Aerobic Activity Research Articles

Assessing older adult physical activity levels in clinical settings: The modified PAVS for older adults.

Participating in recommended levels of physical activity (PA) is critical for preventing functional decline, falls, and frailty, making it essential to identify older adults not meeting national PA guidelines. However, guidance on assessing older adult PA levels, particularly in clinical settings, is lacking. This article presents an overview of clinically feasible PA assessment tools for older adults, identifies gaps in current tools, and provides recommendations on addressing these gaps. We conducted a literature review on clinically feasible PA assessment tools, suggested modifications to an existing PA assessment for older adult patients, and highlighted opportunities for integrating the modified PA assessment tool in clinical settings. We identified 16 PA assessment tools used in clinical settings. The most widely used tool is the Physical Activity Vital Sign (PAVS), which has been successfully integrated into several electronic health records (EHR) and clinical practices. Most tools, including the PAVS, primarily focus on aerobic activities, with limited consideration for strength and balance. We recommend the use of a Modified PAVS for Older Adults that includes items on muscle-strengthening and balance activities to better align with national PA guidelines. We then identified several existing opportunities for broad implementation of the Modified PAVS for Older Adults within clinical settings. Widespread integration of the Modified PAVS for Older Adults will better support healthcare providers in identifying individuals not meeting national PA recommendations, assisting them in prescribing tailored PA prescriptions and better connecting their patients to appropriate resources and professionals for further support.

Physical exercise post-treatment in breast cancer: a longitudinal study

The prevalence of breast cancer has been progressively rising as a result of advancements in anti-cancer therapies, however, these patients also experience a variety of long-term adverse effects from their illness and treatments. The current study sought to determine how an exercise training intervention influenced physical and mental health indices in breast cancer patients. A total of 30 female breast cancer patients (aged 42.81 ± 3.31 years, body mass index (BMI) 26.87 ± 0.59 kg/m2, and waist circumference 97.61 ± 1.94 cm) engaged in 12 weekly exercise regimens twice weekly that comprised aerobic, resistance, and flexibility activities. The exercise intervention improved participants' cardiorespiratory fitness, BMI, waist circumference, and muscle function, including sitting to standing, sit-ups, and push-ups. It also showed positive results for post-traumatic stress disorder (PTSD) symptoms, self-reported fatigue, quality of life, and physical, cognitive, and emotional functioning (p < 0.001). In conclusion, our results imply that the advantages of an exercise training program may help breast cancer patients lessen the negative impacts of treatment-related factors on physical performance, overall quality of life, and mental health. Keywords: breast cancer; physical exercise; anxiety; post-traumatic stress disorder; quality of life

Aerobic Conditioning in Geriatric Rehabilitation

This article reviews the historical development of aerobic conditioning. The many physiological effects of aerobic conditioning are presented including the effects on cardiovascular, muscular, and neuromuscular health leading to increased physical endurance and increased lifespan. Aerobic exercise prescription follows the frequency, intensity, time, and type, as well as the volume and progression principles. Frequency recommendations are at least 3 d/wk and 3 to 5 d/wk appears to be conducive to meeting overall physical activity recommendations. Intensity determination is based on several methods that include heart rate methods, ratings of perceived exertion (Borg and OMNI), the talk test, and the counting talk test. Time recommendations include at least 150 to 300 minutes a week of moderate-intensity aerobic activity, 75 to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activities. Type recommendations include any aerobic activities involving major muscle groups used in a continuous or intermittent manner. Volume recommendations include ≥500 to 1000 metabolic equivalent minutes per week and approximately 150 min/wk of moderate-intensity activity. Progression recommendations include the gradual advancing of the exercise duration, frequency, and intensity, making sure that the progressions allows for the best adherence to aerobic exercise on an ongoing basis. The benefits of aerobic exercise have been shown to be important for every aspect of living a healthy lifestyle across the age span, particularly for aging adults, adults with chronic conditions, and adults with disabilities.

Association between physical activity and immunosuppressive medication adherence among renal transplant recipients: a case-control study.

Behavioural interventions are closely associated with immunosuppressive medication (IM) adherence. We aimed to explore the relationship between physical activity and IM adherence among renal transplant patients (RTPs) to determine potential interventions to improve IM adherence. A case-control study. Single-centre study in Changsha, China. The study population included 624 RTPs who were adherent to IM and 417 RTPs who were non-adherent to IM. Sociodemographic characteristics of RTPs, IM adherence and the association between physical activity patterns or frequency and IM adherence. The proportion of RTPs who were non-adherent to IM was 40.06%. Compared with RTPs non-adherent to IM, those who were adherent were older, more likely to be married, were evaluated closer to initial time of transplant, had shorter pretransplant waiting times and engaged in more physical activity. Multivariate logistic regression analysis showed that, in the pretransplant stage, only high-frequency aerobic physical activity was significantly associated with IM adherence. However, in the post-transplant stage, patients engaging in low-frequency aerobic physical activity, high-frequency resistance physical activity or high-frequency aerobic physical activity had 2.01, 2.96 and 2.67 times greater odds of being adherent to IM, respectively, compared with patients with no physical activity. RTPs without physical activity in the pretransplant stage were more likely to be adherent to IM if they engaged in post-transplant physical activity. RTPs engaging in low-frequency physical activity in the pretransplant stage may have better IM adherence if they engaged in post-transplant physical activity. RTPs engaging in high-frequency post-transplant physical activity were significantly associated with a greater likelihood of being adherent to IM compared with RTPs engaging in low-frequency post-transplant physical activity. Our study revealed that physical activity, especially in the post-transplant stage, is closely associated with IM adherence and presents a potential intervention for improving IM adherence by RTPs.

Rating of perceived exertion as a tool for managing exercise intensity during pregnancy: a scoping review

ObjectiveDuring pregnancy, international guidelines recommend ≥150 min of moderate-intensity aerobic physical activity per week, with an intensity perceived as fairly light to somewhat hard on the Borg Rating of Perceived...

Association Of Aerobic Physical Activity And Resistance Exercise With Glycated Hemoglobin In Women With Diabetes

Association Of Aerobic Physical Activity And Resistance Exercise With Glycated Hemoglobin In Women With Diabetes

Use of cardiopulmonary exercise testing to identify mechanisms of exertional symptoms in children with long COVID.

Little is known about the mechanisms of exercise intolerance and exertional symptoms in children with long COVID. Through utilization of cardiopulmonary exercise testing (CPET), this study is the first of its kind to evaluate exertional symptoms and attempt to identify potential mechanism of long COVID-19 in children. To determine if CPET will uncover potential reasons for persistent symptoms of long COVID when there is no indication of cardiopulmonary or upper airway disease. We performed a retrospective chart review study involving children 6-17 years of age with symptoms of long COVID at Phoenix Children''s Hospital from January 1, 2021, to June 1, 2022. Symptoms included but were not limited to exercise intolerance, fatigue, shortness of breath, dyspnea on exertion, and chest pain. We recorded any measurable abnormalities present on CPET after comparing it to established normal reference ranges. Range, median, and SD of data points were calculated and p values were determined using the Mann-Whitney U and Fisher's exact test. Twenty-three children with exertional symptoms consistent with long COVID were identified. The most frequent symptoms reported during exercise include dyspnea on exertion (35%), followed by chest pain (30%) and dizziness (13%). Nearly half of the children (47%) demonstrated decreased exercise capacity with 30% displaying limitations due to deconditioning, 22% limited by body habitus, and 13% due to bronchospasm. Other contributing factors include ventilation to perfusion mismatch and volitional hyperventilation. Decreased aerobic activity due to multiple factors was found in 47% of children with a history of COVID-19. This study illustrates the importance of ongoing research into this phenomenon to elucidate its mechanism and assist physicians in making decisions regarding referral to specialists for further testing.

Core Components of Cardiac Rehabilitation Programs: 2024 Update: A Scientific Statement From the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation.

The science of cardiac rehabilitation and the secondary prevention of cardiovascular disease has progressed substantially since the most recent American Heart Association and American Association of Cardiovascular and Pulmonary Rehabilitation update on the core components of cardiac rehabilitation and secondary prevention programs was published in 2007. In addition, the advent of new care models, including virtual and remote delivery of cardiac rehabilitation services, has expanded the ways that cardiac rehabilitation programs can reach patients. In this scientific statement, we update the scientific basis of the core components of patient assessment, nutritional counseling, weight management and body composition, cardiovascular disease and risk factor management, psychosocial management, aerobic exercise training, strength training, and physical activity counseling. In addition, in recognition that high-quality cardiac rehabilitation programs regularly monitor their processes and outcomes and engage in an ongoing process of quality improvement, we introduce a new core component of program quality. High-quality program performance will be essential to improve widely documented low enrollment and adherence rates and reduce health disparities in cardiac rehabilitation access.

Early Targeted Heart Rate Aerobic Exercise Reduces Proportion of Subacute Musculoskeletal Injuries After Recovery From Sport-Related Concussion.

There is greater risk of musculoskeletal (MSK) injury after clinical recovery from sport-related concussion (SRC). We determined whether aerobic exercise treatment within 10 days of SRC reduced the proportion of MSK injury in recovered adolescent athletes at 4 months since injury. Planned secondary analysis of a randomized trial of aerobic exercise versus stretching exercise in adolescents after SRC. Outpatient and hospital-based sports medicine centers. Aerobic exercise (n = 38, 58% male, 15.6 years) and stretching exercise (n = 25, 64% male, 15.9 years) participants completed a questionnaire at 3.5 and 3.3 months since recovery, respectively. Individualized subthreshold aerobic exercise versus placebo-like stretching. Proportion of MSK injury, subsequent concussion, and return to exercise training, school, and sport determined 3 months after clinical recovery from SRC. Overall, 24% of participants randomized to stretching experienced an MSK injury versus 5.3% of participants randomized to aerobic exercise. There was no difference in time to return to school, sport, or incidence of subsequent concussion. Stretching participants were 6.4 times (95% confidence interval 1.135-36.053) more likely to sustain MSK injury than aerobic exercise participants when controlling for the duration of exposure to sport and return to preinjury sport participation. All injuries were in male participants. Adolescent male athletes prescribed aerobic exercise within 10 days of SRC had a significantly lower proportion of individuals injured in the 3 months following clinical recovery when compared with stretching. This may be due to a habituation/rehabilitation effect of aerobic activities to improve autonomic, vestibular, and/or oculomotor function after SRC.

'Effects of dehydration on central blood pressure in young healthy adults'.

Brachial blood pressure (BP) is the current gold standard for BP assessment; however, measures of pulse wave velocity (PWV) and central blood pressure (CBP) may contribute uniquely to assessment of cardiovascular health status. As of yet, standards for assessment of CBP and PWV have not addressed the impact of hydration status on proper measurement. To understand the impact of hydration, PWV and CBP should be measured in a euhydrated and hypohydrated state. Forty-three young, healthy participants (21 ± 2 years) completed a dehydration protocol utilizing moderate aerobic activity until they lost 1%-2% of their body weight. PWV and CBP were measured before and following the dehydration protocol. Linear regression was utilized to assess change in hydration status and change in PWV and CBP. No significant relationships were observed between the change in hydration status (% body weight lost) and PWV (β = 0.05, p = 0.78) or central diastolic BP (β = -3.8, p = 0.10), however, a significant relationship was observed with central systolic BP (β = -5.0, p = 0.03). In conclusion, the assessment of hydration status before measurement of CBP or PWV may not be necessary in young, healthy individuals.

The effects of positive psychology and physical activity on depression, anxiety, and stress among students with premenstrual syndrome: a single-blind, randomized controlled trial

BackgroundPremenstrual syndrome affects many women in their reproductive years and often disrupts their social connections and work. This study aimed to compare the effects of positive psychology and physical activity on depression, anxiety, and stress among students with premenstrual syndrome.MethodsIn this four-group parallel clinical trial with blinded data analysis, 120 eligible students who experienced premenstrual syndrome were recruited based on inclusion/exclusion criteria and randomly allocated to four groups (n = 30) including three experiment groups as positive psychology, physical activity, and positive psychology, physical activity, and control group, using a simple randomization method. All four groups completed premenstrual syndrome screening and the DASS-21 questionnaire before the intervention. Then, the positive psychology intervention group received eight sessions of 70–90 min weekly intervention, the second group received eight weeks of aerobic physical activity intervention, and the third group received positive psychology and physical activity intervention for eight weeks. The control group did not receive any interventions. The DASS-21 was completed immediately after the intervention and two months later by all four groups. In this study, the participants and investigators were not blinded; however, the analysts were. The recruitment process took place from September 2018 to March 2019. One hundred twenty participants fulfilled the study. The Data were collected and analyzed using SPSS (v18).ResultsBefore and immediately after the intervention, there was no statistically significant difference in depression, anxiety, and stress mean scores among the positive psychology, physical activity, positive psychology, and physical activity and control groups (p ≥ 0.05). However, two months after the intervention, a significant difference was observed between the four groups so there was a difference between the scores of the three intervention groups and the control group (p < 0.05). There was no significant difference between positive psychology, and physical activity groups. No significant adverse events or side effects were observed.ConclusionOur findings supported the use of aerobic physical activity and educational interventions based on positive psychology as non-pharmacologic interventions to reduce anxiety, depression, and stress. This research should be replicated in different settings.Trial registration clinical trialsIranian Registry of Clinical Trials; https://irct.behdasht.gov.ir/trial/32363 (IRCT20130812014333N97), registered (11/08/2018).

Disparities in adherence to physical activity guidelines among US adults: A population-based study.

The objective of this study was to determine adherence to national guidelines for aerobic and muscle-strengthening physical activity among United States (US) adults and identify factors associated with guideline nonadherence. The 2022 National Health Interview Survey data were analyzed to evaluate self-reported physical activity among 26,494 US adults. Adherence to national guidelines was defined as engaging in ≥150 minutes moderate-intensity or ≥75 minutes vigorous-intensity aerobic activity/week, and muscle-strengthening activity ≥2 days/week. A multivariable logistic regression model evaluated associations between 24 sociodemographic and health variables with nonadherence to physical activity guidelines. Shapley Additive Explanations were used to assess the relative importance of each factor in the model. The population-weighted analysis revealed that only 24.3% of US adults met both the aerobic and muscle-strengthening activity guidelines. The regression model identified 17 factors significantly associated with nonadherence. When evaluating the relative importance of these variables, older age, lower educational attainment, and lower household income emerged as the primary determinants of nonadherence. Guideline adherence was lowest among subgroups with multiple risk factors, with only 6.5% of older adults with lower income and education meeting the guidelines. In contrast, adherence was 42.7% in younger respondents with higher incomes and educational attainment. In conclusion, physical activity rates among US adults remain below public health targets, with significant disparities among sociodemographic groups. Expanded outreach efforts targeting higher-risk populations are urgently needed to address barriers, promote physical activity engagement, and achieve health equity.

Association of aerobic and muscle-strengthening activity with chronic low back pain: population-based study

BACKGROUND CONTEXTChronic low back pain (CLBP) is a significant global health burden, primarily affecting the middle-aged and older; However, there is a lack of clear, evidence-based guidelines for leisure-time physical activity aimed at preventing CLBP. PURPOSEThis study sought to delineate the association between aerobic physical activity (APA) and muscle strengthening activities (MSA) and the prevalence of CLBP. STUDY DESIGNThis was a population-based study conducted across the United States. PATIENT SAMPLEThis nationwide study utilizes deidentified data from 22 consecutive rounds of the National Health Interview Survey (NHIS) from 1997 to 2018. OUTCOME MEASURESThe primary outcome was self-reported CLBP. METHODSWe analyzed the prevalence of CLBP in a representative sample of 324,793 middle-aged and older people. Among 263,871 individuals, we used multiple logistic regression to investigate individual and joint association between the amount of APA and MSA with CLBP. RESULTSIn total, 263,871 participants (mean age, 59.0 years; SD, 9.7) were included in the final analysis. From 1997 to 2018, the prevalence of CLBP was approximately 32%, with an annual increase. Engaging in APA for 75 to 150 minutes weekly was associated with a modest reduction in CLBP risk (OR [95% CI] = 0.97 [0.97–0.98]). Similar benefits were seen with 150 to 225, 225 to 300, and >300 minutes. Engaging in MSA 2 to 3 times and 4 to 5 times weekly also reduced CLBP risk (0.98 [0.98–0.99] and 0.98 [0.97–0.99], respectively). Optimal reductions of CLBP risk may be associated with balanced levels of APA and MSA, with recommended amounts being 225 to 300 min/w of APA and 4 to 5 times/w of MSA (0.92 [0.89–0.95]). CONCLUSIONSThe study found engaging in over 75 minutes of APA and 2 to 5 weekly MSA sessions is associated with a reduced risk of CLBP. Furthermore, a balanced combination of APA and MSA may correspond to the greatest reduction in CLBP risk.

Short physical performance battery in aerobic capacity and physical activity evaluation of individuals with peripheral artery disease: An exploratory study

BackgroundPeripheral artery disease (PAD) negatively affects functional ability. Persons with PAD experience gait limitation, and changes in mobility, muscle strength, and balance. Assessing individuals with PAD with tests of lower limb performance during activities other than walking may provide information about aerobic capacity. ObjectiveTo evaluate whether the Short Physical Performance Battery (SPPB) can discriminate aerobic capacity and level of physical activity in individuals with PAD. MethodsThe SPPB, Incremental Shuttle Walking Test (ISWT), and the Human Activity Profile (HAP) were completed by 42 volunteers with PAD. The sample was stratified into tertiles by the distance walked in the ISWT and the Adjusted Activity Score (AAS) of HAP. One-way analysis of variance with a post-hoc least significant difference was used to compare the SPPB values between tertiles of ISWT and AAS of HAP. P-value < 0.05 was considered significant. ResultsThe mean age was 65 ± 7.7 years, the walking distance was 259.29 ± 115.28 m, and AAS of HAP was 68.36 ± 9.04. There was a significant difference in the total SPPB score and scores for gait speed and sit-to-stand for groups stratified by ISWT and AAS of HAP(p = 0.01). The balance domain was different only for groups stratified into tertiles by AAS of HAP(p = 0.04). ConclusionThe results of this study have clinical relevance for the evaluation of individuals with PAD at different aerobic and physical activity levels. The SPPB is a viable alternative in the practice of the specialty of vascular nursing and other areas of health to assess patients whose ability to perform walking tests is often limited.

183 Association between mental health and different patterns of physical activity in adolescents in Luxembourg – HBSC 2022

Abstract Purpose Regular physical activity (PA) is a key protective factor for health in youths. The WHO recommends that adolescents do at least an average of 60 minutes per day of moderate-to-vigorous physical activity (MVPA) and incorporate vigorous-intensity aerobic activities (VPA) at least 3 days a week. Nonetheless, lower amounts of PA already carry benefits. This study aims to explore and to examine association between well-being and PA levels in adolescents in Luxembourg. Methods A representative sample of 8117 adolescents (11-to-18-years-old) took part in the 2022 Health Behaviour in School-aged Children (HBSC) Luxembourg survey. Based on the WHO-5 Index adolescents were categorised as “depression symptomatology”, “low mood” and normal well-being. In addition, they were categorised as frequency per week (0 to 7 days) of MVPA and VPA practice. Multinomial logistic regressions were performed, controlling by sex and SES. Normal well-being and physical inactivity were the respective refence groups. Results The results showed an association between mental well-being and both MVPA and VPA (p&amp;lt;.001). Compared to their inactive peers and independently of sex and SES, adolescents in Luxembourg who practiced MVPA 4 days per week or VPA 2 times per week had decreased odds to present low mood (ORMVPA=0.63, 95%CI[0.45-0.87] and ORVPA=0.75, 95%CI[0.60-0.92]) and PA even in a small frequency (1 day per week) already decreased the odds to have depressive symptoms (ORMVPA=0.67, 95%CI[0.51-0.89] and ORVPA=0.61, 95%CI[0.49-0.75]). Conclusions These findings highlight the significance of physical activity in fostering well-being, revealing an inverse relationship between the frequency of physical activity and the occurrence of depressive symptomatology and low well-being. In this regard, the advantages of engaging in physical activity are linked not only to physiological benefits but also to social interactions within these practices. In this context, the benefits of regular physical activity extend beyond its direct impact on mental health, encompassing both physiological and social dimensions.

Effect of Aerobic and Indigenous Training on Selected Physiological Variables

The present study aimed to examine the effect of specially designed aerobic activities andindigenous activities training program on selected variable of physiology. Total 45 female collegestudents were selected as the subject of the study. Resting heart rate, vital capacity and resting breathingrate were selected as the physiological variables. The selected subjected were divided into twoexperimental groups and one control group. Both experimental groups were given training for eightweeks. ANCOVA was used as statistical tool for the study. Result of the study showed that the aerobicactivities and indigenous activities training significantly improved heart rate and vital capacity. Whereasthere was no significant change observed in resting breathing rate.

노인의 성별에 따른 골관절염 유병 관련 영향요인

This study aims to identify the factors influencing the prevalence of osteoarthritis among the elderly aged 65 and older, and to provide fundamental data for developing intervention measures for osteoarthritis management. The subjects of this study were 8,175 elderly individuals (3,521 men and 4,654 women) aged 65 and older, drawn from the 2016-2020 Korea National Health and Nutrition Examination Survey data. The analysis was performed using the SPSS/WIN 25 program, applying complex sample analysis methods. Frequencies, percentages, means, standard deviations, and gender comparisons were analyzed using chi-square tests for cross-tabulations, and logistic regression analysis was conducted to identify factors influencing the prevalence of osteoarthritis. The results revealed significant differences in age, education level, cohabitation with a spouse, home ownership, smoking, drinking, aerobic physical activity, walking, BMI, depression experience, and presence of arthritis between male and female elderly subjects. The estimated prevalence of osteoarthritis among the Korean elderly aged 65 and older, based on the sample, was 25.0% (10.3% for men and 35.9% for women). When examining the differences in osteoarthritis prevalence according to sociodemographic and health-related characteristics, it was found that among elderly men, there were statistically significant differences in osteoarthritis prevalence related to education level, drinking, walking, and obesity. Among elderly women, significant differences were observed in education level, presence of a spouse, walking, obesity, and depression. Furthermore, the factors influencing the prevalence of osteoarthritis among elderly men were education level, while for elderly women, the influencing factors were education level, residential area, and BMI. Based on these results, it is necessary to develop multifaceted and individualized nursing intervention programs tailored to gender.

Blended learning in physical education: application and motivation.

The aim of the research was to evaluate outdoor aerobic sport activities (OASA) in the physical education (PE) of university students using wearables and their potential to personalize the learning process and enhance motivation. In total, 368 university students participated. The OASA structure and the key points of application in PE were described. Descriptive statistics of the training units (n = 3,680) were processed. The students recorded their training data in the Strava app (10 sessions per semester), and the data were shared in the online sport community created on the Strava platform. Motivation was evaluated using a questionnaire. The focus was both on intrinsic motivation and extrinsic "ICT" motivation, based on Strava app features and tools. The most preferred outdoor aerobic sport activities were running (58%), cycling (13%), and walking (16%). The results provided insight into motivation and performance analysis. Students' motivation to participate in OASA was mainly in health concerns, such as staying in shape (94%), staying healthy (90%), and psychological concerns, such as having fun (88%), improving state of mind (88%), or relieving stress (83%). In achievement concerns, the motivation was a personal challenge (72%), while competing with others was ranked lowest (32%). The Strava app was a motivating tool for students to record, monitor, and analyze their individual activities and feel "connectedness" to the online sport community. 70% of students were motivated by the non-competitive character of PE, which gave them a personalized opportunity to train without being compared to others. The OASA management, with the use of blended learning methods and the Strava app, uses a motivational approach to create, support, and maintain students' healthy habits of physical activity through PE lessons. The need for students to be motivated to exercise can be confirmed in the analysis of the statistical descriptive parameters of running, cycling, and walking. There was a tendency for students to complete only the minimum required distance/time (not more). On the other hand, students enjoyed the training, and 99% of students confirmed that they would enroll again. That fact underlined the importance of motivating students with an effective learning strategy and giving support and guidance.

Increasing participation in resistance training using outdoor gyms: A study protocol for the ecofit type III hybrid effectiveness implementation trial

BackgroundIn this paper we outline the protocol for an implementation-effectiveness trial of ecofit, a multi-component mHealth intervention aimed at increasing participation in resistance and aerobic physical activity using the outdoor built environment (i.e., outdoor gyms) and social support. We have previously demonstrated the efficacy and effectiveness of the ecofit program in insufficiently active people with (or at risk of) type 2 diabetes and community-dwelling adults, respectively. The objective of this trial is to compare the effects of two implementation support models (i.e., ‘Low’ versus ‘Moderate’) on the reach (primary outcome), uptake, dose received, impact and fidelity of the ecofit program. Research design and methodsThis hybrid type III implementation-effectiveness study will be evaluated using a two-arm randomized controlled trial, including 16 outdoor gym locations in two large regional municipalities in New South Wales, Australia. Outdoor gym locations will be pair-matched, based on an established socio-economic status consensus-based index (high versus low), and randomized to the ‘Low’ (i.e., ecofit app only) or ‘Moderate’ (i.e., ecofit app, face-to-face workout sessions and QR codes) implementation support group. The primary outcome of ‘reach’ will be measured using a modified version of the ‘System for Observing Play and Recreation in Communities’, capturing outdoor gym use amongst community members. ConclusionThis implementation-effectiveness trial will evaluate the effects of different levels of implementation support on participation in resistance-focused physical activity using mHealth and outdoor gyms across the broader community. This may guide widespread dissemination for councils (municipalities) nation-wide wanting to promote outdoor gym usage. Trial registryThis trial was preregistered with the Australian and New Zealand Clinical Trial Registry (ACTRN12624000261516).

Combined association of aerobic and muscle strengthening activity with mortality in individuals with hypertension.

Evidence on the association between meeting both aerobic physical activity (PA) and muscle-strengthening activity (MSA) guidelines with mortality in individuals with hypertension is scarce. We included 34,990 adults from the 2007 to 2013 Korea National Health and Nutrition Examination Survey, linking mortality follow-up data until 2019. Adherence to PA guidelines was assessed based on the current PA guidelines using a self-reported questionnaire and categorized as follows: meeting MSA only, aerobic PA only, both MSA and aerobic PA, or neither. Associations of hypertension and adherence to PA guidelines with all-cause and cardiovascular disease (CVD) mortality were examined using Cox proportional hazard models. Over 9.2 years, 1948 participants died from any cause and 419 from CVD. Meeting both PA guidelines was associated with the lowest risk of all-cause and CVD mortalities in the total sample regardless of hypertension status. In individuals with hypertension, meeting aerobic PA guidelines only had a 24% lower risk of both all-cause and CVD mortality, and meeting both PA guidelines further reduced risks by 40% and 43%, respectively; however, meeting MSA guidelines only was not associated with either all-cause or CVD mortality. In individuals without hypertension, only meeting both MSA and aerobic PA guidelines, but not meeting either MSA or aerobic PA guidelines, showed reduced risk of CVD mortality. In Korean population, non-hypertensive individuals who met both guidelines had a lower risk of CVD mortality. However, hypertensive individuals showed a reduced risk of both all-cause and CVD mortality when meeting aerobic PA or both guidelines, but not MSA alone.