Exercise Therapy: Improving Functionality, Physical Health, and Quality of Life

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Health Assessments".

Deadline for manuscript submissions: 31 May 2026 | Viewed by 4728

Special Issue Editors


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Guest Editor
Research Group in Prevention and Health in Exercise and Sport (PHES), Department of Physical Education and Sports, Facultad de Ciencias de la Actividad Física y el Deporte, Universidad de Valencia, 46010 Valencia, Spain
Interests: pediatric exercise science; blood flow restriction; resistance training; clinical exercise
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Guest Editor Assistant
Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
Interests: physical therapy; exercise therapy; rehabilitation; sports

Special Issue Information

Dear Colleagues,

This Special Issue invites papers that explore, from a multidisciplinary perspective, the interactions among exercise, functional capacity, and both physical and psychological health, as well as their impact on the quality of life.

In recent decades, exercise has become a cornerstone of health promotion across all stages of life, playing a key role in injury prevention, rehabilitation, and enhancing physical and mental capabilities. Well-designed exercise programs—tailored, progressive, and functional—offer a unique opportunity for individuals to improve their performance in everyday activities and even in sports, leading to measurable improvements in quality of life.

Achieving these outcomes requires a comprehensive evaluation of health status, a detailed analysis of functional needs, and the precise prescription of exercise type and dosage. Equally important is ensuring program adherence and balancing the potential risks and benefits.

Moreover, psychological factors, such as motivation and barriers to adopting an active lifestyle, are critical in achieving long-term success. Current research must address these dimensions to fully understand the profound impact of exercise on both physical and mental health.

Therefore, this Special Issue welcomes studies that assess health and functional capacity, analyze quality of life, and validate physical performance measurements. We are particularly interested in research that examines the multifaceted benefits of exercise and explores the innovative programs, tools, or technologies that have been designed to enhance physical activity and well-being. Additionally, as technology becomes increasingly integrated into exercise regimens, we encourage submissions that investigate its role in improving functionality and health outcomes.

Prof. Dr. Iván Chulvi Medrano
Guest Editor

Dr. Fernando Domínguez-Navarro
Guest Editor Assistant

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Keywords

  • exercise therapy
  • functionality
  • physical function
  • quality of life
  • rehabilitation
  • phycological status
  • cognitive interventions
  • prehabilitation

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Published Papers (7 papers)

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23 pages, 1193 KiB  
Article
Disability and Factors Associated with Disability in the Discharge Transition Phase After Acquired Brain Injury: An Observational Follow-Up Study
by Helene Honoré, Peter Preben Eggertsen, Asger Roer Pedersen and Jørgen Feldbæk Nielsen
Healthcare 2025, 13(16), 1989; https://doi.org/10.3390/healthcare13161989 - 14 Aug 2025
Viewed by 277
Abstract
Background/Objectives: Patients with acquired brain injury (ABI) often face complex challenges during the transition from in-hospital rehabilitation to everyday life. This study aimed to investigate disability, health-related quality of life (HRQoL), work, and other aspects of functioning as indicators of a meaningful life [...] Read more.
Background/Objectives: Patients with acquired brain injury (ABI) often face complex challenges during the transition from in-hospital rehabilitation to everyday life. This study aimed to investigate disability, health-related quality of life (HRQoL), work, and other aspects of functioning as indicators of a meaningful life in this transition phase. Additionally, we assessed how disability three months post-discharge correlates with known risk factors. Methods: We conducted a prospective observational follow-up study including patients aged ≥18 years with ABI discharged from a specialized rehabilitation clinic. Patient-reported outcomes, including disability and HRQoL, were collected at discharge and three months later. Associations between disability and known risk factors were analyzed using multiple linear regression. Results: A total of 137 patients were included (mean age 63), with a follow-up completion rate of 59%. At follow-up, 11% reported complete recovery, while a moderate level of disability persisted overall, with no systematic change from discharge. HRQoL improved significantly, reaching a mean score of 0.83. Fatigue, sex, and time from injury to rehabilitation were significantly associated with disability levels. Conclusions: The transition phase after rehabilitation posed challenges for patients with ABI, with 38% experiencing moderate disability. Despite this, HRQoL improved to levels comparable with the general population. Fatigue, sex, and rehabilitation timing emerged as key factors influencing disability outcomes. Full article
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24 pages, 2599 KiB  
Article
Effects of Immersive Virtual Reality on Physical Function, Fall-Related Outcomes, Fatigue, and Quality of Life in Older Adults: A Randomized Controlled Trial
by Damla Parmak, Ender Angın and Gozde Iyigun
Healthcare 2025, 13(15), 1800; https://doi.org/10.3390/healthcare13151800 - 24 Jul 2025
Viewed by 526
Abstract
Background/Objectives: This study aimed to evaluate the impact of an immersive virtual reality (IVR) program on balance, physical fitness, risk of falling, fear of falling, fatigue, and quality of life in older adults compared with an active control group (ACG). Methods: A [...] Read more.
Background/Objectives: This study aimed to evaluate the impact of an immersive virtual reality (IVR) program on balance, physical fitness, risk of falling, fear of falling, fatigue, and quality of life in older adults compared with an active control group (ACG). Methods: A total of 44 older adults were randomly assigned to either the IVR group (n = 22) or the ACG (n = 22) for an 8-week period. The IVR group participated in 35-min immersive virtual reality sessions three times a week, whereas the ACG followed a home-based traditional exercise program. Evaluations were conducted both before and after the intervention period. Results: Compared with the ACG, the participants in the IVR group demonstrated significant improvements in balance, upper and lower extremity strength, lower extremity flexibility, fatigue levels, and specific aspects of quality of life such as autonomy and social participation. Treatment satisfaction was also higher in the IVR group. Conclusions: An 8-week immersive virtual reality intervention was effective in improving physical function, reducing fatigue, and enhancing specific domains of quality of life among older adults. Full article
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17 pages, 532 KiB  
Article
The Six-Minute Walk Test in Community-Dwelling Older Adult Women: The Influence of Physical Activity Levels and Age-Related Factors
by Rocío Cogollos-de-la-Peña, Gemma Victoria Espí-López, Laura Fuentes-Aparicio, Lucas Monzani, Dagmar Pavlu and Anna Arnal-Gómez
Healthcare 2025, 13(13), 1610; https://doi.org/10.3390/healthcare13131610 - 4 Jul 2025
Viewed by 551
Abstract
Background/Objectives: In the context of active ageing, functional assessment is key to preserving autonomy in older women. The six-minute walk test (6MWT) is a practical tool for estimating general health, but its results can be influenced by various factors. This study analysed [...] Read more.
Background/Objectives: In the context of active ageing, functional assessment is key to preserving autonomy in older women. The six-minute walk test (6MWT) is a practical tool for estimating general health, but its results can be influenced by various factors. This study analysed cardiorespiratory variations during the 6MWT in older women according to their physical activity level and age-related variables such as pain, sarcopenia, frailty, and motivation to exercise. Methods: A total of 163 older women with musculoskeletal pain, but without cardiac or respiratory conditions, were classified into groups with high (HPA), moderate (MPA), and low (LPA) physical activity. During the 6MWT, heart rate (HR), dyspnoea, and oxygen saturation (SpO2) were recorded. Pain, sarcopenia, frailty, and motivation to exercise were also assessed. A repeated-measures multivariate analysis of (co)variance (RM-MANCOVA) was performed. Results: The results showed differences in HR depending on the level of physical activity, conditioned by sarcopenia (p < 0.05) and walked distance (p < 0.001), and in dyspnoea conditioned by pain perception (p < 0.01) and social (p < 0.001) and psychological (p < 0.05) motivation to exercise. There were also differences in SpO2 depending on the level of physical activity (p < 0.0001). There were differences between the HPA group and both the MPA and LPA group, which had higher HR, higher dyspnoea, and lower SpO2 when undergoing the 6MWT test. Conclusions: To accurately interpret 6MWT results in older adult women, it is essential to consider physical activity level, perceived pain, sarcopenia, and motivation to exercise, as these factors influence HR, dyspnoea, and SpO2. These variables should guide physical activity recommendations for healthy ageing. Full article
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15 pages, 625 KiB  
Article
An Integrative Neuromuscular Training Program in Physical Education Classes Improves Strength and Speed Performance
by Diego A. Alonso-Aubin, Ignacio Moya del Saz, Ismael Martínez-Guardado and Iván Chulvi-Medrano
Healthcare 2025, 13(12), 1372; https://doi.org/10.3390/healthcare13121372 - 8 Jun 2025
Cited by 1 | Viewed by 778
Abstract
Background/Objectives: This longitudinal randomized controlled study aimed to evaluate the effects of an integrative neuromuscular training (INT) intervention on strength and speed measures in Spanish students across different age groups. Methods: A total of 121 students, aged 11–12 (G1) and 15–16 (G2), [...] Read more.
Background/Objectives: This longitudinal randomized controlled study aimed to evaluate the effects of an integrative neuromuscular training (INT) intervention on strength and speed measures in Spanish students across different age groups. Methods: A total of 121 students, aged 11–12 (G1) and 15–16 (G2), were randomly assigned to four groups: two experimental groups, G1exp (n = 30) and G2exp (n = 31), and two control groups, G1con (n = 30) and G2 (n = 30). Experimental groups participated in two 20 min INT sessions per week for four weeks, focusing on physical literacy (agility, coordination, balance, and speed) and a resistance training program, integrated into the first part of physical education classes (PEC). Results: Experimental groups showed significant improvements (p < 0.001) in lower-body power (G1exp: t = −7.04; d = −1.30; G2exp: t = −5.19; d = −0.91), upper-body power (G1exp: t = −5.94; d = −1.10; G2exp: t = −3.52; d = −0.62), abdominal endurance strength (G1exp: t = −9.72; d = −1.80; G2exp: t = −4.75; d = −0.84) and sprinting (G1exp: t = 5.22; d = 0.96; G2exp: t = 5.90; d = 1.04). A comparison by age groups revealed significantly greater improvements in upper-body power in G1 vs. G2 (t:−2.83; p = 0.02). Conclusions: A four-week INT program implemented at the start of PE classes can improve strength and sprint performance in youth across all ages. We recommend incorporating INT into the first part of physical education sessions to contribute to meeting the physical activity, well-being and conditioning needs of young people. Full article
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16 pages, 647 KiB  
Article
Multimodal Prehabilitation in Colorectal Cancer: Improving Fitness, Lifestyle, and Post-Surgery Outcomes
by María-Pilar Suárez-Alcázar, Ana Folch Ayora, María Muriach, Paula Recacha-Ponce, M.-Elena Garcia-Roca, Alba Coret-Franco, Juan Carlos Pastor-Mora, Pablo Salas-Medina and Eladio J. Collado-Boira
Healthcare 2025, 13(9), 1083; https://doi.org/10.3390/healthcare13091083 - 7 May 2025
Cited by 1 | Viewed by 848
Abstract
Objectives: This study aimed to analyze the effect of a multimodal prehabilitation program for colorectal cancer patients in body composition, physical and cardiorespiratory fitness as well as its ability to reduce postoperative complications. Methods: A longitudinal observational study evaluated the efficacy [...] Read more.
Objectives: This study aimed to analyze the effect of a multimodal prehabilitation program for colorectal cancer patients in body composition, physical and cardiorespiratory fitness as well as its ability to reduce postoperative complications. Methods: A longitudinal observational study evaluated the efficacy of a prehabilitation intervention based on four components: (a) health education and self-care, (b) nutritional counseling, (c) psychological support, and (d) supervised physical exercise. Body composition was determined through bioelectrical impedance analysis; physical fitness variables such as strength was measured by a handgrip dynamometer for upper limbs, and a squat–jump test, countermovement jump test using a contact platform, and a chair–stand test for lower limbs. Flexibility was assessed with the sit-and-reach test. Cardiorespiratory fitness was assessed with the 6 min walking test (6MWT). Moreover, we measured lifestyles related to the amount of physical exercise by accelerometry. Results: The final cohort included 30 patients. Patients completed an average of 9.90 ± 5.26 exercise sessions. Statistically significant changes with varying effect sizes were observed in the following outcomes: SJ values in cm and W for both sexes (p = 0.021/d = 0.14 and p = 0.043/d = 0.10, respectively), SJ in W for women (p = 0.023/d = 0.21), all chair-stand test values (p = 0.021/d = 0.65 for men, p = 0.004/d = 2.08 for women, and p = 0.000/d = 0.84 for both sexes), and sit-and-reach for both sexes (p = 0.005/d = 0.12) and for men (p = 0.044/d = 0.08). All 6MWT values had statistically significant changes (p = 0.001/0.46). Women reduced the weekly minutes spent in sedentary behavior (p = 0.037/d = 0.65) and increased the minutes spent performing light physical activity (p = 0.037/d = 0.63). With regard to surgical outcomes, there was a tendency towards a decrease in postoperative complications and hospitalization days, as well as minutes in postoperative REA (p = 0.009/d = 0.69) in relation to the control group. Conclusions: Participation in a multimodal prehabilitation program improves several aspects of physical condition and lifestyles related to the amount of physical exercise and reduces both days of hospitalization and several complications post-surgery. Full article
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14 pages, 701 KiB  
Article
Tele-Exercise for Fitness: Physical and Psychological Outcomes in Athletes and Non-Athletes’ Trainees
by Enzo Iuliano, Giovanna Zimatore, Antonio Fabbrizio, Andrea De Giorgio, Martina Sausa, Barbara Maria Matteo, Sonia Angilletta, Victor Machado Reis, Nuno D. Garrido, José Vilaça-Alves, Rafael Peixoto, Paulina Perusina, Aleksandra Aristova, Carlo Baldari, Filippo Macaluso, Alberto Fucarino and Manuela Cantoia
Healthcare 2025, 13(4), 354; https://doi.org/10.3390/healthcare13040354 - 7 Feb 2025
Cited by 1 | Viewed by 897
Abstract
Background: This research explored how tele-exercise influenced physical fitness and mental well-being in individuals with and without disabilities and with different training habits. Methods: One hundred and ninety-three participants were categorized into two groups: athletes and non-athletes. Participants were involved in [...] Read more.
Background: This research explored how tele-exercise influenced physical fitness and mental well-being in individuals with and without disabilities and with different training habits. Methods: One hundred and ninety-three participants were categorized into two groups: athletes and non-athletes. Participants were involved in either synchronous or asynchronous tele-exercise programs of two or three sessions of workouts per week, lasting eight weeks. Psychological well-being was evaluated pre- vs. post-intervention by the WHO-Five Well-Being Index (WHO-5), Psychological General Well-Being Index (PGWBI), and Perceived Stress Scale (PSS-10). Fitness assessment tools included the 2-minute step test, curl-up test, forward bending test, and squat test. Body weight was also assessed pre- and post-intervention. Results: The analysis showed a significant increment in all fitness scores (p-value ranged from <0.001 to 0.015) with no change in body weight. Psychological tests indicated an overall increment in the participants’ well-being measured by the WHO-5 and unexpectedly, also in the stress level assessed through PSS-10. Conclusions: Enabled by technology, tele-exercise provides a flexible and convenient complementary approach to conventional workouts, helping individuals maintain an active lifestyle and improve their well-being. Positive effects on the sedentary population’s lifestyles are discussed. Full article
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17 pages, 2237 KiB  
Protocol
Evaluation of the Effectiveness of a Cardiac Telerehabilitation Program in Chronic Heart Failure: Design and Rationale of the TELEREHAB-HF Study
by Marina Garofano, Carmine Vecchione, Mariaconsiglia Calabrese, Maria Rosaria Rusciano, Valeria Visco, Giovanni Granata, Albino Carrizzo, Gennaro Galasso, Placido Bramanti, Francesco Corallo, Lucia Pepe, Luana Budaci, Michele Ciccarelli and Alessia Bramanti
Healthcare 2025, 13(16), 2074; https://doi.org/10.3390/healthcare13162074 - 21 Aug 2025
Abstract
Background: Despite strong guideline recommendations, participation in cardiac rehabilitation (CR) among patients with chronic heart failure (CHF) remains low due to logistical, geographical, and psychosocial barriers. Telerehabilitation may help overcome these limitations by offering remote, structured exercise programs supported by digital technologies. Objective: [...] Read more.
Background: Despite strong guideline recommendations, participation in cardiac rehabilitation (CR) among patients with chronic heart failure (CHF) remains low due to logistical, geographical, and psychosocial barriers. Telerehabilitation may help overcome these limitations by offering remote, structured exercise programs supported by digital technologies. Objective: The TELEREHAB-HF study aims to evaluate the efficacy of an 8-week, home-based cardiac telerehabilitation program compared to standard in-person rehabilitation in patients with CHF. Methods: This is a prospective, controlled cohort study involving 220 adult patients with CHF (NYHA class I–III) clinically stable and on optimized therapy. Participants are assigned to either a telerehabilitation group (remote CR via a digital platform with wearable sensors and real-time physiotherapist supervision) or a standard in-person rehabilitation group. The primary outcome is the change in peak oxygen uptake (VO2max) at 8 weeks. Secondary outcomes include quality of life, functional performance, biochemical and echocardiographic parameters, and cognitive function, assessed at baseline and at 4, 8, 16, and 24 weeks. Expected Results: We hypothesize that telerehabilitation will be non-inferior to standard CR in improving functional capacity and secondary outcomes, with additional benefits in accessibility and adherence. Data from remote monitoring may also support a translational “rehabilomics” approach to exploring exercise-induced biomarker changes. Conclusions: This study seeks to assess the clinical effectiveness, safety, and feasibility of a home-based telerehabilitation model for CHF, with the goal of informing future strategies for broader implementation and personalized rehabilitation. Trial Registration: ClinicalTrials.gov Identifier: NCT07023536 Full article
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