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Open research questions in Physical Activity and Health

436 unresolved questions extracted from the limitations and future-work sections of 5,217 Physical Activity and Health papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • However, a critical gap persists regarding whether obesity and age significantly modify the protective association of physical activity (PA) and T2DM, and the precise nature of this dose-response relationship remains inadequately characterized.

    Physical Activity and Type 2 Diabetes Risk: Heterogeneity in the Dose-Response by Obesity and Age · 2026 · DOI

  • As theory use was neither opera- tionalized nor examined analytically, its contribution to the observed effects cannot be inferred, which also represents a key limitation of the current evidence base. Given the mixed findings in this review and available global evidence, these approaches should be interpreted as potentially useful but not yet consistently effective for sustained PA improve- ment in LMICs [45, 61, 71].

    A Systematic Review of Community-based Interventions to Promote Physical Activity or Reduce Sedentary Behavior among Adults in Low- and Middle-Income Countries · 2026 · DOI

  • • Although the study included gender and education, other demographic factors like age, socioeconomic factors, and culture were not explored in the study, and this might have been a limitation to our understanding of the effect of those factors on mental health and exercise. • It did not control for factors of diet, sleep, life stressors, or concomitant mental health problems that may have played a role in relationships of exercise and both anxiety and depression.

    Role of Exercise in Reducing Anxiety and Depression Among Adults · 2026 · DOI

  • Second, our study used cross-sectional data published in CHARLS 2018, and the findings were limited to Chinese older adults and may not be generalizable to other populations.

    Dose-Related Associations Between Physical Activity and Multimorbidity Among Middle-Aged and Older Adults · 2026 · DOI

  • In addition, further investigation into the role of assistive technology, family support systems, rehabilitation access, and environmental factors may contribute to the development of more com- prehensive evidence-based strategies for promoting active living among adults with visual impairment.

    Physical activity barriers among adults with visual impairment: a comparative analysis of visual status and aetiology · 2026 · DOI

  • Although previous studies have demonstrated both near- and far-transfer effects, like reduced perceived physical effort costs and increased industriousness, in both animals [54] and humans [19], the conditions under which such transfer effects occur remain poorly understood.

    An 8-week jump training did not boost effort value or the willingness to exert effort in a student sample · 2026 · DOI

  • for 9. Cottrell MA, Galea OA, O'Leary SP, et al. Real- time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clin Rehabil. 2017;31:625-638. 10. Latif-Zade T, Tucci B, Verbovetskaya D, et al. Systematic Review Shows Tele-Rehabilitation Might Achieve Comparable Results to Office- Based Rehabilitation for Decreasing Pain in Patients with Knee Osteoarthritis. Medicina (Kaunas). 2021;57:764. 11. Wu YQ, Long Y, Peng WJ, et al. The Efficacy and Safety of Telerehabilitation for Fibromyalgia: Systematic Review and Meta-analysis of Randomized Controlled Trials. J Med Internet Res. 2023;25:e42090 12. de Thurah A, Bosch P, Marques A, et al. 2022 EULAR points to consider for remote care in rheumatic and musculoskeletal diseases. Ann Rheum Dis. 2022;81:1065-1071. 13. Fragoulis GE, Edelaar L, Vliet Vlieland TPM, et al. Development of generic core competences of health professionals rheumatology: a systematic literature review informing the 2019 EULAR recommendations. RMD Open. 2019;5:e001028. in 14. Karaca NB, Ünal E, Karakaya J, et al. Effectiveness of a supervised group exercise therapy based on the biopsychosocial model introduced simultaneously with anti-TNF therapy in anti-TNF-naive patients with active ankylosing spondylitis. Turk J Med Sci. 2022;52:667-676. 15. Kisacik P, Unal E, Akman U, et al. Investigating the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis. Complement Ther Clin Pract. 2016;22:38-43. 16. Unal E, Karaca NB, Saldirdak GA, et al.

    Biopsychosocial exercise model via telerehabilitation in individuals with rheumatic disease · 2026 · DOI

  • suggesting better implementing more regular physical activity in women with mild obesity. Implementing measures to improve awareness of the health benefits of exercising, as well as creating opportunities for women and girls to exercise in female-friendly settings should be priorities. Scheduling barriers associated with parenthood and employment can be alleviated by time-efficient exercise alternatives (home or time short exercise programs).

    Standardization of the Orientation to Regular Physical Activity Scale in obese women aged (30-35 years) · 2026 · DOI

  • This review has several limitations. First, a substantial propor‐ tion of the scales used to assess eating activity measure general activities of daily living and reflect the qualitative and contextu‐ al components of the activity only to a limited extent. This may restrict the evaluation of details specific to eating performance.

    Activities of daily living assessments, interventions, and adaptive products in the area of eating: a review · 2026 · DOI

  • The study has several limitations. Its cross-sectional design prevents causal inference regarding the directionality of associations between perfectionism and exercise dependence. Using selfreport measures introduces the possibility of shared method variance and response bias. As the present analysis represents a secondary use of data collected for a broader academic project, potentially relevant constructs were not included. The sample, although heterogeneous in exercise limiting generalizability. Future studies should examine these associations in adolescent and emerging adult populations using appropriately defined and sufficiently powered samples, as developmental differences in self-regulation and reward sensitivity may shape vulnerability to involvement, was not representative of the general population, 347 I. Canjuga, M. Pomper, M. Višić and I. Lončarić Kelečić maladaptive exercise patterns in distinct ways. Finally, the Burns’ Perfectionism Scale primarily captures maladaptive perfectionism, preventing differentiation between adaptive and maladaptive dimensions.

    Exploring Exercise Dependence and Perfectionism across Age · 2026 · DOI

  • The study is limited to the characteristics measured by the Physical Activity Scale, the Dark Triad Scale, and the Light Triad Scale. In this study, individuals who do not engage in physical activity behavior (sedentary) and individuals who perform outdoor exercise were not included. Therefore, future studies should take this limitation into consideration and include sedentary individuals and individuals who perform open-field exercise, and compare them on personality traits. More comprehensive results can be obtained by investigating the effects of different types of exercise (endurance, strength, flexibility, and balance; outdoor vs. indoor) on personality traits. In future studies, it is recommended to use mixed-methods designs that combine quantitative and qualitative methods to examine the relationship between personality traits and indoor exercise more comprehensively. In this way, it is thought that both subjects can be supported with statistical data, and more comprehensive findings can be obtained by analyzing them in depth. Similarly, in future studies, exercise can be considered an independent variable, and individuals' dark triad (narcissism, psychopathy, Machiavellianism) and light triad (belief in humanity, humanism, Kantianism) traits can be analyzed alongside other variables. Mediating and regulatory mechanisms affecting the relationship between dark triad and light triad traits can be analyzed. In this context, appropriate mediating variables can be identified in line with the literature review, and analyses can be conducted using these variables.

    THE RELATIONSHIP BETWEEN THE DARK TRIAD AND THE LIGHT TRIAD IN INDOOR EXERCISE: A PSYCHOLOGICAL PERSPECTIVE · 2026 · DOI

  • Conclusion Limited low-certainty evidence suggests that DHIs may have potential promotive benefits in increasing the total amount of daily activity in older adults, but their robustness in driving MVPA remains insufficient.

    Effects of digital multimodal interventions on objectively measured physical activity in older adults: a systematic review and meta-analysis · 2026 · DOI

  • 4 Forecasting for strategic planning The persistent gap between regions, particularly the lower out- comes in Africa and South-East Asia compared to the Americas and Eastern Mediterranean, indicates that global averages are insufficient The application of machine learning demonstrates that health forecasting is inherently uncertain and model-dependent.

    Integrating machine learning and statistical analysis to forecast insufficient physical activity trends using socio-demographic predictors · 2026 · DOI

  • Overall, the proposed review aims to provide a trans- parent and structured foundation for future research on lifestyle diseases by clarifying conceptual bounda- ries, mapping determinants and preventive approaches, and identifying underexplored domains within this evolving field.

    Mapping the evidence on lifestyle diseases: protocol for a systematic scoping review · 2026 · DOI

  • Although additional longitudinal evidence is warranted to strengthen causal inference, the present results provide reasonably robust support for public health strate- gies aimed at monitoring and reducing SB during adolescence, particularly in light of its association with a clinically relevant cardiometabolic outcome such as MetS.

    Association between sedentary behavior and metabolic syndrome in adolescents: a systematic review and meta-analysis · 2026 · DOI

  • However, literature on the longitudinal changes in participation in types of LTPA from age 15 to 23 is scarce, especially related to none, interrupted, or continuous SC participation.

    Changes in Sports Club Participation are Related to Changes in Types of Leisure-Time Physical Activity in Early Adulthood · 2026 · DOI

  • However, the impact of multi-dimensional ICT engagement on the unique psychophysiological ecosystem of elite combat athletes remains under-researched.

    Use of Information and Communication Technologies and Health Behaviours in Elite Combat Sport Athletes · 2026 · DOI

  • However, existing literature predominantly describes associations between HL and health behaviours, while the mechanisms through which HL produces behavioural change, particularly in physical activity, remain insufficiently specified.

    Health Literacy, Physical Activity, and Education: Integrating Healthcare and Pedagogical Perspectives · 2026 · DOI

  • Physical activity (PA) supports health and independence in older age, yet little is known about how lifelong attitudes toward PA relate to fitness and PA in advanced age.

    Aging Strong: Lifelong Attitudes to Activity and Late-Life Function in Fit and Active Women From the Czech Republic · 2026 · DOI

  • BACKGROUND: Declines in muscle strength and functional fitness in older adults are associated with multiple adverse outcomes, yet the associations between leisure-time physical activity(LTPA) and multidimensional objective functional measures remain unclear.

    Associations of leisure-time physical activity with muscle strength and functional fitness domains among community-dwelling older adults: a cross-sectional study · 2026 · DOI

  • Despite its strengths such as the use of specific LMMs for each physical fitness component, the incorporation of age groups to detect potential differences between children and adolescents, and the inclusion of a study quality assessment, this review has some limitations. First, it is based on published studies only, which may exclude relevant national data that have not been published in scientific journals, limiting the scope of the findings. Second, not all the European countries are represented in this review. Third, the variability in the study methods, sample sizes, and especially the tests used to assess the physical fitness, introduces heterogeneity that may have affected the results. Although z score standardisation was attempted to mitigate this problem, it should be noted that it does not fully resolve comparability issues. Fourth, while all of the included tests were field-based, and so not as valid or reliable as laboratory tests, it should be considered that some fitness tests may not be appropriate for this population. For instance, although reviews have supported the validity of the 20 m shuttle run test using correlation analyses [106, 107] an age-specific validation study using agreement-based analyses, reported wide limits of agreement between field-estimated and laboratorymeasured peak oxygen uptake in children. Another different example is that the bent arm hang test has been shown to have low discriminatory power due to a high proportion of zero scores, which may limit its sensitivity. Therefore, it should be acknowledged that field-based physical fitness test scores, as well as estimates derived from them, are indirect approximations of physical fitness, and that trends should be interpreted with caution. Fifth, although the five LMMs for each physical fitness component approach may provide more specific results, it has less statistical power than a nested LMM under the physical fitness components. Sixth, the study quality assessment revealed that only nine studies collected data from representative samples of their respective countries, and a further nine studies collected data from at least one representative sample. Of these studies, only six analysed data from national samples at all time points, and five analysed data from at least one time point. Domingo‑del‑Val et al.

    Temporal Trends in Health-Related Components of Physical Fitness of European Children and Adolescents from 1965 to 2025: A Systematic Review of Data on 417,362 Participants from 20 Countries · 2026 · DOI

  • retrospectively on activities, locations, and social accompaniment that occurred during missed prompts. Without careful attention to how EMA nonresponse bias shapes data, these studies risk potentially drawing false conclusions about human behavior, cognition, and psychology. Thoughtful study design and rigorous sensitivity analyses and reporting of missingness are essential to maintain the inferential value of this highly valuable real-time method. This study relied on two probability samples to evaluate the difference between EMA and time diary data. Although sample differences may contribute to the observed differences, we demonstrated that samples were demographically similar, and our models adjusted for demographic and contextual factors. Additionally, we conducted sensitivity analyses to assess the robustness of our findings in light of potential sample differences. We did not have an objective measure of daily life moments to serve as a benchmark, so we cannot definitively determine whether time diaries or EMA more accurately reflect reality. However, obtaining objective time use data, such as through direct observation or wearable cameras, is nearly impossible in a population-based sample. Despite this limitation, our study contributes to the literature by assessing the validity and potential bias of EMA and time diary data within a population-based context. The large sample size also provides greater statistical power, allowing us to examine effect sizes rather than relying solely on p-values to assess validity. Finally, we classified social accompaniment to include only face-to-face interactions, an approach in line with the design of the ATUS. As a result, this classification may overestimate instances in which respondents were alone, particularly for people who regularly engaged in digital communication. Given that digital contact plays an important role in maintaining social connections (Peng and Roth 2022; Peng et al. 2018), future research should examine differences between EMA and time diary methods in capturing digital forms of social interaction. CONCLUSION By comparing data from EMA and time diaries, we evaluate the validity, potential biases, and interpretive implications of each method across various daily activities. For instance, both methods produce similar estimates for moments spent at home and in the workplace, supporting their validity in capturing activities in these settings. However, EMA tends to underestimate aggregate accounts of social accompaniment compared with time diaries, likely because of moment selection bias. Substantial discrepancies in estimates for eating/ drinking and household chores indicate that relying solely on primary activity reports may lead to significant bias, particularly for activities prone to multitasking.

    Comparing Ecological Momentary Assessments and Time Diary Methods for Measuring Daily Life · 2026 · DOI

  • A strength of our study was that findings were based on data from the Young Lives Study, a longitudinal study focusing on the transition from childhood to adolescence. This study is also one of the few studies with repeated measures assess- ing SES, physical inactivity, and insufficient physical activ- ity in our context. However, this study also had several limitations. First, because this was an observational study, it can report only associations and not causality; however, data capture changes in physical activity levels, although self- reported. Despite the cohort design, residual confounding and measurement error may have limited causal inference. Second, selection bias could have been introduced because the Young Lives Study excluded the richest 5% of the study sample, thereby limiting the generalizability of our findings. Moreover, this exclusion may have led to an underestimation of the associations of interest because changes in lifestyles are initially seen among the wealthiest individuals in coun- tries undergoing nutritional transition, which could have affected our estimates. Third, recall and information bias may have occurred because physical activity levels were reported by the mother when participants were children, whereas the participants themselves reported this informa- tion when they were adolescents. In addition, physical activ- ity was evaluated using a single question in each evaluation. Although this approach is commonly used in surveys, it can introduce recall and social desirability bias. Finally, because this was a secondary database analysis, some confounders may not have been included because they were not available, including dietary patterns and ethnicity, among others.

    Socioeconomic Status and Physical Activity Levels: Analysis of the Young Lives Cohort Study in Peru · 2026 · DOI

  • Clinical implications and future directions Despite growing interest in exercise snacks as a potentially feasible strategy for supporting cognitive health in older adults, the current evidence base remains preliminary and incomplete.

    Exercise snacks and cognitive health in older adults: mechanisms, implementation, and public health relevance · 2026 · DOI

  • Future research is needed to evaluate how bar- riers and facilitators related to the SWS can be addressed through cultural tailoring and multi-level strategies in PA interventions for African American women and how the SWS relates to changes in health outcomes over time.

    The role of the ‘obligation to help others’ within the superwoman schema: implications for physical activity in African American women with low activity levels · 2026 · DOI

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436 open questions have been extracted from the limitations and future-work passages of 5,217 Physical Activity and Health papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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