Effects of a six-month combined educational and physical activity program on physical fitness, body composition, sleep quality, and quality of life among university ice-hockey players and recreationally active adults

Abstract

Contemporary physiotherapy is increasingly moving beyond the reactive treatment of injury toward the primary prevention of disease and the proactive promotion of long-term health. Although educational interventions addressing sleep, nutrition, circadian hygiene, and recovery are frequently recommended, empirical evidence regarding their combined effects with physical activity among already physically active populations remains limited. Therefore, this study examined the effects of a six-month program integrating health education and physical activity on physical fitness, body composition, self-reported sleep quality, and quality of life in two groups of physically active adults. Thirty-four participants (33 men and 1 woman, aged 19-41 years) were assigned to two parallel groups: players from the university ice hockey team, CTU Engineers Prague (Group A, n = 17), and members of a recreational fitness community (Group B, n = 17). Both groups completed the same program, consisting of expert-led seminars on sleep and light hygiene, nutrition, stress management, psychosomatic relationships, circadian rhythmicity, and recovery, combined with habitual physical activity and individualized physiotherapy supervision. Body composition was assessed using direct segmental multifrequency bioelectrical impedance analysis. Physical fitness was evaluated with a three-item battery consisting of air bike interval performance, passive bar hang, and one-repetition-maximum deadlift tests. Sleep quality and quality of life were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the WHOQOL-BREF questionnaire. Measurements were repeated after six months. Body composition remained essentially unchanged in both groups (all p > 0.30). Physical fitness improved significantly in every test in both groups: deadlift strength increased by 8.0 kg in Group A (p = 0.003) and 11.4 kg in Group B (p < 0.001); air bike performance improved by 6.7 kcal (p = 0.004) and 11.0 kcal (p < 0.001), respectively; and passive hang endurance increased by 6.0 s (p = 0.044) and 14.3 s (p = 0.015), with a markedly greater relative improvement in Group B (+25.7% versus +10.4%). Quality of life and sleep quality improved significantly only in Group B, with WHOQOL- BREF scores increasing from 72.9% to 83.0% (p = 0.008) and PSQI scores decreasing from 2.8 to 1.4 points (p = 0.005). In Group A, improvements were more favorable but did not reach statistical significance, which may reflect a ceiling effect and the demands of the concurrent competitive season. Baseline analyses revealed a strong inverse association between body fat percentage and passive hang endurance (r = -0.65, p < 0.001). A combined educational and physical activity program delivered by a physiotherapist can improve muscular strength and anaerobic performance and, in recreationally active adults, enhance perceived sleep quality and quality of life without inducing measurable changes in body composition.