12-Week Wearable-Monitored Workplace Exercise Program for Office Workers

Participants are physically active office workers who already meet the recommended physical activity levels. They will maintain their habitual physical activity and usual daily routines throughout the 12-week study period without receiving a specific study exercise intervention.

Sedentary office workers will receive an educational session about the health benefits of reducing and interrupting prolonged sitting. They will use a sitting diary or logbook to monitor their sedentary behavior while maintaining their usual daily routines throughout the 12-week study period.

An educational session providing information about the health benefits of reducing and interrupting prolonged sitting, accompanied by a sitting diary or logbook for monitoring sedentary behavior throughout the 12-week study period.

Sedentary office workers will participate in a 12-week wearable-monitored workplace exercise program using the Intelligent Health Promotion Service System (IHPSS). The system integrates wearable surface electromyography (sEMG) sensors, a six-axis inertial measurement unit (IMU), and a gamified smartphone application to provide physiological feedback, exercise prompts, and personalized guidance. Participants will perform 5-minute exercise sessions following approximately every 60 minutes of work, targeting at least 150 minutes of exercise per week. Exercise performance will be monitored and adjusted according to movement quality and individual performance.

A 12-week workplace exercise intervention using the Intelligent Health Promotion Service System (IHPSS), an integrated platform combining wearable surface electromyography (sEMG) sensors, a six-axis inertial measurement unit (IMU), and a gamified smartphone application. Participants receive automated auditory and haptic notifications after approximately every 60 minutes of work to perform 5-minute exercise sessions. The daily schedule is repeated for approximately 6-8 hours per day, 4-5 days per week, targeting at least 150 minutes of exercise per week. The system provides real-time muscle activation feedback, movement monitoring, personalized exercise guidance, and performance-based progression.

Resting motor threshold (RMT) and active motor threshold (AMT) are assessed using transcranial magnetic stimulation (TMS) and recorded as the percentage of maximum stimulator output required to elicit a motor-evoked potential (MEP). RMT is measured during muscle relaxation, while AMT is measured during a 10-20% maximum voluntary contraction.

Cortical silent period duration is measured in milliseconds using TMS during sustained muscle contraction. CSP is determined from the interval between the end of the MEP response and the recovery of rectified electromyographic activity to the predefined baseline level.

Intracortical inhibition and facilitation are assessed using paired-pulse TMS. The ratio of conditioned to unconditioned MEP amplitudes is calculated. SICI is measured at interstimulus intervals of 1, 2, 3, and 5 ms, while ICF is measured at 8, 10, 12, and 15 ms.

Corticospinal excitability is assessed by recording MEP amplitudes across TMS stimulus intensities ranging from 90% to 150% of resting motor threshold in 10% increments. Mean peak-to-peak MEP amplitudes are calculated and fitted using a Boltzmann sigmoid function to estimate the plateau amplitude.

Extracellular vesicles isolated from plasma and sweat samples are quantified using nanoparticle tracking analysis (NTA). Vesicle concentration is reported as particles per milliliter (particles/mL).

Extracellular vesicle size distribution in plasma and sweat samples is assessed using nanoparticle tracking analysis. The modal vesicle diameter is reported in nanometers, together with the proportion of particles within the 30-150 nm size range.

Protein cargo in plasma and sweat extracellular vesicles is characterized using high-throughput mass spectrometry. Protein profiles are reported as relative protein abundance or presence/absence. Protein identification and functional interpretation are performed using the UniProt human proteome and STRING protein-protein interaction and pathway analyses.

Quadriceps muscle strength is assessed as peak torque during concentric knee extension at angular velocities of 60, 180, and 300 degrees per second. The highest torque across maximal repetitions at each speed is recorded in Newton-meters (Nm).

Shoulder muscle strength is assessed as peak torque during concentric shoulder through a range of motion of 0-150 degrees at angular velocities of 60 and 120 degrees per second. Peak torque is reported in Newton-meters (Nm).

Maximum voluntary isometric handgrip force of the dominant hand is measured. The highest value from three trials is recorded in kilograms (kg) or converted to Newtons (N).

Hand movement cycles are identified using hand-marker trajectories. Peak resultant hand velocity is determined within each movement cycle, and the time at which peak velocity occurs is expressed as a percentage of the normalized movement cycle (0-100%).

Craniovertebral angle is measured in degrees in the sagittal plane between a horizontal line passing through the C7 vertebral marker and a line connecting the C7 marker to the tragus marker.

Body fat percentage is assessed using bioelectrical impedance analysis (BIA). The proportion of total body mass consisting of fat is recorded as a percentage (%).

Skeletal muscle mass is assessed using bioelectrical impedance analysis (BIA). The estimated mass of skeletal muscles is recorded in kilograms (kg).

Fat-free mass is assessed using bioelectrical impedance analysis (BIA). The estimated mass of body components excluding fat is recorded in kilograms (kg).

Physical activity is assessed using the International Physical Activity Questionnaire (IPAQ). Total physical activity is calculated in metabolic equivalent minutes per week (MET-min/week) according to the IPAQ scoring protocol. The results are used to confirm participant classification into active and sedentary groups.

Musculoskeletal discomfort is assessed using the Nordic Musculoskeletal Questionnaire (NMQ). Participants report musculoskeletal problems across nine body regions during the preceding seven days. Point prevalence is calculated as the number of participants reporting problems divided by the total number of participants, expressed as a percentage.

Ergonomic risk is evaluated using the Rapid Upper Limb Assessment (RULA). Postures of the upper arms, lower arms, wrists, neck, trunk, and legs are assessed together with muscle-use and force scores to calculate a grand score ranging from 1 to 7.

Musculoskeletal discomfort severity is assessed using the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Scores are calculated for each body region by multiplying discomfort frequency, severity, and work interference. Scores range from 0 to 90 per body region.

Participants' perceived overall progress is assessed using the Global Rating of Change (GRoC) scale, ranging from -7 (a very great deal worse) to +7 (a very great deal better), with 0 indicating no change.

Usability of the wearable-monitored exercise system is evaluated using the 10-item System Usability Scale (SUS). The total score ranges from 0 to 100, with higher scores indicating better perceived system usability. This assessment is administered to participants in the experimental group.

Intrinsic motivation is assessed using the Intrinsic Motivation Inventory (IMI), evaluating four dimensions: interest/enjoyment, perceived choice, perceived competence, and pressure/tension. Responses are recorded using a 7-point Likert scale. Negatively worded items are reverse-scored, and the subscale score is calculated as the mean of its items. Scores range from 1 to 7, with higher scores indicating greater perceived autonomy and choice (a more favorable outcome).