All the participants were from only one region of Spain,
so the results should be interpreted in that context. Likewise, even though we had the
information provided by the participants about their physical practice during this period,
it was not possible to control exactly what type of exercise they performed. Finally, some
personal situations faced by the participants in the study were not considered, such as
people who had lost their jobs, people who had to work online or personal healthcare.
Therefore, more specific investigations should be carried out to explore possible differences
between these populations.
However, the findings obtained suggest that practicing physical activity during isolation due to COVID-19 is associated with mental health status improvement. These results
agree with the results found in the literature for non-pandemic times [36,69,74]. Specifically,
the results of this research have highlighted the relationships between physical activity and
a better mood, lower state anxiety and higher perception of health. Likewise, women and
the older group show better psychological health when they practiced moderate physical
activity; however, men in the younger age group scored better when they engaged in
vigorous physical activity. These findings show the importance of performing physical
activity to preserve the state of psychological health, even in critical situations such as
those caused by the pandemic due to COVID-19.
Author Contributions: Conceptualization, J.A.P.-M., R.E.R., J.P.M.-B., J.L.P.-B., A.H.-M. and V.M.-S.;
Methodology, J.A.P.-M., R.E.R., A.H.-M. and V.M.-S.; Software, A.H.-M. and V.M.-S.; Validation,
J.A.P.-M., J.P.M.-B., J.L.P.-B., A.H.-M. and V.M.-S.; Formal analysis, R.E.R., J.P.M.-B., J.L.P.-B. and
A.H.-M.; Data curation, J.A.P.-M. and J.L.P.-B.; Writing—original draft preparation, J.A.P.-M., R.E.R.,
J.P.M.-B., J.L.P.-B., A.H.-M. and V.M.-S.; Writing—review and editing, J.A.P.-M., R.E.R., J.P.M.-B.,
J.L.P.-B., A.H.-M. and V.M.-S.; Visualization, J.A.P.-M., R.E.R., J.P.M.-B., J.L.P.-B., A.H.-M. and V.M.-S.;
Sustainability 2021, 13, 5444
8 of 10
Project administration, J.A.P.-M., A.H.-M. and V.M.-S. All authors made substantial contributions to
the final manuscript. All authors have read and agreed to the published version of the manuscript.
Funding: This research received no external funding.
Institutional Review Board Statement: The study was conducted according to the guidelines of the
Declaration of Helsinki, and approved by the Ethics Committee of University of Málaga.
Informed Consent Statement: Informed consent was obtained from all subjects involved in the study.
Conflicts of Interest: The authors declare no conflict of interest.
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J SPORTS MED PHYS FITNESS 2001; 41:539-45
The effects of exercise on mood changes:
the moderating effect of depressed mood
A. M. LANE, D. J. LOVEJOY*
Background. The present study examined the extent to which
From the University of Wolverhampton, Walsall
pre-exercise depressed mood moderated the influence of exer*Brunel University, Isleworth, Middlesex, UK
cise on changes in other mood dimensions. The study was conducted in an ecologically valid setting using participants with
previous experience of aerobic dance exercise. We hypothesized that (a) exercise will be associated with improved mood
regardless of depressed mood, (b) the effect of exercise on mood
changes would be significantly greater among individuals that
reported symptoms of depressed mood before exercise, and (c) sion, and increase in vigor was significantly greater in the
that pre-exercise depressed mood will be associated with a depressed mood group, hence consistent with theoretical premood profile comprising high anger, confusion, fatigue, and dictions. Results demonstrated that pre-exercise depressed
mood was associated with a negative mood profile as hypothtension, with low vigor.
esized.
Methods. Participants were 80 (M=27.90 years, SD=4.32 years) Conclusions. Findings lend support to the notion that exercise
exercisers who had attended an exercise class on a regular is associated with improved mood. However, findings show
basis for the previous three months. Participants completed that this effect was significantly greater among individuals
the Profile of Mood States-A 15 minutes before exercise and then reporting symptoms of depressed mood before exercise.
immediately after an aerobic dance exercise class. To examine
the proposed moderating influence of depressed mood, par- KEY WORDS: Depression – Mental health – Exercise, physiology ticipants were grouped into either a no-depression group, or a Mood disorders.
depressed mood group using pre-exercise depression scores.
The exercise intervention was an aerobic dance session where
participants followed the moves of the instructor. The session
here has been an increase in research to examine
lasted for 60 minutes including a warm-up, main session, and
the influence of exercise on changes in mood.’-7
cool-down.
8
Results. Repeated measures MANOVA (time x depression/no- Using the Profile of Mood States (POMS), the generdepression group) results indicated that anger, confusion, fati- al trend in research findings indicates that exercise
gue, tension, and vigor reduced significantly. Thus supporting has a mood enhancing effect. This mood-enhancing
the notion that exercise reduces negative mood. Results indi- effect is typified by increased vigor and reduced anger,
cated that the reduction in anger, confusion, fatigue, and ten- confusion, depression, fatigue, and tension.236 A limitation to the generalizability of these findings is that
Presented at the British Association of Sport and Exercise Sciences
they have not been unequivocally supported. To date,
Conference, Leeds Metropolitan University, September 9th, 1999.
research has tended to focus on the type of exercise
(running, yoga, swimming, aerobic dance3 4 ), and the
Address reprint requests to: A. M. Lane, School of Sport, Performing
489
(i.e. the percentage of the maxArts and Leisure, University of Wolverhampton, Gorway Road, Walsall. intensity of exercise
imum heart rate, or whether the exercise was aerobic
WS1 3BD. E-mail: AMlane2@wlv.ac.uk
T
Vol. 41 – No. 4
THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS
539
LANE
THE EFFECTS OF EXERCISE ON MOOD CHANGES
or anaerobic in nature). The present study examined the
extent to which mood changes following exercise are
influenced by the presence or absence of depressed
mood before exercise. Specifically, we focus on the
influence of exercise on changes in other moods in
depressed and non-depressed exercisers. The rationale for examining mood in this way is based on a
recent conceptual model on the nature of mood.10 11 The
present study extends proposals made in Lane and
Terry’s 10 11 conceptual model by examining mood
changes in an exercise setting.
The present study tests three hypotheses. First, we
hypothesize that aerobic dance exercise will be associated with improved mood. Second, we hypodiesize
that aerobic dance exercise will have a significantly
greater mood enhancing effect among individuals
reporting symptoms of depressed mood before the
exercise class starts. Third, we hypothesize that preexercise depressed mood will be associated with a
negative profile comprising increased anger, confusion, fatigue, tension, and reduced vigor.10 11
Our hypotheses are grounded in attempts to resolve
issues regarding the equivocality of findings on the
influence of exercise on mood.1-3 9 12 13 Kennedy and
Newton12 found that running at a relatively high intensity had a greater effect on fatigue and anger than running at a relatively low intensity. By contrast, Berger
et al.13 found that swimming shorter distances are preferable to long distances when mood enhancement is a
goal. Dyer and Crouch14 found that while a bout of
exercise improved the mood of those who exercised
regularly through running, the mood states of those
who did not run regularly did not change significantly.
Equivocal research findings for mood changes following exercise might be influenced by methodological issues. Research to examine the effect of exercise on mood changes has typically used experimental conditions or quasi experimental conditions.3 9 In
such research, the type of exercise is prescribed by the
researcher. Also, in experimental research the sample
recruited was for research purposes. Thus, participants do not necessarily take part in the exercise used
as the intervention to examine mood changes for personal benefits such as enjoyment or health related
reasons.
Research has found that individuals vary in the
extent to which they feel that exercise can be used as
a strategy to bring about improved mood.15 For exam-
540
ple, Thayer et al.15 found that 44% of a sample from
the general population reported that exercise was the
most frequently used and most effective strategy to
regulate mood. This finding has been reported as evidence demonstrating the mood-enhancing effect of
exercise.16 However, an alternative way of interpreting
the results of Thayer et al.l5 is that they also show that
56% of the sample did not use exercise to regulate
mood. It is suggested that individuals who use exercise
for mood-enhancement have experienced positive
mood following exercise, and viceversa. Experimental
research showing mood-enhancing effects from exercise might be a function of the sample comprising participants who use that type of exercise to regulate
mood. A process that is reversed for non-significant
findings.
It is suggested that research should control for the
amount of previous experience that participants have
had in taking part in the exercise session used as an
intervention to examine mood changes. Logically,
individuals who exercise on a regular basis believe
that the benefits of exercise outweigh the effort made
to complete the exercise session.
In the present study, we focus on mood changes following exercise in depressed and non-depressed exercises having accounted for previous experience. Lane
and Terry10 11 proposed that depressed mood is associated with increased anger, confusion, fatigue, and
tension, with reduced vigor. Given the widespread
usage of the term depression, some explanation of it is
needed. Lane and Terry10 11 talk about depressed mood
rather than clinical depression. Mood is a continuous
construct on which clinical mood disturbance is at one
end, and depressed mood is somewhere in the middle.17
Lane and Terryl0 11 proposed that depression is the
most important mood dimension because of the demotivating nature of the depression construct.
Depressed mood has been characterized by themes
of sadness, worthlessness, and self-blame.18 19 Lane
and Terry argued that researchers should use a scale
that assesses relatively independent markers of depression and divide the sample into a “depressed mood”
and “no-depression” group. Lane and Terry11 proposed that symptoms of depressed mood, however
small, have a powerful impact on other mood dimensions.
Consistent with theoretical proposals, research has
demonstrated that the depressed mood is associated with
THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS
December 2001
THE EFFECTS OF EXERCISE ON MOOD CHANGES
significantly higher anger, confusion, fatigue, and tension, with lower vigor scores before competitive
sport.20-23 Depressed mood is proposed to derive from the
process of attributing failure to achieve important goals
to internal factors such as lack of ability.18 19 According
to Lane and Terry,11 anticipated thoughts of failure to
attain performance goals lead to depressed mood in the
pre-competition period. To date, the conceptual model 10 11 of the influence of depressed mood on other mood
dimensions has not been tested in an exercise setting.
In the present study, we extend examination of Lane
and Terry’s conceptual model through investigating
the influence of exercise on mood changes in depressed and non-depressed exercisers. We propose that
exercise will have a significantly greater mood-enhancing effect in the depressed mood group. Previous
research has supported the notion that exercise is an
effective method of reducing depressed mood.2 3 5 9 In
the present study, it is suggested that the depressed
mood group will perceive completing an exercise class
to be a greater achievement than the no-depression
group, and this will be evidenced through greater
changes in mood. The rationale for this proposal is
based on the notion that a mechanism though which
exercise leads to improved mood is through exercise
fostering a sense of achievement.
At least two different factors are proposed to influence the extent to which exercise fosters a sense of
achievement in the present study. The first factor is
that participants should see achievement in terms of
completing the exercise session. It is important to recognize the notion of relative achievement in the context of an aerobic dance exercise setting, which is the
type of exercise used in the present study. The activity of aerobic dance requires the individual to follow
the movements of the instructor. Thus movement patterns that are performed are largely determined by the
instructor, and therefore the pace of the exercise is relatively external of the individual. This contrasts with
exercise sessions such as circuit training where the
number of repetitions performed at each station is
individually determined. In exercise types that are
internally paced, it is easier for the individual to set performance goals, and judge achievement through goal
attainment. Consistent with previous research in
sport,20-23 it is suggested that depressed individuals
would fail to attain their performance goals, and that
this would lead to increased negative mood. Thus for
exercise to lead to improved mood in the depressed
Vol.41 -No. 4
LANE
mood group, the exercise experience should be free
of interpersonal competition.
A second factor that contributes to exercise fostering
a sense of achievement is the participants previous experience of the exercise session. The relative difficulty of
aerobic dance is reduced if the individual has sufficient
experience with the instructor. Given sufficient experience, it is likely that he/she could follow the moves of the
instructor. Previous experience of successfully completing the exercise session is especially important for
individuals who report depressed mood before exercise.
Low coping ability associated with depressed mood is
suggested to magnify the perceived difficulty of the
task. Thus depressed individuals will tend to perceive the
task of completing the aerobic dance exercise session is
more difficult than usual. It is suggested that completing
the exercise session when feeling depressed will produce
a greater sense of achievement, and consequently this will
be associated with improved mood.
Collectively, the extent to which pre-exercise
depressed mood influences changes in other mood
dimensions is unknown. The present study investigated the influence of exercise on changes in other moods
in depressed and non-depressed exercisers.
Materials and methods
Participants
Eighty volunteers participated in this study (age:
M=27.90 years, SD=4.32 years, male=37; female=43).
All participants had some experience of aerobic dance
sessions, ranging from 3 months to 2 years (M=1.0
years; SD=1.35 years). To ensure relatively homogeneity in terms of previous experience of the exercise
session used in the present study, an inclusion criterion was set so that participants had to have attended the
exercise class at least once per week for the previous
three months. Thus participants were familiar with
the exercise routine and the exercise instructor.
Two different steps were taken to ensure that previous experience of the exercise session related to the session used as the intervention to assess mood changes.
The first is the aerobics class chosen as the intervention took place at the same time of day and the same
day each week. Second, the same music was used to
accompany each aerobics session as Karageorghis and
Terry24 argued music might mediate the influence of
exercise on mood changes.
THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS
541
LANE
THE EFFECTS OF EXERCISE ON MOOD CHANGES
Exercise intervention
The aerobic dance session lasted for 60 minutes
including a warm-up, main session, and cool-down.
The session involved an instructor performing to the
class from the front. Participants followed the moves
of the instructor. The warm-up comprised exercises
designed to raise heart rate such dance steps and walking. This was followed by a stretching routine. The
main session involved rhythmic movements such as
stepping, lunges, knee lifts, bicep-curls in addition to
basis dance steps. It was designed to raise heart rate so
that individuals exercised between 50 to 70% of their
heart rate maximum. An accepted limitation of the
present study was that no physiological markers of
exercise intensity were taken. It also included a section
designed to increase abdominal muscle strength. The
cool-down included a series of stretching and rhythmic
breathing exercises.
Depressed mood and no-depression groups
Measure of mood
Mood was assessed using the 24-item profile of
mood states-adolescents (POMS-A25). The POMS-A
was chosen as the measure of mood for four reasons.
First, it was validated on samples of athletes whereas
other mood scales, such as the original POMS8 were
developed for use with student or psychiatric populations. Second, it was validated for use with a British
population, hence an appropriate group to the sample
used in the present study. The original POMS 8 has a
North American orientation with items such as “Blue”
and ”Bushed” which are expressions not commonly
used in Britain. Third, brevity was an important consideration as mood was assessed shortly before and
after an exercise class. The completion time of a psychometric questionnaire is a function of the number of
items and the difficulty of items.25 26 As the POMS-A
has been validated so that individuals as young as 11
years old can understand the items, adults should have
little difficulty.
Fourth, the POMS-A has been subjected to a rigorous validation process. Terry et al.25 reported confirmatory factor analysis of the POMS-A which supported the factorial validity of a 24-item six-factor model
using both independent and multisample analyses.
They also reported correlations of POMS-A scores
with previously validated inventories, which were consistent with theoretical predictions and thus provided
evidence of criterion validity. Recent research has sup-
542
ported the predictive validity of this measure among
adult athletes, to the extent that POMS-A scores significantly predicted athletic performance.21-23
The POMS-A inventory assesses six mood constructs: anger, confusion, depression, fatigue, tension,
and vigor. Examples of anger items include “furious”
and “bad-tempered”, confusion items include “muddled” and “uncertain”, depression items include
“unhappy” and “downhearted”, fatigue items include
“worn out” and “tired”, tension items include “panicky”
and “worried”, and vigor items include “alert” and
“energetic”. Items are rated on a 5-point scale anchored
by 0 (“not at all”) to 4 (“extremely”).
Scores on the POMS-A were converted to T-scores
using tables of normative data from adult athletes.20
Transforming raw scores to T-scores is desirable to
facilitate comparisons with an appropriate reference
group.26
To examine the effect of depression mood on mood
changes, participants were grouped into either a nodepression group (N=28) or a depressed mood group
(N=52; M=65.31, SD=10.33) using pre-exercise
depression scores. Depression on the POMS-A is
assessed through asking participants how they feel
“right now” in relation to the four items “depressed”,
“downhearted”, “unhappy”, and “miserable”. Lane
and Terry” argued that depressed mood should be
split into a no-depression group and depressed mood
group on the basis of scores on the POMS-A (Terry et
al.25). Thus the no-depression group comprised individuals who reported zero for each item and the depressed mood group comprised individuals who reported
1 or more.
As the purpose of the present study was to test mood
changes in an ecologically valid setting, no mood
manipulation strategies were employed. Participants
were divided into two naturally occurring groups on the
basis of pre-exercise depressed mood scores. Previous
research using the POMS-A has found that a score of
zero is the mode for symptoms of depressed mood.20
As the participants were drawn from the general population rather than a clinical population, it is reasonable to expect scores of depressed mood to be at the low
end of a scale which ranges from 0 to 16.7 27 An accepted limitation is that participants were not screened for
individuals currently undergoing treatement for clinical depression.
THE JOURNAL OF SPORTS MED1CINF. AND PHYSICAL FITNESS
December 2001
THE EFFECTS OF EXERCISE ON MOOD CHANGES
LANE
TABLE I.—A comparison of mood over time between depressed mood and no-depressed mood group.
Parameters
Anger
No-depression
Depressed mood
Confusion
No-depression
Depressed mood
Fatigue
No-depression
Depressed mood
Tension
No-depression
Depressed mood
Vigour
No-depression
Depressed mood
Pre-exercise mood
Postexercise mood
M
M
SD
SD
47.84
56.60
7.56
9.48
48.90
46.09
11.40
2.70
43.81
54.09
2.26
8.61
43.81
44.62
3.14
3.89
50.15
63.80
9.50
11.96
53.52
57.10
11.28
9.80
39.12
50.42
4.08
14.80
39.11
40.91
4.08
3.93
49.77
45.69
9.01
8.08
44.37
45.32
8.81
5.27
Depressed mood F1.78
(Eta2)
Time F1.78
(Eta2)
Interaction F1.78
(Eta2)
3.26
(0.04)
24.44*
(0.24)
36.72*
(0.32)
29.93*
(0.28)
26.84*
(0.26)
26.83*
(0.26)
14.68*
(0.16)
1.73
(0.02)
15.87*
(0.17)
11.83**
(0.13)
18.55*
(0.19)
18.55*
(0.19)
1.00
(0.01)
9.78**
(0.11)
7.45**
(0.09)
* p
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