The purpose of this study was to compare the effects of two similar high-intensity intermittent exercises (HIIE) but different volume 1.25km (HIIE1.25) and 2.5km (HIIE2.5) on inflammatory and BDNF responses. Ten physically active male subjects (age 25.22±1.74years, body mass 78.98±7.31kg, height 1.78±0.06m, VO2peak 59.94±9.38ml•kg•min-1) performed an incremental treadmill exercise test and randomly completed two sessions of HIIE on a treadmill (1:1 min at vVO2max with passive recovery). Blood samples were collected at rest, immediately and 60-minutes after the exercise sessions. Serum was analyzed for glucose, lactate, IL-6, IL-10 and BDNF levels. Blood lactate concentrations was higher immediately post-exercise compared to rest (HIIE1.25: 1.69±0.26 to 7.78±2.09mmol•L-1, and HIIE2.5: 1.89±0.26 to 7.38±2.57mmol•L-1, p<0.0001). Glucose concentrations did not present changes under the different conditions, however, levels were higher 60-min post-exercise than at rest only in the HIIE1.25 condition (rest: 76.80±11.14 to 97.84±24.87mg•dL-1, p<0.05). BDNF level increased immediately after exercise in both protocols (HIIE1.25: 9.71±306 to 17.86±8.59ng.mL-1, and HIIE2.5: 11.83±5.82 to 22.84±10.30ng.mL-1). Although both exercises increased IL-6, level percent increase between rest and immediately after exercise was higher in the HIIE2.5 than HIIE1.25 (30% and 10%; p=0.014, respectively). Moreover, IL-10 levels percent increase between immediately and 60-min post-exercise was higher in HIIE2.5 than HIIE1.25 (37% and 10%; p=0.012, respectively). In conclusion, both HIIE protocols with the same intensity were effective to increase BDNF and IL-6 levels immediately after exercise while only IL-10 response was related to the durantion of exercise indicanting the importance ofthis exercise prescription variable.

Background: Low back pain (LBP) and knee osteoarthritis (OA) are major contributors to disability worldwide. These conditions result in a significant burden at both individual and societal levels. Engagement in regular physical activity and exercise programs are known to improve physical function in both chronic LBP and knee OA populations. For people residing in rural areas, musculoskeletal conditions are often more frequent and disabling compared to urban populations, which could be the result of reduced access to appropriate health services and resources in rural settings. EHealth is an innovative solution to help provide equitable access to treatment for people with musculoskeletal pain living in rural settings. Methods/design: We will conduct a randomised clinical trial investigating the effects of an eHealth intervention compared to usual care, for people with chronic non-specific LBP or knee OA in rural Australia. We will recruit 156 participants with non-specific chronic LBP or knee OA. Following the completion of baseline questionnaires, participants will be randomly allocated to either the eHealth intervention group, involving a tailored physical activity and progressive resistance exercise program remotely delivered by a physiotherapist (n = 78), or usual care (n = 78) involving referral to a range of care practices in the community. Outcomes will be measured at baseline, 3 and 6 months post-randomisation. The primary outcome will be physical function assessed by the Patient-Specific Functional Scale (PSFS). Secondary outcomes include pain intensity, physical activity levels, activity limitations, quality of life, pain coping. We will also collect process evaluation data such as recruitment rate, attendance and adherence, follow-up rate, participants’ opinions and any barriers encountered throughout the trial. Discussion: The findings from this trial will establish the effectiveness of eHealth-delivered interventions that are known to be beneficial for people with LBP and knee OA when delivered in person. As a result, this trial will help to inform health care policy and clinical practice in Australia and beyond for those living in non-urban areas. Trial registration: This study was prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12618001494224) registered 09.05.2018.

Physical inactivity is a major risk factor for non-communicable disease and premature mortality. People who live in rural settings are usually regarded as more physically active than those living in urban areas, however, direct comparisons between these populations are scarce. We aimed to summarise the prevalence of physical inactivity and sedentary behaviour in rural settings in Australia, compared to urban counterparts. We searched six databases (AMED, Embase, Medline; CINAHL, SPORTDiscus; and RURAL) and identified 28 observational studies that investigated the levels of physical inactivity and/or sedentary behaviour in adults aged 18 years and over in rural Australia. Random effects meta-analysis was used to generate pooled prevalence estimates. Physical inactivity was four percentage points (95% confidence interval (CI) = 0.4 to 8) higher in rural populations compared to urban populations. There was a one percentage point (95% CI = -3 to 5) prevalence difference of physical activity in the rural populations. Rural populations reported on average 7.8 hours of sedentary time per day (95% CI = 5 to 10) and the prevalence of high levels of sedentary behaviour (≥to 8 hours per day) was 7% (95% CI = -8 to -7) greater in urban areas compared to rural areas. People living in rural areas are just as physically inactive as people who live in urban areas. Our findings challenge the popular views that rural lifestyles result in people engaging more frequently in physical activity. Public health campaigns promoting physical activity in rural settings are just as necessary as in urban settings.

Objective: Our objective was to evaluate the effectiveness of a three‐month physiotherapist‐delivered eHealth physical activity program compared with usual care to improve function in adults with low back pain or knee osteoarthritis in rural Australia.Methods: This was a parallel, two‐group, pragmatic, superiority, randomized controlled trial involving three‐ and six‐month posttreatment follow‐ups. There was a total of 156 adults with chronic nonspecific low back pain (n = 97) or knee osteoarthritis (n = 59) from rural Australia. The intervention involved an eHealth physical activity and an exercise program that included five to eight teleconsultations with a physiotherapist (primary time point three months) or usual care (eg, general practitioner, physiotherapy, and pain medication). The primary outcome was the Patient‐Specific Functional Scale (0–30), with a three‐point difference between groups being considered the minimum clinically important difference.Results: Participants receiving the eHealth intervention (n = 78) reported significantly greater and clinically worthwhile improvements in function (mean between‐group difference 3.6; 95% confidence interval [CI] 1.3–5.9) compared to participants receiving usual care (n = 78). Small but statistically significantly greater improvements in disability (7.2 of 100; 95% CI 2.1–12.3) and quality of life (4.5 of 100; 95% CI 0.0–9.0) also favored the eHealth group. No clinical or statistical differences between groups were found for the secondary outcomes of pain, coping skills, and physical activity levels.Conclusion: A physiotherapist‐delivered eHealth intervention is effective and provides clinically meaningful improvements in function compared to usual care for people with musculoskeletal pain in rural communities. These findings highlight the potential for eHealth‐based programs to improve access to evidence‐based exercise interventions for people with musculoskeletal pain in rural communities. image

The aim of this study was to compare heart rate variability (HRV) recovery after 2 sessions of high-intensity intermittent exercise at different volumes (1.25 km [HIIE_1.25] and 2.5 km [HIIE_2.5]). 13 participants determined their maximal aerobic speed (MAS) and completed 2 HIIE (1:1 at 100% MAS) trials. The heart rate was recorded before and after each session. HRV indicators were calculated according to time (RMSSD and SDNN) and frequency (LF, HF and LF/HF ratio) domains. SDNN and RMSSD presented effect of test (F=20.97; p<0.01 and F=21.00; p<0.01, respectively) and moment (F=6.76; p<0.01 and F=12.30; p<0.01, respectively), without interaction. Even though we did not find an interaction effect for any HRV variables, the HIIE_2.5 presented a delay of only 5 min in HRV recovery, when compared to HIIE_1.25. However, the effects of the test (SDNN, RMSSD, LF-log, and HF-log) indicate higher autonomic stress during the entire recovery period. These findings may indicate that exercise volume interferes with HRV recovery. If so, physically active subjects may choose a lower volume exercise (i. e., HIIE_1.25) in order to promote similar physical fitness adaptations with lower loading on autonomic modulation.

Effective management of chronic low back pain (LBP) often relies on maintaining a healthy lifestyle. Mobile health (mHealth) applications provide a unique opportunity to support LBP sufferers by integrating evidence-based health education into daily routines. However, many existing mHealth apps lack scientific rigour in their development, limiting their impact. This study reports on developing and usability testing My Back Exercise, an mHealth app designed to support individuals managing chronic LBP through a user-centred, theory-based approach. The development followed the Double Diamond framework and Software Development Life Cycle (SDLC) model, focusing on behaviour change theory to promote healthy lifestyle habits. Usability testing involved ten users and employed the System Usability Scale (SUS) and Mobile App Rating Scale (MARS) to assess engagement, functionality, aesthetics, and information quality. Additionally, a think-aloud approach captured real-time feedback and guided iterative improvements. Results showed that the app was well-received, achieving a SUS mean score of 79 (total score of 100) and a MARS mean score of 3.7 (out of 5.0). Key intervention components included exercises, sleep management, diet, and pain education, contributing to a holistic self-management tool. This study provides a transparent roadmap for the development of evidence-based digital health tools. The My Back Exercise app offers an innovative, holistic approach to help people self-manage chronic LBP using evidence-based methods.