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Physical Activity, Exercise and Health: Clinical Management and Research

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (15 December 2025) | Viewed by 28653

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Special Issue Editors

Prof. Dr. Do-yeon Kim

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Guest Editor

1. Exercise Physiology Laboratory, Department of Physical Education, Pusan National University, Busan 46241, Republic of Korea
2. School of Health Promotion and Kinesiology, Texas Woman’s University, Denton, TX 76204, USA
Interests: exercise physiology; women’s health; metabolism; rehabilitation; healthy aging
Special Issues, Collections and Topics in MDPI journals

Dr. Dae Yun Seo

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Basic Research Laboratory, Department of Physiology, College of Medicine, Smart Marine Therapeutic Center, Cardiovascular and Metabolic Disease Center, Inje University, Busan 47392, Republic of Korea
Interests: exercise medicine; cellular and molecular control of skeletal muscle metabolism; mitochondrial bioenergetics; nutrition metabolism for enhancement of physical activity

Dr. Ju-yong Bae

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Guest Editor

Department of Physical Education, Dong-A University, Busan 49315, Republic of Korea
Interests: exercise; metabolic syndrome; diabetes; obesity; physiology

Special Issue Information

Dear Colleagues,

Recent research on the impact of physical activity and exercise on health has progressed beyond traditional disease prevention, now focusing on their use as therapeutic tools in clinical settings. For instance, personalized exercise prescriptions for patients with chronic conditions are gaining attention for symptom relief and recovery support. Studies have shown that exercise is effective in managing a range of conditions, including cancer, diabetes, and cardiovascular diseases. Moreover, the positive effects of physical activity on mental health are increasingly recognized, with integrated treatment models that incorporate exercise becoming more prevalent.

However, clear guidelines on how to effectively apply these findings in clinical practice remain lacking. More research is needed on exercise prescription models tailored to diverse patient populations, as well as interdisciplinary approaches that combine exercise with other therapeutic methods. Additionally, follow-up studies are necessary to confirm the long-term health benefits of these interventions, and further exploration is required to understand how physical activity and exercise can inform public health policies.

This Special Issue invites studies on new exercise interventions and prescription programs designed for clinical populations, physical activity and health programs for women and the elderly, and interdisciplinary research that integrates exercise science with related fields, with the goal of providing practical benefits for both healthcare professionals and patients.

Prof. Dr. Do-yeon Kim
Dr. Dae Yun Seo
Dr. Ju-yong Bae
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

physical activity
exercise
exercise physiology
exercise prescription
aging
women’s health
chronic disease

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Published Papers (9 papers)

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Research

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19 pages, 567 KB

Open AccessArticle

Association Between Physical Activity Levels and Chronic Disease Risk Among Korean Adults with Sleep Deficiency

by Jongsuk Park, Seohyung Yang and Sukyool Jung

J. Clin. Med. 2025, 14(23), 8398; https://doi.org/10.3390/jcm14238398 - 26 Nov 2025

Viewed by 1044

Abstract

Background/Objectives: This study investigated the association between physical activity (PA) levels and the risk of chronic diseases in Korean adults with sleep deficiency (SD). Methods: Data were obtained from the Korea National Health and Nutrition Examination Survey (2016–2021; n = 31,338). SD was defined as less than 7 h of sleep per night. The PA levels were categorized as low, moderate, or high. Multivariable logistic regression was used to estimate odds ratios (OR) with 95% confidence intervals (CI) for various chronic diseases, adjusting for demographic and lifestyle covariates. Results: High PA levels were associated with lower odds of abdominal obesity (OR = 0.855, 95% CI = 0.782–0.934, p < 0.001), hypertension (OR = 0.787, 95% CI = 0.657–0.942, p < 0.01), diabetes mellitus (OR = 0.743, 95% CI = 0.622–0.887, p < 0.01), and metabolic syndrome (OR = 0.706, 95% CI = 0.586–0.850, p < 0.001). Moderate PA showed similar but weaker associations. Conversely, high PA levels were associated with higher odds of depression (OR = 1.474, 95% CI = 1.123–1.935, p < 0.01). Subgroup analyses indicated that the protective effects of PA were stronger among women, non-smokers, and individuals with obesity. Conclusions: Among adults with SD, moderate-to-vigorous PA is associated with a lower odds of several metabolic disorders, including abdominal obesity, diabetes, and metabolic syndrome. This highlights the importance of regular PA in maintaining metabolic health. However, a positive association between high PA and depression should warrant further investigation, as reverse causality or residual confounding may explain this association. Full article

(This article belongs to the Special Issue Physical Activity, Exercise and Health: Clinical Management and Research)

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12 pages, 244 KB

Open AccessArticle

Kinesiophobia, Physical Limitations and Psychological Distress as Barriers to Physical Activity in Heart Transplantation Patients: A Qualitative Study

by Elena Marques-Sule, Juan Luis Cabanillas-García, Luis Almenar-Bonet, Amalia Sillero-Sillero, Maria Cruz Sánchez-Gómez, Raquel Ayuso-Margañon, Raquel López Vilella and Noemí Moreno-Segura

J. Clin. Med. 2025, 14(21), 7867; https://doi.org/10.3390/jcm14217867 - 5 Nov 2025

Cited by 1 | Viewed by 1040

Abstract

Background/Objectives: Heart transplantation substantially improves survival and quality of life in patients with advanced heart failure; however, many heart transplantation patients fail to recover normal physical activity levels. Persistent inactivity compromises secondary prevention and long-term outcomes. Kinesiophobia—an excessive and irrational fear of movement—may act as a central barrier limiting physical activity after heart transplantation. This study aimed to explore how kinesiophobia develops and interacts with physical and psychological factors that influence adherence to an active lifestyle after heart transplantation. Methods: A qualitative study was conducted in 24 adult heart transplantation patients (mean age 62.1 years; 83% male) at a tertiary hospital in Spain. Semi-structured interviews lasting 35–60 min were transcribed verbatim and analysed using reflexive thematic analysis. Methodological rigour was ensured through triangulation, reflexivity, and transparent documentation of analytic decisions. Results: Three interrelated themes were identified: (1) Kinesiophobia, characterised by fear of overexertion and avoidance of performing physical activity; (2) physical limitations, including fatigue, muscle weakness, treatment side effects, and intensified perceptions of vulnerability; and (3) psychological distress, encompassing anxiety, demotivation, and frustration, which intensified inactivity. These domains formed a self-perpetuating cycle that restricted participation in physical activity. Some participants reported simple adaptive strategies, such as pacing, walking and social support that enhanced their sense of safety and confidence. Conclusions: Kinesiophobia, physical limitations, and psychological distress interact to restrict physical activity in heart transplantation patients. Our findings suggest that rehabilitation should integrate psychological support, cognitive-behavioural strategies, and tailored education to reduce fear, enhance self-efficacy, and promote sustainable physical activity engagement. Full article

(This article belongs to the Special Issue Physical Activity, Exercise and Health: Clinical Management and Research)

13 pages, 431 KB

Open AccessArticle

Cross-Cultural Validity and Reliability of the Questionnaire on Back-Health-Related Postural Habits During Daily Activities in the Polish Young Adolescent Population

by Manuel Monfort-Pañego, Marta Kinga Labecka, Vicente Miñana-Signes and Agnieszka Jankowicz-Szymańska

J. Clin. Med. 2025, 14(21), 7793; https://doi.org/10.3390/jcm14217793 - 3 Nov 2025

Viewed by 708

Abstract

Background/Objectives: This study aimed to conduct the cross-cultural adaptation and assess the reliability of a validated measurement instrument, the Back-Health Related Postural Habits in Daily Activities (BEHALVES). Methods: Following a standardized methodological framework for the cross-cultural adaptation of health-related instruments, the BEHALVES questionnaire was translated and tested in 104 primary education students (mean age 13.8 ± 0.74 years; 49.1% girls) at two different time points with a 1-week interval between each test. The analysis was expressed as test–retest reliability according to the differences observed between the readings (T1–T2, α = Cronbach’s alpha), the standard deviation of the differences (SD), the intraclass correlation coefficient (ICC), 95% confidence intervals for the intraclass correlation coefficient, standard error of measurement (SEM), coefficient of repeatability (CR), and minimal detectable change (MDC). Results: Internal consistency results for the joint analysis of items grouped into categories were good (α = 0.72). Lying down was the worst-performing category in this study. The ICC was excellent for the total score (0.96) and all categories (0.90–0.99). Regression analysis between the mean of the two measures and their difference indicated that there was a significant difference (F1,103 = 0.19, p < 0.001; beta coefficient = −0.15, p < 0.001; R2 = 0.16). Conclusions: The BEHALVES questionnaire is valid and reliable for the Polish youth population, providing similar results to the original Spanish version. The continued development of reliable measurement instruments will enhance research in education, public health, and clinical practice, ultimately leading to improved strategies for preventing postural issues in young populations. Full article

(This article belongs to the Special Issue Physical Activity, Exercise and Health: Clinical Management and Research)

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13 pages, 783 KB

Open AccessArticle

The Effects of a Combined Exercise Intervention on Body Composition, GDF-15, Apelin-12, and IL-15 Among Older Korean Women According to Obesity Status

by Jeongsook Kim, Eadric Bressel, Minkyo Kim, Taekyu Kim, Suhan Koh and Doyeon Kim

J. Clin. Med. 2025, 14(14), 4981; https://doi.org/10.3390/jcm14144981 - 14 Jul 2025

Cited by 2 | Viewed by 1796

Abstract

Background: The purpose of this study was to investigate the effects of a 16-week exercise program combining aerobic and resistance training on body composition, growth differentiation factor-15 (GDF-15), apelin-12, and interleukin-15 (IL-15) in older Korean women according to obesity status. Methods: Participants were divided into obesity (n = 15) and normal-weight groups (n = 14). A walking exercise was performed at 60–70% heart rate reserve (RPE 13–15). The bodyweight resistance exercises were progressively intensified over 16 weeks. Analysis methods included two-way repeated measures ANOVA, ANCOVA, and paired and independent t-tests. Results: Significant main effects of time and group were observed in body weight (p < 0.001), and both groups demonstrated significant within-group reductions in body mass index (BMI) (obese: p < 0.001; normal-weight: p < 0.05), along with significant between-group differences (p < 0.001). The percentage of body fat significantly decreased over time (p < 0.01) and differed between groups (p < 0.001). GDF-15 exhibited a significant group × time interaction (p < 0.05) and a main group effect (p < 0.05). Although no statistically significant changes were observed in Apelin-12 levels, an opposite trend was identified between groups, with an increase in the obese group and a decrease in the normal-weight group. For IL-15, no significant interaction effect was found between the groups. Conclusions: The 16-week combined exercise intervention improved key markers of body composition, particularly in obese older women, and led to increased GDF-15, indicating potential metabolic benefits. While changes in apelin-12 and IL-15 were not statistically significant, the findings support the utility of combined exercise for mitigating fat accumulation and promoting healthy aging in older adults. Full article

(This article belongs to the Special Issue Physical Activity, Exercise and Health: Clinical Management and Research)

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13 pages, 559 KB

Open AccessArticle

Effects of Walking and Barre Exercise on CES-D, Stress Hormones, hs-CRP, and Immunoglobulins in Elderly Women

by Min-Kyo Kim, Su-Han Koh and Tae-Kyu Kim

J. Clin. Med. 2025, 14(5), 1777; https://doi.org/10.3390/jcm14051777 - 6 Mar 2025

Cited by 2 | Viewed by 5332

Abstract

Objectives: This study explored the impact of a 12-week walking and barre exercise program on depression levels (CES-D), stress hormones (dopamine, epinephrine, norepinephrine, cortisol, serotonin), high-sensitivity C-reactive protein (hs-CRP), and immunoglobulins (IgA, IgG, IgM) in women aged 65 and above. Methods: Twenty-seven participants were divided into a walking exercise group (WG), barre exercise group (BG) and control group (CG), each comprising nine individuals. Sessions lasted 50 min, thrice weekly, with intensity progressing every 4 weeks. Two-way repeated measures of ANOVA assessed time–group interactions and main effects, and paired t-tests and one-way ANOVA were used post hoc with significance set at 0.05. Results: The CES-D scores demonstrated significant interaction (p < 0.001), decreasing significantly in the BG and WG (p < 0.01) while rising in the CG (p < 0.05). Post hoc analysis revealed significantly lower depression levels in the BG compared to the CG (p < 0.01). Stress hormones epinephrine and cortisol showed a main effect of time (p < 0.05), with epinephrine increasing significantly in the BG (p < 0.05) and cortisol decreasing in the BG and WG (p < 0.05). An interaction effect emerged in hs-CRP levels (p < 0.05), while IgA and IgM displayed interaction effects (p < 0.05 and p < 0.01, respectively), both significantly increasing in the BG (p < 0.05). Conclusions: In summary, regular exercise positively impacted depression, stress hormones, and immune functions in older women. Full article

(This article belongs to the Special Issue Physical Activity, Exercise and Health: Clinical Management and Research)

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19 pages, 3457 KB

Open AccessArticle

Effects of Normobaric Hypoxia of Varying Severity on Metabolic and Hormonal Responses Following Resistance Exercise in Men and Women

by Jakub Foltyn, Kamila Płoszczyca, Miłosz Czuba, Adam Niemaszyk, Józef Langfort and Robert Gajda

J. Clin. Med. 2025, 14(5), 1514; https://doi.org/10.3390/jcm14051514 - 24 Feb 2025

Cited by 2 | Viewed by 2256

Abstract

Background/Objectives: Resistance exercise under hypoxic conditions induces various metabolic and hormonal responses, yet the relationship between hypoxia severity and anabolic hormone responses remains unclear. This study aimed to assess the effects of a single bout of resistance exercise on metabolic and hormonal responses in normoxia and three levels of hypoxia in both men and women. Methods: The study involved 16 physically active individuals with at least two years of experience in recreational resistance training. The participants completed resistance exercise sessions in normoxia and normobaric hypoxia at simulated altitudes of 3000 m (H3000), 4000 m (H4000), and 5000 m (H5000). Blood levels of total testosterone (T), cortisol (C), growth hormone (GH), and metabolic variables were measured before and after exercise. Results: In women, severe hypoxia (H4000 and H5000) was found to significantly enhance post-exercise increases in T and GH compared to H3000 (p < 0.05), without affecting C levels. In men, hypoxia (regardless of intensity) did not significantly augment post-exercise changes in T and GH compared to normoxia. In H4000 conditions, an increase in C levels was observed (p < 0.05), leading to an unfavorable reduction in the T/C ratio. Additionally, a reduction in the total number of repetitions performed during the training session and a weakened metabolic response (lactate and creatine kinase) were observed in men at H5000. Conclusions: In women, severe hypoxia (H5000) was found to induce a pronounced hormonal response, particularly in GH levels. The use of severe hypoxia during resistance exercise appears unfavorable in men due to a reduced metabolic response, and diminished exercise capacity, coupled with a failure to induce more favorable changes in the secretion of anabolic hormones than in normoxic conditions. Full article

(This article belongs to the Special Issue Physical Activity, Exercise and Health: Clinical Management and Research)

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15 pages, 2860 KB

Open AccessArticle

Eight Weeks of Resistance Training Is Not a Sufficient Stimulus to Improve Body Composition in Post-COVID-19 Elderly Adults

by Katarzyna Kaczmarczyk, Kamila Płoszczyca, Karol Jaskulski and Miłosz Czuba

J. Clin. Med. 2025, 14(1), 174; https://doi.org/10.3390/jcm14010174 - 31 Dec 2024

Cited by 3 | Viewed by 2769

Abstract

Background: This study sought to assess how body mass (BM) and body composition in post-COVID-19 elderly adults were affected by 8 weeks of resistance training. An additional goal was to determine the agreement between Bioelectrical Impedance Analysis (BIA) and Dual Energy X-Ray Absorptiometry (DXA) in elderly people. Methods: Participants were randomly assigned to an intervention Group, which engaged in 8 weeks of resistance training, and a Control Group, which was advised to maintain their usual activity levels. Before and after the intervention, the body composition was analyzed via the BIA and DXA methods. Results: We found no statistically significant changes in BM or body composition following resistance training. BIA was found to overestimate the participants’ baseline BM and fat-free mass (FFM) and to underestimate the fat mass (FM), compared to the DXA method. There were no significant differences in intervention-induced changes in FM and FFM measured by BIA and DXA. Conclusions: Moderate intensity resistance training lasting 8 weeks was not found to be a sufficient stimulus to improve BM and body composition in post-COVID-19 elderly adults. We also conclude that BIA may serve as a viable alternative to DXA for measuring longitudinal changes in body composition in elderly people. Full article

(This article belongs to the Special Issue Physical Activity, Exercise and Health: Clinical Management and Research)

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Review

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33 pages, 916 KB

Open AccessReview

The Impact of High-Intensity Interval Training on Cardiometabolic, Neurologic, Oncologic, and Pain-Related Outcomes: A Comprehensive Review of Systematic Reviews

by Dmitriy Viderman, Yeltay Rakhmanov, Mina Aubakirova, Sultan Kalikanov and Michael Fredericson

J. Clin. Med. 2025, 14(23), 8328; https://doi.org/10.3390/jcm14238328 - 24 Nov 2025

Cited by 3 | Viewed by 5477

Abstract

High-intensity interval training (HIIT) has gained attention for its potential to improve health outcomes across various conditions. Thus, the aim of the study was to summarize studies on HIIT to understand its effects on various health outcomes. We conducted an umbrella review of systematic reviews and meta-analyses. PubMed, Cochrane Database of Systematic Reviews, EMBASE, Scopus, CINAHL, and Web of Science were searched for relevant articles. The experimental group was subjected to HIIT with or without treatment, while the control group comprised individuals who underwent alternative forms of training or were non-exercisers. Included studies were systematically analyzed for effects of HIIT and cardiovascular, respiratory, metabolic, neurological, gastrointestinal, immunological, and survival-related outcomes. Of 336 identified systematic reviews, 133 were included in the final analysis. HIIT was found to confer significant physiological benefits, including improvements in body composition, cardiovascular and metabolic parameters, and mental health outcomes. Studies demonstrated the efficacy of HIIT across diverse patient populations, with comparable or superior effects to moderate-intensity continuous training in conditions such as diabetes, cardiovascular diseases, neurological, oncologic, and pain-related disorders. Our review highlights the potential of HIIT as a time-efficient intervention for improving health outcomes and managing chronic diseases. However, interpretation of the results should be performed cautiously due to the heterogeneity observed. High-intensity interval training shows promise as an effective strategy for managing chronic diseases among diverse patient populations. Future research should focus on refining HIIT protocols and elucidating their long-term effects and sustainability. Full article

(This article belongs to the Special Issue Physical Activity, Exercise and Health: Clinical Management and Research)

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34 pages, 710 KB

Open AccessReview

Resilience and Intrinsic Capacity in Older Adults: A Review of Recent Literature

by Gabriela Grigoraș, Adina Carmen Ilie, Ana-Maria Turcu, Sabinne-Marie Albișteanu, Iulia-Daniela Lungu, Ramona Ștefăniu, Anca Iuliana Pîslaru, Ovidiu Gavrilovici and Ioana Dana Alexa

J. Clin. Med. 2025, 14(21), 7729; https://doi.org/10.3390/jcm14217729 - 30 Oct 2025

Cited by 10 | Viewed by 6703

Abstract

Aging involves a progressive decline in physiological functions, increasing vulnerability to disorders, functional decline, and disability. Emphasizing resilience and intrinsic capacity offers a proactive framework for promoting successful aging and quality of life. This narrative review selected significant articles published within the last five years on resilience, especially physical resilience, and intrinsic capacity, along with earlier relevant works. Articles were primarily searched in English using PubMed, Google Scholar, and Scopus, employing relevant terms with Boolean operators (“AND”, “OR”). Inclusion criteria included peer-reviewed conceptual, observational, and interventional studies on resilience and/or intrinsic capacity in adults over 60, published between 2020 and 2025, highlighting how the inclusion of geriatric evaluation improves health outcomes. Studies not focused on older adults, outside the date range, or non-English articles were excluded. Out of 145 references, 43 articles met the inclusion criteria. ResEvidence suggests that resilience (a dynamic response to stressors) and intrinsic capacity (baseline reserves across locomotion, vitality, cognition, sensory, and psychological domains) are interconnected, with resilience being associated with better health outcomes, a lower prevalence of chronic diseases, and greater mental health stability. Incorporating assessments of resilience and intrinsic capacity into clinical workflows could support targeted interventions; routine screening may guide personalized exercise and psychosocial plans to help prevent functional decline. Utilizing brief, validated tools (e.g., Short Physical Performance Battery, handgrip strength, Geriatric Depression Scale, brief cognitive tests, and resilience scales) can inform interventions such as physical activity, nutritional support, deprescribing, and psychosocial engagement, which may support healthier aging trajectories. Full article

(This article belongs to the Special Issue Physical Activity, Exercise and Health: Clinical Management and Research)

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