A theoretical model of sports and health integration to promote active health | BMC Public Health
This part of the research is based on the in-depth study of fitness knowledge learning, fitness status monitoring and guidance, and fitness effect evaluation and feedback to build a scientific fitness closed-loop service model, thereby innovating the mass fitness guidance model, promoting the transformation and upgrading of the traditional fitness industry, promoting the concepts and methods of scientific fitness, and further stimulating the fitness enthusiasm of the entire population.
Learning when you do not exercise
Overview and pathway exploration for learning about fitness knowledge
The outline of the nationwide body-building plan of China clearly states that the goal of the fitness movement is to “comprehensively improve the physical fitness and health of the Chinese nation”. In the scientific fitness movement, it is generally accepted that the purpose of exercise for middle-aged and older adults is also to improve function. For example, when the human body is quiet, the contractility of the myocardium stays low, and the stroke volume is small. In the morning, the heart rate is low and the output per beat (stroke volume) is high, showing that the contractility of the myocardium is relatively maintained at a high level rather than reaching its highest level [34]. In addition to the cardiovascular benefits of exercise, it is increasingly important to educate the population, particularly middle-aged and older adults, about the risks associated with sedentary behavior. Prolonged sedentary time has been shown to increase the risk of various chronic conditions, such as hypertension and type 2 diabetes [35]. Promoting physical activity during daily activities, such as walking or cycling to work, can help mitigate the negative effects of sedentary behavior. This aligns with national strategies for improving public health, as it enables the integration of more physical activity into the daily routine, especially for those with limited time for structured exercise [36].
Learning and mastering scientific fitness knowledge can support the current national fitness campaign in the context of low fitness equipment digitisation and delayed fitness feedback, creating “fitness information islands” and other shortcomings. Since universities have a high level of culture, a strong scientific research ability, and a strong track record in education and teaching of professional teachers, teaching professional fitness is a logical extension of their work. There are three implementation approaches. The first is to teach professional fitness to students. Cultivating university students’ individualised exercise ability and lifelong exercise awareness is one of the basic goals of physical education and teaching in colleges and universities [36]. The second is professional teaching to professional fitness instructors. The third is professional fitness teaching directly to the public. In order to ensure the operability of the teaching and the coverage of the national fitness service, universities can disclose the information on the places, times, teaching programmes, and fitness instructors through public announcements to society, letting people conduct their own programme activities according to their own fitness needs [37].
Overview of learning about common chronic diseases and pathway exploration
Chronic diseases are important factors affecting human health and have become a major global public health problem [20, 38]. As the main cause of death globally, they are the cause of about 74% of all global deaths [39, 40]. In recent years, morbidity and mortality due to chronic diseases have been rising rapidly in China, seriously affecting improvements in public health and economic and social development. Chronic diseases are mostly lifelong diseases, such as hypertension, diabetes mellitus, and coronary heart disease, and patients usually require long-term treatment and management. Health education can enable patients to understand the disease and its precautions, enabling them to manage their disease scientifically. It is an important means to promote patients’ self-management and disease recovery [38, 40].
A knowledge service system for chronic diseases is constructed under a multidimensional perspective (Fig. 4) based on fully investigating and analysing the existing services of the online medical community, effectively determining the actual needs of users to expand the disease ontology model, and taking the opportunity to broaden the periphery of the online medical information service and cohesion of the existing knowledge resources for chronic disease to strengthen the connection and communication between the governmental departments, online medical community, and users [41]. The roles of the three main bodies are as follows: (1) multiple bodies govern the chronic disease knowledge service platform; (2) government departments and the medical community optimise the API open interface; and (3) the user community supports the multi-party co-construction of the service [42].
Chronic disease service system under a multidimensional perspective
Overview and exploration of pathways for specialised exercise training
Specialised exercise training has two aspects: exercise health education and screening. The exercise health education model mainly adopts cooperative and inquiry learning, role-playing through the characteristics of different stages, and playing a role according to the characteristics of each member, thereby promoting the team’s in-depth understanding of skills, culture, and health knowledge. Regarding exercise health screening, research has established a broad consensus that regular physical activity can reduce the adverse effects of sedentary and low activity and have comprehensive and wide-ranging health benefits [6].
Presently, community medical institutions delivering health services, which generally provide medical treatment, must cultivate healthcare personnel’s awareness of scientific fitness and good theoretical knowledge to enable them to provide effective fitness guidance and advice to patients and actively participate in fitness activities [42]. The relevant personnel of community institutions must regularly promote and organise fitness activities for the community. In the modern path of social development, the constant broadening of media channels, such as networks, books and newspapers, television, magazines, and social media, has obvious advantages for dissemination. These communication channels not only have convenience and effectiveness but also can be integrated into interpersonal communication, achieving greater coverage with less effort [43].
Periodic screening assessment
Overview of health status assessment and exploration of pathways
Health status assessment refers to an individual’s subjective evaluation and expectation of their health status. It is based on their knowledge of their own physiology, psychology, and other aspects and integrates various subjective and objective health information to form an understanding of their overall health status, which is a common method of obtaining a comprehensive health status and is also the foundation for health self-management [44].
The National Health Commission takes the lead and is specifically responsible for formulating and organising the implementation of health status assessment policies, laws, administrative regulations, and departmental rules, as well as guiding localities in their work of assessing the health status of major development plans as well as major economic development plans and important industries and key regions [45]. The exercise prescription is prescribed according to the different conditions of each person after their physical fitness is measured. Specific requirements are made for factors such as age, gender, physical fitness state, psychological characteristics, interests, physical activity condition, and health. The prescription specifies the exercise content, intensity, and volume of each participant, providing them with a purpose and plan to exercise. The regulation of sports nutrition is also an important prerequisite for assessing health status (i.e. by supplementing the nutrients the body needs) [45]. A reasonable diet and adequate intake of all types of nutrients is an effective and good solution to address poor health [46].
Overview of exercise capacity assessment and pathway exploration
The American College of Sports Medicine categorises physical fitness into sports and health fitness, depending on the target audience and individual needs. Health-related physical fitness is needed to promote health, prevent disease, and improve daily life and work efficiency, and is closely related to mobility. It includes five main areas: cardio-respiratory fitness, muscular strength and endurance, body composition, flexibility, and balance. Therefore, physical mobility must be assessed based on these five dimensions, and the focus of the mobility assessment varies among different age groups.
Regular physical activity is known to protect human health and has been widely confirmed by scientific research [31, 47, 48]. In particular, preventing and treating chronic non-communicable diseases is also beneficial for improving mental health, delaying the onset of dementia, and enhancing quality of life and living. In both high-income and low-middle-income countries, health spending on physical inactivity accounts for as much as 1–3% of national healthcare costs, which may be conservative estimates [48]. Therefore, the comprehensive application of physical fitness testing equipment for assessing exercise capacity is as follows: (1) The current new ultrasound bone density monitor can dynamically analyse and assess bone density and strength, and the entire process has the advantages of being non-invasive, non-destructive, and non-radiation, making it suitable to be applied in monitoring osteoporosis in older adults and physiological development in children; (2) The atherosclerosis monitor can more conveniently and effectively respond to the hardness of the arteries and the function of the blood vessels in the national physical fitness test and the assessment of the physical activity ability; (3) The all-in-one physical fitness test machine has comparatively more complete functions and can automatically identify the examinee’s relevant information, visually and audibly guiding them through the physical fitness test according to the regulations.
Exercise habits assessment overview and pathway exploration
The various definitions of exercise habits can be divided into two categories. One category tends to view exercise habits as automated behaviours or behaviour patterns formed through repeated practice and closely linked to intrinsic needs. Presently, most people still hold this view. Cheng et al. [49] defined exercise habit as “a relatively solid automated behavioral pattern that is gradually formed, intrinsically needed and relatively solid, on the basis of continuous repetitive physical practice in human beings in later life”. In short, exercise habits are automated behaviours formed later in life. The other category considers exercise habits to be exercise behaviours or modes of exercise behaviour formed through repeated practice and closely linked to intrinsic needs, with no emphasis on the automation of behaviours.
Those aged 22–55 years are the main workforce. However, the proportion of these individuals participating in physical exercise is not high. One study concluded that there are two main reasons for this: (1) the influence of life and societal pressures and (2) the lack of awareness of physical exercise. Object sports awareness is the subject itself outside the sports environment, sports activities directed to the objective sports as the object, revealing the sports environment, the surrounding sports activities, reflecting the authenticity of the object sports problem. People’s sports awareness could be improved through effective measures to improve their participation in sports, from which they can gain a good emotional experience, and create a good sports environment, such as through sports policies, sports facilities, sports events, and sports media [50].
Pre-exercise instruction
Overview of pre-exercise instruction and pathway exploration
Exercise planning is key to achieving fitness goals. Effective exercise planning should consider an individual’s lifestyle, exercise interests and goals, as well as adaptability and consistency. The following is a detailed analysis of exercise schedules, type selection, and progression. The goal of scheduling an exercise programme is to make exercise a part of daily life so that it can be sustained over time [51]. Here are some tips: (1) Daily schedule and available time: write down your daily tasks and then see which time slots are available for exercise. (2) Set a regular exercise schedule: exercise at the same time slots every day whenever possible, which will help you develop good exercise habits and make exercise a part of your daily life. (3) Allocate exercise time wisely: you should do at least 150 min of moderate-intensity aerobic exercise or 75 min of vigorous-intensity aerobic exercise each week. (4) Consider variety: avoid doing the same exercise every day wherever possible. Variety not only prevents you from getting bored but also helps you to exercise your body comprehensively.
The choice of exercise type should be based on health and fitness goals [52]. The following are some types of exercise and their effects on the body. (1) Endurance exercise, such as running, cycling and swimming, mainly improves cardio-respiratory fitness, reduces the incidence of sudden cardiac death [53], and helps to increase the basal metabolic rate and burn excess fat. (2) Strength training, such as weight lifting and using elastic bands, mainly enhances muscle and bone strength and helps to increase basal metabolic rate [54]. (3) Flexibility exercise, such as yoga and Pilates, increase flexibility and balance and help prevent sports injuries [55].
Every few weeks, you should check if you need to adjust your exercise planning based on your fitness progress. If progress stalls or fitness goals change, it may be necessary to change the type of exercise, increase the amount of exercise, or increase the intensity of exercise. Exercise planning should be flexible and change as fitness levels and goals change. Most importantly, find a form of exercise that you enjoy and are willing to stick with for the long term, as the continued advancement of sports and health integration changes people’s lifestyles [53].
Monitoring in exercise
Overview of monitoring in exercise and pathway exploration
Four key elements must be monitored and analysed in detail: exercise intensity, time, frequency, and postural movement behaviour. Firstly, exercise intensity is one of the most important indicators of exercise effect. Secondly, exercise duration is directly related to the accumulation of exercise effect. Finally, postural movement behaviour is the most problematic aspect of the exercise process. Incorrect postural movements may lead to poor exercise effects or even trigger sports injuries. In conclusion, exercise monitoring should pay comprehensive attention to participants’ exercise intensity, time, frequency, and postural movement behaviour and provide targeted training recommendations for athletes and fitness enthusiasts.
Exercisers can record their exercise routes in real-time via GPS, and motion analysis software can use this data for real-time analysis, including speed, distance, trajectory and other information. Capturing images through the camera can visualise the exerciser’s posture, movement and path, which is important for detailed analysis of the technical details and movement patterns of sportspeople. Image processing software can be used to extract information such as the key points and bone structure of the exerciser to help understand their movement characteristics, which can be used to improve posture and optimise movements. Heart rate monitors can be used to monitor the exerciser’s heart rate in real-time, providing important information about the intensity of the exercise and physical condition [53].
Post-exercise feedback
Post-exercise feedback is the process of converting information about effector activity from the motor organ into sensory stimuli that the brain can process into information that corrects motor skills [56]. Post-exercise feedback is the basis for the realisation of motor skill learning. It is an internal mechanism for finding cues to improve movements, self-regulate technical movements, and form independent skills.
Overview of goal fulfilment and exploration of pathways
For a given dynamic goal system, such a “controller” should be established so that a certain performance index supports achieving the goal [57]. The scientific fitness programme is an ambitious and complex systematic project. After the goal system is set up, the control function of the goal must be strengthened to continuously revise the goal and adjust behaviours that deviate from the original goal.
To make goal setting more effective, the exercise instructor must give the individual feedback on how the participant is doing with the activity. Whether clear or challenging, goals will have little effect if the individual is unaware of their activity along the way. Knowledge of the results will help them better adjust strategies and improve techniques. Similarly, not setting specific goals or only giving the exerciser feedback will not increase their activity level; their performance will only improve if there are both specific goals and informative feedback.
Overview of fitness indicators and exploration of pathways
According to the connotation requirements of different physical fitness levels, physical fitness is divided into sport-related and health-related physical fitness. (1) Sport-related physical fitness is the body’s adaptation to competitive sports, including explosive force, speed, and endurance, and is often used to evaluate athletes’ performance and ability. (2) Health-related physical fitness refers to the qualities that contribute to promoting health and preventing certain diseases, which is not only the basis for an individual to maintain their health but also a prerequisite to ensure that they can happily complete their daily work and reduce the occurrence of chronic diseases [58].
Regular exercise and physical activity can improve the health and fitness of individuals. A certain length of dance exercise during the lunch break or after work could be advocated to improve fitness in females [59]. Therefore, to improve the health and fitness of individuals, they should be encouraged to actively participate in sports activities and exercise prescriptions should be customised based on their age and gender [60]. Middle-aged and older women could perform relatively soothing activities such as yoga and walking, and middle-aged and older men could choose activities such as badminton, jogging, and sword dancing. Therefore, a good service concept and excellent activity organisation could increase the motivation of individuals to participate in exercise and create a good atmosphere for exercise, thus improving their health and fitness levels [61].
Overview of feedback reporting and exploration of pathways
The feedback reporting suggests that national scientific fitness activities should be popularised among all groups to promote the participation of the entire population. The public’s awareness and motivation for physical fitness should be enhanced to promote sustainable development. The public should be encouraged to adopt reasonable exercise methods to facilitate the acquisition of greater health benefits. Various sports should be developed to attract the participation of ethnic minorities. Fitness professionals should be trained to provide national fitness activities. Sports commercialisation could be improved by starting to meet individual needs in scientific fitness campaigns.
With the promotion of national fitness, the importance of exercise is also slowly being recognised, such as walking, running, and jumping in basic quality training in physical education classes for adolescent, basketball, badminton, table tennis and other sports are well-liked. In contrast, jogging, aerobics, and yoga are more popular among adults, while taijiquan, fitness walking, and square dancing are welcomed by older adults [59,60,61]. Nonetheless, exercise plays an important role in improving physical fitness, preventing diseases, and even controlling disease. Strength training has unique benefits compared to aerobic exercise, such as being more effective in improving muscle strength and bone density. Combining strength with aerobic training is better than aerobic exercise alone in managing some chronic diseases, such as type 2 diabetes [62, 63].
Overview of injury prevention recommendations and exploration of pathways
Sports injury refers to various injuries that occur during sports [46]. With the recent development of the national fitness campaign, increasing numbers of people are participating in exercise. However, due to the lack of necessary health knowledge of exercise among the general population, the exercise method may not be appropriate, occasionally leading to various sports injuries, resulting in people not only being unable to participate in normal exercise but also risking the injury developing into a chronic injury if it is not treated promptly, affecting their daily life [61]. Therefore, once a sports injury occurs, it should be promptly and thoroughly treated to prevent it from becoming a chronic injury and reducing quality of life [60].
If people do not take proper precautions when exercising, they can expose their bodies to different injuries due to irregular movements. How can the body not be harmed while seeking to achieve effective fitness? (1) Focus on adequate warm-up. (2) Choose the right volume of exercise. (3) Understand the use of sports equipment. (4) Understand your own physical fitness. Now, with the availability of various fitness videos, the public should watch them when choosing exercises. Before exercising, they should understand their own physical characteristics and living environment and then choose the right type of exercise based on their actual situation; only in this way can they maximise its benefits with minimal effort.
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