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One Size Does Not Fit All: New Strategies to Improve Overall Health and Physical Activity Behavior in Vulnerable Populations

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Exercise and Health-Related Quality of Life".

Deadline for manuscript submissions: 30 April 2025 | Viewed by 7328

Special Issue Editors

Dr. Gabriel Dias Rodrigues

E-Mail Website
Guest Editor
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20100 Milan, Italy
Interests: respiratory muscle training; autonomic nervous system; cerebrovascular control; aging; rheumatologic diseases; environmental conditions
Special Issues, Collections and Topics in MDPI journals
Dr. Marco Vicenzi

E-Mail Website
Guest Editor
1. Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20154 Milan, Italy
2. Dyspnea Lab, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
Interests: cardiopulmonary exercise testing; exercise physiology; cardiorespiratory physiology; cardiorespiratory rehabilitation; rehabilitation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,           

Sedentary behavior increases the risk for several cardiovascular and metabolic diseases. For vulnerable populations (e.g., older adults and chronic diseases), sedentarism has amplified deteriorative effects on several physiological systems. Hence, the scientific literature has been communicating strategies which would make people more active. However, the physical activity strategy should account for a clear outcome, population characteristics, environmental conditions, and participants' preferences. Thus, this challenge remains today, as one size does not fit all. This Special Issue aims to explore the bridge between ongoing physical activity/exercise strategies and therapeutic targets/overall health benefits in vulnerable populations.  

This Research Topic welcomes review papers and original research regarding the following themes: 

  1. Breaks in the sedentary behavior and exercise promotion in chronic diseases; 
  2. Acute and chronic whole-body exercise and respiratory exercise strategies;
  3. Environmental effects on cardiorespiratory responses and physical capacity.

You may choose our Joint Special Issue in JCM.

Dr. Gabriel Dias Rodrigues
Dr. Marco Vicenzi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic diseases
  • vascular function
  • aging
  • sedentarism
  • active breaks
  • exercise
  • respiratory muscle training
  • hostile environments

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Published Papers (3 papers)

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Research

17 pages, 645 KiB  
Article
Reframing Communication about Fall Prevention Programs to Increase Older Adults’ Intentions to Participate
by Meike C. van Scherpenseel, Lidia J. van Veenendaal, Saskia J. te Velde, Elise Volk, Di-Janne J. A. Barten, Cindy Veenhof, Marielle H. Emmelot-Vonk and Amber Ronteltap
Int. J. Environ. Res. Public Health 2024, 21(6), 704; https://doi.org/10.3390/ijerph21060704 - 30 May 2024
Viewed by 1133
Abstract
Introduction: Falls and fall-related injuries in community-dwelling older adults are a growing global health concern. Despite effective exercise-based fall prevention programs (FPPs), low enrollment rates persist due to negative connotations associated with falls and aging. This study aimed to investigate whether positive framing [...] Read more.
Introduction: Falls and fall-related injuries in community-dwelling older adults are a growing global health concern. Despite effective exercise-based fall prevention programs (FPPs), low enrollment rates persist due to negative connotations associated with falls and aging. This study aimed to investigate whether positive framing in communication leads to a higher intention to participate in an FPP among community-dwelling older adults. Methods: We conducted a two-sequence randomized crossover study. We designed two flyers, a standard flyer containing standard terminology regarding FPPs for older adults, and a reframed flyer highlighting fitness and activity by reframing ‘fall prevention’ as an ‘exercise program’ and ‘old’ as ‘over 65 years’. With a Mann–Whitney U test, we investigated group differences regarding the intention to participate between the flyers. A sensitivity analysis and subgroup analyses were performed. We conducted qualitative thematic analysis on open-ended answers to gain a deeper understanding of participants’ intention to participate. Results: In total, we included 133 participants. Findings indicated a significantly higher intention to participate in the reframed flyer (median = 4; interquartile range = 1–6) compared to the standard flyer (median = 2; interquartile range = 1–4) (p = 0.038). Participants favored more general terms such as ‘over 65 years’ over ‘older adults’. Older adults who were female, not at high fall risk, perceived themselves as not at fall risk, and maintained a positive attitude to aging showed greater receptivity to positively-framed communications in the reframed flyer. Additionally, already being engaged in physical activities and a lack of practical information about the FPP appeared to discourage participation intentions. Discussion: The results in favor of the reframed flyer provide practical insights for designing and implementing effective (mass-)media campaigns on both (inter)national and local levels, as well as for interacting with this population on an individual basis. Aging-related terminology in promotional materials hinders engagement, underscoring the need for more positive messaging and leaving out terms such as ‘older’. Tailored positively framed messages and involving diverse older adults in message development are essential for promoting participation in FPPs across various population subgroups to promote participation in FPPs among community-dwelling older adults. Full article
(This article belongs to the Special Issue One Size Does Not Fit All: New Strategies to Improve Overall Health and Physical Activity Behavior in Vulnerable Populations)
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10 pages, 727 KiB  
Article
Increased Prolonged Sitting in Patients with Rheumatoid Arthritis during the COVID-19 Pandemic: A Within-Subjects, Accelerometer-Based Study
by Ana Jessica Pinto, Diego Rezende, Sofia Mendes Sieczkowska, Kamila Meireles, Karina Bonfiglioli, Ana Cristina de Medeiros Ribeiro, Eloisa Bonfá, Neville Owen, David W. Dunstan, Hamilton Roschel and Bruno Gualano
Int. J. Environ. Res. Public Health 2023, 20(5), 3944; https://doi.org/10.3390/ijerph20053944 - 23 Feb 2023
Cited by 5 | Viewed by 2153
Abstract
Background: Social distancing measures designed to contain the COVID-19 pandemic can restrict physical activity, a particular concern for high-risk patient groups. We assessed rheumatoid arthritis patients’ physical activity and sedentary behavior level, pain, fatigue, and health-related quality of life prior to and during [...] Read more.
Background: Social distancing measures designed to contain the COVID-19 pandemic can restrict physical activity, a particular concern for high-risk patient groups. We assessed rheumatoid arthritis patients’ physical activity and sedentary behavior level, pain, fatigue, and health-related quality of life prior to and during the social distancing measures implemented in Sao Paulo, Brazil. Methods: Post-menopausal females diagnosed with rheumatoid arthritis were assessed before (from March 2018 to March 2020) and during (from 24 May to 7 July 2020) social distancing measures to contain COVID-19 pandemic, using a within-subjects, repeated-measure design. Physical activity and sedentary behavior were assessed using accelerometry (ActivPAL micro). Pain, fatigue, and health-related quality of life were assessed by questionnaires. Results: Mean age was 60.9 years and BMI was 29.5 Kg/m2. Disease activity ranged from remission to moderate activity. During social distancing, there were reductions in light-intensity activity (13.0% [−0.2 h/day, 95% CI: −0.4 to −0.04; p = 0.016]) and moderate-to-vigorous physical activity (38.8% [−4.5 min/day, 95% CI: −8.1 to −0.9; p = 0.015]), but not in standing time and sedentary time. However, time spent in prolonged bouts of sitting ≥30 min increased by 34% (1.0 h/day, 95% CI: 0.3 to 1.7; p = 0.006) and ≥60 min increased by 85% (1.0 h/day, 95% CI: 0.5 to 1.6). There were no changes in pain, fatigue, and health-related quality of life (all p > 0.050). Conclusions: Imposed social distancing measures to contain the COVID-19 outbreak were associated with decreased physical activity and increased prolonged sedentary behavior, but did not change clinical symptoms sitting among patients with rheumatoid arthritis. Full article
(This article belongs to the Special Issue One Size Does Not Fit All: New Strategies to Improve Overall Health and Physical Activity Behavior in Vulnerable Populations)
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10 pages, 871 KiB  
Article
The Time Course of Cardiorespiratory Adaptations to Rowing Indoor Training in Post-Menopausal Women
by Renata Cardoso Araujo, Gabriel Dias Rodrigues, Luana Farinazzo Ferreira and Pedro Paulo da Silva Soares
Int. J. Environ. Res. Public Health 2023, 20(4), 3238; https://doi.org/10.3390/ijerph20043238 - 13 Feb 2023
Cited by 2 | Viewed by 3214
Abstract
Background: Post-menopausal women have impaired cardiorespiratory responses to exercise compared to young women. Exercise training may counterbalance impairments, but the time-dependent effects of exercise training remain unclear. The current study aims to investigate the effects of rowing training on maximal aerobic capacity and [...] Read more.
Background: Post-menopausal women have impaired cardiorespiratory responses to exercise compared to young women. Exercise training may counterbalance impairments, but the time-dependent effects of exercise training remain unclear. The current study aims to investigate the effects of rowing training on maximal aerobic capacity and time-course cardiorespiratory adaptations in older women. Methods: Female participants (n = 23) were randomly allocated to the experimental group (EXP; n = 23; 66 ± 5 years old) enrolled in rowing exercise training and control group (CON; n = 10; 64 ± 4 years old). The cardiopulmonary exercise test (CET) was performed in a cycle ergometer pre- and post-interventions. Oxygen uptake (VO2), stroke volume (SV), cardiac output (CO), and HR were recorded during CET and analyzed at the peak of the exercise. HR was monitored during exercise recovery, and the index of HRR was calculated by ΔHRR (HRpeak—HR one-minute recovery). Every two weeks, Rowing Stepwise Exercise (RSE) in a rowing machine was performed to track specific adaptations to the exercise modality. HR was continuously recorded during RSE and corrected for the average power of each step (HR/watts). The rowing training protocol consisted of three weekly sessions of 30 min at an intensity corresponding to 60–80% of peak HR for ten weeks. Results: Rowing exercise training increased VO2, SV, and CO at the peak of the CET, and ΔHRR. Increased workload (W) and reduced HR response to a greater achieved workload (HR/W) during RSE were observed after six weeks of training. Conclusions: Rowing exercise training is a feasible method to improve cardiorespiratory performance, vagal reactivation and heart rate adjustments to exercise in older women. Full article
(This article belongs to the Special Issue One Size Does Not Fit All: New Strategies to Improve Overall Health and Physical Activity Behavior in Vulnerable Populations)
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