Search Results (71)

Background: Μetabolic syndrome (MetS)—comprises central adiposity, elevated blood pressure, dyslipidaemia, and dysglycaemia, increasing the risk of type 2 diabetes and cardiovascular disease. Exercise training improves cardiorespiratory fitness and several MetS components, but real-world effectiveness is limited by poor adherence, restricted supervision, and insufficient personalisation. Objective: This scoping review mapped the clinical intervention evidence on technology-enhanced exercise and structured physical activity relevant to MetS, while distinguishing direct MetS evidence from translational evidence. Methods: In accordance with PRISMA-ScR, we searched PubMed and extended the search to Scopus and Web of Science; a supplementary IEEE Xplore search and a post hoc Embase check were also conducted. Eligible studies were interventions using web-based delivery, wearables, telemonitoring/mobile health (mHealth), artificial intelligence (AI) coaching, virtual reality (VR)/exergaming, or continuous glucose monitoring (CGM) alongside exercise training or structured physical activity. Results: Nineteen studies met the eligibility criteria. The evidence base was weighted toward wearable/app-based feedback and telemonitoring/mHealth/web-based approaches, with fewer studies on VR/exergaming, CGM-enabled exercise, and AI coaching. Most studies were randomised or cluster-randomised, but interventions were usually short term. Across categories, technology most consistently supported adherence, self-monitoring, accountability, remote supervision, and, in selected cases, physiology-informed personalisation. Direct MetS evidence was strongest for wearables with structured feedback, telemonitoring, mHealth, and web-based delivery, whereas AI coaching and CGM were supported by adjacent translational evidence. Conclusions: Technology-enhanced exercise and structured physical activity show promising but heterogeneous and still preliminary potential for MetS management. Key limitations include short follow-up, uneven representation across categories, inconsistent reporting of exercise dose/intensity fidelity and adverse events, and limited equity and implementation outcomes. Full article

A recent umbrella review evaluated evidence-based interventions for children with developmental central hypotonia, including those with Down syndrome. Motor, sensorimotor, orthotics, positioning, mobility, and infant massage interventions are supported by positive but low- or very-low-quality evidence. Using a retrospective case report format, these interventions are described, and their proposed mechanism of action is examined through the F-words lens tool and from the perspective of the parent. Tummy time, compression garments, early supported sitting for grasp and reach, ON-Time use of a supported stepping device, and orthotics are all used in the context of coaching in natural environments and family-centered care. Full article

Objectives: To develop an effective learning method for using a smartphone-based slit-lamp microscope (SBSL) and to identify key points to emphasize when coaching individuals with no prior SBSL experience. Methods: This study included 60 orthoptic students: 40 second-year students (control group: 20, training group 1: 20) and 20 first-year students (training group 2). Subjects were instructed to record the anterior eye segment of a patient-role subject using the Smart Eye Camera. The control group was given paper instruction and was shown the demonstration of the SBSL beforehand. In addition, training groups 1 and 2 watched a tutorial video, practiced using the SBSL for 30 min, and received guidance from an expert. Four ophthalmologists evaluated the recordings based on the eyelid, conjunctiva, cornea, pupil including iris, lens, and anterior chamber depth. Results: ANOVAs showed significant differences among groups for all items. The control group had significantly lower scores than both training groups, while no significant differences were found between training groups 1 and 2. Principal component analysis of training groups 1 and 2 showed that the first principal component accounted for 74.36% of the variance. The second principal component accounted for 10.71%, with a wide range of loadings (anterior chamber depth of 0.7780 to conjunctiva of −0.5585), implying the existence of different favorite focusing depths within subjects. Conclusions: A coaching program consisting of tutorial video learning, a 30 min hands-on trial, and feedback is effective in helping individuals without an ophthalmological background acquire anterior segment imaging skills using SBSL. Comprehensive focusing across the entire anterior segment should also be emphasized. Full article

This study examines the differences in sports learning among Generation Z based on digital literacy, using the Unified Theory of Acceptance and Use of Technology (UTAUT) and Media Richness Theory (MRT). As non-face-to-face sports learning—including online lectures, remote coaching, and virtual reality—rapidly expands, digital literacy has become a key factor influencing learning outcomes and equity. Data were collected from Generation Z adults engaged in sports learning through platforms including YouTube, social networking services, online lecture platforms, and mobile applications. Participants were classified into low (n = 87)-, medium (n = 80)-, and high (n = 70)-digital-literacy groups. A 32-item questionnaire adapted from prior studies assessed digital literacy (4 items), four UTAUT constructs (performance expectancy, effort expectancy, social influence, and facilitating conditions; 16 items), and three media richness dimensions (multiple channels, immediacy of feedback, and personalness; 12 items). Confirmatory factor analysis demonstrated acceptable model fit (χ² = 779.013, df = 436, p < 0.001, NFI = 0.914, IFI = 0.960, TLI = 0.954, CFI = 0.960, SRMR = 0.037, RMSEA = 0.058), reliability (all ω and α > 0.70), and convergent/discriminant validity (all AVE > 0.50; C.R. > 0.70). Group comparisons indicated that higher digital literacy was linked to higher scores in technology acceptance and media richness perceptions (F = 40.364–64.150, p < 0.001, ηp² = 0.257–0.354) These findings indicate that intra-generational differences in digital literacy shape technology use and media experience in sports learning, highlighting the need to enhance media richness and systematically develop learners’ digital literacy to improve digital sports education’s effectiveness and equity. But causal inferences are limited by the cross-sectional design. Full article

Playing sports remains one of the most common avenues for youth engagement in physical activity. Yet mental health challenges, such as performance anxiety, depressive symptoms, reduced motivation, and burnout, place many young athletes at risk. As key mediators of sport participation, coaches’ roles are often underscored in recognizing shifts in athlete motivation, behavior, or well-being. Gaining better insight into athlete mental health status may enable coaches to provide timely support and strengthen athlete and team well-being. In this study protocol, we employ a mixed-methods design, evaluating the effectiveness of an AI-augmented mobile application (i.e., ThriveNudge) in promoting the mental health of youth athletes. ThriveNudge helps coaches monitor athlete mental health, flag mood disruptions, and practice supportive communication via simulated chats. A target sample of four interscholastic teams (with athletes aged 14–18 years) and their head coaches will be recruited. Teams will be cluster-randomized to either the intervention condition (n = 2), receiving pre-season training to implement ThriveNudge, or to a waitlist control condition (n = 2). Primary outcomes, including athlete burnout, motivation, coach–athlete relationships, and sport enjoyment, will be measured using psychometric scales administered online. Semi-structured interviews will be conducted with coaches and athletes in the experimental group to collect qualitative data on user interface and user experience. We hypothesize that teams using ThriveNudge will report lower athlete anxiety and burnout, higher intrinsic motivation and enjoyment, and stronger coach–athlete relationships than athletes in control teams. We aim to provide a scalable and accessible digital platform that safeguards youth mental health. Full article

Background: Truck drivers constitute a high-risk occupational group due to irregular schedules, prolonged sedentary work, fatigue, and limited access to healthcare, contributing to adverse physical and mental health outcomes. Although mobile health (mHealth) tools offer potential to support driver health, sustained engagement remains a persistent challenge. Objectives: This systematic review aimed to identify behavioural, technological, and contextual determinants influencing truck drivers’ compliance, retention, and long-term engagement with digital health interventions. Methods: Following the PRISMA 2020 guidelines, six eligible studies were identified and thematically synthesised across technology acceptance, behaviour change, and persuasive system design perspectives. Results: Across studies, sustained engagement was facilitated by self-monitoring, real-time feedback, goal-setting, coaching support, and simple, flexible system design. In contrast, technological complexity, high interaction demands, limited digital literacy, privacy concerns, misalignment with irregular schedules, and fatigue consistently undermined engagement and retention. Autonomy, trust, and voluntary participation emerged as cross-cutting determinants supporting continued use. Based on the synthesis, an integrative framework was developed to explain how behavioural, technological, and contextual factors interact to shape truck drivers’ compliance, engagement, and retention with mHealth. Despite generally moderate to high study quality, the evidence base remains fragmented and dominated by short-term evaluations. Conclusions: The findings highlight the importance of context-sensitive, user-centred design to support effective digital health interventions in the trucking sector. Full article

This study proposes an integrated agility assessment system that combines Millimeter-Wave (MMW) radar, Ultra-Wideband (UWB) ranging, and Mixed Reality (MR) technologies to quantitatively evaluate athlete performance with high accuracy. The system utilizes the fine motion-tracking capability of MMW radar and the immersive real-time visualization provided by MR to ensure reliable operation under low-light conditions and multi-object occlusion, thereby enabling precise measurement of mobility, reaction time, and movement distance. To address the challenge of player identification during doubles testing, a one-to-one UWB configuration was adopted, in which each base station was paired with a wearable tag to distinguish individual athletes. UWB identification was not required during single-player tests. The experimental protocol included three specialized agility assessments—Table Tennis Agility Test I (TTAT I), Table Tennis Doubles Agility Test II (TTAT II), and the Agility T-Test (ATT)—conducted with more than 80 table tennis players of different technical levels (80% male and 20% female). Each athlete completed two sets of two trials to ensure measurement consistency and data stability. Experimental results demonstrated that the proposed system effectively captured displacement trajectories, movement speed, and reaction time. The MMW radar achieved an average measurement error of less than 10%, and the overall classification model attained an accuracy of 91%, confirming the reliability and robustness of the integrated sensing pipeline. Beyond local storage and MR-based live visualization, the system also supports cloud-based data uploading for graphical analysis and enables MR content to be mirrored on connected computer displays. This feature allows coaches to monitor performance in real time and provide immediate feedback. By integrating the environmental adaptability of MMW radar, the real-time visualization capability of MR, UWB-assisted athlete identification, and cloud-based data management, the proposed system demonstrates strong potential for professional sports training, technical diagnostics, and tactical optimization. It delivers timely and accurate performance metrics and contributes to the advancement of data-driven sports science applications. Full article

Each year, over 1 million people in the United States die from diabetes and cardiovascular diseases (CVDs). These largely preventable chronic conditions also create a financial burden on patients, payers, and healthcare systems. The popularity of GLP-1-based management of cardiometabolic conditions can escalate healthcare spending, while incentivizing digitization of semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro), and others using the “prescription drug use-related software” (PDURS) framework. In this article, we highlight opportunities to advance digital-first interventions and metformin-enhanced digital therapeutics (DTx) for the primary prevention of diabetes and CVDs. Metformin is a low-cost antidiabetic medication that is effective in preventing diabetes and cardiovascular adverse events. Concurrently, digital health technologies for managing chronic conditions, e.g., Dario Health, Omada Health, and WellDoc, enable digital-first and drug + digital combination therapies for prediabetes and those at risk for CVDs. We describe incentives for advancing Affordable Primary Prevention (APP), suggesting that nonprofit healthcare systems, such as Kaiser Permanente, Intermountain Health or Ascension Health, payers such as Cigna and Aetna/CVS Health, or private equity investors can leverage their venture funds to support development of metformin-enhanced DTx. In conclusion, (1) the PDURS framework can accelerate innovation of preventive medicine by bridging precision digital interventions with low-cost generic drugs, and (2) integrating healthy behaviors with pharmacotherapies is essential for the financially sustainable prevention of lifestyle-related chronic diseases. Full article

Skeletal muscle dysfunction is a major systemic manifestation of COPD that shapes symptoms, exercise tolerance and mortality. Current evidence can be integrated within a Damage–Regeneration–Remodeling framework linking mechanics and biology to clinical phenotypes. Pulmonary hyperinflation and chest wall geometry chronically load the diaphragm and other respiratory muscles in COPD, whereas inactivity and exacerbation-related disuse underload locomotor muscles. Across muscle compartments, oxidative/nitrosative stress, activation of proteolytic pathways, mitochondrial and endoplasmic reticulum stress, microvascular limitations, neuromuscular junction instability, and myosteatosis degrade muscle quality. The diaphragm adapts with a fast-to-slow fiber shift, greater oxidative capacity, and sarcomere foreshortening, improving endurance, whereas limb muscles show atrophy, a glycolytic shift, reduced oxidative enzymes, extracellular matrix accrual, and fat infiltration. Translational levers that address these mechanisms include: (I) Reduce damage: bronchodilation, lung-volume reduction, oxygen, non-invasive ventilation, early mobilization, pulmonary rehabilitation, neuromuscular stimulation, and corticosteroid stewardship; (II) Enable regeneration: progressive resistance plus high-intensity/heavy-load endurance training; adequate protein and vitamin-D intake, and endocrine correction; and (III) Steer remodeling: increase physical activity (with/without coaching/telecoaching), functional assessment and CT or MRI monitoring, inspiratory-muscle training, and phenotype-guided adjuncts in selected cases. This framework clarifies why lung deflation strategies benefit inspiratory mechanics, whereas limb recovery requires behavioral and metabolic interventions layered onto systemic optimization. Full article

Background: Plant-based diets are associated with reduced risk of chronic diseases and improved health outcomes. However, sustaining dietary changes remains challenging. Digital interventions—including virtual culinary medicine programs, web-based nutrition coaching, SMS and email reminders, mobile application–based self-management, and hybrid community programs—offer promising strategies to support behavior change, enhance cooking skills, and improve dietary adherence. These approaches are relevant for both healthy individuals and those living with chronic conditions. Methods: We conducted a narrative review of studies published between 2000 and 2025 in PubMed/MEDLINE, Scopus, and Web of Science, supplemented with manual searches. Included studies comprised randomized controlled trials, quasi-experimental designs, feasibility studies, and qualitative research. Interventions were categorized by modality (SMS, email, web platforms, mobile apps, virtual culinary programs, and hybrid formats) and population (healthy adults, patients with chronic diseases). Outcomes examined included dietary quality, self-efficacy, psychosocial well-being, and program engagement. Results: Most studies reported improvements in dietary quality, cooking skills, nutrition knowledge, and psychosocial outcomes. Virtual cooking programs enhanced dietary adherence and engagement, particularly among individuals at cardiovascular risk. Digital nutrition education supported behavior change in chronic disease populations, including patients with multiple sclerosis. SMS and email reminders improved self-monitoring and participation rates, while mobile applications facilitated real-time feedback and goal tracking. Hybrid programs combining online and in-person components increased motivation, social support, and long-term adherence. Reported barriers included limited technological access or skills, lack of personalization, and privacy concerns. Conclusions: Virtual culinary medicine programs and other digital microinterventions—including SMS, email, web, mobile, and hybrid formats—are effective tools to promote plant-based diets. Future interventions should focus on personalized, accessible, and hybrid strategies, with attention to underserved populations, to maximize engagement and sustain long-term dietary change. Full article

Background: Uchi-mata is one of the most frequently used throwing techniques in judo, yet little is known about the kinematic factors distinguishing specialists from non-specialists. This study compared lower-limb kinematics during uchi-mata across its three phases in elite judokas. Methods: Forty athletes (12 female, 28 male; 24.5 ± 5.9 years) were classified as specialists (n = 20) or non-specialists (n = 20). Photogrammetry assessed hip, knee, and foot displacement, velocity, acceleration, and timing during the Approach, Turning, and Throw phases. Analyses were performed using mixed-effects models with group, phase, and sex as fixed effects, plus exploratory multivariate tests (p < 0.05). Results: Specialists executed faster movements in the Approach (p = 0.036, d = 0.69) and Throw phases (p = 0.010, d = 0.85), showed greater hip displacement during Approach (p = 0.008, d = 0.89), and achieved superior knee and foot displacement in Throw (p = 0.005 and p = 0.003). Final positioning also differed, with specialists displaying higher knee (98.5 ± 14.5 vs. 86.3 ± 17.8 cm, p ≤ 0.001) and foot (121.0 ± 19.7 vs. 104.4 ± 27.4 cm, p = 0.034) heights, but lower hip position (61.9 ± 4.2 vs. 75.6 ± 7.5 cm, p = 0.021). Sex showed no significant effects or interactions, indicating that these group differences were consistent across male and female athletes. Conclusions: Uchi-mata specialists demonstrated superior displacement and velocity control, particularly in the Approach and Throw phases, reflecting greater neuromuscular coordination and efficiency. These findings provide practical markers for coaches and athletes to guide training focused on mobility, strength, and technical drills that enhance hip, knee, and foot displacement, supporting the optimization of uchi-mata performance in elite judo. Full article

Background/Objectives: As global aging accelerates, there is a pressing and empirically substantiated demand for integrated and sustainable strategies, as evidenced by the rising prevalence rates of chronic conditions, social isolation, and digital exclusion among older adults worldwide. These factors underscore the urgent need for multidimensional interventions that simultaneously target physical, psychological, and social well-being. The HOPE-FIT (Hybrid Outreach Program for Exercise and Follow-up Integrated Training) model and the SAGE (Senior Active Guided Exercise) program were designed to address this need through a hybrid framework. These programs foster inclusive aging by explicitly bridging digitally underserved groups and mobility-restricted populations into mainstream health promotion systems through tailored exercise, psychosocial support, and smart-home technologies, thereby functioning as a scalable meta-model across healthcare, community, and policy domains. Methods: HOPE-FIT was developed through a formative, multi-phase process grounded in the RE-AIM framework and a Hybrid Type II effectiveness–implementation design. The program combines professional health coaching, home-based and digital exercise routines, Acceptance and Commitment Performance Training (ACPT)-based psychological strategies, and smart-home monitoring technologies. Empirical data from pilot studies, large-scale surveys (N = 1000), and in-depth user evaluations were incorporated to strengthen validity and contextual adaptation. Culturally tailored content and participatory feedback from older adults further informed ecological validity and program refinement. Implementation Strategy/Framework: The theoretical foundation integrates implementation science with behavioral and digital health. The RE-AIM framework guided reach, fidelity, and maintenance planning, while the Hybrid E–I design enabled the concurrent evaluation of effectiveness outcomes and contextual implementation strategies. Institutional partnerships with community centers, public health organizations, and welfare agencies further facilitated the translation of the model into real-world aging contexts. Dissemination Plan: The multi-pronged dissemination strategy includes international symposia, interdisciplinary academic networks, policy briefs, localized community deployment, and secure, authenticated data sharing for reproducibility. This design facilitates evidence-informed policy, empowers practitioners, and advances digital health equity. Ultimately, HOPE-FIT constitutes a scalable and inclusive model that concretely addresses health disparities and promotes active, dignified aging across systems and disciplines. Full article

Background/Objectives: Conventional ketogenic diets, although effective for weight loss, often contain high total and saturated fat intake, which leads to increased low-density lipoprotein cholesterol (LDL-C). Thus, the Healthy Ketogenic Diet (HKD) was developed to address these concerns. It emphasizes calorie restriction, limiting net carbohydrate intake to 50 g per day, prioritizing unsaturated fats, and reducing saturated fat intake. However, adherence to the HKD remains a challenge in urban, time-constrained environments. Therefore, this pilot randomized controlled trial aimed to investigate the effects of Healthy Ketogenic Diet Ready-To-Eat (HKD-RTE) meals (provided for the first month only) versus HKD alone on weight loss and metabolic parameters among overweight adults. Methods: Multi-ethnic Asian adults (n = 50) with a body mass index (BMI) ≥ 27.5 kg/m² were randomized into the HKD-RTE group (n = 24) and the HKD group (n = 26). Both groups followed the HKD for six months, with the HKD-RTE group receiving HKD-RTE meals during the first month. Five in-person workshops and mobile health coaching through the Nutritionist Buddy Keto app helped to facilitate dietary adherence. The primary outcome was the change in body weight at 6 months. Linear regression was performed on the change from baseline for each continuous outcome, adjusting for demographics and relevant covariates. Logistic regression was performed on binary weight loss ≥ 5%, adjusting for demographics and relevant covariates. Results: In the HKD group, participants’ adherence to the 50 g net carbohydrate target was 15 days, while that in the HKD-RTE group was 19 days over a period of 30 days. Participants’ adherence to calorie targets was 21 days in the HKD group and 23 days in the HKD-RTE. The average compliance with the HKD-RTE meals provided in the HKD-RTE group was 55%. The HKD-RTE group experienced a greater percentage weight loss at 1 month (−4.8 ± 3.0% vs. −1.8 ± 6.2%), although this was not statistically significant. This trend continued up to 6 months, with the HKD-RTE group showing a greater percentage weight reduction (−8.6 ± 6.8% vs. −3.9 ± 8.6%; p = 0.092). At 6 months, the HKD-RTE group had a greater reduction in total cholesterol (−0.54 ± 0.76 mmol/L vs. −0.05 ± 0.56 mmol/L; p = 0.283) and LDL-C (−0.43 ± 0.67 mmol/L vs. −0.03 ± 0.52 mmol/L; p = 0.374) compared to the HKD group. Additionally, the HKD-RTE group exhibited greater reductions in systolic blood pressure (−8.3 ± 9.7 mmHg vs. −5.3 ± 11.0 mmHg), diastolic blood pressure (−7.7 ± 8.8 mmHg vs. −2.0 ± 7.0 mmHg), and HbA1c (−0.3 ± 0.5% vs. −0.1 ± 0.4%) than the HKD group (not statistically significant for any). Conclusions: Both HKD-RTE and HKD led to weight loss and improved metabolic profiles. The HKD-RTE group tended to show more favorable outcomes. Short-term HKD-RTE meal provision may enhance initial weight loss, with sustained long-term effects. Full article

Background: Fundamental movement skills (FMS)—including muscular strength, endurance, and mobility—are linked to better health-related quality of life and higher physical activity in children. Rural children often score lower on FMS tests than urban peers due to resource limitations rather than ability. Thus, increasing access to FMS activities in under-resourced rural areas is essential. The primary objective was to test the feasibility of Hoosier Strength in a rural middle school sample, and the secondary objective was to observe the preliminary changes in FMS-related outcomes pre- to post-intervention and at follow-up. The exploratory objective was to explore how participants responded to different coaches on the Hoosier Strength coaching team (i.e., gender, coaching style during activities). Methods: This study used a Hybrid Type 3 design to evaluate feasibility and FMS outcomes, integrating qualitative and quantitative data. The four-week intervention included a test group (n = 24; 14 females, 10 males; mean age: females 12.4 ± 0.5 years, males 12.7 ± 0.4 years) and a control group (n = 12; 8 females, 4 males; mean age: females 12.9 ± 0.3 years, males 12.7 ± 0.3 years). Data analysis included descriptive statistics for feasibility indicators (Acceptability of Intervention Measures [AIM], Intervention Appropriateness Measure [IAM], and Feasibility of Intervention Measure [FIM]), linear regression for mobility and muscular endurance changes, t-tests for psychological need satisfaction and frustration, and regression analysis for squat knowledge and post-intervention confidence. Results: (1) There was high feasibility across the 4-week Hoosier Strength intervention and at follow-up; (2) there were no statistically significant changes in squat performance; (3) participants’ confidence in their ability to squat at the end of the intervention was significantly predicted by their squat knowledge at baseline; and (4) participants prioritized leadership and team management over tactical analysis, highlighting a preference for coaches who foster teamwork. Conclusions: The findings offer a transparent approach for evaluating the feasibility and preliminary outcomes of the Hoosier Strength intervention in an under-resourced rural middle school, thereby encouraging further investigation into strength training interventions in rural schools. Full article

Multi-component interventions have been demonstrated to be an effective method for the prevention of frailty. Nevertheless, they have not yet been widely adopted in practice due to considerable resource and labor demands associated with their administration. To overcome the limitations, this study aimed to determine the feasibility of unsupervised intervention based on digital therapy. A mobile application has been developed to deliver multi-component exercise coaching to frail older adults. A total of 30 participants (with a mean age of 72.10 ± 4.54 years) were recruited from two community centers and used the mobile application for 12 weeks without supervision. Prior to utilizing the mobile application, each participant received an initial education. Outcomes of the Short Physical Performance Battery (SPPB), the Korean version of the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (K-FRAIL) scale, activities of daily living (ADL), instrumental activities of daily living (IADL), self-efficacy, and depression, were evaluated before and after using the mobile application. Significant improvements in the mean SPPB score (9.6 ± 1.7 to 11.7 ± 0.5) and depression (3.23 ± 3.08 to 2.00 ± 2.11) were observed. The total adherence rate of all participants was 86.1%. No statistically significant differences were observed in the remaining outcomes. These findings suggest that the unsupervised intervention could be a viable option for older adults. Full article