Using the topic you selected on Exercise intensity and its effect on body composition. Formulate it as a research question. Example topic: Exercise intensity and its effect on m

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Literature Review

Model Student

California Baptist University

KIN 473: Research Methods and Evaluation in Kinesiology

Date

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Literature Review

Introduction

This paper will explore the effects of resistance and aerobic exercise on cognitive

and academic outcomes in youth. For the purposes of this paper, the term executive

function (EF) will be used to characterize a broad array of controlled cognitive outcomes

including, but not limited to academic achievement, working memory, arousal, problem

solving, selective attention, and general higher level thought processing. Historically,

Spirduso (1975) was the first to study the association between cardiovascular fitness and

memory. Since that time, the exploration of the effects of varying interventions relating

exercise and executive functions have developed into a substantial research interest.

Much of the foundational research in this spectrum has been correlational in nature,

stemming largely from the works of Kramer et al. (1999). However, in recent years more

attention has been paid to the effects of acute exercise and its role in advancing EF.

While a large percentage of this body of literature has emphasized aerobic work as the

primary exercise mode, evidence has been brought to light giving credence to the notion

that resistance exercise may also play a role in EF and cognition. The distinctions

between these forms of exercise and their EF effects will be analyzed according to

subject age group (youth, adult, senior) in the following paragraphs. Age groupings will

be broken down as follows: youth < 18 years old, adult 18-64 years old, seniors > 65

years old. Additionally, for the sake of this work, all studies that utilize EF testing

during, or immediately following exercise bouts will be examined under the realm of

acute exercise.

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Acute Aerobic Exercise and EF in Youth Populations

The origins of the study of youth EF following acute aerobic exercise (AE) can be

traced back to the work of Gabbard and Barton (1979) who investigated the relationship

between physical exertion and mathematics computation scores in second grade boys and

girls. Students were asked to perform standard relay-type activities in a cyclical method

for the following intervals: no exertion (pre-test), 20, 30, 40, and 50 minutes, followed by

another no-exertion post-test. Mathematics computations were administered five minutes

after each exertion period and consisted of 36 questions that did not require borrowing or

carrying functions. Significant differences were found in mean scores following only the

50-minute treatment, which led the authors to conclude that aerobic exercise of specific

(50-minute) duration could positively affect mental performance in youth. Interestingly,

despite the positive results found by Gabbard and Barton, acute AE was not studied as an

EF intervention in youth for quite some time. Zervas et al. (1991) demonstrated a

significant difference in matching ability measured before and following acute exercise

bouts between nine sets of twin boys. The boys were exposed to either a six-month

aerobic exercise regimen or a standard school PE program, with non-twin peers in a non-

exercising control group. Several years later, Gabbard and McNaughten (1993)

continued exploration of exertion on math computation in youth, looking specifically at

mathematics computation among sixth-grade boys and girls following bouts of paced

walking for 20, 30, and 40 minutes at varying times throughout the school day. Tests

were performed at 8:30 am, 11:50 am, and 2:20 pm for three weeks, after which students

would perform 90-second tests of math computation. Results indicated that scores were

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significantly higher at 11:50 am and 2:20 pm following the 30 and 40-minute bouts of

aerobic exercise.

Re-emergence of the study of acute AE on youth EF arrived in the mid to late

2000’s and has since become a hot topic. Hillman et al. (2009), one of the leading

researchers in the area of youth activity and academic achievement, demonstrated

cognitive improvements in pre-adolescent children following 20 minutes of treadmill

walking at 60% of the child’s max heart rate. Response accuracy, P3 amplitude, and

increased performance on a measure of academic achievement all significantly differed in

the aerobic exercise group over that of a non-exercising control. Similarly, Best (2012)

showed a cognitive enhancement as measured by response time and accuracy in resolving

visual stimuli in children aged 6 to 10 years old following 10 minutes of exergaming.

Results from such research demonstrate reason for inclusion of aerobic physical activity

in schools for the sake of cognition and academic achievement. Further, classroom

teachers may be directly impacted by research findings from Budde et al. (2008), who

showed an increase in attention and concentration among 115 adolescent students in an

elite performance school following just ten minutes of coordinative exercise.

Interestingly, this study also compared the effects of a normal sport lesson matched for

heart rate on the same outcome variables and found that while both exercise modes

improved concentration and attention, results were greater in the coordinative exercise

group. These findings may provide valuable information as to the type of aerobic

exercise that best elevates student achievement in the classroom. Continuing this trend,

Tine and Butler (2012) focused their efforts on improvements in selective attention in

children from low-income homes. This work was especially important, as youths from

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lower income families have typically been shown to exhibit poor EF skills in relation to

their higher-income peers. However, Tine and Butler demonstrated that after a 12-minute

session of aerobic exercise, 6th and 7th grade students from both low and high-income

backgrounds were able to increase their selective attention, with low-income students

showing significantly greater improvements. Finally, with ADD and ADHD being an

ever-increasing dilemma that classroom teachers must deal with on a daily basis, the

work of Chang et al. (2012) was a great step forward for the field of physical activity as

related to AA and EF. This study examined youths aged 8-15 who had been classified as

ADHD by a clinical psychologist and found that following an acute bout of 30-minutes of

moderate-intensity treadmill running, students in the exercise group significantly out-

performed their non-exercising peers in tests of executive function, specifically the

Stroop test and the Wisconsin Card Sorting Test. Results indicate that acute aerobic

exercise may better help allocate executive attention resources in children with ADHD.

It is clear that while this field of research is still relatively young and under-studied, many

positive results have been discovered in the quest to increase youth learning and EF, and

as such, acute aerobic exercise appears to play an important role in many aspects of brain

function and cognition.

Acute Resistance Exercise and EF in Youth Populations

To date there have yet to be any published studies performed on youth

populations looking at acute resistance exercise (RE) and EF. As mentioned previously,

pilot data from the principal investigator has established initial evidence to support equal

efficacy between AE and RE on measures of cognition in high school youth.

Additionally, resistance exercise has received recognition as an appropriate and viable

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form of youth fitness from the National Strength and Conditioning Association

(Faigenbaum et al., 2009). Additionally, RE has been shown to impact such variables as

self-esteem (Courneya et al., 2007), body composition (Garber et al., 2011), coordination

(Garber et al., 2011), strength (Kraemer et al., 2002), cognitive arousal (Chang & Etnier,

2009), improved quality of life (Kraemer et al., 2002), and protection against health- and

age-related disease (Garber et al., 2011). Thus, there is reason to suspect that a well-

designed resistance training program could have a similar effect to that of traditional

aerobic exercise on executive function. Future research should target both chronic and

acute resistance exercise as a means of effecting change in EF in youth, especially as this

line of research continues to grow with the utilization of aerobic exercise.

Acute Aerobic Exercise and EF in Adult Populations

The paucity of studies completed in the examination of EF in youth populations is

quite the opposite of what is seen among adults. In fact, quite a large body of literature

exists documenting acute aerobic and anaerobic exercise and numerous measures of

cognitive function. In a review done by Tomporowski (2003), an interesting theme came

to light, highlighted by several studies from Cian and colleagues (Cian et al., 2000; Cian

et al., 2001) who discovered that EF (specifically short-term memory) was attenuated

following acute bouts of intense aerobic exercise leading to dehydration. In fact, the

studies in which subjects were in a dehydrated state were the only examples that did not

show either an increase in EF or no change between groups studied, indicating that there

may be a link between hydration and cognition, at least as related to acute aerobic

exercise. Tomporowski found several other aspects of EF that were positively influenced

by AE, including reaction time, mathematics computations, Stroop testing, perception,

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decision making, concentration, and memory (2003). The majority of the examined

studies of acute AE made use of modalities such as treadmill running (Heckler & Croce,

1992; Lichtman & Poser, 1983; Marriott et al., 1993; Tomporowski et al., 1987), or

cycling (Hogervorst et al., 1996; Tomporowski, 2003) at various intensities and

durations. Facilitation in measures of EF were seen in the majority of these studies,

while at worst, no effect was seen in measures of choice reaction time, tapping

(Hogervorst et al. 1996), and free recall memory (Tomporowski et al. 1987).

Following publication of Tomporowski’s review, the literature on this topic

continued its growth as researchers made attempts to discover the underlying factors that

related EF to acute exercise. Hillman et al. (2003) examined the neuroelectric response

of 20 undergraduate subjects to an acute 30-minute bout of graded treadmill exercise. P3

amplitude and performance on the Eriksen Flanker test were evaluated when subjects’

heart rates had returned to 10% of pre-exercise levels. Results indicated that following

acute AE, P3 amplitude was increased significantly above baseline levels, hinting at the

possibility of increased cognition via elevated allocation of neuroelectric resources and

speed of executive processing. Similar, positive results following acute exercise were

found by Tomporowski and Ganio (2006), who discovered an increase in performance of

a task-switching test among male and female undergraduate students upon completion of

40 minutes of submaximal AE. The task-switching test was also perceived to be less

frustrating to students following acute exercise as compared to a resting condition.

Interestingly, while students performed better on the measure of processing speed, short-

term memory was not affected in either males or females following completion of acute

AE. A possible explanation for this discrepancy lies in the executive processing theory

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explained by Kramer et al. (2003), which states that physical activity most likely impacts

operations in the prefrontal cortex of the brain, which is responsible for information

processing. Short-term memory functions on the other hand, are the primary

responsibility of the hippocampal region of the brain, which does not appear to be

affected in the same manner by physical activity, chronic or acute. With such

information in mind, Coles and Tomporowski (2008) investigated the impact of 40

minutes of acute AE on aspects of long-term memory in undergraduate students. Similar

in nature to the protocol used by Tomporowski and Ganio in 2006, this study also

observed changes in primacy and recency portions of a word-recall list, or the ability of

the students to recall items in the first and last parts of a word list, which appears to be an

indicator of increased long-term memory storage. Indeed, after acute bouts of AE on a

cycle ergometer, students were able to recall significantly more of these first and last

items in the test as compared to a resting and non-exercising control. Authors believed

that arousal levels were influenced in a positive way by the exercise intervention, leading

to greater cognitive encoding and consolidation of working memory. Caution must be

used when interpreting these results, however, as long and short-term memory did not

actually increase as a result of this intervention, subjects simply performed less poorly in

these measures following acute AE.

An additional aspect of acute exercise of interest to researchers hoping to observe

changes in EF is that of exercise intensity. In this regard, there seems to be some

conflicting evidence relating the ability of acute AE to consistently influence EF. Much

of the research in this regard has dealt with arousal levels, indicating the possibility of an

inverted U-shaped curve as arousal increases related to exercise intensity. This U-shaped

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relationship was first observed by Levitt and Gutin (1971), who found an improvement in

men’s reaction times during treadmill walking at speeds that produced 115 heartbeats per

minute. As heart rate increased to 145 beats per minute, reaction time returned to

baseline levels, and at 175 beats per minute, was further attenuated below basal levels.

Similarities were observed in studies by Salmela and Ndoye (1986), Cote et al. (1992),

Brisswalter et al. (1995), Kamijo et al. (2004), and Chmura et al. (1994).

While the inverted U-shaped curve has been observed in multiple studies of EF

and arousal resulting from acute AE, a more common theme seen in the literature is that

subjects are able to make quicker responses while performing acute AE as compared to

non-exercise or low-intensity exercise (Tomporowski, 2003). Results corroborating the

notion that response time is hastened while exercising at moderate intensities include

studies done by McMorris and Keen (1994), Aks (1998), Allard et al. (1989), Arcelin et

al. (1997), McGlynn et al. (1977), and McMorris et al. (1996, 1997, 1999). The vast

majority of these studies utilized cycle ergometer protocols with subjects performing

cognitive tasks during or after completion of exercise at various intensities.

One of the more recent hypotheses regarding EF and higher-intensity acute

exercise is known as the transient hypofrontality theory. This theory was developed and

further explored by Dietrich (Dietrich & Sparling, 2004; Dietrich, 2006) in an attempt to

explain the findings that indicated a reduction in EF capabilities during acute exercise.

The primary premise behind Dietrich’s hypothesis was that the brain operates on a

limited metabolic supply, and during exercise, while the brain is occupied with the

performance of complex movement patterns, there is limited availability for EF to be

directed towards other tasks. This notion was further supported by DelGiorno et al.

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(2010), who examined EF in a cohort of male and female adults during, immediately

following, and 20 minutes post-exercise. Acute exercise bouts were performed at

ventilatory threshold (VT) and 75% VT for 30 minutes followed by a performance task

test and the Wisconsin Cart Sorting Test. A significant increase in errors and false alarms

were seen during both exercise intensities. Interestingly, errors remained elevated after

20 minutes in the VT group, but not in the 75% VT group, indicating that EF may indeed

be negatively impacted by high intensity acute exercise, and that additional recuperation

time is needed to observe the cognitive benefits associated with exercise. These findings

were corroborated by Labelle et al. (2012), who found that cognitive control, as measured

by the Stroop test, decreased as exercise intensity increased from 60% to 80% of peak

power output. These findings must be taken into account when designing AE

interventions targeted at adult populations.

Acute Resistance Exercise and EF in Adult Populations

As was seen in the comparison of acute resistance and aerobic exercise in youth

populations, a great disparity exists between the number of studies examining the same

variables in adult populations. While the reason for this disparity is unclear, there at least

exist a small number of adult studies looking at RE and its effects on EF. The first study

to examine the effects of RE on EF in adults was performed by Krus et al. (1958). This

work utilized a protocol that required participants to push against a spring-loaded board

for 20 seconds, after which they were given a test of perceptual sensitivity. Results

indicated a significant decrease in perceptual sensitivity, leading authors to assume that

the positive associations observed following acute AE may be task dependent. Not until

2009 was this acute exercise modality again studied in adult populations, when Pontifex

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et al. compared the effects of resistance and aerobic exercise on measures of reaction

time and working memory. Subjects completed EF related tasks before, immediately

after, and 30 minutes after completion of the exercise protocol. Response time was

significantly shorter in the time periods immediately after and 30 minutes after aerobic

exercise, with no observed changes for resistance exercise or seated rest control. A larger

decrease in reaction time was also seen in the aerobic exercise modality for those

conditions requiring increased working memory. No differences were found in this

regard for resistance exercise or resting control. Authors speculated that differences in

cerebral blood flow between aerobic and resistive exercise may be the underlying cause

behind the null response of acute strength training and EF. It should be noted, however,

that another study examining acute resistance exercise and cognitive function was being

performed at the same time by Chang and Etnier (2009b), with contrarian results. The

work by Chang and Etnier focused solely on RE compared to a resting control, and

determined that two sets of 10 repetitions of six exercises induced a significantly

different response in measures of the Stroop test and the Trail Making Test. These

findings give credence to the notion that RE may indeed have an effect on cognition,

albeit specifically in terms of processing speed and task shifting. Additional study of

such measures of EF were examined by Alves et al. (2012), who observed a cohort of 42

healthy middle-aged women in a counterbalanced, crossover, randomized trial design.

Each subject was exposed to the aerobic, resistance, and non-exercise treatments and

analyzed for performance on the Stroop Test and Trail Making Test. Subjects performed

significantly better on the Stroop Test but not the Trail Making Test for both the aerobic

and resistance interventions as compared to the non-exercise control. As with other

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studies, authors concluded that while increases in EF can be seen with RE as well as AE,

changes may be task specific.

Acute Aerobic Exercise and EF in Senior Populations

While clear benefits exist across all ages for increasing cognition and EF, it seems

that young and old populations could benefit to the greatest degree for both health

purposes and increased mental functioning. To this end, there exists encouraging

evidence that older adults display similar increases in EF to those already discussed in

this review. Specifically, Molloy (1988) found an increase in cognition as measured by

logical memory test following 45 minutes of moderate intensity AE in older adults.

Emery et al. (2001) found similar results in a cohort of elderly COPD patients who were

exposed to 20 minutes of a cycling protocol followed by a cool-down period. These

subjects demonstrated increased verbal processing via the Verbal Fluency Test.

Interestingly, a comparison was made to healthy older adults and only those with COPD

were found to demonstrate an increase following acute exercise. Light and moderate

cycling exercise was also used as a modality in determining response to a Flanker task

test and P3 amplitude in a study of young and old males by Kamijo et al. (2009). Both

groups demonstrated a reduction in reaction time following moderate exercise, and a

decrease in P3 latency following light and moderate exercise. P3 amplitude was found to

increase only among the younger subjects, however, lending credence to the idea that

some aspects of cognition may be age dependent. Other increases seen in cognitive tests

performed among seniors following acute AE include the Stroop Test (Hyodo et al.,

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2012) and measures of reaction time and task switching (Kimura & Hozumi, 2012).

Increases in these areas of cognition were seen after bouts of cycle ergometry and free

and choreographed dance, respectively.

Acute Resistance Exercise and EF in Senior Populations

As was seen among youth populations, no studies to date have been performed

utilizing acute bouts of RE in senior populations to affect EF or cognition. However,

there have been a handful of studies looking at the chronic effects of resistance training

on EF in seniors, which indeed sheds light on the possibility of RE to affect cognition in

older adults. Facilitation in measures such as the Stroop Test (Liu-Ambrose et al., 2008),

free recall (Perrig-Chiello et al., 1998), reaction time (Brown et al., 2009), and memory

(Cancela-Carral & Ayan-Perez, 2007) have all been documented following longer term

RE programs in older adults. Cassilhas et al. (2007) also demonstrated that 24 weeks of

either moderate or high intensity RE had equal, positive effects on cognition in elderly

adults. Similar results were also found by Nagamatsu et al. (2012), who discovered that

twice-a-week RE had a countering effect towards the customary decline in cognition seen

among aging adults. Clearly there is a need for more research in this area examining

these or similar measures of cognition and EF following acute RE in elderly subjects.

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