Search Results (57)

Background: Adapted Physical Activity (APA) prescription is a complex decision-making process that integrates clinical guidelines and individual patient characteristics and remains strongly dependent on clinician experience. Generative artificial intelligence (AI) has recently emerged as a potential decision-support tool in exercise prescription; however, its interaction with professional expertise is still unclear. This study compared the perceived quality of APA protocols developed by expert professionals, novice professionals supported by AI, and AI operating autonomously across multiple orthopedic conditions. Methods: In this observational cross-sectional study, five real orthopedic prescriptions (scoliosis, low back pain, osteoporosis, high risk of falls, and osteoarthritis) were used to generate three APA protocols per condition: expert professional (EP), novice professional with AI support (NAI), and AI alone. All protocols were created using an identical standardized prompt and anonymized. A multidisciplinary panel of 135 professionals blindly evaluated the protocols using a structured questionnaire assessing effectiveness, safety, appropriateness, clarity, and progression. Overall quality scores were compared using Friedman tests with post hoc Wilcoxon signed-rank tests. Results: Across all conditions, EP protocols achieved the highest quality scores, followed by NAI, while AI-alone protocols consistently received the lowest ratings (all p < 0.05). NAI protocols showed intermediate performance, partially reducing the expertise gap. Post hoc analyses showed that EP protocols received significantly higher rating than AI protocols in all conditions (p < 0.01). NAI protocols received significantly higher rating than AI protocols in most conditions (p < 0.01) except osteoporosis (p = 0.362). Differences between EP and AI were most pronounced for safety (p < 0.01), appropriateness (tailoring p < 0.01), and progression (p < 0.05), whereas EP–NAI differences were smaller and condition-dependent. AI-alone protocols showed greater variability across pathologies. Conclusions: Professional expertise remains the main determinant of APA protocol quality. AI support can improve protocol structure and perceived quality when used by novice professionals but does not replace expert clinical reasoning. AI-generated protocols without human oversight are not yet suitable for autonomous APA prescription, supporting a complementary, expertise-dependent role of AI in exercise programming. Full article

Over the past decade, given safety, reduced heart failure-related hospitalizations, and, above all, 5-year mortality rates nearly identical to those of heart transplants, left ventricular assist devices (LVADs) have increasingly become a treatment option for patients with advanced heart failure. However, improvements in functional capacity after LVAD implantation are minimal or modest, depending on pre-implantation right ventricular function, the patient’s hemodynamic status, the optimization of guideline-directed medical therapy, and noncardiac factors (physical deconditioning, skeletal muscle alterations, anemia, and alterations in alveolar gas exchange). Therefore, cardiac rehabilitation (CR) is a fundamental element from the early stages after LVAD implantation, as it is not only safe but also highly effective, leading to improved functional capacity and fewer episodes of worsening heart failure, and may be associated with reduced mortality. To perform safe and effective CR in patients with LVADs, it is crucial to account for the unique issues in this group. This includes the difficulty of detecting an arterial pulse with standard tools during CPR and the importance of closely monitoring the transmission line and LVAD controller to prevent unintended damage. Overall, the clinical trial indicates that exercise-based CR has the potential to improve functional capacity. Furthermore, some data suggest that CR is associated with fewer HF-related hospitalizations and may be linked to lower mortality; however, there is no consensus on this matter, partly because most studies supporting this assertion are observational. Full article

Background: People with multiple sclerosis (PwMS) face a wide range of social barriers, including stigma, limited support, and inaccessible environments, that restrict participation in physical activity (PA). Although PA is known to improve physical and psychological outcomes, its role in reducing social barriers has not been clearly synthesized. Methods: Following PRISMA 2020 guidelines, we conducted a systematic search of PubMed, Scopus, and Web of Science (January 1997–October 2025). Qualitative, quantitative, and mixed-methods studies examining how PA relates to social barriers, facilitators, or social outcomes for PwMS were included. Data were synthesized using a thematic analysis approach due to heterogeneity in study designs and outcomes. Risk of bias was assessed using JBI, NIH, RoB 2.0, and MMAT tools. Results: Twenty-nine studies met the inclusion criteria. The thematic synthesis identified three overarching mechanisms through which PA contributes to reducing social barriers: (1) peer support and shared experience, whereby group-based PA reduced isolation and normalized fluctuating symptoms; (2) guidance from knowledgeable professionals, which fostered trust, confidence, and perceived safety; and (3) changes in social identity, with participants shifting from a “sick role” toward identities such as “exerciser” or “athlete.” These mechanisms were supported by high-quality qualitative studies and by quantitative evidence showing small-to-moderate effect sizes for improvements in self-efficacy, social participation, and perceived social support. Conclusions: PA functions as a socially transformative practice for PwMS when delivered in group-based, supervised, and accessible formats. Programs designed to intentionally cultivate peer connection, professional support, and identity-building processes may be especially effective in overcoming social barriers and promoting social inclusion. Full article

As smart education evolves, there is an increasing need for the cloud-centric management and sharing of student exercise physiological data gathered through wearable devices in the physical education domain. However, challenges arise in achieving authentication for data sources, ensuring the security of sensitive data, and implementing efficient dynamic access control. Traditional cryptographic schemes face limitations in resisting quantum attacks, authenticating data sources, protecting identity privacy, handling dynamic permission changes, and computational efficiency. To tackle these challenges, we put forward a lattice-based Online/Offline Identity-Based Matchmaking Proxy Re-Encryption (OO-IB-MPRE) scheme. The scheme offers post-quantum security assurances grounded in lattice cryptography (under the LWE/ISIS assumptions); incorporates Identity-Based matchmaking encryption (IB-ME) to realize bidirectional identity matching, which not only enables identity authentication for data sources but also safeguards the sender’s identity privacy from exposure to other entities; leverages Proxy Re-Encryption (PRE) to support dynamic management of access control; and combines online/offline encryption to adapt to resource constrained sensors. The security of the OO-IB-MPRE scheme is verified under standard lattice assumptions to meet the security requirements of semi-selective privacy and authenticity. Performance analysis and experimental validation demonstrate that in comparison to existing lattice-based PRE schemes, the devised scheme shows notable advantages in both space and computational overhead. Therefore, the proposed OO-IB-MPRE offers a secure, efficient, and scalable solution for the sensitive health data in smart physical education. Full article

Pull-ups are a widely recognized exercise for training and assessing upper-body strength and muscular endurance, requiring coordinated activation of the latissimus dorsi, biceps brachii, forearm flexors, and core stabilizers. However, many individuals experience difficulty performing pull-ups due to inadequate grip strength or core stability. This study aimed to investigate the comparative effects of forearm-specific and core-specific training, combined with standardized pull-up routines, on upper-body performance indicators in physically inactive male students. Thirty participants (age = 21 ± 1.58 years) were randomly assigned to three groups (n = 10): pull-up plus interval training (PIT), pull-up plus forearm training (PFT), and pull-up plus core training (PCT). All groups performed identical pull-up-based programs for eight weeks, differing only in the supplemental exercises. Before and after the intervention, participants were tested for maximum pull-up repetitions, grip strength (both hands), and dead-hanging time. Significant improvements were found in all variables (p ≤ 0.009), with group differences in pull-up repetitions (p < 0.001) and right-hand grip strength (p = 0.004). The PFT group achieved the greatest gains, with a 222.5% increase in repetitions, 12% and 14.0% increases in right- and left-hand grip strength, and a 55.3% increase in hanging time. The PCT group showed moderate progress, while PIT yielded the smallest improvement. Forearm-specific training proved the most effective strategy for enhancing pull-up performance, grip strength, and endurance. Full article

This qualitative study explored physically fit women’s physical, psychological, and societal reasons for engaging in exercise through the lenses of objectification theory and self-determination theory. A phenomenological approach enabled an in-depth examination of the complexity of women’s experiences, including the challenges and successes associated with physical exercise. The participants’ narratives ranged from accounts of perseverance in exercising, despite societal expectations and gendered stereotypes, to expressions of a desire to live long, happy, and healthy lives. Eight key themes were identified: initial motivators for physical exercise, benefits of physical exercise, perseverance, definition of a successful workout, gendered barriers to physical fitness, physical fitness identity, cost of physical fitness pursuit, and appearance motives. The findings highlight how physical exercise fosters empowerment and psychological well-being, with benefits such as self-assurance and self-love supporting sustained motivation over time. This study deepens understanding of how women navigate fitness within a broader sociocultural context and illustrates how external motivators can evolve into intrinsic motivation centered on autonomy, competence, and personal well-being. Full article

Maintaining social adaptation in later life has become a key challenge amid China’s rapidly aging population. Using nationally representative data from the China Longitudinal Aging Social Survey (CLASS 2023), this study examined the relationship between physical exercise and social adaptation among 8913 older adults. Ordinary least squares regression and the Karlson–Holm–Breen decomposition method were applied to test both direct and mediating effects. The results showed that physical exercise significantly improved social adaptation ($\mathsf{\beta }$ = 0.452, p < 0.001), while aging identity played a partial mediating role, accounting for approximately 11.0% of the total effect. The association was stronger among those aged 80 and above, with lower education and income, without chronic diseases, and covered by social security. These findings suggest that physical exercise enhances social adaptation not only through physical benefits but also by strengthening psychological resilience and fostering a positive sense of aging, providing valuable evidence for developing inclusive aging policies and targeted exercise interventions. Full article

This study examined the effect of long-term physical activity during the finishing period on meat and fat quality, and metabolic gene expression in obese Alentejano (AL) pigs. From 87.3 to 161.6 kg BW and for 130 days, eighteen pigs were assigned to either individual pens without an exercise area (NE, n = 9) or an outdoor park with an exercise area (WE, n = 9). Both groups received identical commercial diets at 85% ad libitum intake. Loin (Longissimus lumborum—LL), tenderloin (Psoas major—PM), and dorsal subcutaneous fat samples were obtained at slaughter, and analyzed for fatty acid composition and gene expression. Physical activity modulated the fatty acid profile and key metabolic genes in muscle and fat tissues. WE pigs showed higher palmitoleic (p = 0.031) and linolenic (p = 0.022) acids in LL, while Fatty acid synthase and Leptin in LL were downregulated (p = 0.071 and p = 0.018, respectively); Fatty acid binding protein 4 was downregulated (p = 0.003) and Stearoyl-CoA desaturase upregulated (p = 0.020) in the PM of WE pigs, indicating changes in lipid metabolism. Also, Myosin heavy chain 7 was upregulated (p = 0.016) in LL, suggesting oxidative muscle remodeling. These findings suggest that moderate, long-term physical activity during finishing induces modest but favorable metabolic adaptations in muscle and fat tissues without compromising meat quality in AL pigs, supporting its use in traditional rearing systems aimed at balancing animal welfare and product quality in local breeds. Full article

Background: Irisin, a myokine secreted during physical activity, has garnered attention for its potential roles in cartilage homeostasis and musculoskeletal health. Whole-body electromyostimulation (WB-EMS) is an emerging exercise modality that enhances muscle recruitment and may stimulate greater irisin release. This study aimed to compare the acute serum irisin response following aerobic exercise with and without WB-EMS in healthy individuals. Methods: A total of 24 healthy adults were enrolled and randomized to undergo either aerobic physical activity (PA) or WB-EMS (n = 12 each). Both groups performed identical exercise routines, with the WB-EMS group additionally receiving muscle stimulation via a standardized protocol. Serum irisin levels were measured at baseline (T0), 10 minutes post-exercise (T1), and 1 hour post-exercise (T2) using ELISA. Statistical analysis was performed using two-way ANOVA with post hoc testing. Results: At T1, serum irisin levels did not significantly differ from baseline in either group. At T2, the WB-EMS group demonstrated a statistically significant increase in irisin levels compared to both T0 and T1 (p < 0.01), as well as to the PA group (p < 0.01). In contrast, the PA group showed only a slight, non-significant rise at T2. These findings suggest that WB-EMS induces a more robust irisin response than traditional aerobic exercise. Conclusions: WB-EMS appears to enhance irisin release in healthy individuals following acute exercise. These results support further research into WB-EMS as a novel strategy to modulate myokine production with potential therapeutic relevance in musculoskeletal conditions such as osteoarthritis. Full article

The Red River Jig is a traditional Métis dance practiced among Indigenous and non-Indigenous Peoples. While exercise improves physical health and fitness, the impacts of cultural dances on wholistic health are less clear. This study aimed to investigate the psychosocial (cultural and mental), social, physical function, and physical fitness benefits of a Red River Jig intervention. In partnership with Li Toneur Nimiyitoohk Métis Dance Group, Indigenous and non-Indigenous adults (N = 40, 39 ± 15 years, 32 females) completed an 8-week Red River Jig intervention. Social support, cultural identity, memory, and mental wellbeing questionnaires, seated blood pressure and heart rate, weight, pulse-wave velocity, heart rate variability, baroreceptor sensitivity, jump height, sit-and-reach flexibility, one-leg and tandem balance, and six-minute walk test were assessed pre- and post-intervention. Community, family, and friend support scores, six-minute walk distance (553.0 ± 88.7 m vs. 602.2 ± 138.6 m, p = 0.002), jump, leg power, and systolic blood pressure low-to-high-frequency ratio increased after the intervention. Ethnic identity remained the same while affirmation and belonging declined, leading to declines in overall cultural identity, as learning about Métis culture through the Red River Jig may highlight gaps in cultural knowledge. Seated systolic blood pressure (116.5 ± 7.3 mmHg vs. 112.5 ± 10.7 mmHg, p = 0.01) and lower peripheral pulse-wave velocity (10.0 ± 2.0 m·s⁻¹ vs. 9.4 ± 1.9 m·s⁻¹, p = 0.04) decreased after the intervention. Red River Jig dance training can improve social support, physical function, and physical fitness for Indigenous and non-Indigenous adults. Full article

This paper clarified the correlation among quality of life (QoL) indicators, exercise implementation level, and exercise habits in middle-aged and older adults under identical exercise intervention conditions. The survey items were anthropometric and physiologic measurements, physical strength measurements, and exercise habits. During the 3-month experimental period, a weekly “health exercise course” served as the primary intervention. For all participants, anthropometric and physiologic measurements, physical strength tests, questionnaire surveys, and other surveys were conducted before and after the experiment; then, the pre- and post-intervention effects were compared. After the exercise intervention, significant differences were observed among middle-aged and older adults in terms of various parameters, such as weight, fat rate, diastolic pressure, systolic pressure, sit-up, standing on one foot, lower limb extension force, activity of daily living (ADL), and subjective well-being (PGC). ADL and PGC changed significantly in the participants who engaged in exercise more than twice a week. However, the participants who engaged in exercise for less than twice a week showed no significant differences in any parameters except the life satisfaction (LSI) mean; the LSI increased in the “Less than twice a week” exercise group but decreased in the “More than twice a week” group. In terms of average walking time per session, the “More than 30 min” exercise group showed significant differences in ADL and PGC, whereas the “Less than 30 min” group showed significant differences only in the LSI. The influence of exercise on QoL indicators of middle-aged and older adults, under the same exercise intervention conditions, is related to their exercise habits. This study highlights the benefits of physical exercise in middle-aged and older adults, emphasizing the importance of regular and sustained exercise for this population. Furthermore, the study provides a scientific basis for improving QoL in middle-aged and older adults, thus, to some extent, addressing the concerns related to the growing population of older adults. Full article

Background: Beach volleyball (BVb) is a highly demanding Olympic sport characterized by intense physical activity and unique environmental challenges, including varying weather conditions and sandy, unstable court surfaces. Despite its popularity, there is a notable lack of scientific research addressing the metabolic and immune responses of elite female athletes in this sport. This study aims to address this gap by investigating two world-class Olympic medalists, female BVb players, who represent a country with a rich history in the sport. Methods: Two athletes underwent a simulated competition day consisting of two matches. A standardized protocol was utilized to collect blood and urine samples at seven time points, allowing for analysis throughout the competition and recovery phases. The analysis included various electrolytes, as well as hematological, metabolic, and inflammatory markers. Additionally, we assessed selected hormones, such as insulin, serotonin, ACTH, and cortisol, along with amino acids related to energy metabolism and neurotransmitter synthesis. Results: Both athletes presented a trend toward electrolyte disturbances, especially hypokalemia, with a mean decrease of 15% and individual values reaching as low as 3.3 mmol/L post-match. This indicates that BVb may pose a risk for such disturbances. Additionally, the matches led to 20% to 60% increases in muscle injury markers, with incomplete recovery even after a day of rest, signaling persistent physiological stress post-competition. This increase was matched by stimulating stress hormones (ACTH and cortisol rose up to 4-fold and 3-fold, respectively), and markers of exercise intensity, such as lactate and ammonium. Moreover, the simulated BVb competition day impacted the amino acid response, with the Fischer ratio (BCAA/AAA) and blood tryptophan decreasing to a minimum of 60% of the initial levels and blood serotonin increasing by up to 180%, which are signs of an increased risk of central fatigue onset, according to the Fischer and Newsholme theory. Conclusions: The responses examined in this exploratory study contribute to a deeper understanding of the metabolic and immune demands placed on elite female BVb players, suggesting practical applications. By addressing the similar physiological responses observed among the athletes and emphasizing their unique individual responses—despite following the same protocol under identical conditions and sharing similar life habits for an extended period—this study highlights the critical necessity for the n-of-1 monitoring of athletes. Full article

Background/Objectives: Nasal irrigation with isotonic seawater is a known and oft-used treatment for nasal obstruction in patients with acute and chronic nasal inflammatory disease undergoing therapy with intranasal corticosteroids and antihistamine drugs. Nasal patency in healthy athletes is extremely important; however, to date, the effect of isotonic solutions for nasal irrigation in healthy athletes has not been tested. This randomized controlled trial aimed to investigate the potential synergy of physical exercise and nasal isotonic seawater on airflow and the subjective assessment of nasal patency in healthy, high-level athletes. Methods: The intervention group included 33 healthy athletes who used an isotonic seawater nasal spray daily, with a control group including 31 healthy athletes who did not use any sprays; both groups underwent identical seven-day training periods. The primary outcome measures were subjective NOSE questionnaire scores and secondary peak nasal inspiratory flow (PNIF) measures, while anthropometric and demographic variables were covariates. Results: A significant decrease in subjective nasal resistance scores was observed in the intervention group compared to the control group (binary logistic regression model, p = 0.006, RR 7.695), both in the first and second measurement interval. This effect increased with time (Friedman’s two-way analysis of variance, p < 0.001). Peak nasal inspiratory flow is positively affected by exercise but not by isotonic seawater spray intervention. Conclusions: The effects of nasal isotonic seawater irrigation during intense athletic training are beneficial on subjective nasal patency in the short term, while the effects on objective nasal patency are less clear. Full article

Increasing attention has been paid to the therapeutic effect of gardens on older persons in long-term care homes. However, problems on set up and reliability of implementation were still of concern in studies. This study investigated residents’ experiences of Virtual Zen Garden in Hong Kong. Twenty-four residents were interviewed using semi-structured interviews based on the phenomenological research approach in two long-term care homes. This study aligns with the COREQ (Consolidated Criteria for Reporting Qualitative Research Checklist). Nine theme clusters were organized that described the influence of Virtual Zen Garden on residents’ quality of life in long-term care homes. They are ‘staying engaged despite no change in physical condition’, ‘embracing current physical functioning’, ‘being the one to exercise autonomy’, ‘fostering a sense of relaxation and acceptance to the past, current and future lives’, ‘fostering a sense of satisfaction, purpose and mastery’, ‘open to companionship with staffs’, ‘feeling a sense of connection with other residents’, ‘perceiving a sense of security and identity in the living environment’ and ‘accepting the place they stay as a home in the rest of life’. Virtual Zen Garden demonstrated positive beneficial effect on quality of life in physical, psychological, social, and environmental perspectives. The findings were encouraging for the introduction of Virtual Zen Garden as an innovative intervention, into long-term care homes. Full article

Background and Aims: Post-exercise recovery strategies include massage, low-intensity active exercise, thermal contrast, hydration, and nutritional and herbal approaches. These strategies aim to accelerate recovery, enhance performance, and optimise the physical training process. L-arginine (L-ARG) is the physiological precursor of nitric oxide (NO), a crucial mediator of vasodilation and the inhibition of platelet aggregation. A previous study reported that L-ARG supplementation could significantly reduce the systolic blood pressure (SBP) and diastolic blood pressure (DBP). This study aimed to investigate the effects of L-ARG on autonomic and cardiovascular recovery immediately following submaximal exercise. Methods and Results: Thirty-two healthy individuals were subjected to two experimental protocols. The first protocol included 60 min of rest, a treadmill warm-up, and load increments until reaching 80% of their maximum HR. Before this protocol, the subjects consumed 3 g of starch (placebo protocol). The second protocol was identical, but the subjects consumed 3 g of L-ARG. Heart rate recovery (HRR), heart rate variability (HRV), and blood pressure (BP) responses were assessed. No significant differences in HRR were found (p = 0.944) regarding the root mean square of successive differences in the RR interval (RMSSD30) of HRV (p = 0.562) or in the BP responses (mean arterial pressure (MAP), p = 0.687; pulse pressure (PP), p = 0.929) between the protocols. Conclusions: L-ARG supplementation did not significantly alter immediate post-exercise autonomic recovery in healthy males. Full article