Search Results (318)

Accurate measurement of physical activity is crucial for promoting health and preventing non-communicable diseases, particularly in Sub-Saharan Africa, where the dual burden of infectious and chronic diseases presents significant public health challenges. While self-reported tools are commonly used, they are often limited by recall and social desirability biases. This study aimed to compare self-reported physical activity with objectively measured pedometer data and explore their associations with fitness and anthropometric indicators among university students. A cross-sectional study was conducted among 60 full-time students at a South African university. The study was conducted in two phases: For phase 1, participants completed the International Physical Activity Questionnaire (IPAQ). For phase two, participants wore pedometers for seven consecutive days to measure total and aerobic step counts. Fitness was assessed using the Harvard Step Test to calculate the Physical Efficiency Index (PEI), and anthropometric data (BMI, waist-to-hip ratio, body fat percentage) were recorded. Statistical analyses included Spearman’s correlations, Mann–Whitney U test, Kruskal–Wallis H test, and multivariable linear regression. While 83.3% of participants self-reported high physical activity levels, pedometer data indicated that 61.7% accumulated fewer than 1500 aerobic steps per day and 53.3% recorded fewer than 5000 total steps. No significant association was found between self-reported activity and pedometer-measured steps (p-value = 0.748 and p-value = 0.835, respectively). Objective measures showed significant positive correlations between aerobic steps and PEI (r = 0.274, p-value = 0.034) and significant negative correlations with BMI (r = −0.489, p-value < 0.001) and body fat percentage (r = −0.255, p-value = 0.046). Older age and female gender were associated with lower step counts. This study reveals a significant overestimation of physical activity in self-reports compared to objective measures and stronger links between objectively measured steps and key health outcomes. The findings highlight the need to integrate objective monitoring tools into public health practice and youth-focused interventions in Sub-Saharan Africa. They underscore the importance of exploring context-specific factors influencing activity levels. Enhancing measurement accuracy is vital for advancing evidence-based strategies and achieving Sustainable Development Goal 3. Full article

Introduction: Chronic non-specific neck pain is a musculoskeletal disorder which may affect psychological well-being and work performance. Depression, anxiety, and limitations in daily and work activities may occur differently between genders in individuals with chronic non-specific pain. The main purpose of the present cross-sectional study was to investigate the differences between men and women with chronic non-specific neck pain in disability due to pain, quality of life, and sedentary behavior. Secondly, we investigated the intercorrelations between the three above measured variables in the total sample. Methods: Eighty patients (44 men and 36 women), aged 20–55 years (Μ = 33.55, SD = 11.16) with chronic non-specific neck pain in the last 3 years participated. They completed three validated questionnaires which measured neck disability pain, quality of life, and sedentary behavior with (a) the Neck Disability Index (NDI), (b) the quality-of-life EuroQol-5D (EQ-5D), and (c) the International Physical Activity Questionnaire (IPAQ), respectively. Gender comparisons with Kruskal–Wallis H tests and correlation analysis with Spearman r tests were performed between the above variables using SPSS 29.00. Results: Men reported (a) better quality of life (H = 16.14, p < 0.001), (b) lower pain-related disability (H = 13.96, p < 0.001), (c) more time spending in vigorous physical activity (H = 3.37, p < 0.05), (d) more time spending in moderate physical activity (H = 5.17, p < 0.05), and (e) more time spending in walking (H = 11.24, p < 0.001). A strong positive correlation was found between the NDI and the EQ-5D Index (r = 0.74, p = 0.002) and a negative correlation was found between NDI and the EQ-5D VAS (r = −0.65, p = 0.003). Discussion: The present findings reported that men have more time walking, and have lower disability due to neck pain than women, thus they have better quality of life than women with chronic non-specific neck pain. Full article

Background: Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. This study aimed to evaluate the associations of sociodemographic factors, lifestyle habits, and insomnia severity with multiple obesity indices in a large population of Spanish workers. Methods: We conducted a cross-sectional analysis of 84,898 workers (2021–2024). Data were obtained from annual occupational health assessments conducted across multiple Spanish regions between 2020 and 2024. Insomnia severity was assessed using the Insomnia Severity Index (ISI), dietary quality using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), and physical activity using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Adiposity was measured using Body Mass Index (BMI), waist-to-height ratio (WtHR), the Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF). Multivariable logistic regression models were used to examine associations adjusted for age, sex, education, and occupational social class. Results: Higher ISI scores were significantly and independently associated with elevated adiposity across all indices, with the strongest association observed for METS-VF (odds ratio = 1.19, 95% CI 1.14–1.25, p < 0.001). Women showed higher mean CUN-BAE and METS-VF values than men (CUN-BAE: 37.4 ± 6.2 vs. 25.6 ± 6.4; p < 0.001; METS-VF: 5.7 ± 0.7 vs. 6.4 ± 0.6; p < 0.001), despite lower BMI (25.3 ± 4.8 vs. 26.8 ± 4.3; p < 0.001). Lower physical activity (OR = 5.70; 95% CI 4.91–6.50), poor adherence to the Mediterranean diet (OR = 3.29; 95% CI 2.88–3.70), smoking (OR = 1.29; 95% CI 1.22–1.36), and lower occupational class (Class III: OR = 1.77; 95% CI 1.56–1.97) were also significantly associated with higher obesity markers. Associations were more pronounced among women and participants with severe insomnia symptoms. Conclusions: Insomnia severity, sociodemographic disadvantage, and unhealthy behaviors (low physical activity, poor diet, smoking) were all independent correlates of general and visceral adiposity. The findings underscore the need for comprehensive workplace health programs that integrate sleep quality assessment, dietary improvement, and physical activity promotion to prevent obesity and its metabolic consequences. Full article

Background: Cardiac autonomic dysfunction is a frequent complication of diabetes type 2 (T2DM). Heart rate variability (HRV) is a sensitive biomarker, but its relationship with habitual physical activity adjusted for metabolic and anthropometric factors remains underexplored. This study aimed to compare HRV indices between physically active and inactive adults with T2DM and assess the association between physical activity and clinical variables. Methods: In this cross-sectional observational study, 41 T2DM adults were classified as physically active (n = 22) or inactive (n = 19) using the short form of the International Physical Activity Questionnaire IPAQ-S. Resting HRV recordings were performed under standardized procedures. We analyzed the following time- and frequency-domain HRV indices: root mean square of successive heartbeat interval differences (RMSSD), standard deviation of normal-to-normal R-R intervals (SDNN), low-frequency (LF) and high-frequency (HF) power and their ratio (LF/HF). The analysis has been performed between-groups, and backward stepwise quantile regression examined the independent association of physical activity with HRV, adjusting for covariates. Results: Active participants exhibited higher HRV indices (SDNN p = 0.021; RMSSD p = 0.028; LF p = 0.032; HF p = 0.030), despite similar anthropometric and metabolic profiles. BMI correlated negatively with mean RR (ρ = −0.339, p = 0.030) and positively with mean HR (ρ = 0.339, p = 0.030). Physical activity was positively associated with LF (p = 0.015), and remained independently associated with SDNN (p = 0.021) and RMSSD (p = 0.048) after adjusting for HbA1c. Conclusions: Habitual physical activity was independently associated with enhanced autonomic modulation, with SDNN emerging as an early marker, supporting HRV as a biomarker for guiding exercise interventions in T2DM. Full article

Background/Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterised by musculoskeletal manifestations such as myopathies, arthritis, and arthralgia. Physical activity may improve patients’ quality of life and overall wellbeing. This study aimed to evaluate physical activity levels in patients with SLE and identify how clinical, psychosocial, and sociodemographic factors influence these levels. Methods: A multicentre cross-sectional study was conducted including 64 patients with SLE. Clinical variables were obtained from medical records, and patient-reported outcomes were collected at the time of the survey. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ-SF). Independent variables included fatigue (FAS), quality of life (SF-36), sleep (PSQI), depression (BDI-II), anxiety (HARS), age, disease factors (activity, duration, damage), sex, smoking, and comorbidities. Results: Significant associations were found between physical activity levels and smoking status (χ² = 11.88; p = 0.003), sleep quality (χ² = 6.81; p = 0.03), and anxiety (χ² = 18.39; p = 0.001). In multivariable analyses, poor sleep (PSQI > 5) (OR = 14.40; 95% CI: 2.50–82.99), higher anxiety (HARS; per point OR = 1.12; 95% CI: 1.05–1.20), and higher SF-36 Physical Component Summary (PCS) scores (per point OR = 1.29; 95% CI: 1.15–1.45) were associated with being in a higher physical activity category. Given the counterintuitive direction for sleep and the limited model fit, these results should be interpreted cautiously. Conclusions: In patients with SLE, physical activity was associated with sleep disturbances, anxiety, and perceived physical health. These findings underscore the need to integrate psychosocial and behavioural factors into multidisciplinary strategies promoting physical activity in lupus care and provide a rationale for future longitudinal and interventional studies to validate and extend these associations. Full article

This paper assesses the correlates of perceived well-being among young women aged 18 to 30 in five Balkan cities: Athens, Greece; Plovdiv, Bulgaria; Bucharest, Romania; Nis, Serbia; and Shtip, North Macedonia, by integrating urban, travel behavioural, and socio-economic features. A cross-sectional survey was employed using standard questionnaires including the Warwick–Edinburgh Mental Well-being Scale (WEMWBS), the short version of the International Physical Activity Questionnaire (IPAQ), and the adapted ALPHA environmental questionnaire. To answer research questions, linear regression models were developed to analyse predictors of well-being at both regional and national levels. Results show that neighbourhood and mobility features play a significant role in shaping mental well-being. Access to walkable sidewalks, green spaces, mixed land-use structure, and attractive local facilities (e.g., shops, recreational centres in the neighbourhood) were consistently associated with higher levels of well-being. Conversely, perceived insecurity, especially at night or regarding bicycle theft, significantly reduced well-being. Physical activity levels, particularly days of walking and vigorous activity, showed strong positive associations, underscoring the role of active lifestyles in promoting mental health. Socio-economic variables, including financial status, relationship status, and work status, were also found to be linked to perceived well-being. Cycling-related variables may affect Greek well-being up to 16.5 times. Perception of crime during the night may negatively affect both Bulgarian and Serbian well-being (up to 10 times), while Romanian well-being is mostly affected by the existence of shopping facilities. Finally, the most impactful factors for well-being in North Macedonia refer to cycling safety and scooter accessibility. Full article

Background/Objectives: Breast cancer survivors often experience adverse body composition changes and reduced quality of life (QoL) after chemotherapy. This study aimed to assess changes in body composition in postoperative breast cancer patients undergoing chemotherapy and to examine their associations with physical activity and QoL. Methods: This longitudinal observational pilot study included two repeated assessments (after surgery and before the third chemotherapy cycle – six weeks period). Sixty women (mean age 57 ± 10 years) who had undergone breast cancer surgery and were scheduled for chemotherapy were assessed twice: after surgery and prior to the third chemotherapy cycle. Body composition was analyzed using anthropometric and bioelectrical impedance methods. Physical activity was evaluated with the International Physical Activity Questionnaire–Long Form (IPAQ-L), while QoL was measured with the World Health Organization Quality of Life–bref version (WHOQOL-BREF) questionnaire as well. Results: During chemotherapy, participants showed significant increases in body weight (p = 0.001), BMI (p = 0.001), and muscle mass (p = 0.001), with stable fat percentage. Physical activity levels improved overall, particularly in moderate activity (p = 0.001), while sedentary time decreased (p = 0.020). QoL remained generally stable, with significant improvement in the environmental domain (p = 0.028). Higher fat percentage correlated negatively with physical (p = 0.040) and social (p = 0.049) QoL, while BMI correlated inversely with psychological well-being (p = 0.020). Waist-to-hip ratio was also negatively associated with psychological QoL (p = 0.017). Conclusions: Vigorous activity showed an association with more favorable body composition, whereas sedentary behavior correlated with higher BMI and muscle mass. Full article

Background: Physical activity provides substantial survival and quality-of-life benefits for cancer survivors, yet participation remains suboptimal globally, particularly in the Middle East and North Africa (MENA) regions. This study represents the first comprehensive examination of physical activity barriers and facilitators among Tunisian cancer survivors. Methods: This cross-sectional study recruited 120 cancer survivors ≥3 months post-chemotherapy completion from University Hospital Farhat Hached, Sousse, Tunisia (October–December 2024). Participants completed validated questionnaires via structured telephone interviews: the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Physical Activity Barriers After Cancer scale (PABAC), the Fatigue Assessment Scale (FAS), and the Patient Activation Measure (PAM-13). Statistical analyses included descriptive statistics, receiver operating characteristic (ROC) analysis, correlation analyses, and multivariable regression modeling with Bonferroni correction for multiple comparisons. Results: Participants (mean age 51.89 ± 10.2 years, 73.9% female) demonstrated significant physical activity declines post-chemotherapy: moderate activity decreased from 31.1% to 1.7% (p < 0.001), median intensity declined from 297 to 44 MET-min/week (p < 0.001). Mean PABAC score was 29.72 ± 5.13, with cognitive barriers predominating (2.85 ± 0.58). Fatigue was universal (100%), with 21% reporting severe fatigue (FAS ≥ 35). Only 26.1% received exercise guidance from healthcare professionals. PABAC demonstrated excellent predictive performance for physical inactivity (AUC = 0.805, 95%CI: 0.724–0.887). Independent predictors of higher barriers included fatigue severity (β = 0.466, p < 0.001), low patient activation (β = −0.091, p = 0.010), and advanced cancer stage (β = 1.932, p = 0.008). Conclusions: Tunisian cancer survivors experience substantial, multidimensional barriers to physical activity, with inadequate healthcare guidance representing a critical system-level gap. Findings support the development of culturally adapted, multidisciplinary interventions that target modifiable cognitive and symptom-related barriers, while enhancing patient activation and healthcare provider engagement. Full article

Mental health issues and insufficient physical activity (PA) among students pose significant public health concerns. This study aimed to examine the prevalence of depression, anxiety, and stress symptoms, alongside PA levels, among Croatian medical students, with a focus on sex-specific differences and associations between these variables. A cross-sectional study was carried out during May and June 2025 among medical students at the University of Osijek, Croatia. Participants completed a self-reported questionnaire consisting of three sections: sociodemographic characteristics, the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The study included 244 students (70 males, 174 females) with a median age of 21 years (IQR: 20–23). Symptoms of depression, anxiety, and stress were reported by 33.1%, 48.4%, and 42.6% of participants, respectively. According to IPAQ-SF, 39.7% of students reported PA levels below current recommendations. Female students reported significantly higher depression (p = 0.009), anxiety (p < 0.001), and stress scores (p < 0.001), lower levels of moderate (p = 0.009) and vigorous PA (p < 0.001), and more time spent sitting (p = 0.006) compared to their male counterparts. Furthermore, significant positive correlations were identified between sitting time and depression (ρ = 0.17, p = 0.01), anxiety (ρ = 0.18, p = 0.006), and stress (ρ = 0.26, p < 0.001). Conversely, higher PA—particularly vigorous activity—was associated with lower levels of depression (ρ = −0.21, p = 0.001) and anxiety (ρ = −0.15, p = 0.018). Croatian medical students demonstrated a substantial prevalence of depression, anxiety, and stress symptoms, combined with inadequate levels of PA. These findings highlight the importance of implementing strategies aimed at supporting mental health and fostering regular PA among future healthcare professionals. Full article

Introduction: Unhealthy eating habits combined with low levels of physical activity and cardiorespiratory fitness pose a serious threat to the health of young people. The aim of this research was to determine the relationship between selected components of body composition, the occurrence of eating disorders, and cardiorespiratory fitness (CRF) and physical activity levels among university students. Material and Methods: This study was conducted among 254 students at a university in Poland. It included the measurements of body height, body composition analysis using bioelectrical impedance analysis (BIA), and assessment of cardiorespiratory fitness (CRF). This research also employed the My Eating Habits (MEH) questionnaire and the short version of the International Physical Activity Questionnaire (IPAQ-SF). Results: Based on body fat percentage (BF%), nearly one-fifth (19.69%) of participants were classified as obese. According to the body mass index (BMI), over one-third had excess body weight (overweight 24.02%, obesity 10.24%), while 6.7% were underweight. Eating disorders were significantly more prevalent in women (p = 0.0002). A significant relationship was observed between eating disorders and BMI, muscle mass (MM%), skeletal muscle mass (SMM%), body fat (BF%), and visceral fat (VFATL). Higher BMI, BF%, and VFATL were associated with a greater risk of developing eating disorders. Emotional overeating was significantly less common among individuals with normal body weight compared to those who were underweight or overweight. No statistically significant associations were found between students’ physical activity levels and eating habits. However, cardiorespiratory fitness (CRF) was significantly negatively correlated with the presence of eating disorders. Conclusions: Understanding the relationship between components of body composition, eating disorders, physical activity levels, and cardiorespiratory fitness is crucial for designing effective interventions that promote a healthier lifestyle and psychological well-being among university students. Full article

Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95% CI 3.70–4.75) and AD (OR 2.95, 95% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings. Full article

Background: Prolonged sedentary behavior and associated obesity are recognized risk factors for poor health across the lifespan. Globally, data show that many children and adolescents aged 5 to 17 significantly increased their sedentary behaviors during the COVID-19 pandemic, failing to meet recommended physical activity levels and reporting increased smartphone use. While mobile devices and video games have been traditionally linked to physical inactivity, formats like exergaming, which combine gameplay with gross motor activity, offer potential to promote physical activity. However, many digital health tools for children are developed without incorporating feedback from key stakeholders and end-users (e.g., children, teachers, and guardians). Therefore, this paper, within the Walk around the Earth (E-Walk) project, describes a prospective study that aims (1) to identify the most influential factors or characteristics affecting engagement with and usability of a mobile application promoting physical activity among primary school students; (2) to develop a mobile application for children based on the identified factors and characteristics. Methods: This project will use a group concept mapping approach to identify the most influential features/factors/characteristics affecting engagement with and usability of an app. By involving primary stakeholders (e.g., children, teachers, guardians, and physical activity experts), the project seeks to align the app’s features with primary end-user needs and motivations. Following the app’s development, its effectiveness in increasing physical activity levels and reducing sedentary behaviors will be evaluated through a mixed-method design, incorporating anthropometric data, validated physical activity questionnaires (Physical Activity Questionnaire for Older Children (PAQ-C) and International Physical Activity Questionnaire (IPAQ)), and engagement metrics. Conclusions: The E-Walk project integrates participatory design with educational content and activity-based challenges, representing a multidimensional strategy for promoting health and learning in primary school students. Ultimately, this study contributes to the development of user-informed digital interventions that support sustainable behavioral changes, in line with broader goals of child well-being and digital health promotion. Full article

Background/Objectives: Pokémon GO has had a substantial global impact, emerging as one of the most prominent smartphone game releases of the 21st century. Beyond its entertainment value, this game has the potential to encourage physical activity alongside recreational engagement. Consequently, it may facilitate the integration of augmented reality into daily routines within the context of advancing mobile device technology. This study aimed to assess the impact of Pokémon GO on users’ physical activity levels, as well as to identify other implicit health outcomes and potential risks. Methods: A cross-sectional study was conducted using the International Physical Activity Questionnaire (IPAQ-long form) and a custom-designed survey (including demographic characteristics) administered to a cohort of 243 Pokémon GO players (112 females and 131 males, mean age 27 ± 7 years). Results: According to IPAQ-long form data, 68% of Pokémon GO users demonstrated high physical activity levels, 29% moderate, and 2.5% insufficient activity. More than 80% of participants reported increased walking distances, and 39% indicated that playing the game had improved their overall mood, while 13% reported enhanced social interactions. However, some findings are concerning, with 27% of respondents admitting to sacrificing sleep, 20% considering themselves addicted, and more than half exceeding the World Health Organization (WHO) screen time guidelines based solely on the time spent playing Pokémon GO. Conclusions: Pokémon GO has a positive impact on users’ physical activity levels, particularly in terms of low-intensity physical activities such as walking. This observational study suggests that the application may be associated with a healthy lifestyle and enhanced interpersonal contact. Prudent and safe usage is advised, as the game has the potential to be addictive and may pose risks when misused. Full article

Background: Informal caregivers of individuals with mild cognitive impairment (MCI) experience high levels of psychological and physical stress, with limited access to supportive interventions and time constraints. Virtual Reality (VR) technologies may provide brief and accessible opportunities to support caregiver well-being, particularly during waiting periods in clinical settings. This pilot study aimed to explore the potential of a semi-immersive VR intervention to enhance psychological well-being in informal caregivers. Methods: This non-randomized pilot study investigated the effects of a semi-immersive VR-based physical training program (K-HERO^®) on psychological well-being and coping strategies in informal caregivers. Participants were recruited from January to May 2025 at the IRCCS Centro Neurolesi “Bonino-Pulejo” (Messina, Italy), and the intervention was delivered individually in a dedicated room within the rehabilitation facility, while caregivers accompanied their relatives to treatment sessions. Ten caregivers completed six sessions (30–40 min each). The study was conducted in accordance with TREND reporting guidelines. Pre- and post-intervention assessments included the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), COPE Inventory, Caregiver Burden Inventory (CBI), and International Physical Activity Questionnaire (IPAQ). Visual Analog Scales and instrumental data from the VR system were used to monitor physical performance and user experience. Non-parametric statistics were applied. Results: Significant reductions were observed in avoidance (p = 0.033) and social support-based (p = 0.023) coping strategies. Differences emerged based on caregiver-patient relationships: parental caregivers showed increased anxiety, while offspring caregivers showed improvements. The intervention was well tolerated, with high usability and no adverse events reported. Conclusions: A short, structured, VR-based intervention delivered during clinical waiting periods may effectively reduce maladaptive coping strategies and support emotional well-being in informal caregivers. These findings highlight the potential of brief digital interventions in real-world care contexts. Larger randomized studies are needed to validate these preliminary findings and personalize interventions to different caregiver profiles. Full article

This study aims to explore the relationship between physical activity and interpersonal distress among high school students and its mechanism of action. Based on triadic reciprocal determinism, social cognitive theory, and the protective factor–protective factor Model, a cross-sectional study was conducted on 2072 high school students using the International Physical Activity Questionnaire Short Version (IPAQ-S), the Regulatory Emotional Self-Efficacy Scale, the Adolescent Psychological Resilience Scale, and the Interpersonal Relationship Comprehensive Diagnosis Scale. The results showed that (1) physical activity has a significant adverse predictive effect on interpersonal distress among high school students. (2) Physical activity can not only directly predict interpersonal distress among high school students, but also indirectly predict interpersonal distress through the mediating effect of regulatory emotional self-efficacy. (3) Psychological resilience plays a moderating role in the relationship between emotional regulation self-efficacy, and interpersonal distress. For high school students with low psychological resilience, emotional regulation self-efficacy has a more significant predictive effect on interpersonal distress; however, for high school students with high psychological resilience, the moderating effect is not significant. Full article