Children and adolescents with chronic kidney disease (CKD) often exhibit reduced physical fitness due to physical inactivity, fatigue, and muscle weakness. Despite the exercise benefits, participation remains limited due to barriers such as limited access, inadequate resources, and poor motivation. The m-Health platform may provide an adaptable strategy to address these challenges. Hence, this study aimed to assess the feasibility of the m-Health-based exercise program among the pediatric CKD population. Thirty children and adolescents with CKD stages 3-5, aged 6-18years, were enrolled in a 4-week m-Health-based exercise program. Feasibility was evaluated through adherence, usability, satisfaction, and semi-structured telephonic interviews with participants and caregivers. Functional outcomes included the 6-min walk test (6-MWT) and hand grip strength (HGS). Adherence, usability, and satisfaction data were summarized using descriptive statistics. Thematic analysis was used to represent the qualitative data. Pre- and post-intervention 6-MWT and HGS values were compared using paired t-tests. Twenty-seven participants completed the study. Adherence to the m-Health exercise program was low, with 18.5% meeting the criteria. However, 51.8% reported excellent usability, and satisfaction was reported by 70.3% of parents and 62.9% of participants. Qualitative data highlighted three key aspects-alternative exercise practices, perceived exercise benefits, and multifaceted barriers. Participants demonstrated significant improvements in their functional outcomes post-intervention (6-MWT, 48.8m, p < 0.001; HGS, 0.7kg, p = 0.021). Despite low adherence, the m-Health-based exercise program served as a motivating stimulus for promoting physical activity and facilitating positive behavior change among children and adolescents with CKD. This study was registered with the Clinical Trials Registry of India (CTRI) on 20-11-2024 under registration number CTRI/2024/11/077131.

The influence of regular monitoring and exercise on employee health: A study at Cicendo Eye Hospital measuring differences between clinical and non-clinical staff.

This randomised controlled trial examined the impact of a combined stabilisation exercise (SE) and back extensor endurance exercise (BEEE) programme versus BEEE alone on pain, disability, health-related quality of life (HRQoL), sleep, function, sports performance, peak force and peak power in athletes with chronic low back pain (CLBP). Forty-eight university-level athletes with CLBP were randomly assigned to either the SE+BEEE group or the BEEE alone group. Both groups received their respective exercise interventions three times per week for 8weeks. Outcomes were assessed at baseline, 8th week, and 12-week follow-up. Repeated measures ANOVA with partial eta-squared (ηp2) effect sizes was used to evaluate group, time, and interaction effects. Significant time effects were observed across all outcomes (p<0.05). Significant time×group interactions (p<0.05) were found for pain (ηp2=0.17), disability (ηp2=0.14), functional score (ηp2=0.07), sprint (ηp2=0.45), and agility (ηp2=0.23), indicating greater improvements in the SE+BEEE group than in the BEEE alone group. Both groups improved in HRQoL, sleep, peak force and power over time with no interaction effects. Most improvements achieved after 8weeks were maintained at 12-week follow-up. While both exercise regimens yielded significant improvements, adding SEs to BEEE resulted in larger effect sizes and greater gains in key outcomes including pain, disability, function, and sports performance compared with BEEE alone, highlighting the added benefit of combined training in athletes with CLBP.

Multicomponent exercise for people at high risk of frailty in the local context

Older adults with (pre)frailty are vulnerable to deteriorations in physical functioning, mobility and independence. Evidence for frailty interventions utilizing existing services within primary healthcare structure is limited. The PromeTheus trial aimed to evaluate the effectiveness of a home-based, multifactorial, interdisciplinary intervention to prevent functional and mobility decline in (pre)frail older adults. In this multicentre, assessor-blinded, randomized controlled trial, 385 community-dwelling (pre)frail older adults (clinical frailty scale 4-6, ≥ 70 years) were randomly allocated (1:1) into the intervention group (IG: n = 196) or control group (CG: n = 189). The IG underwent the PromeTheus programme for 12 months, which included an obligatory unsupervised home-based physical exercise programme and facultative counselling services (person-environment fit, nutrition and coping with everyday life), implemented through existing healthcare services and referral to community group activities. The CG received usual care. The first primary outcome was the function component of the Late-Life Function and Disability Instrument (LLFDI-FC) after 12 months; Life-Space Assessment (LSA) served as the second primary outcome. Secondary outcomes included participation (short-form LLFDI disability component, LLFDI-DC), frailty status, physical capacity (Short Physical Performance Battery, SPPB) and fall rate. Data analyses followed the intention-to-treat principle. An exploratory stratified analysis according to baseline physical capacity (SPPB ≤ 6 points [n = 210] vs. SPPB > 6 points [n = 175]) was also conducted. Participants had a mean age of 81.2 ± 5.9 years, with 73.5% (n = 283) being female. At the 12-month follow-up, a significant between-group difference in favour of the IG was observed for the change in the LLFDI-FC (1.38 points, 95% confidence interval [CI] 0.08, 2.68) but not for the change in the LSA (0.49 points, 95% CI -3.65, 4.64). Change in frailty status (odds ratio for being in a 'better' change status 1.72, 95% CI 1.11, 2.64) and SPPB (0.58 points, 95% CI 0.10, 1.05) also showed significant between-group differences in favour of the IG. The intervention did not affect the short form LLFDI-DC or fall rate (p = 0.055-0.689). The stratified analysis showed significant improvements in the LLFDI-FC, short-form LLFDI-DC (limitation), frailty status and SPPB (p = 0.002-0.020) in the IG compared to the CG for participants with SPPB ≤ 6 points but not for those with SPPB > 6 points. There were no study-related serious adverse events. The PromeTheus programme had positive effects on physical functioning, frailty status and physical capacity but not on life-space mobility and fall rate in community-dwelling (pre)frail older adults. Participants with lower baseline physical capacity may benefit more from the programme.

To assess pediatric clinician knowledge of physical activity recommendations, their approach to physical activity counseling, and their interest in a structured academic fitness program for children and youth with special health care needs (CYSHCN). Electronic questionnaire was developed by cardiovascular, psychology, and exercise physiology collaborators at an academic children's hospital. Regional pediatric clinicians across an urban and rural catchment area were anonymously surveyed. Subgroup differences were assessed using Student's t test, Fisher's exact test, and logistic regression. Survey response rate was 22% (78/351), including 60 general and 18 subspecialty clinicians, half of which (49%) are in rural practice. Over 80% reported general knowledge of physical and psychological benefits of physical activity, although only 49% were aware of specific physical activity recommendations for CYSHCN. Most (90%) perceive that CYSHCN participate in physical activity less than age-matched peers but only 55% routinely discuss physical activity recommendations. Clinicians who report exercising ≥ 4days per week are more likely to discuss physical activity with their patients (OR 2.74, 95% CI 1.06-7.13; p = 0.038). Nearly, all (95%) clinicians supported development of a dedicated academic cardiometabolic exercise program for CYSHCN. Clinicians identified time commitment (89%), transportation (84%), insurance (79%), and differing interest levels of patients/families (43%) as potential participation barriers. While most clinicians are aware that physical activity benefits CYSHCN, clinical knowledge gaps exist regarding appropriate recommendations and counseling. Physical activity practices of healthcare professionals may be associated with frequency of patient counseling. Development of structured physical activity programs for CYSHCN should seek to improve knowledge and counseling, include clinicians as physical activity role models, and limit participation barriers.

Adults with attention deficit/hyperactivity disorder (ADHD) often experience difficulties regulating emotions and balancing activity and rest. Impairments such as motor skills challenges and reduced body awareness, including interpretation of sensory signals and attitudes toward the body, often receive little clinical attention despite their potential negative impact on daily functioning and health. The START intervention is a 12-week structured exercise program that combines regular physical exercise with mindful attention to the body during movement. This study aimed to evaluate the effect of the START intervention on body awareness and movement quality in adults with ADHD. In this randomized controlled trial, 63 adults with ADHD were assessed for body awareness and movement quality before and after a 12-week intervention or treatment-as-usual control period using the Body Awareness Scale - Movement Quality and Experience. Thirty-nine participants completed the study (26 intervention/13 control). Participants in the intervention group showed significantly greater improvement in body awareness compared to the control group, both in total score and in subscales for muscular tension and physical activity. Movement quality improved significantly within the intervention group, although no significant between-group differences were observed. Structured physical exercise with mindful attention to the body enhanced body awareness in adults with ADHD compared to standard care. Effects on movement quality were not statistically different between groups and therefore remain uncertain. These findings suggest that such exercise may be a useful complement to conventional treatments and may support a healthier relationship with the body.

Many colorectal cancer (CRC) survivors who have undergone resection surgery experience persistent bowel dysfunction that significantly affects their quality of life, highlighting the need for defecatory function rehabilitation in survivorship care. Although mobile health (mHealth) applications are increasingly recognized as promising tools for supporting post-surgical recovery, few are specifically designed to address the complex needs of CRC survivors. This study explores these challenges and identifies design requirements through ExerCompass-a prototype mHealth application designed to support recovery by offering a guided exercise program, bowel and dietary tracking, and condition-aware feedback. We conducted a formative study with 22 CRC survivors using task-based interaction sessions and semi-structured interviews. The prototype was developed by incorporating clinical knowledge specific to CRC, provided by healthcare experts, along with established design principles for digital health tools. We captured participants' overall experiences, uncovered usability challenges and gathered feedback on the prototype's capacity to support recovery. Participants valued the unified delivery of guided exercise, symptom tracking, and condition-aware feedback, noting its therapeutic relevance to their recovery. However, they reported difficulties in logging variable bowel symptoms, interpreting dietary trends, and sustaining motivation over time. While some interface-level issues were mentioned, most emphasized the need for flexible, personalized, and emotionally supportive features. This study highlights the importance of designing mHealth tools that address condition-specific needs of post-surgical CRC survivors and offers design implications for digital interventions that support both symptom management and psychosocial recovery.

Effects of an exercise program on long-term care certification and incidence of bone fracture among community-dwelling older adults: Matched cohort study

Effects of a mobile data-based exercise intervention on postpartum depressive symptoms, maternal bonding, and infant crying: a randomized controlled trial.

Good Life with OsteoArthritis in Denmark (GLA:D®) is an evidence-based education and exercise program for people with hip or knee osteoarthritis. The program largely operates in private healthcare settings around the world. This study evaluated its implementation and delivery in public outpatient settings in Tasmania, Australia. A process and outcome evaluation was conducted to evaluate the implementation and delivery of GLA:D® within the publicly funded Tasmanian Health Service. The evaluation was conducted using the RE-AIM QuEST Framework, including health system and service-level metrics, patient-level data and program fidelity. Semi-structured focus groups and qualitative interviews were conducted with staff and patients who participated in the program, with thematic analysis of the outputs. Implementation and Adoption: GLA:D® was implemented at three outpatient clinics. Successful implementation factors included GLA:D® being a recognisable evidence-based program that was straightforward to deliver, executive support and buy-in, local physiotherapist champions, and the establishment of an eReferral pathway which improved efficiency. Reach: Twelve physiotherapists were trained in GLA:D®, while 89 patients enrolled in the program (21 cohorts), of which 63 participated in the GLA:D® registry at baseline. Effectiveness: Most patients noted improvements in symptoms; however, some patients with co-morbidities or complex pain did not benefit. Maintenance. All three centres have elected to continue the program. GLA:D® can be effectively, efficiently and sustainably implemented in public outpatient settings. Operational and administrative considerations have been identified and provide a foundation for broader implementation of the program in public and regional settings.

Preliminary effects of a modified Otago Exercise Program on metabolic, cellular, and epigenetic biomarkers in people living with dementia: A pilot randomized controlled trial.

To assess the effectiveness of a six‑week online exercise program on self‑assessed urinary incontinence (UI) symptoms and their impact on daily life among postpartum women immediately and six months after the intervention. A quasi-experimental pre-post design without a control group was used. Participants (n=297) completed a six-week online exercise program focused on core and pelvic floor strengthening. Data were collected via electronic questionnaires at baseline, post-intervention, and six months later. UI symptoms were measured with the UDI-6 and symptoms impact on daily life with the IIQ-7. Changes across timepoints were analyzed using linear mixed models. Attrition increased across measurement points, with 89 women completing the six‑month follow‑up questionnaire. UI symptoms decreased statistically significantly over time (p<0.001) from baseline (mean 18.8; 95% CI 16.9, 20.7) to posttest (13.2; 95% CI 11.1, 15.4). At the 6-month follow-up, the scores had increased slightly (14.1; 95% CI 11.4, 16.9) but were still lower than at the baseline. For the perceived impact of UI on daily activities, the overall change was not statistically significant (p=0.269). Mean (95% CI) IIQ-7 scores were 8.5 (6.9, 10.0) at baseline, 6.6 (4.7, 8.5) at posttest, and 6.7 (3.9, 9.4) at 6‑month follow‑up. Time since childbirth, BMI, mode of birth, and dysfunctions or symptoms related to pelvic floor and core muscles were associated with variation in studied outcomes. A six‑week self‑directed online exercise program was associated with a reduction in postpartum UI symptoms, with improvements largely maintained at six months. Individual characteristics were associated with symptom severity and responsiveness, highlighting the need for tailored postpartum rehabilitation and further controlled studies.

Systematic review of cardiovascular intervention studies in women after Preeclampsia.

Alzheimer's disease (AD) is associated with behavioral and physical manifestations, such as sleep disturbances, which worsen the course of the disease and require effective management strategies. This review investigates non-pharmacological interventions available for the control of sleep disorders in patients with Alzheimer's disease. This is an integrative review, with searches carried out in the Public Medical Database, Science Direct, Scientific Electronic Library Online and Latin American and Caribbean Literature in Health Sciences, using the descriptors: "Alzheimer Disease", "Sleep Wake Disorders", "Sleep Disorders", and "Therapeutics". Original studies evaluating non-pharmacological treatments for sleep disorders in patients with AD and using specific instruments to assess improvement in sleep disorders were included. The non-pharmacological interventions evaluated included bright light therapy, morning light exposure, personalized lighting intervention, blue-enriched white light exposure, transcranial magnetic stimulation, acupressure, multimodal exercise program, aromatic oil bath salts, light visor phototherapy, transcutaneous electrical nerve stimulation and deep brain stimulation. Additionally, one article investigated the combination of bright light exposure with walking, as well as the isolated effects of each intervention. Non-pharmacological interventions for managing sleep disorders in patients with AD have shown promising strategies, including approaches such as light therapy, physical stimulation techniques, and acupressure, with results indicating potential benefits in improving sleep quality and mitigating behavioral and cognitive symptoms associated with the disease. However, current evidence highlights the need for future studies with more rigorous methodologies, larger population samples, and long-term follow-up to consolidate the efficacy and applicability of these interventions in clinical practice.

Effect of a virtual walking and therapeutic exercise-based intervention on gait and balance in people with incomplete spinal cord injury.

The world population is aging rapidly. Fractures are more frequent in older people are associated with high rates of mortality and morbidity. Several studies have implemented various nursing care interventions to improve health outcomes in older patients following fractures. The current systematic review and meta-analysis aimed to study the effects of various nursing care interventions on the rehabilitation of older patients following fractures. A comprehensive search was conducted across the seven reputable databases (Epistemonikos, Cochrane, Scopus, PubMed, Medline, Embase, and Web of Science) employing four sets of keywords up to April 2025, following the PRISMA approach. The PICOS framework was developed to elucidate the research question, and studies that did not meet the specified criteria were excluded. 94 articles were included in the current review. Among the interventions, multidisciplinary intervention programs, evidence-based nursing, and comprehensive nursing programs demonstrated the highest effectiveness. Nevertheless, educational nursing interventions, exercise programs, discharge programs, family-centered care programs, and pain management programs, despite their low cost, also had a significant positive impact on patient rehabilitation. It was found that nursing interventions in the observational group, compared to the control group, significantly improved satisfaction rates and alleviate complication rates. These findings suggest that various nursing intervention programs can effectively enhance rehabilitation outcomes in older patients following fractures.

Exercise is recommended as a core component of supportive cancer care; however, its implementation remains inconsistent. Beyond individual motivation, social and healthcare system factors may shape access to structured exercise programs. This study aimed to develop and content-validate the Motivators, Obstacles, Values, and Exercise in Oncology (MOVE-Onco) questionnaire and to provide preliminary evidence on informational and structural barriers to exercise among oncology patients in Spain. A multi-phase study was conducted including: (1) qualitative item generation through patient interviews and cognitive debriefing; (2) a two-round Delphi process with a multidisciplinary expert panel (N = 16) using a ≥ 75% consensus criterion; and (3) a pilot cross-sectional application in 53 oncology patients to assess internal consistency and describe perceived barriers, facilitators, knowledge, and preferences. Content validity was achieved with ≥ 75% expert agreement in the final Delphi round. Internal consistency was excellent for the Barriers scale (α = 0.91) and good for the Facilitators scale (α = 0.85). Although most participants believed exercise improves health outcomes (98.1%) and expressed interest in structured programs (86.9%), 67.9% reported not receiving professional exercise guidance and 94.3% were unaware of specialized oncology exercise resources. Informational barriers were more frequently endorsed than physical or psychological limitations in this pilot sample. The MOVE-Onco questionnaire demonstrates preliminary content validity and internal consistency in a Spanish oncology context. Pilot findings suggest that limited professional guidance and low awareness of available resources, rather than lack of patient motivation, may constitute key barriers to exercise engagement. These results highlight potential structural gaps in supportive cancer care delivery. However, these findings should be interpreted cautiously and require confirmation in larger studies.

FLOW Trial - The effect of fluoxetine combined with exercise on motor recovery after stroke: an RCT.

Body Awareness Therapy in Peripheral Arterial Disease: A Randomized Controlled Trial.