Exercise is a critical determinant of both immediate and long-term health for individuals with congenital heart disease (CHD). While pediatric cardiologists increasingly recognize the importance of promoting physical activity, formal training in exercise counseling remains limited. Exercise cardiology is an evolving subspecialty, with growing educational and training opportunities for congenital cardiologists to develop diagnostic and therapeutic approaches and expand access to exercise resources for patients with CHD. As part of this effort, the Global Coalition for Fitness and CHD (GloCo) convened a multi-institutional Education Working Group to develop practical, evidence- and consensus-based guidance for exercise counseling in children, adolescents, and young adults with CHD. This guide outlines foundational elements of exercise counseling, including strategies for obtaining an exercise history, performing cardiac risk assessments, shared decision-making, and tailoring exercise recommendations to individual patient needs. Exercise counseling in CHD must be personalized, taking into consideration the patient's medical status, psychosocial context, and available resources. Core components include risk assessment through multimodal imaging, rhythm monitoring, and exercise assessment, including but not limited to cardiopulmonary exercise tests. Based on these evaluations, clinicians can provide or recommend general physical activity promotion, formal exercise prescriptions, or structured programs such as cardiac fitness and rehabilitation. Importantly, the aim is not simply meeting physical activity targets but fostering positive attitudes toward lifelong exercise and instilling the confidence to sustain it. By aligning exercise plans with patient and family preferences, motivations, goals, and resources, clinicians can promote sustainable engagement and improved overall fitness. This guide aims to support pediatric and congenital cardiologists in providing safe and effective exercise counseling to their patients with CHD to help them achieve optimal physical and psychosocial well-being.

Aim: To identify the key strengths and weaknesses of Smart MOVE, a 12-week virtual home-based exercise program combining exercise coaching and counseling on healthy behaviors with mobile health for veterans with symptomatic PAD, through qualitative exploration of participant experiences, focusing on the benefits and challenges of mobile technologies. Methods: Qualitative interviews were conducted with veterans who completed Smart MOVE. Interviews focused on veterans' experiences with mobile health tools—including a watch and a phone-based app that enabled two-way messaging with coaches, provided educational content, and included an electronic diary—interactions with health coaches, and overall impressions. Transcripts were coded with an a priori codebook and later revised based on emerging salient topics. Results: We interviewed 11 veterans between 2022 and 2023. Participants reported improved health-conscious behaviors, motivation to exercise, routine-setting, and a sense of accomplishment. However, they expressed frustration over limitations on sharing health vitals (e.g., heart rate, blood pressure, etc.) with other providers and a sense of failure when established goals were unmet. The health coach was consistently praised for providing personalized support and motivation. Technological components elicited mixed responses. The app and watch increased accountability and motivation by allowing participants direct access to their health vitals and step counts, but were difficult to navigate, reducing usage. Despite challenges, participants reported overall positive experiences and a strong willingness to recommend the program. Conclusion: Smart MOVE can enhance health outcomes for veterans with PAD, but technology and goal achievement challenges must be addressed. Comprehensive training sessions may improve user experience and satisfaction with the technology. Future efforts should leverage patient testimonials for recruitment, conduct long-term follow-up studies on health-conscious behavior, and expand health coaches’ roles through structured support mechanisms.

Objective: To evaluate the impact of continuity of care on delivery outcomes in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: This retrospective controlled study was conducted at a tertiary general hospital in Hubei Province, China. The control group consisted of 60 GDM patients who received standard prenatal care between September 2020 and September 2021. The intervention group included 200 GDM patients who received continuity of care between October 2021 and June 2023. The continuity of care model encompassed health education, dietary and exercise counseling, psychological support, and online follow-up from the time of diagnosis until one week postpartum. Delivery outcomes—including rates of vaginal delivery, pelvic adhesions, premature rupture of membranes, postpartum hemorrhage, dystocia, and manual placental removal—were compared between groups. Results: The intervention group had a significantly higher rate of vaginal delivery compared to the control group (44.5% vs. 28.3%, P = 0.02). Rates of pelvic adhesions (5.5% vs. 28.3%), premature rupture of membranes (2.0% vs. 11.7%), postpartum hemorrhage (1.5% vs. 8.3%), and dystocia (3.5% vs. 18.3%) were significantly lower in the intervention group (P < 0.05). There was no statistically significant difference in the rate of manual placental removal (5.5% vs. 13.3%, P = 0.07). Conclusion: Continuity of care is associated with improved delivery outcomes in pregnant women with GDM and demonstrates strong potential for clinical application in perinatal management.

Sedentary behavior (SB) is a growing global health concern, particularly among bank employees, contributing to NCDs and increased mortality. While exercise and dietary modifications are recognized as effective interventions, their combined impact remains underexplored. This randomized controlled trial examined the impact of an integrated exercise and dietary counseling program on physiological biomarkers in sedentary bank employees. Forty participants (mean age: 47.55 ± 4.07 years) were randomly assigned to one of four groups: aerobic, resistance, or combined exercise (all with dietary counseling), or a control group (n = 10 each). Over the 12-week period, significant improvements (p < 0.001) were observed in pre- to post-intervention measurements of physiological markers, including Body Mass Index (BMI), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Resting Heart Rate (RHR), among the intervention groups. The statistical analysis in MANOVA indicated a significant inter-group differences for BMI (F(3,36) = 58.554, p = 0.001, η² = 0.830), SBP (F(3,36) = 32.155, p = 0.001, η² = 0.728), DBP (F(3,36) = 27.288, p = 0.001, η² = 0.695), and RHR (F(3,36) = 37.274, p = 0.001, η² = 0.756). Post-hoc analysis revealed that all intervention groups showed statistically significant improvements (p < 0.001) in all measured biomarkers compared to the control group. Moreover, aerobic and combined exercise interventions alongside dietary counseling groups demonstrated significant improvements over other groups.

BackgroundExercise guidelines for older adults are predominantly “one-size-fits-all,” primarily focusing on aerobic activity with limited emphasis on motor components.ObjectiveWe examined the hypothesis that remotely delivered, personalized multicomponent exercise—based on a simple yet highly reliable and accurate smartphone motor fitness assessment and individually tailored using machine learning—can improve balance, flexibility, and strength among older adults, obviating the need for a laboratory or professional supervision.MethodsThis randomized controlled study recruited community-dwelling healthy older adults aged ≥65 years, with normal cognition, low fall risk, and no hospitalization within the last year for cardiac/neurological illness. Participants were randomly assigned to an experimental 8-week personalized exercise group (5×/wk, multicomponent exercises), an 8-week active-control group (exercise counseling according to World Health Organization guidelines), or a control group (no intervention). Participants were assessed at baseline, 4, 8, and 12 weeks. Measurements were remotely recorded using smartphone sensors and analyzed using machine learning to create each participant’s unique fitness profile. Primary outcomes were fitness profile changes at 8 weeks.ResultsWe assessed 317 volunteers; 239 of them consented and met inclusion criteria (155 women, mean age 72.63, SD 5.38 y). Compared to both controls, the personalized exercise group significantly improved in dynamic balance (F6,404=3.232, P=.004, η2=0.046), total balance (sum of all balance measurements; F6,432=3.03, P=.006, η2=0.040), arm flexion (F6,448=2.527, P=.02, η2=0.033), arm extension (F6,450=2.753, P=.01, η2=0.035), and arm strength (F6,424=2.394, P=.03, η2=0.033). Significant improvement was observed with adherence as low as 1.5 exercise sessions/week over 8 weeks and often within just 4 weeks. No improvement was observed on torso rotation and on sit-to-stand.ConclusionsA smartphone platform, with remote assessment and delivery of home-based individually tailored exercises, effectively targets the often-neglected key fitness components—balance, arm flexibility, and arm strength—in older adults. This approach has the potential to generate varied movement profiles and personalized exercise programs for both healthy individuals and those with mobility or cognitive impairments.

BackgroundObesity, overweight and their associated diseases pose serious challenges to the health system. General practitioners are in an especially favourable position to contribute to obesity prevention, make timely diagnoses, and initiate treatment in their patients. Beyond individual findings, the German-speaking world has a lack of studies giving a reliable reflection of the status quo for obesity management in primary care towards establishing common attitudes and behaviour patterns in treating this patient cohort. The aim of the present study was to determine the opinions, attitudes, experiences, and desires for improvement amongst GPs regarding obesity care. The aim of this study is to serve as a basis for developing an approach towards optimisation.MethodsAll 13,912 GPs in active practice in Baden-Württemberg, Hesse, Rhineland-Palatinate, and Saarland between January and April 2024 were invited to take part in an online survey. A total of 4,038 fully completed questionnaires were included in the analysis; this corresponds to a response rate of 29%. Apart from descriptive analysis, Student’s t-test for independent samples was performed to determine significant differences between two groups.ResultsThe results have shown that most GPs see obesity as a major challenge that is clearly on the increase. Many of the GPs surveyed saw it as their responsibility to care for and provide therapeutic support for their overweight and obese patients. GPs especially prioritised assessing individual life situations surrounding their patients in the causes and consequences of overweight during weight counselling. Every second respondent provided dietary counselling, but fewer gave exercise counselling. Only some respondents used the opportunity to recommend specific health services to patients or refer their patients to these services. Respondents addressed dietary changes followed by psychosocial support and physical exercise issues. GPs were often unsatisfied with obesity management outcomes. This was worsened by general lack of time, resources, and connections to interprofessional support networks. Two groups in the sample stood out as drawing more optimistic conclusions after reflecting on their own counselling activities and therapeutic interventions. One group comprised GPs with specific additional qualifications, especially in diet and sports medicine. The other group consisted of GPs who regularly used digital health apps (DHAs) in their therapeutic approach; physicians in this group were markedly more satisfied with the results of disease management in their patients. Many respondents welcomed the introduction of the German DMP Adipositas obesity management programme and showed great interest in taking part in it. Many GPs expressed a desire for an easier overview of available local and regional health services.ConclusionsEven with the favourable conditions of primary care, the interview results indicate that the potential in primary care is currently not being fully exploited in overweight and obesity management. It would seem to make sense to raise awareness amongst GPs as to the circumstances of obesity while encouraging more motivational and behavioural consultation with patients. An obesity diagnosis should include actual recommendations on diet and exercise. Focussed diet and exercise counselling would also be welcome in primary care. GPs should also be encouraged to take on a role as mediators by referring patients to a broader healthcare network as necessary. Increased effort should be made towards developing structured, GP-compliant care programmes for obesity management towards implementing evidence-based treatment concepts adaptable to patient needs.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12875-025-03048-w.

Postpartum physical activity (PA) is linked to improved mental health and sleep. Yet, many women do not return to pre-pregnancy PA levels, and sedentary behavior may increase. This study mapped PA, sedentary time, and sleep from early pregnancy to one year postpartum, and examined if prenatal PA interventions affect these outcomes postpartum. In the FitMum randomized controlled trial, 220 healthy, inactive pregnant women (< 15 + 0 weeks gestation) were assigned to standard care (CON), supervised exercise (EXE), or motivational PA counselling (MOT). Participants wore wrist-worn activity trackers from inclusion to one year postpartum and completed the Pregnancy Physical Activity Questionnaire and Pittsburgh Sleep Quality Index. We found that postpartum daily steps increased by ~ 2,000 compared to late pregnancy (p < 0.001), while moderate-to-vigorous-intensity PA (MVPA) declined (p < 0.001). Sedentary time remained similar. Sleep duration dropped postpartum in the first three months (p < 0.05), while sleep quality improved (p = 0.006). Prenatal PA interventions had minimal impact postpartum, however, EXE participants reported slightly better sleep than MOT at one year. In conclusion, PA patterns and sleep changed postpartum, with more daily steps, less MVPA, and reduced sleep duration. Prenatal PA interventions had limited effect. Longitudinal studies are needed to optimize timing of interventions for maternal health. The study is registered at ClinicalTrials.gov; NCT03679130;20/09/2018.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-18186-5.

Abstract Issue To support functional capacity in the aging society, a national Strength in Old Age Program targeting older persons aged 75+ years was launched in 2004. Description of the problem The Program promotes health-enhancing physical activity for independently living older adults who experience limitations in functioning. The Coordinator, Age Institute, selects municipalities to undergo a three-year mentoring in the Program. Implementation Municipalities in the Program implement exercise counseling, strength and balance exercise, and outdoor exercise. They commit to implementation through intersectoral collaboration, including e.g. social, health care, sports services, and NGOs. Local cross-sectoral work is supported by mentoring from Age Institute, which includes counseling, continuing education, materials, network events, development tools, and collection of follow-up data. The exercise group participants undergo functional capacity tests. Results 109 municipalities out of 297 have participated in the Program. Intersectoral collaboration and tailored mentoring were seen among the success points. Of the municipalities, 80% perceived receiving high or very high benefits from participation in the Program and 89% were committed to continue the good practices after their 3-year mentoring phase. Free-of-charge continuing education and materials were well received. Challenges were recognized, e.g. high turnover of workers and lack of support from decision-makers. The main target group, older adults with functional limitations benefited from the Program. More exercise groups were locally offered. The participants perceived social and physical benefits from the exercise groups. Physical functioning tests showed that majority of the participants improved their strength and balance. Lessons Program showed effectiveness in intersectoral collaboration, local implementation, learning skills, physical activity opportunities, and functional capacity. Good practices were developed. Key messages • The Strength in Old Age Program is effective in improving intersectoral collaboration, local implementation, learning skills, physical activity opportunities and functioning of older adults. • Good practices for physical activity among older adults have been developed as part of the implementation, including exercise counseling, strength and balance exercise and outdoor exercise.

Adaptive dietary and exercise strategies for weight loss in Adults with Prediabetes Trial (ADAPT): a sequential multiple assignment randomized trial.

Patients with hypertrophic cardiomyopathy (HCM) often reduce their physical activity due to concerns about sudden cardiac death. However, objective data on activity patterns in HCM, particularly in relation to clinical phenotype and quality of life (QoL), remain limited. We assessed physical activity using 7-day accelerometry in 203 patients with HCM and 37 genotype-positive, phenotype-negative (G+/P-) individuals. Outcomes included daily step counts, time spent in moderate-to-vigorous physical activity (MVPA) and sedentariness. QoL was measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the EuroQoL 5-domain 5-level (EQ-5D-5L). HCM patients took fewer steps/day (5254 vs 6573), engaged in less MVPA (3.4% vs 4.5% of the day) and were more often sedentary (61% vs 35% spending >80% of the day sedentary) compared with G+/P- controls (all p<0.01). Symptomatic and obstructive HCM patients showed the lowest activity levels. Notably, asymptomatic obstructive HCM patients demonstrated reduced activity comparable to symptomatic individuals. Obesity and use of cardiac medications were also associated with lower activity. Step counts were positively associated with QoL scores: a 250 steps/day increment corresponded to a 2.15-point higher KCCQ score and a 1000 steps/day increment to a 0.05-point higher EQ-5D-5L score (both p<0.001), remaining significant after adjustment for age and sex. Most HCM patients (62%) recalled receiving exercise guidance, and many (59%) reported reducing their activity as a result. Objectively measured physical activity was significantly lower in HCM patients compared with G+/P- individuals, particularly among those with symptoms, obstruction or obesity. Even modestly higher daily step counts were associated with better QoL, highlighting the relevance of individualised, phenotype-informed exercise counselling in HCM.

Simultaneous physical and nutritional intervention reduces frailty in patients with cirrhosis listed for liver transplantation: a randomized controlled trial.

Cardiac rehabilitation consists of comprehensive risk factor reduction with demonstrated effectiveness in combating cardiovascular disease. The American Heart Association defines cardiac rehabilitation as a supervised program to improve cardiovascular health through a combination of exercise, education, and emotional counseling for those who have had a myocardial infarction, heart failure, angioplasty, or heart surgery. Cardiac rehabilitation programs involve evaluations by a team of specialists, structured exercise, and lifestyle risk factor modification, and a focus on long-term goals to improve overall health and reduce coronary heart disease morbidity and mortality. Family physicians play a vital role in ensuring that patients are connected to and complete cardiac rehabilitation training because the program remains underused nationwide. After a coronary heart disease event and cardiac rehabilitation, these programs continue to support patients by helping them adhere to lifestyle modifications.

Arteriovenous fistula (AVF) stenosis is one of the most frequent complications among patients receiving hemodialysis, leading to inadequate blood flow, impaired dialysis adequacy, repeated interventions, and AVF management. This study evaluated the effectiveness of a structured AVF stenosis prevention program designed to improve vascular access outcomes through exercise, nutrition, and patient education. A quasi-experimental design was used, and 62 patients undergoing hemodialysis at a tertiary care hospital were purposively selected. The intervention comprised a phosphorus-restricted diet, upper extremity strengthening with a hand gripper, postoperative AVF care instructions, motivational text messages, and ongoing counseling. Data were collected on upper limb muscle strength, AVF blood flow, physiological markers of vascular calcification (serum calcium and phosphorus), and self-care behavior before and after the intervention. Results indicated significant improvements in muscle power, blood flow rate, and physiological indices, along with enhanced patient self-care behaviors. The findings suggest that incorporating exercise and dietary counseling into routine hemodialysis can prevent stenosis, prolong AVF patency, and reduce complications. This study underscores the importance of a multidisciplinary approach in empowering patients with self-management strategies to improve quality of life and ensure sustainable hemodialysis outcomes.

Background/Objectives: There is growing interest in non-diet approaches to support health, well-being, and performance in different populations. The aim of this study was to evaluate the effects of a 12-week intuitive eating (IE) intervention on participants’ body composition, body image, eating behaviors, and athletic performance. Methods: The study included both an intervention group and a control group. It was conducted between September and December 2021. Participants were recruited from a sports center in Istanbul, where they had applied for nutrition and exercise counseling. Inclusion criteria included being 18–65 years old, not having engaged in regular physical activity in the past month, having no chronic disease, and not using any regular medications. Participants were not randomly assigned to groups; allocation was based on availability and willingness to attend the intervention sessions. The study involved 57 participants who were healthy adults between 18 and 65 years old and followed a structured exercise program. At the beginning of the study, a demographic questionnaire was administered. The anthropometric measurements were taken at the beginning and at the end of the intervention. In addition, validated performance and psychometric assessment tools were used, including the Cooper test for cardiovascular endurance, the Davies test for upper-body agility, and the 1-RM bench press for muscular strength, alongside standardized self-report questionnaires for eating attitudes (EAT-26), IE (IES-2), and body image (BCS). Results: The intervention group did not show any statistically significant changes in body composition (p > 0.05). The post-intervention means of the intervention and control groups were not statistically different (p > 0.05). The intervention group showed significant improvements in cardiovascular endurance, agility, and strength performance scores compared to the control group after the intervention (p < 0.05). The intervention group showed significant improvements in body image scores (p < 0.05) and eating attitude scores (p < 0.05). The post-intervention eating attitude and body image scores of the intervention group were significantly different from those of the control group (p < 0.05). The results of the correlation analysis showed a significant positive correlation between intuitive eating and body image (r = 0.455; p < 0.05) and a significant negative correlation between IE and disordered eating attitudes (r = −0.449; p < 0.05). Conclusions: These findings suggest that longer-term interventions may be beneficial and warrant further investigation. IE may serve as a promising strategy to enhance psychological well-being and performance outcomes without focusing on weight control.

Large-language models (LLMs) are increasingly used for health advice, but their alignment with evidence-based guidelines and sensitivity to question phrasing remain unclear. In May 2025, we evaluated ChatGPT 4.0, ChatGPT 4.5, and DeepSeek V3 using four clinical vignettes: major depression with polysubstance use, irritable bowel syndrome flare, new-onset hypertension requiring exercise counseling, and chronic low back pain. Each scenario was tested with clinician- and patient-style prompts, generating 24 responses. Outputs were benchmarked against 89 guideline-derived recommendations from three authoritative sources per domain. Two blinded reviewers scored concordance (1 = actionable detail, 0.5 = generic mention, 0 = absent), with adjudication by a third reviewer. Inter-rater reliability was measured using Cronbach's α. ChatGPT 4.5 achieved the highest guideline concordance (61.9%), followed by DeepSeek V3 (60.7%) and ChatGPT 4.0 (53.7%). Performance varied by domain, exceeding 67% in mental health but dropping below 45% in nutrition. Prompt phrasing influenced capture rates, with clinician-style prompts improving scores in exercise and pain domains, while patient-style prompts outperformed in nutrition. Reviewer agreement was high (α = 0.97 for chatbot scoring; 0.80 for matrix coding). LLMs can rapidly generate draft care plans that reflect clinical guidelines, though they favor generic over individualized advice. By introducing a unique, domain-agnostic scoring rubric that aligns AI-generated 30-day care plans with gold-standard guidelines, and by applying it in parallel to mental health, nutrition, exercise, and physical therapy scenarios, our study delivers the first prompt-sensitive audit showing where current LLMs exceed, match, or fall short of multidisciplinary best practices. The online version contains supplementary material available at 10.1007/s13755-025-00368-0.

ABSTRACT The UWorkItOut UWin program is a 6-week exercise training and counseling intervention aimed to improve the mental health of university students. Benefits of the program include a reduction of anxiety and depression symptoms, physical, psychological, and cognitive outcomes, as well as the development of various coping skills. Despite these favorable outcomes, a process evaluation of the program is needed to understand its effectiveness. The present study conducted a process evaluation using the RE-AIM framework to assess the UWorkItOut UWin program. Data collected from a mixed-method quasi-experimental pretest-posttest single group design was analyzed using the RE-AIM dimensions (i.e. Reach, Effectiveness, Adoption, Implementation, and Maintenance). Sixty participants (n = 60) completed pre-post surveys, exercise training data, self-report physical activity questionnaires, and exit interviews. The program performed well across the RE-AIM dimensions. The program had high adherence rates (reach) and positive outcomes related to mental health, such as decreased anxiety (d = −0.58), depression (d = −0.36), and loss of emotional control (d = −0.42) as well as increased general positive affect (d = 0.47) emotional ties (d = 0.40), and increased physical activity levels (effectiveness). Program staff were valuable for the social support they provided to participants (adoption). However, the program faced barriers with respect to securing dedicated space to conduct the program (implementation) and lacked evidence of long-term maintenance of physical activity participation (maintenance). The program prioritizes a client-centered approach to meet the needs of the participants. As such, continued program evaluation and adaptation is needed.

Leaders in the field have called for exercise counseling to become standard of care by 2029. An Affect-based exercise prescription (Affect-Rx) may be a viable strategy for supporting this effort. Guided by the ORBIT Model for developing behavioral treatments, this Phase 1b study evaluated breast cancer survivors' perceived acceptability of Affect-Rx. Additionally, the feasibility of trial methods and opportunities for protocol refinements were assessed. Participants were 36 stage 0-III breast cancer survivors within 5years of completing primary cancer treatment. Demographics were collected at baseline and via medical record review. Affect-Rx was delivered in conjunction with a low-touch, physical activity promotion intervention over videoconference call. At end-of-study, participants rated Affect-Rx using the Treatment Acceptability and Preferences (TAP) Measure. Participants responded to the Stanford L-Cat at baseline and end-of-study. ActiGraph wGT3X-BT accelerometers measured moderate-vigorous physical activity (MVPA) over 10-day periods at baseline and follow-up. Affect-Rx was rated acceptable (TAP overall M=3.30, SD=0.53). Study retention and accelerometer measurement completion was ≥80% across time. L-Cat scores were discordant from accelerometer-measured MVPA at baseline. Affect-Rx warrants further testing. The trial methods were feasible; however, physical inactivity verification procedures along with targeted recruitment efforts are needed to support future work. The field needs intervention strategies that can be deployed with limited resources and at low cost to offer survivors exercise counseling support in line with the new National Standards for Cancer Survivorship Care, the affect-based exercise prescription is designed to serve this mission. The study protocol was registered with ClinicalTrials.gov prior to the initiation of participant recruitment NCT04903249.

Cancer is a leading cause of mortality worldwide, with approximately 19.6 million new cases and 10 million deaths reported in 2020. Exercise interventions have demonstrated positive effects on physical and mental health in cancer patients, yet there is limited evidence on the efficacy of tailored, high-intensity exercise programs designed using genomic data. This protocol outlines a study aimed at integrating genomic analysis and personalized exercise interventions to improve health outcomes and reduce cancer-related risk factors. This study aims to evaluate the feasibility and potential impact of a personalized exercise intervention delivered through the EXESALUS mobile application. The program integrates genomic information to tailor exercise regimens for cancer prevention, muscle strength improvement, and quality-of-life enhancement. This is a protocol for a 3-month, parallel-group, randomized controlled trial involving 500 participants, including 100 cancer patients undergoing treatment or rehabilitation and 300 non-cancer participants with elevated disease risk. Participants will engage in the EXESALUS program, which includes low-, moderate-, and high-intensity exercise tailored to genomic profiles, supported by exercise counseling and wearable device feedback. Biospecimens (blood, urine, and oral epithelial cells) will be collected at baseline, 6 weeks, and 3 months to assess genomic variations and physiological changes. Primary outcomes include physical performance (SPPB), muscle strength (1RM and peak power), and skeletal muscle mass (DXA). Secondary outcomes will evaluate mental health indicators such as fatigue (FACIT-F), resilience, anxiety, depression, and quality of life. This study will provide a detailed framework for implementing ICT-based personalized exercise interventions that incorporate genomic analysis. The EXESALUS program is expected to highlight the potential of tailored high-intensity exercise as a preventive and therapeutic strategy for cancer patients and individuals at risk of chronic diseases. The findings of this protocol will contribute to the development of precision medicine approaches for cancer prevention and management, emphasizing the scalability and utility of ICT-based solutions in health promotion. This study was registered in the Korean Clinical Trials Registry (KCT0010187).

BackgroundCancer is a leading cause of mortality worldwide, with approximately 19.6 million new cases and 10 million deaths reported in 2020. Exercise interventions have demonstrated positive effects on physical and mental health in cancer patients, yet there is limited evidence on the efficacy of tailored, high-intensity exercise programs designed using genomic data. This protocol outlines a study aimed at integrating genomic analysis and personalized exercise interventions to improve health outcomes and reduce cancer-related risk factors. This study aims to evaluate the feasibility and potential impact of a personalized exercise intervention delivered through the EXESALUS mobile application. The program integrates genomic information to tailor exercise regimens for cancer prevention, muscle strength improvement, and quality-of-life enhancement.MethodsThis is a protocol for a 3-month, parallel-group, randomized controlled trial involving 500 participants, including 100 cancer patients undergoing treatment or rehabilitation and 300 non-cancer participants with elevated disease risk. Participants will engage in the EXESALUS program, which includes low-, moderate-, and high-intensity exercise tailored to genomic profiles, supported by exercise counseling and wearable device feedback. Biospecimens (blood, urine, and oral epithelial cells) will be collected at baseline, 6 weeks, and 3 months to assess genomic variations and physiological changes. Primary outcomes include physical performance (SPPB), muscle strength (1RM and peak power), and skeletal muscle mass (DXA). Secondary outcomes will evaluate mental health indicators such as fatigue (FACIT-F), resilience, anxiety, depression, and quality of life.DiscussionThis study will provide a detailed framework for implementing ICT-based personalized exercise interventions that incorporate genomic analysis. The EXESALUS program is expected to highlight the potential of tailored high-intensity exercise as a preventive and therapeutic strategy for cancer patients and individuals at risk of chronic diseases. The findings of this protocol will contribute to the development of precision medicine approaches for cancer prevention and management, emphasizing the scalability and utility of ICT-based solutions in health promotion.Trial registrationThis study was registered in the Korean Clinical Trials Registry (KCT0010187).

BackgroundScientific evidence has sufficiently proved that antenatal physical exercise benefits maternal, fetal, and child health. Despite the World Health Organization strongly recommends that health care providers advise pregnant women on physical exercise, many of them have reported they didn’t receive any exercise recommendations from their health care providers. Therefore; this study aimed to assess the practice level of antenatal physical exercise counseling and its associated factors among healthcare providers who work at Bench Sheko, Southwest Ethiopia.MethodsAn institutional-based cross-sectional study design was employed, and 384 study participants were interviewed consecutively from January 25, 2023, to March 25, 2023. Data entry was made using Epi-Data software version 4.6 and exported to SPSS version 25 for analysis. A bivariate logistic regression was used to assess the association of each independent variable and the outcome variable, and variables with a p-value < 0.25 were candidates for the multivariable logistic regression. Finally, variables with a p-value of < 0.05 were declared as statistically significant and reported with their AOR and 95% CI.ResultIn this study, only 36.5% of healthcare providers had an adequate antenatal physical exercise counseling practice. An adequate antenatal exercise counseling practice is more likely to occur in health care providers who are exposed to mass media (AOR: 3.51, 95% CI: 1.90, 6.48), MSc and above educational level (AOR 2.74, 95% CI, 1.15, 6.56), having an adequate level of knowledge (AOR 6.62, 95% CI: 3.40, 12.78), having a good level of attitude (AOR 3.64, 95% CI: 1.85, 7.16), and works in urban area of health facility (AOR: 3.23, 95% CI: 1.50, 6.94).ConclusionThe practice of antenatal physical exercise counseling, meeting the World Health Organization exercise recommendation among health care providers in bench Sheko zone is low compared to other similar studies. Therefore, it shall be beneficial if the zonal health office works towards improving exercise counseling practice by providing education, exercise training, and media campaigns on antenatal exercise.