Impact of Wearable Acceleration-Monitored Simulated Vigorous Intermittent Lifestyle Physical Activity on Muscle Strength in Young Adults

doi:10.21203/rs.3.rs-4953032/v1

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Research Article

Impact of Wearable Acceleration-Monitored Simulated Vigorous Intermittent Lifestyle Physical Activity on Muscle Strength in Young Adults

https://doi.org/10.21203/rs.3.rs-4953032/v1

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Background

The benefits of sustained structured physical activity for general health have been widely investigated. Current guidelines also recognize the research potential of short bouts of activity. The aim of this study was to investigate the effects of a simulated vigorous intermittent lifestyle physical activity (VILPA) intervention monitored by wearable devices on lower limb muscle strength.

Methods

Totally, 40 healthy sedentary college-age students were recruited to wear accelerometry for a prolonged period of time and undergo an eight-week simulated VILPA intervention using a single-arm pre-post design. Demographic information and blood lipids were collected before and after the intervention. Muscle strength was measured by isokinetic muscle strength testing and surface electromyography. Finally, 35 participants completed the study.

Results

The mean age of the participants was 19.9 ± 1.1 years. After the simulated VILPA intervention, participants experienced significant increases in weight, body mass index, body fat percentage, waist circumference, and triglyceride levels. Additionally, there were significant improvements in peak torque and peak torque normalized to body weight for bilateral ankle dorsiflexor and plantarflexor muscle groups post-intervention. The surface electromyography examinations revealed significant increases in root mean square (RMS) and average electromyography (AEMG) values for all three calf muscle groups (anterior tibialis, gastrocnemius, and soleus) post-intervention, although parameters for the gastrocnemius muscle were significantly different only in the right calf.

Conclusion

Three bouts of VILPA per day enhance calf muscle strength in healthy populations. VILPA appears to be suitable for non-exercisers as a timesaving and potentially effective intervention measure.

Wearable acceleration

vigorous intermittent lifestyle physical activity

isokinetic strength testing

young adults

Increasing studies suggested that any physical activity would be beneficial and the latest PA guidelines no longer mandate prolonged activity accumulation (> 10 minutes or longer) for adults ^1–3. This has led to an increase in research on short-term, easily overlooked physical activity. Even if the overall level of physical activity falls below the recommended guidelines, benefits can still be obtained from both short bouts of intermittent physical activity ⁴ and exercise snacks ⁵. Vigorous intermittent lifestyle physical activity (VILPA) is a novel paradigm that distinguishes itself from conventional physical activities by involving short, intermittent bursts of high-intensity physical exertion occurring sporadically during daily life activities ⁶, such as brisk walking while rushing to catch public transportation. Recent epidemiological evidence indicates that VILPA is associated with a lower risk of cardiovascular, cancer, and all-cause mortality ⁷, as well as decreased incidence of cardiovascular diseases ⁸ and cancer ⁹. However, there is currently no formal intervention guideline outlining the benefits of VILPA and vigorous exercise snacks. Based on this, there is a growing consensus for further research into physical activity lasting < 10 minutes ^5,10. Although there has been a growing body of research in recent years on physical activity with durations < 10 minutes, much of it relies on recall-based questionnaires to measure physical activity. Subjectivity and reporting biases are major limitations of this approach. Although there has been an increase in research on physical activity with durations < 10 minutes in recent years, the majority of studies rely on recall-based questionnaires to measure physical activity. This method is insufficient for capturing short-duration activities, including brief and incidental physical activities, due to subjectivity and reporting biases being the primary limitations ^7,8. Therefore, the use of wearable devices is deemed more suitable for investigating the health-enhancing potential of VILPA and unexplored patterns of exercise ⁶.

Isokinetic strength testing is the preferred method for assessing dynamic muscle function, recognized for its objectivity and effectiveness ¹¹. Various exercise modalities can lead to varying degrees of improvement in muscle isokinetic strength performance ^12,13. Muscle strength enhancement is one of the benefits of physical activity. However, there has been little focus on the volume of exercise required to achieve this enhancement. Despite being a short-duration and high-efficiency exercise, VILPA remains relatively unexplored in terms of its effects on muscle strength, with no studies to date investigating the impact of this exercise paradigm. Therefore, in this study, participants engaged in simulated VILPA while continuously monitored using wearable devices for heart rate, with accelerometer data collected over an 8-week period, and with no leisure exercise. Our objective is to evaluate the impact of wearable device-measured VILPA on calf muscle strength and electromyographic parameters in a healthy university population.

Study design

This study employed a single-arm pre-post design to investigate the impact of "simulated VILPA" on muscle strength, body composition and lipid profiles in a healthy university population. All participants agreed to consistently wear smart wearable devices (VID-B99, HUAWEI WATCH GT 2 Pro - ECG, China) on their wrists for at least 16 hours daily and underwent the simulated VILPA protocol for 8 weeks. All participants were required to maintain their prior diet and lifestyle throughout the experiment. Trained personnel conducted a series of data collections both before and after the intervention. Each participant was apprised of the inherent risks associated with the study, and they meticulously reviewed and signed an informed consent document before baseline measurements. This study has been approved by the institutional review board of the first affiliated hospital of Guangdong Pharmaceutical University [Number: 2023(07)], and was registered on ClinicalTrials.gov (Identifier: NCT06259370).

Participants

Forty volunteers aged over 18 from the university population, comprising 16 males (age: 20.1 ± 1.4 years, BMI: 23.6 ± 4.3 kg/m²) and 24 females (age: 19.5 ± 0.8 years, BMI: 21.0 ± 3.1 kg/m²). Inclusion criteria dictated that participants were required to be individuals in good health within the sedentary population (daily sitting time > 5 hours per day, and who did not meet the guideline-recommended physical activity volume, i.e., engaging in at least 150 minutes/week of moderate-intensity exercise or more than 75 minutes/week of vigorous-intensity exercise, and this sedentary state persisted for more than 3 months) ^1–3. Exclusion criteria encompassed recent lower limb injuries or surgeries, current or past three-month usage of any therapeutic medications (such as cardiovascular, musculoskeletal and neurological medications, etc.), pregnancy, or the presence of acute or chronic diseases potentially limiting their capacity for intense physical activity. Of the 40 participants, 35 successfully completed the whole trial (Fig. 1).

VILPA simulation protocol

In accordance with the established definitions, a VILPA bout requires the achievement of absolute or relatively high-intensity physical activity within a brief timeframe (30 seconds to several minutes) ^6,7. In our study, the specific VILPA simulation protocol was executed as follows: participants performed short-duration, vigorous jump rope exercises while wearing wearable devices. The criteria for reaching intense intensity were determined follow: (1) > 80% of maximum heart rate; and (2) Borg rating of perceived exertion > 15. To mitigate noise interference and prevent the accumulation of residual fatigue, the percentage of maximum heart rate had to be sustained for at least 30 seconds. Wearable devices were utilized for continuous heart rate monitoring throughout the day, and the maximum heart rate was calculated using the Fox Eq. (220-age). Participants were mandated to complete 3 simulated VILPA sessions during a day, ensuring a full recovery of heart rate and respiration to resting levels before initiating the subsequent bout. VILPA, characterized by intense physical activity occurring at any time during daily life, prompted us not to strictly define exercise intervals to better align with this concept. Furthermore, we incorporated both workdays and rest days, with participants engaging in physical activity five days per week, sustaining this routine over an 8-week period (Fig. 2).

Data collection

Pre- and Post-intervention, all participants underwent examinations to assess muscle strength, body composition, and lipid profiles.

Muscle strength The IsoMed2000 (D&R Ferstl, Hemau, Germany) was employed to evaluate ankle joint dorsiflexion and plantarflexion strength. Following an explanation of the testing procedure to the participants, a 2-minute warm-up period was conducted. Subsequently, participants executed 5 consecutive ankle joint dorsiflexion-plantarflexion movements at 60°/s. This testing protocol facilitated the measurement of concentric strength in the anterior tibialis (ankle dorsiflexion) and the triceps surae (ankle plantarflexion). For each repetition at 60°/s, the highest peak torque observed, the maximal work value, and the total work were recorded.

Before and after the simulated VILPA intervention, a standard surface electromyography system (MyoMove-EOW, NCC, China) was utilized. Surface electrodes were placed using the belly tendon method at 6 specified locations on both sides of the lower legs (anterior tibialis, gastrocnemius and soleus, on both sides). The electrode placement positions and operational procedures strictly adhered to the SENIAM guidelines ¹⁴ (http://www.seniam.org). During the testing process, root mean square (RMS) and average electromyographic (AEMG) values were collected to reflect the muscle force and motor unit recruitment of the selected muscle groups.

Body composition and lipid profiles The entire data collection process conducted both pre- and post-intervention, encompassed a comprehensive set of assessments. Demographic information, comprising age, weight, height, waist circumference, and hip circumference, was meticulously documented. Blood pressure measurements were undertaken with participants in a rested state, three separate blood pressure readings were obtained, each spaced at intervals exceeding 5 minutes, the average of the final two measurements was computed to ensure accuracy and served as the representative blood pressure value for analysis. Baseline lipid profiles, encompassing high-density lipoprotein cholesterol (HDL-C) and triglycerides, were assessed using the CardioChek device (Polymer Technology Systems, Inc., 7736 Zionsville Road, USA). Maximal oxygen uptake (VO₂max) was determined utilizing the Fox indirect method, this involved participants engaging in a 5-minute cycling exercise on a power cycle ergometer (Cycling-based cardiopulmonary exercise testing system, Highermed, China) at a workload of 150 watts, the submaximal heart rate recorded during this exercise was employed in the calculation of VO₂max using the formula VO₂max = 6300 − 19.26*submaximal heart rate.

Statistical analysis

Data form pre- and post-intervention are presented as mean ± SD (for continuous variables) and counts (percentages) (for categorical variables). Two-tailed Student's t-test to compare values between pre- and post-intervention. All statistical analyses were performed in SPSS version 26 (SPSS, Chicago, IL, USA), and a two-sided P < 0.05 was considered statistically significant. Sample size was calculated by PASS 2021 using paired T-tests, setting a minimum power at 0.9, with a significance level of 0.05. According to the report, Actual power surpassing the set target power of 0.9. The effect size (Cohen's d) was calculated at 0.57, indicating a moderate to large effect. Therefore, the sample of 35 individuals proved to be sufficient for detecting the observed effect size with a high degree of confidence.

Baseline and changes

The primary demographic characteristics and laboratory examination results of the participants are presented in Table 1. A total of 35 participants were included in the analysis, with a mean age of 19.9 ± 1.1 years (range, 18–24 years), and over half of the participants were female. The average body fat percentage was 27.0 ± 7.0%, the mean BMI was 22.0 ± 4.0 kg/m², and the maximal oxygen consumption was 3307.0 ± 226.5 mL/kg/min. Table 2 contrasts the changes in variables before and after the intervention. Following an 8-week simulated VILPA intervention, participants exhibited significant increases in body weight, BMI, body fat percentage, waist circumference, and triglycerides (all p < 0.05). While HDL-C showed an increase, it did not reach statistical significance (p = 0.134).

Table 1

Descriptions of participants (n = 35).
Age, years	19.9 ± 1.1
Females	19 (54.3)
Weight, kg	61.3 ± 14.5
Body fat percentage, %	27.0 ± 7.0
BMI, kg/m²	22.0 ± 4.0
Waist circumstance, cm	80.5 ± 11.2
Waist-to-hip ratio	0.83 ± 0.06
SBP, mmHg	102.7 ± 12.1
DBP, mmHg	65.9 ± 8.7
Heart rate, per minute	74.4 ± 9.6
HDL-c, mmol/L	1.1 ± 0.6
Triglyceride, mmol/L	1.9 ± 0.6
VO₂max, mL/kg/min	3307.0 ± 226.5
Values are mean ± SD or n (%); BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; HDL-c: high density lipoprotein cholesterol; VO₂max: Maximal oxygen uptake.

Table 2

Post-intervention changes.
Variables	Mean ± SD		Difference		t		P value
Variables	Pre	Post	Difference		t		P value
Weight, kg	61.3 ± 14.5	59.6 ± 14.5		-1.7		5.858		< 0.001
Body fat percentage, %	27.0 ± 7.0	21.7 ± 8.1		-6.3		6.624		< 0.001
BMI, kg/m²	22.0 ± 4.0	21.4 ± 3.9		-0.6		5.858		< 0.001
Waist circumstance, cm	80.5 ± 11.2	76.5 ± 16.3		-4.0		2.277		0.029
Waist-to-hip ratio	0.83 ± 0.06	0.80 ± 0.14		-0.03		1.285		0.208
SBP, mmHg	102.7 ± 12.1	103.5 ± 12.2		+ 0.8		-0.416		0.680
DBP, mmHg	65.9 ± 8.7	64.9 ± 8.5		-1.0		0.705		0.486
Heart rate, per minute	74.4 ± 9.6	76.4 ± 11.8		+ 2.0		-1.132		0.265
HDL-c, mmol/L	1.1 ± 0.6	1.3 ± 0.3		+ 0.2		-1.535		0.134
Triglyceride, mmol/L	1.9 ± 0.6	1.1 ± 0.7		-0.8		5.666		< 0.001
VO₂ max, mL/kg/min	3307.0 ± 226.5	3353.2 ± 318.8		+ 46.2		-0.942		0.353
Values are mean ± SD; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HDL-c, high density lipoprotein cholesterol; VO₂ max, Maximal oxygen uptake.

VILPA improves muscle strength

The results of the isokinetic strength testing after the simulated VILPA intervention demonstrated varying degrees of improvement, as summarized in Table 3. Overall, post-intervention, there was a notable enhancement in the isokinetic test parameters of the ankle dorsiflexor muscles (primarily the anterior tibialis) and plantarflexion muscles (primarily the triceps surae) of the left lower limb relative to the right. Specifically, the peak torque, peak torque normalized to body weight, and work performed during both dorsiflexion and plantarflexion at the left ankle joint were numerically higher than those at the right ankle joint. Although the peak torque during right plantarflexion was higher than that of the left before the intervention (left vs. right, 28.5 ± 11.0 vs. 29.7 ± 14.7), post-intervention, the left side exhibited higher strength (left vs. right, 46.6 ± 23.9 vs. 44.0 ± 21.6). Regarding dorsiflexion, all parameters on the left side consistently outperformed those on the right side both before and after the intervention.

Table 3

Changes in isokinetic strength testing parameters pre- and post-intervention.
Variables	Mean ± SD		Difference	t	P value
Variables	Pre	Post	Difference	t	P value
Plantarflexion 60°/s
Left
Peak torque, Nm	28.5 ± 11.0	46.6 ± 23.9	+ 18.1	-5.579	< 0.001
Peak torque/weight, Nm/kg	0.47 ± 0.15	0.77 ± 0.32	+ 0.30	-6.185	< 0.001
Total work, J	69.2 ± 26.2	121.8 ± 59.6	+ 52.6	-5.841	< 0.001
Max work, J	16.6 ± 6.3	28.5 ± 13.0	+ 11.9	-6.065	< 0.001
Right
Peak torque, Nm	29.7 ± 14.7	44.0 ± 21.6	+ 14.3	-4.633	< 0.001
Peak torque/weight, Nm/kg	0.50 ± 0.25	0.73 ± 0.29	+ 0.23	-5.180	< 0.001
Total work, J	70.1 ± 37.3	108.1 ± 56.9	+ 38.0	-4.894	0.001
Max work, J	17.5 ± 8.6	26.4 ± 12.3	+ 8.9	-4.901	< 0.001
Dorsiflexion 60°/s
Left
Peak torque, Nm	15.3 ± 7.9	24.8 ± 7.7	+ 9.5	-7.053	< 0.001
Peak torque/weight, Nm/kg	0.25 ± 0.11	0.43 ± 0.14	+ 0.18	-6.441	< 0.001
Total work, J	37.0 ± 23.7	56.0 ± 22.6	+ 19.0	-3.908	< 0.001
Max work, J	8.3 ± 4.9	13.2 ± 5.0	+ 4.9	-5.028	< 0.001
Right
Peak torque, Nm	13.5 ± 7.8	21.3 ± 7.5	+ 7.8	-5.732	< 0.001
Peak torque/weight, Nm/kg	0.21 ± 0.10	0.37 ± 0.15	+ 0.16	-5.495	< 0.001
Total work, J	26.6 ± 22.5	42.9 ± 18.6	+ 16.3	-3.554	0.001
Max work, J	6.1 ± 4.7	10.2 ± 4.2	+ 4.1	-4.406	< 0.001

The surface electromyography was conducted on the three muscles of the lower leg, namely the anterior tibialis, gastrocnemius, and soleus muscles, yielding RMS and AEMG values (Table 4). Prior to the intervention, the RMS and AEMG values of the bilateral anterior tibialis were approximately equivalent. Following the application of the simulated VILPA intervention, both parameters exhibited significant enhancement (P < 0.001), with comparable pre- and post-intervention differences. Regarding the plantar flexion muscle group, the soleus demonstrated significant increases in both RMS and AEMG (P < 0.001). However, the post-intervention performance of the left leg surpassed that of the right leg. In contrast, the surface electromyographic parameters of the gastrocnemius exhibited significant differences exclusively in the right lower leg.

Table 4

Changes in surface electromyography parameters pre- and post-intervention.
Muscles		Left				Right
Muscles		RMS	P	AEMG	P	RMS	P	AEMG	P
Anterior tibialis	Pre	150.9 ± 81.7	< 0.001	108.9 ± 62.7	< 0.001	150.8 ± 85.2	< 0.001	110.7 ± 62.2	< 0.001
	Post	215.8 ± 70.2		162.1 ± 54.7		204.0 ± 73.0		149.2 ± 52.6
	Dif.	+ 64.9		+ 53.2		+ 53.2		+ 38.5
Soleus	Pre	68.4 ± 32.4	< 0.001	50.3 ± 24.0	< 0.001	74.2 ± 37.2	< 0.001	54.2 ± 27.0	< 0.001
	Post	132.9 ± 65.0		100.1 ± 49.5		97.2 ± 28.5		71.9 ± 20.4
	Dif.	+ 68.1		+ 50.2		+ 23.0		+ 17.7
Gastrocnemius	Pre	79.4 ± 32.4	0.286	59.0 ± 23.8	0.358	95.2 ± 62.7	0.001	69.8 ± 32.3	< 0.001
	Post	88.9 ± 46.4		65.0 ± 33.2		142.3 ± 79.7		108.4 ± 60.2
	Dif.	+ 9.5		+ 6.0		+ 47.1		+ 38.6
RMS: root mean square; AEMG: average electromyographic; Dif. Difference

In this single-arm pre-post design, we conducted an 8-week simulated VILPA intervention on a healthy university population. To our knowledge, our study represents the first investigation into the short-term effects of vigorous intermittent physical activity during daily life on lower limb muscle strength in non-exercisers. The consistent evidence from isokinetic strength testing and surface electromyography indicates that VILPA intervention benefits muscle strength growth in healthy adults. This partially elucidates the benefits of VILPA and supports the changes in minimum exercise requirements outlined in the latest guidelines.

The consistent results from both isokinetic strength testing and surface electromyography of calf muscles suggest that brief, intense daily exercise benefits muscle strength growth, primarily reflected in peak torque/weight and RMS. For the ankle dorsiflexor muscle group (primarily the tibialis anterior), significant increases in muscle strength were observed bilaterally after the intervention, with comparable RMS progression. Similarly, significant increases in isokinetic strength testing results were observed for the plantar flexor muscle group (comprising the triceps surae, including the soleus and gastrocnemius). However, there were differences in RMS between these two muscles. Specifically, the RMS of the left gastrocnemius did not exhibit significant differences, while contrasting numerical changes revealed a significant increase in RMS of the left soleus and a significant increase in RMS of the right gastrocnemius. The aforementioned differences suggest variations in muscle involvement, which may stem from differences in participants' muscle-tendon dynamics ¹⁵. Consistent with previous research findings, intermittent bouts exercise improves cardiovascular health and lower limb muscle strength ¹⁶. Snack exercise has also been shown to enhance leg muscle function and size in older adults ¹⁷. However, there are also studies indicating that high-intensity intermittent snack exercise only improves cardiorespiratory functional parameters in middle-aged individuals without altering their body composition and lower limb muscle strength ¹⁸.

The individual factors contributing to insufficient physical activity in healthy adults are commonly attributed to time constraints and low prioritization ¹⁹. In addition to these factors, difficulties in coping with discomfort associated with high-intensity exercise and executing vigorous physical activities on a regular, continuous, and structured basis also contribute to the issue ⁶. In response to such challenges, researchers have proposed utilizing VILPA to facilitate access to vigorous physical activity for non-exercisers ⁶. Subsequently, studies have identified 6 barriers and 10 enabling factors related to VILPA in middle-aged and older adults ²⁰, further evaluating the potential of such interventions. Early investigations into short-term stair climbing interventions have suggested potential health benefits, providing support for the potential public health advantages of this mode of activity ^21,22. Epidemiological studies focusing on the UK Biobank accelerometer cohort have demonstrated that VILPA, in the form of exercise snacks, reduces mortality ⁷, incidence of cardiovascular diseases ⁸, and cancer ⁹. These associations may be attributed to the transient, repeated bouts of high-intensity exercise embedded in daily activities, impacting the accrual of benefits ²³. The distinction between snack exercise and VILPA lies in its primarily planned or organized nature as part of daily activities (rather than being occasional or inherent in life). The key elements of snack exercise - structure, planning, repetition, and intention - further differentiate it from VILPA ²⁴. However, categorizing snack exercise as a unique subset of short, intense exercise is most appropriate. Additionally, this exercise paradigm has been shown to have a positive influence on cardiopulmonary and cardiac metabolic health, including the enhancement of the indices of cardiometabolic health in non-exercising adults ^7,8,25. Clinical trials have shown that relatively high-intensity exercise snacks are feasible in older adults ^26,27.

The physiological basis of brief intense exercise primarily involves enhancing cardiorespiratory adaptation (increase in VO₂max) and improving blood glucose control ²⁸. Lundby et al. ²⁹ suggest that VO2max is largely dependent on the expansion of training-induced red cell volume and improvement in stroke volume, with the latter being independent of the expansion of red cell volume, leading to differences in cardiorespiratory adaptation between exercisers and non-exercisers. Research on central and peripheral adaptations to intense intermittent exercise has found that changes in VO₂max may be attributed to increased muscle capillary density and maximal activity of β-hydroxyacyl-CoA dehydrogenase (mitochondrial-related) ³⁰. There is limited evidence on the physiological mechanisms underlying the increase in VO₂max due to brief intense exercise, warranting further research. Intermittent intense exercise can improve blood glucose control ³¹, and more frequent and longer interruptions in sedentary behavior can reduce postprandial blood glucose and insulin responses ³². On the other hand, brief intense exercise appears to increase activation of skeletal muscle signaling pathways associated with insulin sensitivity ³³. High-intensity interval training programs improve hepatic insulin resistance and β-cell dysfunction ³⁴. In adolescents with type 1 diabetes who underwent snack exercise intervention, improvements were observed only in body composition in the short term, while metabolic control remained unchanged post-intervention, and the daily insulin total dose did not decrease ³⁵. The authors attribute this negative result to the small sample size.

Several limitations should be considered when interpreting the findings of this study. Firstly, the single-arm pre-post design employed in this research lacks a control group, which limits the ability to establish causality and control for potential confounding variables. Additionally, the relatively small sample size of 35 participants may restrict the generalizability of the results to broader populations. Furthermore, the absence of long-term follow-up assessments prevents the assessment of sustained effects beyond the 8-week intervention period. Another limitation pertains to the generalizability of the findings to individuals with specific health conditions or demographics, as the study focused solely on healthy university students. Additionally, completely dependent on wearable devices without supervision may introduce measurement error or inconsistency in data collection. Lastly, while efforts were made to ensure participants' compliance with the intervention protocol, variations in adherence to the prescribed exercise regimen may impact the consistency and reliability of the results. Thus, while the study provides valuable insights into the effects of simulated VILPA on various outcome measures, these limitations underscore the need for future research with improved study designs and larger sample sizes to confirm and extend the findings.

In conclusion, our findings suggest that engaging in three bouts of VILPA per day enhances calf muscle strength in healthy university populations. Our methodology indicates that prolonged use of wearable devices to monitor brief bouts of activity occurring in daily life provides a clearer understanding of VILPA occurrences. For both mandatory and non-mandatory "non-exercisers," VILPA appears to be more suitable, serving as a timely and potentially effective intervention to overcome barriers associated with structured exercise. Future research endeavors should extend to middle-aged and elderly individuals or those with chronic illnesses, and validate and expand upon the public health potential of VILPA in larger sample sizes.

AEMG

average electromyography

BMI

body mass index

DBP

diastolic blood pressure

HDL-c

high density lipoprotein cholesterol

RMS

root mean square

SBP

systolic blood pressure

VILPA

vigorous intermittent lifestyle physical activity

VO₂max

Maximal oxygen uptake.

Ethics approval and consent to participate

This study was ethically approved and all participants signed an informed consent form.

Consent for publication

All participants agree to publish.

Availability of data and material

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Funding

This study was supported by

(1) the Shenzhen Science and Technology Program (JCYJ20230807115308018)

(2) Sanming Project of Medicinein Shenzhen (szzysm202311020)

Authors' contributions

Y.Z. and Z.K. contributed to the manuscript equally. Y.Z., Z.K., L.L. and J.Z. conceive the research idea, design the analysis, and advised on statistical analysis methods. Y.Z. drafted the manuscript. K.Z., Z.H., S.W., X. Zhang, X. Zhuang, L.L. and S.C. contributed to the discussion and critical revision of the manuscript for important intellectual content. All authors reviewed and approved the final manuscript.

Acknowledgements

Our heartfelt thanks to all participants.

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No competing interests reported.

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Impact of Wearable Acceleration-Monitored Simulated Vigorous Intermittent Lifestyle Physical Activity on Muscle Strength in Young Adults

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Introduction

Methods

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VILPA simulation protocol

Data collection

Statistical analysis

Results

Baseline and changes

VILPA improves muscle strength

Discussion

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