Int. J. Environ. Res. Public Health 2015, 12, 3077-3090; doi:10.3390/ijerph120303077 
 
International Journal of 
Environmental Research and 
Public Health 
ISSN 1660-4601 
www.mdpi.com/journal/ijerph 
Article 
Attentional Distraction during Exercise in Overweight and 
Normal-Weight Boys 
Benedicte Deforche 1,2,* and Ilse De Bourdeaudhuij 3 
1 Department of Public Health, Ghent University, De Pintelaan 185, 9000 Gent, Belgium 
2 Department of Human Biometrics and Biomechanics, Vrije Universiteit Brussel, Pleinlaan 2,  
1050 Brussel, Belgium 
3 Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2,  
9000 Gent, Belgium; E-Mail: Ilse.Debourdeaudhuij@UGent.be 
* Author to whom correspondence should be addressed; E-Mail: Benedicte.Deforche@UGent.be. 
Academic Editor: Andrew P. Hills 
Received: 19 October 2014 / Accepted: 4 March 2015 / Published: 13 March 2015 
 
Abstract: The purpose of this study was to investigate the effect of attentional distraction 
on field running distance and activity intensity during an exercise session in normal-weight 
and overweight youngsters and to investigate potential mediators. Fifty-three 12–14 yr-old 
boys participated twice in a 12-min running test and a 20-min exercise session, once  
with attentional distraction (by listerning to music) and once without distraction 
(counterbalanced randomised controlled design). At the end of the endurance test running 
distance was recorded. During the exercise session activity intensity was assessed by 
accelerometers. After each experiment, rate of perceived exertion (RPE) was estimated and 
seven questions were asked about how participants experienced the experiment. Both 
overweight and normal-weight boys ran further during the running test with music  
(p < 0.05) and this effect was mediated by a decrease in feelings of annoyance. During the 
exercise session with music, both overweight and normal-weight boys exercised less at low 
and high intensity and more at moderate and very high intensity (p < 0.01) and this effect 
was mediated by a decrease in RPE. We can conclude that attentional distraction  
has a positive effect on running distance on a field endurance test and on activity  
intensity during an exercise session through different mechanisms in both overweight and 
normal-weight boys.  
OPEN ACCESS
Int. J. Environ. Res. Public Health 2015, 12 
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Keywords: adolescents; music; obesity; physical activity; running performance 
 
1. Introduction 
Overweight youngsters are found to be less active or to be active at a lower intensity than  
normal-weight counterparts [1,2]. As regular physical activity of high enough intensity is essential in 
the prevention of obesity [3,4], efforts should be made to increase physical activity adherence in 
overweight youngsters.  
Enjoyment is the most important predictor of physical activity in children [5–7]. Unfortunately, 
overweight youngsters generally do not choose to be active because they like it, but rather because 
they hope to lose weight or look better [8]. These extrinsic motives may not encourage continued 
participation in physical activity, since weight-loss directly attributable to increased physical activity is 
usually small [9]. The lack of direct effects of physical activity may disappoint overweight youngsters 
and cause drop-out. In addition, overweight youngsters perceive more barriers towards physical 
activity [8,10,11]. They find it more exhausting and report more physical complaints such as side 
stiches, knee pain, suffocating feeling, excessive sweating, etc. Moreover, a higher perception of 
barriers in overweight youngsters is related to a lower participation in physical activities [11]. Since 
physical activity plays an important role in the prevention of overweight, it is important to find 
solutions to overcome these barriers and to intrinsically motivate overweight youngsters to be 
physically active. A key element is that overweight youngsters should perform enough activity to 
substantially increase total energy expenditure. This can be accomplished either by prolonging the 
duration of the activity or by raising its intensity. Generally, the importance of exercise duration, rather 
than intensity, is emphasized to promote a significant fat oxidation and to prevent drop-out [12].  
The intensity of physical activity has been found to be negatively associated with exercise adherence 
in overweight children and adults [13,14]. This could be due to the fact that higher intensity activities 
entail more physical complaints and are therefore experienced as less pleasant. However, especially 
activities of moderate to high intensity have shown to contribute to the prevention of weight gain in 
adults [15,16]. It might be interesting to investigate ways to increase exercise intensity in overweight 
youngsters without increasing physical complaints or annoyance.  
It is possible that attentional distraction may increase adherence to higher intensity activities in 
overweight youngsters. Previous experiments in athletes showed that by focusing attention to external 
stimuli (such as music) instead of internal sensory information (such as heart rate, breathing, bodily 
symptoms) running performances increased [17]. Although the effect of attentional distraction is well 
established in athletes, only one study has investigated this issue in overweight people. A previous 
experiment in obese children and adolescents [18] showed that attentional distraction by music has a 
positive effect on perseverance during a treadmill test. This study was performed in a controlled 
laboratory environment. As findings from a laboratory setting might not be transferable to field 
settings and the effect of attentional distraction on activity intensity during an exercise session has not 
been studied yet, further research is needed to investigate whether attentional distraction is also useful 
to increase performance in field conditions and during exercise programs in overweight youngsters.  
Int. J. Environ. Res. Public Health 2015, 12 
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The purpose of this study is to investigate the effect of attentional distraction in overweight versus 
normal-weight youngsters on: (1) running distance in the field and on intensity of activity during an 
exercise session (primary outcomes) and (2) rate of perceived exertion (RPE), degree of annoyance, 
attention given to bodily sensations or thoughts about being able to carry on (secondary outcomes).  
We hypothesize that attentional distraction will have a positive effect on primary and secondary 
outcomes in both exercise conditions. As overweight youngsters report more physical complaints 
while exercising [8], we further hypothesize that this effect will be stronger in overweight compared to 
normal-weight youngsters. In addition, we want to investigate whether the effect of attentional 
distraction on exercise performance is mediated by changes in rate of perceived exertion (RPE), degree 
of annoyance, attention given to bodily sensations or thoughts about being able to carry on. 
2. Methods 
2.1. Participants 
Four classes of 12 to 14 year old boys (N = 53) were recruited in a boys’ technical/vocational 
school with high overweight prevalence and were grouped into normal-weight or overweight 
according to international cutoffs for overweight in children [19]. Based on differences in running 
performance with and without distraction found in a previous laboratory study in obese children and 
adolescents [18] an a priori power analysis was conducted. This analysis showed that to study 2 × 2 
within-between interactions with a power of 0.80 (given a 0.05 level of significance), a total sample 
size of minimum 38 subjects was needed. All participants were orally informed about the purpose of 
this study and received an information letter for their parents. Written informed consent was obtained 
from all boys and their parents before participating in the study. The study was conducted in 
accordance with the Declaration of Helsinki, and the protocol was approved by the ethical committee 
of the Ghent University Hospital.  
2.2. Procedure 
Participants performed twice a field running test and participated twice in an exercise session, once 
with attentional distraction and once without distraction. To control for order effects, in both the 
running test and the exercise session, half of the classes started with distraction and half of the classes 
without distraction (counterbalanced design). As randomization of order of the conditions was at the 
class level and not individual level, this was a quasi-experimental randomized controlled design. Since 
tests were performed during physical education classes, they took place each time at the same day of 
the week and the same time of the day. There were two weeks between each test. No encouragement 
was given during the tests.  
2.3. Measurements 
2.3.1. Anthropometric Measurements 
Height was measured to the nearest 0.1 cm using a stadiometer (Holtain Ltd, Crymmych, Pembs, 
UK). Body mass was measured to the nearest 0.1 kg on a digital balance scale (Seca, max 200 kg, 
Int. J. Environ. Res. Public Health 2015, 12 
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Hamburg, Germany) with the participant wearing lightweight clothing and no shoes. BMI was 
calculated from height and weight measures (weight in kg/height in m2). 
2.3.2. Physical Activity 
Physical activity was estimated using a modified version of the Baecke Questionnaire [20], 
previously used to assess physical activity in 12–18 year old youngsters [8,21]. Responses to  
13 questions were scored on a 5-point scale and resulted in two indices reflecting physical activity 
during sport (sport index) and during leisure time excluding sport (leisure time index). Items regarding 
physical activity during work were omitted for this study. A sport score was calculated from a 
combination of the intensity of the (organised or non-organised) sport which was played, the amount 
of time per week playing that sport, and the proportion of the year in which the sport was played 
regularly. The sport index was calculated from the sport score, level of activity in comparison with 
friends and frequency of sweating during leisure time physical activities. The leisure time index was 
based on the amount of television watching and the frequency and daily amount of walking or cycling 
as a means of transportation. The validity of the Baecke Questionnaire for the assessment of physical 
activity has been previously reported [22,23].  
2.3.3. Field Running Performance 
Field running performance was assessed by the Cooper Test [24] which is a 12 min running test. 
Different investigators found high correlations (0.82 < r < 0.94) between VO2max and performance on 
the 12 min running test in young adults [25,26]. The tests were performed on an outdoor athletics 
track. Weather conditions were similar on the test days with and without attentional distraction. In the 
condition with attentional distraction, participants were wearing a portable audio player (Sony D-EJ 750, 
G-protection). As the largest benefits to RPE were found with music that is preferred [27], each 
participant could bring his own favourite music. Music volume was standardised, however tempo was 
not controlled. At the end of the endurance tests running distance was recorded. 
2.3.4. Activity during Exercise Session 
The exercise session consisted of a 20 min exercise circuit with focus on movements with vertical 
displacement of the body. Participants were not wearing a portable audio player, but music was played 
on a CD-player (AZ 2030, Philips, Eindhoven, The Netherlands). It was a mix of popular hits with a 
fast tempo and a strong rhythm. During the exercise sessions physical activity was assessed by 
accelerometry (model 7164, Computer Science Application, Inc., Shalimar, FL, USA). The 
accelerometers were set to measure activity counts in an epoch time of one minute. Activity counts are 
the summation of the accelerations measured over the epoch and are used to determine the intensities 
of activities performed. A distinction was made between minutes of less than 1952 counts (less than  
3 METS), 1952 to 5724 counts (3.0 to 5.99 METS), 5725 to 9498 counts (6.0 to 8.99 METS) and more 
than 9498 counts (more than 8.99 METS), corresponding respectively to activity of light, moderate, 
high and very high intensity [28]. Participating boys were imposed to wear the accelerometer above 
the right hipbone, underneath the clothes. Accelerometers were held in place with an elastic belt and 
Int. J. Environ. Res. Public Health 2015, 12 
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adjustable buckle. The accelerometer has been shown to be a valid and reliable tool for the assessment 
of physical activity in children [29–31].  
2.3.5. Rate of Perceived Exertion 
After each test or exercise session, rate of perceived exertion (RPE) was obtained using the Borg 
15-point category scale [32]. RPE is defined as the subjective intensity of effort, strain, discomfort 
and/or fatigue experienced during exercise. The Borg 15-point category scale consists of numbered 
categories, 6–20, and verbal cues from “very, very light” to “very, very hard”. This scale is commonly 
used to measure RPE during exercise in normal-weight and overweight youth [33–35]. 
2.3.6. Questionnaire 
After each test or exercise session seven questions were asked about how the participants 
experienced the test or the session using a 5-point scale (1 = not at all, 5 = very much). Participants 
reported (1) how annoying they experienced the test (or exercise session), (2) how much attention was 
given to bodily sensations during the test (or exercise session), (3) how often they had thoughts about 
being able to carry on with the test (or exercise session), (4) to what extent they liked the music, (5) to 
what extent they could listen to the music during the test (or exercise session), (6) how pleasant they 
found the test (or exercise session) while listening to music, and (7) to what extent they believed they 
could run further (or exercise more intensively) while listening to music. The latter four questions were 
only assessed in the conditions with attentional distraction. The first three questions were assessed 
after the tests with and without attentional distraction.  
2.4. Statistical Analyses 
Data were analysed using SPSS software (version 21.0). Values of p < 0.05 were considered 
statistically significant. Effect of attentional distraction was studied using a 2 (condition: distraction 
versus no distraction) × 2 (group: normal-weight versus overweight) repeated measures analyses of 
variance. Results from items only obtained during the tests with distraction were analysed with 
independent samples t-tests. 
Mediation of attentional distraction effects in primary outcomes (running distance and activity 
intensity) by attentional distraction effects in secondary outcomes (RPE, degree of annoyance, 
attention given to bodily sensations or thoughts about being able to carry on) was tested using a 
within-subject method suggested by Judd et al. [36]. In order to do this analysis, there must first be a 
distraction effect for both the primary outcomes (dependent variable) and secondary outcomes 
(mediator variables). Mediation analysis was performed by estimating a regression model where the 
difference in running distance/activity intensity (with music minus without music) was regressed onto 
the sum of the mediator variables and the difference of the mediator variables. If the regression 
coefficient for the difference predictor is significant, this indicates that differences in running 
distance/activity intensity are mediated by differences in the mediator variable. If the sum predictor, 
but not difference predictor, is mean-centered (each participant’s score subtracted from the mean score 
of the sample), complete mediation is indicated by a non-significant intercept [36]. In order to be able 
Int. J. Environ. Res. Public Health 2015, 12 
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to assess complete mediation mean-centered sums of the mediator variables were included in the 
regression analyses. 
3. Results 
3.1. Descriptive Charateristics of Participants 
Table 1 presents descriptive charateristics of the participants. There were no differences in age, 
height and leisure time index between overweight and normal-weight boys, but overweight boys had a 
higher weight and BMI and lower sport index compared to normal-weight peers. 
Table 1. Descriptive characteristics of participants. 
Characteristics 
Normal-Weight (n = 33) 
Overweight (n = 20) 
t 
p 
age (yrs) 
12.8 ± 0.6 
12.8 ± 0.8 
0.42 
0.67 
height (cm) 
160.0 ± 9.4 
163.2 ± 8.4 
−1.63 
0.11 
weight (kg) 
45.4 ± 7.3 
70.3 ± 13.7 
−7.5 
<0.001 
BMI (kg/m2) 
17.9 ± 1.5 
26.2 ± 3.7 
−9.5 
<0.001 
leisure time index * 
3.0 ± 0.6 
3.1 ± 0.7 
−0.52 
0.61 
sport index * 
3.3 ± 0.7 
2.9 ± 0.6 
2.04 
0.05 
Note: * 5 point scale.  
3.2. Field Running Performance 
Primary outcomes: Running distances during the field tests are shown in Figure 1. There were no 
significant distraction by group interaction effects (F = 1.3, n.s.). Both overweight and normal-weight 
boys ran further in 12 min with music than without music (F = 5.0, p < 0.05). Overweight youngsters 
showed poorer performances compared to their normal-weight counterparts (F = 40.5, p < 0.001).  
1445
2207,9
1617,2
2265,4
0
500
1000
1500
2000
2500
3000
normal weight
overweight
metre
no music
music
 
Figure 1. Running distance on the Cooper test with and without attentional distraction by 
music in normal-weight and overweight youngsters. 
Int. J. Environ. Res. Public Health 2015, 12 
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Secondary outcomes: There were no significant distraction by group interaction effects for RPE  
(F = 0.6, n.s). With music (11.8 ± 2.9), participants reported lower RPE compared to without music 
(13.1 ± 3.7) (F = 5.9, p < 0.05). Overweight youngsters reported higher rates of perceived exertion 
after the running tests compared to their normal-weight counterparts (14.0 ± 3.5 versus 11.2 ± 2.8)  
(F = 11.9, p < 0.001). When asking how participants experienced the running tests, both overweight 
and normal-weight youngsters found the test less annoying with music (2.1 ± 1.1) compared to without 
music (2.8 ± 1.4) (F = 10.1, p < 0.01). They also reported to pay less attention to bodily sensations 
during the test with music (2.3 ± 1.0) compared to without music (2.7 ± 1.4) (F = 4.6, p < 0.05). 
Overall, degree of annoyance was higher in overweight (2.3 ± 1.1) compared to normal-weight 
youngsters (2.8 ± 1.5) (F = 5.3, p < 0.05). There were no significant differences between conditions or 
groups, nor interaction effects (F < 3.8, n.s.) regarding how often they had thoughts about being able to 
carry on with the test. Experiences during the test with music did not differ between overweight and 
normal-weight boys (t < 1.6, n.s). Both groups reported that they liked the self-selected music a lot  
(3.9 ± 1.4), that they could listen quite good to the music during the test (3.4 ± 1.3), that it was quite 
pleasant to run while listening to the music (3.3 ± 1.5) and that they believed they could run further 
while listening to music (3.6 ± 1.5).  
Mediation: As attentional distraction had a significant effect on (1) RPE, (2) how annoying they 
experienced the running test and (3) attention given to bodily sensations during the running test, 
mediation analyses were performed for these three potential mediators. Only the difference in degree 
of annoyance mediated the difference in running distance between both conditions (β = −0.46,  
t = −3.34, p < 0.01). The intercept of the regression was non-significant (t = 0.7, n.s.) indicating a 
complete mediation. 
3.3. Activity during Exercise Session 
Primary outcomes: In Figure 2 the total duration of the exercise session is equalled to 100%.  
The proportion of time spent in activities of different intensity is represented by the different coloured 
bars. There were no significant distraction by group interaction effects (F < 0.8, n.s). Both overweight 
and normal-weight boys exercised less at low and high intensity and more at moderate and very high 
intensity with music compared to without music (F = 6.0, p < 0.01). Overweight boys exercised a 
higher proportion of time at low and moderate intensity and a lower proportion of time at high and 
very high intensity, compared to the normal-weight boys (F = 4.0, p < 0.05).  
Secondary outcomes: In both overweight and normal-weight boys, RPE was lower in the condition 
with music (11.7 ± 3.0) than without music (12.9 ± 2.5) (F = 9.3, p < 0.01). Overweight boys reported 
higher RPE after the exercise session (13.0 ± 2.9) compared to their normal-weight peers (11.2 ± 3.3) 
(F = 5.9, p = 0.01). When asking how participants experienced the exercise sessions, both overweight 
and normal-weight youngsters found the session less annoying with music (2.5 ± 1.1) compared to 
without music (3.1 ± 1.5) (F = 7.1, p = 0.01). Both groups also reported to pay less attention to bodily 
sensations during the session with music (2.1 ± 1.1) compared to without music (2.4 ± 1.1) and to 
think less about being able to carry on with the exercise during the session with music (1.9 ± 1.2) 
compared to without music (2.2 ± 1.3), but these differences were not statistically significant (F = 2.1 
and F = 3.2, n.s.). Although scores were generally somewhat higher in overweight compared to 
normal-weight boys, there were no significant group effects (F < 1.2, n.s.), nor distraction by group 
Int. J. Environ. Res. Public Health 2015, 12 
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effects (F < 0.3, n.s.). Experiences during the exercise session with music did not differ between 
overweight and normal-weight participants (t < 1.9, n.s). Both groups reported that they quite liked the 
music (3.0 ± 1.4), that they could listen quite good to the music during the exercise session (2.9 ± 1.3), 
that it was quite pleasant to exercise while listening to the music (3.2 ± 1.5) and that they believed they 
could exercise more intensively while listening to music (3.4 ± 1.3).  
2
4.2
3.7
26.6
38.2
44.5
51.8
38
43.7
36.1
24.3
35.2
13.9
15.8
0.2
22
0%
25%
50%
75%
100%
no music
music
no music
music
normal weight                overweight
low
moderate
high 
very high
 
Figure 2. Proportion of time spent in activities of different intensities during the  
exercise session with and without attentional distraction by music in normal-weight and 
overweight participants. 
Mediation: As attentional distraction had a significant effect on (1) RPE and (2) how annoying they 
experienced the exercise session, mediation analyses were performed for these two potential 
mediators. Only the difference in rate of perceived exertion mediated the difference in mean activity 
intensity during the exercise session between both conditions (β = −0.37, t = −2.6, p = 0.01).  
The intercept of the regression was non-significant (t = 1.8, n.s.) indicating a complete mediation. 
4. Discussion 
The purpose of this study was to investigate the effect of attentional distraction by music on field 
running distances and on intensity of activity during an exercise session. We also wanted to investigate 
whether the effect of attentional distraction was moderated by overweight status and mediated by RPE, 
degree of annoyance, attention given to bodily sensations or thoughts about being able to carry on. 
Results clearly indicated that both overweight and normal-weight boys ran further in 12 min while 
listening to their favourite piece of music compared to without music. This finding is in line with 
previous studies in students and athletes [17] and with the previous laboratory experiment in obese 
youngsters [18]. Further, we also found that both overweight and normal-weight youngsters were 
exercising at a higher intensity during the exercise session with music compared to without music. With 
music, some proportion of time spent in low intensity activity was probably replaced by moderate 
intensity activity and some proportion of time spent in high intensity activity was replaced by very high 
intensity activity. To our knowledge, this is the first study to investigate the effect of attentional 
distraction within the context of an exercise session. Since participants were exercising at a higher 
Int. J. Environ. Res. Public Health 2015, 12 
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intensity while listening to music, more energy was expended, which is the main aim of any exercise 
program for overweight youngsters.  
Previous studies suggest different ways in which music may enhance exercise performance. 
Szmedra and Bacharach [37] suggest that music might allow participants to relax and reduce muscle 
tension, thereby increasing blood flow and lactate clearance while decreasing lactate production in the 
working muscles and consequently having a psychobiological impact on exercise. Further, it is 
assumed that the exerciser has a limited attentional capacity [38,39]. During exercise individuals have 
access to internal sensory information (such as heart rate, breathing, pain,…) and external 
environmental cues (such as noise, music, other exercisers, scenery) that compete for attentional  
focus [40]. So, turning participants’ attention away from internal cues resulting from physiological 
stimuli through some distracter (such as music) during exercise, will prevent them from focusing on 
feelings of discomfort associated with exercise and will reduce perceived exertion. This hypothesis has 
been confirmed by several previous studies in adults [37,41–49] and is also in agreement with the 
findings of this study. With music, participants reported lower RPE and paid less attention to bodily 
sensations compared to without music. However, only RPE and not attention paid to bodily sensations 
was found to be a mediator of the effect of attentional distraction and a decrease in RPE only mediated 
the effect of attentional distraction on activity intensity during the exercise session, but not on field 
running performance. Some studies also suggest that music enhances enjoyment levels during  
exercise [40,43,49,50]. Music may influence emotions and mask unpleasant feelings during  
exercise [51]. In this study, participants found the running test and the exercise session with music less 
annoying compared to without music. They may associate the music with positive past experiences,  
they may indulge in pleasant fantasizing or may focus attention on pleasant future events which may 
improve emotional or affective state during exercise [51]. Synchronisation of music with exercise may 
have a psyching-up effect [41]. However, a decrease in feelings of annoyance only mediated the effect of 
attentional distraction on field running performance, but not on activity intensity during the exercise 
session. From the mediation analyses, we can conclude that the effect of attentional distraction works 
through different mechanisms depending on the type of activity. Effect of music on the running test, 
which is a very monotonous and less pleasant activity, is mediated by feelings of annoyance, while the 
effect of music on activity intensity during the exercise session, which is a more diverse and pleasant 
activity, is mediated by RPE. 
Previous research showed that the effect of attentional distraction is different in trained versus 
untrained athletes [52]. Elite and novice athletes employ different cognitive coping strategies to meet 
exercise demands [53]. Trained athletes direct their focus to internal cues during exercise in order to 
adapt pace and intensity to the functional information of bodily sensations. Brownley et al. [54] 
demonstrated that listening to fast, upbeat music during exercise is beneficial for untrained runners but 
counterproductive for trained runners. We hypothesized that the effect of attentional distraction would 
also be different in overweight compared to normal-weight youngsters. Overweight youngsters report 
more physical complaints while exercising [8]. Therefore we expected the effect of attentional 
distraction to be stronger in overweight compared to normal-weight youngsters. However, this 
hypothesis was not confirmed, the effect of attentional distraction was similar in both groups.  
Although this was not the main purpose of this study, we also found that overweight youngsters 
showed poorer performances on the field running tests. This is in agreement with findings of previous 
Int. J. Environ. Res. Public Health 2015, 12 
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studies [21,55,56]. This poorer performance in this weight-bearing activity in overweight youngsters is 
probably mainly due to the fact that excess body fat adds to the mass of the body without contributing 
to its force producing capability, thus becoming an inert load to be moved during running. Another 
explanation could be that overweight youngsters avoid running because of the greater energy cost 
required to move the total body. In this case the poorer performance could be the consequence of a 
lack of experience in running. Overweight youngsters also exercised at a lower activity intensity 
during the exercise sessions compared to normal-weight counterparts. Although performances were 
generally lower in overweight youngsters, they reported higher rates of perceived exertion and they 
found the exercise session more annoying compared to normal-weight youngsters. Obese children 
generally rate perceived exertion higher than normal-weight counterparts when subjected to standardised 
workload on a treadmill [57,58]. These higher rates of perceived exertion and annoyance are in line with 
previous findings that overweight youngsters report more physical complaints and perceive less 
enjoyment while exercising [8]. Since this study demonstrated that attentional distraction by music 
increases exercise performance and intensity without increasing physical complaints or annoyance, this 
might be a useful strategy to increase enjoyment and exercise adherence in overweight youngsters. 
Future research needs to investigate whether listening to music also has a positive effect on motivation 
to exercise. As exercising while listening to music is perceived as less annoying or more pleasant, this 
might increase intrinsic motivation [59]. 
This was the first study to investigate the effect of attentional distraction in overweight and  
normal-weight youngsters in field settings. Previous studies in this field were conducted in  
normal-weight adults, only one laboratory study was conducted in obese youngsters [18]. However, 
this study has some limitations. First, the results of this study are limited to overweight boys and 
cannot be generalised to overweight girls. Secondly, it is possible that there were differences in sexual 
or skeletal maturity between normal-weight and overweight boys. Unfortunately we were not able to 
assess this. Thirdly, it is unknown which features of the music were critical in obtaining the distraction 
effect. Previous studies showed that the effect of distraction may depend on type of music, music 
tempo, music loudness, synchronisation with exercise or emotional significance of the music [17]. 
Next, the effect of distraction on exercise intensity was limited to a standardised 20 min exercise 
session. Further research is needed to investigate whether attentional distraction also works within a 
more comprehensive exercise program consisting of a variety of activities. Finally, in this study 
attention was distracted by music, the usefulness of other forms of distractions such as watching a 
video or environmental distraction (f.i. running on the beach or in a forest) needs further investigation. 
Our experience in overweight 6 to 12 year old children is that making activities part of an exciting 
adventure works well as a way of distraction.  
5. Conclusions 
The present study showed that attentional distraction by music has a positive effect on running 
distances on a field endurance test and on activity intensity during an exercise session. The effect on 
the field endurance test was mediated by feelings of annoyance, while the effect on activity intensity 
during the exercise session was mediated by RPE. This indicates that the effect of attentional 
distraction is working through different mechanisms depending on the type of activity. Despite our 
hypothesis that the effect of attentional distraction would be stronger in overweight compared to 
Int. J. Environ. Res. Public Health 2015, 12 
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normal-weight youngsters, the effect was similar in both groups. Motivating overweight youngsters to 
exercise at high enough intensity is a big challenge. Music may help overweight adolescents to enjoy 
physical activity and adhere to higher intensity physical activity. Further research is needed to 
investigate whether attentional distraction is a useful technique to increase exercise adoption and 
adherence in obesity prevention and treatment.  
Acknowledgements 
The authors are grateful to Cindy Stevens and Vanessa Vanhooren for their assistance in collecting 
the data.  
Author Contributions 
Benedicte Deforche and Ilse De Bourdeaudhuij conceived and designed the study. Benedicte Deforche 
coordinated the experiments analysed the data and wrote the paper. Ilse De Bourdeaudhuij critically 
reviewed the paper for writing and intellectual content. 
Conflicts of Interest 
The authors declare no conflict of interest. 
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Attentional distraction during exercise in overweight and normal-weight boys.
Deforche, Benedicte,De Bourdeaudhuij, Ilse