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Completed

NCT Number: NCT07477262

Health Effects of a Walking Program in a High-Quality Tourism Environment for Older Women

The goal of this randomized controlled trial is to evaluate the effect of environmental context on the health benefits of a standardized walking program in sedentary, overweight older women (aged ≥60 years, BMI ≥24.0 kg/m²) . The main questions it aims to answer are:

Does exercising in a high-quality natural tourism environment (Yangshuo) lead to greater improvements in body composition (e.g., body fat percentage) compared to exercising in a conventional institutional setting?

Does this environment lead to greater improvements in psychological well-being (e.g., depressive symptoms, sleep quality) than the conventional setting?

Researchers will compare a group that walks in the Yangshuo landscape to a group that performs the same walking regimen in a nursing home setting to see if the natural environment amplifies the health benefits of the exercise.

Participants in both groups will take part in a supervised, 10-week walking program (5 days/week, 60 mins/session). All participants will have their physiological (e.g., weight, body fat, strength) and psychological (e.g., mood, sleep, quality of life) health measured before and after the program.

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Key information

Conditions

Overweight , Obesity Body Weight Nutrition Disorders Nutritional and Metabolic Diseases Obesity Overnutrition Overweight Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

60 year–75 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Guangxi Residential Elderly Care Demonstration Base

Guilin, Guangxi, 541004, China

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Female sex.
  • Age ≥ 60 years.
  • Body mass index (BMI) ≥ 24.0 kg/m² (consistent with Chinese criteria for overweight status).
  • Sedentary lifestyle, defined as engaging in < 60 minutes of moderate-intensity exercise per week over the preceding 6 months.
  • Ability to walk independently without assistive devices.
  • Sufficient cognitive capacity to understand the study protocol and provide written informed consent.

Exclusion criteria

  • Severe or uncontrolled cardiometabolic conditions (e.g., heart failure, unstable angina).
  • Musculoskeletal disorders contraindicating exercise.
  • Major psychiatric disorders.
  • Planned extended absence during the 10-week intervention period.

Treatment and study plan

Walking Program in Natural Tourism Environment

Behavioral

A 10-week supervised walking program conducted in the high-quality natural tourism environment of Yangshuo. Participants are accommodated in a local homestay with direct views of the iconic karst mountains. Walking sessions are conducted on pre-selected, scenic, low-traffic riverside paths. The program consists of group walking 5 days/week, 60 mins/session, at a target intensity of 60-70% heart rate reserve, objectively monitored using Polar H10 chest-worn heart rate sensors.

Walking Program in Conventional Institutional Environment

Behavioral

A 10-week supervised walking program conducted in a standard institutional setting. Participants reside in a local nursing home with views of institutional buildings or internal courtyards. Walking sessions are conducted on pre-measured, paved urban streets surrounding the nursing home. The program consists of group walking 5 days/week, 60 mins/session, at a target intensity of 60-70% heart rate reserve, objectively monitored using Polar H10 chest-worn heart rate sensors to match the exercise dose with the experimental group.

Primary outcomes

  1. Change in Body Weight

    Time frame: Baseline (Week 0) and within one week post-intervention (Week 10)

    Measured in kilograms (kg) using a multi-frequency bioelectrical impedance analysis device (InBody 770) under standardized conditions.

  2. Change in Body Mass Index (BMI)

    Time frame: Baseline (Week 0) and within one week post-intervention (Week 10)

    Calculated as weight in kilograms divided by height in meters squared (kg/m²). Height measured at baseline using a stadiometer; weight measured at each time point using the InBody 770 device.

  3. Change in Body Fat Percentage

    Time frame: Baseline (Week 0) and within one week post-intervention (Week 10)

    Measured as percentage (%) of total body weight using multi-frequency bioelectrical impedance analysis (InBody 770) under standardized conditions.

  4. Change in Lower-body Muscular Endurance

    Time frame: Baseline (Week 0) and within one week post-intervention (Week 10)

    Assessed by the 30-second chair stand test, measuring the number of full stands completed in 30 seconds from a seated position. Higher numbers indicate better lower-body muscular endurance.

  5. Change in Handgrip Strength

    Time frame: Baseline (Week 0) and within one week post-intervention (Week 10)

    Measured in kilograms (kg) using a calibrated handgrip dynamometer. Participants performed the test with their dominant hand, and the best of two trials was recorded. Higher values indicate greater handgrip strength.

  6. Change in Depressive Symptoms

    Time frame: Baseline (Week 0) and within one week post-intervention (Week 10)

    Assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) . This 20-item scale measures the frequency of depressive symptoms experienced in the past week. Total scores range from 0 to 60, with higher scores indicating more severe depressive symptoms (a worse outcome) .

  7. Change in State Anxiety

    Time frame: Baseline (Week 0) and within one week post-intervention (Week 10)

    Assessed using the State subscale of the State-Trait Anxiety Inventory (STAI-S) . This 20-item scale measures transient anxious emotional states at the moment of assessment. Total scores range from 20 to 80, with higher scores indicating higher levels of state anxiety (a worse outcome) .

  8. Change in Mental Health-Related Quality of Life

    Time frame: Baseline (Week 0) and within one week post-intervention (Week 10)

    Assessed using the Mental Component Summary (MCS) of the 36-Item Short Form Health Survey (SF-36) . This score is a standardized T-score based on normative data, with a population mean of 50 and a standard deviation of 10. Higher scores indicate better mental health-related quality of life (a better outcome) .

  9. Change in Sleep Quality

    Time frame: Baseline (Week 0) and within one week post-intervention (Week 10)

    Assessed using the Pittsburgh Sleep Quality Index (PSQI) . This 19-item instrument assesses sleep quality and disturbances over a one-month period. The global score ranges from 0 to 21, with higher scores indicating poorer sleep quality (a worse outcome) . A global score >5 is indicative of poor sleep quality.

  10. Change in Perceived Mastery

    Time frame: Baseline (Week 0) and within one week post-intervention (Week 10)

    Assessed using the Pearlin-Schooler Mastery Scale. This 7-item scale measures the extent to which individuals perceive themselves as having personal control over factors that significantly impact their lives. Total scores range from 7 to 28, with higher scores indicating a stronger sense of personal mastery (a better outcome) .

Sponsors and collaborators

Lead sponsor

Yu-fan Li

Other

Registry information

Official study title

Amplifying Healthy Aging: How A High-Quality Tourism Environment (Yangshuo, China) Selectively Enhanced Exercise Outcomes for Older Women - A Randomized Controlled Trial

Important dates

Study start
2024
Primary completion
2024
Study completion
2024
First posted
Mar 17, 2026
Registry last updated
Mar 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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