Associations of various exercise types with self-rated

J Phys Fitness Sports Med, 7 (2): 95-102 (2018)DOI: 10.7600/jpfsm.7.95

JPFSM: Regular Article

Associations of various exercise types with self-rated health status:A secondary analysis of Sports-Life Data 2012

Zhennan Wang1, Takehiko Tsujimoto2, Hiroyuki Sasai3 and Kiyoji Tanaka4*

Received: October 11, 2017 / Accepted: December 27, 2017

Abstract This study investigated the association between exercise type and self-rated health (SRH) in Japanese adults. A secondary data analysis was performed on the results of a cross-sectional study of 2,000 Japanese adults (20 years or older) who responded to the National Sports-Life Survey in 2012. The most-frequently practiced exercises were classified into five categories: simple movement without exercise equipment, complex movement without exercise equipment, non-confrontational movement with exercise equipment, confrontational movement with exercise equipment, and synchronous movement with exercise equipment. A logistic re-gression analysis was used to investigate the association between exercise type and poor SRH. Results showed that 1,459 (74.7%) participants enjoyed exercises or sports at least once in the past year, and 469 (24.0%), 32.9% non-exercisers vs. 21.2% exercisers, rated their health as fair or poor. Compared with simple movement without exercise equipment, the odds ratio and 95% confidence intervals (CI) for poor SRH were significantly higher for non-exercisers (1.98, 95% CI: 1.37-2.87) and significantly lower for confrontational movement with exercise equip-ment (0.61, 95% CI: 0.38-0.96) after adjusting for confounders. This study suggests that exer-cise type was associated with SRH. Exercisers participating in confrontational movement with exercise equipment indicated better SRH.Keywords : exercise type, self-rated health, secondary analysis, Japanese adults

Introduction

Self-rated health (SRH) is a measure of participants’ perception of their overall health status. SRH has been well documented as a reliable predictor of functional dis-ability, cardiovascular disease, mortality, and life prog-nosis1-4). SRH was found to worsen with advancing age and to be correlated with socioeconomic status, physical activity, alcohol consumption, chronic disease, and func-tional status5). In particular, the associations of physical activity with SRH have been studied in various popula-tions. Participation in physical activity or regular exercise was associated with a better SRH status6). An ability to go out alone to distant places was also found to be strongly correlated with SRH7). Most previous studies have focused primarily on dura-tion and intensity (i.e., volume or amount) of exercise or sports when testing the association with SRH8-10). Apart from the amount of exercise, modes or types have been

considered as other unique characteristics of exercise or sports. A few studies have reported that exercise types were associated with various health conditions. Duncan et al.11) confirmed that runners had significantly higher total body, femoral neck, and leg bone mineral density than swimmers and greater leg bone mineral density than cyclists. King et al.12) proved that, compared to non-exercisers, people who regularly engaged in jogging and aerobic dancing were significantly less likely to have el-evated cardiovascular markers, but those who engaged in gardening, swimming, cycling, calisthenics, and weight lifting were not, after controlling for age, race, gender, body mass index (BMI), smoking, and health status. It is certainly not easy to classify all exercises or sports, as there are over 3,000 sports disciplines and sports games, and more than 8,000 indigenous sports world-wide13). Exercises or sports are classified using differ-ent perspectives such as energy consumption (aerobic exercise or anaerobic exercise), playing fields (indoor or outdoor), and number of participants (personal or group sports). Among the numerous classification theories, *Correspondence: [email protected]

1 Doctoral Program in Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan

2 Faculty of Human Sciences, Shimane University, 1060 Nishikawatsu, Matsue, Shimane 690-8504, Japan3 Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro, Tokyo 153-8902, Japan

4 Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan

96 JPFSM : Wang Z, et al.

Udo14) classified exercise or sports into five categories based on the characteristics of motor skills: simple move-ment without exercise equipment, complex movement without exercise equipment, non-confrontational move-ment with exercise equipment, confrontational movement with exercise equipment, and synchronous movement with exercise equipment (Table 1). Udo’s classification was se-lected as it focuses on motor skills that play a significant role in fitness levels and physical activity outcomes15-17). Specific motor skills are needed for the development of fitness components such as strength, power, or endurance, and they are also used as a health-related index. Better motor skills were proved to be associated with a lower body fat percentage18). Progressive deterioration of motor skills was considered to be one of the criteria for clinical diagnosis of probable Alzheimer’s disease19). Although motor skills are important health-related indicators, asso-ciations of SRH with exercise types classified according to motor skills have not been adequately studied. This study aims to investigate the associations of vari-ous exercise types with SRH among a representative sample of Japanese adults based on Udo’s classification.

Materials and Methods

Data We used data from the 2012 National Sports-Life Sur-vey conducted by the Sasakawa Sports Foundation20). The National Sports-Life Survey has been conducted every two years since 1992 to describe the current exercise or sports situation of Japanese adults (20 years old or above). The 2012 survey was conducted from June 22 to July 22 and covered 210 areas (190 urban areas and 20 rural ar-eas) nationwide by two-stage stratified random sampling with 9-10 samples in each area and a set sample size of 2,000 individuals, based on the national population cen-sus for 2011 (or 2010 for 22 areas without 2011 national population census data due to the 2011 northeast region [Tōhoku] earthquake and tsunami). The questionnaire was administered and collected by survey staff using a placement method. The recovery rate of the questionnaire was 100%. Following the Personal Information Protec-tion Law (Japan) and the guidelines of the Japan Market-ing Research Association, the data were anonymous, and no personal information, such as name, address, date of birth, was recorded. Through these procedures, 2,000 responses were obtained. Data without missing values were considered valid for our primary data analysis. The Sasakawa Sports Foundation approved the data usage for this secondary analysis.

Surveyed itemsParticipation in exercise or sports Participants were asked to choose the exercises they had practiced in the past year from a list of 60 exercises or sports. They were also asked to list up to five exercises

or sports that they practiced most frequently. If the ex-ercises or sports that they practiced were not included in the given list, they were instructed to indicate them in the “Other” section. Information about the exercise frequency and average duration for each exercise or sports session was also obtained. According to the official survey report20), the activ-ity levels of exercise practitioners (i.e. exercise practice level) were classified into five levels (Levels 0 to 4) by exercise frequency, time, and subjective exercise intensity (rating of perceived exertion [RPE]). Level 0 referred to no exercises or sports in the past year. Level 1 was de-fined as exercises or sports practiced ≥ 1 time/year, but < 2 times/week (i.e., 1-103 times/year). Level 2 was defined as ≥ 2 times/week (≥ 104 times/year) and an exercise duration of < 30 minutes/time. Level 3 was defined as ≥ 2 times/week and an exercise duration of ≥ 30 minutes/time. Finally, Level 4 referred to ≥ 2 times/week, exercise duration of ≥ 30 minutes/time, and an RPE of “somewhat hard” or “moderately hard.”

Classification of exercise types The most frequently practiced exercise types were clas-sified into five categories based on Udo’s classification14) (Table 1).

Self-rated health (SRH) Participants were asked to rate their own health using a single question: “How would you describe your gen-eral health?” with four possible options: (1) excellent, (2) good, (3) fair, and (4) poor. SRH was categorized as “good” in cases of “excellent” or “good” responses and as “poor” in cases of “fair” or “poor” responses.

Sociodemographic and lifestyle variables Sociodemographic information included age, gender, height, weight, BMI, family composition (live alone or not), and job (full-time, part-time, or unemployed). Life-style information included status of alcohol consumption (current alcohol drinker or not) and tobacco smoking (current smoker or not). BMI was calculated as weight in kilograms divided by height in meters squared (kg/m2). The participants were divided into the following three classes according to their BMI: underweight (BMI < 18.5 kg/m2), normal weight (BMI 18.5-24.9 kg/m2), and overweight (BMI ≥ 25 kg/m2)21).

Statistical analysis Statistical analyses were performed using the statistical package IBM SPSS Statistics Version 18.0. The distribu-tions of the characteristics of participants were computed using the chi-squared test for categorical variables (gender, family composition, employment status, tobacco smoking, alcohol drinking, exercise practice level, and poor SRH), which were expressed by number and percentage. Con-tinuous variables (age and BMI) were computed using a

97JPFSM : Exercise types and self-rated health status

one-way analysis of variance and expressed by mean and standard deviation. P values < 0.05 were considered to be statistically significant. The primary analysis assessed the association between poor SRH and exercise type using a logistic regression analysis considering the exercise type category as the in-dependent variable, poor SRH as the dependent variable, and sociodemographic and lifestyle variables as confound-ing factors. The sub-analysis examined the association between poor SRH and different exercise type categories by gender, age, and exercise frequency group. To compare poor SRH among exercisers, we used simple movement without exercise equipment as the reference category for the logistic regression analysis in our study.

Results

Data from 46 participants (2.3%) with missing values were deleted, and data from the remaining 1,954 partici-pants were analyzed. No difference was observed between individuals with complete and incomplete data in terms of gender, age, height, weight, BMI, family composition, and job (data not shown). A total of 181 exercises or sports (including sports games) were reported by participants. Among the 1,954 participants, 1,459 (74.7%) reported having enjoyed an exercise or sport in the past year. These 1,459 partici-pants were classified into five categories based on the motional characteristic of the exercise type of their most-frequently-practiced exercise or sport in the past year. Major exercises or sports in each category and their dis-

tributions are presented in Table 1. The characteristics of participants stratified by exercise or sport classification are presented in Table 2. Gender, age, BMI, employment status, tobacco smoking state, alcohol drinking state, and exercise practice level signifi-cantly differed according to the classification categories. Overall, 469 (24.0%) participants, 32.9% non-exercisers vs. 21.0% exercisers, rated their health as fair or poor (considered as poor SRH). The lowest prevalence of poor SRH (16.0%) was observed among participants who prac-ticed confrontational movement with exercise equipment. Table 3 shows that, compared to simple movement without exercise equipment, the odds ratio (OR) for poor SRH was significantly higher for non-exercisers both before and after adjusting for confounding factors. The OR for poor SRH was significantly lower for exercisers participating in confrontational movement with exercise equipment. Table 4 shows that the OR for poor SRH was significantly lower for the exercise type of confronta-tional movement with exercise equipment in male, young (age 20-44 years), and old (age ≥ 65) participants, and in habitual exercisers (exercise frequency ≥ 1 time/week). It was also significantly lower for the exercise type of non-confrontational movement with exercise equipment in older participants compared to simple movement without exercise equipment.

Discussion

The main purpose of this cross-sectional study was to explore the association between exercise type and self-

Table 1. Classification of exercise type, its characteristics, and representative examples of exercises or sports for each exercise type (n=1,459)

Exercise type Characteristics Examples n (%)

Simple movement without

exercise equipment (n=707)

Simple physical exercise,

evaluation for speed or distance.

Walking (including strolling) 591 (83.6%)

Jogging/running 61 (8.6%)

Swimming 32 (4.5 %)

Complex movement without


Moving by directional stepping,

body stretch and tilt, etc. mostly

with rhythm of music.

Calisthenics (including light,

radio calisthenics)146 (48.2%)

Dance (any form) 51 (16.8%)

Yoga 29 (9.6%)

Non-confrontational movement

with exercise equipment (n=188)

Playing by operating exercise

equipment, most of the

environment is predictable and

response can be planned.

Golf (including golf course

and golf practice range)95 (50.5%)

Fishing 32 (17.0%)

Bowling 19 (10.1%)

Confrontational movement with


Playing with one or more battle

opponents by using exercise

equipment, conditions are

variable and unpredictable.

Soccer 47 (22.8%)

Volleyball 33 (16.0%)

Baseball 26 (12.6%)

Tennis 26 (12.6%)

Synchronous movement with


Controlling and operating

exercise equipment is key point

of completing the movement.

Cycling 38 (69.1%)

Surfing 8 (14.5%)


P values were from chi-squared test (categorical variable) and one-way analysis of variance (continuous variables). a I-V: Simple movement without exercise equipment; Complex movement without exercise equipment; Non-confrontational movement with exercise equipment; Confrontational movement with exercise equipment; Synchronous movement with exercise equipment.BMI: body mass index; SRH: self-related health.Level 0: did not participate in any exercise or sports in the past year.Level 1: exercises or sports practiced ≥ 1 time/year, but < 2 times/week (1-103 times/year).Level 2: exercises or sports practiced ≥ 2 times/week (≥ 104 times/year) and < 30 min/time.Level 3: exercises or sports practiced ≥ 2 times/week and ≥ 30 min/time.Level 4: exercises or sports practiced ≥ 2 times/week, ≥ 30 min/time and somewhat hard or moderately hard.

Table 2.Basic information of participants by different exercise type categories (n=1,954)

No exercise

(n=495)I

a

(n=707)

II a

(n=303)

III a

(n=188)

IVa

(n=206)

Va

(n=55)P value

Gender (male), n / % 221 / 44.6 330 / 46.7 116 / 38.3 140 / 74.5 135 / 65.5 37 / 67.3 < 0.001

Age, year 51.8 ± 17.6 52.5 ± 15.6 46.9 ± 17.2 49.9 ± 16.1 40.0 ± 14.0 42.1 ± 13.1 < 0.001

20-44 years, n / % 185 / 37.4 240 / 33.9 142 / 46.9 82 / 43.6 139 / 67.5 36 / 65.5 < 0.001

45-64 years, n / % 166 / 33.5 282 / 39.9 102 / 33.7 62 / 33.0 53 / 25.7 16 / 29.1

≥ 65 years, n / % 144 / 29.1 185 / 26.2 59 / 19.5 44 / 23.4 14 / 6.8 3 / 5.5

BMI, kg/m2

22.5 ± 3.5 22.7 ± 3.0 22.1 ± 3.1 22.7 ± 3.1 22.9 ± 3.4 22.0 ± 2.9 0.102

< 18.5, n / % 42 / 8.5 39 / 5.5 23 / 7.6 12 / 6.4 9 / 4.4 3 / 5.5 0.029

18.5-24.9, n / % 340 / 68.7 521 / 73.7 231 / 76.2 134 / 71.3 153 / 74.3 46 / 83.6

≥ 25.0, n / % 113 / 22.8 147 / 20.8 49 / 16.2 42 / 22.3 44 / 21.4 6 / 10.9

Family composition (live

alone), n / %39 / 7.9 43 / 6.1 16 / 5.3 13 / 6.9 14 / 6.8 4 / 7.3 0.269

Job (unemployed), n / % 93 / 18.8 112 / 15.8 36 / 11.9 28 / 14.9 10 / 4.9 4 / 7.3 < 0.001

Current smoker, n / % 150 / 30.3 117 / 16.5 48 / 15.8 70 / 37.2 68 / 33.0 11 / 20.0 < 0.001

Current alcohol drinker, n / % 264 / 53.3 455 / 64.4 197 / 65.0 134 / 71.3 162 / 78.7 42 / 76.3 < 0.001

Exercise practice level

Level 0, n / % 495 / 100.0 0 / 0 0 / 0 0 / 0 0 / 0 0 / 0 < 0.001

Level 1, n / % 0 / 0 158 / 22.3 68 / 22.4 131 / 69.7 112 / 54.4 26 / 47.3

Level 2, n / % 0 / 0 75 / 10.6 82 / 27.2 8 / 4.3 6 / 2.9 7 / 12.7

Level 3, n / % 0 / 0 282 / 39.9 52 / 17.2 30 / 16.0 20 / 9.7 10 / 18.2

Level 4 (active), n / % 0 / 0 192 / 27.2 101 / 33.3 19 / 10.1 68 / 33.0 12 / 21.8

SRH (poor), n / % 163 / 32.9 169 / 23.9 56 / 18.5 39 / 20.7 33 / 16.0 9 / 16.4 < 0.001

OR: odds ratio; CI: confidence interval.a: Adjusted for age, gender, body mass index, job, tobacco smoking, alcohol consumption, and exercise practice level.

Table 3.Associations of exercise types with poor self-rated health (n=1,954)

Category Crude OR 95% CI Multiple-adjusted OR a

95% CI

No exercise 1.57 1.22-2.02 1.98 1.37-2.87

Simple movement without exercise

equipment1.00 ref. 1.00 ref.

Complex movement without

exercise equipment 0.72 0.53-1.01 0.82 0.56-1.19

Non-confrontational movement

with exercise equipment0.87 0.59-1.28 0.73 0.47-1.15

Confrontational movement with


Synchronous movement with



rated health in a randomly selected population of 2,000 Japanese adults aged 20 years or above. We found that, compared to simple movement without exercise equip-ment, non-exercisers were associated with poor SRH. We also found that exercisers who participated in confronta-tional movement with exercise equipment were inversely associated with poor SRH. Our most striking finding was the significant negative association between poor SRH and confrontational move-ment with exercise equipment. Compared to the exercise type of simple movement without exercise equipment (e.g., walking, jogging, and swimming), the OR for poor SRH was significantly lower for confrontational move-ment with exercise equipment (e.g., soccer, volleyball, and tennis). Confrontational movement with exercise equipment always results in wins or loses involving one

or more opponents. Competitive behavior may affect mental states. A survey of adolescent ice hockey players showed that the players emphasized the importance of be-ing aggressive, which they defined as being powerful, and at times fearless in the use of their bodies22). Similarly, in another study, participants expressed their enjoyment of the physical activity of wrestling and the sense it gave them of being “in control” and able “to manage” their bodies23). Therefore, we believe that exercisers engaged in confrontational movement with exercise equipment should develop methods for self-assessment in order to report better SRH. We examined the association between poor SRH and different exercise type categories stratified by gender, age group, and exercise frequency. The results of the sub-analysis revealed a significantly inverse association be-

a I-V: Simple movement without exercise equipment; Complex movement without exercise equipment; Non-confrontational movement with exercise equipment; Confrontational movement with exercise equipment; Synchronous movement with exercise equipment.b: Adjusted for age, gender, body mass index, job, tobacco smoking, alcohol consumption and exercise practice level.c: Interaction for gender × exercise type.d: Interaction for age group × exercise type.e: Interaction for exercise frequency group × exercise type.OR: odds ratio; CI: confidence interval; SRH: self-rated health.Occasional: < 1 time/week.Habitual: ≥ 1 time/week.

Table 4.Odds ratios of poor self-rated health by gender, age, and exercise frequency (n=1,954)

I esicrexe oN a IIa IIIa IVa Va P for

interaction )303=n( )707=n( )594=n( (n=188) (n=206) (n=55)

Gender < 0.001c

Male (n=979) Poor SRH, n / % 82 / 37.1 95 / 28.8 22 / 19.0 28 / 20.0 24 / 17.8 8 / 21.6

96.0 34.0 56.0 07.0 00.1 15.1 RO

IC %59 b 0.87-2.63 ref. 0.28-1.80 0.41-1.04 0.25-0.73 0.35-1.37

Female (n=975) Poor SRH, n / % 81 / 29.6 74 / 19.6 34 / 18.2 11 / 22.9 11 / 15.5 1 / 5.6

53.0 28.0 21.1 98.0 00.1 90.2 RO

IC %59 b 1.19-3.65 ref. 0.52-1.52 0.57-2.18 0.44-1.52 0.09-1.28

Age 0.047d

20-44 years (n=824) Poor SRH, n / % 42 / 22.7 44 / 18.3 22 / 15.5 22 / 26.8 23 / 16.5 5 / 13.9

OR 1.08 1.00 0.88 1.37 0.50 0.50

IC %59 b 0.54-2.60 ref. 0.39-1.98 0.72-2.60 0.27-0.90 0.21-1.16

45-64 years (n=681) Poor SRH, n / % 57 / 34.3 75 / 26.6 22 / 21.6 10 / 16.1 10 / 18.9 3 / 18.8

OR 2.97 1.00 1.02 0.74 0.97 0.87

IC %59 b 1.52-5.80 ref. 0.50-2.08 0.39-1.41 0.50-1.85 0.34-2.22

65 years (n=449) Poor SRH, n / % 64 / 44.4 50 / 27.0 12 / 20.3 7 / 15.9 2 / 14.3 1 / 33.3

OR 1.69 1.00 0.50 0.45 0.07 0.48

IC %59 b 0.80-3.59 ref. 0.20-1.25 0.21-0.96 0.01-0.58 0.04-5.28

Exercise frequency 0.620e

Occasional (n=471) Poor SRH, n / % 43 / 24.9 16 / 25.0 26 / 21.3 20 / 22.5 4 / 17.4

OR --- 1.00 1.18 0.90 0.87 0.60

IC %59 b ref. 0.54-2.56 0.46-1.76 0.41-1.82 0.17-2.14

Habitual (n=988) Poor SRH, n / % 126 / 23.6 40 / 16.7 13 / 19.7 15 / 12.8 5 / 15.6

OR --- 1.00 0.63 0.75 0.46 0.76

IC %59 b ref. 0.40-1.01 0.37-1.55 0.23-0.90 0.25-2.27


achievement35) which were associated with affecting par-ticipation in exercise and with mental health36). Therefore, we have reason to believe that exercisers would obtain greater communication and self-challenges by participat-ing in non-confrontational movement with exercise equip-ment that may help improve their mental health. Although not significant, synchronous movement with exercise equipment showed a lower proportion (16.4%) of poor SRH that was close to that of confrontational move-ment with exercise equipment (16.0%). A representative example of this exercise type was cycling. Cycling can be practiced not only for leisure or recreation, but also for basic transportation37). Of course, cycling is a form of physical activity that effectively taxes the cardiorespira-tory and metabolic functions of the whole body in a wide range of intensities and thus lends itself to many potential health benefits38). The present study has high external validity as the Na-tional Sports-Life Survey is a national-scale social survey based on well-designed research with a sufficient sample size. The present classification according to exercise type, however, has a significant limitation. We classified exercises or sports based on motional characteristics. However, specific exercises have differences in exercise intensity (e.g. walking vs. running) and exercise time (e.g. golf vs. bowling), even in the same category. The classifi-cation was based solely on the most frequently practiced exercise and lacked discussion on the effects of multiple exercise types on SRH. The associations of multiple exer-cise types with SRH will be our next study focus. Further-more, the cross-sectional study does not allow for making inferences about causality. Physical fitness condition and exercise participation were documented on a self-reported basis that may have affected information accuracy and strengthened or weakened the effect of exercise on SRH. Further studies are needed to grasp the relationship be-tween exercise type and health-related information based not only on subjective indicators, but also physical indi-cators and psychological scales. Longitudinal studies are needed to further explore these associations.

Conclusions

Exercise type was associated with SRH. Exercisers participating in confrontational movement with exer-cise equipment indicated better SRH status, and non-confrontational movement with exercise equipment was negatively associated with poor SRH, particularly in older adults. Developing habitual exercises with appropriate exercise types is likely to result in more health benefits. Considering the needs of different populations, instructors who provide health-supporting or health-promotion pro-grams should provide more options for multiple exercise types in order to prompt participants to engage in more exercises or sports for a better health state.

tween confrontational movement with exercise equipment and poor SRH, particularly in males, young participants, and habitual exercisers. This tendency may relate to the purposes and cognitions of exercise in different partici-pants. Confrontational movement with exercise equip-ment always results in wins or losses. Reis and Jelsma24) discovered that male exercise practitioners might enjoy this type of exercise more than their female counterparts, as male athletes often mentioned winning as an important reason for athletic participation, while female athletes rat-ed opportunities for socializing as important. The trend of younger people participating in sports was more evident in confrontational games such as soccer, baseball, and basketball25). With regard to the characteristics of these exercise types, males participate in confrontational move-ment more than females, particularly younger males23). Exercise frequency was confirmed to be associated with health risk factors and diseases26). The exercise frequency of confrontational movement with exercise equipment may impact a poor SRH. We also found that the old age group indicated a signifi-cantly lower OR for poor SRH for non-confrontational movement with exercise equipment. For older adults, exercise partners and communication were reported as important factors for exercise adherence. A survey in North America has shown that participation in golf has risen considerably, particularly amongst senior play-ers (50 years or older)27). “Playing time with partners” proved to be a factor influencing golfer enjoyment28) and “communication” was cited as an initial motivating fac-tor for taking up golf 29). Group exercise has been proven to have beneficial effects on physiological and cognitive functioning and well-being in older people30). Diehl et al.31) confirmed that the number of exercise partners was an important issue for females with high social physique anxiety, and an exercise partner should help moderate their anxiety, increasing the acceptability of the exercise setting. As a form of social integration and social support, the existence of exercise partners is expected to facilitate the adoption and maintenance of physical activity32). Of course, the existence of exercise partners occurs not only in group exercises or confrontational exercises, but also in single-person exercises. However, through the use or control of exercise equipment, exercise practitioners were capable of learning or gaining unique motor skills that could affect exercise motivation, and skillful performance or progress in skill acquisition could also enhance self-efficacy33), which is associated with good SRH34). For elders with physical weakness, skill exercises that do not rely on a high level of physical fitness may make them enjoy the fun of exercise more. Another characteristic of non-confrontational movement with exercise equipment is that, even if there is no competition with other players, exercisers can also enjoy the pleasure of breaking their own records (e.g. bowling score, golf score). Challenges for higher goals could promote motivation and a sense of


Acknowledgments

We would like to acknowledge the Sasakawa Sports Foundation for providing data. This work was supported by JSPS KAKENHI Grant Number JP16K16593 and MEXT-supported Program for the Strategic Research Foundation at Private Universities, 2015-2019 from the Ministry of Education, Culture, Sports, Science and Technology (S1511017).

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Conflict of Interests

The authors have no conflict of interests to report.


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Documents

Associations of various exercise types with self-rated