Background: Poor cardiorespiratory fitness poses the highest risk of mortality. Long-COVID-19 survivors exhibit a reduced cardiorespiratory fitness (CRF). While exercise rehabilitation, such as cardiopulmonary exercise, is used for long-COVID-19 survivors, the effects of exercise on CRF in this population remain inconclusive. In this study, we aim to systematically summarise and synthesise whether exercise rehabilitation improves CRF among long-COVID-19 survivors. Methods: A comprehensive search was performed through PubMed, CINAHL, Embase, Scopus, and the Cochrane Library (since their inception to November 2023) and study reference lists. Studies presenting the effects of exercise rehabilitation on CRF (peak oxygen consumption (VO_2peak) and six-minute walk distance (6MWD)) in long-COVID-19 survivors were identified. The standardised mean difference (SMD), mean difference (MD), and 95% confidence interval (CI) were used for analyses. The certainty of evidence was measured using a Grading of Recommendation Assessment, Development and Evaluation approach. Results: Twelve eligible studies (five RCTs and seven non-RCTs) with 682 participants were analysed. The meta-analysis showed significantly improved 6MWDs (MD 76.47, 95% CI 59.19–93.71, low certainty) and significantly greater 6MWDs (SMD 0.85, 95% CI 0.11–1.59, very low certainty) in the exercise rehabilitation group compared to the control group. A significantly improved 6MWD was found in subgroups of young to middle-aged adults and subgroups of patients who undertook aerobic exercise combined with resistance and respiratory exercise and centre-based training programs. Conclusions: Exercise rehabilitation is effective for improving CRF, as measured by the 6MWD in long-COVID-19 survivors. Improvements are likely to be more pronounced in specific subgroups of young to middle-aged adults and patients undertaking aerobic exercise combined with resistance and respiratory exercise and centre-based training programs. However, recommendations for clinical practice are limited due to the very low evidence certainty.

Among obesity, cumulative fat and poor physical activity are risk factors for cardiovascular disease. Due to the limit in performing aerobic exercise (AER), whole-body vibration (WBV) as a passive form of exercise is an alternative therapeutic strategy. Herein, this study aimed to compare the immediate effects of AER and WBV on metabolic and cardiovascular responses, and dyspnea level in obesity. Forty-nine eligible obesities performed both AER and WBV, with a random order assignment (age = 28.94 ± 11.39 years). Fat oxidation, cardiovascular parameters (i.e., heart rate (HR) and blood pressure (BP)), and dyspnea level (i.e., rating perceived exertion (RPE)) were measured during exercise, while lipid mobilization (i.e., triglycerides) was collected pre- and post-exercise. Fat oxidation rate in AER was significantly higher than in WBV. Significantly increased fat oxidation rates were shown in both groups (within-group analyses) (also shown in females aged 20–45). Triglyceride levels between AER and WBV were similar. A significant decrease in triglyceride levels was only observed in WBV (within-group change). HR and RPE in AER were significantly higher than in WBV (p < 0.05). HR and RPE were significantly increased throughout both AER and WBV, while systolic blood pressure was only significantly elevated in AER (whining-group analyses). WBV may facilitate fat oxidation (particularly in females aged below 45), induce lipid mobilization, and reduce interference on cardiovascular parameters in obesity.

Background/Objectives: Peripheral arterial disease (PAD) is a common complication in patients with type 2 diabetes mellitus (T2DM) and is associated with substantial morbidity. Standard diagnostic tools such as the ankle–brachial index (ABI) may be limited in certain clinical settings. Therefore, simple and practical approaches for identifying individuals at increased risk of PAD are needed. This study aimed to examine the association between functional walking capacity and PAD and to develop a simple clinical risk equation for identifying PAD risk in patients with T2DM. Methods: A cross-sectional analytical study was conducted in 223 patients with T2DM attending an outpatient clinic. PAD was diagnosed using ABI and toe–brachial index measurements. Functional walking capacity was assessed using the Incremental Shuttle Walk Test (ISWT). Multivariable logistic regression analysis was used to identify factors associated with PAD and to develop a risk equation. Model performance was evaluated using receiver operating characteristic (ROC) curve analysis. Results: An ISWT distance ≤ 215 m was independently associated with PAD (OR = 1.96, 95% CI 1.10–3.50, p = 0.022). The developed model demonstrated fair discriminative ability (AUC = 0.67). At a probability cutoff of 0.57, the model showed a sensitivity of 53.8% and a specificity of 76.4%. Conclusions: Reduced functional walking capacity was associated with PAD in patients with T2DM. The proposed equation demonstrated fair discriminatory ability and may provide preliminary information for PAD risk identification; however, further validation is required before clinical implementation.

Background: Chronic Obstructive Pulmonary Disease (COPD) is a major global health burden, and early intervention in at-risk individuals may improve outcomes. Emerging technologies such as artificial intelligence (AI) offer novel means of identifying individuals at risk of COPD, enabling targeted preventive strategies. Tele-pulmonary rehabilitation (Tele-PR) has shown promise in managing chronic respiratory conditions, but its effectiveness in AI-identified at-risk individuals remains underexplored. Objectives: To evaluate the effectiveness of a 12-week Tele-PR program in improving disease-related symptoms, muscular strength, and exercise capacity in individuals identified as at risk of COPD by AI prediction. Materials and methods: Out of 286 screened participants, 38 were identified by AI as being at risk of COPD and enrolled in the study. They were allocated by village-level cluster assignment (quasi-experimental design) to either an intervention group (N=20) or a control group (N=18). The intervention group participated in a Tele-PR program conducted three sessions per week for 12 weeks. The control group received only verbal information on COPD and preventive self-management. Outcome measures included the modified Medical Research Council (mMRC) dyspnea scale, COPD Assessment Test (CAT), back and leg muscle strength using a dynamometer, and six-minute walk distance (6MWD). Assessments were conducted at baseline and post-intervention. Results: All participants completed the study without adverse events. Following the intervention, the Tele-PR group showed a statistically significant improvement in 6MWD compared to the control group (p=0.011). However, no significant differences were observed between groups in mMRC scores, CAT scores, or muscle strength measurements. Conclusion: A 12-week Tele-PR program significantly enhances exercise capacity, as measured by 6MWD, in individuals identified by AI as being at risk for COPD. These findings support the use of Tele-PR as an early intervention strategy in high-risk populations.

Background/Objectives: Although the adverse metabolic effects of PM2.5 and the health benefits of physical activity are well-established, evidence on whether physical activity modifies the association between PM2.5 exposure and metabolic syndrome or health-related quality of life (HRQoL) remains limited. Methods: This observational analytical cross-sectional study examined the modifying effect of physical activity on the associations between long-term PM2.5 exposure and metabolic syndrome and HRQoL in Chiang Mai, Thailand, and to explore these associations across physical activity levels using stratified analyses. A total of 347 participants (209 from higher PM2.5 areas and 138 from lower PM2.5 areas) were recruited in Chiang Mai between March and May 2024. Metabolic syndrome was assessed using blood tests and anthropometric measurement, while HRQoL was evaluated using the Thai version of the SF-36 questionnaire. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for metabolic syndrome. HRQoL differences were analyzed using generalized linear models with robust standard errors. Interaction between PM2.5 exposure and physical activity was assessed to examine potential effect modification. All models were adjusted for age, sex, BMI, smoking status, and educational level, with additional stratified analyses across physical activity levels. Results: Higher long-term PM2.5 exposure was associated with lower odds of metabolic syndrome (OR = 0.34, 95% CI: 0.14–0.83) but was not associated with HRQoL. Physical activity was not independently associated with either outcome, and no interaction between PM2.5 exposure and physical activity was observed. In stratified analyses, the inverse association between PM2.5 exposure and metabolic syndrome was observed only among individuals with high physical activity, while significantly lower HRQoL scores were observed among those with moderate and high physical activity levels. Conclusions: Higher long-term PM2.5 exposure was associated with lower odds of metabolic syndrome and lower HRQoL. Physical activity was not independently associated with these outcomes, and no interaction between PM2.5 exposure and physical activity was observed. Stratified analyses suggested variation in these associations across physical activity levels.

Background: Living donor liver transplantation (LDLT) poses significant physiological challenges, especially during early postoperative recovery. While the long-term benefits of structured rehabilitation are well documented, data on short-term effects—particularly during the critical early inpatient phase—remain limited. This study aimed to evaluate the short-term impact of a structured exercise program on cardiopulmonary function, respiratory muscle strength, physical performance, oxidative stress markers, and quality of life in LDLT recipients. Methods: Four LDLT recipients (2 males, 2 females; mean age 48.00 ± 18.35 years) underwent a 4-week inpatient rehabilitation protocol. Weeks 1–2 involved conventional care, while weeks 3–4 included structured exercise consisting of early mobilization and inspiratory muscle training. Outcome measures included cardiopulmonary exercise testing (CPET), spirometry, maximal inspiratory and expiratory pressures (PImax, PEmax), 6 min walk distance (6MWD), lower limb muscle strength, Chronic Liver Disease Questionnaire (CLDQ), and serum oxidative stress markers (total antioxidant capacity [TAC] and malondialdehyde [MDA]). Results: All patients demonstrated postoperative declines in VO₂ peak, PImax, PEmax, and TAC. Structured exercise yielded clinically meaningful improvements in respiratory muscle strength, notably in female and younger participants. Two younger patients showed increased 6MWD; however, no patient regained preoperative VO₂ peak. TAC levels decreased following the intervention, and MDA levels remained stable in most cases. Conclusions: A two-week structured exercise program during early postoperative recovery may provide partial benefits in respiratory muscle strength and physical performance but is insufficient to restore full cardiopulmonary function in LDLT recipients. Longer rehabilitation periods may be necessary to achieve preoperative recovery levels.