Search Results (815)

Artificial intelligence (AI), virtual reality (VR), and exergame technologies have been increasingly used in dance and movement activities. However, this literature remains dispersed across different areas, making it difficult to determine how the field has developed. This study mapped the research landscape and thematic development of AI-, VR-, and exergame-based dance and movement research on psychological outcomes using bibliometric analysis and latent Dirichlet allocation (LDA) topic modeling. A total of 252 records indexed in the Web of Science Core Collection from 2011 to 2025 were included. Five related thematic strands were identified: immersive dance interaction and technology-supported teaching; rehabilitation-oriented dance or rhythm training; school-based exergaming and psychophysiological assessment; behavioral program design and intervention implementation; and AI-based motion or emotion recognition. These strands indicate that the field has developed into a multi-layered research space shaped by technology functions, movement contexts, intervention formats, and psychological constructs, rather than a single dance-intervention or technology-application domain. At the same time, psychological outcomes were not represented with equal clarity across these strands. Participation-related and psychosocial constructs, including enjoyment, motivation, engagement, self-efficacy, social interaction, emotional expression, and quality of life, were more frequently represented, whereas mental-health-related outcomes such as anxiety, depression, stress, loneliness, and psychological well-being were less consistently connected to technology-supported dance or movement interventions. These findings clarify where evidence is concentrated, how major themes are organized, and where psychological outcome measurement requires clearer theoretical and methodological specification. Future studies should use comparative and longitudinal designs to examine whether VR/AI-based feedback-supported movement training offers added value over conventional dance or movement programs for psychological outcomes, participation, exercise experience, and longer-term behavior change. Full article

Sustained engagement in physical activity during adolescence is a critical determinant of long-term health and well-being. Performance feedback is widely used in youth sport settings, yet its motivational impact may depend on athletes’ developmental stage and training experience. This study examined adolescents’ motivational responses following individualized sprint performance feedback and investigated whether training experience and sprint performance moderated these responses. Fifty-three adolescent athletes (mean age = 14.86 ± 0.81 years) completed a brief five-item questionnaire assessing commitment, enjoyment, self-determination, intention to continue training, and self-efficacy immediately after receiving individualized sprint performance feedback. Exploratory and confirmatory factor analyses were conducted to evaluate the scale’s factorial structure and reliability. A two-way analysis of variance examined the effects of training age (1–6 vs. 7–12 years) and sprint performance (faster vs. slower) on overall motivational response. Factor analyses provided preliminary support for a unidimensional motivational response construct (ω = 0.92; α = 0.92). Overall motivational responses following feedback were moderately positive. Sprint performance demonstrated a significant main effect on motivation. Importantly, a significant interaction between training age and performance emerged as the key finding, indicating that less experienced athletes were more sensitive to performance outcomes, whereas motivation among more experienced athletes remained relatively stable. Individualized sprint performance feedback appears to be associated with moderately positive motivational responses in adolescent athletes, particularly during early stages of sport participation. These findings highlight the importance of developmentally appropriate feedback strategies that emphasize progress and competence development to support engagement in youth sport, which may be relevant for sustained participation over time. Full article

Background: Poor adherence and monotony in home-based pelvic floor muscle training (PFMT) often lead to suboptimal rehabilitation outcomes. Serious games using virtual reality (VR) may improve training motivation and precision. This study aimed to explore user demands for a VR pelvic floor rehabilitation training system with game-based features. Methods: A Kano model-based questionnaire was developed and distributed to patients receiving PFMT. The survey assessed 20 demand items spanning five dimensions: system operation, exercise guidance, personalization, device use, and interaction. Traditional Kano categorization and an optimized mixed-method classification were used to identify core demand attributes. Satisfaction and dissatisfaction indices were also calculated. Results: A total of 112 valid questionnaires were analyzed. Using the Kano model, 20 demand items were classified as attractive (n = 7), one-dimensional (n = 5), must-be (n = 6), or indifferent (n = 2). Personalization-related demands were mainly identified as attractive attributes, whereas exercise guidance-related demands were primarily classified as must-be or one-dimensional attributes. Satisfaction Index (SI) values ranged from 0.27 to 0.64, and absolute Dissatisfaction Index (DSI) values ranged from 0.34 to 0.71. Optimized Kano analysis identified nine mixed attributes. The questionnaire demonstrated excellent internal consistency (Cronbach’s α = 0.96). Conclusions: Participants demonstrated positive willingness to adopt a game-based VR system for PFMT, with diverse needs identified across functional and motivational dimensions. These findings suggest that integrating immersive, personalized, and gamified design features may hold promise for enhancing user engagement and anticipated training adherence, though direct evaluation of clinical effectiveness awaits future prototype-based studies. The identified demand priorities provide structured, evidence-informed guidance for the user-centered design of serious game–oriented VR pelvic floor rehabilitation systems. Full article

Background: Physical activity in urban green environments contributes to both physical and psychological well-being. Although negotiation strategies help individuals overcome barriers to participation in recreational sport, their interaction with environmental factors such as urban green spaces remains underexplored. This study examines the relationship between negotiation strategies and well-being among urban residents and introduces “Green Commitment” to capture engagement with green exercise environments. Methods: The sample consisted of 233 adults (28.8% men, 71.2% women) aged 19–77 years living in Athens. Data was collected using the Negotiation Strategies Scale (33 items across eleven dimensions) and an adapted PERMA Profiler, which assesses well-being across five dimensions: positive emotions, engagement, relationships, meaning, and achievement. Six additional items measured engagement with urban green environments. Exploratory factor analysis, reliability analysis, descriptive statistics, ANOVA, MANOVA, and Pearson correlations were conducted using SPSS v.29. Results: The analysis confirmed satisfactory reliability and a five-factor structure of well-being, including Green Commitment, explaining 64.97% of total variance. Self-motivation recorded the highest mean value (M = 6.2). Significant positive correlations were found between most negotiation strategy dimensions and well-being, particularly for physical health and engagement–achievement (e.g., r = 0.469). Demographic differences were also observed. Conclusions: Negotiation strategies facilitate participation in recreational sport and enhance well-being in urban populations. Engagement with urban green environments, reflected in Green Commitment, further supports these outcomes. The study offers an integrated framework linking behavioral strategies, environmental context, and well-being. Full article

Objectives: This systematic review identifies and synthesizes quantitative evidence regarding whether psychosocial constructs, specifically groupness, social support, self-efficacy, enjoyment, and instructor behavior, are associated with behavioral adherence to adult group fitness classes. Methods: Electronic searches were conducted in PubMed, Scopus, and Web of Science. Eligible studies included quantitative analyses of adults in instructor-led group exercise. Risk of bias was appraised using ROBINS-I, and JBI critical appraisal tools, as appropriate to study design. Results: Twenty-one studies met inclusion criteria. Self-efficacy was the most consistently supported domain, with several behavior-specific efficacy measures showing small-to-moderate positive associations with attendance-based adherence, although null findings were also observed when measures were less temporally aligned or when outcomes shifted to post-program continuation. Social-relational and instructor-related constructs showed more context-dependent evidence: social attraction, social cohesion, reliable alliance, group identification, and selected leader behaviors were more consistently favorable than generic social support or broad cohesion measures. Enjoyment and affective response showed the weakest independent evidence, with positive associations mainly when affective constructs were measured close to the attendance decision. Adherence in instructor-led group exercise settings appears to be influenced by perceived capability, social-relational processes, instructor-shaped motivational climate, and affective valuation, although the available evidence is heterogeneous and predominantly observational. Future research should use multilevel longitudinal designs, instructor- and class-level clustering, repeated affective assessment, and causal pathway modeling to test how these mechanisms support repeated attendance and longer-term maintenance. Full article

Background: Artificial intelligence (AI) is increasingly used in nephrology, including rehabilitation planning for patients with chronic kidney disease (CKD). However, most AI systems are predominantly trained on English-language data, which may influence the quality and clinical relevance of the generated recommendations. Objective: To evaluate the impact of query language on the quality and clinical applicability of AI-generated exercise programs for CKD patients undergoing renal replacement therapy. Methods: We conducted a structured qualitative comparison using predefined evaluation criteria based on KDIGO and ERA rehabilitation guidelines. Outputs were assessed for structure, clinical detail, safety framing, and adaptability. Identical prompts were formulated in Ukrainian and English. Generated exercise programs were assessed for alignment with international guidelines (KDIGO, ERA), level of clinical detail, progression, safety considerations, and adaptability. Results: All AI systems produced safe exercise programs incorporating aerobic, resistance, flexibility, and relaxation components. However, significant differences were observed depending on the query language. Ukrainian-language outputs were simpler and focused on general well-being, with limited progression and monitoring. In contrast, English-language outputs demonstrated greater clinical depth, including structured progression, intradialytic adaptations, and the use of validated monitoring tools (e.g., Borg RPE scale). Copilot provided the highest clinical precision, ChatGPT delivered structured programs, and Gemini emphasized safety and motivation. English-language prompts produced more detailed and guideline-aligned outputs, whereas Ukrainian-language prompts generated simpler, wellness-oriented recommendations. Conclusions: Query language influences the structure and clinical completeness of AI-generated rehabilitation programs. English-language prompts currently yield more detailed and guideline-aligned outputs. Further multilingual model development is needed. English-language queries currently yield more clinically robust outputs. Development of multilingual AI systems and standardized prompt frameworks is essential to ensure equitable access to AI-assisted healthcare. Full article

Background/Objectives: While body dissatisfaction is frequently studied as an outcome of physical activity, less is known about how pre-existing body image perceptions shape the quality of behavioral regulation. Grounded in Self-Determination Theory, this study aimed to investigate the associations of different perceived body image discrepancy profiles with autonomous and controlled motivation for both exercise and eating, and to explore the interaction effects between these profiles and sex. Methods: The sample comprised 939 regular gym exercisers (32.99 ± 11.90 years; 55.1% female). Using the Stunkard Figure Rating Scale, participants were categorized into four discrepancy profiles: desire to increase, satisfied, mild desire to reduce, and moderate/severe desire to reduce. Data were analyzed using Two-Way ANOVAs. Results: The Satisfied group reported the highest autonomous and lowest controlled motivation across both domains (main effects: p < 0.001, η²_p = 0.019–0.046). A significant body image × sex interaction emerged for controlled eating motivation (F(3, 931) = 6.22, p < 0.001, η²_p = 0.020). Females exhibited a “U-shaped” curve, demonstrating low controlled eating motivation when satisfied (M = 1.65) but elevated levels at extremes (desire to increase: M = 2.50; moderate/severe desire to reduce: M = 2.39). Males maintained stable controlled eating motivation across all discrepancy profiles (M = 2.06–2.30). Although these main and interaction effects were statistically significant, all observed multivariate effect sizes were small (η²_p = 0.012–0.046). Conclusions: Perceived body image discrepancy acts as a significant antecedent of motivational quality. The absence of a perceptual gap is linked to highly adaptive, autonomous behavioral regulation. Furthermore, the distinct sex-based patterns in controlled eating motivation underscore the necessity for health and exercise professionals to adopt tailored, sex-specific strategies when addressing body image concerns. Full article

Background/Objectives: In the school setting, high-intensity interval training (HIIT) has emerged as a time-efficient strategy to improve children’s physical fitness; however, different implementation modalities have not been compared. The aim of this study was to compare the effects of an individual versus paired HIIT protocol based on functional bodyweight exercises on physical fitness-related and anthropometric outcomes in primary school children. Methods: Sixty-one children (11.6 ± 0.3 years) participated in a 10-week experimental study with three parallel groups: individual HIIT (EG1, n = 21), paired HIIT (EG2, n = 20), and a control group (CG, n = 20). Although both HIIT groups performed the same bodyweight functional exercises, in EG2 the exercises required coordinated movement between the partners. The HIIT protocol was integrated into the warm-up of Physical Education (PE) classes twice per week (Tabata-type protocol; 8 × 20 s/10 s/≤8 min per session). Body composition, muscular strength, and cardiorespiratory fitness (estimated VO₂max) were assessed at pre- and post-test, along with a rating of perceived exertion (1–10 scale) and enjoyment/motivation (1–5 scale) across several sessions (1, 7 and 14). Data were analyzed using pre-post comparisons, ANOVA, and ANCOVA models adjusted for baseline values. Results: Body fat percentage decreased in all groups. The individual HIIT group showed within-group improvements in VO₂max (+5.3%, p < 0.001), handgrip strength (+10.1%, p = 0.003), and standing long jump (+4.1%, p = 0.033), with moderate-to-large effect sizes, whereas the paired HIIT group showed smaller and statistically non-significant changes. Between-group comparisons suggested a tendency toward greater improvements in VO₂max and handgrip strength in the individual HIIT group compared with the paired group, although the overall ANOVA for VO₂max was not statistically significant. Perceived exertion declined over time in the paired group but remained relatively stable in the individual group. Conclusions: A low-volume HIIT program performed individually was associated with improvements in several physical fitness outcomes in schoolchildren. In contrast, paired execution showed smaller and mostly non-significant changes, together with a progressive reduction in perceived intensity. Full article

Background: Physical inactivity among Saudi Arabian adolescents is a critical public health concern due to its contribution to the rising prevalence of overweight, obesity, and non-communicable diseases. Despite this, the motivational profiles and perceived barriers that differentiate athletic from non-athletic adolescents remain understudied in the Saudi literature, particularly within the school Physical Education (PE) context. Grounded in Self-Determination Theory (SDT), the present study examined the factors preventing and motivating Saudi adolescents to engage in physical activity (PA) and discusses findings in terms of their implications for PE teachers and school-based intervention. Method: A cross-sectional study was conducted with 124 male high school students in Riyadh (mean age: 16.79 ± 0.66 years). Participants were categorized as either athletes (n = 70) or non-athletes (n = 54) based on pre-defined engagement criteria: athletes were required to report vigorous-intensity sport participation on three or more days per week for a minimum of 60 min per session. Anthropometric measurements, lifestyle behaviors (diet, screen time, sleep), motivations, and barriers were assessed using the validated Arab Teens Lifestyle Study (ATLS) questionnaire. Independent samples t-tests and chi-square tests were used to compare between-group differences; effect sizes are reported. Result: Non-athletes had a significantly higher mean BMI (29.40 ± 6.77 kg/m²) and waist circumference (98.65 ± 21.63 cm) compared to athletes (BMI: 22.19 ± 4.44 kg/m²; waist: 78.84 ± 9.51 cm; both p < 0.001). No significant differences were observed in screen time, sleep duration, or dietary habits. The primary motivations for PA among athletes were health benefits (27.1%), recreation (25.7%), and competition (20.0%), reflecting an autonomous motivational profile consistent with SDT. Among non-athletes, the predominant barriers were the lack of suitable facilities (25.9%) and the absence of an exercise partner (22.2%); reflecting unmet SDT needs for competence and relatedness respectively, while only 9.3% cited having a lack of time. Conclusions: Non-athletic participants face a significant health disadvantage characterized by higher rates of overweight and central obesity. In contrast to global trends, where academic commitments dominate barriers to PA, the principal barriers in this population are environmental and social, reflecting unmet psychological needs that PE teachers are uniquely positioned to address. Rather than focusing solely on infrastructure, PE promoters should implement need-supportive teaching practices, including competence-building tasks and cooperative peer structures, to foster the intrinsic motivational profile observed in the athletes and promote long-term PA adherence among non-athletic students, in alignment with the health objectives of Saudi Vision 2030. Full article

Background and Objectives: Multiple sclerosis (MS) is characterized by progressive disability and a spectrum of motor and cognitive impairments. Exergames and virtual reality (VR) are proposed as motivating exercise tools, potentially useful for improving adherence and expanding access to rehabilitation. The objectives are to explore the feasibility and safety of a supervised rehabilitation program based on a high-intensity exercise program with immersive virtual reality (IVR) in people with MS and to describe its effects on physical, cognitive, and functional domains, as well as on the serum biomarker neurofilament light chain (sNfL). Materials and Methods: Pre–post exploratory study in five volunteers from a local MS Association [Vigo, Spain]. Intervention: 8 weeks, two sessions/week, 10 min/session of an IVR boxing-based exergame combined with usual rehabilitation, supervised by a physiotherapist. The variables studied were safety (Simulator Sickness Questionnaire [SSQ]), usability (System Usability Scale [SUS]), disability (Expanded Disability Status Scale [EDSS]), gait (25-Foot Walk Test [25FWT]), manual dexterity (9 Hole Peg Test [9HPT]), cognition (Symbol Digit Modalities Test [SDMT]), and axonal damage biomarker (sNfL). Results: The intervention could be feasible and safe (100% adherence, no adverse events (without SSQ symptoms), 95% usability [SUS]). There were positive changes in all variables studied (mean ± SD): EDSS −0.5 ± 0.9; 25FWT −4.9 ± 9.8 s; right 9HPT −3.3 ± 0.9 s; sNfL −4.4 ± 4.5 pg/mL, except for left 9HPT +0.5 ± 5.0 s and cognition (SDMT −2.4 ± 1.3 points). Conclusions: A brief, supervised exercise program combing an IVR exergame with standard rehabilitation was feasible and safe in people with MS. Although the results seem promising with the proposed design, the clinical and biological changes are merely exploratory, and it is not possible to infer their efficacy. Our findings open the door to future controlled studies including perceived high-intensity exercise programs and larger sample sizes to explore efficacy and estimate clinically relevant effect sizes. Full article

Purpose: This study explores how older adults with chronic back pain (CBP) evaluate different user interface (UI) designs and gamification elements for an ultrasound-based wearable providing real-time biofeedback during segmental stabilization exercises (SSE). The aim is to identify design preferences and motivational factors to enhance usability, engagement, and adherence in this specific population. Methods: We conducted a mixed-methods study with 15 older adults (aged ≥ 65) experiencing CBP. Participants interacted with three UI mockups (simple, anatomical, and playful) via a Wizard-of-Oz simulation and evaluated additional motivational elements (e.g., points, badges, progress charts). Semi-structured interviews and the Technology Usage Inventory (TUI) subscales were used to assess usability, acceptance, and intention to use. Results: Participants preferred the simple and anatomical UI designs, citing clarity, professionalism, and ease of interpretation. The playful design was viewed as less appropriate due to perceived infantilization. Game elements such as progress tracking, points, and levels were positively received, while competitive features like leaderboards were viewed critically. Most participants expressed interest in integrating pain education, favoring multimedia formats. Conclusions: Digital health tools for older adults must prioritize intuitive, medically reliable interfaces and allow personalization of motivational and educational components. The findings highlight the need for age-appropriate UI design and suggest that well-balanced gamification and educational features may enhance perceived acceptance and have the potential to support long-term use, which should be evaluated in longitudinal studies. Full article

This paper presents a novel platform for automated self-paced learning in Computer-Aided Design (CAD) courses within engineering education. The platform fully automates the entire learning cycle, including exercise generation, submission, scheduling, test design, and grading. The central hypothesis posits that complete automation reduces repetitive tasks for instructors, allowing them to dedicate more time to individualized student support. The system also provides key advantages: it generates unique exercises for each student to prevent plagiarism while maintaining comparable complexity; it delivers instantaneous grading and feedback to enhance motivation; and it enables students to work with almost any CAD software, as the evaluation relies on physical properties rather than commercial tools. After several years of successive testing and refinement, the tool can generate and accurately grade frequent activities in large student cohorts, providing abundant data points. Their statistical analysis, via multiple approaches, confirms that the system reliably produces individualized exercises, reduces grading errors, and offers prompt, consistent feedback, thereby supporting a more efficient and engaging learning process. Full article

Background: Children and adults with disabilities are widely acknowledged to have poorer health and emotional wellbeing than their non-disabled peers, which is further compounded by less access to health services and health-promoting activities. A relatively untried solution is to mobilize community initiatives such as sports to promote better health. Method: Special Olympics (SO) is an international sports organization present in over 200 countries and jurisdictions, engaging with just under four million athletes with intellectual disabilities annually. Research on the perceptions of sports coaches around incorporating health promotion within their sports training has been scarce. Likewise, little attention has been paid to identifying athletes’ understanding of what health means to them and actions that would make them healthier. A qualitative, descriptive study was conducted with eight national SO programs involving 62 coaches and 47 athletes. Group interviews were conducted via Zoom and a thematic content analysis was made of their responses. Results: In all countries, coaches and athletes agreed that the most common needs were healthy eating, healthy weight and exercise. Good mental wellbeing and sleeping well were also named. Ideas were sought from both sets of participants regarding how coaches could assist their athletes to attain better health and the barriers they might face in doing so. Conclusions: Three main conclusions emerged. Athletes and coaches were aware of health deficits and knew of ways to reduce them. Both appreciated the contribution that coaches could make through motivating athletes and providing training activities but were dependent on suitable resources being available to them. Engagement with families and available health and social care services was essential. Health-oriented, sporting activities offer promise in improving the health and wellbeing of persons with developmental disabilities, particularly in less affluent countries with fewer health professionals and poorly developed primary care services. Full article

Background: A physically active lifestyle is crucial for long-term cardiovascular health; however, access to supervised exercise programs for children and adolescents with congenital heart disease (CHD) remains limited. Although prior digital exercise interventions for this population have demonstrated safety and feasibility, adherence has often been low. Mobile health approaches integrating gamification may enhance motivation and engagement, particularly among young “digital natives.” FOOTLOOSE is an app-based home exercise program developed specifically for children and adolescents with CHD. This study aimed to evaluate user experience, usability, and perceived impact using a multimethod approach. Methods: Children and adolescents aged 10–18 years with simple, moderate, or complex CHD were recruited between July and December 2025 mainly during routine outpatient visits at the TUM Klinikum Deutsches Herzzentrum. Participants used the FOOTLOOSE app in their daily lives over a two-week period. Evaluation included semi-structured qualitative interviews and standardized questionnaires assessing physical activity self-efficacy, enjoyment of physical activity (PACES-S), user experience (UEQ), and health-related quality of life (KINDL^®). Interviews were conducted digitally, transcribed verbatim, and analyzed using qualitative content analysis according to Kuckartz until thematic saturation was reached. Results: A total of 22 participants (mean age 13.4 ± 2.3 years; 54.5% female) were included. Overall, the FOOTLOOSE app was perceived positively, with participants highlighting enjoyment, intuitive usability, and personalized workout creation. Participants contributed diverse and creative suggestions for further app development, particularly regarding more advanced gamification features (e.g., games or rankings). Most participants reported self-perceived increase in physical activity during the intervention period (n = 15). UEQ scores (mean ± SD) were as follows: attractiveness (1.3 ± 0.8), perspicuity (1.7 ± 1.1), efficiency (1.2 ± 0.9), dependability (1.4 ± 0.7), stimulation (1.0 ± 1.1), and novelty (0.6 ± 1.0). Conclusions: This study demonstrates the feasibility and user acceptance of a gamified, app-based home exercise program for children and adolescents with CHD. User-centered feedback highlights important directions for iterative refinement, particularly regarding age-appropriate and engaging gamification elements. These findings provide a foundation for future studies evaluating long-term engagement and effectiveness in larger samples. Full article

Regular physical activity is essential for health promotion, yet participation patterns and the motivational determinants of exercise vary widely among recreational exercisers. This study examined exercise behavior and motivational profiles among members of two Hungarian fitness centers using the Physical Activity and Leisure Motivation Scale (PALMS). A cross-sectional survey was completed by 1087 adults, assessing demographics, BMI, exercise frequency, service use, and eight motivational dimensions. Health- and body-related motives were most strongly endorsed, while intrinsic motives (Mastery, Enjoyment) and social or external motives showed greater variability. Exercise frequency was positively associated with Mastery and Competition/Ego motivation, and regression analysis identified Mastery as a significant predictor of attendance, whereas age and female gender were negative predictors. Appearance motivation was positively related to BMI, Affiliation predicted participation in group fitness classes, and Others’ Expectations predicted the use of personal training services. Significant gender- and age-specific motivational differences were also observed. The findings demonstrate that although health and appearance motives dominate, intrinsic and social motives are more strongly linked to sustained engagement. These results highlight the need for motivation-sensitive approaches in fitness programming and public health strategies aimed at promoting long-term exercise adherence and disease prevention. Full article