The Effect of Combined (Physical - Skill) Exercises Using a Designed Device on Developing Some Shooting Skills for Basketball Players Under 18

The study aimed to dentifying the effect of using mixed physical and skill exercises with auxiliary tools to develop some basic skills to basketball players & as well as identifying the differences between the averages in physical tests between the control and experimental groups in some basic skills for players aged (14-16) years. The study assumed there are statistically significant differences between the tribal and remote tests of the control and experimental groups in some basic skills of basketball players aged (14-16) years, as well as the presence of statistically significant differences between the post tests of the control and experimental groups in some basic skills of basketball players. The researcher used the experimental method for its suitability to the nature of the research and the problem of the research. The research sample consisted of (12) players of the (Sulaymaniyah) basketball club, and they were chosen in a deliberate way, then they were randomly divided into two control and experimental groups, and each group consisted of (6) players. The control group used the coach’s approach, while the experimental group used exercises (physical and skill) with auxiliary tools prepared by the researcher to develop some basic skills in basketball. The exercises lasted for (8) weeks, with (3) training units per week. The researcher reached the compound exercises (physical and skill) with auxiliary tools had a great impact in developing some basic skills of basketball players & The skill exercises with auxiliary tools had an effective role in developing these skills adopted in the research. Through the conclusions, the researcher recommends The need to pay attention to the use of various complex physical and skill exercises with auxiliary tools to develop some of the basic skills of the players & Emphasis on the use of compound exercises (physical and skill) with auxiliary tools during the training units because of their effective role in developing the basketball skills of the players.

Wheelchair basketball is one of the sport that plays a significant role in the rehabilitation of individuals with special needs. Players must have a high degree of speed and focus their attention on different perceptual situations in the field. A total of 10 players were selected as sample from the Paralympics Subcommittee in the Babylon Province. They were randomly divided into experimental and control groups. After conducting the pre-tests, the combined exercises prepared by researchers were applied to the experimental group. These exercises were given to the experimental group in sessions of 30 minutes, three days per week. The control group followed the traditional curriculum. After conducting the post-test, the data were processed using the SPSS. The results indicated that the combined exercises positively contributed to the development of mental, physical, and dribbling skills of the wheelchair basketball players. Therefore, the authors recommend to include these combined physical exercises in the training curricula.

BACKGROUND Implementation of a structured physical exercise program can improve glycemic control in patients with type 2 diabetes mellitus. OBJECTIVE To evaluate the efficacy of aerobic exercise and resistance training (either alone or in combination) in the management of type 2 diabetes mellitus. DESIGN AND INTERVENTION DARE (Diabetes Aerobic and Resistance Exercise) was a 26-week, single-center, parallel-group, randomized, controlled trial of patients with type 2 diabetes mellitus of >6 months' duration. Participants were aged 39-70 years with a baseline [HbA.sub.1c] level 6.6-9.9%. Exclusion criteria included current insulin therapy, regular exercise regime and blood pressure >160/95 mmHg. All participants underwent a 4-week run-in period that comprised 12 sessions of combined aerobic exercise and resistance training; participants who attended [greater than or equal to] 10 sessions were eligible to enter the study. Eligible participants were randomly allocated to one of four groups: aerobic exercise alone; resistance training alone; combined aerobic exercise and resistance training; and no intervention (control group). Exercise was performed three times weekly. The aerobic exercise group progressed from 15-20 min on a treadmill or bicycle ergometer per session at 60% of the maximum heart rate to 45 min per session at 75% of the maximum heart rate. The resistance training group performed 7 different exercises on weight machines per 45 min session, and progressed to 2-3 sets of each exercise at the maximum weight that could be lifted 7-9 times. The combined exercise group performed the full aerobic exercise program plus the full resistance training program. Participants in the control group reverted to their pre-study exercise levels. OUTCOME MEASURES The primary outcome measure was the change in [HbA.sub.1c] from baseline. Secondary outcome measures included changes in blood pressure, lipid profile, and body composition. RESULTS A total of 251 participants were eligible for intervention. The median session attendance was 80% (aerobic exercise), 85% (resistance training) and 86% (combined exercise). When compared with the control group, the HbA1c levels were reduced by 0.50% in the aerobic exercise group (P = 0.007) and by 0.38% in the resistance training group (P = 0.038). The combined exercise group had an additional reduction of 0.46% when compared with the aerobic exercise group (P = 0.014) and of 0.59% when compared with the resistance training group (P = 0.001). Decreases in [HbA.sub.1c] levels were greatest for participants with a baseline [HbA.sub.1c] level = 7.5% (P CONCLUSION Although aerobic exercise or resistance training alone improved glycemic control, additional improvements were observed with the combined exercise regimen.

The combination of simultaneous physical and cognitive training has rarely been assessed in young adults. Here we consider whether one dual-task cognitive and physical session was more effective than a single – cognitive or physical session in enhancing mood and cognitive functioning. In addition, we assessed whether habitual physical activity (PA) is a moderator of these training regimens. Individuals (N = 116) aged 19–35 were randomly divided into four groups: physical exercise, cognitive exercise, combined physical-cognitive exercise, and control. Cognitive functioning was assessed by two tests of verbal fluency – phonemic fluency (PF) and semantic fluency (SF), and mood by the Profiles of Mood States (POMS). Level of PA was assessed by the International Physical Activity Questionnaire (IPAQ), and based on Metabolic Equivalents (METs) calculations, participants were divided into moderate- and high-level of PA. Three-way ANOVAs with repeated measures for the intervention groups and level of PA were conducted for each of the outcome measures – PF, SF, and POMS, followed by post-hoc comparisons. Results indicated that for those who engage in moderate-level PA, a session of combined physical and cognitive exercise is preferable over only physical or only cognitive, as the combined exercise may benefit both PF and mood. For high-level PA, combined exercise is not a stimulator for verbal fluency or for mood. Physical exercise as a single task is efficient in enhancing mood in those who engage in both moderate and high-level habitual PA. Further studies are recommended to explore the effect of simultaneously performed physical and cognitive exercise in young adults.

Background Children’s cognitive development includes key skills such as creativity, verbal fluency and executive functions, essential for academic performance, social interaction and adaptive behaviour. Educational interventions that integrate cognitive and physical stimulation have shown potential in supporting these developmental processes. Purpose This study adopted a randomised controlled trial (RCT) design to examine the effects of a combined abacus training and physical exercise intervention on 82 children aged six to 12 in Andalusia, Spain. The intervention lasted 12 weeks and consisted of twice weekly sessions integrating physical activity and abacus-based cognitive tasks. The study hypothesised that: Children who participated in the combined intervention would demonstrate significantly greater improvements in creativity, executive functioning, and verbal fluency compared with children in the control group. Method Participants were randomly assigned either to receive the intervention (experimental group), or to a control group. The three outcomes of interest were evaluated as follows: Creativity – through the Creative Intelligence Test (CREA); executive functions – through the Behaviour Rating Inventory of Executive Function (BRIEF); and verbal fluency – through phonological and semantic subtests of the Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V). Findings Children in the experimental group showed statistically significant improvements compared with their baseline performance and, in several outcomes, compared with the control group. Improvements were observed in creativity; executive functioning domains such as behavioural regulation, planning, and working memory; and phonological and semantic verbal fluency. Conclusions These findings provide promising evidence that combining physical exercise with abacus-based cognitive training may support the development of key cognitive skills in children. Further research involving larger samples, longer interventions, and longitudinal follow-up is recommended to confirm and extend these findings.

Background Some degree of cognitive decline is a normal, non-clinical part of aging. Physical exercise has been suggested as one strategy which may improve cognition in nondemented older adults. The findings of randomised, controlled trials conducted since the 1980s have been promising, but not unequivocal, and much remains to be understood about the relationship between exercise and cognition in older adults. There have also been suggestions that combining exercise and cognitive training may be beneficial. There has, however, been only one reported study comparing the benefits of exercise training, and combined exercise and cognitive training (Fabre, Chamari, Mucci, Masse-Biron, & Prefaut, 2002). While combined training was reported to be even more effective than exercise training alone for improving cognition in older adults, the study had some substantial limitations. Aims The overall aims of this thesis were to further explore the effect of exercise training on cognition in older adults, and to compare exercise training alone with combined exercise and cognitive training. Following a narrative review of the relevant literature, this thesis is presented in two parts. In Part One a randomized, controlled trial comparing the impact of exercise training, and combined exercise and cognitive training, on the cognitive functioning, physical functioning, functional performance, and psychological well-being of community dwelling older adults is presented. For Part One, there were three specific aims: (1) To assess the efficacy of a 16 week exercise program (relative to control), on measures of cognitive functioning, physical functioning, functional performance, and psychological well-being; (2) To compare the efficacy of the 16 week exercise program with that of a 16 week combined exercise and cognitive training program; and (3) To identify the physical, psychological and training factors associated with changes in cognitive and physical functioning from baseline to post-test. In Part Two a qualitative evaluation of older adults’ experiences and perceptions of exercise training, and combined exercise and cognitive training, is presented. Methods Thirty-nine community dwelling, older adults (aged between 60 and 80 years) were randomly allocated to one of three groups: Exercise, Combination or Control. Participants in the Exercise group attended three aerobic and strength training sessions per week for 16 weeks. Participants in the Combination group attended two aerobic and strength training sessions, and one cognitive training session, per week for 16 weeks. Participants in the Control group were contacted every four weeks. Assessments were conducted at baseline, post-test (16 weeks) and six-month follow-up (40 weeks). Measures of physical function, cognitive function, functional performance, and psychological wellbeing were collected, along with anthropometric and physiological measures. For the qualitative evaluation, participants from the Exercise and Combination groups provided written feedback to questions about their experiences of the two training programs and their perceptions of the outcomes. These qualitative data were collected after post-test. Results Significant within-group improvements in physical and cognitive function, from baseline to post-test, were seen in Exercise and Combination participants. Combination participants also showed significant within-group reductions in symptoms of anxiety and depression. There were, however, only a few significant between-group differences among Exercise and Control participants, and among Exercise and Combination participants. There were no significant within-group improvements in functional performance, from baseline to post-test, among Exercise or Combination participants. Six-month follow-up data were difficult to interpret, due to the paucity of between-group differences at post-test and the small sample size. There were several significant associations between physical, psychological and training factors, and changes in cognitive and physical functioning. The most pertinent finding was that baseline functioning was consistently associated with change, such that participants with low baseline scores were most likely to improve from baseline to post-test. In the qualitative evaluation participants reported positive experiences of the training programs and reported improvements in physical, cognitive, functional and psychological wellbeing. Participants also highlighted components of the programs which require improvement and made recommendations for future programs. Conclusions The results of this thesis provide some cautious support for the notion that exercise, and combined exercise and cognitive training, may result in small improvements in cognition, physical functioning, and psychological well-being in older adults. Some of the findings must be interpreted with caution, however, given the small sample size. More research is required into the functional (or ‘real world’) impact of this type of training, the long-term effects of training, and the factors associated with changes in cognitive and physical function. Based on these findings, recommendations for the development and implementation of future research were made. As the population ages and the public health burden attributable to aging increases, research into the development and efficacy of programs to enhance well-being and independence in older adults is of great importance.

Objective To investigate the effect of early combined functional exercise on lower limb rehabilitation of vessel bridge taken in coronary artery bypass surgery. Methods From January to October 2017, 90 patients undergoing coronary artery bypass surgery were randomly divided into control group and experimental group by coin toss, with 45 patients in each group. The control group was given routine nursing care, and the experimental group was given early combined functional exercise (foot dorsiflexion, ring rotation exercise and straight leg raising exercise) on the basis of routine nursing care. The difference of correlation index between two groups was compared. Results In the experimental group, the number of swelling in the thigh, crus and ankle were 20, 25 and 35 respectively; the control group was 32, 35, 43, the difference was statistically significant(χ2=6.55, 5.00, 8.38, P<0.05). The remission of limb swelling in the experimental group was also better than that in the control group(P<0.01). The incidence of limb wound complications: 6 cases in the experimental group, 18 cases in the control group (χ2=11.79, P<0.01)); limb muscle strength grade Lovett: experimental group 0 case with grade 3, 19 cases with grade 4, 26 cases with grade 5, control group 9 cases with grade 3, 26 cases with grade 4, 10 cases with grade 5, there were significant differences between two groups (χ2=17.20, P<0.05). The limb comfort score, postoperative bed time, postoperative hospital stay was (7.11±1.15) points, (5.28±1.07) d, (11.04±2.01) d in the experimental group and (5.18±1.13) points, (6.97±1.21) d, (12.67±1.59) d in the control group, the differences were significant(t=-8.02, 6.97, 4.23, P<0.01). Conclusions To carry out early functional exercise can not only take angiogenesis effectively reduce limb swelling rate after coronary artery bypass grafting, relieve the severity of limb swelling, but also can reduce the incidence of incision complications, promote the recovery of limb muscle strength, shorten the postoperative recovery time and postoperative hospitalization time, is worthy of promotion and use in clinical nursing work Key words: Functional exercise; Early rehabilitation; Vascular bridge; Lower limb; Coronary artery bypass grafting

This study aimed to assess the impact of a 12-week Aqua Fitness program on the physical fitness of older women and emphasize sustainable health practices for aging populations. We focused on evaluating the program's effectiveness, using the Senior Fitness Test to measure improvements in physical capabilities. An experimental research design was implemented, with 30 participants aged 60 and older. The participants were divided into a control group and an experimental group, each comprising 15 individuals. The control group received aqua Fitness exercises, and the experimental group received aqua fitness exercises and isometric (combined) exercises. Lower limb muscle strength, upper limb muscle strength, lower body flexibility, upper body flexibility, dynamic balance, agility, and endurance were assessed using the Senior Fitness Test. Assessments were conducted pre- and post-training. For a comparison within the group, combined exercises (aqua fitness and isometric exercises) had a significant effect on lower limb muscle strength, upper limb muscle strength, lower body flexibility, upper body flexibility on the right side, dynamic balance, agility, and endurance. Aqua fitness exercises alone showed significant effects on upper limb muscle strength, lower body flexibility, and endurance and no significant effects on other variables. For the comparison between groups, no significant differences were found between the effects of aqua fitness exercises and combined exercises on lower limb muscle strength, upper limb muscle strength, lower body flexibility, upper body flexibility, and endurance. Significant differences were found only in dynamic balance and agility between the two groups of aqua fitness and combined exercises. Although the combined program (aqua fitness and isometric exercises) had a greater effect on improving the physical fitness of older adults than aqua fitness alone, there was no significant difference between the two groups. Therefore, the results of this study highlight the potential of aqua fitness in promoting sustainable health and physical fitness in the older adult population.

The purpose of the present investigation was to evaluate the effects of 12 weeks exercise program participation on changes in %fat, serum lipid metabolism, leptin and adiponectin concentrations by groups in middle aged women. 20 obese women(above %fat 30) were participated in 12 weeks combined exercise program by exercise types and their %fat, leptin and adiponectin levels were assessed before program(0 week) and after program(12 weeks). Experimental groups were divided into two groups, control group(CG, n=10) and combined exercise group(EG, n=10), respectively. Regularly combined exercise(walking & resistance exercise) performed for 12 weeks. All data were expressed as mean and standard deviation by using SPSS/PC+ program, and to evaluate the differences before and after program groups, data were analyzed by paired t-test(a≤.05) and 2-way ANOVA was performed to examine the differences between groups and within groups by variables. In TC, TG and LDL-C after 12 weeks exercise program was decreased significantly in combined exercise group(p0.05), and in HDL-C after 12 weeks exercise program was increased significantly in combined exercise group(p0.05). In leptin response after 12 weeks exercise was decreased significantly in combined exercise group(p0.05). In adiponectin response after 6 weeks exercise was increased significantly in combined exercise group(p0.05). The change of leptin concentration was statistical significant difference between groups and within groups, and there was significant difference between group × period interaction(p0.01). And the change of adiponectin concentration was statistical significant difference within groups(p0.05). In conclusion, the regular combined(walking & resistance) exercise altered serum lipid metabolism, leptin and adiponectin responses in middle-aged obese women. Leptin and adiponectin responses to exercise training in obese women appear to be associated with body composition(body weight and %fat) alterations and exercise type(aerobic exercise or resistance training).

Background. This study focused on the effect of two selected training methods on angiogenic and angiostatic regulating factors in the blood circulation of elderly men. Methods. The present research is of a practical nature and was conducted with two experimental groups and one control group in the form of a pre-test and post-test. Overall, 30 people in the age range of 60‒65 years in the aerobic, combined, and control groups were selected as the research sample. An aerobic exercise protocol with an intensity of 60‒75% of the maximum reserve heart rate and combined exercise, including aerobic and strength training, with an intensity of 60‒75% of 1RM were implemented over 8 weeks. Blood sampling was performed 24 hours before the first session. Forty-eight hours after the last training session, leucine-rich alpha-2-glycoprotein 1 (LRG-1) and thrombospondin-1 (TSP-1) were measured by enzyme-linked immunosorbent assay, and the data were analyzed by the analysis of covariance test, post hoc least significant difference, and intra-group changes using a paired t-test at a significance level of P≤ 0.05. Results. After the protocol, there was a significant difference between the research groups in terms of LRG-1 (P≤ 0.005) and TSP-1 (P ≤ 0.001) compared to the control group. LRG-1 increased after combined training, while TSP-1 showed the greatest decrease after aerobic training. The results of the paired t-test indicated a significant increase in LRG-1 and a decrease in TSP-1 after the test compared to the pre-test in the group of aerobic and combined exercises. Conclusion. Combined and aerobic exercises are effective on the angiogenic and angiostatic factors of the elderly, but due to the greater effect of combined exercises on the angiogenic factors, it is recommended that the elderly, in addition to aerobic exercises, use strength exercises in their sports programs as well. Practical Implications. Compared to combined exercises, aerobic exercises have the greatest effects on increasing the angiogenic factor and reducing angiostatic factors in this age group, which may lead to an improvement in the quality of life.

체지방률 30% 이상인 비만 남고생을 대상으로 복합운동과 마늘환을 섭취시켜 신체조성, C-반응단백, 아디포넥틴에 미치는 영향을 구명하였다. 복합운동은 주 3회 70분씩 16주간 실시 하였으며, 마늘환 섭취는 점심 저녁 식후 5 g씩 섭취시켰으며, 실험 시작 전과 후에 신체조성과 혈액 분석결과 다음과 같은 결론을 얻었다. 신체조성에서 제지방률은 집단 내 복합운동+마늘환 섭취군에서 유의하게 감소하였다. 체지방률은 복합운동+마늘환 섭취군이 유의하게 감소하였고, 집단간 복합운동+마늘환 섭취군이 대조군보다 유의하게 감소하였다. 체수분은 집단 내 복합운동+마늘환 섭취군이 감소하였다. C-반응단백은 복합운동+마늘환 섭취군이 집단 내 유의하게 감소하였으며, 운동과 마늘의 성분의 상승작용으로 인해 긍정적인 효과가 나타난 것으로 생각된다. 아디포넥틴은 집단 내 모두 유의하게 감소하였다. 이상의 결과 복합운동과 마늘환의 섭취는 비만남고생의 체지방률 개선에 도움을 주었으며, 아디포넥틴에 대한 연구들이 필요하다고 생각된다. The purpose of this study was to investigate the effects of combined exercise program and garlic pill intake on Body Composition, CRP and Adiponectin in obese high school male students. Twenty-one male students in city B volunteered to participate, and the signed consents were received before the study. Experimental groups were garlic pill intake with combined exercise group (n=7), combined exercise group (n=7), control group (n=7). The total experimental period was 16 weeks. The combined exercise group exercised 3 times a week for 16 weeks with intensity of RPE 7~15. Each exercise was 70 minutes long. A 5 g garlic pill was consumed after lunch and dinner every day. For statistics, two-way repeated test within the group was conducted through SPSS 12.0; for post-examination, Scheffe was utilized; and for inter-group examination, a paired t-test was used. The conclusions of this study are as follows. Between groups, combined exercise with garlic pill group had a significant decrease in %body fat. Within each group, combined exercise with garlic pill group had a significantly greater decrease in %body fat than the control group. Between groups, combined exercise with garlic pill group had a significant decrease in LBM. Between groups, combined exercise with garlic pill group had a significant decrease in CRP. Between groups, combined exercise with garlic pill group, combined exercise and control group showed a decrease in adiponectin. In conclusion, regular exercise and garlic pill intake improved % body fat in obese high school male students.

Effects of combined exercise and sleep hygiene on obstructive sleep apnea severity in older adults: a randomized controlled trial.

We evaluated the cardiometabolic effects of a 15-week combined exercise programme, implemented in sports clubs, for 50–70-year-olds with low aerobic fitness. In a randomized controlled trial, 45 participants (26 women) with low fitness were randomly assigned (2:1-ratio) to a training group (TG, n = 30) or inactive control group (CG, n = 15). TG had 15 weeks with one weekly 90-min supervised group-based session in a recreational sports club with combined aerobic exercise and strength training and were encouraged to perform home-based training 30 min/wk. Evaluations of relative VO2max (mLO2/min/kg), blood pressure, resting heart rate (HR), echocardiography, peripheral arterial tonometry, body composition, lipid profile and HbA1c were performed at 0 and 15 wks. Average HR during supervised training was 113 ± 13 bpm (68.6 ± 7.0%HRmax), with 4.3 ± 6.6% spent >90%HRmax. At 15-wk follow-up, intention-to-treat analyses revealed no between-group difference for VO2max/kg (0.4 mLO2/min/kg, 95%CI −0.8–1.5, P = 0.519; −3 mL/min, 95%CI −123–118, P = 0.966) or other cardiovascular outcomes (all P > 0.05). Compared to CG, total fat mass (−1.9 kg; 95%CI −3.2 to −0.5, P = 0.005), total fat percentage (−1.3%, 95%CI −2.2 to −0.3, P = 0.01) and total/HDL cholesterol ratio (P = 0.032) decreased in TG. Regular adherence to supervised training was high (81%), but 0% for home-based exercise. In conclusion, the group-based supervised training was associated with high adherence and moderate exercise intensity, whereas insufficiently supported home-based training was not feasible. Together, 15 wks of combined exercise training did not improve aerobic fitness or affected cardiovascular function in 50–70-yr-olds with low aerobic fitness, whereas some positive effects were observed in metabolic parameters. Highlights Combined exercise training implemented in a sports club elicited moderate aerobic intensity in 50-70-year-old untrained individuals. Supervised group-based training had high adherence whereas unsupported home-based training had very low adherence. 15 weeks of low-frequency combined moderate intensity exercise training improved lipid profile and fat mass, but had no effect on cardiovascular fitness.

The aim of this study was to test whether combined physical exercise training of moderate intensity executed during the development of monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH) hinders the progression of pulmonary and right heart harmful functional and structural remodeling in rats. Wistar rats were injected with MCT (60 mg/kg) and after 24 h were exposed to a combined exercise training program: aerobic exercise (treadmill running-60 min/day; 60% of maximum running speed); and resistance exercise (vertical ladder climbing-15 climbs; 60% of maximum carrying load), on alternate days, 5 days/wk, for ∼3 wk. After euthanasia, the lung and right ventricle (RV) were excised and processed for histological, single myocyte, and biochemical analyses. Combined exercise increased the tolerance to physical effort (time until fatigue and relative maximum load) and prevented increases in pulmonary artery resistance (acceleration time (TA)/ejection time (TE)] and reductions in RV function [tricuspid annular plane systolic excursion (TAPSE)]. Moreover, in myocytes isolated from the RV, combined exercise preserved contraction amplitude, as well as contraction and relaxation velocities, and inhibited reductions in the amplitude and maximum speeds to peak and to decay of the intracellular Ca2+ transient. Furthermore, combined exercise avoided RV (RV weight, cardiomyocyte, extracellular matrix, collagen, inflammatory infiltrate, and extracellular matrix) and lung (pulmonary alveoli and alveolar septum) harmful structural remodeling. In addition, combined exercise restricted RV [nitric oxide (NO) and carbonyl protein (CP)] and lung [catalase (CAT), glutathione S-transferase (GST), and NO] oxidative stress. In conclusion, the applied combined exercise regime hinders the progression of pulmonary and right heart functional and structural harmful remodeling in rats with MCT-induced PAH.NEW & NOTEWORTHY This study reveals that combined exercise improves tolerance to physical effort, prevents increases in pulmonary artery resistance, and conserves the right heart function during the progression of pulmonary arterial hypertension. Our analyses show that combined exercise hinders harmful right ventricular and lung structural remodeling and oxidative stress, which reflects in the maintenance of right ventricular myocytes' contractile function by preserving the intracellular calcium cycling. An attenuated progression of the disease impacts positively on its prognosis.

This randomized-controlled trial demonstrates that an exercise consultation, based on the transtheoretic model of exercise behavior change, significantly improves short-term adherence to exercise.