Exercise
Physical activity timing and intensity effects on sleep architecture.
Moderate-intensity aerobic exercise (150 min/week) significantly improves sleep quality in adults with chronic insomnia
A 4-week RCT found 150 min/week of moderate aerobic exercise significantly improved PSQI scores and objective sleep measures in adults with chronic insomnia. Exercise is recommended as a first-line behavioral intervention for insomnia.
Mind-body exercise combined with aerobic exercise is most effective for sleep disorders in Chinese adolescents
A network meta-analysis of 14 RCTs with 1,375 participants found that the combination of aerobic and mind-body exercise (AE+ME) had the highest probability (SUCRA=87.1%) of being most effective for improving sleep disorders in Chinese adolescents. Mind-body exercise alone (ME) also showed strong effectiveness (SUCRA=71.3%). The optimal regimen was 40-60 min sessions, ≥5 times per week, for less than 8 weeks, with moderate certainty evidence.
Combined endurance and resistance exercise training improves peak oxygen consumption, quality of life, and six-minute walk test performance in heart failure patients, but does not significantly affect sleep parameters or depression levels.
A meta-analysis of 9 studies found that combined endurance and resistance exercise training significantly improved peak oxygen consumption (MD=4.36, 95% CI: 1.68-7.04, P=0.001), quality of life (MD=-9.32, 95% CI: -16.92 to -1.71, P=0.02), and six-minute walk test performance (MD=53.76, 95% CI: 38.81-68.70, P<0.0001) in heart failure patients. However, no statistically significant effects were observed on sleep parameters or depression levels.
Mind-body exercise at 500 METs-min/week may be the most effective exercise modality and dose for improving sleep quality in breast cancer survivors after primary treatment.
A systematic review and dose-response network meta-analysis of 24 studies with 1495 breast cancer survivors found an inverted U-shaped relationship between exercise dose and sleep quality, with an effective range of 0 to 1100 METs-min/week and peak effect at 780 METs-min/week (SMD=0.7, 95% CrI: 0.38-1.06). Stratified by modality, mind-body exercise at 500 METs-min/week showed the largest effect (SMD=1.06, 95% CrI: 0.3-1.83), while aerobic and combined aerobic-resistance training also significantly improved sleep quality but with smaller effects.
Aerobic exercise improves sleep-related outcomes in children and adolescents
A meta-analysis of 14 randomized controlled trials found that aerobic exercise was associated with improved sleep-related outcomes in children and adolescents (SMD = 0.91, 95% CI: 0.40-1.43). However, considerable heterogeneity (I² = 91.5%) and a prediction interval crossing the null (-0.98 to 2.80) indicate uncertainty in the magnitude and consistency of the benefit.
Aerobic intradialytic exercise reduces general fatigue and improves health-related quality of life compared to resistance intradialytic exercise in hemodialysis patients.
In a randomized controlled trial of 35 hemodialysis patients, aerobic exercise during dialysis was significantly more effective than resistance exercise in reducing general fatigue (MD: 2.2; 95% CI: 0.4-4.0) and improving health-related quality of life utility (MD: -0.04; 95% CI: -0.10 to -0.04). No significant between-group differences were found for handgrip strength or other secondary outcomes.
A single bout of moderate-intensity aerobic exercise following acute sleep restriction enhances psychological aspects of daytime functioning but does not improve neurocognitive function.
In a randomized controlled trial, 56 adults who were sleep-restricted to 4 hours performed either moderate-intensity aerobic exercise or seated rest. The exercise group reported significantly increased energy (d=0.69) and arousal (d=0.94), and decreased fatigue (d=-0.79) and sleepiness (d=-0.95) compared to controls. No significant differences were found in neurocognitive measures (P3 amplitude, latency, accuracy, reaction time).
Tai Chi reduces pain and improves functional disability in patients with chronic nonspecific low back pain, but does not significantly improve sleep quality.
A meta-analysis of 8 RCTs involving 526 patients found that Tai Chi significantly reduced pain (VAS: MD = -1.40, 95% CI: -2.41 to -0.40) and improved functional disability (RMDQ: MD = -1.67, 95% CI: -2.75 to -0.59). However, improvements in sleep quality measured by PSQI were not statistically significant (MD = -0.18, 95% CI: -1.82 to 1.45).
Ecological momentary interventions increase daily moderate-to-vigorous physical activity in older adults
A systematic review and meta-analysis of 12 studies found that ecological momentary interventions significantly increased daily moderate-to-vigorous physical activity in older adults (SMD = 0.24, 95% CI 0.09 to 0.39, p = .002, I² = 0%). Narrative analysis also suggested potential improvements in sleep quality and sleep efficiency, but no significant effects on sedentary behavior were observed.
Exercise plus cognitive behavioral therapy improves subjective sleep quality and sleep continuity in insomnia patients
In a network meta-analysis of 31 RCTs with 2,457 participants, exercise combined with cognitive behavioral therapy (EX + CBT) ranked highest for improving Pittsburgh Sleep Quality Index (PSQI), sleep onset latency (SOL), and wake after sleep onset (WASO). Compared to conventional control, EX + CBT showed significant effects on PSQI, SOL, and WASO, but no intervention significantly increased total sleep time.
Lifestyle interventions, primarily physical activity, produce a small reduction in depressive symptoms in informal caregivers of older adults
This meta-analysis of 21 randomized controlled trials (N=2,099) found that lifestyle interventions, mostly physical activity-based, led to a small but significant reduction in depressive symptoms (SMD = -0.34, 95% CI -0.47 to -0.20). However, no consistent effects were observed for physical activity, sleep quality, caregiving burden, stress, or self-rated health. Subgroup analyses indicated that only hybrid interventions combining in-person sessions with technology-supported monitoring showed significant reductions in depressive symptoms.
Physical activity interventions improve multiple developmental outcomes in children and adolescents with autism spectrum disorder, with an overall adjusted effect size of g=0.58.
This second-order meta-analysis of 34 first-order meta-analyses found that physical activity interventions yield significant positive effects across developmental domains in children and adolescents with ASD, with an overall adjusted effect size of g=0.58. The largest effects were observed for motor skills and sleep quality, while executive function and cognitive outcomes showed more modest effects. Outdoor activities and ball sports showed larger pooled effects than other intervention types.
Traditional Chinese exercises, especially Tai Chi, improve physical function, pain, mental health, sleep quality, and bone mineral density in patients with musculoskeletal disorders.
This umbrella review of 92 meta-analyses (1744 RCTs) found high-certainty evidence that traditional Chinese exercises (TCEs) significantly improve physical function in knee osteoarthritis, mental health in knee osteoarthritis and neck pain, and sleep quality in fibromyalgia. Tai Chi significantly alleviated chronic MSD-related pain and stiffness and increased bone mineral density in osteopenia/osteoporosis. Longer duration, higher frequency, and moderate-to-high weekly volume were associated with greater clinical gains.
Acute caffeine supplementation may slightly improve maximal strength and may benefit muscular endurance in some protocols in female participants, but certainty of evidence is low or very low for most outcomes.
A systematic review and three-level meta-analysis of 24 studies (23 in quantitative synthesis, 107 effect sizes) found a small mean effect of caffeine on maximal strength (g = 0.17, 95% CI 0.06 to 0.29; low GRADE) and a larger mean effect on muscular endurance (g = 0.54, 95% CI 0.06 to 1.02; low GRADE), but the latter had a wide prediction interval indicating low reproducibility. Movement speed showed a small, uncertain estimate (g = 0.13; CR2 p = 0.072; very low GRADE), and other domains were not pooled due to insufficient clusters.
Structured exercise interventions improve overall sleep quality in university students as measured by the PSQI global score
A meta-analysis of 7 randomized controlled trials (701 participants) found that structured exercise significantly reduced the PSQI global score compared to non-exercise controls (MD = -2.43, 95% CI -3.72 to -1.14). However, the prediction interval included the null value, and certainty of evidence was very low, indicating substantial uncertainty in the effect.
Lifestyle interventions improve 24-hour movement behaviors in preschool children
Lifestyle interventions were associated with increases in moderate-to-vigorous physical activity (MD 5.77 min/day) and sleep duration (MD 0.18 h/day), and reductions in sedentary behavior (MD -7.62 min/day) and screen time (MD -0.33 h/day) in preschool children aged 2-6 years. However, heterogeneity was substantial and the certainty of evidence was low.
Mindfulness-based exercise improves motor function and certain cognitive domains in Parkinson's disease patients
This meta-analysis of 28 studies found that mindfulness-based exercise (MBE) significantly improved motor function (UPDRS-III: MD -4.74, 95% CI [-6.78, -2.70]) and cognitive function (MoCA: MD 1.93, 95% CI [1.12, 2.74]; MMSE: MD 2.80, 95% CI [0.32, 5.29]) in Parkinson's disease patients. However, no significant improvements were observed for non-motor symptoms like depression, sleep, or quality of life.
Exercise interventions improve sleep quality in patients with depression
This meta-analysis of 17 RCTs with 1,457 participants found that exercise interventions significantly improved sleep quality in patients with depression (SMD = -0.37, 95% CI: -0.48 to -0.27). Dose-response modeling suggested that exercise doses around 312.75 MET·min/week may yield greater improvements (Hedges' g = -0.51, 95% CI: -0.71 to -0.31).
Exercise plus cognitive behavioral therapy (EX + CBT) improves subjective sleep quality and sleep-continuity parameters in insomnia patients
In a network meta-analysis of 31 RCTs with 2,457 participants, exercise combined with cognitive behavioral therapy (EX + CBT) ranked highest for improving Pittsburgh Sleep Quality Index (PSQI), sleep onset latency (SOL), and wake after sleep onset (WASO). Compared to conventional control, EX + CBT showed significant effects on PSQI, SOL, and WASO, but no intervention significantly increased total sleep time.
Tai Chi/Qigong, yoga, and combined exercise improve sleep quality in individuals with breast cancer
A Bayesian network meta-analysis of 39 RCTs with 4066 participants found that Tai Chi/Qigong showed the largest sleep benefit (Hedges' g = -0.45, 95% CrI: -0.86 to -0.04), followed by yoga and combined exercise (both g = -0.30) compared to active controls. Dose-response analyses suggested optimal benefits at moderate doses around 4.5 METs, 281.3 MET·min/session, and 910 MET·min/week.
Physical exercise improves sleep quality in patients with psychiatric disorders.
A systematic review and meta-analysis of 21 RCTs (1628 participants) found that physical exercise significantly improves sleep quality in patients with psychiatric disorders, with a moderate overall effect size (g = -0.57, 95% CI: -0.75 to -0.38, P < 0.001). Larger effects were observed for aerobic modalities (g = -0.69), low-to-moderate intensity (g = -0.70), and frequency of ≥3 sessions per week (g = -0.60).
Baduanjin exercise improves sleep quality in older adults
A systematic review and meta-analysis of 18 randomized controlled trials with 1,527 participants found that Baduanjin significantly improved sleep quality (MD = -2.81, 95% CI: -3.38 to -2.24, p < 0.001). The intervention also reduced depressive symptoms and improved quality of life, body composition, and handgrip strength.
Evening/nighttime exercise is associated with higher wake after sleep onset (WASO) compared to morning exercise, indicating a modest effect on sleep continuity.
A meta-analysis of 16 randomized controlled trials found that evening/nighttime exercise was associated with higher wake after sleep onset (WASO) compared to morning exercise (SMD = -0.51, 95% CI [-0.89, -0.12]), indicating a modest effect on sleep continuity. However, this finding should be interpreted with caution due to potential small-study effects. Overall, the evidence does not indicate a clear advantage of morning over evening exercise for most sleep outcomes.
Physical activity participation is associated with lower obesity risk in male Saudi adolescents
Physically active male Saudi adolescents had significantly lower BMI (23.64 vs. 30.28 kg/m2), waist circumference (85.46 vs. 97.35 cm), and waist-to-height ratio (0.488 vs. 0.562) compared to inactive peers. Obesity prevalence by IOTF criteria was 17.1% in active vs. 51.9% in inactive, and abdominal obesity was 31.4% vs. 72.2%.
A single session of resistance exercise does not markedly alter sleep architecture in young males, regardless of regimen type (maximum strength vs. hypertrophy training).
This study compared the effects of maximum strength training (MST) and hypertrophy training (HYP) on sleep quality in 11 young males. MST significantly reduced REM sleep time compared to a control condition, but no other sleep parameters (total sleep time, sleep efficiency, sleep onset latency, wake after sleep onset, non-REM sleep) differed significantly. The findings suggest that a single bout of resistance exercise, whether strength- or hypertrophy-focused, does not substantially change overall sleep architecture.
Correction notice for the article on Baduanjin exercise effects on sleep quality, depressive symptoms, quality of life, and body composition in older adults.
This paper is a correction notice for a previously published systematic review and meta-analysis (DOI: 10.3389/fpubh.2026.1882039). It does not present new findings but corrects errors in the original article. The original article reported that Baduanjin exercise improved sleep quality, depressive symptoms, quality of life, and body composition in older adults.
Meditation and breathing exercises may improve quality of life in patients with eye diseases
A systematic review of seven studies (six RCTs and one single-arm trial) found preliminary evidence that meditation and breathing exercises improve quality of life, anxiety, depression, and sleep quality in patients with eye diseases. However, the evidence is limited by concerns with study quality and short follow-up durations.
Baduanjin exercise alleviates anxiety, depressive symptoms, and improves sleep quality and quality of life in patients with primary glaucoma
An 8-week Baduanjin exercise intervention (5 sessions per week, 30 min each) significantly improved anxiety (HADS-A), depressive symptoms (HADS-D), and sleep quality (PSQI) compared to routine care in patients with primary glaucoma. Benefits were more pronounced in patients with higher baseline symptom levels. The intervention also improved domain-specific quality of life, particularly glare/dark adaptation and outdoor mobility.
A psycho-behavioural intervention reduces cancer-related fatigue in post-treatment colorectal cancer patients
In a pilot RCT of 50 post-treatment colorectal cancer patients, a 6-week psycho-behavioural intervention significantly reduced cancer-related fatigue compared to usual care (F=6.49, p=0.014, Hedges' g=-0.71). The intervention also improved physical activity, dietary behaviours, and sleep disturbance, but not anxiety or depressive symptoms.
Niacin ingestion during exercise suppresses fatty acid availability and increases carbohydrate oxidation, but does not detectably influence post-exercise energy intake.
In a crossover study of 15 healthy participants (5 female), niacin ingestion during cycling suppressed plasma NEFA concentrations and total fat oxidation (mean difference vs fasted: -9±5 g, p=0.001), similar to carbohydrate ingestion. Niacin increased plasma GLP-1 total concentrations compared to fasting, but ad libitum energy intake two hours post-exercise did not differ between conditions (FAST 833±206 kcal, CARB 786±219 kcal, NIACIN 780±158 kcal, p=0.37).
Early home-based pulmonary rehabilitation is feasible and safe for post-hospitalisation exertional hypoxaemia patients, but adding high-flow nasal oxygen reduces adherence.
This pilot feasibility trial found that a 3-week home-based pulmonary rehabilitation program for patients with exertional hypoxaemia after hospital discharge had 67% acceptance and 62% uptake. However, the addition of high-flow nasal oxygen during exercise training was associated with lower program completion (60% vs 89%) and reduced adherence to self-directed sessions.
Home-based remotely supervised high intensity interval training (HIIT) improves aerobic fitness and reduces fat mass in older adults
In older adults (61-74 years), 8 weeks of home-based remotely supervised HIIT on an all-extremity non-weight-bearing ergometer increased maximal oxygen consumption by 4.5 ml·kg⁻¹·min⁻¹ and decreased fat mass by 1.4 kg, while no adverse events occurred and 96% of sessions were completed. Aerobic fitness declined during the control period but improved significantly after HIIT.
Home-based, remotely monitored pulmonary rehabilitation increases moderate-to-vigorous physical activity in patients with idiopathic pulmonary fibrosis on antifibrotic therapy
In a randomized controlled trial of 29 patients with IPF, a 12-week home-based, remotely monitored exercise program increased daily moderate-to-vigorous physical activity (MVPA) by 28% in the intervention group, while the control group decreased by 35% (p=0.001 for group*time interaction). The intervention group's improvement of 49±19 min/week was nearly double the minimal clinically important difference for IPF. The program was feasible with 100% completion, 92% adherence, and no adverse events.
Evening high-intensity interval training (HIIT) and moderate-intensity interval training (MIIT) produce similar acute changes in circadian core body temperature mesor and phase in adults with obesity, with a borderline non-significant difference in amplitude change.
In a randomized crossover trial of 9 adult males with obesity, evening HIIT (~30 min at 90% HRR) and MIIT (~50 min at 60% HRR) both produced approximately one-hour phase advances in circadian core body temperature rhythm. The change in circadian temperature amplitude differed in direction between conditions (MIIT -0.01 ± 0.19 °C; HIIT +0.12 ± 0.24 °C) but did not reach statistical significance (p = 0.060, d_z = 0.73).
Adding supervised exercise to ergonomics training does not provide statistically significant additional benefit over ergonomics training alone for pain intensity in construction workers with work-related musculoskeletal disorders.
In a 12-week randomized controlled trial of 52 male construction workers with musculoskeletal complaints, both ergonomics training plus exercise and ergonomics training alone significantly improved pain, fatigue, sleep quality, and symptom burden from baseline. However, the between-group difference in pain intensity was not statistically significant (adjusted difference -0.34, 95% CI -0.99 to 0.32), and no significant incremental effect of added exercise was found on any secondary outcome.
A structured recreational exercise program reduces digital addiction and improves sleep quality in children aged 10-14
An 8-week recreational exercise program (3 sessions per week) significantly reduced digital addiction levels and improved sleep quality in 40 children aged 10-14, with large effect sizes. Improvements were maintained at a 6-week follow-up, while the control group showed no significant changes.
Evening endurance exercise performance is superior to morning performance, and circadian phenotype is associated with the magnitude of this diurnal variation.
In 24 healthy young adults, a 10-min cycling time trial showed significantly higher mean power, peak power, and distance covered in the evening (17:00-18:00) compared to morning (08:00-09:00). Chronotype and sleep midpoint accounted for 22% and 27% of the variance in the morning-evening performance difference, respectively.
Six weeks of exercise training improves parasympathetic heart rate variability in obese adults, but the effect on sympathetic HRV differs by obstructive sleep apnea severity
In obese adults, a six-week supervised exercise program improved cardiorespiratory fitness and parasympathetic HRV (VLF%, HF%) across the sample. However, an interaction effect showed that SDNN increased in those with no/mild OSA but decreased in those with moderate/severe OSA, suggesting insufficient sympathetic improvement in the latter group.
Intravenous lidocaine does not provide additional pain reduction beyond placebo in probable nociplastic chronic low back pain
In a randomized equivalence trial, 84 adults with probable nociplastic chronic non-specific low back pain received either intravenous lidocaine or saline placebo, both alongside multimodal pain management. At 3 months, the between-group difference in VAS pain was 0.24 (90% CI -0.33 to 0.81), within the prespecified equivalence margin of ±1.5, confirming therapeutic equivalence. Lidocaine did not improve pain but did improve sleep quality (mean difference in change score 1.81; 95% CI 0.49-3.14; p=0.027).
Nature-based exercise therapies (surf or hike) reduce residual depression symptoms in service members with MDD, but sleep difficulties, low energy, and appetite changes commonly persist even among those who lose their diagnosis
In a secondary analysis of an RCT comparing weekly surf or hike therapy among 96 active duty service members with MDD, both interventions significantly improved depression symptoms. Among 88 completers, loss of MDD diagnosis reduced odds of most residual symptoms (ps ≤ .039), but sleep difficulties (56%), low energy (38%), and appetite changes (22%) remained common at postprogram even in those who lost diagnosis. Exercise type did not affect residual symptom odds.
Combined early in-bed cycling and intravenous amino acid supplementation does not improve 6-minute walk distance in patients with acute respiratory failure.
In a multicenter phase 2 RCT of 115 patients with acute respiratory failure, the intervention group received in-bed cycling (mean 40 min/d) and intravenous amino acid (total protein 1.9 g/kg/d) plus usual care, while controls received usual care alone (protein 0.9 g/kg/d). The median 6-minute walk distance at hospital discharge was similar between groups (108 m vs 95 m, P=0.51), and secondary outcomes also showed no significant differences.
Progressive relaxation exercises reduce postoperative pain and improve sleep quality in patients undergoing total knee replacement surgery
In a randomized controlled trial of 96 patients undergoing total knee replacement, progressive relaxation exercises led to significantly faster and greater reductions in postoperative pain (F=14.11, P=.000, η²=0.131) and significantly greater improvements in sleep quality (F=14.22, P<.001, η²=0.131) compared to control. Recovery index scores also improved more in the intervention group (F=6.531, P=.000, η²=0.065).
Qigong (Baduanjin) intervention reduces cesarean section rate in pregnant women
This multicenter RCT protocol aims to evaluate whether adding a qigong (Baduanjin) intervention to standard prenatal care and lifestyle education reduces the cesarean section rate compared to standard care alone. The study plans to enroll 1062 pregnant women aged 18-45 with singleton pregnancies at 11-13+6 weeks gestation across 11 centers in China.
Total physical activity moderates the effect of exercise type on high-altitude acclimatization among college students
In a cluster-randomized controlled trial, 295 college students at high altitude participated in either basketball or badminton for 18 weeks. The effect of exercise type on high-altitude acclimatization was significantly moderated by total physical activity (interaction B = -2.9965, p = 0.0056), with badminton showing better adaptation than basketball only at high activity levels. Sleep quality did not mediate this relationship.
Parent-mediated screen time usage module reduces screen time and improves sleep quality in children with borderline IQ
A randomized controlled trial of 60 children with borderline IQ found that a parent-mediated screen time usage module (PM-STUM) significantly reduced screen time (η²p=0.4), improved sleep quality (η²p=0.3), increased physical activity (η²p=0.2), and reduced behavioral difficulties (η²p=0.2) compared to controls at 6 weeks postintervention.
High-intensity interval training-based virtual reality exergaming improves inhibitory control and inattention symptoms in adolescents with ADHD compared to an active, nonexercise VR control condition
This protocol describes an ongoing RCT testing whether HIIT-based VR exergaming (Move Sapiens) produces greater improvements in inhibitory control and inattention than an active VR control without vigorous exertion in 98 adolescents with ADHD. As of April 2026, 58 participants have been enrolled, with 79.3% completing the intervention. Results are expected by December 2026.
LLM-driven coaching prompts grounded in the Transtheoretical Model of Change increase daily step count compared to generic prompts in adults at risk for cardiovascular disease.
This study will test whether personalized text-based coaching prompts generated by a large language model (LLM) increase daily step count more than generic prompts. The primary endpoint is change in daily step count over each intervention week in a randomized crossover trial with 15,000 adults across the US and UK. Recruitment began in March 2026 and is ongoing.
PhYoMind intervention (physiotherapy-integrated yoga and mindfulness) plus home exercise improves disease impact and functional impairment in fibromyalgia syndrome compared to home exercise alone
This protocol describes an 8-week randomized controlled trial (n=40) comparing PhYoMind (physiotherapy, yoga, and mindfulness) plus home exercise versus home exercise alone in individuals with fibromyalgia syndrome. The primary outcome is the Fibromyalgia Impact Questionnaire total score, with secondary outcomes including sleep quality, pain, fatigue, and autonomic function. The study is powered at 80% with an effect size of Cohen's f=0.675.
Presleep whey protein ingestion improves sleep quality after resistance exercise compared with an isocaloric control in resistance-trained individuals
In a randomized, double-blind, crossover trial of nine resistance-trained young adults, consuming 40 g of whey protein 30 minutes before bed significantly improved sleep-onset latency (9.0 vs 19.0 min), sleep efficiency (96% vs 93%), total sleep time (400 vs 363 min), and subjective sleep rating (8.0 vs 6.0) compared with an isocaloric maltodextrin control. Whey also reduced delayed onset of muscle soreness at 12 and 24 hours post-training.
A 20-min exercise session and a 90-min nap both preserve episodic memory encoding after 30 hours of sleep loss, with distinct neural mechanisms.
In a randomized controlled trial, both a 20-min exercise session and a 90-min nap improved episodic memory encoding after 30 hours of sleep deprivation by an average of 22% compared to a no-intervention control. EEG revealed that napping reduced neural fatigue and sleep pressure, while exercise enhanced episodic memory-related neural processing. These findings support the principle of neural degeneracy, where different interventions can achieve similar cognitive benefits through distinct brain mechanisms.
Adding a qigong (Baduanjin) intervention to standard prenatal care and lifestyle education reduces the rate of caesarean section in pregnant women.
This multicenter RCT protocol aims to evaluate whether a pregnancy-adapted qigong (Baduanjin) program, added to routine lifestyle intervention, reduces the caesarean section rate. The study plans to enroll 1062 women with singleton pregnancies at 11-13+6 weeks gestation across 11 Chinese institutions. The primary outcome is caesarean section rate, with secondary outcomes including obstetric complications, neonatal indicators, gestational weight gain, and mental health/sleep measures.
MOTIVATE increases device-measured moderate-to-vigorous physical activity (MVPA) at 3 and 6 months among community-dwelling stroke survivors compared with general PA information.
The MOTIVATE trial is a hybrid type 1 effectiveness-implementation randomized controlled trial testing a theory-informed, co-designed behavior change intervention to increase physical activity after stroke. The primary outcome is average daily minutes of moderate-to-vigorous physical activity (MVPA) measured by Fitbit Inspire 3 at 3 and 6 months. The trial aims to recruit 120 participants to detect a 10-minute/day difference in MVPA with 80% power, allowing for 20% attrition.
Benson relaxation exercise reduces anxiety levels and improves sleep quality in adolescents receiving inpatient psychiatric treatment
In a randomized controlled trial of 60 adolescents in a psychiatric clinic, those performing Benson relaxation exercise five times had significantly lower state anxiety and better sleep quality at post-test (Day 6) and follow-up (Day 10) compared to the control group. The intervention group showed sustained improvements over the 10-day study period.
Adding aerobic exercise to physical therapy reduces pain and central sensitization-related symptoms in temporomandibular disorder patients with nociplastic pain
In a randomized-controlled trial of 43 TMD patients with nociplastic pain, adding high-intensity interval aerobic exercise (stationary bike) to physical therapy significantly reduced central sensitization symptoms (-9.5; p=0.04), pain intensity (-23.2; p=0.04), kinesiophobia (-4.1; p=0.04), and sleep impairment (-3.8; p=0.01) at 6 weeks. Pain reductions persisted at 12-week follow-up (VAS -26.2; p=0.04). Strength training only reduced kinesiophobia at follow-up.
Exercise affects sleep outcomes in human trials
Transcranial electric stimulation in chronic pain: Effects on quality of life, physical function, activity and clinical status.. Published in Journal of neuropsychology (2026). PMID: 42490298.
Outdoor aerobic exercise may provide greater therapeutic advantages than indoor aerobic exercise for adolescents with subthreshold depression
This randomized controlled trial protocol aims to compare the psychological effects of indoor versus outdoor aerobic exercise in adolescents with subthreshold depression. The study will recruit adolescents meeting standardized subthreshold depression screening criteria and randomly assign them to an indoor or outdoor aerobic exercise group for an 8-week program (2-3 sessions per week, 40 minutes per session at moderate intensity). Depressive symptoms, anxiety, and sleep quality will be assessed at baseline, mid-intervention, and post-intervention.
Electrical dry needling combined with therapeutic exercise is not yet proven to be more effective than therapeutic exercise alone in patients with chronic nonspecific neck pain, as the trial is ongoing and results are pending.
This protocol describes a randomized controlled trial comparing electrical dry needling (EDN) combined with therapeutic exercise versus therapeutic exercise alone in 70 participants with chronic nonspecific neck pain. The trial is ongoing, with recruitment partially completed (35 of 70 as of January 2026), and results are expected to be published in late 2026. No efficacy results are available yet.
A hybrid digital intervention combining continuous monitoring with embedded RCTs is feasible for promoting healthy movement behaviors in university students.
This pilot study protocol describes a five-month hybrid design using Apple Watches and iPhones to monitor sleep, physical activity, and screen time in first-year university students, with three embedded RCTs testing ecological momentary interventions. Feasibility outcomes include recruitment, engagement, and user experience, with preliminary effectiveness explored for each movement behavior.
Qigong (Baduanjin) intervention reduces caesarean section rate in pregnant women
This multicenter RCT protocol aims to evaluate whether adding a qigong (Baduanjin) intervention to standard prenatal care and lifestyle education reduces the caesarean section rate compared to standard care alone. The study plans to enroll 1062 pregnant women aged 18-45 with singleton pregnancies at 11-13+6 weeks gestation across 11 institutions in China. The primary outcome is caesarean section rate, with secondary outcomes including obstetric complications, neonatal indicators, gestational weight gain, and mental health/sleep outcomes.
Acute sleep fragmentation decreases skeletal muscle blood flow during exercise
In a randomized crossover study of 20 adults, one night of fragmented sleep (induced by audio alarms every 30 minutes) significantly reduced brachial artery dilation and forearm blood flow during rhythmic handgrip exercise compared to habitual sleep. Peak and total hyperemic responses to single contractions were not affected, and endothelial sensitivity to shear rate was similar between conditions.
Evening high-intensity swimming exercise impairs REM sleep and increases wake after sleep onset in male swimmers
In a crossover trial, 12 competitive male swimmers completed high-intensity evening swimming (6:30-8:30 pm) and a no-exercise control condition. The exercise condition significantly reduced REM sleep duration (81.4 vs 107.6 min) and increased wake after sleep onset (23.5 vs 3.4 min) compared to control, while other sleep variables were unaffected. Core body temperature was higher during exercise but returned to baseline by bedtime.
Exercise combined with ergonomics training improves sleep quality in automotive workers with non-specific chronic low back pain
A randomized controlled trial compared ergonomics training plus exercise to ergonomics training alone in 56 automotive workers with low back pain. After 12 weeks, the intervention group showed significantly greater improvements in sleep quality (p<0.05) compared to the control group, with no significant between-group difference in fatigue severity.
Two-week high-frequency aerobic exercise reduces depressive symptoms and improves frontal function in subthreshold depression
A two-week high-frequency aerobic exercise (6-7 sessions/week) significantly decreased BDI-II and PHQ-9 scores in female participants with subthreshold depression, while increasing response and remission rates. The intervention also reduced activation in the dorsolateral prefrontal cortex, frontal eye field, and premotor and supplementary motor areas, and improved functional connectivity and network efficiency.
Remotely delivered gamified exercise intervention shows feasibility and preliminary efficacy for preventing Parkinson's disease in prodromal subgroups
The Slow-SPEED trials are the first non-pharmacological Parkinson's disease prevention trials worldwide, testing a gamified, remotely administered exercise intervention versus active control over 18-36 months in three complementary prodromal subgroups: iRBD (n=110, Netherlands), hyposmia (n=110, UK), and LRRK2/GBA1 mutation carriers (n=600, US). The trials aim to provide unique insights for large-scale Parkinson's prevention studies.
Six months of multimodal exercise in individuals on the Alzheimer's disease continuum is associated with short-term preservation of hippocampal and amygdala subfield volumes and increased hippocampus-amygdala connectivity, which are linked to sleep and activity parameters.
In the MOVE study, 46 individuals on the AD continuum were randomized to 6 months of multimodal exercise or psychoeducation. The exercise group showed increased hippocampus-amygdala connectivity and attenuated subfield atrophy after the intervention, but both groups progressed in cognitive decline and hippocampal atrophy one year later. Hippocampal and amygdalar volumes and connectivity were associated with sleep parameters, suggesting a link between exercise, sleep, and brain structure.
A qigong (Baduanjin) intervention program reduces the rate of caesarean section in pregnant women when added to routine lifestyle intervention.
This multicenter RCT protocol aims to evaluate the additive effect of a qigong intervention program (modified seated Baduanjin) compared to routine lifestyle intervention alone on reducing caesarean section rate in 1062 pregnant women aged 18-45 with singleton pregnancies at 11-13+6 weeks gestation. The primary outcome is caesarean section rate, with secondary outcomes including obstetric complications, neonatal indicators, maternal gestational weight gain, and mental health and sleep-related outcomes.
LLM-driven text-based coaching prompts grounded in the Transtheoretical Model of Change increase daily step count compared to generic prompts in adults at risk for cardiovascular disease.
The My Heart Counts study is a prospective observational cohort with an embedded randomized crossover trial (N=15,000) evaluating personalized LLM-generated coaching prompts versus generic prompts. The primary endpoint is change in daily step count, analyzed using mixed-effects models.
Cognitive behavioral therapy reduces sedentary time and increases sleep duration in adults with major depressive disorder
In a secondary analysis of the CBT+ trial, adults with major depressive disorder who underwent 8 weeks of cognitive behavioral therapy (CBT) showed a significant average within-person decrease of 47.2 minutes/day of sedentary time (95% CI: -82.0 to -14.4; p = .007) and a significant increase of 36.5 minutes/day in sleep duration (time in bed; 95% CI: 4.2 to 68.8; p = .028). Total physical activity increased by a non-significant 12.3 minutes/day (95% CI: -34.5 to 59.1; p = .589).
Progressive relaxation exercises administered via telenursing improve sleep quality in nursing students after an earthquake
A randomized controlled trial with 86 nursing students from two universities in eastern Turkey found that 20 minutes of nightly progressive relaxation exercises via video call for 4 weeks significantly improved sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI). The post-test PSQI scores showed a significant difference between the experimental and control groups (P < 0.005), while pre-test scores were not significantly different (P > 0.05).
Repeated-sprint exercise in hypoxia does not alter sleep quality in young male adults
In a crossover trial, ten healthy young men performed repeated-sprint exercise in hypoxia (FiO2 14.5%), normoxia (FiO2 20.9%), or no exercise (REST). Sleep quality measures (total sleep time, sleep efficiency, sleep latency, sleep stages) did not differ significantly among conditions, but heart rate was higher and HRV-derived pNN50 was lower during the first 90 minutes of sleep after exercise compared to REST.
Inhalation of 2.5% CO2 increases arterial oxygen partial pressure and exercise performance at high altitude in healthy lowlanders
In a double-blind pilot study at 4505 m, inhalation of 2.5% CO2 significantly increased PaO2 (42.3 vs. 34.9 mmHg) and PaCO2 (33.5 vs. 31.4 mmHg) compared to ambient air. Endurance shuttle walk test distance was also significantly longer with CO2 inhalation (960.0 m vs. 677.0 m).
Hot water immersion improves sleep quality in athletes
Hot water immersion (HWI) significantly improved sleep quality in athletes compared to control conditions, while cold water immersion (CWI) did not show consistent benefits for sleep. The review included eight studies and found HWI also enhanced acute anaerobic power, whereas CWI impaired immediate power output.
Physical exercise is associated with better sleep quality in university students, mediated by reduced mobile phone addiction and rumination
A cross-sectional study of 1,300 university students found that physical exercise negatively predicted PSQI scores (β = -0.022, p < 0.01), indicating better sleep quality. This association was mediated by a chain pathway through reduced mobile phone addiction and rumination.
A four-week combined respiratory muscle training and breathing exercise program improves sleep quality and reduces perceived stress in healthy university students.
A 4-week intervention combining diaphragmatic breathing, pursed-lip breathing, and threshold-loaded inspiratory/expiratory muscle training (40-60% maximal inspiratory pressure, 5 days/week) was associated with a 26% improvement in sleep quality (PSQI) and a 19% reduction in perceived stress (PSS) in 40 healthy university students (median age 22, BMI 23.14 ± 4.05 kg/m²). Breath-holding time increased by 132% (p < 0.001, r = 0.87), and functional performance improved significantly (TUG decreased 9%, d_z = 1.01; STS improved 12%, d_z = 1.12).
Association rules derived from multimodal sleep data reveal significant co-occurrences between lifestyle interventions and sleep patterns in adults with mild-to-moderate OSA using a digital therapeutics application.
The study analyzed a 12-week digital intervention for 192 adults with mild-to-moderate OSA, combining sleep diary, smartwatch, and app engagement data. Using the Apriori algorithm, association rules with lift and confidence scores significantly higher than random chance were generated, showing co-occurrences between lifestyle missions and sleep diary or watch measurements.
PPG-based wearable devices show varying heart rate measurement accuracy across exercise intensities, with Apple Watch SE and Polar Verity Sense demonstrating highest agreement with ECG reference
In 37 healthy young adults, heart rate accuracy of four PPG-based wearables was compared to ECG across exercise intensities. The Apple Watch SE and Polar Verity Sense had significantly lower mean absolute error (MAE) and higher concordance correlation coefficients (CCC) than Polar Pacer Pro and Galaxy Watch 6, with MAE decreasing as intensity increased.
Health behaviors account for approximately half of the rural-urban gap in life satisfaction among graduate students at an elite Chinese university
In a cross-sectional survey of 497 graduate students at a Double First-Class university in China, rural-origin students scored 1.95 points lower on the Satisfaction with Life Scale (SWLS) than urban-origin peers after adjusting for sociodemographic covariates (p=0.003). Adding health behaviors (sleep, physical activity, insomnia) to the model reduced this gap by roughly half (p=0.088), with insomnia, physical activity, and sleep duration independently associated with life satisfaction.
Adherence to two or more 24-h movement behavior guidelines reduces hypertension risk in adolescents
Adolescents who adhered to two or more movement behavior recommendations (physical activity, screen time, sleep) had a reduced risk of hypertension (RR=0.31; 95% CI: 0.09-0.98) compared to those meeting fewer guidelines. This association was not modified by social determinants of health.
Nearly all patients with chronic pain experience sleep-wake disturbances, with none achieving 85% sleep efficiency.
In a cohort of 100 patients with chronic pain, 95% had poor sleep quality based on PSQI scores, 67% had clinical insomnia (ISI ≥ 15), and average sleep efficiency was 64% (range 28-81%). A significant correlation was found between sleep efficiency and physical activity level (rs=0.31, 95% CI 0.10-0.50).
Adherence to the Canadian 24-Hour Movement Guidelines is associated with lower all-cause mortality in adults with chronic kidney disease.
Among 5578 adults with CKD, meeting the MVPA or sedentary behavior recommendations individually was associated with lower all-cause mortality (MVPA: HR=0.48; SB: HR=0.75), while sleep alone was not significant. Combined adherence to all three components showed a strong protective effect (HR=0.45), particularly in adults aged ≥65 years.
A wearable-supported digital health intervention with personalized feedback and light incentives improves attitudes toward sleep and physical activity but shows limited behavioral change in a community setting
This proof-of-concept study tested a wearable device (Oura Ring or Fitbit) integrated with the Welloop app and light incentives in 130 participants (median age 49, 83% women) in Kobe, Japan. Attitudinal outcomes showed significant or near-significant improvements in perceived enjoyment and necessity of physical activity and a significant shift in dietary stage of change, while objective behavioral changes were modest (small improvements in exercise duration, walking time, reduced sleep procrastination) and mostly not statistically significant.
Sleep duration of approximately 7 hours on weekdays and at least moderate-intensity physical activity are associated with better early glycemic control in newly diagnosed type 2 diabetes patients
In a cross-sectional study of 340 newly diagnosed type 2 diabetes patients, a U-shaped association was found between weekday sleep duration and fasting blood glucose, with optimal sleep around 6.92 hours. Moderate- to high-intensity physical activity was associated with significantly lower fasting blood glucose and glycated hemoglobin, and may partially offset adverse glycemic effects of insufficient sleep.
Depressive symptoms are negatively associated with both physical and mental health-related quality of life among physical education teacher education students
In a cross-sectional study of 168 physically active physical education teacher education students in Chile, depressive symptoms were negatively associated with both the physical component summary (PCS) and mental component summary (MCS) of HRQoL, with stronger associations for MCS. The model explained 61% of variance in MCS but only 6% in PCS, indicating mental health symptoms are more strongly linked to HRQoL than physical activity in this sample.
Elevated VE/VCO2 slope predicts higher mortality in hypersensitivity pneumonitis
In patients with hypersensitivity pneumonitis, an elevated VE/VCO2 slope (≥42) was associated with a higher risk of 5-year mortality (HR 3.65; 95% CI 1.04 to 12.80). Restricting analysis to HP patients showed a similar hazard ratio of 5.49 (95% CI 1.19 to 33.54).
Smartphone addiction and sedentary time are associated with poorer sleep quality and more frequent neck/shoulder symptoms in university students
In a cross-sectional study of 585 university students, higher smartphone addiction and longer sedentary time were associated with higher PSQI scores, a higher prevalence of poor sleep (43.8%), and a higher prevalence of neck/shoulder symptoms (46.2%). Meeting physical activity recommendations was associated with lower PSQI scores and lower prevalence of poor sleep but not with neck/shoulder symptoms.
Organized sports participation is associated with higher physical activity levels and lower BMI in Saudi male adolescents, but also with shorter sleep duration.
Among 124 Saudi male adolescents (70 athletes, 54 non-athletes), athletes had significantly higher physical activity levels (98.6% vs 55.6% meeting guidelines) and lower BMI (23.64 vs 29.69 kg/m2). However, athletes reported shorter average sleep duration (9.06 vs 11.28 hours per day), though both groups exceeded 8 hours. No significant difference was found in daily screen time.
A remote physical activity intervention improves physical activity and quality of life but has limited effects on sleep quality and musculoskeletal symptoms in Brazilian education professionals.
A 12-week remote physical activity intervention using motivational messages delivered via digital platforms significantly increased light, moderate, vigorous, and total physical activity in education professionals. Quality of life improved in physical, psychological, and environmental domains, but overall sleep quality did not change significantly, while sleep duration worsened slightly. Upper back pain decreased significantly, but other musculoskeletal symptoms showed no significant improvement.
Physical exercise reduces bedtime procrastination in college students through a chain mediation of self-control and time management tendencies
A survey of 1,069 college students found that physical exercise negatively predicted bedtime procrastination (β = -0.158, p < 0.01). Self-control and time management tendencies mediated this relationship in a chain pathway: physical exercise → self-control → time management tendency → bedtime procrastination.
Semaglutide 2.4 mg reduces the incidence of obesity-related complications and is cost-effective in Japan under retreatment scenarios.
In a lifetime economic model from a Japanese public payer perspective, semaglutide 2.4 mg plus diet and exercise reduced the incidence of obesity-related complications such as type 2 diabetes, cardiovascular events, obstructive sleep apnea, and gout compared to diet and exercise alone. The incremental cost-effectiveness ratio was ¥5,300,580/QALY for patients without type 2 diabetes and ¥7,077,984/QALY for those with type 2 diabetes, with retreatment improving QALY gains.
Walking habit reduces colorectal cancer risk in adults in Hunan, China
In a case-control study of colorectal cancer (CRC) patients and matched controls in Hunan, China, participants with a walking habit had a significantly lower risk of CRC compared to those without (OR=0.533, 95% CI: 0.392-0.725, P<0.001). This protective effect was observed after adjusting for gender and age.
Sleep duration of approximately 7 hours on workdays and at least moderate-intensity physical activity are associated with better early glycemic control in newly diagnosed type 2 diabetes patients
In a cross-sectional study of 340 newly diagnosed type 2 diabetes patients, a U-shaped association was found between weekday sleep duration and fasting blood glucose, with optimal sleep around 6.92 hours. Moderate- to high-intensity physical activity was associated with significantly lower fasting blood glucose and glycated hemoglobin, and could partially offset the adverse glycemic effects of insufficient sleep.
Moderate-to-vigorous physical activity combined with optimal sleep duration (6-8 h/night) is associated with the lowest risk of falls in Chinese older adults
Among 10,232 Chinese adults aged 60+, moderate-to-vigorous physical activity (MVPA) was associated with 15.8% lower odds of falls (OR=0.842, 95% CI: 0.745-0.952) compared to low physical activity. The combination of MVPA and optimal sleep (6-8 h) was associated with the lowest fall risk (OR=0.524, 95% CI: 0.440-0.626) relative to the reference group.
Advanced age, prolonged hypertension duration, severe hypertension, sedentary lifestyle, and frequent pre-bedtime electronic device use are independently associated with sleep disorders in elderly hypertensive patients.
In a cross-sectional study of 528 elderly hypertensive patients, the prevalence of sleep disorders was 39.02%. Multivariate logistic regression identified advanced age (≥70 years), prolonged hypertension course (≥10 years), high hypertension grade (grade 2-3), lack of regular exercise, and frequent pre-bedtime electronic device use (≥3 times/week) as independent factors associated with sleep disorders (all P < 0.001).
Long sleep duration is associated with sarcopenia in community-dwelling older adults, with a stronger association in those with lower physical activity
In a cross-sectional study of 2855 older adults (mean age 75.6 years), those sleeping ≥9 hours had higher odds of sarcopenia (OR 2.09, 95% CI 1.01-4.29) after adjusting for covariates. The association was stronger in participants with lower moderate-to-vigorous physical activity (OR 3.34, 95% CI 1.21-9.21) and not significant in those with higher activity (OR 1.37, 95% CI 0.47-3.99).
Both regular exercise and weekend warrior activity patterns are associated with better physical health in adolescents compared to insufficient activity, with no significant difference between the two patterns.
In a cross-sectional study of 1,070 Tibetan and Han adolescents aged 12-18, both regular exercise (≥60 min/day of MVPA on most days) and weekend warrior patterns (≥60 min/day on fewer days) were associated with better physical health scores compared to insufficient activity. The odds ratios were 2.193 (95% CI: 1.324-3.633) for regular activity and 3.278 (95% CI: 1.386-7.749) for weekend warrior pattern, with no significant difference between them (p=0.417).
Probable respiratory sarcopenia is independently associated with reduced exercise capacity in elderly smokers
In a COPD-enriched smoking cohort, probable respiratory sarcopenia (defined as respiratory muscle weakness plus low muscle mass) was identified in 12% of participants. This group showed significantly impaired physical performance, including reduced gait speed, 6-minute walking distance (6MWD), and knee extension strength, with probable respiratory sarcopenia independently associated with lower 6MWD (β = -0.24; p = 0.02) after adjusting for confounders.
Bilingual health education improves dietary behavior and metabolic indicators in obese Mongolian adolescents
A 6-month Mongolian-Chinese bilingual health education intervention for 111 obese adolescents (from 2,210 screened) significantly improved dietary choices, exercise habits, sleep patterns, and metabolic profiles. Fasting blood glucose, total cholesterol, and LDL-C levels were significantly reduced, with abnormal LDL-C and total cholesterol prevalence dropping to 0% at 6-month follow-up.
Reallocating 30 minutes of sedentary behavior to sleep or physical activity is associated with reduced depressive and anxiety symptoms in Chinese adolescents, particularly among those with insufficient sleep.
In a cross-sectional study of 7,767 Chinese adolescents, replacing 30 minutes of sedentary behavior with sleep was associated with lower depression (B = -0.47) and anxiety (B = -0.31) scores. Replacing sedentary behavior with physical activity also reduced symptoms (depression B = -0.12, anxiety B = -0.07). Associations were stronger in adolescents with insufficient sleep.
Suboptimal sleep duration and inadequate physical activity are associated with increased waist circumference and central obesity risk in Chinese adults
In a large Chinese cohort (106,518 participants), both short (<7 h/day) and long (≥9 h/day) sleep durations were associated with higher waist circumference and increased risk of central obesity compared to optimal sleep (7-<9 h/day). Joint analyses showed that individuals with inadequate physical activity and short sleep had the highest waist circumference and central obesity risk.
Higher apnoea-hypopnoea index is associated with reduced exercise capacity and increased all-cause mortality in a general population
In a population-based study of 1001 participants, a higher AHI was inversely associated with peak oxygen uptake (V'O2 peak) and significantly associated with all-cause mortality over a median 10.3-year follow-up (hazard ratio 1.31-1.72). Mediation analysis suggested a possible but non-significant indirect effect via reduced exercise capacity.
Participation in Japanese croquet and strength exercise is associated with a lower risk of developing dementia in older Japanese community-dwelling adults
In a prospective cohort of 5074 older Japanese adults, participation in Japanese croquet (adjusted HR 0.68, 95% CI 0.46-0.99) and strength exercise (adjusted HR 0.26, 95% CI 0.08-0.81) was significantly associated with a reduced risk of developing dementia over a 4-year follow-up, compared to non-exercisers. Other exercise types (calisthenics, walking, golf) did not show significant associations.
Sleep duration of approximately 7 hours on weekdays and moderate-to-high intensity physical activity are associated with better early glycemic control in newly diagnosed type 2 diabetes patients
In a cross-sectional study of 340 newly diagnosed type 2 diabetes patients, a U-shaped association was found between weekday sleep duration and fasting blood glucose, with optimal sleep around 6.92 hours. Moderate- and high-intensity physical activity were significantly associated with lower fasting blood glucose (β = -2.76 and -3.22) and glycated hemoglobin (β = -1.50 and -2.01) compared to low activity. Combined analysis showed that 'moderate sleep & high physical activity' on weekdays (β = -3.57) and 'long sleep & high physical activity' on weekends (β = -4.25) provided notable glycemic control benefits.
Healthy lifestyle is associated with higher life satisfaction among new university students
A cross-sectional study of 419 new undergraduate students at Tehran University of Medical Sciences found that those with healthy lifestyles had significantly higher odds of good life satisfaction (aOR = 1.91; 95% CI: 1.10, 3.35; p = 0.02). Each one-unit increase in lifestyle score was associated with a 28% increase in the odds of good life satisfaction (aOR = 1.28; 95% CI: 1.05, 1.57; p = 0.02).
Healthy dietary practices, adequate sleep duration, and regular physical activity are associated with lower BMI, body fat percentage, and visceral fat levels in nursing intern students.
In a cross-sectional study of 801 nursing intern students, healthy lifestyle patterns including adequate sleep, regular physical activity, and healthy diet were significantly associated with lower BMI, body fat percentage, and visceral fat. Physical activity showed the strongest inverse association with BMI (r = -0.447, β = -0.389), and the regression model explained 52% of BMI variance (R² = 0.52, F = 48.72, p < 0.001).
Replacing 15 minutes of sleep or sedentary behavior with moving at any intensity reduces the risk of physical activity-related cancer in UK adults.
In a prospective analysis of 59,218 UK Biobank participants, replacing 15 minutes of sleep or sedentary behavior with moving at any intensity was associated with a 2% lower risk of PA-related cancer (HR 0.98, 95%CI 0.97-0.99). Greater moderate-to-vigorous physical activity, particularly vigorous activity, showed the most robust risk reduction.
Higher dietary quality and physical activity are associated with better glycemic control in hospitalized patients with type 2 diabetes, with trait mindfulness (Act with Awareness) moderating these associations.
In a cross-sectional study of 400 hospitalized patients with T2DM, higher dietary scores were associated with lower HbA1c (β = -0.019, 95% CI: -0.032 to -0.005) and fasting blood glucose (β = -0.023, 95% CI: -0.042 to -0.003). Physical activity was negatively associated with HbA1c (β = -0.002, 95% CI: -0.004 to 0.000) but not with FBG. Significant interactions with Act with Awareness were found for both outcomes.
Resistance exercise training improves vascular and autonomic function in individuals with chronic anxiety and high sleep irregularity
A retrospective analysis of 20 young adults with chronic anxiety who completed 10 weeks of resistance exercise training found that those with high total sleep time irregularity (≥67.67 minutes) showed significant improvements in flow-mediated dilation (p < 0.01) and cardiovagal baroreflex sensitivity (p = 0.04), while those with low irregularity showed no significant changes. This suggests resistance exercise training may be particularly effective for higher-risk anxiety phenotypes with sleep irregularity.
The GLIDE-C digital therapeutic program integrating CGM with personalized lifestyle coaching reduces HbA1c in adults with mildly uncontrolled type 2 diabetes.
In a prospective observational cohort study of 18 adults with T2DM (baseline HbA1c 7.5%-9.5%), the GLIDE-C app-based intervention combining CGM with diet, exercise, and cognitive behavioral therapy led to a mean HbA1c reduction of 0.59% (P=.05) over 60 days. Postprandial glucose decreased by 25.42 mg/dL (P=.06), and time in range increased by 9.98%, with improvements in sleep quality (P=.04).
Physical exercise is associated with reduced cognitive frailty in community-dwelling older adults, partially mediated by self-efficacy
In a cross-sectional study of 563 community-dwelling older adults in China, the prevalence of cognitive frailty was 21.3%. Physical exercise was directly associated with cognitive frailty and indirectly through self-efficacy, with the mediation effect accounting for 35.17% of the total effect.
Higher physical activity scores and healthier nutrition-related behaviors are associated with lower odds of insomnia among female nurses
In a cross-sectional study of 328 female nurses in Taiwan, higher physical activity scores (AOR=0.92, 95% CI: 0.85-0.99) and healthier nutrition-related behaviors (AOR=0.91, 95% CI: 0.84-0.98) were associated with lower odds of insomnia. Working 10-12 hours per day was associated with higher odds of insomnia (AOR=2.21, 95% CI: 1.20-4.07).
Ticagrelor is associated with a greater than 7-fold increased risk of periodic breathing during exercise in coronary patients undergoing cardiac rehabilitation.
In a retrospective observational study of 84 coronary patients, ticagrelor was independently associated with a >7-fold increased risk of exercise-induced periodic breathing compared to thienopyridines (OR=7.17, 95% CI [2.31-25.19], p<0.001). Despite this ventilatory disturbance, ticagrelor did not impair gas exchange or aerobic capacity, and patients on ticagrelor had significantly higher peak VO2.
School connectedness is inversely associated with sleep disorders in adolescents, mediated by physical exercise and anxiety.
Among 519 adolescents aged 11-15 from northwestern Hunan, China, higher school connectedness was significantly correlated with fewer sleep disorders. This relationship was mediated by increased physical exercise and reduced anxiety, forming a chain mediation pathway.
Physical activity habit automaticity is prospectively associated with higher quality of life through lower psychological distress, moderated by exercise identity
In a three-wave longitudinal study of 1024 Chinese university students, higher physical activity habit automaticity at baseline was associated with lower psychological distress at the second wave (B = -0.503, p < 0.001), which in turn was associated with higher quality of life at the third wave (B = -0.086, p < 0.001). The indirect effect was significant (effect = 0.043, 95% CI [0.028, 0.059]), with a mediated proportion of 30.9%, and this indirect pathway was stronger among students with higher exercise identity.
Older age, female sex, smoking, and comorbidity are associated with lower accelerometer-measured physical activity in adults with cardiovascular diseases.
In a cross-sectional study of 1,484 Swedish adults aged 50-64 with cardiovascular diseases, being in the oldest age group (OR=0.59), female sex (OR=0.73), regular/occasional smoking (OR=0.37), and having one (OR=0.61) or more comorbidities (OR=0.45) were significantly associated with lower odds of higher moderate-to-vigorous physical activity levels. A healthy diet was associated with higher physical activity (OR=1.84).
Limited screen time is associated with the strongest improvement in physical fitness among children, followed by healthy eating, regular physical activity, and sufficient sleep.
In a nationwide cross-sectional study of 60,177 children in China, a higher Health Lifestyle Score (HLS) was significantly associated with better general physical fitness. Among individual lifestyle factors, limited screen time showed the strongest positive correlation (β=1.34; 95% CI, 1.24 to 1.45), followed by healthy eating (β=0.49; 95% CI, 0.39 to 0.59), regular physical activity (β=0.40; 95% CI, 0.34 to 0.46), and sufficient sleep (β=0.12; 95% CI, 0.04 to 0.20).
Additive effects of lifestyle behaviors, rather than interactions, primarily drive type 2 diabetes onset, with each additional recommendation met progressively extending diabetes-free survival.
In 259,448 UK Biobank adults followed for up to 16 years, additive effects of fruit/vegetable intake, physical activity, sleep duration, alcohol consumption, and smoking explained about 93% of between-strata variance in T2D onset. Never smoking and meeting physical activity guidelines consistently characterized longer survival, and each additional recommendation met progressively extended T2D-free survival.
Higher maternal physical fitness is associated with a more favorable 24-hour movement behavior profile in preschool children, including greater sleep duration, higher physical activity, and lower sedentary time.
In a cross-sectional study of 161 preschool children aged 4-6 years, maternal physical fitness (moderate vs. low) was associated with increased child sleep duration (β=0.41 h/night), higher total physical activity (β=60.70 min/day), higher light physical activity (β=32.80 min/day), higher moderate-to-vigorous physical activity (β=27.88 min/day), and lower sedentary time (β=-52.70 min/day). No significant associations were found for paternal physical fitness or parental moderate-to-vigorous physical activity with child anthropometry, motor competence, or physical fitness.
Multi-level factors across the Health Ecological Model are independently associated with subjective cognitive decline among hypertensive patients in rural China
In a cross-sectional study of 860 hypertensive patients in rural Shanxi, China, 80.58% met criteria for subjective cognitive decline (SCD). Factors associated with higher odds of SCD included advanced age (OR=1.042), family history of hypertension (OR=2.352), hypertensive complications (OR=3.049), moderate hypertension risk (OR=1.847), lack of physical exercise (OR=1.611), fairly good or fairly poor sleep quality (OR=1.644 and 1.939), lower household income (OR=3.282), utilization of county-level hospitals (OR=1.697), and mild depression (OR=2.068). Former drinker status was associated with lower odds of SCD (OR=0.294) but may reflect residual confounding.
Poor sleep quality is associated with increased fall risk in older adults
In a cross-sectional study of 67 older adults, fall occurrence was associated with poorer sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) (ρ = 0.243; p = 0.047). Participants in a community-based physical activity program (G60UP) had better sleep quality (lower PSQI scores) and reported fewer falls (0.26 ± 0.51 vs. 0.78 ± 0.83; p = 0.005) compared to sedentary older adults.
Company cafeteria use, regular exercise, and breakfast consumption are associated with reduced hyperuricemia risk, while smoking and breakfast skipping increase risk among male manufacturing workers
In a cross-sectional study of 613 male manufacturing workers in Japan, 20.6% had high uric acid (≥7.0 mg/dL). Multivariable logistic regression identified smoking (OR=1.861), skipping breakfast ≥3 times/week (OR=1.684), and higher ALT (OR=1.035) as risk factors, while company cafeteria use (OR=0.528), regular exercise (OR=0.501), older age (OR=0.952), and higher eGFR (OR=0.969) were protective.
Vigorous-intensity work is associated with increased odds of cough or expectoration in individuals with mild to moderate COPD
In a cross-sectional study of 723 participants with mild-to-moderate COPD from NHANES 2007-2012, self-reported vigorous-intensity work was associated with higher odds of cough or expectoration (OR = 2.43, 95% CI: 1.41-4.22, P = 0.002) after full adjustment. A dose-response relationship was observed between longer duration of vigorous work and increased symptoms.
Persistent cognitive dysfunction in POTS is associated with abnormal cerebral blood flow and may persist despite conventional cardiovascular-centered treatments.
This scoping review of 18 studies found that abnormal cerebral blood flow was reported in 61% of 56 POTS patients with cognitive dysfunction. Sustained cognitive stress induced a greater reduction in cerebral blood flow velocity in POTS patients (approximately 7.8%) compared to controls (1.8%), suggesting a hemodynamic mechanism for brain fog and other cognitive symptoms.
Exercise duration during a brief pre-transplant step test independently predicts overall survival, ICU admission, and invasive mechanical ventilation after hematopoietic cell transplantation.
In a single-center retrospective cohort of 3,458 adult HCT recipients, each additional minute of exercise during a 3-minute step test was associated with lower mortality (HR 0.90, 95% CI 0.82-0.99), lower odds of ICU admission (OR 0.80, 95% CI 0.69-0.92), and lower odds of invasive mechanical ventilation (OR 0.70, 95% CI 0.55-0.89) after full adjustment. Oxygen desaturation did not predict any outcome after hemoglobin adjustment.
Physical activity is associated with white matter integrity in a nonlinear, age- and region-specific manner, with greatest benefits in sedentary and older individuals
In a cross-sectional analysis of 4188 participants (mean age 55.4 years), higher energy expenditure was associated with lower orientation dispersion, with the effect leveling off at higher activity levels (standardized βlinear = -0.153, βquadratic = 0.034). Physical activity was linked to lower neurite density in motor tracts, but with advancing age, it became more strongly associated with higher neurite density and lower mean diffusivity of supratentorial fibers. Body weight, cardiometabolic, and inflammatory factors partly mediated these effects.
Exercise reduces the risk of hepatic steatosis, fibrosis, and hepatocellular carcinoma in a dose-dependent manner in individuals with MASLD.
The paper reports that exercise is associated with a dose-dependent reduction in the risk of hepatic steatosis, fibrosis, and hepatocellular carcinoma in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD). This effect is partly independent of weight loss, and lifestyle interventions including exercise improve cardiometabolic health beyond the liver.
Higher proportions of moderate-to-vigorous physical activity (MVPA) relative to other 24-hour movement behaviors are associated with greater bone strength in older women.
In a cross-sectional study of 296 older adults (mean age 76.3 years), compositional data analysis showed that higher proportions of MVPA within the 24-hour movement composition were associated with higher distal radius and tibia estimated failure load in women. Hypothetically displacing 10-60 minutes of inactivity with MVPA resulted in more favorable bone microarchitecture and strength parameters.
Regular moderate-to-vigorous exercise is associated with better sleep quality and quality of life in perimenopausal women, partly explained by less severe menopausal symptoms.
In a cross-sectional study of 457 Chinese perimenopausal women, those who exercised regularly (≥3 times/week, ≥30 min/session) had significantly lower (better) PSQI and MENQOL scores. The association between regular exercise and better sleep quality was independent of other factors, but effect sizes were small (|r|<0.2) and causality cannot be inferred.
Meeting all three 24-Hour Movement Guideline components (MVPA, sleep duration, sedentary behavior) is associated with lower odds and hazard of frailty in two nationally representative populations.
In cross-sectional analyses, meeting all three components was associated with lower odds of frailty in NHANES (OR=0.21; 95% CI, 0.14-0.32) and CHARLS (OR=0.29; 95% CI, 0.16-0.46). In longitudinal CHARLS analyses over a median follow-up of 7.0 years, meeting all three components was associated with a lower hazard of incident frailty (HR=0.33; 95% CI, 0.27-0.41) compared to meeting none.
Higher physical activity levels and less sedentary time are associated with more robust diurnal cortisol rhythms in colorectal cancer survivors up to 12 months post-treatment.
In 74 colorectal cancer survivors, more total sedentary time (per 2 hours/day) was associated with a flatter cortisol slope (β=0.19; 95%CI=0.06,0.33) and higher cortisol awakening response (β=0.14; 95%CI=0.01,0.27). More total physical activity (per 1 hour/day) was associated with higher relative amplitude of cortisol (β=0.23; 95%CI=0.03,0.43), indicating more robust diurnal rhythms.
Obesity is strongly associated with cardiomyopathy in UK Biobank participants
In a UK Biobank analysis of 442 individuals with cardiomyopathy and 173,429 matched controls, obesity was strongly associated with cardiomyopathy (OR 3.7, 95% CI 2.88 to 4.76, p<0.0001). The study also found that males had higher odds of cardiomyopathy than females (OR 2.5, 95% CI 2.04 to 3.05, p<0.0001).
Longer moderate-to-vigorous physical activity duration is associated with better macular choroidal circulation in older adults with primary open-angle glaucoma
In a cross-sectional study of older adults with POAG, longer MVPA duration was independently associated with greater choroidal vascular volume (β = 0.04, P = 0.021) and higher choriocapillaris flow density (β = 0.06, P = 0.004). Patients with POAG had lower PA levels and reduced choroidal circulation compared to age-matched controls.
Adherence to 24-h movement guidelines, particularly including the sleep guideline, is associated with lower odds of non-suicidal self-injury in adolescents, with mediation by psychological health and moderation by sex.
In a cross-sectional study of 4,205 Chinese adolescents, meeting more 24-h movement guidelines was associated with progressively lower odds of NSSI (1 vs 0: OR=0.72; 2 vs 0: OR=0.44; 3 vs 0: OR=0.31). Combinations including the sleep guideline were associated with lower NSSI than those without, and the association was stronger in girls. Psychological health significantly mediated the relationship.
Increased frequency of vigorous physical activity is associated with reduced difficulty falling asleep
In a cross-sectional analysis of 3960 participants from the Adventist Health Study-2, each unit increase in frequency of vigorous physical activity was associated with 3% lower odds of difficulty falling asleep (OR = 0.97; 95% CI = 0.94-0.98; P = 0.03). No significant association was found between vigorous activity and waking during the night.
COVID-19 stay-at-home orders reduced physical activity in older African Americans
In a subset of older African American participants with valid actigraphy data, mean daily step count decreased significantly by 20.1% from 1646 to 1315 steps after the COVID-19 stay-at-home order. Nightly sleep duration decreased but not significantly from 7.1 to 6.9 hours.
Unbalanced 24h movement behavior trajectories after acute stroke are associated with increased risk of poor functional recovery at 12 months
In a prospective longitudinal study of 298 stroke survivors, four distinct 24h movement behavior trajectories were identified. Compared to a balanced trajectory, the imbalance group (OR=5.237, 95%CI: 1.848-14.835) and the long-sleep, increased-sedentary, decreased-physical-activity group (OR=4.160, 95%CI: 1.589-10.891) had significantly higher odds of poor functional recovery at 12 months, after adjusting for multiple confounders.
Afternoon exercise was associated with greater fat loss than morning exercise in overweight/obese adults with the PER3 rs228697 CC genotype
In an 8-week supervised moderate-intensity continuous training (MICT) intervention, overweight/obese university students with the PER3 rs228697 CC genotype who exercised in the afternoon (16:00-19:00) showed descriptively larger reductions in body weight, BMI, waist circumference, body fat percentage, and total fat mass compared to those who exercised in the morning (7:00-10:00). However, the between-group differences were modest and imprecise, and the study was exploratory, so strong conclusions cannot be drawn.
Work-influenced circadian disruption is associated with cardiometabolic disease risk indicators but not microbiome composition in nurses
In a cohort of 75 Philadelphia nurses, circadian rhythm disruption (CRD) was associated with higher cardiometabolic risk indicators such as hs-CRP, triglycerides, and blood pressure, and with unfavorable work environment factors (e.g., less break time, fewer staff/resources). However, CRD variables were not significantly associated with gut microbiome profiles. Lower exercise, higher exhaustion, less mealtime, and night shifts were specific CRD-related factors linked to elevated risk markers.
A healthy lifestyle, particularly regular physical activity and low sedentary behavior, is associated with reduced all-cause and cardiovascular disease mortality in individuals with cardiovascular-kidney-metabolic syndrome.
In two prospective cohorts (UK Biobank and NHANES), higher healthy lifestyle scores were associated with significantly lower risks of all-cause and CVD mortality. For example, in UK Biobank, each unit increase in lifestyle score was linked to a 19% lower all-cause mortality risk (HR 0.81) and an 18% lower CVD mortality risk (HR 0.82). The associations were stronger in early stages of CKM syndrome.
Short sleep and physical inactivity are independently and jointly associated with prevalent cardiovascular disease in US adults
In a cross-sectional study of 1,577,591 US adults, short sleep (OR 1.26, 95% CI 1.22-1.30) and long sleep (OR 1.17, 95% CI 1.13-1.21) were independently associated with prevalent cardiovascular disease, as was physical inactivity (OR 1.11, 95% CI 1.09-1.14). The joint effect of short sleep and inactivity conferred the highest risk (OR 1.38, 95% CI 1.31-1.44), with no significant additive interaction (RERI -0.03, 95% CI -0.11 to 0.06), suggesting independent, additive risks.
Home-based anodal tDCS targeting the left DLPFC reduces cognitive fatigue in a patient with refractory post-mTBI fatigue
A single patient with chronic post-mild traumatic brain injury (mTBI) cognitive fatigue received 14 days of home-based anodal tDCS (2 mA, 20 min daily) over the left DLPFC, guided by FDG-PET/MRI findings. Fatigue severity (FSS-7) improved from 5.4 to 3.7, exceeding the minimal clinically important difference, and cognitive performance improved (SDMT: 46 to 58; MoCA: 26 to 29). No serious adverse events were reported.
Physical activity is associated with better sleep quality in adolescents, mediated by psychological resilience and academic stress, and moderated by peer support.
In a cross-sectional study of 1,347 high school students in Shanghai, physical activity was negatively associated with PSQI scores (indicating better sleep quality), with a direct association (β = -0.202, 61.3% of total effect) and indirect associations through psychological resilience (β = -0.053, 16.0%), academic stress (β = -0.040, 12.1%), and the serial pathway of resilience and academic stress (β = -0.035, 10.6%). Peer support weakened the positive association between academic stress and PSQI scores.
Engaging in multiple healthy lifestyle behaviors is associated with better health outcomes than focusing on a single domain
In a cross-sectional study of 510 adults, four multibehavioral clusters were identified: unhealthy behavior, mixed behavior-healthy diet, mixed behavior-stable good mood, and healthy behavior. Compared to the unhealthy behavior cluster, the mixed behavior-stable good mood and healthy behavior clusters had significantly higher mental health-related quality of life (β=6.32, 95% CI 3.73-8.91 and β=5.61, 95% CI 2.47-8.75, respectively) and well-being (β=11.62, 95% CI 7.86-15.38 and β=9.63, 95% CI 5.17-14.10, respectively). Participants in these clusters and those in the mixed behavior-healthy diet cluster also reported better perceived health (OR 3.19, 95% CI 1.20-8.49; OR 9.85, 95% CI 3.54-27.40; OR 12.18, 95% CI 4.04-36.71, respectively).
Muscular endurance and strength are lower in lymphangioleiomyomatosis (LAM) patients compared to matched healthy controls, coincident with greater self-reported fatigue.
In a cross-sectional study of 15 LAM patients and 15 matched controls, LAM patients exhibited significantly lower muscular force (by 220±89 N), power (by 312±129 W), endurance (by 4674±1974 N*sec), and worse fatigue survey scores (p=0.02 to 0.0004). Poorer muscular endurance in LAM was associated with shorter 6-minute walk distance (r=0.68), lower VO2max (r=0.58), and worse fatigue (r=0.56). No differences in fiber type distribution were found.
Physical exercise is associated with better sleep quality among college students, mediated by mobile phone addiction tendency and moderated by psychological resilience.
In a sample of 1,583 college students, physical exercise was significantly negatively associated with sleep quality (β = -0.19, p < 0.001), indicating better sleep quality with more exercise. The relationship was partially mediated by mobile phone addiction tendency (indirect effect = -0.03, 95% CI [-0.04, -0.02]), and psychological resilience moderated the first stage of this mediation, with exercise linked to reduced mobile phone addiction only among students with moderate to high resilience.
Physical activity improves executive function in college students through sequential reduction of anxiety and improvement of sleep quality
In a cross-sectional study of 2,033 Chinese college students, physical activity positively predicted executive function, with a direct effect accounting for 49.53% of the total variance. Three mediating pathways were identified: anxiety reduction (31.78%), sleep quality enhancement (14.02%), and a sequential chain of anxiety reduction leading to better sleep quality (4.67%). All mediating effects were statistically significant based on bootstrap confidence intervals.
Physical activity interventions are associated with the broadest range of health benefits among female cancer survivors, including improved quality of life, cardiorespiratory fitness, physical functioning, mental health, sleep, and survival.
This review found that physical activity interventions among female cancer survivors are associated with improvements across multiple outcomes, including quality of life, cardiorespiratory fitness, physical functioning, mental health, sleep, and survival. The evidence is based on large observational studies and intervention trials, with physical activity showing the broadest benefits compared to other lifestyle pillars.
Gas-exchange derived pulmonary vascular capacitance (GXCAP) and ventilatory efficiency (VE/VCO2) measured during submaximal exercise testing can identify non-severe PH-ILD patients with exercise-induced increases in pulmonary vascular resistance.
In 16 patients with non-severe pulmonary hypertension associated with interstitial lung disease, GXCAP was significantly higher in those with static PVR (471 ± 85 mL·mmHg) versus dynamic PVR (311 ± 38 mL·mmHg, p < 0.01), while VE/VCO2 was lower in static PVR (33 ± 2 vs 37 ± 2.5, p < 0.01). ROC analysis showed excellent discrimination for GXCAP (AUC 0.98) and good discrimination for VE/VCO2 (AUC 0.90) in identifying the dynamic PVR phenotype.
Earlier or more regular eating patterns, postprandial physical activity, and stable sleep-wake schedules are associated with more favorable cardiometabolic profiles, but integrated eating-activity-sleep coherence is not yet validated.
This narrative review proposes 'rhythm coherence' as a framework for the temporal stability and alignment of eating, physical activity, and sleep. Based on a staged evidence-identification process, 131 high-priority records were synthesized, and selected studies showed associations between regular eating, postprandial activity, and stable sleep with better cardiometabolic profiles. However, the evidence is heterogeneous and does not establish an effect of the integrated framework or the proposed Rhythm Coherence Index (RCI).
Selected standardized adaptogen preparations, particularly Withania somnifera, may provide beneficial effects on exercise recovery and selected aspects of exercise performance in trained athletes, but evidence is limited and preliminary.
This narrative review summarizes current evidence on adaptogens (Withania somnifera, Panax species, Rhodiola rosea, Cordyceps species) for exercise recovery and performance in athletes. The most consistent evidence supports Withania somnifera, while evidence for other adaptogens is limited and preliminary. The review concludes that current evidence is insufficient for definitive recommendations due to heterogeneity and limited studies.
Nature-based physical activity may improve sleep disturbances in breast cancer survivors
The paper discusses that breast cancer survivors frequently experience sleep disturbances, and nature-based physical activity (NBPA) is proposed as a promising complementary approach to improve these outcomes. However, direct evidence specifically addressing breast cancer survivors remains limited, and the proposed mechanisms are considered plausible hypotheses requiring further validation.
Integrating sleep and circadian health assessment into cardiac rehabilitation may enhance cardiac recovery, improve exercise tolerance and adherence, and support comprehensive secondary prevention.
This narrative review argues that systematic assessment and management of sleep and circadian health are underutilized in cardiac rehabilitation (CR) programs, despite evidence linking sleep disorders and circadian disruption to impaired cardiac recovery and increased adverse events. The authors propose practical strategies including sleep screening, sleep hygiene education, and chronotype-informed exercise scheduling, which may improve CR outcomes. No quantitative effect sizes are provided as this is a narrative review.
Participation in cardiac rehabilitation and younger age are associated with increased physical activity in coronary heart disease patients
This systematic review of 24 observational studies found that the primary explanatory variables for 24-hour movement behaviors in coronary heart disease patients were concentrated at the intrapersonal level. Aging was significantly associated with reduced physical activity, while participation in cardiac rehabilitation was linked to increased physical activity. No significant associations were found at the policy level.
Wearable HRV monitoring indicates autonomic dysfunction and delayed sympathovagal recovery after exercise above VT1 in long COVID patients, suggesting increased risk of post-exertional malaise.
Continuous multi-day HRV recordings showed lower HRV in long COVID patients compared to healthy controls during daily activities and sleep (p=0.027). Nighttime HRV decreased with intense exercise and longer durations in patients (p=0.018), indicating exercise-induced autonomic disturbances. The delayed recovery of sympathovagal balance after exercise close to and above VT1 suggests that the risk of PEM rises above this threshold.
Caffeine improves aerobic endurance exercise performance via central adenosine receptor antagonism
Caffeine is a well-established ergogenic aid that enhances performance primarily through antagonism of central adenosine A1 and A2a receptors. The most robust and consistent benefits are observed for aerobic endurance exercise, with effects on strength and power being more variable.
Synchronous tele-pulmonary rehabilitation may enhance safety and group camaraderie, while asynchronous delivery offers flexibility and individualized engagement.
This narrative review from a 2025 ATS symposium discusses unresolved issues in tele-pulmonary rehabilitation, comparing synchronous vs. asynchronous delivery, equipment needs, and outcomes. Synchronous tele-PR may improve safety and real-time feedback, whereas asynchronous delivery provides flexibility. The review emphasizes that all PR models must deliver core components and be rigorously evaluated.
Postgraduate medical residents have an alarmingly high prevalence of low back pain, with significant associations to exercise, lifestyle, work satisfaction, and anxiety.
The study found a 1-year prevalence of low back pain of 67.2% among 195 postgraduate medical residents. Key risk factors included long hours of sitting (74.4%), improper posture (72.8%), fatigue (64.6%), and bad mattress (53.8%).
Carbohydrate intake of ~1.2 g/kg body mass per hour for up to 4 hours post-exercise is essential for restoring glycogen reserves, supporting immune system energy needs, and facilitating tissue repair in athletes.
The paper recommends consuming approximately 1.2 grams of carbohydrate per kilogram of body mass per hour for up to four hours after exercise to optimize glycogen restoration, immune function, and tissue repair. This is part of the 'Refuel' component of the 4Rs framework for post-exercise recovery within an allostasis paradigm.
Breakfast intake and physical activity are associated with skeletal muscle mass and SMI in male Japanese workers
In a cross-sectional study of 377 male Japanese workers, multiple regression analysis revealed that skeletal muscle mass and skeletal muscle index (SMI) were associated with age, BMI, breakfast intake, and waist circumference, with skeletal muscle mass also associated with heavy physical activity. The findings suggest that prioritizing breakfast intake and physical activity may help maintain muscle mass.
Public health measures during COVID-19 reduced children's physical activity and increased sedentary time, with variable impacts on sleep
A rapid global scoping review of 182 studies across 48 countries (2020-2023) found consistent declines in children's physical activity and increases in sedentary time during COVID-19 public health measures, with variable impacts on sleep. The review highlights that movement behaviours were insufficiently considered in emergency response planning, and recommends embedding movement opportunities in future preparedness efforts.
Endurance training attenuates acute exercise-induced monocyte transcriptomic responses in adolescents, with sex-specific molecular adaptations
In adolescents aged 14-17, an 8-week endurance training program markedly reduced the number of differentially expressed monocyte transcripts in response to acute exercise, from 5,135 to 94 in females (98% reduction) and from 567 to 165 in males (70% reduction). Pre-training, females showed a much larger transcriptomic response than males, with pathway enrichment related to adipose tissue crosstalk and oxidative metabolism, while males showed vascular function-related pathways.
Medical students report a significant decline in healthy dietary, exercise, and sleep habits compared to their pre-matriculation status.
A cross-sectional survey of 401 medical students found that 70% did not eat as healthy and 79% did not exercise as much as they would like, with 48% and 57% perceiving their diet and exercise habits as healthier before medical school. Time constraints (88%), fatigue (73%), and cost (62%) were the most commonly cited barriers.
Older adults and people with limited mobility perceive more barriers than facilitators to physical activity, with environmental factors and safety concerns being primary barriers, while social support and routine-based strategies facilitate healthier movement and sleep behaviors.
In a cross-sectional focus group study of low-income older adults and people with limited mobility in urban and rural Mexico, participants reported more barriers than facilitators to physical activity, citing poor infrastructure, medical instructions, physical fatigue, and safety concerns. Barriers to sleep included noise, hot weather, insects, and screen use, while facilitators for sleep included relaxation techniques and consistent bedtime routines. Social support encouraged physical activity, and active breaks reduced sedentary behavior, but family overprotection increased sedentary behavior in people with limited mobility.
Structured lifestyle and behavioural interventions reduce OSA severity and daytime sleepiness in adults with obstructive sleep apnoea.
Randomised controlled trials consistently show that healthy dietary patterns, structured physical activity, alcohol reduction, and interdisciplinary lifestyle programmes can reduce OSA severity, daytime sleepiness, and cardiometabolic risk markers. Some benefits occur without substantial weight loss, suggesting additional mechanisms such as improved ventilatory stability, reduced rostral fluid shift, enhanced upper-airway neuromuscular responsiveness, and lower systemic inflammation.
Daytime dysfunction predicts poorer cognitive flexibility only in children with ADHD who engage in low physical activity levels
In a cohort of 282 children with ADHD (mean age 8.59 years, 78.4% boys), approximately 60% had sleep problems. Children with sleep problems had longer sleep latency, poorer cognitive flexibility, and less moderate-to-vigorous physical activity (MVPA). The relationship between daytime dysfunction and cognitive flexibility was moderated by MVPA guideline attainment, such that daytime dysfunction predicted poorer cognitive flexibility only in children with low PA levels.
Lifestyle habits including age, BMI, smoking status, and treatment pill intake predict breast cancer survival in female patients
This study analyzed 21,219 female breast cancer patients from the UK Biobank and found that age, BMI, smoking status, and treatment pill intake are key lifestyle-related factors influencing survival. The XGBoost model achieved AUCs of 0.748, 0.749, and 0.765 at 3, 6, and 9 years, respectively, and high-risk patients had significantly worse survival (P < 0.0001).
Prader-Willi Syndrome presents with initial growth failure followed by progressive weight gain, excessive eating, and cognitive impairment in children
This case report describes a 7-year-old Nigerian girl with Prader-Willi Syndrome confirmed by DNA analysis, who presented with a 4-year history of progressive weight gain, voracious appetite, snoring during sleep, and poor academic performance. She had feeding difficulties and growth failure in the first year of life, followed by excessive eating and weight gain from age 3. Dietary modification and planned exercises led to a 3 kg weight loss over eight months.
Multi-level interventions reduce emotional exhaustion and depersonalization in nurses
This narrative review found that interventions at individual, team, and system levels reduce emotional exhaustion and depersonalization, enhance staff well-being, and improve patient safety among nurses. The review highlights that effective strategies include mindfulness-based programs, cognitive-behavioral therapy, physical exercise, and resilience training, with improved effectiveness in supportive environments with allocated participation time and leadership engagement.
The Health Mode On and Health Mode On Plus protocols implement a stepped, integrated model of prevention and care to assess and promote mental wellbeing and healthy lifestyles among Italian university students.
The paper describes a multisite protocol (HMO and HMO+) funded by the Italian Ministry of University and Research, which combines harmonized surveillance with a stepped care model aligned with the WMH-ICS framework. It includes a cross-sectional survey, longitudinal follow-up, and an embedded randomized evaluation of digital cognitive-behavioral therapy (e-CBT) versus counseling-as-usual for students with anxiety risk. Primary outcomes are DSM-5 disorder status and safety outcomes, with secondary outcomes including sleep, physical activity, and other lifestyle factors.
The Family Nutrition and Physical Activity screening tool was successfully translated and culturally adapted for Portuguese parents, demonstrating strong face and content validity.
The FNPA-PT was developed through a rigorous seven-stage translation and cross-cultural adaptation process, achieving 85% semantic equivalence between forward and back translations. Cognitive interviews with 10 parents of 5-year-old children showed the tool was well understood, acceptable, and feasible for use during well-child visits.
Wearable-based physical activity and sleep monitoring in substance use disorder treatment settings is feasible but requires structural and procedural safeguards to manage high wearable loss rates.
In a longitudinal study across 8 SUD treatment and recovery service sites in Western Australia, 13 out of 63 wearables (20.6%) were permanently lost, compared to approximately 1% in general population studies. Loss occurred almost exclusively in residential care settings and coincided with participant exit from treatment, with no losses due to technical malfunction or deliberate non-compliance.
Wearable devices and AI-supported physical activity management improve behavioral outcomes in chronic disease populations
This review synthesizes evidence on wearable- and AI-supported physical activity management across chronic diseases. Current evidence most consistently supports improvements in behavioral outcomes including steps, physical activity levels, self-monitoring, and in some cases sedentary behavior. Evidence for functional and intermediate clinical outcomes is promising but heterogeneous, while long-term clinical endpoints and cost-effectiveness remain less definitive.
Higher training intensity and volume are associated with lower depressive symptoms in young adults
In a cross-sectional study of 349 predominantly young adults (median age 21), higher training intensity and volume were associated with lower depressive symptoms as measured by the Beck Depression Inventory. Sleep quality did not mediate this relationship except for the daytime dysfunction domain. Participants with 3-5 years of training experience had lower BDI scores than those with less than 12 months of experience.
Lifestyle practices including diets, physical exercise, sleep quality, and cognitive activity can help minimize aging effects on the brain.
The paper reviews evidence that lifestyle factors such as nutrition, exercise, sleep, and cognitive activity may reduce or delay negative effects of brain aging. It emphasizes the role of specific nutrients (lipids, glucose, vitamins, protein, flavonoids) and metabolic regulation in supporting brain health across the lifespan.
Exercise dose architecture, rather than modality alone, may determine therapeutic benefits in autism spectrum disorder, with potential effects on executive function, stereotyped behaviors, sleep, motor competence, social communication, and quality of life.
This narrative review proposes that the therapeutic value of exercise in ASD depends on dose architecture (including motor complexity, cognitive demand, social embeddedness, sensory load, predictability, progression rate, and adherence burden) rather than just modality labels. The review synthesizes clinical and indirect evidence, but does not provide specific effect sizes or quantitative results.
The translated and culturally adapted FNPA-PT screening tool demonstrates strong face and content validity for assessing obesogenic family environments in Portuguese well-child visits.
The FNPA-PT was developed through a rigorous seven-stage translation and cross-cultural adaptation process, achieving high semantic equivalence (85% of items with satisfactory or perfect equivalence). Cognitive interviews with 10 parents of 5-year-old children showed the tool was well understood, acceptable, and feasible for use during well-child visits.
Insomnia induces intestinal microbiota disorder, and artificial interventions targeting gut microbiota can improve sleep.
This narrative review summarizes evidence that insomnia can disrupt intestinal microbiota by activating immune responses, the HPA axis, and neuroendocrine systems, while gut microbiota can exacerbate insomnia via neurotransmitter and inflammatory factor release. Artificial interventions such as probiotics, traditional Chinese medicine, fecal microbiota transplantation, diet, and exercise may improve sleep by affecting neurotransmitter and microbial metabolite release.
Sleep continuity is crucial for fatigue and sustained attention during cold-environment military training
First-year cadets with higher physical activity and less total sleep showed increased fatigue and declines in sustained attention (PVT reaction time) and jump performance, while second-year cadets with more sleep showed partial recovery. Perceived fatigue increased post-first training block only in first-year cadets (p=0.003), and increased fatigue correlated negatively with PVT performance (all p<0.043).
Immersive VR exercise (exergaming) generates moderate-to-vigorous physical activity comparable to traditional exercise and may enhance NAD+ metabolism via NAMPT activation.
The review finds that immersive VR exercise (exergaming) produces levels of moderate-to-vigorous physical activity similar to traditional exercise. It suggests that such activity may enhance NAD+ metabolism through NAMPT activation, though no human study has yet measured blood NAD+ levels alongside VR interventions.
Circadian rhythm disruption is closely associated with obesity and chronic inflammation, and regular exercise can serve as an effective zeitgeber to realign disrupted biological rhythms and reduce obesity-related inflammation.
This review paper summarizes evidence that circadian clock disruption contributes to a vicious cycle involving rhythm disturbance, obesity, and inflammation. Regular exercise acts as a zeitgeber to help realign disrupted biological rhythms and reduce obesity-related inflammation, though the optimal exercise timing remains unclear.
Circadian misalignment exacerbates symptoms of disorders of gut-brain interaction (IBS and FD) by altering gut-brain interactions, and interventions such as exercise and time-restricted feeding may mitigate GI motor dysfunction by restoring circadian rhythmicity.
This review paper synthesizes evidence that circadian disruption impairs GI motility and contributes to disorders of gut-brain interaction (DGBI) such as IBS and FD. It highlights that women have heightened sensitivity to circadian disruption, correlating with higher prevalence of IBS and FD in females. The paper proposes that chronotherapeutic interventions like exercise and time-restricted feeding may restore circadian alignment and improve GI symptoms.
Physiotherapists perceive fibromyalgia management as a multidimensional process involving validation, pain neuroscience education, individualized exercise, and group-based support to facilitate adherence and functional recovery.
This qualitative study of 13 physiotherapists in Spain identified three overarching themes: clinical validation, shifting therapeutic goals from pain reduction to function and autonomy, and the use of pain neuroscience education and individualized exercise as main strategies. Group-based interventions were noted to promote social support, motivation, and adherence, while lifestyle recommendations complemented treatment.
The FNPA-PT screening tool demonstrates strong face and content validity for assessing obesogenic family environments in Portuguese well-child visits
The study translated and culturally adapted the Family Nutrition and Physical Activity (FNPA) screening tool for Portugal (FNPA-PT). Cognitive interviews with 10 parents of 5-year-old children showed 85% semantic equivalence and high acceptability, with minor revisions to three items.
Structured physical exercise improves sleep disorders through interconnected biological pathways including thermoregulation, neurochemical adaptations, endocrine signaling, and autonomic nervous system balance.
This narrative review consolidates evidence that structured physical exercise, including aerobic, resistance, and mind-body modalities, is an effective non-pharmacological intervention for sleep disorders such as insomnia, sleep apnea, and circadian rhythm dysfunctions. The beneficial effects are mediated by multiple biological mechanisms, including thermoregulatory, neurochemical, endocrine, and autonomic nervous system changes. The review highlights exercise's efficacy and favorable safety profile compared to pharmacological treatments.
Sleep quality mediates the relationship between mental health and functional outcomes in early adolescence
Sleep quality mediated 18.5%, 36.3%, and 8.3% of the relationships between depression, anxiety, and psychotic-like experience distress with academic functioning, respectively, and 19.6-23.3% of the relationships with social problems. Screen time was the second strongest mediator, but only sleep quality showed >3% mediation for social problems.
Breast cancer survivors with sleep disturbances have positive attitudes toward text messaging-based mobile health interventions for improving sleep and physical activity.
This qualitative study explored preferences of 16 breast cancer survivors (mean age 59.3 years) with sleep disturbances for SMS text messaging-based interventions targeting sleep and physical activity. Most participants reported positive attitudes and high acceptance of text messaging and mobile apps, but not voice interactions, with daily reminders scheduled 1 hour before bedtime being acceptable.
Tirzepatide may trigger exercise-induced anaphylaxis, which resolves upon discontinuation of the drug.
A patient developed exercise-induced anaphylaxis after initiating tirzepatide, a dual GIP/GLP-1 receptor agonist. After discontinuing tirzepatide, the exercise-induced anaphylaxis resolved. This suggests a causal relationship between tirzepatide and exercise-induced anaphylaxis.
The 24HMBQ shows good criterion validity for sleep and moderate validity for sedentary behavior, but limited validity for physical activity in Chinese college students.
The 24HMBQ was validated against accelerometer data in 88 Chinese college students. Strong correlations were found for sleep (weekdays Rho=0.77, weekends Rho=0.68), moderate for sedentary behavior (weekdays Rho=0.55, weekends Rho=0.33), but weak for light PA (Rho=0.30) and non-significant for MVPA (Rho=0.15).
High role overload among nursing students is associated with frequent night shifts, irregular sleep, and lack of physical exercise.
A cross-sectional study of 512 nursing students identified three latent profiles of role overload (low, moderate, high). Students in the high overload group reported significantly more frequent night shifts, irregular sleep, and less physical exercise compared to other groups (all p < 0.05).
High-intensity aerobic exercise improves cardiorespiratory fitness and selected motor outcomes in carefully screened and supervised Parkinson's disease patients
The review suggests that high-intensity aerobic exercise and high-intensity interval training may improve cardiorespiratory fitness and selected motor outcomes in Parkinson's disease patients. However, this is based on limited clinical evidence with heterogeneous definitions of exercise intensity, small samples, and short intervention periods.
Substituting screen or sedentary time with physical activity reduces irritability in early childhood
In a longitudinal study of 1,266 children aged 2-4 years, those who typically spent more time in physical activity were irritable significantly less often, while more screen time was linked to greater irritability. Substituting screen or sedentary time with physical activity was associated with reduced irritability.
Exercise affects sleep outcomes in research
Probable Serotonin Syndrome Precipitated by the Addition of Trazodone to Lurasidone and Valproic Acid: A Case Report.. Published in Sante mentale au Quebec (2026). PMID: 42490704.
Long sleep duration and low physical activity are associated with sarcopenia in older adults, supporting a 24-hour exercise rehabilitation framework.
This observational study found that long sleep duration and low physical activity are linked to sarcopenia in older adults. The findings suggest that a 24-hour approach integrating sleep and activity may be beneficial for rehabilitation. Specific numbers were not provided in the abstract.
Exercise interventions that satisfy students' basic psychological needs for autonomy, competence, and relatedness are more decisive for weight reduction than the specific exercise modality prescribed.
This paper argues that the effectiveness of exercise interventions for weight reduction among university students depends more on whether the delivery of exercise satisfies psychological needs (autonomy, competence, relatedness) per Self-Determination Theory than on the specific type of exercise. It reinterprets barriers like weight-related self-stigma, low exercise self-efficacy, academic time pressure, and digital overload as threats to these needs.
Exercise modulates circadian rhythm regulation and may improve neurological outcomes in stroke and Alzheimer's disease
This review synthesizes evidence that exercise acts as a non-photic zeitgeber, regulating core clock gene expression, synchronizing hormonal and metabolic rhythms, and reducing neuroinflammation. These mechanisms enhance circadian amplitude, stability, and phase alignment, potentially promoting physiological resilience and reducing disease vulnerability. In stroke and Alzheimer's disease, appropriately timed exercise may improve neurological outcomes through neuroplasticity, immune regulation, and metabolic synchronization.
A machine learning model using routinely available variables can identify COPD patients at increased risk of exercise-induced desaturation during the 6-minute walk test.
The study developed a screening-oriented machine learning approach to identify COPD patients at risk of exercise-induced desaturation (EID), defined as SpO2 < 90% with a decrease of ≥ 4%p. Among 1,788 patients, 10.3% exhibited EID. The XGB model achieved the highest sensitivity and stable performance in the test set, with baseline SpO2 and diffusion capacity of the lung for carbon monoxide as the most influential predictors.
Non-pharmacological interventions, particularly physical activity and cognitive rehabilitation, are first-line management for cancer-related cognitive impairment in adult cancer survivors
This clinical practice review found that non-pharmacological interventions are recommended as first-line management for cancer-related cognitive impairment (CRCI), with physical activity and cognitive rehabilitation showing the strongest benefits. CRCI affects approximately 60-75% of individuals with cancer and is multifactorial, involving biological and psychosocial contributors.
Saliva cell-free mitochondrial DNA (cf-mtDNA) increases in response to acute physical and cognitive stress, with individual differences linked to fitness, sleep quality, and stress perception.
In a crossover study of 47 participants, saliva cf-mtDNA levels increased by 90% after baseline during exercise and peaked 160% above baseline during cognitive stress. Higher cf-mtDNA elevations during exercise were associated with fewer recent stressful incidents, lower alcohol use, higher VO2 max, and lower BMI; more dynamic responses to cognitive stress were seen in those with poorer sleep quality and greater blood pressure reactivity.
Long-term wearable monitoring reveals that sustained behavior change leading to substantial weight loss is associated with favorable cardiometabolic adaptations in a highly motivated young adult male.
In a single-participant case study, a young adult male achieved a 27.8% reduction in body weight over three years, accompanied by improvements in resting heart rate (69.5 to 53.6 bpm), heart rate variability (40.6 to 75.5 ms), and clinical biomarkers such as fasting glucose (102 to 82 mg/dL) and triglycerides (134 to 74 mg/dL). Post-weight-loss VO2max (46.9 ml/kg/min) and body fat (21.6%) were favorable compared to norms. The study demonstrates the potential of continuous wearable monitoring to capture behavior-driven cardiometabolic changes in real-world settings.
Higher physical activity and lower sedentary behavior are associated with better quality of life in cardiac rehabilitation participants, but sleep duration shows no significant association.
In a cross-sectional study of 105 cardiac rehabilitation participants, only 2.9% met all three Canadian 24-Hour Movement Guidelines recommendations. Higher physical activity was positively associated with functional capacity, vitality, and social aspects, while sedentary behavior was negatively associated with functional capacity; sleep duration was not associated with any quality-of-life domain.
Semaglutide 2.4 mg is cost-effective for obesity disease management in Japan under retreatment scenarios
Semaglutide 2.4 mg plus diet and exercise reduced the incidence of obesity-related complications including type 2 diabetes, cardiovascular events, obstructive sleep apnea, and gout. The incremental cost-effectiveness ratio was ¥5,300,580/QALY for patients without type 2 diabetes and ¥7,077,984/QALY for patients with type 2 diabetes, with retreatment improving QALY gains.
Weekly physical activity trajectories differ between adolescent and adult childhood cancer survivors and controls, with weekend drops in activity common across groups.
The study identified four weekly physical activity trajectories among adolescent and adult childhood cancer survivors using accelerometer data. Key factors associated with different trajectories included sex, age, sleep, and parental education, with diagnosis important only in adolescents. Adolescent survivors had fewer individuals in the low activity trajectory compared to controls, while adult survivors showed no low regular MVPA trajectory.
Residential medical students demonstrate a knowledge-practice gap in healthy lifestyle behaviours, with high health awareness but poor adherence to healthy practices.
Among 199 residential undergraduate medical students, 65.3% reported sometimes or often skipping breakfast, 45.7% slept less than six hours per night, and 94.5% used digital devices before bedtime. Despite 69.8% reporting physical activity, only 25.1% exercised daily, indicating a significant gap between health awareness and actual lifestyle practices.
Non-pharmacological pain care with supportive trial evidence is underused in people with inflammatory arthritis, while long-term opioids and gabapentinoids are commonly prescribed despite absent trial evidence for efficacy.
The guideline highlights that UK electronic health record data show long-term opioid and gabapentinoid prescribing is common in people with inflammatory arthritis, despite a lack of trial evidence supporting their efficacy. Patient survey data indicate that non-pharmacological pain management approaches with supportive trial evidence are underutilized.
Endurance runners experience a higher prevalence of several mental health symptoms, including anxiety, exercise addiction, sleep disorders, and suicidal ideation, which is multifactorial and involves self-selection, sport-specific demands, and biopsychosocial factors.
This commentary highlights that endurance runners have a higher prevalence of mental health symptoms such as anxiety, exercise addiction, sleep disorders, and suicidal ideation. The authors argue that these outcomes are multifactorial, involving self-selection processes, sport-specific demands, and broader biopsychosocial factors, and emphasize the need for longitudinal and qualitative research.
Better sleep is associated with higher physical activity the next day in adults with autism
In a cohort study of 17 adults with autism, better sleep was significantly associated with higher physical activity (step count) the next day. No consistent effect was found of sleep on stress the next day or of stress on sleep quality the following night, with substantial individual variability.
The Integrated Resilience Method improves chronic low back pain management in women over 50
The Integrated Resilience Method is a six-pillar framework for postmenopausal women with chronic low back pain, integrating exercise, pain education, and self-efficacy as core components with the strongest evidence. It addresses biopsychosocial factors including hormonal change, sarcopenia, sleep disruption, fear-avoidance, and caregiving stress.
Ventilatory response to CO2 during exercise remains profoundly low in patients with Congenital Central Hypoventilation Syndrome, with no significant difference from resting values.
In 10 patients with CCHS, the ventilatory response to CO2 during exercise was 2.27 mL/min/mmHg/kg, which was not significantly different from the resting value of 1.56 mL/min/mmHg/kg (p=0.85). Both values were markedly lower than the reference value in healthy children (34.6 mL/min/mmHg/kg), indicating persistent impairment of CO2-driven ventilatory control despite increased metabolic demand.
Family home-based intervention improves physical quality of life in guardians with overweight/obesity and reduces BMI z-score in children with overweight/obesity
A 12-month home-based family intervention was tested in 142 families with at least one child with overweight/obesity. Children with overweight/obesity showed decreased BMI z-score over time (p = 0.001), and guardians with overweight/obesity improved physical quality of life at the end of the program (p = 0.002). The study suggests family-centered strategies may be effective for childhood obesity.
An 8-week multicomponent group exercise program improves muscle strength and sleep quality in community-dwelling older adults in Taiwan.
This quasi-experimental study found that an 8-week multicomponent group exercise program significantly improved gait speed, upper limb muscle strength, sleep quality, and heart rate recovery in the intervention group compared to baseline. Between-group posttest comparisons showed significant differences in arm curls, grip strength, and sleep quality favoring the intervention group.
A standardized multicomponent respiratory guidance and nursing care protocol improves sleep quality in elderly patients with COPD
This paper describes a 12-week multicomponent intervention integrating breathing training, respiratory muscle training, aerobic exercise, and continuous nursing support based on Orem's self-care deficit theory. Sleep quality measurement is included as a standardized outcome, but no numerical results are reported in the abstract.
AI and chatbot-supported interventions for pediatric physical activity and obesity-related lifestyle behaviors show mixed effectiveness, with 4 of 8 studies reporting significant improvements in physical activity or fitness outcomes.
This scoping review of 14 studies found that AI-enabled chatbot interventions for pediatric physical activity and obesity-related behaviors are a rapidly emerging field, with most studies published since 2023. Among 8 studies reporting direct physical activity or fitness outcomes, 4 showed significant improvement, 2 found no significant change, and 2 reported mixed or indirect findings. Family involvement was present in 71.4% of studies, and feasibility and acceptability were generally favorable.
Sport-related activities may facilitate post-disaster mental health recovery through physiological regulation, psychological empowerment, and social reconnection.
This narrative review of 11 studies proposes that sport-related activities (participatory and spectator-based) can aid mental health recovery after natural disasters by modulating the HPA axis, restoring self-efficacy, and rebuilding social networks. The evidence is observational and heterogeneous, so causal effects cannot be established.
Physical activity improves mental well-being in esports practitioners through improved sleep quality and reduced cognitive fatigue
Physical activity (PA) positively predicted mental well-being in esports players, serially mediated by improved sleep quality and reduced cognitive fatigue. SHAP analysis revealed a non-linear dose-response pattern, with the steepest benefits at 600-1,200 MET-min/week and plateauing beyond approximately 1,800 MET-min/week.
Respiratory muscle training is insufficient as a standalone intervention for treating objective sleep-disordered breathing outcomes in heterogeneous spinal cord injury cohorts
A scoping review of six studies found that while case reports showed clinically significant reductions in global sleep-disordered breathing indices, larger experimental trials found no significant between-group differences in objective SDB severity or nocturnal oxygenation. A randomized pilot trial suggested combined RMT and oropharyngeal exercises could reduce upper airway collapsibility, and a prospective cohort study found modest improvements in nocturnal gas exchange among those who gained maximal inspiratory pressure.
Moderate-intensity continuous training (MICT) improves sleep continuity by reducing wake-sleep transitions and prolonging NREM bout duration in mice, whereas high-intensity interval training (HIIT) increases total sleep time and NREM sleep duration.
In a randomized animal study, MICT reduced wake-sleep transitions and prolonged NREM bout duration, indicating improved sleep continuity, while HIIT increased total sleep time (β=18.50, 95% CI: 9.03-27.97, p<0.001) and NREM sleep duration (β=19.46, 95% CI: 10.38-28.54, p<0.001). However, direct comparisons between MICT and HIIT did not reach statistical significance after FDR adjustment, so the differential patterns are descriptive trends relative to untrained controls.
Exercise improves overall functioning and reduces depressive symptoms in individuals with bipolar disorder
Preliminary clinical trial findings indicate that exercise improves overall functioning, reduces mood episode frequency and hospitalizations, and alleviates depressive symptoms in individuals with bipolar disorder. One pilot study reported an 82% antidepressant response rate. Evidence also suggests potential benefits for anxiety and sleep, though robust data are limited.
24-h movement behaviors (physical activity, sedentary behavior, sleep) in preschool children with developmental disabilities show mixed and inconsistent differences compared to children without developmental disabilities.
This scoping review of 20 predominantly cross-sectional studies (2004-2024) found that findings on sleep, sedentary behavior, and physical activity among preschool children with developmental disabilities were mixed, with some studies reporting significant group differences while others found no or inconsistent differences. The review highlights variability and gaps in research on movement behaviors in this population.
24-hour movement behaviors (physical activity, sedentary behavior, sleep) in preschool children with developmental disabilities show mixed differences compared to typically developing peers, with some studies reporting significant group differences and others finding no or inconsistent differences.
This scoping review of 20 predominantly cross-sectional studies (2004-2024) examined 24-hour movement behaviors in preschool children (33-72 months) with developmental disabilities such as autism spectrum disorder, cerebral palsy, and developmental coordination disorder. Findings on sleep, sedentary behavior, and physical activity were mixed, with some studies reporting significant group differences while others found no or inconsistent differences compared to children without developmental disabilities.
Aerobic exercise interventions improve cognitive function in older adults with cognitive frailty
This systematic review of 16 RCTs found that 87.5% of studies reported significant cognitive benefits from aerobic exercise interventions in older adults. Pure aerobic and dual-task interventions consistently improved cognition, while intrinsic/embedded interventions enhanced both cognitive and physical outcomes.