A pilot holistic exercise protocol for improving quality of life

Stefania Tronconi; Mirco Bonoli; Davide Giusti; Pasqualino Maietta Latessa; Niccolò Baldoni; Mario Mauro

doi:10.55225/hppa.725

Authors

Stefania Tronconi Associazione Bioginnastica APS, Faenza, Ravenna, Italy
Mirco Bonoli Associazione Bioginnastica APS, Faenza, Ravenna, Italy
Davide Giusti Associazione Bioginnastica APS, Faenza, Ravenna, Italy
Pasqualino Maietta Latessa University of Bologna, Department for Life Quality Studies, Rimini, Italy https://orcid.org/0000-0002-6525-0532
Niccolò Baldoni University of Bologna, Department for Life Quality Studies, Rimini, Italy
Mario Mauro University of Bologna, Department for Life Quality Studies, Rimini, Italy https://orcid.org/0000-0002-8171-5096

DOI:

https://doi.org/10.55225/hppa.725

Keywords:

health, body awareness , posture, wellness, holistic therapy

Abstract

This study aimed to investigate the effects of a new HMP method, a mind–body exercise protocol, on health-related Quality of Life(QoL) in adults and to explore possible differences by gender and age. A pilot longitudinal study was conducted involving 171 adults (female: 151, male: 20) who completed a 10-week exercise program consisting of one supervised session per week. The protocol integrated self-body awareness, postural control, breathing regulation, muscle activation–relaxation, and multisensory stimulation exercises. Quality of life was assessed before and after the intervention using the Italian version of the SF-36 Health Survey. A two-way ANCOVA was used to evaluate pre-post changes, accounting for the interaction between gender and age categories.Significant improvements were observed across several SF-36 domains following the intervention. Notable gains were observed in physical functioning, role-physical, bodily pain, general health, vitality, and mental health, with medium to large effect sizes in the physical domains. Improvements were independent of gender and age, although an interaction effect between gender and age emerged for physical functioning in the oldest participants.The proposed method appears to be an effective, low-dose HMP, suggesting that it may enhance multiple dimensions of adult QoL. These preliminary findings support the potential role of mind–body practices as accessible health-promotion strategies.

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References

Barofsky I. Can quality or quality-of-life be defined? QualLife Res. 2012;21(4):625-631. doi: 10.1007/s11136-011-9961-0. Google Scholar

Matheson D, Abdel-Aty H, O’Shea L. Quality of life measurements from the patient perspective: Capturing the heterogeneity of the patient experience in a standardised way. Eur Urol Focus. 2023;9(3):425-426. doi: 10.1016/j.euf.2023.03.013. Google Scholar

Freire Pequeno NP, de Araújo Cabral NL, Marchioni DM, Cunha Lima SCV, de Oliveira Lyra C. Quality of life assessment instruments for adults: A systematic review of population-based studies. Health Qual Life Outcomes. 2020;18(1). doi: 10.1186/s12955-020-01347-7. Google Scholar

Tarlov AR, Ware JE Jr, Greenfield S, Nelson EC, Perrin E, Zubkoff M. The medical outcomes study: An application of methods for monitoring the results of medical care. JAMA. 1989;262(7):925-930. doi: 10.1001/jama.1989.03430070073033. Google Scholar

Ware JE Jr. SF-36 Health Survey update. Spine. 2000;25(24):3130-3139. doi: 10.1097/00007632-200012150- Google Scholar

Apolone G, Mosconi P. The Italian SF-36 Health Survey: Translation, validation and norming. J Clin Epidemiol. 1998;51(11):1025-1036. doi: 10.1016/S0895-4356(98)00094-8. Google Scholar

Kheiraoui F, Gualano MR, Mannocci A, Boccia A, La Torre G. Quality of life among healthcare workers: A multicentre cross-sectional study in Italy. Public Health. 2012;126(7):624-629. doi: 10.1016/j.puhe.2012.03.006. Google Scholar

Guerra F, Corridore D, Peruzzo M, et al. Quality of life and stress management in healthcare professionals of a dental care setting at a teaching hospital in Rome: Results of a randomized controlled clinical trial. Int J Environ Res Public Health. 2022;19(21). doi: 10.3390/ijerph192113788. Google Scholar

Yang X, Ge C, Hu B, Chi T, Wang L. Relationship between quality of life and occupational stress among teachers. Public Health. 2009;123(11):750-755. doi: 10.1016/j.puhe.2009.09.018. Google Scholar

El Asmar N, Yazbeck Karam V, Sakr R, Khoury El Malhame M, Chatila R, Akiki Z. Assessing burnout and quality of life among residents and fellows in a high-stress environment: A cross-sectional study. BMC Psychol. 2025;13(1):557. doi: 10.1186/s40359-025-02863-1. Google Scholar

Bató A, Brodszky V, Rencz F. Development of updated population norms for the SF-36 for Hungary and comparison with 1997–1998 norms. Health Qual Life Outcomes 2025 23:1. 2025;23(1):14-. doi: 10.1186/S12955-025-02343-5. Google Scholar

WHO. World Mental Health report. World mental health report: Transforming mental health for all. World Health Organization. World Health Organization. Published online 2022. Google Scholar

Marquez DX, Aguinãga S, Vásquez PM, et al. A systematic review of physical activity and quality of life and well-being. Transl Behav Med. 2020;10(5):1098-1109. doi: 10.1093/tbm/ibz198. Google Scholar

Choi MJ, Park YG, Kim YH, Cho KH, Nam GE. Association between type of exercise and health-related quality of life in adults without activity limitations: A nationwide cross-sectional study. BMC Public Health. 2020;20(1). doi: 10.1186/s12889-020-08699-1. Google Scholar

Alves da Cunha R, Barbosa de Lira CA, Vancini RL, Weiss K, Knechtle B, Andrade MS. Striking the balance: xploring the influence of exercise quantity and intensity on quality-of-life outcomes. Clinics. 2025;80. doi: 10.1016/j.clinsp.2025.100782. Google Scholar

Yang H, Li J, Shan W, et al. The effect of different exercise modalities on older adults’ quality of life: An assessor-blinded randomized controlled trial. Sci Rep. 2025;15(1). doi: 10.1038/s41598-025-11047-1. Google Scholar

Fukushima T, Nakano J, Hashizume K, et al. Effects of aerobic, resistance, and mixed exercises on quality of life in patients with cancer: A systematic review and meta-analysis. Complement Ther Clin Pract. 2021;42. doi: 10.1016/j.ctcp.2020.101290. Google Scholar

Silva FM, Ferreira JP, Teixeira AM, Massart A, Duarte- Google Scholar

-Mendes P. Effects of combined aerobic-resistance training on health-related quality of life and stress in sedentary adults. FrontAging. 2025;6. doi: 10.3389/fragi.2025.1603635. Google Scholar

Reina-Gutiérrez S, Cavero-Redondo I, Martínez-Vizcaíno V, et al. The type of exercise most beneficial for quality of life in people with multiple sclerosis: A network meta-analysis. Ann Phys Rehabil Med. 2022;65(3). doi: 10.1016/j.rehab.2021.101578. Google Scholar

Yin J, Dishman RK. The effect of Tai Chi and Qigong practice on depression and anxiety symptoms: A systematic review and meta-regression analysis of randomized controlled trials. Ment Health Phys Act. 2014;7(3):135-146. doi: 10.1016/j.mhpa.2014.08.001. Google Scholar

Vergeer I, Klepac-Pogrmilovic B. Diversification of physical activities: An exploration of provision characteristics of holistic movement practices in a large Australian city. Int J Environ Res Public Health. 2021;18(19). doi: 10.3390/ijerph181910365. Google Scholar

Li L, Fan Q. Fostering cultural sustainability and student wellbeing: An embodied practice of teacher support in bilingual Tai Chi. Front Psychol. 2026;17:1764998. doi: 10.3389/fpsyg.2026.1764998. Google Scholar

Li X. Tai Chi – dance movement therapy integration: A cross-cultural approach to mind- body psychotherapy. Harvard Library. Published 2024. Accessed May 20, 2026. https://dash.harvard.edu/entities/publication/93ed6b0e-13a0-4b9a-8439-b0ddac95851c. Google Scholar

Geroge Feuerstein. The Yoga Tradition, ItsHistory, Literature, Philosophy and Practice. Hohm Press;1998. Google Scholar

Kim D, Cho M, Park Y, Yang Y. Effect of an exercise program for posture correction on musculoskeletal pain. J Phys Ther Sci. 2015;27(6). doi: 10.1589/jpts.27.1791. Google Scholar

Balban MY, Neri E, Kogon MM, et al. Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Rep Med. 2023;4(1). doi: 10.1016/j.xcrm.2022.100895. Google Scholar

Seber GAF, Lee AJ. Linear Regression Analysis. John Wiley & Sons; 2012. doi: 10.1002/9780471722199. Google Scholar

Hart PD, Kang M. Reliability of the Short-Form health survey (SF-36) in physical activity research using meta-analysis. World J Prev Med. 2015;3(2):17-23. doi: 10.12691/jpm-3-2-1. Google Scholar

Singh B, Murphy A, Maher C, Smith AE. Time to form a habit: A systematic review and meta-analysis of health behaviour habit formation and its determinants. Healthcare (Switzerland). 2024;12(23). doi: 10.3390/healthcare12232488. Google Scholar

Murias JM, Kowalchuk JM, Paterson DH. Time course and mechanisms of adaptations in cardiorespiratory fitness with endurance training in older and young men. J Appl Physiol. 2010;108(3): 621-627. doi: 10.1152/japplphysiol.01152.2009. Google Scholar

DeFreitas JM, Beck TW, Stock MS, Dillon MA, Kasishke PR. An examination of the time course of training-induced skeletal muscle hypertrophy. Eur J Appl Physiol. 2011;111(11):2785-2790. doi: 10.1007/s00421-011-1905-4. Google Scholar

Staron RS, Karapondo DL, Kraemer WJ, et al. Skeletal muscle adaptations during early phase of heavy-resistance training in men and women. J Appl Physiol. Google Scholar

;76(3):1247-1255. doi: 10.1152/jappl.1994.76.3.1247. Google Scholar

Wernbom M, Augustsson J, Thomeé R. The influence of frequency, intensity, volume and mode of strength training on whole muscle cross-sectional area in humans. Sports Med. 2007;37(3):225-264. doi: 10.2165/00007256-200737030-00004. Google Scholar

Büssing A, Ostermann T, Lüdtke R, Michalsen A. Effects of yoga interventions on pain and pain-associated disability: A meta-analysis. Journal of Pain. 2012;13(1):1-9. doi: 10.1016/j.jpain.2011.10.001. Google Scholar

Wayne PM, Kaptchuk TJ. Challenges inherent to T’ai Chi research: Part I - T’ai Chi as a complex multicomponent intervention. J. Altern Complement. Med. 2008;14(1):95-102. doi: 10.1089/acm.2007.7170A. Google Scholar

Vergeer I, Johansson M, Cagas JY. Holistic movement practices – An emerging category of physical activity for exercise psychology. Psychol Sport Exerc. 2021;53. doi: 10.1016/j.psychsport.2020.101870. Google Scholar

Cagas JY, Biddle SJH, Vergeer I. For exercise, relaxation, or spirituality: Exploring participation motives and conformity to masculine norms among male and female Yoga participants. Int J Environ Res Public Health. 2022;19(2). doi: 10.3390/ijerph19020770. Google Scholar

Zhou Y, Li C, Wang W, Ding L. Large-scale data reveal disparate associations between leisure time physical activity patterns and mental health. Commun Med. 2023;3(1). doi: 10.1038/s43856-023-00399-2. Google Scholar

Kosma M. Editorial: A holistic and embodied approach to movement programming for health and well-being. Front Public Health. 2025;13. doi: 10.3389/fpubh.2025.1688972. Google Scholar

Chawla V, Brems C, Freeman H, Ravindran A, Noordsy DL. The future of Yoga for mental health care. Int J Yoga. 2023;16(1)38-41. doi: 10.4103/ijoy.ijoy_25_23. Google Scholar

Sani NA, Yusoff SSM, Norhayati MN, Zainudin AM. Tai Chi exercise for mental and physical well-being in patients with depressive symptoms: A systematic review and meta-analysis. Int J Environ Res Public Health. 2023;20(4). doi: 10.3390/ijerph20042828. Google Scholar

Mehling WE, Wrubel J, Daubenmier JJ, et al. Body Awareness: A phenomenological inquiry into the common ground of mind-body therapies. Philos Ethics Humanit Med. 2011;6(1). doi: 10.1186/1747-5341-6-6. Google Scholar

Zaccaro A, Piarulli A, Laurino M, et al. How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Front Hum Neurosci. 2018;12. doi: 10.3389/fnhum.2018.00353. Google Scholar

Kuang X, Dong Y, Song L, et al. The effects of different types of Tai Chi exercise on anxiety and depression in older adults: a systematic review and network meta-analysis. Front Public Health. 2023;11. doi: 10.3389/fpubh.2023.1295342. Google Scholar

McHorney CA, Ware JEJr, Raczek AE. The MOS 36-item short-form health survey (Sf-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993;31(3):247-263. doi: 10.1097/00005650-199303000-00006. Google Scholar

Marques A, Peralta M, Martins J, Catunda R, Gaspar de Matos M, Saboga Nunes L. Associations between physical activity and self-rated wellbeing in European adults: A population-based, cross-sectional study. Prev Med (Baltim). 2016;91:18-23. doi: 10.1016/j.ypmed.2016.07.021. Google Scholar

Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection. Med Care. 1992;30(6):473-483. doi: 10.1097/00005650-199206000-00002. Google Scholar