Exercise In Adults Research Articles

Respiratory effects of obesity on the ventilatory response to exercise in older adults: the impact of a shift in operational lung volumes.

Bidirectional dynamics: A cross-lagged examination of physical exercise and loneliness in older adults.

Exercise is a key component in the management of type 2 diabetes mellitus (T2DM), but its benefits in older adults with comorbidities remain unclear. To evaluate the metabolic effects of therapeutic exercise on older patients with T2DM and comorbidities and identify clinical characteristics associated with glycaemic improvement. We retrospectively analysed patients with T2DM and at least one comorbidity (e.g. chronic kidney disease, cardiovascular disease, osteoporosis, cancer, stroke and dementia) who received therapeutic exercise guidance from physical therapists between November 2022 and October 2023. Biochemical data were collected at baseline and 3 and 6 months. Patients were considered to be glycated haemoglobin (HbA1c) responders if their HbA1c levels decreased after the intervention. Among 43 patients (mean age: 74.1 ± 12.5 years; 44% men), 21 were HbA1c responders at 3 months. Responders had higher baseline HbA1c levels (7.88% vs 6.87%, P < 0.05), and a greater proportion had HbA1c ≥ 7% (71.4% vs 40.9%, P < 0.05). At 6 months, triglyceride levels significantly decreased in responders (123.3 to 108.7 mg/dL, P < 0.005) and significantly increased in non-responders (113.6 to 149.7 mg/dL, P < 0.01). HbA1c declined significantly in patients with baseline HbA1c ≥ 7% compared to those with HbA1c < 7% (-0.62% vs +0.34%, P < 0.05). Therapeutic exercise improves glycaemic control and triglyceride levels in older patients with T2DM and comorbidities, particularly among those with poorly controlled baseline HbA1c. Baseline HbA1c can be a useful indicator for identifying patients who are likely to benefit from exercise.

Acute exercise has been demonstrated to improve cognitive functioning among the general population. We provide the first review to establish the evidence for acute exercise to improve cognitive function among adults with cognitive impairment (CI). We conducted a systematic review with meta-analysis of randomized controlled trials that investigated the effects of a single exercise session on cognitive function. Data sources were PubMed, SportDiscus, PsychINFO, Cochrane Central, PEDro, and Embase. Eligibility criteria were randomized controlled trials of acute exercise with participants aged 18+ and physician diagnosed or self-reported CI. We used dual data abstraction, risk-of-bias assessment, and strength of evidence assessment. We pooled results using the inverse variance heterogeneity model or with narrative synthesis. Fifteen studies (8 parallel group and 7 crossover) representing 500 participants were included, 10 in the meta-analysis. Acute exercise significantly improved executive function (moderate evidence, 9 studies, 330 participants, g = 0.33, small effect, 95% CI, 0.07-0.59, P = .01, I2 = 26.77%). However, this was only for high risk of bias/crossover studies. Acute exercise improved reaction time but not significantly (very low evidence, 7 studies, 271 participants, g = 0.17, small effect, 95% CI, -0.20-0.54, P = .36, I2 = 50.18%). Narratively, improvements were noted for memory, but there was mixed evidence for attention, information processing, and motor memory. Acute exercise provides a small improvement in executive function and may also improve reaction time and memory for adults with CI. Additional research is needed before reaching an evidence-based consensus on the promotion of acute exercise for adults with CI.

Abstract Disclosure: S. Mauro: None. K.C. Anderson: None. A.A. Panzer: None. K.S. Fitzgibbon: None. K.M. Love: None. Introduction and Objective: Physical activity (PA) is vital for people with type 1 diabetes (T1D) as it is associated with improved mortality, glycemic control, and quality of life. Despite this, people with T1D exercise less than their unaffected peers. This study aimed to identify barriers and facilitators to exercise in adults with T1D and determine if sociodemographic, T1D management self-efficacy, or quality of life factors were independently associated with meeting recommended PA. Methods: We conducted a cross-sectional online survey study of adults with T1D aged ≥18 years old recruited through the T1D Exchange and Reddit. Questions related to exercise quantity and intensity, diabetes quality of life (DQOL), self-efficacy, demographic characteristics, and exercise facilitators. Exercise barriers were rated using a 7-point Likert scale. SAS 9.4 was used to conduct descriptive, Mann-Whitney U, and logistic regression analyses. Logistic regression was performed to determine if the following predictors were independently associated with meeting PA recommendations: age, gender, income level, insurance payor, urban/rural location, automated insulin delivery (AID) use, and DQOL. Results: Of the 281 respondents who completed questions about exercise quantity, 162 (62%) were women, mean age 52.6 ± 16.6 years and 150 (53%) met PA guideline recommendations. Most commonly selected facilitators were insurance reimbursement of exercise program/gym (50.9%), attending an exercise group (39.9%), and one-on-one advising from a health advisor (37.4%). For those not meeting PA recommendations, most commonly reported barriers to PA were risk of hypoglycemia and weather conditions (median response 5, “likely” to prevent activity). Other common barriers for those not reaching PA recommendations and which showed discordance between the meeting and not meeting recommended PA groups included: fatigue before and during exercise, exercise cost, activity location, and loss of glycemic control (all p&amp;lt;0.01, meeting vs. not meeting PA recommendations). Upper (vs. middle) income status was independently associated with meeting PA recommendations (adjusted odds ratio 2.3, 95% CI: 1.2-4.4) but the other covariates including age, gender, insurance payor, location, AID use, and DQOL were not. Conclusion In this cohort with T1D not meeting recommended PA, most commonly reported modifiable barriers to PA were fear of hypoglycemia/loss of control, fatigue before and during exercise, exercise cost and location. Addressing fatigue and glucose self-management surrounding PA with counseling and future research interventions may promote PA uptake, and advocacy is needed to promote insurance reimbursement of exercise facilities/programs in this population. Presentation: Saturday, July 12, 2025

Purpose:To evaluate participant demographics and program distributions and understand characteristics of access in an older adult exercise program in Saskatchewan, Canada.Methods:A cross-sectional survey was circulated to exercise participants and leaders to understand and evaluate demographics, program locations, and characteristics of participant access.Results:Of 589 complete participant and 207 leader surveys, most respondents were female (87% and 94%, respectively) and white (97% for both groups), with 68% of participants and 49% of leaders being urban residents. Some equity-deserving groups such as widows and low-income earners were well-represented. Program density was higher in regions with dedicated implementation staffing, and travel was the most agreed-upon barrier to access.Conclusion:There is evidence of under- and over-representation of certain equity-deserving populations in this exercise program, as well as regional differences in program availability. Future research could explore system-wide factors that support ongoing program implementation while reducing equity-related gaps.

Older adults consulting Emergency Departments (EDs) for minor injuries are at risk for new functional impairments in the 6 months following their injuries. To compare the effects of exercise programs versus usual ED practices on functional status and physical performance at 3-6 months in at-risk older adults with minor injuries. Stepped-wedge randomized trial in six Canadian EDs from 2017 to 2020. Participants aged ≥ 65 years were screened for low, moderate, or high risk of functional decline and assessed three times: baseline at ED, 3 and 6 months. Multicomponent (flexibility, balance, strengthening, aerobic) and risk-level adapted exercise programs targeting moderate- and high-risk patients, 3×/week for 12 weeks, at home or in community groups. Usual ED care. Functional decline was defined as a 2/28-point loss from baseline on the Older Americans Resources and Services (OARS) scale. Basic physical performance (leg strength, balance, walking speed) was measured using the Short Physical Performance Battery (SPPB) test. Generalized linear mixed log-binomial regressions were used to examine the effects of the intervention on outcomes compared to usual ED care, stratified by risk level. The intervention and control phases included 277 and 205 moderate-risk individuals, and 249 and 128 high-risk individuals, respectively. Among moderate-risk individuals, functional loss in intervention participants at 3 months was half that of controls: 12% [95% CI: 8%-17%] vs. 25% [95% CI: 18%-34%], RR: 0.48 [0.26, 0.90]. 12-week multicomponent exercises implemented early after minor injuries are associated with lower proportions of functional decline at 3 months in moderate-risk seniors and may help those at high risk recover some physical performance. ClinicalTrials.gov, ID Cedecoms NCT03991598.

Intermuscular adipose tissue (IMAT) is an anatomically distinct depot that is associated with metabolic dysfunction and aging. IMAT decreases with exercise in older adults with obesity, but less is known about how exercise influences IMAT in healthy, non-obese older adults in relation to insulin sensitivity. The purpose of this study was to determine if lower leg IMAT accumulates in healthy older adults in the absence of obesity, diabetes, or frailty and its relationship to insulin sensitivity. We also determined the influence of exercise training on lower leg IMAT. 29 young (25.0 ± 3.7 years) and 22 older (70.0 ± 4.0 years) adults underwent MRI-based measurements of lower leg IMAT and insulin sensitivity measurements by hyperinsulinemic euglycemic clamp before and after 12 weeks of exercise training. IMAT was higher in older compared to young adults (521 ± 217 mm3 vs 278 ± 131 mm3; p<0.0001). The glucose infusion rate (GIR) during hyperinsulinemia was similar in young and older adults (13.5 ± 2.9 mg/kg FFM/min vs 14.1 ± 4.2 mg/kg FFM/min; p=0.38), but negatively associated with IMAT (r=-0.43; p=0.002), particularly in older adults (r=-0.55; p=0.01). Exercise training reduced IMAT in young (p=0.04) but not older adults. GIR increased in response to exercise but dissociated from changes in IMAT. These data demonstrate that lower leg IMAT accumulated even in healthy aging, and although IMAT may have metabolic implications, the metabolic improvements with exercise training appear to be independent of lower leg IMAT in this population of older adults.

Validity of repetitions in reserve for prescribing resistance exercise in older adults.

BackgroundAerobic exercise is promising for preventing Alzheimer’s disease (AD) and AD-related dementia (ADRD), but exercise trials have shown mixed results. An important, understudied factor potentially contributing to mixed results is individual differences in aerobic fitness responses to moderate-intensity continuous training (MICT). This trial will test the effects and mechanisms of 6 months of aerobic exercise tailored on aerobic fitness response to MICT in community-dwelling older adults with early symptomatic AD. We aim to (I) test the effects of aerobic exercise on aerobic fitness, white matter hyperintensity volume (WMHv), and patient-centered outcomes in older adults with early symptomatic AD; (II) determine the best exercise to improve aerobic fitness and reduce non-responses over 6 months; and (III) examine the mechanisms of aerobic exercise’s action on cognition.MethodsThis stage II trial is a Sequential, Multiple Assignment, Randomized Trial (SMART). The hypothesis is that MICT augmented with high-intensity interval training (HIIT) or combined aerobic and resistance exercise (CARE) will improve aerobic fitness, WMHv, and AD/ADRD plasma biomarkers. This trial will enroll 108 dyads (participants and their study partners). Participants (n = 108) are randomized using a 2:1 allocation ratio to 3-month MICT or 6-month stretching control. After the initial 3-month intervention period for participants assigned to MICT, aerobic fitness is measured with peak oxygen consumption (VO2peak) from a cycle-ergometer exercise testing and the shuttle walk test to identify non-response (< 5% increase). Non-responders are subsequently re-randomized (1:1) to either HIIT or CARE for 3 months. Responders continue MICT. All participants are followed for an additional 6 months post-intervention. Primary outcomes are VO2peak measured at 0, 3, 6, 9, and 12 months and WMHv at 0, 6, and 12 months. Secondary outcomes include memory, physical function, behavioral and psychological symptoms of dementia (BPSD), quality of life (QoL), caregiver burden, and AD plasma biomarkers. This trial has 80% power, assuming 18% and 25% attrition at 6 and 12 months, respectively, to detect changes in aerobic fitness.DiscussionIndividual differences in VO2peak responses were reported in older adults with AD/ADRD previously but how this affects response to exercise interventions is unknown, Precision exercise tailored to VO2peak is critical to advance exercise research in AD.Trial registrationClinicalTrials.gov NCT05877196. Registered on May 25, 2023.

BackgroundPeople with moderate to severe intellectual disability can have difficulties accessing leisure stimuli and engaging in basic cognitive and physical activity independently. These difficulties may be even more marked in individuals with a combination of intellectual disability and sensory or sensory-motor impairments.ObjectiveThis study assessed a new program relying on touch screen technology, which was set up to support access to leisure stimuli and the performance of a simple form of cognitive activity and basic physical exercise for adults with intellectual or intellectual and hearing disabilities, lack of functional speech, and poor motor dexterity.MethodsThe program alternated access to preferred stimuli (ie, songs, comic sketches, or cartoons) with cognitive activity (ie, matching-to-sample tasks) and physical exercise (ie, body movements). The touch screen technology was modified to ensure that people with poor motor dexterity would be effective in their responding regardless of the accuracy of their responses. The program was implemented with 7 participants. Its impact was assessed through the use of single-case research methodology.ResultsDuring the baseline (when standard technology was used), the mean percentage of songs, comic sketches, or cartoons accessed; match-to-sample responses provided; and body movements performed correctly and independent of research assistants’ help was 0% for all participants with a single exception. During the intervention (when the new program with modified touch screen technology was used), the participants’ mean percentage of songs, comic sketches, or cartoons accessed correctly and independent of research assistants’ help per session was virtually 100%. Their mean percentage for correct match-to-sample responses provided and correct body movements performed independent of research assistants’ help was within the 90% to 100% range.ConclusionsThe findings suggest that the program may constitute a useful tool for helping people with intellectual and multiple disabilities access leisure stimuli and engage in cognitive and physical activity.

Acute exercise induces rapid hematological alterations, including hemoconcentration, leukocyte mobilization, and platelet activation. While such responses are well documented globally, data from North Africa are lacking. To investigate acute changes in complete blood count (CBC) parameters, hemoglobin (Hb), hematocrit (Hct), red blood cell count (RBC), white blood cell count (WBC), and platelet count (Plt) in a Libyan cohort, and to assess the influence of gender and training status. A total of 150 healthy adults (92 males, 58 females; aged 18-35 years) underwent maximal treadmill exercise. Participants were classified as trained (n=80) or untrained (n=70). Venous blood samples were collected 30 minutes pre- and 30 minutes post-exercise. CBC indices were measured using an automated hematology analyzer. Statistical analyses included paired t-tests and two-way ANOVA (gender - training). Hb, Hct, RBC, WBC, and Plt significantly increased post-exercise. Hb rose from 14.0 ± 1.3 to 14.8 ± 1.2 g/dL (p&lt;0.001), Hct from 42.5 ± 3.8% to 44.1 ± 3.7% (p&lt;0.01), RBC from 4.8 ± 0.5 to 5.0 ± 0.5 ×10⁶/µL (p=0.03), WBC from 6.1 ± 1.2 to 6.8 ± 1.3 ×10³/µL (p=0.01), and Plt from 238 ± 46 to 263 ± 49 ×10³/µL (p&lt;0.001). Males exhibited larger platelet increases, while untrained participants showed greater Hb and Hct rises. Acute maximal exercise in Libyan adults induces hemoconcentration, leukocytosis, and thrombocytosis, with gender and training status modulating specific responses. These results provide the first sports hematology dataset from Libya, aligning with international literature and informing athlete monitoring in the region.

BackgroundAlthough Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain.MethodsA non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise. The main outcomes were assessed at baseline and after 12 weeks of intervention: a pain numeric rating scale (NRS), the pressure pain threshold (PPT), the Tampa Scale of Kinesiophobia (TSK), the Pain Catastrophizing Scale (PCS), and the Central Sensitization Inventory (CSI). As secondary outcomes, TSK and PCS subscales were evaluated with the same procedures. The statistical analyses used the t-test, χ2-test, Wilcoxon rank-sum test, and analysis of covariance with adjustment for baseline characteristics.ResultsNo baseline characteristics differed significantly between the groups. At 12 weeks, the intervention group showed significant improvements in the NRS (p = 0.02, 95%CI: −2.20, − 0.18), PPT (p = 0.003, 95%CI: 0.22, 0.99), TSK (p = 0.004, 95%CI: −6.35, − 1.22), and PCS (p = 0.01, 95%CI: −10.18, − 1.43) versus the control group. There was no significant between-group difference in the CSI values. After adjustment for baseline characteristics, significant interactions were revealed between time and group for PPT (p = 0.02), TSK (p = 0.02), and PCS (p = 0.03) as well as the subscales TSK-Somatic Focus (p = 0.02) and PCS-Rumination (p = 0.01).ConclusionTai Chi intervention may serve as a potential treatment for chronic pain by addressing sensory, emotional, and cognitive aspects of pain.Trial registrationThe University Hospital Medical Information Network Clinical Trials Registry, UMIN000052727, Date: 2023-11-13. https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000058307.

To investigate the effects of tongue-strengthening exercise (TSE) based on exercise intensity on tongue strength and thickness in older adults with sarcopenic dysphagia. Participants were randomly assigned to groups 1 and 2. Group 1 underwent TSE at an intensity of 80% 1-repetition maximum (1RM) for 90 times/day, 5 days/week, for 8 weeks. In contrast, group 2 performed TSE at an intensity of 50% 1RM for the same period and number of times as group 1. The outcome measures were tongue strength, thickness and dropout rate owing to exercise compliance. Tongue strength increased from 16.7 to 22.1 kPa in Group 1 (d = 2.97) and from 16.9 to 19.1 kPa in Group 2 (d = 1.18). Tongue thickness increased from 37.1 to 40.5 mm in Group 1 (d = 1.13) and from 37.9 to 38.8 mm in Group 2 (d = 0.31). Post-intervention, Group 1 achieved greater gains than Group 2 in both strength (+3.0 kPa, d = 1.46) and thickness (+1.7 mm, d = 0.56). Dropout rates were 26.7% in Group 1 and 6.7% in Group 2. TSE with an intensity of 80% 1RM was more effective than 50% 1RM in increasing tongue strength and thickness in older adults with sarcopenic dysphagia, but showed a relatively high dropout rate. Thus, it is recommended to select and apply an appropriate exercise intensity.

PurposeEstimating energy expenditure (EE) accurately and conveniently has always been a concern in sports science. Inspired by the success of Transformer in computer vision (CV), this paper proposed a Transformer-based method, aiming to promote the contactless and vision-based EE estimation.MethodsWe collected 16,526 video clips from 36 participants performing 6 common aerobic exercises, labeled with continuous calorie readings from COSMED K5. Then we specifically designed a novel approach called the Energy Expenditure Estimation Skeleton Transformer (E3SFormer) for EE estimation, featuring dual Transformer branches for simultaneous action recognition (AR) and EE regression. Comprehensive experiments were conducted to compare the EE estimation performance of our method with existing skeleton-based AR models, the traditional heart rate (HR) formula, and a smartwatch.ResultsWith pure skeleton input, our model yielded a 28.81% mean relative error (MRE), surpassing all comparative models. With adopting the heart rate and physical attributes of each participant as multi-modal input, our model achieved a 15.32% MRE, substantially better than other models. In comparison, the smartwatch showed an 18.10% MRE.ConclusionExtensive experimentation validates the effectiveness of E3SFormer, aiming to inspire further research in contactless measurement for EE. This study is the first attempt to estimating EE using Transformer, which can promote contactless and multi-modal physiology analysis for aerobic exercise.

Knee osteoarthritis (OA) is a leading cause of disability in older adults, with health and economic impacts. Despite pharmacological advances, exercise continues to be a fundamental pillar in the management of OA, with lower limb strength training showing significant benefits. Virtual reality (VR)-based interventions have emerged as innovative tools, providing immersive environments to facilitate functional movement exercises. VR offers pain relief, improved functionality and reduced fall risks, although its efficacy in OA management requires further exploration. The main aim of the study is to assess whether a VR-based intervention provides superior improvements in pain, stiffness, physical function and movement biomechanics compared with conventional therapeutic exercise in adults aged 60 years and older with knee OA. This is a protocol for a randomised controlled trial comparing the effects of immersive VR interventions with conventional therapeutic exercises in individuals aged 60 years and older with knee OA. Participants are allocated 1:1 to experimental (VR) and control groups. The VR intervention involves 18 supervised sessions over 8 weeks, using Meta Quest 3 goggles to perform functional movements in virtual environments. The control group follows standard therapeutic exercise protocols per Osteoarthritis Research Society International guidelines. Outcomes include OA-related symptoms, kinematic performance, pain intensity, kinesiophobia and fall risk. Secondary measures assess cybersickness, depressive symptoms, medication use and comorbidities. Assessments occur at baseline, ninth week, sixth and 12th months. Data analysis employs intention-to-treat principles, leveraging descriptive statistics, t-tests and multiple imputations for missing data. This study was approved by the A Coruña-Ferrol Research Ethics Committee (reference: 2023/557), under the Galician Health Service. All participants will be required to provide written informed consent prior to their inclusion in the study. Participant data will be pseudonymised and securely stored. Additionally, anonymised datasets will be deposited in open-access repositories (Zenodo). NCT06362785.

Acute Effects of Cluster Sets on Exercise Performance and Perceptual Responses during Power Exercise in Older Adults

Microneedle-assisted iontophoretic transdermal administration of adrenergic antagonists does not modulate palmar sweating induced by static exercise in healthy young adults.

Dysanapsis is a determinant of expiratory flow limitation during exercise in master athletes.

Eight week short-term effects of military training on foot structure and function in young adults.