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Physical Activity Promotion and Exercise Intervention for Persons with Chronic Disease

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 31 December 2026 | Viewed by 13751

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Editors

Dr. Edmar Lacerda Mendes

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Guest Editor

Department of Sport Sciences, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba 38025-350, Brazil
Interests: aerobic capacity; body composition; cardiovascular disease; chronic disease management; exercise interventions; functional capacity; healthy lifestyle; hemodialysis; HIV; immune markers; inflammatory markers; metabolic syndrome; muscle power; muscular strength; multicomponent exercise program; obesity prevention; periodization; physical activity; physical fitness; physical rehabilitation; resistance training; sedentary behavior; sleep quality; strength training; technology use; weight management; youth health

Dr. Alynne Andaki

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Guest Editor

Department of Sport Sciences, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba 38025-350, Brazil
Interests: physical activity; sedentary behavior; COVID-19 pandemic; children and adolescents; sleep quality; obesity and overweight; mental health; fall prevention; social determinants of health; motor coordination

Special Issue Information

Dear Colleagues,

Chronic diseases, such as cardiovascular diseases, diabetes, obesity, and respiratory conditions, represent significant global health challenges. The role of physical activity in preventing and managing these conditions has garnered substantial attention in recent years. This Special Issue aims to explore innovative strategies and evidence-based approaches in promoting physical activity and implementing exercise interventions for individuals living with chronic diseases. With growing evidence supporting the positive impact of physical activity on health outcomes, it is crucial to examine the effectiveness of exercise programs designed to meet the specific needs of these populations. Topics of interest include, but are not limited to, the development of exercise protocols, barriers to physical activity participation, and the integration of physical activity into clinical and rehabilitation settings. We invite contributions that examine both the physiological and psychological benefits of exercise, explore how physical activity can improve quality of life, and assess the feasibility of implementing physical activity programs in diverse healthcare settings.

Dr. Edmar Lacerda Mendes
Dr. Alynne Andaki
Guest Editors

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Keywords

cardiovascular disease
diabetes management
exercise interventions
exercise protocols
health outcomes
obesity prevention
physical activity promotion
physical fitness
rehabilitation
chronic disease management

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Published Papers (5 papers)

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Research

14 pages, 1140 KB

Open AccessArticle

Effects of Moderate-Intensity Aerobic Exercise on Clinical Symptoms and Physiological Outcomes in Young Adults with Persistent Allergic Rhinitis: A Randomized Controlled Trial

by Kanphatson Kerdkaew, Phisut Rattanathamma, Wannaporn Tongtako, Timothy Mickleborough and Bulin Jirapongsatorn

Int. J. Environ. Res. Public Health 2026, 23(5), 611; https://doi.org/10.3390/ijerph23050611 - 5 May 2026

Viewed by 2033

Abstract

Allergic Rhinitis (AR) is an IgE-mediated inflammatory disorder that impairs quality of life and systemic function. Following the ‘one airway, one disease’ paradigm, AR-related inflammation often extends to the lower respiratory tract. This randomized controlled trial investigated the effects of an 8-week moderate-intensity aerobic exercise (MOA) program on clinical symptoms, nasal airflow, airway inflammation, pulmonary function, and cardiorespiratory parameters in young adults with physician-confirmed persistent AR. To isolate the exercise effects, all participants discontinued antihistamines, corticosteroids, and leukotriene antagonists before and during the study period. Eighteen participants were allocated to either the MOA group (n = 9), which performed treadmill walking or jogging at 50–60% heart rate reserve three times per week for eight weeks, or a control group (CON, n = 9) that maintained usual daily activities. Clinical symptoms, peak nasal inspiratory flow, fractional exhaled nitric oxide, pulmonary function, heart rate, blood pressure, aerobic fitness, and perceived exertion were assessed at baseline, week 4, and week 8 using standardized procedures. Compared with baseline and the CON group, the exercise intervention resulted in significant reductions in nasal congestion, itching, sneezing, and rhinorrhea, accompanied by increased nasal airflow and reduced airway inflammation. Pulmonary function indices and cardiorespiratory parameters also improved following training. These findings suggest that moderate-intensity aerobic exercise may offer a valuable non-pharmacological approach to support conventional care, potentially enhancing respiratory and physiological outcomes in young adults with persistent AR. Full article

(This article belongs to the Special Issue Physical Activity Promotion and Exercise Intervention for Persons with Chronic Disease)

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16 pages, 838 KB

Open AccessArticle

Effect of a Community Health Worker-Led Intervention on Physical Activity in Adults with Type 2 Diabetes in Primary Health Care in the Brazilian Amazon

by Elisa Brosina de Leon, Camila Fabiana Rossi Squarcini, Iasmin Machado Soares, Hércules Lázaro Morais Campos and Rafael Martins da Costa

Int. J. Environ. Res. Public Health 2026, 23(3), 276; https://doi.org/10.3390/ijerph23030276 - 24 Feb 2026

Cited by 1 | Viewed by 1299

Abstract

Type 2 diabetes mellitus (T2DM) is a major global public-health problem, and physical inactivity contributes to poor disease control. In settings with limited access to health services, as in the Brazilian Amazon, interventions delivered by Community Health Workers (CHWs) within Primary Health Care (PHC) may offer a pragmatic strategy to increase physical activity (PA). We aimed to evaluate the effect of a CHW-led, theory-based intervention on PA among adults with T2DM in PHC in a cluster-randomized, community-based trial. A total of 274 participants were enrolled (intervention: n = 140, control: n = 134). CHWs in the intervention group completed a blended training (e.g., asynchronous modules, printed educational materials, and hands-on guidance). They conducted six home visits over six months to support behavior change, including increased PA. PA was measured using the International PA Questionnaire (IPAQ-LF), which assessed active commuting, walking, moderate-to-vigorous PA (MVPA), and total PA. Group-by-time effects were examined using mixed-effects zero-inflated Gamma models. No significant intervention effects were observed for the conditional mean of minutes or the probability of participation in active commuting, walking, or total PA. However, for MVPA, the zero-inflated Gamma model revealed a significant intervention effect on the probability of engaging in activity. The intervention group showed a marked reduction in the likelihood of remaining at zero minutes of MVPA (Odds Ratio = 0.08; 95% CI = 0.01–0.79; p = 0.001) compared to the control group, indicating effective behavioral activation among previously inactive participants. These findings suggest that empowering CHWs to deliver structured, theory-driven interventions within PHC can reduce inactivity among high-risk adults with T2DM in underserved communities. Full article

(This article belongs to the Special Issue Physical Activity Promotion and Exercise Intervention for Persons with Chronic Disease)

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20 pages, 379 KB

Open AccessArticle

Bone Health in Former Artistic Gymnasts Aged 45 Years and Over: Case–Control Comparison with Controls and Reference Populations

by Patrícia Arruda de Albuquerque Farinatti, Cinthia Sousa, Rodrigo Zacca, Lurdes Ávila Carvalho, Jorge Mota, Igor Monteiro, Joana Carvalho, Nádia Souza Lima da Silva and Paulo Farinatti

Int. J. Environ. Res. Public Health 2026, 23(2), 159; https://doi.org/10.3390/ijerph23020159 - 27 Jan 2026

Viewed by 2252

Abstract

Peak bone mass gained in youth is crucial for preventing osteoporosis. Artistic gymnastics (AG) is highly osteogenic, yet its long-term effects on adults ≥ 45 years are not well documented. This case–control study compared bone mineral density (BMD) and the prevalence of osteopenia/osteoporosis in former gymnasts, age-matched controls, and reference populations from Brazil and Portugal. Participants included 65 former gymnasts (32 males, 33 females; 45–84 years), who trained for 12.6 ± 4.3 years and included 41 international competitors, and 91 controls (37 males; 45–87 years). Whole-body and femoral BMD were assessed by DXA. Physical activity during youth (10–20 years) (PA-Youth) and the past decade (PA-10) was recorded. Reference data were drawn from large cohorts in Brazil (FIBRA, n = 828) and Portugal (CIAFEL, n = 1089). Former gymnasts had substantially higher PA-Youth than controls, while PA-10 was similar. Gymnasts displayed 4–6 times higher femoral Z-scores (neck and total) and a markedly lower prevalence of osteopenia/osteoporosis (males: 3% vs. 16%; females: 36% vs. 52%, p < 0.05). These benefits remained after adjustment for age, PA-10, and hormonal/calcium therapy. Relative to reference populations, gymnasts showed greater whole-body and femoral mineralization, with no osteoporosis cases (vs. 6–12% overall; 9–13% among those ≥60 years). Age-stratified analysis (45–59 and ≥60 years) revealed a consistently lower osteopenia prevalence across age groups, except in females ≥ 60 years. In conclusion, early-life AG participation is associated with enduring skeletal benefits, including higher bone mineralization and reduced osteopenia/osteoporosis in adults ≥ 45 years. The protective effect appears diminished in older females, likely reflecting prolonged postmenopausal bone loss. Full article

(This article belongs to the Special Issue Physical Activity Promotion and Exercise Intervention for Persons with Chronic Disease)

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16 pages, 817 KB

Open AccessArticle

Sedentary Behavior, Physical Inactivity, and the Prevalence of Hypertension, Diabetes, and Obesity During COVID-19 in Brazil

by Jeferson Roberto Collevatti dos Anjos, Igor Massari Correia, Chimenny Auluã Lascas Cardoso de Moraes, Jéssica Fernanda Corrêa Cordeiro, Atila Alexandre Trapé, Jorge Mota, Dalmo Roberto Lopes Machado and André Pereira dos Santos

Int. J. Environ. Res. Public Health 2025, 22(9), 1367; https://doi.org/10.3390/ijerph22091367 - 30 Aug 2025

Cited by 2 | Viewed by 3313

Abstract

Objectives: To analyze, across the periods before, during, and after the implementation of Social Isolation and Distancing Measures (IMDIS): (a) changes in the prevalence of non-communicable chronic diseases (NCDs), stratified by age group in the Brazilian population; and (b) the association between physical inactivity (PI), insufficient moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB) with the occurrence of these conditions. This cross-sectional study used data from VIGITEL (Brazil’s Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey), an annual population-based telephone survey conducted across the country. Data were collected in 2019, 2021, and 2023, with a total sample size of 101,226 participants. Arterial hypertension (AH) and diabetes mellitus (DM) were self-reported, and obesity (OB) was diagnosed using body mass index. PI, insufficient MVPA, and SB were identified via VIGITEL indicators. Chi-square tests assessed differences in prevalence overall and by age group. Logistic regression models estimated odds ratios (ORs) for associations between demographic variables, behavioral factors, and the studied periods. The prevalence of AH and DM was highest among individuals over 60 years, reaching 61% after IMDIS, a period when OB also peaked across all age groups. Individuals aged 30–59 and those over 60 had higher odds of AH, DM, and OB across all periods. Female participants had higher ORs for AH and DM both before and after IMDIS. PI and insufficient MVPA were associated with increased odds of AH, DM, and OB in all periods, while SB significantly elevated the OR for OB at all time points. After IMDIS, there was an increase in the prevalence of AH, DM, and OB among older adults and younger individuals. PI, insufficient MVPA, SB, and advanced age were all associated with a greater likelihood of NCDs at every stage of the study. The high post-IMDIS rates of AH, DM, and OB highlight the need for urgent public health strategies. Low-cost programs, such as live videos and online group sessions, should be included in national physical activity guidelines. These initiatives are affordable, aligned with WHO goals, and reduce PI in IMDIS scenarios. Incorporating them into Academia da Saúde and Agita Brasil strengthens NCD prevention and increases the resilience of the health system for future health crises. Full article

(This article belongs to the Special Issue Physical Activity Promotion and Exercise Intervention for Persons with Chronic Disease)

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15 pages, 1222 KB

Open AccessArticle

Benefits of Multimodal Exercise Intervention for BDNF and Cytokines Levels, Cognitive Function, and Motor Functionality in Alzheimer’s Disease: A Preliminary Study

by Emmanuel Dias de Sousa Lopes, Flávia Gomes de Melo Coelho, Sheilla Tribess, Jonatas da Silva Catarino, Bruno Naves Ferreira, Marina de Melo Reis, Antônio Ribeiro Neto, Carlo José Freire Oliveira and Jair Sindra Virtuoso Júnior

Int. J. Environ. Res. Public Health 2025, 22(8), 1245; https://doi.org/10.3390/ijerph22081245 - 9 Aug 2025

Cited by 6 | Viewed by 3955

Abstract

Background: Physical exercise has been linked to improvements in motor and cognitive functions as well as to the modulation of neurotrophic and inflammatory factors, particularly in older adults. This aim of this study was to investigate the effects of a 12-week multimodal exercise program on cognitive function, motor performance, and plasma levels of brain-derived neurotrophic factor (BDNF) and cytokines in elderly individuals with Alzheimer’s disease (AD). Methods: A non-randomized controlled trial design was employed, involving 23 participants aged 62 to 85 years diagnosed with mild to moderate AD. The intervention group (n = 7) attended 60-minute sessions three times per week, incorporating aerobic, strength, flexibility, and motor coordination exercises, while the control group (n = 8) maintained usual activities. Methods: A non-randomized controlled trial design was used, involving 23 participants aged 62 to 85 years. Of these, 15 had a clinical diagnosis of mild to moderate AD and were allocated to either an intervention group (n = 7) or and AD control group (n = 8). The remaining eight participants were cognitively healthy and formed a control group matched for age and sex, used exclusively for baseline comparisons. The intervention group participated in 60-minute sessions three times per week, including aerobic, strength, flexibility, and motor coordination exercises. The AD control group (n = 8) maintained their usual daily routines. Results: Compared to baseline, the intervention group demonstrated significant improvements in executive and attentional functions, as measured by the Frontal Assessment Battery (FAB) and Clock Drawing Test (CDT); mobility, balance, gait speed, and lower limb strength also improved (p < 0.05). Additionally, plasma BDNF levels increased significantly, and interleukin-2 (IL-2) levels decreased. Conclusions: In conclusion, the multimodal exercise program resulted in cognitive and motor benefits and positively modulated biomarkers related to neuroplasticity and inflammation, supporting its potential as a complementary intervention in elderly individuals with AD. Full article

(This article belongs to the Special Issue Physical Activity Promotion and Exercise Intervention for Persons with Chronic Disease)

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