Search Results (75)

Background/Objectives: Children with severe physical and communication disabilities face many challenges. They have very limited opportunities for upright, hands-free, self-initiated mobility. Current findings in neuroscience and theories on child development suggest that self-initiated mobility can have positive cascading effects on various developmental areas, including language and communication. This study was conducted to examine the current use of hands-free support walkers with children who have severe physical and communication disabilities and use augmentative and alternative communication and to identify the benefits and problems perceived by their parents and professionals from different disciplines. Methods: Online surveys were utilized to collect information from 127 participants, including 31 parents and 96 professionals or paraprofessionals. Results: The participants reported that these children could perform various motor activities in the hands-free support walkers to achieve different goals. Benefits identified by both parents and professionals included providing a way to exercise and stay active, improving motor control, enhancing independence, and bringing enjoyment. Professionals also observed positive impacts on communication, vocalization, use of eye contact, and problem solving. Conclusions: Results suggest that children with severe physical and communication disabilities can benefit from the upright, hands-free, self-initiated mobility provided by hands-free support walkers. Clinical implications and needs for future research are discussed. Full article

Background/Objectives: Physical activity is a cornerstone of diabetes mellitus (DM) management and is strongly recommended in the American Diabetes Association (ADA)’s guidelines. This study aims to investigate the self-reported physical activity levels of individuals with DM in Germany, as well as the barriers and facilitators they encounter. Methods: Individuals with type 1 DM (T1DM) and type 2 DM (T2DM) were asked to fill out an online questionnaire that was partly based on the International Physical Activity Questionnaire (IPAQ). Results: The questionnaire was completed by 338 persons with either T1DM (57.1%) or T2DM (42.9%) (females: 56.2%, males: 42.0%, gender diverse persons: 1.8%) of all age groups (at least 18 years). In total, 80.5% of respondents were aware of the current physical activity recommendations. Among the respondents, 58% reported meeting the recommendations for endurance-type physical activity, while only 30.5% reported meeting those for strength training. The three most frequently cited barriers to physical activity were lack of time, lack of motivation and current state of health. Supporting factors included coverage of costs, availability of exercise programs in close proximity to the patient’s home and target group specific exercise programs. Conclusions: The results imply that many individuals with DM in Germany do not meet ADA’s physical activity recommendations, especially considering that self-reports often overestimate actual behavior. In particular, the actual number of individuals who regularly engage in strength training may be too low. There is a clear need to better communicate the benefits of different forms of physical training and to provide physical activity programs aligned with patients’ individual needs. Full article

Background: Mass casualty events in conflict-affected regions can lead to the displacement of civilians and are often accompanied by substantial psychological and emotional impact on those affected. While physical activity is known to support mental health, the ways in which it relates to anxiety, resilience, and well-being in conflict-affected populations are still being explored. Objective: This study examined the associations among physical activity, anxiety, resilience, and well-being in evacuees from a conflict-affected zone. We hypothesized that higher levels of intense physical activity would be associated with higher levels of resilience and well-being and lower levels of anxiety. Methods: In this cross-sectional study, 107 evacuees completed an online survey in December 2023. The questionnaire assessed the frequency and intensity of physical activity, generalized anxiety, resilience, and well-being. Participants were categorized by weekly total physical activity levels. Data was analyzed using ANOVA, Pearson correlations, and multiple linear regression. Results: Evacuees engaging in more than three hours of vigorous-intensity physical activity exhibited significantly higher resilience and better well-being compared to those with lower activity levels. Although not statistically significant, the data suggested a possible pattern of lower anxiety among evacuees engaging in higher levels of physical activity. Regression analysis identified higher resilience and lower anxiety as significant predictors of greater mental well-being. Additionally, residing in a community exposed to a higher number of traumatic events was associated with reduced well-being. The overall model explained a substantial portion of the variance in mental well-being. Conclusions: Physical activity, especially intense exercise, is associated with improved mental health and resilience among evacuees, supporting its inclusion in interventions for trauma-affected populations. Full article

For the majority of human history, humans lived in sustenance hunter–gatherer tribes. Due to rapid cultural evolution in the past few thousand years, our biological evolution has not kept up, and many of the adaptations are, as a result, better suited to ancestral conditions than they are to modern conditions. This is known as evolutionary mismatch. While evolutionary mismatches can be seen across many facets of contemporary human life (e.g., diet, exercise, online communication), evolutionary mismatches are particularly pervasive in our elementary schools. Due to the critical nature of social learning and cultural transmission, there is a long history of learning that has shaped the evolved learning mechanisms of children. Rather than learning from hands-on, collaborative experiences as was typical for our ancestors, children today often learn in age-segregated classrooms through passive instruction and standardized curricula. In this entry, eight common school-related issues are identified and the associated evolutionary mismatch is outlined. The goal is to provide educators with a model of how an evolutionary lens can be used to better understand, and potentially improve, modern schooling systems. Full article

Background/Objectives: Population aging and the rise in chronic diseases challenge healthcare systems to adopt person-centered approaches, especially in palliative care (PC), where symptom management remains limited. Physiotherapy plays a key role in alleviating discomfort but faces inconsistent integration in Portugal due to lack of recognition. Variations in intervention methods hinder uniform care delivery, limiting timely patient access to comfort-focused treatments and knowledge. This study aims to deepen the understanding of physiotherapy’s role in Portuguese PC to improve its integration into teams and enhance patient access to comfort care. Methods: This study used a descriptive qualitative approach with online focus groups (FG), guided by Krueger and Casey’s methodology and adhering to the COREQ checklist. A non-probabilistic convenience sample of physiotherapists working in palliative care across mainland Portugal and the islands was selected based on inclusion criteria. Three FGs were planned with up to ten participants each. However, due to availability and attendance issues, only 15 physiotherapists participated: 5 in FG1 (in-hospital PC units), 6 in FG2 (inpatient units), and 4 in FG3, the minimum appropriate number from community-based units. Results: Physiotherapy plays a crucial yet underrecognized role in PC, emphasizing the need for its full integration into care teams rather than reliance on late, on-call referrals. Techniques such as positioning, mobilization, pain and dyspnea relief, adapted exercises, massage, music therapy, and emotional support are employed. Conventional physiotherapy tools are used and personalized according to the patient’s context, duration, setting, dosage, and individual needs. Conclusions: Physiotherapy should be recognized as a fundamental part of PC, contributing not only to the prolongation of life but also to ensuring comfort and dignity for patients and their families. To achieve this, its role within multidisciplinary teams must be strengthened and supported by regulations that guarantee access and the formal integration of physiotherapists. However, a significant gap remains in patients’ regular access to comfort-focused interventions at the appropriate time, perhaps due to the considerable variation in physiotherapy practices depending on the patient and care setting, which presents a challenge for knowledge development both in Portugal and globally. Full article

Background/Objective: Sustained exercise adherence among older adults is essential for healthy aging but remains challenging due to psychological, social, and economic barriers. This study aimed to investigate how perceived exercise barriers, financial burden, constraint negotiation mechanisms, and social support influence exercise adherence among adults aged 50 and older by integrating behavioral economics, constraint negotiation theory, and social cognitive theory. Methods: A cross-sectional survey was conducted with 1000 community-dwelling older adults in South Korea using a convenience sampling method. Participants were recruited from community centers, senior welfare facilities, and public health clinics in urban and suburban areas. Data collection was conducted between 11 January and 21 April 2024, using both online (Qualtrics) and offline (paper-based) surveys. Participants completed validated instruments measuring perceived exercise barriers, financial burden, constraint negotiation mechanisms (including financial management and social support mobilization), perceived social support, and behavioral exercise adherence. The final sample used for analysis included 974 individuals (mean age = 60.24 years, SD = 6.42). Structural Equation Modeling (SEM) was used to assess direct, mediating, and moderating effects. Additional exploratory analyses (ANOVA and t-tests) examined subgroup differences. Results: SEM results showed that perceived exercise barriers (β = –0.352, p < 0.001) and financial burden (β = –0.278, p < 0.001) were negatively associated with exercise adherence. Constraint negotiation mechanisms (β = 0.231, p < 0.001) and perceived social support (β = 0.198, p < 0.001) were positively associated. Mediation analyses revealed that constraint negotiation strategies partially mediated the relationships between perceived barriers and adherence (indirect β = 0.124) and between financial burden and adherence (indirect β = 0.112). Moderation analysis confirmed that social support buffered the negative effects of financial and psychological barriers. Conclusions: Exercise adherence in later life is shaped by the dynamic interplay of structural constraints, behavioral strategies, and social reinforcement. Interventions should combine financial support with socially embedded structures that promote behavioral planning and peer accountability to sustain long-term physical activity among older adults. Full article

Introduction: Longevity is increasingly recognized as the result of modifiable lifestyle, environmental, and social factors rather than genetics alone. While global interest in healthy aging is growing, public awareness of these determinants remains understudied in the Middle East. This study aimed to assess public awareness and perceptions of longevity-related factors among adults in Saudi Arabia. Methods: A cross-sectional online survey was conducted between November 2024 and January 2025 targeting residents of Saudi Arabia aged 18 and above. A researcher-validated questionnaire explored awareness across various domains, including lifestyle, environment, genetics, sleep, and religious beliefs. Perceptions were assessed using a series of items measuring beliefs about the influence of lifestyle, environmental, technological, and cultural factors on health and longevity. Descriptive and inferential statistics were used to analyze responses from 395 participants. Results: The sample included 395 participants, with 67.8% females and more than half (51.4%) aged 18–25 years. The participants exhibited high awareness of key lifestyle factors; greater than 88% acknowledged the role of sleep, and more than 90% recognized the importance of exercise and nutrition. However, fewer were aware of environmental (72.2%) or social determinants, and nearly half believed that genetic factors exert a primary influence on longevity. Higher awareness was significantly associated with behaviors like regular exercise (p = 0.004), dietary supplement use (p = 0.002), and recognition of the importance of sleep (p < 0.001). Younger adults showed higher awareness than older adults, while there were no significant differences in regards to gender, education, and income. Support for incorporating religious themes into health campaigns was also linked to greater awareness. Insurance status and chronic illness were not associated with awareness levels. Conclusions: While awareness of lifestyle-related longevity factors is strong, gaps remain in understanding broader influences such as environmental and social determinants. Culturally grounded public health strategies that integrate religious framing and emphasize actionable, evidence-based behaviors may enhance community engagement and support healthy aging across Saudi Arabia. Full article

Background: Vast spatial mobility changes happened globally during the COVID-19 pandemic, profoundly affecting older adults’ well-being and active aging experience. This study aims to examine how the virtual environment and cyberspace, in conjunction with the physical and social neighbourhood environments, influence outdoor activities and spatial mobility for older immigrants. Methods: Four online focus groups were conducted with 25 older Chinese immigrants aged 65 and over in the Greater Toronto Area, Canada. The focus groups explored coping strategies during the pandemic and spatial mobility patterns related to different activity types such as grocery shopping, leisure activities and physical exercises, social and familial activities, and healthcare. Qualitative thematic analysis was conducted guided by the neighbourhood and health theoretical framework. Results: The overall engagement of older Chinese immigrants in various types of outdoor activities declined drastically and the spatial mobility pattern was complex. This change was shaped largely by the intersecting physical/built (e.g., residential conditions, access to public spaces), social (e.g., social support, interpersonal cohesion) and virtual (e.g., online communities and internet-based resources) environmental factors, as well as individual risk perceptions towards COVID-19 and public health interventions during the pandemic. Conclusions: Virtual environment emerged as an important domain that compensates for the heavily reduced spatial mobility of the group during the pandemic. It functioned as a vital channel for older Chinese immigrants to sustain the necessary leisure, social, and healthcare-related activities and maintain well-being during the pandemic. The study provides implications for addressing neighbourhood-level factors in policymaking and implementing initiatives to enhance active ageing experience of older Chinese immigrants. Full article

As online health and wellness programs become more ubiquitous post-pandemic, there is a need to better understand how people with physical disabilities respond to different types of program offerings. Online health promotion programs have become popular in the disability community, and programs offer a range of activities across various wellness domains (e.g., exercise, nutrition). This study examined factors predicting adherence to three different types of online health promotion programs tailored for people with physical disabilities. A survey was developed to examine factors associated with high, moderate, and low adherence to three different types of health promotion programs. Participants who completed an online wellness program were sent a survey that asked questions related to adherence to a range of wellness activities. The three programs included the MENTOR (Mindfulness, Exercise, and Nutrition to Optimize Resilience), GROWTH (Growing Resilience Out of Wellness and Thoughtful Habits), and SOSE (State of Slim Everybody) programs, all of which focus on different self-care strategies. MENTOR focused on educating participants about mindfulness, exercise, and nutrition; GROWTH aimed to deliver mental and emotional health techniques, while SOSE’s purpose was to teach participants how to implement healthy weight loss, weight management, and daily exercise practices. Results indicated that participant perceptions of program delivery, specifically programs being disability friendly, virtual environment enjoyment, having positive instructor relationships, adaptable content, the instructor’s knowledge about disability, the instructor’s use of appropriate language, and program satisfaction, affected the likelihood of high adherence among people with physical disabilities enrolled in the health and wellness programs. Full article

Today, cardiovascular diseases contribute to approximately 17.9 million deaths annually worldwide. With reference to Europe, coronary artery disease (CAD) causes about 3.9 million deaths annually. Considering the positive physical and psychological outcomes of on-site exercise for CAD patients, this study aimed to expand the literature by examining the effects of a 6-month online exercise training program using wearable devices on CAD patients’ perceived well-being, measured with the PERMA profiler. Individual well-being is considered today as an important prerequisite for healthy societies. Thirty patients with a recent myocardial infarction (i.e., <4 weeks) were randomly assigned to either the online home-based or the community-based exercise group. Both groups followed the same 24-week exercise-based cardiac rehabilitation program three times per week. Each session consisted of a 30-min aerobic, followed by a 15-min strength workout, and then a 15-min balance and flexibility training. The results of the Mann–Whitney U tests and the z scores indicated that the Meaning of Life, Health, Accomplishment, Engagement, and Positive Relationship dimensions of the PERMA were statistically improved, and Negative Emotions were decreased. These findings support the importance of cardiac telerehabilitation for patients’ psychological health, demonstrating that online exercise using wearable devices can be a meaningful alternative to on-site exercise for patients with recent myocardial infarction. These results have policy implications as they provide arguments for providing online exercise for CAD patients as an alternative means for improving their psychological health. Full article

Background/Objectives: Dementia leads to cognitive decline, affecting memory, reasoning, and daily activities, often requiring full-time care. Multisensory stimulation (MSS), combined with cognitive tasks, can slow this decline, improving mood, communication, and overall quality of life. This systematic review aims to explore methods that utilize MSS in the rehabilitation of patients with dementia. Its clinical value is rooted in its ability to offer a deep comprehension of how MSS can be successfully incorporated into rehabilitation treatments. Methods: Studies were identified from an online search of PubMed, EBSCOhost, Cochrane Library, Web of Science, Embase, and Scopus databases with a search time frame from 2014 to 2024. This review has been registered on Open OSF (n) 3KUQX. Results: Pilot studies investigating MSS interventions, encompassing Cognitive Stimulation Therapy (CST), Sonas therapy, and combined physical–cognitive exercise programs, have yielded mixed findings in individuals with dementia. CST has demonstrated significant improvements in general cognitive function, particularly in language skills, offering a promising approach for cognitive enhancement. Sonas therapy, while showing positive trends in some studies, does not consistently achieve statistically significant outcomes across all cognitive domains. Conversely, combined exercise programs have shown efficacy in improving dual-task performance, suggesting benefits for motor–cognitive integration. MSS delivered within specialized environments like Snoezelen rooms consistently produces positive effects on mood, reducing agitation and promoting relaxation. Conclusions: This review emphasizes how MSS can enhance cognitive, emotional, and behavioral results for individuals with dementia. It is essential for future research to standardize protocols, incorporate advanced technologies such as virtual reality, and rectify diversity gaps. Collaboration between different fields will improve the effectiveness and usefulness of MSS in caring for individuals with dementia. Full article

Background: The Beat It program is a clinician-led, community-based group exercise intervention for adults with Type 2 Diabetes Mellitus (T2DM). While previous studies have demonstrated its effectiveness in improving physical and mental health outcomes, this study explores the perspectives of Beat It Trainers to identify key factors contributing to the program’s success and areas for improvement. Methods: Semi-structured interviews were conducted with 11 Accredited Exercise Physiologists who had delivered both in-person and online versions of the program. Interviews were thematically analyzed using inductive approaches. Results: Eight main themes emerged: customization to individual needs, capability building, outcome improvement, affordability, accessibility, sustainability, and a holistic approach delivered in a group setting. Challenges identified included managing group dynamics, maintaining participant commitment in a fully subsidized program, and providing nutrition advice within the trainers’ scope of practice. The program’s adaptability to both in-person and online delivery modes was highlighted as enhancing its accessibility and resilience. Conclusions: This study provides valuable insights into the factors contributing to the success of the Beat It program from the implementers’ perspective. The findings suggest that investing in comprehensive training for facilitators, particularly in group dynamics management, could benefit similar programs. While the program’s fully subsidized structure reduces financial barriers to entry, innovative strategies to enhance participant engagement and perceived value should be explored. The success of the online delivery mode indicates that hybrid models offering both in-person and virtual options could increase accessibility in future supervised, community-based exercise programs for T2DM management. Full article

In the early stages of the COVID-19 pandemic and the resultant stay-at-home mandates, local governments in some cities in the United States implemented programs in response to the pandemic. This article focuses on Slow Streets, which were several programs implemented in eleven cities (Los Angeles, Oakland, San Francisco, Seattle, Portland, Denver, Chicago, Minneapolis, Detroit, Boston, and New York) in the United States. The programs were intended to keep people healthy by providing temporary public spaces on residential roads where residents were allowed to exercise and socialize. Some practitioners characterized the programs as tactical urbanism or tactical placemaking and as agile responses to the public health crisis. The programs deserve a critical reflection, considering their potential impact on community health and the limited amount of the literature on the program in terms of design justice, which is an approach to design that prioritizes marginalized communities and challenges their structural inequality. This reflective study attempts to fill that gap in the literature of architecture and urban design. This article aims to examine whether the Slow Streets programs promoted design justice. To address that aim, we propose a social justice framework to evaluate the program, because social justice is essential to design justice. Data from publicly available information online about the eleven cities’ Slow Streets programs, interviews, surveys, focus groups, and the interdisciplinary literature support the qualitative research. The study outcomes suggest that the Slow Streets program had limited success because their attention to the priorities of underserved populations was ineffective. We argue that while the programs provided a timely response to the pandemic, the programs did not adequately address the vulnerability of low-income communities of color due to the limited consideration of design justice. Building on the lessons from social justice and human geography, the article concludes with recommendations for future practices including place-cultivating and human geography-informed design to better serve vulnerable communities of color. Full article

Background/Objective: Frailty is a growing public health challenge in Japan’s rapidly aging population, where 28.8% are aged ≥ 65. While multicomponent interventions have shown potential in preventing frailty, traditional face-to-face programs face accessibility challenges. This study evaluated the feasibility and short-term changes of an online multicomponent intervention on frailty-related factors among community-dwelling older adults. Methods: In this single-arm feasibility study, 132 participants (mean age 75.7; standard deviation 4.8 years, 65.2% women) completed a six-week online intervention combining exercise, nutrition education, cognitive activities, and the Coimagination Method to foster social connections, meeting weekly for 75 min sessions in groups of up to 10 participants. Results: The intervention demonstrated feasibility with a 96.4% retention rate and a 94.0% average participation rate. While no significant changes were observed in physical activity levels, autonomic nervous system indicators, or cognitive function, carotenoid scores and hemoglobin concentration improved significantly, with more pronounced improvements among women than men. Conclusions: This study demonstrates the high feasibility of online multicomponent interventions for older adults and suggests potential benefits for nutritional status markers, particularly among women. These findings indicate a promising and accessible approach to frailty prevention, though randomized controlled trials with longer intervention periods and direct frailty assessments are required to establish effectiveness conclusively. Study Trial registration: UMIN Clinical Trials Registry (UMIN000053089). Full article

Background: In Korea, substantial disparities exist in physical environments across regions, exacerbating the polarization between metropolitan and provincial areas and urban and rural regions. Objectives: This study examines the differences in the physical activity and self-rated health of local communities in relation to satisfaction with the physical environment. By identifying and addressing these underlying causes of health disparities, the study provides foundational data to inform policy efforts. Methods: The study utilized data from the 2023 Community Health Survey conducted by the Korea Disease Control and Prevention Agency. It included 231,752 individuals aged 19 and older (105,754 men and 125,998 women) selected through a two-stage probability proportional systematic sampling method. One-on-one online interviews were conducted from 16 May to 31 July 2023. The physical environment was assessed based on public satisfaction with safety, natural and living environments, public transportation, and medical services. Study variables included subjective health status and physical activity, with subvariables for physical activity encompassing the duration of vigorous and moderate physical activity, walking, and flexibility exercises. For data analysis, MANOVA and ANOVA were conducted, with Bonferroni correction for multiple comparisons. Results: Considerable variations in physical activity were observed based on satisfaction with the local community environment. Regarding self-rated health, significant differences were found in safety levels, living environment, and medical services. Satisfaction with the physical environment positively influenced physical activity and self-rated health. Conclusion: Therefore, it is imperative to reduce disparities in the physical environment between regions and enhance residents’ satisfaction. Full article