Walking Program Research Articles

IMPACT OF WALKING GROUP INTENSITY & TIMING ON EXERCISE ATTITUDES IN OLDER ADULTS: MIXED-EFFECTS ANALYSIS

Abstract How does physical activity intensity influence pre-frail and frail older adults’ attitudes toward physical activity? Casual-speed walking is enjoyable but more intense walking programs can stimulate greater physiologic adaptations and benefits. However, intensity might negatively impact motivation if it leads older adults to evaluate physical activity less favorably. These attitudes can be affective (involving emotional responses, such as enjoyment) or instrumental (involving perceived practical benefits, such as health improvements) and influence future physical activity through their effects on intentions. Whether high-intensity exercise alters the dynamics of attitude change is unclear. This study was a secondary analysis of the effects of 16-week casual-speed versus high-intensity walking intervention on attitudes toward walking in pre-frail and frail older adults. Participants (n = 156; M age = 79.9 years, SD = 7.0) were randomized into casual-speed or high-intensity walking groups and reported attitudes toward the intervention at four time points (baseline, 6, 12, and 16 weeks). Generalized linear mixed models (GLMM) with a gamma distribution assessed attitude changes over time. Results showed instrumental attitudes initially declined (Estimate = -0.006, p <.001) but followed a quadratic pattern, stabilizing or slightly improving later (Estimate = 0.0002, p =.008). Affective attitudes remained stable, with no significant changes over time. Intensity did not affect the rate of change for either attitude type, suggesting similar changes regardless of intensity. We concluded that high intensity walking did not influence attitudinal changes toward walking, and concerns about adverse motivational impacts of high-intensity activity in older adults may be overstated.

The Effect of Baduanjin Qigong on Impact of Disease and Sleep Quality in Elderly Fibromyalgia Patients

Introduction: Fibromyalgia is marked by widespread chronic pain, fatigue, and disrupted sleep, significantly impacting quality of life. This study aimed to explore the effect of Baduanjin Qigong (BQ) on impact of the disease and quality of sleep in elderly patients with fibromyalgia. Methods: The study employed a semi-experimental design. A total of thirty-four elderly female patients with fibromyalgia were recruited through convenience sampling and allocated into two intervention groups: BQ group (n = 17) and a walking group (n = 17). The BQ protocol was conducted for 12 weeks, with sessions held three times a week. The walking group participated in a 12 week fitness walking program. Impact of the disease and quality of sleep were assessed at baseline and after 12 weeks using The Revised Fibromyalgia Impact Questionnaire (FIQR) and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using paired t-test and independent t-test. Results: The significant improvements were observed in PSQI total (t (16) = 3.65, p = 0.002), FIQR (t (16) = 3.76, p = 0.002), FIQR function (t (16) = 2.16, p = 0.04), FIQR symptoms (t (16) = 2.957, p = 0.009) in BQ group. There was a significant difference between the average post-test data of the walking group and BQ group in daytime dysfunction, with the BQ group performing better than the walking group (p ≤ 0.05). Conclusion: BQ significantly improves fibromyalgia impact and sleep quality in elderly patients and reduces daytime dysfunction more effectively than walking. However, it is not superior to walking in other aspects of disease impact and sleep quality enhancement.

Exercise for Cancer Patients with Bone Metastasis: Literature Review

Preservation of physical function is the primary goal of cancer rehabilitation in patients with advanced cancer. The presence of bone metastases can lead to decreased physical function, decreased quality of life and fewer treatment options. The purpose of this study was to summarize and assess the safety and effectiveness of exercise in patients with bone metastases. The method used was a literature review through searching articles from several database journals used such as Google Scholar (Article Scholar). The results of a review of four articles related to exercise interventions in cancer patients such as exercise preserves physical function (aerobic, resistance, and flexibility exercises) supervised resistance training and unsupervised walking programs, unsupervised home-based exergaming can significantly improve physical function, strength, mental health, quality of life, fatigue. only one article was not very significant. Conclusion exercise in people with bone metastases, exercise appears to be safe and feasible, when it includes elements of supervised exercise instruction and is delivered by qualified exercise professionals.

Supervised vs home-based exercise program in kidney transplant recipients: A pilot pragmatic non-randomized study.

Although the benefits of exercise for kidney transplant recipients (KTRs) have been widely demonstrated, these patients experience several barriers in undertaking a structured exercise program in hospital and non-hospital facilities. To compare the effects of a supervised moderate-intensity gym-based intervention with a home-based low-intensity walking program on exercise capacity in KTRs. KTRs were asked to choose between two six-month programs. The first group performed a low-intensity interval walking intervention at home-based exercise intervention (HBex). The second group performed a supervised training program at an adapted physical activity gym (Sgym), including aerobic and resistance training. The outcomes, collected at baseline and at the end of the programs, included the 6-minute walking test, the peak oxygen consumption (VO2peak) during a treadmill test, the 5-time sit-to-stand test, and blood pressure. Seventeen patients agreed to participate and self-selected into the HBex (n = 9) and Sgym (n = 8) groups. Two patients in the Sgym group dropped out because of familial problems. At baseline, patients in the HBex group were significantly older and had lower walking distance, VO2peak, and lower limb strength. Primary outcome changes were significantly greater in the HBex group than in the Sgym group (52 ± 23 m vs 8 ± 34; P = 0.005). No other significant differences between groups were observed. Both groups improved most of the outcomes in the within-group comparisons, with significant variations in VO2 peak. Six-month moderate-intensity supervised or low-intensity home-based training programs effectively improved exercise capacity in KTRs. Gym-based programs combine aerobic and resistance training; however, in-home walking may be proposed for frail KTRs.

Inspiratory muscle resistance combined with strength training: effects on aerobic capacity in artistic swimmers.

This study aimed to investigate the effects of combining inspiratory muscle resistance with strength training on lung function and aerobic capacity in artistic swimmers. This research constitutes a placebo-controlled randomized trial, involving a five-week walking program conducted twice a week. Fourteen female artistic swimmers were randomly assigned to either the experimental group (TG group, n = 7) or the control group (CG group, n = 7). Both groups underwent the same strength training program. The TG group performed inspiratory muscle strengthening at 50% of maximum inspiratory pressure (MIP) during strength training, whereas the CG group engaged in strength training with 15% MIP inspiratory muscle training twice a week. Pre- and post-intervention assessments included an incremental stress test, pulmonary function test, inspiratory muscle strength test, and a specialized performance test. Following the 5-week intervention, within-group comparisons revealed that the inspiratory muscle strength index, vital capacity, and forced vital capacity significantly increased in both the CG and TG groups (P < 0.01). The TG group exhibited a significant increase in minute ventilation (P < 0.05), while the CG group showed a significant increase in tidal volume (P < 0.05). Additionally, the TG group demonstrated a significant improvement in running speed at the ventilation threshold and maximum oxygen uptake (P < 0.05), along with a significant increase in tidal volume (P < 0.01). Both the CG and TG groups showed significant increases in the scores for the 50-meter diving and 25-meter torpedo (P < 0.05). Between-group comparisons showed that the TG group experienced significant improvements in the inspiratory muscle strength index, minute ventilation, running speed corresponding to maximum oxygen uptake, and 25-meter torpedo performance (P < 0.05). The findings suggest that a 5-week program combining inspiratory muscle resistance with strength training can effectively enhance the aerobic exercise capacity of artistic swimmers. Moreover, high-intensity inspiratory muscle resistance combined with strength training can improve the muscle's ability to utilize oxygen during exercise. Beijing Research Institute of Sports Science (TKSLL202201); China Clinical Trial Registry, ChiCTR2300072833, 26/06/2023.

An Outdoor Walking Program for Immigrant Muslim Older Adults: A Community-Based Participatory Intervention.

To explore Muslim immigrant older adults' experiences of a modified community-based outdoor walking program and identify factors that facilitate or hinder program acceptance and participation. An exploratory qualitative description single-group pilot study was designed and implemented in three phases: (1) pre-intervention focus group interviews; (2) intervention implementation with tracking of physical activity levels using personal activity monitors; and (3) postintervention individual interviews. Participants were recruited using a convenience sampling strategy in a mosque in Edmonton, Canada, in June 2019. After focus group discussions with participants, walking sessions were conducted for 10 weeks in a local accessible park with required amenities such as benches and restrooms. A fitness instructor delivered the weekly program that was followed by individual semistructured interviews to explore participants' satisfaction and program acceptance. Content analysis was used for qualitative data and sociodemographic, health and physical activity level (via step counts) data was documented for all participants. Thirteen participants with a mean age of 66.9 years completed the program. The majority of participants led a sedentary lifestyle. Participants identified three motivators that increased program satisfaction, which were socialising with peers, having a fitness instructor, and using Fitbit activity trackers. Difficulties with transportation and lack of appropriate educational components were areas for improvement that could enhance acceptability of the program. This study suggests that early incorporation of older immigrants' preferences increases acceptance of physical activity programs. Nurses' engaging in healthy lifestyle support for older immigrants can identify the influences on positive uptake of physical activity programs in this population. Immigrant Muslim older adults lack access to evidence-based physical activity programming that meets their cultural and religious preferences. This study provides some insights into ways to engage this population in similar programs. Community-dwelling older adults who participated in this study completed focus groups and interviews and engaged in the 10-week pilot intervention. Their input informed the modifications to the intervention.

Association between number of days of leisure sports participation and frequency of symptoms of sleep, social isolation, and diet

Aims: This study examined the association between the number of days of walking participation and frequency of eating, depressive, and sleep disorders symptoms.Methods: Data of 231,351 Korean adults were obtained from the 2022 Community Health Survey. Multivariate logistic regression analysis was performed to evaluate the association, which was also analyzed by sex and age. The results showed that the more days adults with eating or depressive disorder walked, the less likely they were to suffer from symptoms. Additionally, the more severe the eating or depressive disorder symptoms, the greater the effect of walking. Thus, walking was effective in reducing the symptoms of eating and depressive disorders. For adults with sleep disorders, walking compared with not walking was more likely to cause symptoms. However, regardless of the age and sex, as the number of walking days increased, the degree of sleep disturbance decreased. Specifically, for eating disorder symptoms, adults who walked 5 or more days per week compared with those who did not walk were 0.939 (95% confidence interval [CI]: 0.912–0.968, P<0.001), 0.755 (95% CI: 0.705–0.808, P<0.001), and 0.667 (95% CI: 0.623–0.713, P<0.001) less likely to suffer from eating disorder symptoms for several days, more than a week, and almost daily, respectively. For depressive disorder symptoms, adults who walked 5 or more days per week compared with those who did not walk were 0.967 (95% CI: 0.938–0.997, P<0.05), 0.717 (95% CI: 0.666–0.773, P<0.001), and 0.645 (95% CI: 0.594–0.700, P<0.001) less likely to suffer from depressive disorder symptoms for several days, more than a week, and almost daily, respectively. For sleep disorder symptoms, adults who walked 5 or more days per week compared with those who did not walk were 1.126 (95% CI: 1.095–1.158, P<0.001) more likely to suffer sleep disorder symptoms for several days.Conclusion: Walking was effective for women with eating disorders and depression and for men with sleep disorders. Furthermore, the effect of walking was greater among individuals aged 65 years or older, as they were less likely to suffer from eating, depressive, and sleep disorder symptoms than those observed among individuals aged 19–44 and 45–64 years. The results of this study serve as foundational data for the development and implementation of walking programs that improve the quality of life of people suffering from eating, depressive, and sleep disorder symptoms.

Effects of Assisted Walking Exercise in Chronic Dependent Ambulatory Stroke Survivors: A Mini-Review.

Assisted walking exercise programs are widely recommended in rehabilitation guidelines for stroke survivors. However, most evidence supporting these programs primarily focuses on ambulatory stroke survivors or those dependent ambulatory in acute and subacute stages. There is a notable gap in the application of walking exercise programs for chronic dependent ambulatory stroke survivors despite potential benefits in reducing sedentary behavior and improving rehabilitation outcomes. Thus, this literature review aims to summarize the existing evidence on the feasibility and efficacy of assisted walking exercise programs for chronic stroke survivors who are dependent ambulators. Six major databases were searched for clinical trials related to assisted walking exercise and chronic dependent ambulatory stroke. Seven studies (evidence with low- to moderate-quality) involving 91 chronic dependent ambulatory stroke subjects are included in this review. These studies indicated that assisted walking exercise is feasible to perform by chronic dependent ambulatory stroke survivors and can induce continued motor recovery and functional improvement. However, the mixed and limited evidence from existing research underscores the need for future high-quality randomized controlled trials with standardized designs and outcome measures to establish evidence-based walking programs for this population.

Effects of Barefoot Walking in Urban Forests on CRP, IFNγ, and Serotonin Levels.

This study investigated the effects of barefoot walking on an urban forest path on participants' C-reactive protein (CRP), interferon gamma (IFNγ), and serotonin levels, which are associated with feelings of well-being. Participants in the walking program included 62 consenting adults, divided into a sneaker-wearing and barefoot group (each N = 31). The program comprised 20 sessions, each consisting of a 90 min 4.4 km walk at a 50-70% target heart rate, held four times per week for 5 weeks. Physiological measurements were taken from pre-program saliva samples and after 10 and 20 sessions, respectively. The sneaker-wearing group showed a consistent CRP increase, with levels reaching statistical significance after 20 sessions. In the barefoot group, CRP increased up to Session 10 but was lower than at the end of Session 20. The analysis of those with an initial CRP above 100 pg/mL showed that CRP was statistically significantly lower in the barefoot (N = 14) than in the sneaker-wearing (t = -0.048, p = 0.963) group after 20 sessions compared to before the program (t = 3.027, p = 0.010). IFNγ increased in both groups up to Session 10 but showed minimal change between Sessions 10 and 20. Serotonin was statistically significantly higher after 20 sessions than before the program in the barefoot group (t = -2.081, p = 0.046). Barefoot walking on forest trails is effective for people with above-normal inflammation, increasing serotonin levels.

Upper limb muscle strength and wheelchair-related abilities following an exoskeleton-assisted walking programme in individuals with chronic spinal cord injury: An exploratory study.

To measure the potential effects of an overground exoskeleton-assisted walking programme on upper limb strength and mass, as well as on wheelchair propulsion performances and abilities in individuals with chronic spinal cord injury. Prospective, single-group, pre-post intervention study. Ten individuals with chronic (≥ 18 months) spinal cord injury who use a wheelchair as their primary mode of locomotion and who had little-to-no motor function in the lower limbs. Individuals completed a progressive 16-week exoskeleton-assisted walking programme (34 × 1-h sessions, 1-3 sessions/week). Upper limb muscle strength was measured with dynamometers (isokinetic, Jamar). Upper limb lean mass (dual-energy X-ray absorptiometry) was used to calculate relative strength. Field tests (20-m wheelchair propulsion, and slalom test) and the Wheelchair Skills Test Questionnaire determined performances and abilities. Wilcoxon signed-rank tests were used with the following criteria: p < 0.1, effect size ≥ 0.5, and relative variation > 5%. Only natural velocity during the 20-m wheelchair propulsion test (i.e., fundamental wheelchair ability) changed following the intervention (p = 0.01, effect size = 0.82, relative variation = +14.5%). Overall, upper limb muscle function did not significantly and meaningfully change following the exoskeleton-assisted walking programme in this population. Additional research is needed to verify how changes in training volume would affect strength and advanced wheelchair-related abilities and performance, as well as the response in individuals who are deconditioned or novices to wheelchair use (e.g., subacute spinal cord injury).

Keep it Movin’: Design and methods of a church-based physical activity program to improve physical function among midlife and older black adults

BackgroundOlder Black adults have high rates of physical function (PF) limitations. Physical activity (PA) is effective for improving PF and reducing mobility disability risk; however, community-based PA interventions focused on improving PF for older Black adults are lacking. Given the importance of churches as trusted institutions in Black communities, church-based interventions developed through community collaborations may help increase access to PA interventions. MethodsKeep it Movin’ is a church-based cluster randomized controlled trial testing the effectiveness of a 24-week group-based (intervention arm) versus a self-guided (comparator arm) program in improving PF among Black adults aged ≥ 40 years with PF limitations (short physical performance battery [SPPB] score ≤ 9). A church-wide virtual walking program is available to congregants in both arms. The intervention arm receives weekly group-based classes held at the church that include education, goal setting, and structured PA (walking, lower-extremity strength, balance, and stretching). The comparator arm receives educational materials about PA appropriate for people with PF limitations. Outcomes are assessed at 6 (program completion) and 12 months (maintenance). The primary outcome is PF change as measured by the SPPB at 6 months. Secondary outcomes include change in moderate-to-vigorous PA, social support and self-efficacy for PA, quality of life, and self-reported PF. Factors related to successful adoption, implementation, and maintenance are assessed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. ConclusionThis is the first study to evaluate the effectiveness of a group-based PA program delivered in Black churches to improve PF.

Implementing a Walking Program for Sedentary Patients in a Weight Management Clinic: Methodology

Promoting physical activity in weight management patients promotes better patient outcomes.

Engagement in a virtual group-based walking intervention for persons with schizophrenia: a qualitative study

BackgroundExercise is beneficial for persons with schizophrenia; however, high dropout rates limit the impact of interventions. Virtual exercise programs have the potential to improve engagement; however, few intervention studies of virtual programs have been conducted in this population.MethodsThis study examined qualitative data from 15 adults with schizophrenia who participated in a pilot randomized controlled trial of Virtual PACE-Life, a live, video-delivered group walking intervention guided by self-determination theory. Interviews elicited feedback on the intervention, barriers and facilitators to engagement, recommendations for intervention refinement, and preferences for exercise programming modality. Rapid qualitative analysis was used to explore similarities and differences between completers (i.e., those that attended ≥ 50% of virtual walking sessions; n = 9) and non-completers (i.e., those that attended < 50% of virtual walking sessions; n = 6).ResultsBoth groups viewed Virtual PACE-Life positively but found the virtual exercise sessions challenging and inadequate for facilitating social interaction. Work obligations impacted completers’ attendance whereas technological issues and forgetting impacted non-completers’ attendance at virtual walking sessions. Completers preferred virtual exercise programs and non-completers preferred in-person exercise programs.ConclusionsThese findings suggest that future virtual group-based walking programs should prioritize enhancing the social aspect, offering scheduling choices, and regularly assessing the perceived difficulty of exercise sessions. These modifications not only have the potential to improve intervention engagement but they also may increase participant autonomy and relatedness, core components of self-determination theory.

StepFit-18K: Improving Irritable Bowel Syndrome (IBS) Symptoms with a Simple, Structured Walking Intervention.

Background: Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal (GI) disorder characterized by abdominal pain, altered bowel habits, and bloating, affecting approximately 10.1% of the global population. While current treatments emphasize dietary modifications and symptom management, emerging evidence suggests that physical activity (PA) may help alleviate IBS symptoms. This study evaluated the effects of a structured walking program, "StepFit-18K", on IBS symptom relief. Methods: A total of 106 participants (68 females and 38 males) completed the 12-week intervention, which consisted of 18,000 additional steps per week (6000 extra steps on three days per week) tracked via fitness devices. The program emphasized step count, ease of adoption, and social support through walking groups. Results: As assessed by validated questionnaires, significant reductions in GI symptoms were observed. The IBS Symptom Severity Score (IBS-SSS) decreased from 118.30 ± 98.73 to 74.46 ± 74.93, with a delta score of -43.84%, highlighting bloating as the most improved symptom. No clinically significant changes were observed in anthropometric or biochemical markers. Conclusions: StepFit-18K is a simple, accessible, and effective form of physical activity that has demonstrated therapeutic benefits for IBS symptoms. This offers an additional application beyond its well-established role in preventing cardiovascular diseases.

IMPLEMENTASI DANA KANYAAH DI RT 05 KELURAHAN SUKAMULYA : MEMBANGUN SOLIDARITAS ANTAR AGAMA MELALUI PEMBIAYAAN KESEHATAN DAN PEMAKAMAN

This study aims to determine the implementation of the kanyaah fund in RT 05 Sukamulya Village which is one of the programs in building interfaith solidarity through health and funeral financing. This research is a qualitative study with data collection techniques of participant observation and in-depth interviews, using social solidarity theory analysis in responding to universal human needs and how individuals play an active role in the creation of social solidarity for people who have different beliefs in it. The results showed that through the kanyaah fund walking program, social solidarity was created in maintaining a life that upholds tolerance and harmonization in Sukamulya Village.

Causal mediation analysis of factors influencing physical activity and community access among people with mild to moderate Parkinson's disease

ObjectiveTo examine how known causal factors (exercise self-efficacy, balance, walking capacity) affect outcomes (moderate intensity physical activity, community access) in people with Parkinson's disease (PD): through a direct pathway, indirectly through potential mediators (non-motor impairments), or through combined direct and mediated paths. DesignCausal mediation analyses using baseline and three-month data from pooled treatment groups in a randomized controlled trial. SettingData were collected at two university clinical research centers. ParticipantsOne hundred thirty-eight people with PD. InterventionsHome and community-based walking and strength exercise program. Main Outcome Measure(s)Exposures were exercise self-efficacy, walking ability, and balance. Potential mediators included pain, fatigue, mood (anxiety, depression, affect, apathy), stigma, and cognition (executive function and cognitive flexibility). Outcomes were physical activity and community access behaviour at three-month follow-up. Separate models were developed for each causal factor-mediator-outcome combination. To minimise bias, all models were adjusted for known confounders (comorbidities, freezing of gait, severity of motor impairments, and/or age) and baseline values of the outcomes. ResultsSelf-efficacy of walking duration had a causal relationship with moderate intensity physical activity through direct and combined paths (p<.001). Walking capacity had a causal relationship with community access through direct (p=.03-.04) and combined (p=.02-.03) paths. Balance did not affect community access (p>.05). There were no significant mediation effects through indirect pathways for either outcome. ConclusionsThe effect of known causal factors on physical activity and community access was not mediated by non-motor impairments. Walking self-efficacy and walking capacity remain the primary intervention targets for improving physical activity and community access, respectively, in people with PD.

Toowoomba Healthy Towns: A Citizen Science Initiative on Active Transport in Regional South East Queensland, Australia.

Engaging in active transport will enable individuals across the life course to increase their habitual levels of physical activity. The aim of this study was to engage citizen scientists (CS) to identify factors that influence active transport in their community. The Our Voice citizen science methodology developed at Stanford University was employed. CS completed a "discovery walk," taking photos of things that help or hinder active transport. Three groups were recruited: children aged 10-12years (n = 11), adults (n = 12), and older adults >65years (n = 10). CS rated each photo and provided a narrative explaining their reason for taking the photo. Once all CS in a specific age group had completed the walk, they met for a group discussion. The CS worked together to analyze the data, arranging them into themes and identifying priority actions. Two CS representatives from each age group presented their findings to the local council decision makers. Children highlighted the need for safer crossings, especially from their school to the local park, and suggested zebra crossings as a solution. The adults highlighted that road signs prioritized vehicles, not pedestrians, and requested that this be reversed. Older adults noted that the poor condition of the pavements made it harder for people in wheelchairs to navigate. The CS recommendations have informed the council's walking and cycling network program. Engaging with citizen science provided the community with an opportunity to advocate for meaningful yet realistic improvements in the built environment that could promote neighborhood active transport and physical activity across the lifespan.

Protocol of randomized controlled trial to evaluate the effect of moderate exercise training on the functional capacity of patients with an implantable cardioverter defibrillator in a tertiary care center in South India.

Cardiac rehabilitation programs are planned to reduce the physiological and psychological stress of Cardiovascular Disease, decrease the risk of mortality secondary to CVD, improve cardiovascular function, and help patients to achieve their highest quality of life. However, data on the safety and efficacy of exercise training (ET) in patients with implantable cardioverter defibrillators (ICDs) is sparse. Exercise interventions in those with an ICD have not been extensively studied. A randomized controlled trial will be conducted to determine the effects of moderate ET on the functional capacity of patients with an Implantable cardioverter defibrillator with age group of >18 years, NYHA with grade II and III, EF ≤50%, No evidence of ICD discharge for past 3 months with minimum post-ICD implantation period of a minimum of 3 months. This study includes a total of 70 patients. Random allocation will be used to randomize participants into two groups (35 in each). Home-based walking exercises in the form of aerobic walking will be advised to patients with ICD. They will be advised to walk within the target heart rate for 1 to 24 weeks, which is divided into two components. Initial components included 1-8 weeks of exercise as an Aerobic conditioning component, which includes 1 hour/day x 5 days/week, followed by 9 to 24 weeks as an Aerobic maintenance component, which includes 30 minutes/day x 5 days/week. Adherence to the home walking program with the pulse, spo2, and BP will be tracked using a smartwatch, home exercise log book, and telephone follow-up (if less than 35km - monthly home visit will be done). Functional capacity will be assessed using a 6-minute walk test at baseline and at 6-month intervals. This study will identify the safety and efficacy of ET among patients with ICD, which will contribute to the important evidence base for cardiac rehabilitation among this group of patients.

PERFECT: Personalized Exercise Recommendation Framework and architECTure

Background : The health benefits of regular physical activity (PA) are well-established and widely acknowledged. Through the integration of wearable trackers, the Internet of Things (IoT)—a network of interconnected devices capable of collecting and exchanging data—coupled with mobile health (mHealth), which refers to the use of mobile devices to support medical and public health practices, it is now feasible to systematically gather and present individual exercise behaviors. This advanced approach enables the precise correlation of users’ physiological data and daily activities with their specific fitness needs, offering a personalized pathway to improving health outcomes. Objective : This study aims to enhance PA levels among individuals by developing a personalized exercise recommendation system. Utilizing reinforcement learning, the system proposes tailored exercise plans based on biomarkers and the user’s specific context. Methods : In this study, we developed applications for smartphones and smartwatches designed to gather, monitor, and recommend exercise routines through the application of a contextual multi-arm bandit algorithm. To evaluate the efficacy of this mHealth exercise regimen, we enlisted the participation of twenty female college students. Results : The outcomes of our investigation revealed a significant enhancement in the average daily duration of exercise (P \({\lt}\) . 001). Participants expressed high levels of satisfaction with both the walking program and the recommendation system, achieving average ratings of 4.31 (SD \(=\) 0.60) and 3.69 (SD \(=\) 0.95), respectively, on a 5-point scale. Furthermore, the average scores for participants’ confidence in safely performing the recommended walking exercises, as well as their perception of the study’s effectiveness in meeting their PA needs, were both above 4, indicating a positive reception and confidence in the program’s design and implementation. Conclusions : The evolution of the IoT and wearable technology has marked the beginning of a new era for mHealth systems, particularly in the personalization of health interventions. Such advancements enable the precise personalization of PA recommendations, potentially enhancing user engagement and performance outcomes. This paper introduces a novel exercise recommendation system that utilizes reinforcement learning to personalize walking exercises based on the user’s biomarkers and context, aiming to improve the user’s aerobic capacity significantly.

Evaluating Biomarkers of Bone Health After an 8-Week Walking Program in Non-Ambulatory Stroke Survivors: A Pilot Study.

Background/Objectives: Stroke survivors have a significantly increased likelihood of developing osteoporosis, a condition characterized by weak and brittle bones as well as an elevated risk of bone fractures. However, previous studies on exercise intervention have mostly been on stroke survivors who are able to walk. The objective of this study was to examine the effect of walking exercise on bone health in non-ambulatory stroke survivors. Methods: This pre- and post-test study enrolled a group of chronic non-ambulatory stroke survivors. They were instructed to complete an 8-week aerobic walking exercise program, three sessions per week. Serum concentrations of osteocalcin (OC) and carboxy-terminal telopeptides of type I collagen (ICTP) were evaluated at baseline and after completing the walking exercise program. In addition, we assessed the ambulation capacity and balance control using the functional ambulation category (FAC) and Berg Balance Scale (BBS), respectively. Results: A total of 9 out of 10 non-ambulatory stroke survivors who were recruited completed the intervention. The serum concentration of OC significantly increased from 8.51 ± 2.28 ng/mL to 9.39 ± 2.97 ng/mL (p < 0.10). The serum concentration of ICTP significantly increased from 4.45 ± 2.58 ng/mL to 5.31 ± 2.92 ng/mL (p < 0.10). Both FAC and BBS scores significantly improved from 1.0 ± 0 to 1.33 ± 0.5 (p < 0.1) and from 7.22 ± 10.02 to 15.78 ± 14.81 (p < 0.01), respectively. Conclusions: The findings of this pilot study suggest that walking exercise may improve bone health by initiating a bone remodeling process in chronic non-ambulatory stroke survivors.