Effects of Exercise Snacking on Physical Fitness, Cognition, and Pain in Institutionalized Older Adults

The Short Physical Performance Battery (SPPB) is a test of lower extremity functioning that combines scores from usual gait speed, standing balance, and chair stand tests. Scores range from 0 to 12, with higher scores indicating better physical functioning.

HADS consists of two subscales, one measuring anxiety, with seven items, and one measuring depression, with seven items, which are scored separately. Each item was answered by the participant on a 4-point (0-3) response category so the possible scores ranged from 0 to 21 for anxiety and 0 to 21 for depression. The HADS manual indicates that a score between 0 and 7 is ''normal'', between 8 and 10 ''mild'', between 11 and 14 ''moderate'' and between 15 and 21 ''severe''.

Pain will be assessed using the Nordic Musculoskeletal Questionnaire. Participants will report as yes/no the presence of chronic pain (pain that persists or recurs more than three months) in nine body regions (neck, shoulders, elbows, wrists/hands, upper back, lower back, hips/thighs, knees, and ankles/feet). Symptom intensity in the last 7 days will be rated on a numeric scale from 0 to 10, where 0 indicates no pain and 10 indicates the worst possible pain.

The SF-12 includes 12 items covering eight health domains (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health). Responses will be scored using standard algorithms to generate two summary measures: the Physical Component Summary (PCS) and the Mental Component Summary (MCS). Scores will range from 0 to 100, with higher scores indicating better health-related quality of life. Outcomes will be reported as mean PCS and MCS scores.

Cognitive function will be assessed using the MMSE, a standardized interviewer-administered screening tool. The MMSE will evaluate orientation, attention, memory, language, and visuospatial abilities. Total scores will range from 0 to 30, with higher scores indicating better cognitive function. Cognitive impairment will be defined according to education-adjusted cut-off scores, as follows: illiterate participants ≤15 points; participants with 1 to 11 years of education ≤22 points; and participants with more than 11 years of education ≤27 points.