How AI coach voice anthropomorphism influences exercise adherence: A PLS-SEM and fsQCA analysis.

"To move or not to move"exercise adherence in home-based cardiac rehabilitation after coronary artery bypass graft surgery: A qualitative study.

Best evidence summary for exercise adherence management in outpatient rehabilitation following coronary artery bypass graft surgery.

OBJECTIVE: To evaluate a 3-month post-hip arthroscopy rehabilitation program within a randomized controlled trial comparing hip arthroscopy to sham surgery for femoroacetabular impingement syndrome (HIP ARThroscopy International [HIPARTI] trial) by describing exercise adherence, type, and pain; 6-month changes in International Hip Outcome Tool-33 (iHOT-33); and physical impairments and functional performance. DESIGN: Exploratory cohort study nested in a pilot randomized controlled trial. METHODS: Participants aged 18 to 50 years with femoroacetabular impingement syndrome completed a 3-month, physical therapist-led, postsurgical rehabilitation program, self-reporting rehabilitation adherence and pain levels on the visual analog scale using weekly training diaries. Baseline to 6-month changes in quality of life (iHOT-33), physical impairment (hip strength, range of motion [ROM]), and functional performance (single-leg hop, side bridge endurance) were reported as mean (standard deviation). RESULTS: Twenty-nine people (37% female, 29.9 ± 7.9 years) participated. Hip extension, abduction, and functional exercises were performed most often. Exercise adherence analysis was limited by underreporting. Training diary data adequate to assess adherence were available for 20 participants (69%). Among those with available data, 16 (80%) met the predefined adherence target of ≥2 sessions per week, and average pain remained acceptable (<2 visual analog scale); iHOT-33 (+18.6 ± 22.5; 95% confidence interval: 10.2, 27.0) and hip flexion ROM (+6°; 95% confidence interval: 2.14, 9.60) improved significantly. Hip extension, adduction, external and internal rotation strength improvements exceeded the minimal detectable change, although they were not significant. CONCLUSION: Adherence was generally high among participants with available data, though limited by underreporting. Hip-related quality of life (iHOT-33) improved despite limited changes in physical impairments, and no improvement in functional performance. J Orthop Sports Phys Ther 2026;56(7):456-464. Epub 23 April 2026. doi:10.2519/jospt.2026.13775.

Cardiovascular (CV) prevention in young adults is pivotal due to escalating morbidity and mortality rates in this demographic. Assessing CV awareness and its socio-behavioural correlates is essential for developing effective prevention strategies. This study assessed CV awareness and lifestyle behaviours among Polish 18-year-olds, hypothesising that significant gender-specific disparities exist at the threshold of adulthood. A nationwide, representative survey was conducted over 10,000 students in final-year grades from 250 Polish secondary schools. Sampling employed a stratified cluster method. Data were weighted to ensure national representativeness. Awareness of CV risk factors and lifestyle behaviours (diet, physical activity, sleep, and substance use) were evaluated. Of 10,095 participants (6,076 females, 4,019 males), overweight and obesity were recorded at 17.0% and 4.1% in males, and 8.4% and 2.1% in females, respectively (p < 0.001). Only 14.6% of women and 14.3% of men knew their current blood pressure values (p = 0.48). Weekday screen time averaged 5.9 ± 2.7 hours, rising to 6.7 ± 2.8 hours on weekends, with significant gender differences on weekends (p = 0.009). Sleep duration was concerning, with 52.6% of women and 40.5% of men sleeping under seven hours on weekdays (p < 0.001), though 95% slept sufficiently on weekends. Awareness of sleep-related diabetes and obesity risks was minimal. Men had higher alcohol consumption, with 20.5% consuming 100g or more weekly, compared to 12.6% of women (p < 0.001). Smoking was prevalent, with 22.8% of women and 23.7% of men smoking daily. Exercise adherence varied, with only 61.0% of women and 76.7% of men meeting guidelines in summer, declining in winter (p < 0.001). Men generally consumed unhealthy foods more often. While most recognized common myocardial infarction risk factors, under 65% identified high cholesterol as a risk, with women generally performing better in awareness. Polish 18-year-olds exhibit distinct, gender-specific cardiovascular risk profiles. While females possess superior theoretical knowledge, they are more prone to physical inactivity and poor sleep hygiene. In contrast, males are primarily burdened by adverse dietary habits and substance use. These findings indicate that public health interventions should be gender-tailored: prioritising physical activity for young women and focusing on dietary improvements and addiction prevention for young men to effectively mitigate future cardiovascular risk.

Prolonged waiting times for total knee replacement (TKR) leave patients with end-stage knee osteoarthritis (OA) with persistent pain and functional limitation. We evaluated the effectiveness of a structured physiotherapy-led non-operative program for patients awaiting TKR. This retrospective cohort included 2,243 end-stage knee OA patients awaiting TKR (October 2021-March 2024). The Structured Non-Operative Treatment Program (SNTP) comprised six sessions delivered over one year, integrating aerobic, strengthening, neuromuscular exercises, and education to support lifestyle modification and home exercise adherence. Outcomes were assessed at baseline, program completion, and longitudinally thereafter; analyses focused on follow-up up to 2years due to attrition. Primary outcomes were pain (Numeric Pain Rating Scale, NPRS), perceived change (Numeric Global Rating of Change, NGRCS), and knee function (Knee Injury and Osteoarthritis Outcome Score, KOOS). Participants were stratified by baseline Knee Society Score (KSS): Poor (≤ 66), Fair (67-76), Good (77-89), and Excellent (90-100). Significant improvements were observed across most outcomes in all subgroups. Total KSS and KSS Function scores declined over time, consistent with progression in an end-stage cohort. Benefits were sustained up to 1.5years in the Poor subgroup, 1year in the Fair subgroup, and less than 1year in the Good and Excellent subgroups. A structured six-session programme was associated with sustained symptom relief in patients awaiting surgery, particularly among those with poorer baseline function. Severity-stratified progression strategies warrant further evaluation in controlled studies. Key Points • A scalable six-session physiotherapy-led programme improved pain and functional outcomes in patients with end-stage knee OA awaiting TKR. • Benefits were sustained for up to 18months, particularly among patients with poorer baseline knee function. • Baseline severity modified durability of response, suggesting a need for severity-stratified progression and maintenance strategies.

The objective of this cross-sectional observational study was to validate a scale that highlights the personal and environmental barriers that hinder adherence to regular physical exercise in older adults. Individuals aged 60 years or over, sedentary and/or ex-practitioners, regular practitioners of physical exercise, with Brazilian Portuguese as their mother tongue. In addition to the Regular Physical Exercise Adherence Scale (REPEAS), the following instruments were applied: sociodemographic data sheet and Baecke Habitual Physical Activity Questionnaire. The measurement properties tested were: structural validity, construct validity, reliability, consistency internal and ceiling and floor effects. This research involved 200 older adults' participants, predominantly women. The confirmatory factor analysis supported the two-domain, 12-item structure of the REPEAS, demonstrating good model fit with the following indices: chi-square/degrees of freedom = 1.60, comparative fit index = 0.965, Tucker-Lewis index = 0.957, root mean square error of approximation = 0.078, and standardized root mean square residual = 0.078. Construct validity was evidenced by a statistically significant difference (p < 0.05) in the personal factors domain between groups. Additionally, the domains of the REPEAS showed appropriate correlations with the items in the factor analysis. Reliability was acceptable, with composite reliability ≥ 0.84 and intraclass correlation coefficient ≥ 0.89. This scale presented adequate measurement properties when tested on Brazilian older adults to assess environmental and personal barriers to regular physical exercise. However, as this was a study conducted with a convenience sample, generalization of the findings should be made with caution. Despite this, the REPEAS can serve as a practical tool for health professionals and researchers to identify modifiable barriers and guide strategies to promote physical activity among older adults. Not applicable.

Motivation and self-efficacy are well-established predictors of engagement and persistence within structured exercise programmes. Yet it remains unclear whether these psychological factors predict objective adherence metrics and associated fitness outcomes within home-based exercise programmes for older adults. This study adopted a person-centred approach to examine whether distinct psychological profiles predict objective adherence and fitness outcomes following a 26-week home-based exercise programme in 88 older adults (age = 67.2 ± 5.5 years). Objective adherence was defined as compliance with the prescribed exercise volume and quantified using cumulative metabolic equivalent minutes (MET-mins) derived from heart rate data reflecting session intensity and duration across the programme, as opposed to behavioural self-report measures. Psychological profiles were generated using latent profile analysis based on autonomous motivation, controlled motivation, and exercise self-efficacy. Two profiles were identified: an autonomous and highly confident profile characterised by high self-efficacy and autonomous motivation, and a moderately autonomous and confident profile characterised by lower self-efficacy and autonomous motivation. Controlled motivation was similar between groups. Profiles did not differ in demographic or physiological characteristics at baseline. Adherence was high and comparable across the two profiles for all indices (e.g., cumulative MET-mins: 129 ± 66% vs. 116 ± 38%). Furthermore, both profiles demonstrated significant and comparable improvements in cardiorespiratory fitness (V̇O₂peak), handgrip strength, flexibility (chair sit-and-reach; back scratch), and mobility (8-foot up-and-go). Baseline differences in self-efficacy and autonomous motivation among older adults did not significantly predict adherence or fitness outcomes within a structured, well-supported home-based exercise programme. The programme incorporated consistent objective monitoring of exercise behaviour, along with regular guidance and feedback from the research team delivered through scheduled participant contact. This level of structured behavioural support may have reduced the influence of psychological profile membership on exercise adherence and fitness outcomes, resulting in comparable positive outcomes across participants. Future research should investigate whether motivation profiles become more predictive of long-term adherence and sustained fitness outcomes once external behavioural support is reduced or withdrawn. Open Science Framework: https://osf.io/6fqg7.

Community-based rehabilitation services face significant challenges including limited access, poor exercise adherence, and resource constraints. Telerehabilitation using gamified exergaming platforms offers a promising solution to extend rehabilitation services into home settings while maintaining patient engagement. This multi-center single-arm pilot study evaluated the feasibility, acceptability, and preliminary efficacy signals of a caregiver-supported, home-based telerehabilitation program comprising 30 days of active home use within an 18-week protocol, using the EvolvRehab gamified exergaming platform among community-dwelling adults with functional limitations who were receiving outpatient rehabilitation in Singapore. Ten participants (mean age: 64.6 years, SD 8.5, range 48-78) were recruited from three community rehabilitation sites: Handicaps Welfare Association Day Rehabilitation Centre, Home Nursing Foundation, and Ren Ci Hospital Day Rehabilitation Centre. Participants underwent an 18-week protocol comprising onboarding, a 30-day period of active home-based telerehabilitation with therapist-prescribed daily exercises and remote monitoring, and follow-up. A primary caregiver was present during all home sessions to assist with device setup, supervise exercise, and support fall prevention. Functional outcomes were assessed at baseline (Week 0), post-intervention (Week 8), and follow-up (Week 18) using the Modified Barthel Index (MBI), Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), grip strength, and EQ-5D-5L. System usability and patient-reported outcomes were evaluated using the System Usability Scale (SUS) and a non-validated custom questionnaire, the latter analysed as exploratory data. Mean exercise compliance was 80.6%, with participants exercising an average of 23.97min daily. Within-group improvements from baseline to Week 18 follow-up were observed in MBI (75.8 to 81.2, p = 0.019), BBS (33.3 to 38.0, p = 0.037), and right-hand grip strength (15.1 to 18.0kg, p = 0.005). SPPB improved at the post-intervention assessment (5.2 to 6.2, p = 0.015), but this change was not sustained at the Week 18 follow-up relative to baseline (6.4, p = 0.104). EQ-5D-5L descriptive sum scores decreased (indicating reduced symptom burden) from 11.6 at baseline to 8.5 at Week 8 (p = 0.002; FDR-adjusted p = 0.048) and 8.7 at Week 18; EQ-VAS scores increased from 66.9 at baseline to 80.9 at Week 18 (p = 0.022). As an uncontrolled single-arm study, these findings represent preliminary efficacy signals rather than evidence of effectiveness, and require confirmation in controlled trials. The mean SUS score was 67.75, indicating marginal acceptability. Patient-reported outcomes showed high engagement with the gamified exercises, though concerns about cost were noted. No falls or adverse events were reported in this selected sample under caregiver-supported conditions. Gamified caregiver-supported telerehabilitation using the EvolvRehab platform appeared feasible and acceptable among community-dwelling adults with functional limitations, and was associated with within-group functional outcome signals. High compliance rates and the absence of adverse events under caregiver-supported conditions support the conduct of larger controlled trials, though the uncontrolled single-arm design precludes conclusions about effectiveness, and usability refinements and cost considerations require attention for scalability.

BackgroundHome-based cardiac rehabilitation (CR) using digital health technologies (ie, cardiac telerehabilitation [CTR]) has emerged as a practical alternative to conventional center-based CR, particularly during and after the COVID-19 pandemic. However, maintaining sustained participation in CR remains challenging. Gamification holds the potential to enhance motivation and adherence in CR, but its role in CTR for patients with acute coronary syndrome (ACS) remains under-studied.ObjectiveThis feasibility study evaluated the feasibility, acceptability, and safety of a combination of a gamification-enabled smartphone app and a smartwatch supporting CTR after ACS. We focused specifically on participation motivation, adherence to prescribed exercise intensity, and short-term physiological outcomes.MethodsThis single-arm, pre-post intervention study was conducted at 2 Japanese institutions. Sixteen patients diagnosed with ST-elevated myocardial infarction or non–ST-elevated myocardial infarction and undergoing percutaneous coronary intervention were enrolled after discharge. Each patient received a smartphone and smartwatch connected to the Shin-po Kei app, through which participants earned points when exercising within their target anaerobic threshold heart rate (HR) range (±10 bpm). The 1-month intervention prescribed walking for 30 minutes or longer 3 to 5 days or more per week, at an intensity corresponding to a Borg scale score of 11 to 13. The primary end point was the number of app log-in days divided by the number of intervention days (app use rate). Secondary end points included the target HR exercise adherence rate (defined as the proportion of patients who exercised for 30 minutes within the target HR range on 3 or more days per week), changes in peak oxygen consumption, and changes in perceived exertion using a visual analog scale.ResultsThe mean patient age was 62 (SD 13) years, and 94% (15/16) were male. The mean intervention duration was 29 (SD 6) days, and the overall app use rate was 59.9%. The target HR exercise adherence rate was 50%. Peak oxygen consumption increased from 18.4 (SD 4.1) to 21.1 (SD 5.4) mL/kg/min, and the mean visual analog scale score for exercise-related hassle reduced from 57 (SD 33) to 32 (SD 26). No adverse events related to app use were identified, and 1 hospitalization unrelated to the intervention occurred during the study period.ConclusionsThis feasibility study suggests that short-term engagement with a smartwatch-linked gamified smartphone app is achievable in CTR after ACS. However, adherence to predefined gamified exercise standards was lower than app use rates, suggesting that refinement of reward rules and target HR thresholds may be necessary.

BackgroundChronic rotator cuff injuries (CRCIs) often lead to shoulder pain and dysfunction. Although ultrasound-guided injections provide rapid pain relief, subsequent rehabilitation efficacy is often compromised by poor exercise adherence and inaccurate movement execution. Digital therapeutics may enhance patient engagement and movement accuracy, potentially improving outcomes.ObjectiveThis study compared the effects of ultrasound-guided corticosteroid plus local anesthetic injection combined with the Digital Rehabilitation System training versus traditional exercise on pain intensity and shoulder function in patients with CRCIs.MethodsThis was a single-center, parallel-group, superiority randomized controlled trial with a blinded outcome assessor, injection physician, and data analyst. Sixty eligible participants were randomized to either the conventional treatment group (group C, n=30) or the digital treatment group (group D, n=30) for a 3-month intervention. Following pain-alleviating ultrasound-guided injections, group C performed prescribed exercises, while group D used the intelligent system for self-corrective adaptive training. Primary outcome was the Constant-Murley Score. Secondary outcomes included the University of California Los Angeles Shoulder Scale, Numerical Rating Scale for pain, range of motion (ROM), and system proficiency scores. Assessments occurred at baseline (T1), 1-week (T2), 1-month (T3), and 3-month (T4) follow-ups.ResultsNo significant between-group differences existed in baseline characteristics or outcome measures (all P>.05). No group × time interactions were observed for any outcomes. At T4, group D demonstrated significantly greater improvements in Constant-Murley Score (Hodges-Lehmann estimator [HLE] −6, 95% CI −10 to −2; P=.007), University of California Los Angeles Shoulder Scale score (HLE −2, 95% CI −4 to −1; P=.001), and Numerical Rating Scale score (HLE 1, 95% CI 0-2; P=.002), and their improvement values (Δ) all exceeded the corresponding minimal clinically important differences. ROM also showed significant intergroup differences in all planes. Compared with T1, ROM was significantly improved in both groups at T4, with the greatest improvement in abduction (Δ group C=20.7 and Δ group D=30.5). Subgroup analysis revealed better enhanced shoulder function and ROM in participants with no or mild shoulder motion restrictions using digital therapy.ConclusionsFor participants with CRCIs, combining ultrasound-guided injection with subsequent Digital Rehabilitation System training achieves greater shoulder ROM and functional scores than traditional exercise after pain relief. This approach demonstrates enhanced efficacy in subgroups with no or mild shoulder mobility limitations.

Revisiting satisfaction with life: A hybrid study based on linear models and machine learning.

A study on the impact of AI health monitoring devices on exercise persistence among physical education students.

Overweight and obesity are prevalent health concerns among postmenopausal women. However, the effects of aerobic exercise training on multidimensional body composition outcomes in postmenopausal women with overweight or obesity, as well as the potential dose-response relationship, remain unclear. This systematic review and meta-analysis followed PRISMA guidelines. PubMed, Cochrane Library, Web of Science, EBSCO, and ProQuest were searched from inception to March 8, 2026. Randomized controlled trials comparing aerobic exercise training with non-exercise control in postmenopausal women with overweight or obesity were included. Three-level meta-analyses were performed to account for dependent effect sizes. Restricted cubic spline models, subgroup analyses, and meta-regression were used to explore dose-response patterns and potential moderators. Sixteen RCTs involving 1,571 participants were included. Compared with non-exercise control, aerobic exercise training reduced body weight (MD = -2.17kg, P < 0.01; low certainty), body mass index (MD = -0.73kg/m2, P < 0.01; low certainty), body fat percentage (MD = -1.40%, P < 0.01; moderate certainty), fat mass (MD = -1.83kg, P < 0.01; moderate certainty), waist circumference (MD = -2.02cm, P < 0.01; moderate certainty), and hip circumference (MD = -1.39cm, P = 0.04; low certainty). The pooled estimate for lean body mass was positive but imprecise (MD = 0.72kg, P = 0.14; low certainty). Baseline age was inversely associated with changes in body weight and BMI. No clear non-linear dose-response association was observed between total aerobic exercise volume and pooled body composition effects, although some fitted curves suggested possible plateau-like patterns. Aerobic exercise training may improve several adiposity-related body composition outcomes in postmenopausal women with overweight or obesity, although the evidence for hip circumference and lean body mass remains less certain. Future trials should improve reporting of exercise dose, adherence, dietary control, and follow-up outcomes.

Cancer is a leading cause of morbidity and mortality worldwide, with millions of survivors facing long-term health complications, particularly cardiovascular diseases (CVD). Treatments such as chemotherapy and radiation therapy can induce cardiotoxicity, resulting in significant cardiovascular morbidity. As cancer survival rates improve, the need for effective management strategies to address the cardiovascular health of cancer survivors has become increasingly critical. This study aimed to develop a smartphone-based application for cardiovascular rehabilitation in cancer survivors. This research was conducted in two phases. In the first phase, users' requirements were investigated by using a questionnaire. The participants were 31 cardio-oncologists. In the second phase, a prototype of the application was designed and implemented, and its usability was evaluated quantitatively by 27 cancer survivors with cardiovascular complications and eight cardio-oncologists using a QUIS questionnaire (version 5.5). The statistical analysis was conducted using SPSS software, version 28. Most of the proposed educational content, data elements, and application features, including necessary steps to prevent cardiovascular complications in cancer survivors, risk factors for cardiovascular complications in cancer survivors, guidance on quitting smoking and exercise training, the ability to track personal and clinical data, fatigue and anxiety assessments, and communication with physicians, were considered essential items for the application. Ultimately, users evaluated the application's usability, resulting in an average mean score of 8.19 out of 9 from patients' perspectives and 8.22 out of 9 from cardio-oncologists, indicating a "good" level of user satisfaction. The development of a smartphone-based application for cardiovascular rehabilitation in cancer survivors represents a significant step toward improving cardiovascular health management in this vulnerable population. However, more research is needed to compare the effects of remote education versus face-to-face rehabilitation on improving health literacy and patient exercise adherence.

BackgroundWith the increasing burden of chronic diseases, self-management education (SME) is crucial. Traditional SME based on face-to-face delivery by clinicians is resource-intensive, and general digital tools such as web-based platforms often provide limited interactivity for patient learning. Although chatbots based on large language models (LLMs) show promise in interactivity, their real-world effectiveness lacks empirical evidence.ObjectiveThis study aimed to explore the feasibility and preliminary effectiveness of an LLM-based chatbot specifically designed for osteoporosis SME.MethodsA formative randomized controlled trial was conducted in a tertiary hospital from February 2024 to March 2025. Adults aged ≥18 years with osteoporosis were recruited and randomly assigned (1:1) to either the intervention (OPBot) group or a control group receiving traditional health education. The chatbot provided interactive educational content and question-and-answer support, while the control group received face-to-face education and written materials. Osteoporosis knowledge was assessed using the Osteoporosis Knowledge Assessment Tool at baseline and discharge. Nurses’ time spent on health education was self-recorded during each intervention session and aggregated across sessions. Adherence to disease management was assessed at 1, 3, and 6 months after discharge via telephone using Likert-scale questionnaires. The reliability of OPBot responses was evaluated by 2 clinician assessors using a 5-point Likert scale, with interrater agreement calculated using Cohen κ. Group comparisons were conducted using 2-tailed independent t tests, Mann-Whitney U tests, and chi-square tests, and adherence outcomes were analyzed using mixed-effects models.ResultsA total of 100 participants were randomized; 12% (12/100) were excluded due to loss to follow-up, refusal of the second knowledge assessment, or death, leaving 88% (88/100) participants for analysis (n=45, 51.1% in the OPBot group and n=43, 48.9% in the control group). The OPBot group showed significantly higher postintervention knowledge scores than the control group (median 80.0, IQR 70.0-89.0 vs median 75.0, IQR 65.5-80.0; P=.01). Nurses in the OPBot group spent lesser time on SME than those in the control group (median 5.0, IQR 2.0-17.0 vs median 23.0, IQR 20.0-25.0 minutes; P<.001). For adherence outcomes, a significant group×time interaction was observed for calcium supplement intake (odds ratio 1.49, 95% CI 1.08-2.06; P=.02), indicating differing adherence trajectories over time. The OPBot group also showed higher odds of consuming calcium-rich foods across time points (odds ratio 2.87, 95% CI 1.04-7.89; nominal P=.04), although this association did not remain significant after Holm correction. No significant effects were observed for sun exposure (P=.56), exercise (P=.79), or total adherence scores (P=.33). In the question-and-answer module, most OPBot responses were rated as highly reliable 89.4% (76/85), with high interrater agreement (Cohen κ=0.83).ConclusionsLLM-based chatbots specifically designed for osteoporosis SME may improve patient knowledge, supporting adherence behaviors, and reducing healthcare workload. However, further large-scale studies are needed to confirm these findings.

IntroductionSubjective measures for assessing exercise adherence in patients with non-cancer widespread chronic muscle pain (CMP) are limited. Following the recent development of the valid and reliable Adherence To Exercise for Musculoskeletal Pain Tool (ATEMPT), this study aimed to assess the reliability of the Slovenian translation of the questionnaire for measuring exercise adherence in Slovenian patients with CMP.MethodsThis cross-sectional study included 107 patients with CMP (95% female), with a mean (SD) age of 56 (8) years, to assess the reliability and construct validity of the Slovenian version of ATEMPT. Following initial translation into Slovenian by 2 experienced translators and minor adaptation of terminology after discussing with people and an exercise specialist, the questionnaire was administered on 2 occasions, with a median (IQR) of 8 (0) days between assessments.ResultsOverall, test-retest comparisons showed similar scores for each item and for the score. Correlations between test and retest scores for each item and the total score were positive and moderate to high (all 0.533 < r < 0.733, all p < 0.001). Reliability of each item and the total score was significant and ranged from moderate (first, third and fourth items; intraclass correlation coefficients [ICCs] = 0.688–0.700) to good (second and sixth items and overall score; ICC = 0.824–0.852). Construct validity was strong, with all items loading onto a single underlying factor that explained 57% of the variance in ATEMPT scores.ConclusionsThe Slovenian translation of ATEMPT demonstrated moderate to excellent measurement properties and can therefore be used to assess exercise adherence in people with CMP.

Real-time feedback-based personalized moderate-intensity aerobic brisk walking intervention using wrist-worn photoplethysmography (PPG) on mild-to-moderate depressive.

To compare swallowing exercise adherence, swallowing function, and media satisfaction between stroke patients with dysphagia using a video-guided exercise program on mobile electronic devices versus those using a handbook. Randomized controlled trial. Forty-four stroke patients with dysphagia were randomized to either a video-guided intervention group (n = 23) or a handbook-based control group (n = 21). The prescribed exercises included lip exercises, tongue range of motion and strengthening, chin tuck against resistance (CTAR), and Masako exercises, performed as three sets of ten repetitions daily. Baseline swallowing function was assessed using the Functional Oral Intake Scale (FOIS), and adherence was self-reported via logbooks. Outcomes were reassessed at 1-month follow-up. Forty participants completed the study (21 intervention, 19 control). Baseline characteristics were comparable, except for a higher prevalence of left hemiparesis and a longer time since stroke onset in the intervention group. Exercise adherence was significantly higher in the intervention group (median 42.9% [IQR 24.6, 78.4]) compared to the control group (19.4% [IQR 0, 38.7]; p = 0.009). Both groups showed FOIS score improvements, with no significant between-group difference. Media satisfaction did not differ significantly. A video-guided swallowing exercise program delivered via mobile devices significantly improved adherence compared to handbook-based instruction. This approach may offer a feasible and accessible strategy for post-stroke dysphagia rehabilitation.

To analyze the influence of patients' health beliefs on adherence to rehabilitation exercise after knee replacement and to verify the mediating role of exercise psychological needs satisfaction. From January 2023 to December 2025, patients who underwent knee replacement at the First Affiliated Hospital of Henan Medical University were selected by convenience sampling as the research subjects. According to the inclusion and exclusion criteria and patients' voluntary participation in screening, 316 cases were finally included. This study was a cross-sectional study. Patients' adherence to rehabilitation exercise was evaluated using the Exercise Adherence Questionnaire (EAQ). The Chinese version of the Champion Health Belief Model Scale (SF-HBMS) was used to evaluate the health beliefs of the participants. The Psychological Need Satisfaction in Exercise Scale (PNSES) was used to evaluate the satisfaction of exercise psychological needs. The current status of patients' health beliefs, rehabilitation exercise adherence, and exercise psychological needs was summarized. Pearson correlation analysis and mediation analysis were conducted to examine the relationships among the three variables. The total EAQ score of the 316 patients was (32.02 ± 5.22), and the adherence index was (57.17 ± 13.57)%. Among them, 68 cases were in a low adherence state, accounting for 21.52%; 227 cases were in a moderate adherence state, accounting for 71.84%; and 21 cases were in a high adherence state, accounting for 6.65%. The total SF-HBMS score was (59.85 ± 9.88), and the total PNSES score was (83.47 ± 13.08). Pearson correlation analysis revealed positive correlations between EAQ and SF-HBMS (r = 0.665), EAQ and PNSES (r = 0.581), as well as SF-HBMS and PNSES (r = 0.525) (all P < 0.001). Mediation effect analysis involved three models, namely: rehabilitation exercise adherence = 10.689 + 0.351 × total health belief score; exercise psychological needs satisfaction = 41.887 + 0.695 × health beliefs; rehabilitation exercise adherence = 5.347 + 0.263 × health beliefs + 0.128 × exercise psychological needs satisfaction. The indirect effect of exercise psychological needs satisfaction on the relationship between rehabilitation exercise adherence and health beliefs was significant [b = 0.089, P < 0.001, 95% CI (0.064, 0.115)]. Exercise psychological needs satisfaction played a partial mediating role between rehabilitation exercise adherence and health beliefs, with an effect value of 0.089, accounting for 25.23%. Health beliefs had a significant positive predictive effect on exercise psychological needs satisfaction [a = 0.695, P < 0.001, 95% CI (0.570, 0.820)], and exercise psychological needs satisfaction had a significant positive predictive effect on rehabilitation exercise adherence [a = 0.128, P < 0.001, 95% CI (0.091, 0.164)]. At the same time, the direct effect of health beliefs on rehabilitation exercise adherence was significant [b = 0.263, P < 0.001, 95% CI (0.215, 0.311)], and the total effect was also significant [c' = 0.351, P < 0.001, 95% CI (0.307, 0.395)]. Rehabilitation exercise adherence among patients following knee arthroplasty was moderate. Health beliefs were positively correlated with both exercise adherence and exercise psychological needs satisfaction. Mediation effect analysis indicated that exercise psychological needs satisfaction partially mediated the relationship between health beliefs and rehabilitation exercise adherence. The direct correlation between health beliefs and rehabilitation exercise adherence was also statistically significant.