Eun-Surk Yi

Background: Evidence linking fascia-oriented rhythmic movement to executive function and prefrontal hemodynamics in older adults remains limited. This pilot study examined the feasibility and preliminary within-subject associations of a four-week Fascial Circulation Exercise (FCE) program in older Korean women. Methods: Twelve cognitively screened women (74.3 ± 6.7 years) completed supervised FCE for four weeks. Pre–post assessments included body composition, grip strength, isokinetic knee performance, executive tasks (TMT-A/B, CDT), and task-evoked prefrontal activation measured via functional near-infrared spectroscopy (ΔHbO). Paired t-tests with effect sizes were reported. Results: Fat mass decreased (−0.71 kg, p = 0.016; dz = −0.74), whereas body weight and BMI were unchanged. Selective improvements were observed in knee flexor peak torque and extensor endurance (p < 0.05), with no change in grip strength. ΔHbO increased in the orbitofrontal, ventrolateral, and frontopolar regions during executive tasks. Behavioral performance improved in CDT and showed a trend toward improvement in TMT-B. Conclusions: Short-term FCE was feasible and was associated with reduced fat mass, selective neuromuscular gains, and increased task-evoked prefrontal oxygenation. The findings are exploratory and support future randomized controlled trials to determine clinical efficacy.

Acceptance and Commitment Therapy (ACT) has been widely applied in clinical contexts; however, its systematic adaptation to elite sports, particularly precision-based disciplines such as shooting, remains underexplored. The present study aimed to develop and preliminarily validate an ACT-based psychological training program—the Acceptance and Commitment Performance Training for Shooters (ACPT-S)—by reframing ACT from a therapeutic intervention into a performance-oriented training framework. Using a multiphase formative evaluation design, a needs assessment was first conducted with 28 elite and collegiate shooters to identify sport-specific psychological demands. Based on these findings, a ten-session ACPT-S program was developed by integrating the six core ACT processes with shooter-specific routines, embodied exercises, and performance-relevant metaphors. The program was subsequently examined through two pilot studies: Phase 1 with four collegiate/corporate athletes and Phase 2 with 15 national-level shooters. Data were collected via session reflections, focus group interviews, and expert panel evaluations, and the Content Validity Ratio (CVR) analysis was used to assess conceptual clarity and implementation feasibility. The results indicated that ACPT-S was perceived as both feasible and contextually appropriate, with athletes reporting improvements in attentional focus, emotional acceptance, value-based motivation, and reduced anxiety. Qualitative analyses demonstrated strong engagement with ACT principles and their functional integration into shooting performance contexts, while all program components achieved CVR scores of ≥0.80, indicating a strong expert consensus. Program refinements were guided by feedback related to activity sequencing, metaphor resonance and personalization strategies. Overall, this study reconceptualizes ACT as a performance-enhancement framework rather than a purely clinical approach and introduces the ACPT-S as a novel, theory-driven, and scalable psychological training model for precision sports, providing a robust foundation for future longitudinal and comparative research.

Background/ Objective: Acceptance and Commitment Therapy (ACT) has been widely applied in clinical settings, yet its adaptation to elite sports—particularly precision-based disciplines such as shooting—remains underexplored. This study aimed to develop and preliminarily validate an ACT-based psychological training program, the Acceptance and Commitment Performance Training for Shooters (ACPT-S). By reframing ACT from therapy to performance training, the program sought to enhance psychological flexibility, attentional control, and emotional resilience in elite shooters. Methods: A multi-phase formative evaluation design was employed. Needs assessment was conducted with 28 elite and collegiate shooters to identify psychological demands. A ten-session ACPT-S framework was then developed by integrating ACT’s six processes with sport-specific routines and metaphoric interventions. Two pilot studies were conducted: Phase 1 with four collegiate/corporate athletes, and Phase 2 with 15 national-level shooters. Data sources included session reflections, focus group interviews, and expert panel evaluations. Content Validity Ratio (CVR) analysis was applied to assess conceptual clarity and implementation feasibility. Results: ACPT-S was perceived as both feasible and contextually relevant. Athletes reported improved attentional focus, emotional acceptance, value-based motivation, and reduced performance anxiety. Thematic analysis confirmed strong engagement and integration of ACT principles. All program elements achieved CVR scores ≥ .80, indicating expert consensus. Revisions were guided by feedback on activity sequencing, metaphor resonance, and personalization strategies. Conclusions: This study redefined ACT as a performance-enhancement framework, extending its reach beyond clinical contexts. The ACPT-S model represents a novel, theory-driven, and scalable intervention for cultivating psychological skills in precision sports. Its metacognitive foundation and sport-specific design provide a promising basis for future longitudinal and comparative validation.

Background/Objectives: As global aging accelerates, there is a pressing and empirically substantiated demand for integrated and sustainable strategies, as evidenced by the rising prevalence rates of chronic conditions, social isolation, and digital exclusion among older adults worldwide. These factors underscore the urgent need for multidimensional interventions that simultaneously target physical, psychological, and social well-being. The HOPE-FIT (Hybrid Outreach Program for Exercise and Follow-up Integrated Training) model and the SAGE (Senior Active Guided Exercise) program were designed to address this need through a hybrid framework. These programs foster inclusive aging by explicitly bridging digitally underserved groups and mobility-restricted populations into mainstream health promotion systems through tailored exercise, psychosocial support, and smart-home technologies, thereby functioning as a scalable meta-model across healthcare, community, and policy domains. Methods: HOPE-FIT was developed through a formative, multi-phase process grounded in the RE-AIM framework and a Hybrid Type II effectiveness–implementation design. The program combines professional health coaching, home-based and digital exercise routines, Acceptance and Commitment Performance Training (ACPT)-based psychological strategies, and smart-home monitoring technologies. Empirical data from pilot studies, large-scale surveys (N = 1000), and in-depth user evaluations were incorporated to strengthen validity and contextual adaptation. Culturally tailored content and participatory feedback from older adults further informed ecological validity and program refinement. Implementation Strategy/Framework: The theoretical foundation integrates implementation science with behavioral and digital health. The RE-AIM framework guided reach, fidelity, and maintenance planning, while the Hybrid E–I design enabled the concurrent evaluation of effectiveness outcomes and contextual implementation strategies. Institutional partnerships with community centers, public health organizations, and welfare agencies further facilitated the translation of the model into real-world aging contexts. Dissemination Plan: The multi-pronged dissemination strategy includes international symposia, interdisciplinary academic networks, policy briefs, localized community deployment, and secure, authenticated data sharing for reproducibility. This design facilitates evidence-informed policy, empowers practitioners, and advances digital health equity. Ultimately, HOPE-FIT constitutes a scalable and inclusive model that concretely addresses health disparities and promotes active, dignified aging across systems and disciplines.

Background/Objective: The global acceleration of population aging presents profound challenges to the physical, psychological, and social well-being of older adults. As traditional exercise programs face limitations in accessibility, personalization, and sustained social support, there is a critical need for innovative, inclusive, and community-integrated digital movement solutions. This study aimed to develop and evaluate Movement Poomasi, a hybrid digital healthcare application designed to promote physical activity, improve digital accessibility, and strengthen social connectedness among older adults. Methods: From March 2023 to November 2023, Movement Poomasi was developed through an iterative user-centered design process involving domain experts in physical therapy and sports psychology. In this study, the term UI/UX—short for user interface and user experience—refers to the overall design and interaction framework of the application, encompassing visual layout, navigation flow, accessibility features, and user engagement optimization tailored to older adults’ sensory, cognitive, and motor characteristics. The application integrates adaptive exercise modules, senior-optimized UI/UX, voice-assisted navigation, and peer-interaction features to enable both home-based and in-person movement engagement. A two-phase usability validation was conducted. A 4-week pilot test with 15 older adults assessed the prototype, followed by a formal 6-week study with 50 participants (≥65 years), stratified by digital literacy and activity background. Quantitative metrics—movement completion rates, session duration, and engagement with social features—were analyzed alongside semi-structured interviews. Statistical analysis included ANOVA and regression to examine usability and engagement outcomes. The application has continued iterative testing and refinement until May 2025, and it is scheduled for re-launch under the name Wello! in August 2025. Results: Post-implementation UI refinements significantly increased navigation success rates (from 68% to 87%, p = 0.042). ANOVA revealed that movement selection and peer-interaction tasks posed greater cognitive load (p < 0.01). A strong positive correlation was found between digital literacy and task performance (r = 0.68, p < 0.05). Weekly participation increased by 38%, with 81% of participants reporting enhanced social connectedness through group challenges and hybrid peer-led meetups. Despite high satisfaction scores (mean 4.6 ± 0.4), usability challenges remained among low-literacy users, indicating the need for further interface simplification. Conclusions: The findings underscore the potential of hybrid digital platforms tailored to older adults’ physical, cognitive, and social needs. Movement Poomasi demonstrates scalable feasibility and contributes to reducing the digital divide while fostering active aging. Future directions include AI-assisted onboarding, adaptive tutorials, and expanded integration with community care ecosystems to enhance long-term engagement and inclusivity.

Background/Objective: Sustained exercise adherence among older adults is essential for healthy aging but remains challenging due to psychological, social, and economic barriers. This study aimed to investigate how perceived exercise barriers, financial burden, constraint negotiation mechanisms, and social support influence exercise adherence among adults aged 50 and older by integrating behavioral economics, constraint negotiation theory, and social cognitive theory. Methods: A cross-sectional survey was conducted with 1000 community-dwelling older adults in South Korea using a convenience sampling method. Participants were recruited from community centers, senior welfare facilities, and public health clinics in urban and suburban areas. Data collection was conducted between 11 January and 21 April 2024, using both online (Qualtrics) and offline (paper-based) surveys. Participants completed validated instruments measuring perceived exercise barriers, financial burden, constraint negotiation mechanisms (including financial management and social support mobilization), perceived social support, and behavioral exercise adherence. The final sample used for analysis included 974 individuals (mean age = 60.24 years, SD = 6.42). Structural Equation Modeling (SEM) was used to assess direct, mediating, and moderating effects. Additional exploratory analyses (ANOVA and t-tests) examined subgroup differences. Results: SEM results showed that perceived exercise barriers (β = –0.352, p < 0.001) and financial burden (β = –0.278, p < 0.001) were negatively associated with exercise adherence. Constraint negotiation mechanisms (β = 0.231, p < 0.001) and perceived social support (β = 0.198, p < 0.001) were positively associated. Mediation analyses revealed that constraint negotiation strategies partially mediated the relationships between perceived barriers and adherence (indirect β = 0.124) and between financial burden and adherence (indirect β = 0.112). Moderation analysis confirmed that social support buffered the negative effects of financial and psychological barriers. Conclusions: Exercise adherence in later life is shaped by the dynamic interplay of structural constraints, behavioral strategies, and social reinforcement. Interventions should combine financial support with socially embedded structures that promote behavioral planning and peer accountability to sustain long-term physical activity among older adults.

Background/Objective: As the global aging population grows, digital leisure services have emerged as a potential solution to improve older adults’ social engagement, cognitive stimulation, and overall well-being. However, their adoption remains limited because of digital literacy gaps, psychological barriers, and varying levels of adaptability. This study aims to analyze and predict older adults’ intention to adopt digital leisure services by integrating psychosocial factors, demographic characteristics, and digital adaptability using artificial intelligence (AI)-based predictive models. Methods: This study utilized data from the 2022 Urban Policy Indicator Survey conducted in Seoul, South Korea, selecting 2239 individuals aged 50 years and above. A two-step clustering approach was employed: hierarchical clustering estimated the optimal number of clusters, and K-means clustering finalized the segmentation. An artificial neural network (ANN) model was applied to predict the likelihood of digital leisure adoption by incorporating demographic and psychosocial variables. Logistic regression was used for validation, and model performance was assessed through accuracy, precision, recall, and F1-score. Results: Four distinct clusters were identified based on digital adaptability and social media engagement. Cluster 3 (highly educated males in their 60s with family support) showed the highest probability (84.35%) of digital leisure adoption despite low social media engagement. Cluster 4 (older women with high social media usage) exhibited lower adaptability to structured digital services. The ANN model achieved an overall classification accuracy of 85.2%, highlighting digital adaptability as a key determinant for adoption. Conclusions: These findings underscore the need for targeted policy interventions, including tailored digital education programs, intergenerational digital training, and simplified platform designs to enhance digital accessibility. Future research should further explore psychological factors influencing digital adoption and validate AI-based predictions using real-world behavioral data.

Background: Understanding the general health and well-being of the aged population requires an understanding of several factors, among which the interplay between physical activity and sleep quality are the most efficient determinants. There is still much to learn about the precise ways that different components of sleep quality affect different kinds of physical activity in older persons, accordingly, the study aims to provide a comprehensive understanding of the interaction between these variables. Methods: An online questionnaire-based investigation was conducted between August and September 2023. This cross-sectional study analyzed data from 1,437 participants aged 50 to 89 years. The questionnaire evaluated levels of physical activity, sleep satisfaction, and demographic data. We used cluster analysis, regression analysis, and factor analysis to investigate the connections between these variables. Results: Factor analysis revealed a single factor that accounted for 51.95% of the variance in all variables linked to sleep, and this factor represented overall quality of sleep. Regression analysis revealed that gender significantly predicted sleep quality, with females reporting lower sleep satisfaction. While strenuous exercise did not significantly affect sleep quality, moderate exercise was a positive predictor of sleep quality that neared statistical significance. Furthermore, cluster analysis revealed that those who engaged in more physical activity had higher-quality sleep. Conclusion: These results highlight the significance of encouraging physical activity to improve older adults' sleep quality. Specific programs that promote moderate exercise may enhance this population's general health and sleep quality. Future research should focus on longitudinal studies to create causality and modify intervention strategies aimed at promoting healthy aging.

Lack of access to social bonding sessions owing to the COVID-19 pandemic has had negative effects on older adults' exercise participation. This study examined the relationships between bridging capital, bonding capital, relationship commitment, and exercise participation intention. We surveyed 740 adults aged 50 years or over who visited welfare, health, and senior centers in South Korea. The results showed that bridging capital and bonding capital were positively associated with relationship commitment and exercise participation intention, and that the effect of bridging capital on exercise participation intention was mediated by relationship commitment. Thus, it is necessary to find ways to develop programs that can connect older adults and help them form small networks, in order to promote their exercise participation.

Background: Korea’s aging population and the lack of older adult participation in sports are increasing medical expenses. Aims: This study aimed to segment older adult sports participants based on their demographic characteristics and exercise practice behavior and applied artificial neural network and logistic regression models to these segments to best predict the effect of medical cost reduction. It presents strategies for older adult sports participation. Methods: A sample comprising data on 1,770 older adults aged 50 years and above was drawn from the 2019 National Sports Survey. The data were analyzed through frequency analysis, hierarchical and K-means clustering, artificial neural network, logistic regression, cross-tabulation analyses, and one-way ANOVA using SPSS 23 and Modeler 14.2. Results: The participants were divided into five clusters. The artificial neural network and logistic analysis models showed that the cluster comprising married women in their 60s who participated in active exercise had the highest possibility of reducing medical expenses. Discussion: Targeting women in their 60s who actively participate in sports, the government should expand the supply of local gymnasiums, community centers, and sports programs. If local gymnasiums and community centers run sports programs and appoint appropriate sports instructors, the most effective medical cost reduction effect can be obtained. Conclusions: This study contributes to the field by providing insights into the specific demographic segments to focus on for measures to reduce medical costs through sports participation.