Exercise Research Articles (Page 1)

From inflammation to intervention: exploring shared mechanisms and lifestyle strategies in diabetes mellitus and multiple sclerosis.

Sarcopenia, the age-related loss of skeletal muscle mass and function, poses a major health challenge. While leucine's anabolic properties are well documented, its clinical efficacy as a standalone intervention remains limited. This review explores the potential of integrated strategies combining leucine with other nutrients, physical activity, and gut microbiota modulation to enhance sarcopenia prevention and treatment. Recent studies confirm that leucine supplementation alone fails to significantly improve muscle mass or strength in older adults. However, its benefits emerge when combined with resistance training, or gut microbiota-targeted interventions. The gut-muscle axis has gained attention as a key modulator of muscle health. Additionally, leucine supports the resumption of physical activity in sarcopenic patients by mitigating exercise-induced muscle damage and inflammation. These findings underscore the need for multimodal approaches, leucine, optimized nutrition, exercise, and microbiota modulation, to maximize therapeutic benefits. Future research should focus on defining optimal dosages, personalized protocols, and clinical feasibility. Such strategies could revolutionize sarcopenia management by integrating innovative, patient-centred care.

ABSTRACT Engaging those most disaffected from participation in sport and physical activity is an enduring challenge for policymakers and practitioners. The barriers to participation are most acute for individuals and groups that experience a complex and emergent set of social, cultural and economic issues within their local communities. In light of these challenges, in the UK over the past decade, there has been a proliferation of funding and strategic buy-in for place-based working. A place-based approach is now often advocated as the model for community-based provision, though the evaluation of place-based approaches delivered through community sport systems remains limited. This paper illustrates novel insights into how a process evaluation, when integrated with a place-based programme, can increase the chances of securing public health benefits that incorporate considerations of equity. To do this we reflect critically on the national evaluation of the Active Through Football (ATF) programme which began delivery in 2022. The paper presents a generic theory of change for place-based physical activity interventions based on our accumulated learning across 25 ATF place-based programmes. Our findings demonstrate how activities within a place-based approach contribute to a range of outcomes through the activation of key underlying programme mechanisms. This theory of change will be useful for those who wish to emulate ATF’s place-based approach, or evaluate key processes within place-based practice. This understanding of programme mechanisms is central to the continued accumulation of practical and theoretical knowledge to guide place-based sport practice and policy.

Intrinsic capacity (IC) is a composite that includes five different domains related to a person's capacities: sensory, locomotion, vitality, psychological and cognitive. IC represents part of a global effort to promote healthy ageing, one aspect of which is healthy cognitive functioning. This study aimed to elucidate the association of IC and cognitive decline in older adults. Using data from the English Longitudinal Study of Ageing (ELSA, wave 6), IC composite was derived through z-score and item-response theory (IRT) methods in a sample of cognitively normal older adults (n = 731, aged 70.1 ± 6.77years). Global cognition (GC) was derived by categorizing Mini-mental State Examination scores obtained in the same population 4-5years later (ELSA-HCAP, 2018). After algorithm selection, GC categories were regressed on IC scores, demographic and lifestyle covariates. The IRT algorithm showed better model fit and strong associations with age, sex and education. Lower IC was associated with higher likelihood of developing mild cognitive impairment (MCI) 4 to 5years after IC assessment. Increased age and lower education were also strong predictors of GC, whereas no significant effects were found for sex, physical activity, or number of comorbidities in the fully adjusted model. Although bivariate regressions showed that reduced moderate or vigorous physical activity and increased number of comorbidities are associated with higher odds of developing later MCI, the lack of associations between these covariates and GC in the fully adjusted model suggests a possible mediation effect on IC. No study had previously explored the association of IC on later cognitive impairment. Results agree with previous evidence associating low IC to females, older ages and lower education. Further research to reveal possible underlying mechanisms explaining this association is needed to improve our understanding and relevance of IC for healthy ageing.

This article provides an analytical overview of the levels and possibilities of expressing creative activity during physical movement. It emphasizes individual characteristics of motor activity and focuses on the conscious and unconscious levels of creativity in physical performance. It substantiates the development of students’ creative abilities through physical movement activities.

ABSTRACT Promoting physical literacy offers a promising approach to enhancing physical activity among older adults. However, methods to measure physical literacy have primarily been limited to developed regions globally. This study evaluated the reliability (internal consistency), validity (content, construct, and convergence validity), and floor and ceiling effects of the Perceived Physical Literacy Instrument (PPLI) among Nigerian older adults. This cross-sectional study included 409 Nigerian older adults [mean age (SD) = 67.9 (6.7) years]. Data were analyzed using Cronbach’s alpha for internal consistency, exploratory and confirmatory factor analysis for construct and convergent validity, and item-level (I-CVI), scale-level (S-CVI) content validity index, along with kappa statistics, for content validity. The Cronbach’s alpha was 0.736, indicating adequate internal consistency. The analysis revealed two factors: functional competency (α = 0.80) and psychosocial empowerment (α = 0.73), with an average variance extracted of 0.62, suggesting the items captured a sufficient proportion of construct-relevant variance. The I-CVI ranged from 0.22 to 0.67, and the S-CVI was 0.49; the kappa coefficients ranged from 0.22 to 0.67. Floor and ceiling effects were both minimal at 0.24%. While the PPLI demonstrates acceptable internal consistency and preliminary evidence of construct validity, it requires further face and content validity to ensure its language and items are fully appropriate for Nigerian older adults with a lower level of education.

Caregivers of patients with metastatic cancer may be exposed to an overwhelming sense of burden. Physical exercise may help patients improve their physical condition, manage symptoms, and enhance their quality of life. Nevertheless, it is unclear if these interventions may also likely affect caregivers. Five focus group (n = 20 participants) were conducted to explore the caregivers' experiences/perspectives of patients affected by metastatic cancer and performing a supervised physical exercise intervention. Thematic analysis using an inductive approach was performed. Theme, sub-themes, and illustrative quotes are displayed. Four themes were identified. Theme 1 captured, with two sub-themes, the impact of the diagnosis on caregivers' emotional status and daily routines. Theme 2 was related to the perceived benefits of patients' engagement in the physical exercise program, enclosing three sub-themes (physical advantages, management of side effects, psychological well-being) and how this has helped caregivers enhance their emotional well-being. Theme 3 reported how caregivers have felt supported by the physical exercise program for the care of their loved ones (three-sub-themes: supervised by specialists, tailored and flexible program). Finally, theme 4 explained that caregivers, thanks to the patient's participation in the exercise, were able to take back control of their own lives, having more time available and enhancing their relationship with the patient. Participation of patients with metastatic cancer in a structured physical exercise program may be effective in reducing caregiver's burden. This study may serve as a trailblazer to guide future investigations and consolidate the present findings.

ABSTRACT The current study investigated the potential group differences in mental strength, resilience, and grit between combat sports practitioners and non-practitioners, and between competitors and non-competitors. For this, a sample of 213 individuals (72.8% males) between 18 and 45 years of age was categorised into five groups (1: Brazilian jiu-jitsu, 2: Judo, 3: Kickboxing, 4: Physically Active, and 5: Physically Inactive). Participants responded to the Mental Strength Scale, Brief Resilience Scale, Grit Scale, and additional physical activity and combat sports-related questions. The main results revealed that Brazilian jiu-jitsu and judo practitioners presented higher mental strength, resilience, and grit than physically inactive individuals. Kickboxers showed higher mental strength than physically inactive individuals. Brazilian jiu-jitsu practitioners reported higher mental strength than physically active individuals, and judo players reported higher resilience than physically active individuals. It was revealed that combat sports competitors presented higher resilience than non-competitors. Moreover, significantly positive relationships were found between combat sports training experience and mental strength (4.3% variance), resilience (2.2% variance), and grit (5.8% variance). A significant positive relationship was also found between the number of competitions engaged in and resilience (1.9% of the variance). Based on these results, the practice of combat sports appears to be associated with better levels of mental strength, resilience, and grit. Besides, competition engagement appears to be associated with better levels of resilience. Future studies are encouraged to address whether mental strength, resilience, and grit are prerequisites for continued combat sports training or whether a causal relationship exists.

Exercise may lead to disease progression and higher risk of sudden death in individuals with genetic cardiomyopathies, but the effects of exercise among individuals carrying a cardiomyopathy-associated variant without clinical manifestations (G+P-) are unclear. To examine whether the effects of moderate to vigorous physical activity (MVPA) on cardiovascular (CV) outcomes, cardiac structure and function, and risk of developing overt cardiomyopathy and malignant ventricular arrhythmias (VAs) vary by G+P- status. UK Biobank participants with whole-genome sequencing providing 1 week of accelerometer-based physical activity data and without prevalent heart failure (HF), atrial fibrillation (AF), cardiomyopathy, VAs, or implantable cardioverter-defibrillators were included in this cohort study. The study was conducted at 22 assessment centers throughout the UK from February 2013 to December 2015 with a median follow-up of 8 years. Data were analyzed from March 2024 to June 2025. Accelerometer-measured MVPA (minutes/week). Associations were analyzed between MVPA volume and future incidence of adverse CV outcomes (AF, HF, myocardial infarction [MI], and stroke), cardiac magnetic resonance (CMR)-based measures of cardiac remodeling, and surrogates for clinical cardiomyopathy onset (cardiomyopathy and VA). Associations were compared between G+P- carriers and noncarriers. Among 84 699 individuals (mean [SD] age, 62 [8] years; 48 353 [57%] women; 3979 G+P- carriers), greater MVPA was associated with a lower risk of adverse CV outcomes over a median (IQR) 8.0 (7.5-8.5) years, irrespective of genotype. In multivariable models, higher MVPA was broadly associated with lower risk of incident CV disease in G+P- carriers (hazard ratio [HR] at optimal MVPA level vs zero [95% CI], AF: 0.68 [0.58-0.79]; HF: 0.58 [0.47-0.71]; MI: 0.49, [0.24-1.00]; stroke: 0.35 [0.12-0.99]). For G+P- carriers, MVPA in the range of 100 to 400 minutes per week was generally associated with lowest risk. Among individuals with CMR imaging, MVPA was associated with a similar pattern and extent of cardiac remodeling (eg, left ventricular dilation and left ventricular hypertrophy) in G+P- carriers vs noncarriers. Among G+P- carriers, higher MVPA was associated with lower risk of incident cardiomyopathy (HR at optimal MVPA vs 0, 0.03; 95% CI, 0.00-0.98) with no increase in risk of VA (eg, HR at 400 minutes of MVPA vs 0, 0.98; 95% CI, 0.83-1.14). Findings were generally consistent across variants associated with dilated cardiomyopathy, hypertrophic cardiomyopathy, or arrhythmogenic right ventricular cardiomyopathy, although precision of estimates for arrhythmogenic right ventricular cardiomyopathy were limited. In this cohort study, MVPA within the general range of guideline-based recommendations was associated with lower risk of adverse CV outcomes and similar degrees of cardiac remodeling for G+P- carriers compared to noncarriers. Findings support the appropriateness of guideline-based MVPA recommendations for G+P- carriers.

Wearable technologies for mental health monitoring older adults: systematic review.

The purpose of this study was to examine the relationship between the motivational climate and older adults' basic psychological needs (BPNs), subjective wellbeing, and exercise commitment in group fitness classes. Members of fitness centers offering older adult programming (N = 284) completed a survey about their group fitness experiences. A caring, task-involving climate was positively (and an ego-involving climate negatively) associated with BPNs, wellbeing, and commitment. Wellbeing and commitment were positively correlated, and both were predicted by BPNs. The structural equation model indicated that BPNs mediated the relationship between a caring, task-involving climate and wellbeing/commitment. The motivational climate may improve older adults' exercise experiences as exercise leaders who foster a caring, task-involving climate have opportunity to enhance wellbeing and commitment, promoting healthy aging. These results align with the idea that physical activity supports overall wellbeing in later years. Fitness programs tailored to the unique needs of older adults can support resilient, health-focused communities, ensuring opportunities for physical activity across generations.

The Role of Sports, Peer Support, and Teacher Involvement in Bullying: A Quantitative Study from the Teachers’ Perspective. Objectives: The research aims to analyze teachers' perceptions of the direct effects of sports activities, colleagues' support, and their role in bullying behavior; to explore the mediating role of mental health; and to examine the moderating effect of self-regulation from the teachers' perspective. Methods: A quantitative method involving Structural Equation Modeling with Partial Least Squares (SEM-PLS) was employed. The sample consisted of 250 sixth-grade elementary school teachers in the Rampah District. The data were collected using a 5-point Likert scale structured questionnaire that assessed teachers' perceptions of student bullying behavior, mental health, peer support, and self-regulation. The data were then processed to evaluate the measurement model and the structural model. Findings: This study revealed that teachers regarded sports activities and their role as the primary direct factors influencing the reduction of bullying. The study results indicated that the proposed direct influence of peer support on bullying (H2) was not confirmed (β = -0,021, p = 0,312). Rather, the teachers viewed peer support as a significant indirect influence, leading to a notable improvement in students' mental health (β = 0.494, p < 0.001), which in turn contributed to a decrease in bullying behavior. The teachers' perceptions suggested that mental health was a significant mediator in the relationship between the protective school factors and bullying behavior. Moreover, according to teachers' assessments, self-regulation had a moderating effect and was instrumental in elevating the impact of mental health on bullying abatement. The model accounts for 37.7% of the variance in teachers' perceptions of mental health and 50.8% of the variance in bullying behavior, with a predictive relevance (Q²) of 0.694, indicating strong explanatory power. Conclusion: The findings confirm that preventing bullying in schools requires a comprehensive strategy that incorporates physical activities, peer relationships, teacher participation, and mental health promotion, facilitated by self-regulation training. This research contributes to the current conceptual models of bullying prevention from the perspective of teachers, providing practical advice for creating a safer and more supportive educational setting grounded in educators' viewpoints. Keywords: bullying, sports activities, peer support, teacher’s role, mental health, self-regulation.

Glucagon-like peptide-1 (GLP-1) receptor agonists stand out in the treatment of type 2 diabetes mellitus and obesity, demonstrating efficacy in reducing body weight and controlling glycemia, as well as providing additional metabolic and cardiovascular benefits. However, the popularization of these medications, driven by social media and aesthetic use, has led to self-medication, off-label use, and inequities in access, representing significant challenges for public health. High costs and the lack of consolidated policies for incorporation into the Brazilian Unified Health System (SUS) further reinforce barriers to equitable access. In this context, pharmaceutical care assumes a crucial role, including guidance on dosing, monitoring adverse effects, preventing drug interactions, and promoting rational use. The pharmacist’s intervention contributes to patient safety and therapy effectiveness, highlighting the importance of combining GLP-1 receptor agonist treatment with sustainable lifestyle changes, such as balanced nutrition and regular physical activity. The integration of therapeutic innovation, ethical responsibility, and equitable access policies is essential to maximize the clinical benefits of these medications and mitigate risks to public health.

Physical activity and sleep prescriptions are indicated for the treatment of psychiatric disorders among youth. However, there is limited clinical adoption of these practices. Exergaming (ie, games that require physical activity) is a feasible intervention to promote physical activity and sleep hygiene and is appealing to youth given their interest in video gaming. Integrating exergaming prescriptions into clinical mental health practices may offer an opportunity to expand access to these interventions, yet pragmatic considerations for adopting these programs are poorly understood. This study aimed to gain feedback from practicing clinicians on adopting GamerFit, an app-based intervention that incorporates exergames, step and sleep tracking, and online coaching to promote physical activity and sleep, as a tool in treatment plans for youth aged 13 to 17 years with psychiatric disorders. Mental health clinicians participated in 2 online focus groups. A semistructured interview collected information on perceptions of the importance of physical activity and sleep, considerations for using GamerFit with clients, and approaches for incorporating GamerFit into standard care. Qualitative analysis included a hierarchical thematic coding system of isolated quotes, with the structure, frequency, and interrelationships of the coded quotes used for analysis. All clinicians (8/8, 100%) endorsed physical activity and sleep prescriptions as important interventions, although they were not typically a focus of treatment. Clinicians reported varying levels of self-efficacy in encouraging physical activity goals (6/8, 75%) and, to a lesser extent, sleep hygiene (4/8, 50%). Most perceived eHealth approaches positively (7/8, 88%) and noted their appeal given the accessibility of this physical activity option via gaming (2/4, 50%). Clinicians were optimistic about the feasibility of using GamerFit; the exergame and health coaching aspects of GamerFit were perceived favorably (5/8, 62%). Clinicians desired to access app data in electronic health systems to incorporate in therapeutic sessions (4/8, 50%) and recommended using the app in residential settings with continued use at home (2/8, 25%). Clinicians expressed concern regarding the implementation of GamerFit with families with low technology literacy, noting that some patients would likely require parental assistance to help with reminders and technology use (1/8, 12%). Suggestions for improvement included a greater variety of exergames and features to increase adolescents' engagement (6/8, 75%). There was a considerable willingness to incorporate this technology into clinicians' clinical practices and a strong desire for insurance provisions to cover coaching and technological components (7/8, 88%). Clinicians perceived GamerFit as a feasible and acceptable clinical approach to physical activity and sleep prescriptions for youth with psychiatric disorders. The remote delivery of this intervention was perceived to be of interest to patients and provided helpful guidance for clinicians who were short on time to address many important topics within limited session time frames.

The moderating role of spouse loss and physical exercise remains understudied in the sedentary behavior - psychological distress relationship. We aimed to explore the association between sedentary behavior and psychological distress, as well as the role of spouse loss and physical exercise in this association among rural older adults. The data came from the wave 3 of Shandong Rural Elderly Health Cohort (SREHC). A total of 3,235 rural older adults were included in the analysis. The linear regression model and marginal effects analysis were performed to examine the association of sedentary behavior with psychological distress, and the moderating effect of spouse loss and physical exercise in this association. After adjusting the confounders, sedentary behavior was significantly associated with psychological distress among rural older adults (β = 0.202, P < 0.001). Spouse loss may modify the relationship between sedentary behavior and psychological distress (β = 0.210, P = 0.033) and physical exercise also moderate this relationship (β = -0.265, P = 0.011). Our findings highlighted that spouse loss and physical exercise moderated the association between sedentary behavior and psychological distress among Chinese rural older adults. These findings highlight the need to pay greater attention to older adults who have experienced spouse loss, and suggest that promoting physical exercise could be considered as a supportive approach to alleviate psychological distress associated with sedentary behavior in rural China.

Factors that affect engagement with physical activity for patients who have received radiotherapy as part of their gynaecological cancer treatment - A rapid review.

Skeletal dysplasia (SD) encompasses over 700 heterogeneous genetic conditions affecting the development, growth and maintenance of the human skeleton. Challenges regarding feeding, nutrition, and physical activity are reported across the lifespan, but the lived experience of these issues is poorly understood. This study uses a qualitative mixed methodology to explore feeding, nutrition, and physical activity from the perspectives of individuals living with SD or their parents. Three semistructured focus groups were conducted in Norway and 13 interviews in Australia. The two qualitative datasets were thematically analyzed separately, and themes were then synthesized together. Thirty-five participants with SD or their parents participated across the two sites. Six major themes were identified: (i) early life feeding, development, and activity; (ii) managing energy intake and nutrition in older children and adults; (iii) practical considerations related to food preparation; (iv) weight gain; (v) holistic health care; and (vi) physical activity in older children and adults. Subthemes identified included breastfeeding challenges, inappropriate assessment of growth and nutritional status, barriers to being physically active in adulthood, and difficulty navigating food portions. Understanding the experiences of people with SD will support and inform future codesigned tailored solutions to address feeding, nutrition, and physical activity.

Physical activity (PA) is a significant predictor of physical and mental health, particularly among older adults. In India and China, gendered social norms shape physical patterns, and the intensity of androcentric settings is different. As a result, the gendered perspective of physical activity and its association with health outcomes could be different in China and India. Therefore, the study examines gender differences in physical activity and their impact on health outcomes. This study utilizes nationally representative data from older adults aged 60 and above in India and China. Gender disaggregated physical activity is considered a key explanatory variable, and functional limitations (IADL/ADL), multimorbidity, and self-rated health are selected as outcome variables. Separate logistic regression analyses were conducted for males and females to examine the gender-specific associations between PA and health. Indian women show lower moderate PA (54.58%) than Chinese women (49.99%), with markedly fewer engaging in intense PA (12.35% vs. 24.01%). Health disparities are more severe in India: 56.15% report IADL limitations (China: 42.86%) and 25.2% ADL problems (China: 29.09%). While moderate PA strongly protects against poor SRH/ADL in both countries, Indian women face higher multimorbidity risks (aOR: 1.38 vs. China's Non-Significant) when inactive. This comparative study reveals that Indian women face greater physical activity disparities and worse functional health outcomes than Chinese women, highlighting the urgent need for gender-sensitive health interventions to address these inequities.

Health anxiety (HA) is a growing concern among medical students due to their continuous exposure to illness-related content, academic stress, and self-monitoring tendencies. While some studies suggest an association between HA and health-related behaviors, findings remain inconclusive, especially particularly among Chinese medical students. This study aimed to examine the relationship between HA and health-related behaviors. This cross-sectional study was conducted among 2,283 Chinese medical students. Participants completed standardized self-report measures assessing demographic characteristics, HA (via the Chinese Short Health Anxiety Inventory, CSHAI), body mass index (BMI), smoking status, dietary patterns, and physical activity levels (via the International Physical Activity Questionnaire-Short Form, IPAQ-SF). Group differences were examined using independent-samples t-tests and chi-square tests. Multiple linear regression was performed to identify factors associated with HA. Approximately one-third of the students reported clinically HA. Among participants, 46.3% were classified as physically inactive and 40.3% were overweight or obese. Additionally, 9.55% were current smokers, and 36.4% reported an unhealthy diet pattern. No significant differences were observed between students with and without HA in terms of BMI, smoking status, or dietary habits (p > 0.05). However, weekly physical activity level was significantly lower among students with HA compared to those without HA (p < 0.001). In regression analysis, physical activity was negatively associated with HA (p < 0.001), indicating that higher levels of physical activity were related to lower HA scores (β= - 0.343). Lower physical activity was associated with higher HA, suggesting that promoting physical activity may be a relevant in efforts to reduce HA among medical students.

Background: People living with long-COVID (PLWLC) experience a broad range of persistent coronavirus disease 2019 (COVID-19) symptoms extending beyond 4 weeks. Long-term, multi-organ damage in the body negatively impacts physical activity, which is vital to improving mental well-being and quality of life. People living with long-COVID experiment with self-management strategies, and this can have damaging outcomes. Objectives: Our study explored the influence of the 2019 coronavirus on physical activity, through the lived experiences of PLWLC, to inform future rehabilitation initiatives for this population. Method: A qualitative research study design involving semi-structured interviews was utilised to gather the experiences of 17 purposively selected participants who have long-COVID at a private facility in KwaZulu-Natal, South Africa. Data collected from the interviews were transcribed verbatim and thematically analysed. Results: Four main themes emerged, namely, perceptions of pre-COVID and post-COVID physical activities in daily life, approaches to coping strategies with physical activity limitations, perceptions of physical activity’s influence in recovery and progressive informal exercise therapy. Conclusion: Our study reveals long-COVID’s complex and multifactorial nature, which imposes challenges on PLWLC’s individual functioning and daily activities, community participation and societal roles. Individuals perceived poor, mixed or beneficial effects with the uptake of physical activity and resorted to self-taught management strategies. Further research on safe, tailored and contextualised rehabilitation advice and interventions for the common debilitating symptoms of long-COVID is needed. Clinical implications: Inform future rehabilitation considerations for healthcare professionals and provide insight for further interventional explorative studies for long-COVID rehabilitation.