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Journal of Exercise Physiologyonline
April 2015
Volume 18 Number 2
Editor-in-Chief
Official Research Journal of
Tommy
the American
Boone, PhD,
Society
MBA
of
Review
Board
Exercise
Physiologists
Todd Astorino, PhD
Julien Baker,
ISSN 1097-9751
PhD
Steve Brock, PhD
Lance Dalleck, PhD
Eric Goulet, PhD
Robert Gotshall, PhD
Alexander Hutchison, PhD
M. Knight-Maloney, PhD
Len Kravitz, PhD
James Laskin, PhD
Yit Aun Lim, PhD
Lonnie Lowery, PhD
Derek Marks, PhD
Cristine Mermier, PhD
Robert Robergs, PhD
Chantal Vella, PhD
Dale Wagner, PhD
Frank Wyatt, PhD
Ben Zhou, PhD
Official Research Journal
of the American Society of
Exercise Physiologists
ISSN 1097-9751
JEPonline
The Psychological Health of Women After 16 Weeks of
Practicing Different Exercise Programs
Rosa Maria Soares Costa de Mendonça1, Adenilson Targino de
Araújo Júnior1, 2, Maria do Socorro Cirilo de Sousa2, 3, Helder Miguel
Fernandes1, 4
1University
of Trás-os-Montes and Alto Douro, Vila Real, Portugal
Institute of Technology Education, Campina Grande,
Paraíba, Brazil, 3Laboratory of Kinanthropometry and Human
Performance, Federal University of Paraíba, Brazil, 4Research Centre
for Sport, Health and Human Development, Vila Real, Portugal
2Federal
ABSTRACT
Mendonça RMSC, Araújo Jr AT, Sousa MSC, Fernandes HM. The
Psychological Health of Women After 16 Weeks of Practicing Different
Exercise Programs. JEPonline 2015;18(2):32-44. The purpose of this
study was to examine the effects of practicing different exercise
programs for 16 wks on various psychological dimensions of women.
A sample of 89 Brazilian women between 25 and 55 yrs of age (41.42
± 9.23 yrs), was divided into the following experimental groups:
strength training, dance, hydrogymnastics, and a sedentary control
group. Women completed rating scales with the following dimensions:
satisfaction with physical appearance (SPA), health perception (HP),
body image perception, self-esteem (SE), and depression. For the
analysis, estimated marginal averages for SPA, HP, and depression
were used. The ANCOVA results showed significant effects favorable
to all experimental groups on the group × time interaction factor for
SPA, HP, and SE. It was concluded that 16 wks of practical exercise
resulted in significant improvements in SPA, HP, and SE regardless of
the program, with the greatest effect shown by the strength training
group.
Keywords: Women, Health, Exercise
33
INTRODUCTION
Although the relationship between exercise and psychological well-being is not fully understood,
evidence suggests that exercise increases the levels of serotonin, norepinephrine, and dopamine, all
of which are important neurotransmitters of thoughts and emotions (39). Epidemiological studies
show that women have higher prevalence rates of mental and behavior disorders than men,
especially those related to anxiety and mood (3). Women are genetic carriers with greater
vulnerability and also experience physiological changes attributable to the reproductive cycle. These
considerations, together with environmental and psychosocial factors, neuroendocrine and
neurotransmitter functioning, and individual levels of resilience, play an important role in the diagnosis
of comorbidities (40,44). These conditions are generally accompanied by changes in behavior,
feelings, and personality traits throughout life (39).
According to previous research, the effects of exercise are better identified in programs lasting more
than 10 wks, both with regard to kinanthropometry (5,6,13,14,15,19,22) and psychologically
(2,8,9,17,22,28,34,41). However, the dose-response relationship to physical exercise and the
duration of the programs seem to be important factors in determining the effects. It is possible that a
longer intervention time not only promotes clearer recognition of the intensity of the effects but also
makes it more likely to distinguish the satisfactory dose-response relationship for each variable
investigated. Therefore, in this study, the intervention period was set at 16 wks -- a condition also
found in other studies (25,49,51). Gaining a better understanding of the relationship between exercise
programs and their effects may enhance our ability to use specific interventions involving exercise to
treat various psychological conditions.
However, much of this effectiveness is linked to the intervention processes of exercise combined with
other therapies such as medication and psychotherapy (41). Thus, the scientific interest in
investigating the behavior of different psychological dimensions such as satisfaction with physical
appearance, perceived health, self-esteem, and depression, and their association with physical
exercise is continuing (9).
Satisfaction with physical appearance, combined with the perception of body image, forms an
essential part of the complex mechanism of personal identity. Body image is observed to exceed the
characteristics of physical functional competencies and biological integrity (10). It is recognized as a
feeling where one experiences fulfillment as a person, integrating components related to physical
appearance in addition with the mental representation of size, shape, and facial features as well as
attitudes, cognition, feelings, and behaviors (36).
Although the concern for physical appearance is a common feature of behavior among women in
Western cultures, special attention should be paid to the representation of the body in Brazilian
culture, where this concept is closely tied to good physical appearance. This situation results in a
fertile ground for vanity, because women in search of the ideal body become obsessed with beauty.
The importance of physical appearance, particularly for women, is well known (2). Positive body
image together with good physical appearance represent an important vehicle for social mobility and
successful relationships (36), forming a significant portion of the aesthetic component of life, often to
the detriment of physical health (26).
The perception of health is a dimension that relates to one’s subjective opinion of health, that is, how
individuals view themselves when considering the daily stimuli of life (52). It is not only influenced by
variations in the experiences of each person but also by the availability of social and health services.
34
Although women live longer than men, they report higher morbidity and psychological problems and
use more health services (7). Demographic data on the Brazilian population show a higher
prevalence of negative health perceptions in women with low education, higher age, elevated stress
levels, reduced sleep periods, obesity, smoking habits, and little involvement in physical leisure
activities (23).
Self-esteem is a psychological dimension that plays a key role in explaining human behavior, and it is
an important indicator of emotional and social adjustment (20). It is defined as the quantitative
evaluative dimension of self-knowledge related to how individuals express appreciation of
themselves, their self-image, or their performance in a specific area of life (48). Women with higher
levels of self-esteem seem to be more emotionally stable and resistant to stress. On the other hand,
those with low self-esteem seem to be more susceptible to negative influences such as depression,
anxiety, dissatisfaction with their body, eating disorders, and suicidal tendencies (18).
Among the dimensions considered in this study, depression is a persistent, prolonged form of
negative mood that interferes with many aspects of life and should be understood as a multifactorial
disease that needs to be diagnosed and treated appropriately (50). Studies show that women are
more susceptible to depression than men. Biological factors are apparently the main reason for this
high incidence because of the constant hormonal fluctuations suffered during different stages of
reproductive life (4).
In general, it is understood that the female body has a greater vulnerability to changes in behavior
that are likely to impact psychological health. This research is relevant to social, economic, and
political concerns as well as public health, because psychological and physical dysfunctions lead to
chronic diseases, resulting in greater damage to quality of life and higher spending on health (28,45).
Finally, this study seeks to expand our knowledge of the effects of exercise on women’s
psychological health based on the hypothesis that practicing different exercise programs for 16 wks
can cause changes in the psychological dimensions of satisfaction with physical appearance, health
perception, self-esteem, and depression.
METHODS
Study Design
This is a longitudinal, quasi-experimental study that was conducted using comparative analysis within
and between groups on pre- and post-tests.
Subjects
The population consisted of a sample of 89 adult women aged between 25 and 55 (41.42 ± 9.23 yrs),
chosen to be examined in specific locations such as strength training and hydrogymnastics gyms,
and a public municipal institution. The probabilistic sample was randomly divided into four groups, of
which one was designated as the sedentary control group (CG) (n = 25) and three were experimental
groups: strength training (SG; n = 25), dance (DG; n = 18), and hydrogymnastics (HG; n = 21).
Participation was strictly voluntary, considering that women could neither be suffering from infectious
and/or chronic musculoskeletal diseases nor could they give any negative responses to questions on
the readiness for Physical Activity Readiness Questionnaire (PAR-Q).
Procedures
This study complied with the guidelines for research involving humans (Brazil, 2012). It was approved
by the Institutional Ethics Committee (number 124/2011). After signing the Statement of Individual
Consent Form, the subjects were given a scheduled day and time during which they had to complete
35
the questionnaire. All subjects were evaluated before starting the exercise program and again after
16 wks, providing two measurements at different times following the same procedures.
Dependent Variables: Psychological Dimensions and Instruments Used
With regard to satisfaction with their physical appearance (SPA), the following question was used:
“From 1 to 10, indicate how satisfied you feel with your body/appearance.” A response of 1 indicated
“not satisfied” and 10 indicated “very satisfied” (21). Perception of health (PH) relied on the question:
“From 1 to 10, indicate how healthy you consider yourself,” with 1 meaning “not healthy” and 10 “very
healthy” (52).
To measure body image perception (BIP), we used the Stunkard scale of silhouettes for adults,
validated in studies with the Brazilian population (1,16,42,46). The degree of body dissatisfaction is
given by the difference between current silhouettes (CS) and ideal silhouettes (IS). Values range
between −8 and 8, with a value of zero corresponding to satisfaction with the current body size,
positive values expressing a desire to be slimmer, and negative values indicating a desire to be fatter.
For the self-esteem dimension, we used the validated version of the Rosenberg self-esteem scale in
Portuguese (31,48). It consists of 10 items relating to one’s feelings of self-respect and selfacceptance. After the reversal of negative items, the sum of the 10 items provides a score with a total
range between 10 and 40; a high score reflects high self-esteem.
Finally, to evaluate depression, we used the adapted Beck Depressive Inventory (BDI) (27,29), which
consists of 21 items answered on a scale from 0 (“never”) to 3 (“always”), where the individual
expresses the amount of symptomatology experienced during the past week.
Independent Variables: Protocols of Physical Exercise (Experimental Groups)
All exercise protocols prescribed for the experimental groups followed the recommendations of the
American College of Sports Medicine (ACSM) (24).
Strength Training (SG)
To assess the initial condition of this group, the 8RM test was chosen with intervals of 2 to 5 min
between attempts of each exercise (43). After obtaining the exercise load, intervals equal to or
greater than 10 min were applied before moving on to the next exercise. When a fault signal was
obtained in the execution, the test was stopped. Thus, we validated, as the maximum baseline load,
the weight obtained in the last correct execution.
The training frequency was performed 3 times·wk-1 with a maximum weight established between 60%
and 70% of 8RM during a session of 50 to 60 min with 3 sets of 8 to 12 repetitions and intervals of 2
to 3 min. The major muscle groups were exercised by using weight machines, free weights, or
resistance equipment. Each session included a 10-min cardiorespiratory warmup (treadmill, bike, or
elliptical), followed by 40 min of strength training (muscular endurance) and 5 min of recovery. The
sequence of exercises comprised two types of training performed on alternate days. Training day A
consisted of 8 exercises and training day B had 9 exercises. A load increase of 5% to 10% was
applied when observed a facility in execute the exercise series.
Dance Group (DG)
This group also had 3 sessions·wk-1 with a maximum heart rate of 60% to 85% in a session of 50 to
60 min with the maximal heart rate calculated by the equation (220 – age). In the first week, the
subjects were instructed to measure their heart rate by palpation of the radial artery, pressing lightly
with the index and middle finger for 15 sec and then multiplying their count by 4. This group featured
36
aerobic training; the basic movements involved the major muscle groups in a continuous and
progressive form, using a minimum of three rhythmic variations of Brazilian folk dance per session
(samba, forró, axé, funk, xote, lambada) with a rhythmic cadence between 100 to 160 beats·min-1.
Each session included 10 min of warm-up, 45 min of main activity, and 5 min of recovery.
Hydrogymnastics Group (HG)
For the hydrogymnastic sessions, a pool 1.40 m deep was used so that water reached the subjects’
shoulder height. The water temperature was 25ºC. Exercise took place 3 times·wk-1 at a maximal
heart rate frequency intensity of 60% to 85%. The heart rate measurement was performed following
the pattern already described for the DG. The movement activities consisted of combined exercises
(cardiorespiratory and muscular endurance) of the major muscle groups and were organized into 4
parts, beginning with a 10-min warm-up. The first main part included 20 min of cardiorespiratory
exercises in the pool without equipment and with maximal heart rate frequency intensities of 50% to
65% and 60% to 85%. The second main part (15 min) involved resistance exercises using various
hydrogymnastic equipment along the edges of the pool, each lasting 2 to 3 min at a maximal heart
rate of 60% to 75% until the time was completed. Each session ended with 5 min of stretching and
relaxation.
Control Group (CG)
Subjects who met the inclusion criteria but reported no regular physical exercise activity during the
previous 6 months – the standard recommended by the ACSM (24) – were classified as sedentary.
They were asked not to start any exercise program but maintain their regular activities of daily life and
their normal eating habits during the study.
Statistical Analyses
Data were analyzed using the SPSS statistical sofware version 20 for the descriptive statistics of
mean and standard deviation and for inferential correlation analysis with regard to each health factor
(SPA, HP, BIP, SE, and depression). As for the differences between groups throughout the study
(baseline T1 and final T2 measurements), an ANCOVA of repeated measurements was performed.
The magnitude values of the differences (F value), significance (P value), and estimated effect size
(value of η²) with values greater than 0.01, 0.06, and 0.14 (representing small, medium, and high
effects, respectively) (12) were identified. In addition, the deltas of variation (Δ%) were determined by
calculating (T2 − T1)/T1 × 100. The level of significance was set at 5%. Moreover, using Cronbach’s
alpha coefficient, the internal consistency of the instruments to assess the levels of depression and
SE were estimated; pre- and post-test values of 0.89 for depression and 0.73 – 0.86 for SE were
obtained.
RESULTS
Good values were observed for the reliability of measurements, attesting to the internal consistency
of the questionnaire (Table 1).
Table 1. Values of the Internal Consistency of the Instruments (Cronbach’s α).
Beginning (Baseline)
16 Weeks
Self-Esteem (SE)
0.73
0.86
Depression (BDI)
0.89
0.89
Regarding satisfaction with physical appearance (SPA), results demonstrated a significant interaction
effects of the time × group factor (F (3, 84) = 8.29, P<0.001, η² = 0.23), with Group (F (3, 84) = 8.29,
37
P<0.001, η² = 0.23), having the most positive average change (Table 2). In addition, the significant
effects of the time factor (F (1, 84) = 108.732, P<0.001, η² = 0.56) were reported with an elevated effect
size, where an increase in the SPA during the study, especially for SG (24.7%), was observed. CG
group (−5.1%) alone did not indicate an improvement on this variable.
Results for health perception (HP) were similar. A significant interactive effect of time × group (F (3, 84)
= 13.76, P<0.001, η² = 0.33) and group (F (3, 84) = 13.76, P<0.001, η² = 0.33) occurred, showing the
highest amount of change for the SG (21.1%). The time factor likewise had a large effect on the
change (F (1, 84) = 140.114, P<0.001, η² = 0.62), and again only the CG (−9.0%) showed lower levels
of HP at the end of the study (Table 2).
As for the BIP, which was established by the difference between the current (CS) and ideal (IS)
silhouette, the ANCOVA results showed no interactive effect for the Time x Group factor (F (3, 85) =
0.899, P=0.445, η² = 0.03) or for the group effect on the measurements (F (3, 85) = 1.520, P=0.215, η²
= 0.05). The level of bodily dissatisfaction (CS-IS) was also unaffected by the time factor (F (1, 85) =
3.079, P = 0.083, η² = 0.07). Although no significant interaction effect of the group and time factors
were observed, the average variations (Table 2) show that the experimental groups SG, DG, and HG
had less dissatisfaction than the CG.
Table 2. Descriptive Analysis of the Psychological Variables: Satisfaction with Physical
Appearance, Perception of Health and Body Image Perception (n = 89).
Satisfaction with Physical Appearance
Strength Group-SG (n = 25)
Dance Group-DG (n = 18)
Hydrogymnastic Group-HG (n =21)
Control Group-CG (n = 25)
Perception of Health
SG
DG
HG
CG
Body Image Perceptionɟ
SG
DG
HG
CG
SE = Standard error
ɟVariable
Beginning (T1)
16 Weeks (T2)
Δ%
M ± SE
M ± SE
(T2−T1)
6.53 ± 0.00
6.53 ± 0.00
6.53 ± 0.00
6.53 ± 0.00
8.14 ± 0.26
7.42 ± 0.30
7.44 ± 0.29
6.20 ± 0.27
24.7
13.6
13.9
−5.1
7.15 ± 0.00
7.15 ± 0.00
7.15 ± 0.00
7.15 ± 0.00
8.66 ± 0.23
7.72 ± 0.26
8.14 ± 0.24
6.51 ± 0.24
21.1
8.0
13.8
−9.0
1.00 ± 081
1.44 ± 0.98
1.52 ± 0.81
1.44 ± 1.26
0.92 ± 0.86
1.11 ± 1.23
1.14 ± 0.65
1.48 ± 1.15
−8.0
−23.1
−25.0
2.8
described as average
Regarding self-esteem (SE), a moderate interaction effect of the two measurements occurred during
the 16 wks (F (3, 85) = 2.740, P=0.048, η² = 0.09) along with an effect of the group factor (F (3, 85) =
5.060, P=0.003, η² = 0.15), where only SG, DG, and HG had positive average variations. Moreover,
the effect of the time factor on SE level was high (F (1, 85) = 10.364, P=0.002, η² = 0.11). The CG was
38
the only group to have a negative change in score (−1.3%), apparently reflecting a lower level of SE
in the sedentary group when compared with the initial assessment (Table 3).
With regard to depression, all average variations were negative (Table 3, n = 89). However, the
ANCOVA demonstrated that the interaction effects of time × group (F (3, 84) = 1.417, P=0.244, η² =
0.05) and group (F (3, 84) = 1.417, P=0.244, η² = 0.05) were not relevant. The same effect occurred for
the Time factor (F (1, 84) = 2.811, P=0.097, η² = 0.03).
Table 3. Descriptive Analysis of the Psychological Variables: Self-Esteem and Depression.
Self-esteem ɟ
Strength Group-SG (n = 25)
Dance Group-DG (n = 18)
Hydrogymnastic Group-HG (n = 21)
Control Group-CG (n = 25)
Depression
SG
DG
HG
CG
Beginning (T1)
16 Weeks (T2)
Δ%
M ± SE
M ± SE
(T2−T1)
33.32 ± 4.46
33.22 ± 2.57
33.67 ± 3.02
31.68 ± 4.79
36.12 ± 4.19
34.33 ± 3.86
36.14 ± 2.88
31.28 ± 5.17
8.4
3.3
7.4
−1.3
10.91 ± 0.00
10.91 ± 0.00
10.91 ± 0.00
10.91 ± 0.00
7.38 ± 1.04
7.18 ± 1.21
6.29 ± 1.13
9.50 ± 1.09
−32.4
−34.2
−42.3
−12.9
SE = Standard error ɟVariable described as average ± SD
DISCUSSION
The comparative analysis was favorable to all three experimental groups over the control group.
Regardless of the exercise program selected, physically active women had better results than the CG
in the psychological dimensions studied, most significantly in their SPA, HP, and SE, after 16 wks of
training.
The scores for SPA and BIP, two somewhat related variables, showed a higher difference for the SG.
Similarly, this condition was present in other studies (2,8,16,17,28,33,37), suggesting that resistance
training may provide the most visible changes in body appearance with more toned and defined
muscles when compared with the practitioners of dance and hydrogymnastics. Another fact to
consider is the slightly younger average age of the SG (38.84 ± 9.97 yrs), as studies on body image
in Brazil have repeatedly demonstrated that younger women show more concern with physical
appearance (36).
A longitudinal study (22) of the effects of exercise on psychological variables (perception of health,
body and life satisfaction, and depression) in middle-aged and elderly women showed that 24 wks of
resistance training promoted beneficial changes in health perception and depressive symptoms.
Moreover, significant changes in these measurements were found only in the second phase (13 to 24
wks) of intervention, corroborating the findings of this study at 16 wks. The authors comment that
muscle strengthening can provide the stimulus needed to improve the performance of daily life
activities and feelings about one’s general welfare. Thus, the perceived improvements in functional
capacity would also provide an experience of being in charge, increasing one’s physical self-efficacy,
experiencing positive mood changes, and reflecting better psychological health. These results are
39
consistent with the present study, in which the experimental groups showed significant improvement
in HP and depression. However, it is noteworthy that the hydrogymnastics group, consisting of
somewhat older women (45.50 ± 8.81 yrs), showed minor fluctuations between the scores of the
dimensions analyzed. They stand out among other groups as less depressed after 16 wks. This result
may be explained by the different attitude toward health aspects adopted by older people. It is likely
that, as people grow older, their body’s functioning and basic health may become more important to
them than SPA and BIP (9).
Research conducted on Brazilian adults’ satisfaction with their bodies has found disparities in terms
of sex, age, and other evaluated dimensions (36). Simultaneously, most studies focus on female
adolescents and college-age samples and dissatisfaction with appearances is undeniably the most
analyzed component of the problematic relationship of a woman with her body (26,30). A neglect of
the perceptual dimension and cognitive, behavioral, and emotional components of body image has
been noticed (32). Therefore, the observations mentioned are also attributable to female samples in
other studies.
In literature reviews (2,28) and a meta-analysis (8) as well as other studies (17,33,37), changes in
body image and satisfaction with the body have been shown to occur through exercise. Some authors
have argued that resistance training produces the best results by promoting the most visible changes
in body appearance compared with other methods, leaving the muscles more toned and defined. It is
possible that strength training causes practitioners to feel stronger for this reason. Changes in body
weight, muscularity, and physical competence are considered to be possible influences in
understanding the effects of exercise on body image. In each individual, these perceptions can
produce positive changes in general attitude, whether or not any changes in body image have
actually occurred (11). This can be a positive feedback mechanism that enhances self-esteem and
increases satisfaction with the body. Likewise, it is reported that changes in body image are related to
subjective (perception) and objective (increased strength) physical changes. Thus, despite the
methodological differences between these studies, they appear to agree that strength training
induces more positive self-assessment of satisfaction with the body, BIP, and self-esteem among
women. This view is corroborated by the present study, which found through comparative analysis
that the practitioners of strength training had higher scores in SPA and SE. Similarly, scores related
to BIP reflected less dissatisfaction with the body among this group after 16 wks of training.
Finally, some research studies have associated positive changes in depression with physical activity
(50), while others state that the frequency of exercise influences the amount of impact on the severity
of the disorder (38). Alternatively, the type of physical activity may be an important factor. For
instance, some studies have found that aerobic exercise has a greater influence on mood disorders
(22), which has been a major research focus in psychiatry. Researchers still do not know exactly what
causes depression, but they recognize that changes in brain function, particularly those caused by
physical exercise, advance one’s ability to combat depression at almost all levels (44). Aerobic
exercise performed over a significant time (at least 10 wks) has shown favorable results
(34,35,38,41,47). This condition was also confirmed by the present study, as women who engaged in
predominantly aerobic activities (dance and hydrogymnastics) experienced greater reduction of their
level of depression. Thus, at a superficial level of analysis, it is possible that improvement in certain
psychological constructs, represented here by SPA, HP, and SE, may not necessarily be associated
with positive changes in another construct (in this case, depression).
This study, along with evidence presented in previous studies, suggests some possibilities for future
research as well as guidance for professional practice. First, we should recognize the importance of
40
encouraging physical exercise among the sedentary population, given that the sedentary condition is
consistently associated with a less satisfactory state of health, physiologically and psychologically.
Another recommended measure would be to prescribe exercise programs lasting more than 12 wks
within a well-defined frequency, intensity, type, and time (FITT) model with an established empirical
basis. This study showed that time factor had significant influence on the effects of exercise on the
psychological dimensions studied, reinforcing the fact that interventions lasting fewer than 10 wks are
unlikely to have much impact.
The results also suggest the inclusion of strength training programs aimed at adult women as an
important activity for improving their SPA, HP, and SE. In this situation, although the SG consisted of
relatively younger women who tend to have the greatest level of concern about physical
attractiveness, the mean changes in these variables were largest among this group.
Discovering positive changes in the body, such as weight reduction or muscularity, may also lead to
the increased sense of self-efficacy and perception of personal skills, confirming that the complexity
of body image construction is related to the characteristics of physical appearance and encompasses
physical skills and biological integrity. In this study, the HG, consisting of older women who tend to
pay more attention to aspects of health, displayed greater change on these dimensions than the DG,
comprising younger women. The DG was the only group to experience a predominantly aerobic
exercise program, and it displayed less improvement on the three psychological variables tested.
This study has some limitations such as the sample size and length of intervention. It would be helpful
to reproduce this study with a larger number of subjects and a longer duration of exercise programs.
Still, delimiting the age and length of tighter physical practice complements the systematic control of
the daily habits of the control group with sedentary women. Similarly, there was no attempt to
maintain a record of subjects’ food intake, an important intervening variable in changes in body
composition, which could greatly influence the responses given to questions on psychological
dimensions.
CONCLUSIONS
The results indicate that 16 wks of practice of different exercise programs promoted significant
improvements in satisfaction with physical appearance, health perception, and self-esteem in adult
women. Furthermore, the effect was greatest among the practitioners of strength training, suggesting
that this type of exercise may be more effective and beneficial in certain psychological dimensions.
These results point to the need for deeper knowledge about the effects of exercise on the
psychological health of women. The results also provide insight to healthcare professionals,
particularly exercise physiologists, with regard to the suitability of various programs, the selection of
programs, and the dose-response relationship of exercise in promoting a more satisfactory level of
psychological health. They can also offer a direction for multidisciplinary teams such as the possibility
of including the practice of exercise in women’s health care.
Address for correspondence: Rosa Maria Soares Costa de Mendonça, PhD, University of Trás-osMontes and Alto Douro, Research Centre for Sport, Health and Human Development. Governador
Sílvio Pedroza Avenue 310/400 – Areia Preta – Natal/RN – Brazil. Zip-code 59014-100. Phone 55 84
99530313, Email: rosamendo@hotmail.com
41
REFERENCES
1. Almeida GAN, Santos JE, Pasian SR, Loureiro SR. Percepção de tamanho e forma corporal de
mulheres: estudo exploratório. Psicologia em Estudo. 2005;10:27-35.
2. Alves D, Pinto M, Alves S, Mota A, Leirós V. Cultura e imagem corporal. Motricidade. 2009;5:
1-20.
3. Andrade LHSG, Viana MC, Silveira CM. Epidemiologia dos transtornos psiquiátricos na mulher.
Rev Psiq Clín. 2006;33:43-54.
4. Boing AF, Melo GR, Boing AC, Moretti-Pires RO, Peres KG, Peres MA. Associação entre
depressão e doenças crônicas: um estudo populacional. Rev Saúde Pública. 2012;46:617623.
5. Bonganha V, Conceição MS, Chacon-Mikahil MPT, Madruga VA. Response of the Resting
Metabolic Rate after 16 Weeks of Resistance Training in Postmenopausal Women. Br J
Sports Med. 2011;17:350-353.
6. Bravo MF, Paredes FZ, Rodriguez FJR, Montero CC. Occupational physical activity and body
composition in adult women; pilot study. Nutricion Hospitalaria. 2013;28:1060-1064.
7. Brasil. Ministério da Saúde. Inquérito domiciliar sobre comportamentos de risco e
morbidade referida de doenças e agravos não transmissíveis: Brasil, 15 capitais e
Distrito Federal, 2002-2003. 2004; Rio de Janeiro: INCA.
8. Campbell A, Hausenblas HA. Effects of exercise interventions on body image: A meta-analysis.
J Health Psychol. 2009;14:780-793.
9. Cardoso FL, Zequinão MA, Felizola FLV, Ceola EPA, Matos PH. Percepção e satisfação
corporal em relação ao exercício físico. Revista Brasileira de Atividade Física & Saúde.
2011;16:95-99.
10. Cash TF. Encyclopedia of Body Image and Human Appearance. Waltham; Academic Press:
Ed, 2012.
11. Cash TF, Smolak L. Understanding Body Image: Historical and contemporary Perspectives. In:
T. F. Cash, L. Smolak (Editors.), Body Image: A Handbook of Science, Practice, and
Prevention, New York: The Guilford Press, 2011, pp. 3-11.
12. Cohen J. Statistical Power Analysis for the Behavioral Sciences: L. Erlbaum Associates,
1988.
13. Colado JC, Triplett NT. Effects of a short-term resistance program using elastic bands versus
weight machines for sedentary middle-aged women. J Strength Cond Res. 2008;22:14411448.
14. Colado JC, Xavier GM, Rogers ME, Tella V, Benavent J, Dantas EH. Effects of aquatic and dry
land resistance training devices on body composition and physical capacity in postmenopausal
women. J Hum Kinet. 2012;32:185-195.
42
15. Costa PRF, Assis AMO, Silva MCM, Santana MLP, Dias JC, Pinheiro SMC, Santos NS.
Change in anthropometric parameters: The impact of a nutritional intervention program and
physical exercise on adult women. Public Health J. 2009;25:1763-1773.
16. Damasceno VO, Lima JRP, Vianna JM, Vianna VRA, Novaes JS. Tipo físico ideal e satisfação
com a imagem corporal de praticantes de caminhada. Rev Bras Med Esporte. 2005;11:181186.
17. Damasceno V, Vianna J, Silva J, Lima J, Fernandes H.M, Reis VM. Relationship between
anthropometric variables and body image dissatisfaction among fitness center users. Revista
de Psicologia Del Esporte. 2011;20:367-382.
18. Elavsky, S. Longitudinal examination of the Exercise and Self-Esteem Model in middle-aged
women. JSEP. 2010;32:862-880.
19. Fagherazzi G, Vilier A, Balkau B, Chapelon FC, Magliano DJ. Anthropometrics, body shape
over 12 years and risk of cancer events in pre- and post-menopausal women. Int J Cancer.
2013;133:740-749.
20. Fernandes HM. O Bem‐Estar Psicológico em Adolescentes: uma abordagem centrada no
florescimento humano. [Tese de doutorado]. Vila Real—Portugal: Universidade de Trás-osMontes e Alto Douro, 2007.
21. Fernandes HM, Vasconcelos-Raposo J, Brustad R. Factors associated with positive mental
health in a Portuguese community sample: A look through the lens of Ryff’s psychological wellbeing model. In: Essential Notes in Psychiatry. Victor Olisah (Editor), InTech Europe,
Croatia, 2012:415-514.
22. Fernandes HM, Vilaça-Alves J, Novaes GS, Furtado H, Oliveira D, Aidar FJ, et al.
Psychological responses to resistance training in middle-aged and older women. J Sports Med
Phys Fitness. 2013;53:57-62.
23. Fonseca SA, Blank VLG, Barros MVG, Nahas MV. Percepção de saúde e fatores associados
em industriários de Santa Catarina, Brasil. Cad Saúde Pública. 2008;24:567-576.
24. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM et al. American
College of Sports Medicine position stand. Quantity and quality of exercise for developing and
maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy
adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43:1334-1359.
25. Gerage AM, Cyrino ES, Schiavoni D, Nakamura FY, Ronque ERV, Gurjão ALD, Gobbi S. Efeito
de 16 semanas de treinamento com pesos sobre a pressão arterial em mulheres normotensas
e não-treinadas. Rev Bras Med Esporte. 2007;13:361-365.
26. Goldenberg M. Afinal, o que quer a mulher brasileira? Psicologia Clínica. 2011;23:47-64.
27. Gomes-Oliveira MH, Gorenstein C, Neto FL, Andrade LH, Wang YP. Validation of the Brazilian
Portuguese version of the Beck Depression Inventory-II in a community sample. Rev Bras
Psiquiatr. 2012;34:389-394.
43
28. Gonçalves CO, Campana AN, Tavares MC. Influência da atividade física na imagem corporal:
Uma revisão bibliográfica. Motricidade. 2012;8:70-82.
29. Gorenstein C, Andrade L. Inventário de depressão de Beck: Propriedades psicométricas da
versão em português. Revista de Psiquiatria Clínica. 1998;25:245-250.
30. Grogan, S. (2008). Body Image: Understanding Body Dissatisfaction in Men, Women, and
Children. (2nd Edition.). Routledge: Taylor & Francis Group.
31. Hutz CS, Zanon C. Revisão da adaptação, validação e normatização da escala de autoestima
de Rosenberg. Avaliação Psicológica. 2011;10:41-49.
32. Kakeshita IS, Laus MF, Almeida SS. “Living well but looking good: A modern health dichotomy”
A brief overview on women’s body image. Motriz. 2013;19:558-564.
33. Koyuncu M, Tok S, Canpolat A, Catikkas F. Body image satisfaction and dissatisfaction, social
physique anxiety, self-esteem, and body fat ratio in female exercisers and nonexercisers. Soc
Behav Personal. 2010;38:561-570.
34. Krogh J, Nordentoft M, Sterne JAC, Lawlor D. The Effect of Exercise in Clinically Depressed
Adults: Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin
Psychiatry. 2009;72:529-538.
35. Kull M, Ainsaar M, Kiive E, Raudsepp L. Relationship between low depressiveness and domain
specific physical activity in women. Health Care Women Int. 2012;33:457-472.
36. Laus MF, Kakeshita IS, Costa TMB, Ferreira MEC, Fortes LS, Almeida SS. Body image in
Brazil: Recent advances in the state of knowledge and methodological issues. Rev Saúde
Pública. 2014;48:331-346.
37. Martin Ginis KA, Eng JJ, Arbour KP, Hartman JW, Phillips SM. Mind over muscle? Sex
differences in the relationship between body image change and subjective and objective
physical changes following a 12-week strength-training program. Body Image. 2005;2(4):363372.
38. Moraes H, Deslandes A, Ferreira C, Fernando AMS, Ribeiro P, Laks J. O exercício físico no
tratamento da depressão em idosos: revisão sistemática. Rev Psiquiatr. 2007;29:70-79.
39. Ratey JJ, Hagerman E. Corpo ativo, mente desperta: A nova ciência do exercício físico e
do cérebro. Rio de Janeiro; Objetiva: 2012.
40. Rennó Jr J, Demarque R, Lobo HR, Cavalsan JP, Silva AG. Saúde Mental da Mulher:
transtornos psiquiátricos relacionados ao ciclo reprodutivo. Revista debates em psiquiatria.
2012;2:6-11.
41. Rethorst CD, Wipfli BM, Landers DM. The antidepressive effects of exercise: A meta-analysis
of randomized trials. Sports Med. 2009;39:491-511.
44
42. Scagliusi FB, Alvarenga M, Polacow VO, Cordas TA, Queiroz GKO, Coelho D, et al.
Concurrent and discriminant validity of the Stunkard’s figure rating scale adapted into
Portuguese. Appetite. 2006;47:77-82.
43. Simão R, Maior AS, Nunes APL, Monteiro L, Chaves CPG. Variações na Força Muscular de
Membros Superior e Inferior nas Diferentes Fases do Ciclo Menstrual. R bras Ci e Mov.
2007;15:47-52.
44. Souza VMS, Valadares AL, Costa-Paiva LS, Moraes SS, Pinto-Neto AM. Multimorbidity and
associated factors in Brazilian women aged 40 to 65 years: A population-based study.
Menopause. 2012;19:569-575.
45. Spence JC, McGannon KR, Poon P. The effect of exercise on global self-esteem: A
quantitative review. J Sport Exerc Psychol. 2005;27:311-334.
46. Stunkard AJ, Sorenson T, Schlusinger F. Use of the Danish Adoption Register for the study of
obesity and thinness. In: S.S. Kety, S.S., Rowland, L.P., Sidman, R.L., Matthysse, S.W. (Ed.),
The Genetics of Neurological and Psychiatric Disorders. New York: Raven, 1983, pp. 115120.
47. Vasconcelos-Raposo J, Fernandes HM, Mano M, Martins E. Relação entre exercício físico,
depressão e índice de massa corporal. Motri. 2009;5:21-32.
48. Vasconcelos-Raposo J, Fernandes HM, Teixeira CM, Bertelli R. Factorial validity and
invariance of the Rosenberg Self-Esteem Scale among Portuguese youngsters. Soc Indic Res.
2012;105:483-498.
49. Vecchio FB, Galliano LM, Coswig VS. Aplicações do exercício intermitente de alta intensidade
na síndrome metabólica. Rev Bras Ativ Fis e Saúde. 2013;18:669-687.
50. Vieira JLL, Rocha PGM, Porcu M. Influência do exercício físico no humor e na depressão
clínica em mulheres. Motriz. 2008;14:179-186.
51. Vieira JLL, Porcu M, Buzzo VAS. A prática da hidroginástica como tratamento complementar
para pacientes com transtorno de ansiedade. J Bras Psiquiatr. 2009;58:8-16.
52. Vintém JM. Inquéritos Nacionais de Saúde. Auto-percepção do estado de saúde: uma análise
em torno da questão de gênero e da escolaridade. Revista Portuguesa de Saúde Pública.
2008;26:5-16.
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