Physical Activity In Adults Research Articles

Osteoarthritis genu is a type of arthritis that is degenerative in nature and affects the knee joint. Osteoarthritis is associated as a leading cause of morbidity and limited physical activity in adults and the elderly. This study aims to analyze the level of physical activity and the degree of pain in knee osteoarthritis. This study uses a cross-sectional approach. The subject of the study was a patient with osteoarthritis genu at the Orthopedic Polypedia of the Buleleng Regional General Hospital. There were 68 subjects who met the criteria, divided into 18 males and 50 females. The independent variable of the study was the level of physical activity measured using the International Physical Activity Questionnaire (IPAQ) questionnaire. The dependent variable is the degree of pain measured using the Numerical Rating Scale (NRS). Both variables were tested using the Spearman test. The results of this study found a significant relationship between the level of physical activity and the degree of pain (p<0.001) and the correlation of negative values with moderate correlation values (r = -0.571). The level of physical activity has a negative correlation with the degree of pain in patients with knee osteoarthritis at the Buleleng Regional General Hospital.

Estimated pulse wave velocity (ePWV), a noninvasive marker of arterial stiffness, serves as a potential biomarker for cardiovascular disease (CVD) risk. This 7 year prospective cohort study of 10,055 adults aged 35-75 investigated whether ePWV mediates the association between physical activity (PA) and CVD risk. PA levels (high/moderate/low in 2016), ePWV (measured in 2018), and CVD incidence (2018-2023) were defined as exposure, mediator, and outcome, respectively. Cox models and causal mediation analysis (CMA) assessed associations and the natural indirect effect (NIE) of PA on CVD via ePWV. During follow-up, CVD incidence was 1.29/100 person-years. Elevated ePWV (≥ 10m/s) significantly increased CVD risk (HR = 1.673, 95% CI 1.319, 2.124). ePWV may mediate the link between low/moderate PA and CVD incidence. In the high ePWV group (≥ 10m/s), low/moderate PA levels showed an NIE of HR = 1.025 (95% CI 1.013, 1.041), with 10.6% of the effect mediated by ePWV. Arterial stiffness appears to mediate the association between PA and incident CVD in middle-aged and older adults. These findings highlight ePWV as a potential metric for CVD risk prediction, and future validation in randomized settings is required before considering clinical utility.

Background: Exercise tolerance is known to be decreased in adults with congenital heart disease (ACHD), and this is associated with prognosis. While regular physical activity is essential in ACHD patients, it is known to be impaired. However, there are few reports on the effects of regular exercise on exercise tolerance in ACHD patients. This study examined the association between regular exercise and exercise tolerance in contemporary ACHD patients. Methods: Among ACHD patients who attended our hospital regularly between April 2019 and March 2025, information on their employment status and exercise habits was obtained from a transition questionnaire. Those who underwent cardiopulmonary exercise stress testing (CPX) were selected for a retrospective study. NT-proBNP, ventricular contractility, maximal oxygen uptake (MVO2) and predicted MVO2 (ppMVO2) data were collected from blood samples, echocardiography, cardiac MRI and CPX. In addition, daily physical activity METs of 4 METs or more were defined as high activity (HA) and less than 4 METs were defined as low activity (LA). The association between each covariate and ppMVO2 was analysed. Results: A total of 30 patients were analyzed: median age at CPX was 27 [IQR 23-39] years, 37% male, BMI was 21.4±3.9, disease complexity was 46%/27%/27% complex/moderate/simple, median NT-proBNP was 90 [53-156] pg/mL, MVO2 21.1±5.1 ml/min/kg (ppMVO2 76.2±14.9%), with the high MVO2 group accounting for 40% of the total and HA for 37% of the total. The percentages of patients with normal/mildly/moderately/severely impaired ventricular contractility were 22/5/2/1 (73%/17%/7%/3%) and 22/5/2/1 (73%/17%/7%/3%), respectively. In univariate analysis, systemic ventricular contractility was not associated with high MVO2, but disease complexity and high activity group were significantly associated (p=0.01, respectively). Logistic regression analysis showed no association between NT-proBNP and high MVO2 (p=0.01 and p=0.005, respectively). Only HA was significantly associated in multivariate analysis with disease complexity and HA as covariates (p=0.002). Conclusions: Regular physical activity of 4 METs or more was associated with higher exercise tolerance. Although a cross-sectional study, the results suggest that regular physical activity in adulthood may improve exercise tolerance in ACHD patients.

The continuous growth of the older adult population demands an urgent need to provide innovative ways to stimulate physical activity and promote functional health. This study presents FitFest, a custom-made virtual reality (VR) designed to deliver a complete physical activity (PA) session for older adults. A pilot study involving seven older adults (67.0 ± 3.8 years) was conducted, comprising 18 user testing sessions of two VR exergames: Wine Fest and Flower Fest. PA intensity and heart rate (HR) were measured. The rate of perceived exertion (RPE) and the participants’ rating of the system’s usability were also registered. Overall, sessions involved mostly sedentary behavior (56.5 ± 20.4%) and light PA (42.1 ± 19.3%), with an average of 436.7 steps and 92.1 bpm. Wine Fest elicited less sedentary behavior (53.6 ± 22.1% vs. 62.8 ± 16.2%), higher light PA intensity (44.7 ± 20.4% vs. 36.4 ± 17.0%), and a higher step count (503.0 ± 345.4 vs. 291.0 ± 143.1) than the Flower Fest, although not significantly. Tasks requiring cardiovascular effort and strength were rated as more physically demanding. Most participants found the system user-friendly and showed interest in continued use, though technical support was essential due to limited familiarity with VR. The findings suggest FitFest has potential to promote light PA in older adults, highlighting the importance of usability and support in tech-based interventions.

IntroductionWith the global population ageing rapidly, older adults face increased risks of physical and cognitive decline. Despite the well-documented benefits of physical activity (PA), many older adults fail to meet PA guidelines. Mobile health (mHealth) apps offer promising tools to promote PA, but user engagement remains a challenge. In response, the MIA app was co-created with older adults using the Behavior Change Wheel framework to enhance usability, relevance and sustained engagement. A feasibility study showed promising results in usability and user satisfaction, supporting further evaluation. The goal of this study is to evaluate the effectiveness of MIA on PA promotion in older adults.Methods and analysisA randomised controlled trial conducted in Belgium at a university college will assess the effectiveness of the MIA app in promoting PA in older adults. Participants will be randomly assigned in a 1:1 ratio to either the intervention group (MIA app use) or the control group (no use of MIA) for 8 weeks. The primary outcome is moderate-to-vigorous PA, measured via Garmin wearable devices. Secondary outcomes include self-reported measures (PA, well-being, user satisfaction), clinical assessments (physical and cognitive functioning) and time series assessments (daily steps). A total of 75 participants will be recruited to ensure sufficient power, accounting for dropout. Eligible participants must be ≥65 years, medically stable, have no significant cognitive or physical limitations, understand and speak Dutch and have access to a smartphone and/or computer. Exclusion criteria include an active lifestyle, participation in other exercise programmes or clinical trials, or any condition deemed by a healthcare professional to compromise safety or study validity.Ethics and disseminationThe study was approved by the UHasselt Medical Ethics Committee (B1152025000012) and complies with Belgian legislation on human research. Written informed consent will be obtained from all participants prior to enrolment. Data will be securely stored for up to 25 years. Results will be disseminated via peer-reviewed publications and conference presentations.Trial registration numberNCT06983574.

Evidence on the link between physical activity (PA) and telomere length (TL) in childhood is scarce and inconsistent. This study examined the association between extracurricular PA at age 4 and changes in TL ranking from 4 to 8 years. Longitudinal data from 547 children in the INMA birth cohort study (ages 4-8) were analyzed. Parent-reported extracurricular PA at age 4 was used to calculate metabolic equivalents (METs) in hours per day and categorized into tertiles (low, middle, and high). Leukocyte TL was measured at ages 4 and 8 using qPCR, with the primary outcome being the percentage change in TL ranking between ages 4 and 8. Multiple robust regression models were used for the main analyses. Children in the highest tertile of extracurricular PA (11.9-31.0 METs h/day) showed a significant 2.25% increase (95% CI: 0.01, 4.48; p = 0.04) in TL ranking between 4 and 8 years compared to the lowest tertile (2.2-7.8 METs h/day). No association was observed for moderate extracurricular PA (i.e., middle tertile) levels. Higher levels of extracurricular PA were prospectively associated with TL rank changes from 4 to 8 years, suggesting its potential to reduce cellular damage and support healthy ageing. Research shows an association between PA and TL maintenance in adults, but evidence in childhood is limited and inconsistent. This study investigates the association between extracurricular PA and changes in TL ranking in children aged 4-8 years, finding that higher PA levels are linked to increased TL ranking, possibly slowing telomere shortening. Findings support promoting PA in childhood to enhance cellular health and reduce chronic disease risk. Results can inform strategies by healthcare professionals, educators, and policymakers to encourage PA in children.

BackgroundStudies show that despite the positive effects of physical activity (PA), most university students are not active enough. For interventions, it is necessary to understand the determinants of PA behavior. Theory of planned behavior (TPB) is one of the most widely used frameworks to describe the psychological determinants of health behavior. Research has shown that in addition to the determinants included in TPB (attitudes, subjective norms, perceived control, and intention), fear of negative outcomes (eg, discomfort or pain) is a major barrier to increasing one’s PA. It has been shown that accepting the possibility of unpleasant outcomes may help in reaching one’s PA goals.ObjectiveThe purpose of this study was to create a questionnaire of PA determinants based on TPB and complemented by the topic of acceptance of unpleasant outcomes. The questionnaire is thus meant for evaluating the effectiveness of health psychological PA interventions in university students and young adults.MethodsThis study was carried out using qualitative and quantitative methods and consisted of three phases: (1) an elicitation study for item generation, (2) pretesting for clarity and understanding, and (3) item selection using conceptual and psychometric criteria (based on a pretest with N=447) to maximize domain coverage and avoid redundancy.ResultsA questionnaire covering the core topics of TPB plus acceptance of negative outcomes was constructed, using a combination of qualitative and quantitative methods. The final shortened questionnaire consists of the following question blocks: positive and negative behavioral beliefs, acceptance of negative outcomes, subjective norms (injunctive and descriptive norms, and motivation to comply), and control beliefs. In terms of predicting self-reported PA, the shortened questionnaire was equal to the unabridged version. Notably, negative behavioral beliefs and acceptance of negative outcomes had opposite-signed correlations with self-reported PA (–0.22 and 0.32, P<.001). Despite the aim of avoiding redundancy, several item bundles (eg, positive and negative behavioral beliefs, and acceptance of negative outcomes) were highly homogenous in the final version, and are thus usable as psychometric scales.ConclusionsThis questionnaire can assess a range of PA determinants and has good psychometric properties. The questionnaire can be used to assess the beliefs and attitudes (behavioral beliefs, perceived norms, control beliefs, and acceptance of negative consequences) related to PA in young adults when planning interventions, as well as evaluating the effects of health psychological interventions aiming to increase PA.

BackgroundThe Confident Moves (CM) intervention is a newly developed, theory-based online intervention to promote physical activity (PA) in adults with obesity by providing a set of theory-informed behavior change techniques intended to enhance participants’ self-efficacy for PA. Uncertainties remain regarding the feasibility and acceptability of implementing the CM intervention in an obesity care center, where additional supports (e.g., meal plans, appetite suppressants) are typically provided. The objective of this longitudinal pilot trial was to investigate the feasibility and acceptability of implementing the CM online intervention for adults with obesity recruited from a local weight management center in the United States of America, in preparation for a future definitive randomized controlled trial (RCT).MethodsThis study was designed as a prospective, individually randomized, two-arm pilot trial. Data were collected across three waves over a period of up to 14 weeks, depending on each participant’s progression. Thirty participants were randomized to either the CM intervention group or the usual care group. The survey battery assessed demographic characteristics, anthropometric measures, self-efficacy, and acceptability. Free-living PA was objectively measured using a research-grade accelerometer (ActiGraph wGT3X-BT). Primary outcomes included: (a) participation rate, (b) engagement behavior in CM, and (c) a preliminary estimate of the CM intervention’s effect size on PA. Secondary outcomes (e.g., consent rate) were also evaluated. Predetermined threshold values outlined in a protocol guided the assessment of each outcome. Data analyses included both quantitative and qualitative approaches.ResultsSupporting evidence (i.e., meeting or exceeding the predetermined upper threshold) was found for all primary outcomes (i.e., participation rate, engagement behavior in CM, and preliminary effect size of CM on PA). Mixed evidence (i.e., meeting or exceeding the upper threshold, within the middle threshold range, or below the lower threshold) was observed for secondary outcomes.ConclusionsThis longitudinal pilot trial supports the viability of a future definitive RCT of the CM intervention and highlights areas for refinement in study procedures, intervention duration, and assessments. The findings also suggest important directions for optimization and real-world implementation, particularly through partnerships with obesity care.Trial registrationClinicalTrials.gov, NCT05935111, registered 7 July 2023.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-24763-0.

ABSTRACT Previous research links higher physical activity (PA) and lower sedentary behavior (SB) to improved health in adults with heart failure (HF); however, disparities in measurement methods and adherence to activity guidelines persist. This study aimed to synthesize PA and SB measurement approaches used in HF research and assess adherence to recommendations. A systematic review identified studies measuring PA or SB in adults with HF. Studies were categorized based on adherence to national PA and SB guidelines. Of 131 eligible articles, 49.4% used subjective, 39.1% used objective, and 11.5% used both measurement tools. Among studies reporting PA levels, 44.9% had sufficiently active participants; for SB levels, 72.2% had sedentary participants. Studies using objective measures were less likely to meet recommendations than studies using subjective measures (χ2 = 4.46, p = .035). Diverse measurement approaches produced inconsistent adherence estimates, highlighting challenges in assessing PA and SB levels in adults with HF.

Health literacy and adherence to physical activity guidelines among adults with hypertension: evidence from a Korean National Survey

BackgroundProlonged Sedentary behavior (SB) and lack of Physical Activity (PA) in the older population significantly increase the risk of chronic disease development. The use of mobile health (mHealth) apps may have a positive impact on older adults, helping to increase their physical activity levels and optimize body composition. However, the effectiveness of mHealth-based interventions and potential moderators in this population is not fully understood.ObjectiveTo assess the effectiveness of a mHealth-based intervention in promoting PA/moderate to vigorous physical activity (MVPA), reducing SB, and lowering body mass index (BMI) in older adults. The moderating effects of the mHealth intervention effects were also explored through subgroup analysis.MethodThis study searched Embase, PubMed, Web of Science, and Cochrane databases (as of June 2025) to include randomized controlled trials (RCT) evaluating the effects of mHealth on PA, MVPA, SB, and BMI in older adults. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated using random effects models.ResultsA total of 14 RCTs were included (sample size = 2,511). mHealth intervention significantly elevated PA (SMD = 0.18, 95%CI: 0.01 to 0.35) and MVPA (SMD = 0.48, 95%CI: 0.20 to 0.75) and reduced SB (SMD = -0.55, 95% CI: −0.79 to −0.32), but no significant improvement in BMI (SMD = −0.27, 95% CI: −0.79 to 0.25). Subgroup analyses showed that: Commercial applications were better than research-based applications (PA: SMD = 0.18 vs. 0.07; MVPA: SMD = 0.70 vs. 0.31); more than 3 behavior change techniques (BCTs) interventions were effective for MVPA enhancement (SMD = 0.49) and SB reduction (SMD = −0.77); and the use of a theory paradigm intervention was more effective on SB reduction (SMD = −0.77 vs. 0.38).ConclusionmHealth apps were effective in increasing PA/MVPA levels and reducing SB levels in older adults, but did not reach statistical significance in terms of BMI improvement. Through subgroup analyses, this study further found that commercial apps demonstrated greater strengths in promoting PA/MVPA; meanwhile, integrating more than 3 BCTs synergistically promoted MVPA levels and reduced SB.

Psychosocial health concerns and physical activity in adults with epilepsy: Cross-sectional analysis from 2022 National Health Interview Survey

BackgroundHigh SES is associated with more PA in life course. There is conflicting evidence about the importance of the residential area for PA. The aim of this study was to determine how family SES of urban and rural children is associated with PA in adulthood. This study provides new information on how the childhood family SES and growth environment affects PA in adulthood.MethodsWe used population-based cohort data from the Northern Finland Birth Cohort 1986. Participants’ (n = 9432) parents reported residential area and family SES when the participants were 7 years old (n = 8370). At age 35, participants underwent clinical measurements (n = 1807) and completed questionnaires (n = 3322) about health, health behaviours and SES. PA data was collected with Oura ring (n = 1578). The final data consisted of 813 participants. We used linear models to study the associations of the childhood residential area and family SES with PA in adulthood.ResultsDifference in total daily PA minutes was 40.99 min greater in the unadjusted model for male participants living in rural area during childhood, with high childhood family SES (CI = 18.65, 63.33). After adjusting with BMI, work strenuousness and adulthood residential area the difference was 26.73 min greater (CI = 0.81, 52.65). Difference in daily LPA minutes was 40.38 min greater in the unadjusted model (CI = 19.83, 60.93) and 27.64 min greater in the adjusted model (CI = 3.84, 51.43).ConclusionsHigh SES children living in rural areas during childhood had more PA in adulthood. Efforts to promote an active lifestyle should consider family SES and residential areas during childhood.Key messages• Efforts to promote an active lifestyle should consider family SES and residential areas during childhood.• SES and residential area should be considered in promoting active lifestyles in men.

Hypertension especially systolic hypertension is common in older adulthood and disproportionately affects Black adults. Physical activity (PA) contributes to improved blood pressure (BP) and cardiovascular health. However, opportunities for PA for older adults are often limited. We used a prospective observational design and data collected fall 2022 (time-1) and spring 2023 (time-2) from Black adults (n = 177) ≥ 60years-of-age participating in the congregate meal program at community dining sites in Washington DC. Sites included senior centers, park/recreation facilities, and public housing. Measured height/weight/BP and a self-report survey were collected, with PA measured using the 9-item Rapid Assessment of Physical Activity, validated for use in older adults. Chi-square tests compared participant's PA levels by dining site. Hierarchical, repeated-measures linear regression was used to examine the association between PA at time-1 and systolic blood pressure (SBP) at time-2. Most participants were female (78%), lived alone (72%), with 52% reporting ≤ high school education. Mean (SD) age was 75 (8) years. Mean (SD) SBP was 138 (20) mm Hg. Mean (SD) diastolic BP was 70 (11) mm Hg. Most (75%) self-reported hypertension. PA varied by dining site, with lowest rates reported by participants at public housing sites (p < 0.001). PA was inversely related to SBP (Beta -1.01; 95% CI -1.94, -0.09; p = 0.03). Study findings support the benefit of PA to lower SBP among an older Black adult population and suggest increasing PA programming at community dining sites may be one strategy to improve PA and cardiovascular health. Further study is warranted.

Background: Physical activity is essential in the prevention and management of type 2 diabetes mellitus (T2D), yet adherence to recommended activity levels remains insufficient. Wearable electronic devices have emerged as tools to support physical activity through self-monitoring and enhanced user engagement. This review synthesizes current evidence on the effectiveness of wearable technologies in improving adherence to physical activity and promoting clinical and metabolic health in adults with T2D. Methods: The review was conducted using systematic search strategies in PubMed and Scopus. We included studies that involved the use of wearable devices to monitor physical activity for at least seven consecutive days. The reported outcomes were related to physical activity adherence or clinical-metabolic health. Thirty-two studies met the inclusion criteria and were analyzed in terms of study design, device type, intervention characteristics, and outcomes. Results: Wearable devices were used either for monitoring daily activity in free-living conditions or within structured, often supervised, interventions. Most studies reported increased physical activity, particularly in step count. Several studies showed improvements in blood pressure and lipid profile, while results for HbA1c and BMI were mixed. Structured interventions with behavioural support produced more consistent and clinically relevant outcomes than passive monitoring alone. Conclusions: Wearable technologies can support physical activity in adults with T2D, especially when integrated into structured behavioural programmes. From a clinical standpoint, they may serve as useful tools to enhance lifestyle adherence, particularly when combined with professional support. Their inclusion in care pathways could help personalize interventions and improve long-term self-management.

BackgroundVigorous intermittent lifestyle physical activity (VILPA; short bursts of vigorous-intensity activities in a person’s daily life) could be an attractive and feasible option to increase physical activity (PA) in adults transitioning to retirement.Design and settingTwo-arm pilot randomised controlled trial (RCT) to test the feasibility of the intervention and the plausibility of the intervention to increase PA in adults transitioning to retirement in Perth, Western Australia.ParticipantsInsufficiently physically active adults transitioning to retirement.InterventionTwelve-week theory-based and evidence-informed VILPA intervention designed to increase PA in adults transitioning to retirement.Objectives and measurementsThe feasibility of the pilot was determined by the projected sample size with actual sample size, drop-out rates and reporting rates. The feasibility, acceptability and appropriateness of the intervention were assessed using validated questionnaires. The intervention’s plausibility to increase PA was assessed by accelerometer-measured PA, functional fitness test and general health questionnaire.ResultsEighty individuals expressed interest in participating in the trial; 42 (feasibility of recruitment = 52.5%) were recruited and 34 completed the trial (retention = 80%). The preliminary data indicated increases in both total PA and VILPA, with positive impacts in self-reported general health and functional fitness. Participants found the intervention acceptable and intended to continue participation in VILPA and accumulate PA after the intervention.ConclusionsThe VILPA intervention appears to be feasible for promoting PA in ageing adults. The findings of this pilot RCT also support a larger trial to seek the effectiveness of VILPA in improving health outcomes in ageing adults.

AimsTo assess the frequency and management of hypoglycaemia during unstructured physical activity (PA) in adults with type 1 diabetes (T1D) using automated insulin delivery (AID) systems in real‐life settings.Materials and MethodsRAPPID is a prospective, multicenter, observational study conducted over 1 month in four French tertiary care centres. Adults with T1D using one of three AID systems (MiniMed 780G, Tandem t:slim X2 with Control‐IQ, or Ypsopump with CamAPS FX) and performing ≥2 unstructured PA sessions per week were included. Participants completed paper logbooks documenting each PA session (type, intensity, hypoglycemia, adjustments). Continuous glucose monitoring (CGM) and pump data were downloaded. Glycaemic control was assessed using CGM‐derived metrics within predefined peri‐exercise time windows.ResultsEighty‐six participants (mean age 42.5 ± 14.3 years; 43% women; diabetes duration 23.6 ± 13.1 years; mean HbA1c 52 ± 7 mmol/mol (6.9% ± 0.6%)) reported 954 PA sessions (73% aerobic; 61% moderate intensity). TBR (<70 mg/dL) increased from 1% pre‐exercise to 6% during and 5% post‐exercise (early recovery phase). Clinical hypoglycaemia occurred in 20% of sessions (one‐third of episodes were asymptomatic); 38% of participants experienced at least 1 level 2 event (<54 mg/dL). Anaerobic or high‐intensity sessions were associated with lower hypoglycaemia risk. Temporary targets were used in 73% of sessions but initiated ≥1 h before PA in only 27%. Carbohydrate intake before and during PA was frequent but often suboptimally timed or dosed.ConclusionsHypoglycemia remains common during and after PA in AID users. Suboptimal adjustment strategies and impaired symptom awareness contribute to risk. Individualised education remains essential to enhance safety.

Effectiveness of mobile health interventions on physical activity management in adults with hypertension: A systematic review and meta-analysis.

The combination of chronic pain, fatigue, physical activity restrictions, and a potentially life-threatening disease poses significant challenge for individuals with syndromic Heritable Thoracic Aortic Disease (sHTAD). The primary aim of this study is to explore the interplay between chronic pain, fatigue, and physical activity in adults with sHTAD, how these factors affect daily life management. The intention is to draw on both patient-reported outcomes and the lived experiences of individuals with sHTAD to provide a comprehensive understanding of their challenges and coping strategies. A mixed-methods triangulation approach was employed, combining qualitative focus group interviews (n = 36), and a quantitative questionnaire (n = 52) including validated instruments measuring pain, fatigue, sleep problems, physical activity and multi-organ symptoms. The study primarily emphasizes the qualitative component to gain a deeper understanding of the participants` lived experiences. An overarching theme "Patients` Experiences and Coping" and three subthemes emerged from the triangulated data: (1) Health Challenges in Daily Life. 2) Balancing Chronic Pain and Fatigue with Physical Activity and Restrictions. 3) Interaction and Communication with Healthcare Providers. Quantitative analysis revealed that 79% of participants reported experienced chronic pain, while 58% reported fatigue. Both conditions were strongly associated to sleep disturbances and multi-organ involvement, with fatigue also associated with low physical activity and anxiety. The qualitative data supported these findings, with participants describing pain and fatigue as "energy drainers" that profoundly impacted family life and hindered work participation. They reported that managing the interplay of pain, fatigue, anxiety, and physical restrictions due to having a life-threatening disease as sHTAD was particularly challenging. Addressing pain and fatigue in the healthcare settings can be especially difficult in this population, as these symptoms may be overshadowed by concerns about life-threatening complications. Given the importance of physical activity in mitigating pain and fatigue, recognition and interventions aimed at breaking this vicious cycle are essential. The triangulation of quantitative and qualitative data highlights the profound impact of chronic pain and fatigue on individuals with sHTAD in association with the broader health complications. More research, along with an interdisciplinary approach that integrates both healthcare and social support system, is essential to address the physical, emotional, and psychosocial needs of these patients, ultimately improving their quality of life (QoL).

Improvement of physical and cognitive capabilities through physical activity (PA) contributes to well-being in older age. Unfortunately, many older adults lack sufficient PA, due to reasons such as PA not being enjoyable for them. As a result, older adults are unable to maintain their motivation for the initiation and continuation of PA. In our previous works, a boxing glove-type sensory augmentation system was developed to solve this problem by inducing enjoyment during PA. However, the effect of our device on physical and cognitive capabilities, which are crucial for well-being, and motivation for initiation and continuation of PA remains unclarified. In this study, we aimed to evaluate these effects. We hypothesized that our device may help improve capabilities, and that the enjoyment it provides may potentially contribute to increased motivation for initiation and continuation of PA. Fourteen healthy older adults participated in the study. Kickboxing lessons for the older adults using our device were conducted a total of five times over a six-week period, and the participants were free to attend the sessions as many times as they wished. They participated in three measurement sessions: pre-measurement before the lesson period, post-lesson measurement after each lesson, and post-measurement at the end of the lesson period to evaluate the effects of our device. Physical capabilities were assessed through two-step, stand-up, and center-of-pressure tests. Cognitive capabilities were assessed using illustration memory and computation tests. Mental state was assessed using a positive and negative affect schedule (PANAS). Subjective evaluations of enjoyment and motivation for the initiation and continuation of PA through the use of our device were also conducted. In the results, physical and cognitive capabilities and mental states tended to improve. Subjective evaluations indicated increased enjoyment from using our device and greater perceived effectiveness in motivating PA initiation and continuation. These evaluations improved over time. While the pre-post design without a control group limits causal interpretation, improvements in physical, cognitive, and mental states may have contributed to enhanced enjoyment. As a result, the device may have the potential to enhance motivation for initiation and continuation PA in older adults.