Web-based exercise intervention leads to mental health improvements in 3 months, according to controlled trial

Participants of a web-based physical activity intervention saw improvements in their depression, anxiety, and stress levels, according to findings published in the journal Mental Health And Physical Activity. Interestingly, these mental health benefits seem to have occurred without notable improvements in physical activity.

Despite the overwhelming evidence that physical exercise can improve mental health, many adults do not meet current physical activity recommendations — the World Health Organization recommends at least 150 minutes of moderate-intensity physical activity per week. Evidence suggests that the COVID-19 pandemic further decreased exercise levels among the public.

To encourage people to increase their movement, tech-based physical activity interventions have been developed. These interventions help support people in increasing their activity levels using online methods like smartphone apps, activity trackers, and social networks. Though these interventions are promising, it is unclear whether they offer mental health benefits.

“Web-based interventions have the potential to reach large populations cost-effectively,” explained study author Corneel Vandelanotte (@CorneelVDL), a research professor and Future Fellow at the Central Queensland University in Australia. “We know that they can improve physical activity outcomes, but much less is known on 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 residents of Australia who were currently inactive (i.e., they engaged in less than 150 minutes of moderate-to-vigorous physical activity per week). At baseline, the 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 a web-based physical activity intervention group.

The intervention group was given access to an action planning tool and eight physical activity sessions which were delivered over three months. Questionnaire responses and IF-THEN algorithms were used to offer participants personally tailored content and advice. The sessions addressed concepts like 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 following baseline, participants again completed psychological assessments.

The results revealed that, at all time points, participants who received the exercise intervention reported lower depression, anxiety, and stress and higher mental quality of life relative to baseline. Moreover, when compared to the control group, they reported lower depression, anxiety, and stress at the 3-month mark and lower anxiety at the 9-month mark.

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 as measured via an accelerometer. This is interesting given that participants nonetheless experienced significant improvements in mental health.

The findings indicate “that mental health improvements can be achieved using web-based physical activity interventions, even if physical activity does not improve (we found no significantly improved physical activity levels 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 results align with a psychological explanation for the mental health benefits of exercise. It seems 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 may promote feelings of achievement and improvements in self-worth and body image, regardless of whether or not a person has increased their exercise.

“What people believe has happened (they think they are more active), is more important than what actually happened (there was no actual physical activity increase) to achieve mental health improvements,” Vandelanotte said.

While the findings suggest that internet-based physical activity interventions are effective in improving mental health, the past literature has been mixed. Additional studies will be needed to confirm the findings. Furthermore, despite a large and well-powered sample, most of the study participants reported good mental health at baseline which may have limited the detection of mental health improvements due to ceiling effects. It is possible that populations with poorer mental health — like clinical samples — would have experienced greater mental health impacts with the intervention.

“This is only one study, findings need to be confirmed in other studies,” Vandelanotte said. “The findings do not apply to populations with clinical mental health problems, as participants in this study had generally good mental health even before the study (and the study was able to further improve mental health outcomes, but not by much, because of the high baseline).”

The study, “Impact of a web-based personally tailored physical activity intervention on depression, anxiety, stress and quality of life: Secondary outcomes 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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