Prescribing Personalized Exercise Programs Using Smartphone Sensors For Remote Fitness Assessment

Guidelines for physical activity emphasize multiple fitness components among people aged >65. The age-related increase in variability of fitness components necessitates accurate individualized assessment prior to optimal prescription for personalized exercise program. Accordingly, we tested feasibility and effectiveness of a novel tool designed to remotely assess balance, flexibility, and strength using smartphone sensors (accelerometer/gyroscope), and subsequently remotely deliver personalized exercise programs via smartphone. This pilot study enrolled 52 healthy volunteers (34 females) aged 65+, with normal cognition and low fall-risk. Baseline preliminary data from smartphone fitness assessment were analyzed to generate 42 fitness digital-markers, used to generate personalized exercise programs (5 times/week for 6 weeks). Programs included graded exercises for upper/lower body, flexibility, strength, and balance (dynamic, static, vestibular). Fitness was remotely assessed at baseline and after six weeks. Average age was 74.7±6.4 years; adherence was 3.6±1.7 exercise sessions/week. Significant improvement for pre/post testing was observed for 10/12 digital-markers of strength/flexibility for upper/lower body (sit-to-stand repetitions/duration; arm-lift duration; torso-rotation; arm-extension/flexion). Balance improved significantly for 6/10 measures of tandem-stance, with consistent (non-significant) trends observed across 20 balance digital-markers of tandem-walk and one leg-stance. Balance showed greatest improvement among the 37 participants exercising ≥3/week. These preliminary results serve as proof of concept among people aged >65: high adherence and improved fitness confirm the potential benefits and niche for remote fitness assessment used to generate personalized exercise programs. Future research is required to confirm the benefits among specific patient groups, such as those with frailty, deconditioning, cognitive and functional impairment.

The importance of standard operating procedures in physical fitness assessment: a brief review

Background Physical fitness status is a key aspect of health and, consequently, it is important to create and adopt appropriate interventions to maintain or improve it, and assess it using valid measures. While in other testing contexts, standard operating procedures (SOPs) are commonly and widely adopted, in physical fitness testing, a variety of unstandardized testing protocols are proposed. Aims The topic of this review was to evaluate the existing literature on SOPs in physical fitness assessment and to provide guidelines on how SOPs could be created and adopted. Method The electronic databases PubMed, Web of Science and Scopus were screened and original, peer-reviewed studies that included SOPs, related to physical fitness, were recorded. Results After the inclusion and exclusion criteria screening, a total of six studies were included and these were critically and narratively analyzed. Conclusions Standard operating procedures are rarely adopted in the field of physical fitness and a step by step guide has been provided in this manuscript. In the future, it is suggested to follow protocols as a routine, because this is the only way to generalize and contextualize findings.

Associations between Physical Status and Training Load in Women Soccer Players

This study aimed to analyze the variations of fitness status, as well as test the relationships between accumulated training load and fitness changes in women soccer players. This study followed an observational analytic cohort design. Observations were conducted over 23 consecutive weeks (from the preseason to the midseason). Twenty-two women soccer players from the same first Portuguese league team (22.7 ± 5.21 years old) took part in the study. The fitness assessment included anthropometry, hip adductor and abductor strength, vertical jump, change of direction, linear speed, repeated sprint ability, and the Yo-Yo intermittent recovery test. The training load was monitored daily using session rating of perceived exertion (s-RPE). A one-way repeated ANOVA revealed no significant differences for any of the variables analyzed across the three moments of fitness assessments (p > 0.05). The t-test also revealed no differences in the training load across the moments of the season (t = 1.216; p = 0.235). No significant correlations were found between fitness levels and accumulated training load (range: r = 0.023 to −0.447; p > 0.05). This study revealed no differences in the fitness status during the analyzed season, and the fitness status had no significant relationship with accumulated training load.

Fitness Assessment Feedback May Lower Intrinsic Motivation for Physical Activity among College Students

Fitness assessments are commonly used as a motivational tool in exercise classes and fitness training. However, there is little research on their actual effect. This study explored how the feedback from a fitness assessment may affect intrinsic motivation for physical activity in college students. The study utilized a quasi-experimental design where 430 college students were assigned to either an intervention or one of two control groups. The fitness assessment was only distributed to the subjects in the intervention group. Students were surveyed at four-time points to examine subjects’ competence, autonomy and intrinsic motivation. A repeated measures general linear model measured differences between those who did and did not receive the fitness assessment. Intrinsic motivation (F(6,848)=2.33 p=.031) and competence (F(6, 848)=3.81, p=.001) diminished significantly in the group receiving fitness assessment feedback as compared to either control group. Additionally, for those in the intervention group that perceived their feedback as negative there was a significant decrease in competence (F(1,155)=15.59, p<.001), intrinsic motivation (F(1, 155)=6.41, p=.012), and physical activity (F(1,155)=7.46, p=.007). Fitness assessment feedback may hinder intrinsic motivation toward physical activity at least among those dissatisfied with the feedback.

Personalized Exercise Programs Based upon Remote Assessment of Motor Fitness: A Pilot Study among Healthy People Aged 65 Years and Older

<b><i>Background:</i></b> The World Health Organization has recently updated exercise guidelines for people aged &#x3e;65 years, emphasizing the inclusion of multiple fitness components. However, without adequate recognition of individual differences, these guidelines may be applied using an approach that “one-size-fits-all.” Within the shifting paradigm toward an increasingly personalized approach to medicine and health, it is apparent that fitness components display a significant age-related increase in variability. Therefore, it is both logical and necessary to perform an accurate individualized assessment of multiple fitness components prior to optimal prescription for a personalized exercise program. <b><i>Objective:</i></b> The aim of the study was to test the feasibility and effectiveness of a novel tool able to remotely assess balance, flexibility, and strength using smartphone sensors (accelerometer/gyroscope), and subsequently deliver personalized exercise programs via the smartphone. <b><i>Methods:</i></b> We enrolled 52 healthy volunteers (34 females) aged 65+ years, with normal cognition and low fall risk. Baseline data from remote smartphone fitness assessment were analyzed to generate 42 fitness digital markers (DMs), used to guide personalized exercise programs (×5/week for 6 weeks) delivered via smartphone. Programs included graded exercises for upper/lower body, flexibility, strength, and balance (dynamic, static, and vestibular). Participants were retested after 6 weeks. <b><i>Results:</i></b> Average age was 74.7 ± 6.4 years; adherence was 3.6 ± 1.7 exercise sessions/week. Significant improvement for pre-/posttesting was observed for 10/12 DMs of strength/flexibility for upper/lower body (sit-to-stand repetitions/duration; arm-lift duration; torso rotation; and arm extension/flexion). Balance improved significantly for 6/10 measures of tandem stance, with consistent (nonsignificant) trends observed across 20 balance DMs of tandem walk and 1 leg stance. Balance tended to improve among the 37 participants exercising ≥3/week. <b><i>Discussion:</i></b> These preliminary results provide a proof of concept, with high adherence and improved fitness confirming the benefits of remote fitness assessment for guiding home personalized exercise programs among healthy adults aged &#x3e;65 years. Further examination of the application within a randomized control study is necessary, comparing the personalized exercise program to general guidelines among healthy older adults, as well as specific populations, such as those with frailty, deconditioning, cognitive, or functional impairment. The study tool offers the opportunity to collect big data, including additional variables, with subsequent utilization of artificial intelligence to optimize the personalized exercise program.

Wearables and Internet of Things (IoT) Technologies for Fitness Assessment: A Systematic Review

Wearable and Internet of Things (IoT) technologies in sports open a new era in athlete’s training, not only for performance monitoring and evaluation but also for fitness assessment. These technologies rely on sensor systems that collect, process and transmit relevant data, such as biomarkers and/or other performance indicators that are crucial to evaluate the evolution of the athlete’s condition, and therefore potentiate their performance. This work aims to identify and summarize recent studies that have used wearables and IoT technologies and discuss its applicability for fitness assessment. A systematic review of electronic databases (WOS, CCC, DIIDW, KJD, MEDLINE, RSCI, SCIELO, IEEEXplore, PubMed, SPORTDiscus, Cochrane and Web of Science) was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From the 280 studies initially identified, 20 were fully examined in terms of hardware and software and their applicability for fitness assessment. Results have shown that wearable and IoT technologies have been used in sports not only for fitness assessment but also for monitoring the athlete’s internal and external workloads, employing physiological status monitoring and activity recognition and tracking techniques. However, the maturity level of such technologies is still low, particularly with the need for the acquisition of more—and more effective—biomarkers regarding the athlete’s internal workload, which limits its wider adoption by the sports community.

Cardiorespiratory fitness assessment using risk-stratified exercise testing and dose–response relationships with disease outcomes

Cardiorespiratory fitness (CRF) is associated with mortality and cardiovascular disease, but assessing CRF in the population is challenging. Here we develop and validate a novel framework to estimate CRF (as maximal oxygen consumption, VO2max) from heart rate response to low-risk personalised exercise tests. We apply the method to examine associations between CRF and health outcomes in the UK Biobank study, one of the world’s largest and most inclusive studies of CRF, showing that risk of all-cause mortality is 8% lower (95%CI 5–11%, 2670 deaths among 79,981 participants) and cardiovascular mortality is 9% lower (95%CI 4–14%, 854 deaths) per 1-metabolic equivalent difference in CRF. Associations obtained with the novel validated CRF estimation method are stronger than those obtained using previous methodology, suggesting previous methods may have underestimated the importance of fitness for human health.