Web-Based Exercise Intervention Leads to Mental Health Improvements in 3 Months, Controlled Trial Shows

Web-Based Exercise Intervention Leads to Mental Health Improvements in 3 Months, Controlled Trial Shows

Participants in a web-based physical activity intervention saw improvements in their levels of depression, anxiety and stress, according to findings published in the journal Mental health and physical activity. Interestingly, these mental health benefits appear to have occurred without a noticeable improvement in physical activity.

Despite overwhelming evidence that physical exercise can improve mental health, many adults are not meeting current recommendations for physical activity – the World Health Organization recommends at least 150 minutes of intense physical activity moderate per week. Evidence suggests that the COVID-19 pandemic has further reduced exercise levels among the public.

To encourage people to increase their movements, technology-based physical activity interventions have been developed. These interventions help people increase their activity levels using online methods such as smartphone apps, activity trackers, and social media. While these interventions show promise, it is unclear whether they provide mental health benefits.

“Web-based interventions have the potential to reach large populations in a cost-effective way,” explained study author Corneel Vandelanotte (@CorneelVDL), research professor and Future Fellow at Central Queensland University in Australia. “We know they can improve physical activity outcomes, but much less is known about how they can positively influence mental health outcomes. The association between physical activity and improved mental health outcomes is well established, as such, in theory, web-based physical activity interventions should also improve mental health outcomes.

For their study, Vandelanotte and his colleagues recruited a sample of 501 Australian residents who were currently inactive (meaning they engaged in less than 150 minutes of moderate to vigorous physical activity per week). At baseline, participants completed sociodemographic measures and measures of depression, anxiety, stress, and health-related quality of life. Participants were then randomly assigned to a control group or an online physical activity intervention group.

The intervention group had access to an action planning tool and eight physical activity sessions that were delivered over three months. Questionnaire responses and IF-THEN algorithms were used to provide participants with personalized content and advice. The sessions touched on concepts such as self-efficacy, intentions and motivation. They also applied the following behavior change techniques: feedback, instruction, goal setting, habit formation, self-monitoring, action planning, and problem solving. At 3 months and 9 months after baseline, participants again performed psychological assessments.

The results revealed that at all times, participants who received the exercise intervention reported lower depression, anxiety and stress, and better mental quality of life compared to baseline. Moreover, compared to the control group, they reported lower depression, anxiety and stress after 3 months and lower anxiety after 9 months.

The researchers note that in a previous study, this web-based exercise intervention was found to improve self-reported physical activity, but not physical activity measured via an accelerometer. This is interesting given that the participants nevertheless experienced significant improvements in their mental health.

The results indicate “that improvements in mental health can be achieved using web-based physical activity interventions, even if physical activity does not improve (we found no level of ‘significantly improved physical activity using objective measures), but participants believe their physical activity has improved (we found significant improvements in self-reported activity levels),” Vandelanotte told PsyPost.

The study authors say these findings fit a psychological explanation for the mental health benefits of exercise. It appears that people can experience positive psychological outcomes with physical activity interventions when they believe they have become more active, even if they have not actually increased their activity. For example, an intervention can promote a sense of accomplishment and improved self-esteem and body image, whether or not a person has increased physical activity.

“What people think happened (they think they’re more active) is more important than what actually happened (there hasn’t been an actual increase in activity physical) to improve mental health,” Vandelanotte said.

Although the results suggest that Internet-based physical activity interventions are effective in improving mental health, the prior literature has been mixed. Further studies will be needed to confirm the results. Additionally, despite a large and well-nourished sample, most study participants reported good mental health at baseline, which may have limited detection of improvements in mental health due to ceiling effects. It is possible that populations with poorer mental health—such as clinical samples—experienced greater mental health impacts with the intervention.

“This is just one study, the results need to be confirmed in other studies,” Vandelanotte said. “The results do not apply to populations with clinical mental health conditions because participants in this study generally had good mental health even before the study (and the study may have improved health outcomes further mental, but not by much, due to the strong baseline).

The study, “Impact of a Web-Based Personalized Physical Activity Intervention on Depression, Anxiety, Stress, and Quality of Life: Secondary Results from a Randomized Controlled Trial,” was authored by Corneel Vandelanotte, Mitch J. Duncan, Ronald C. Plotnikoff, Amanda Rebar, Stephanie Alley, Stephanie Schoeppe, Quyen To, W. Kerry Mummery, and Camille E. Short.

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