{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T21:41:59Z","timestamp":1792532519830,"version":"4.5.0"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"\n Importance<\/jats:title>\n Loud music in group fitness classes is often believed to enhance motivation and performance but poses a risk for noise-induced hearing loss.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess whether lower music volume during fitness classes results in comparable perceived exertion compared with higher music levels and to explore hearing protection behaviors among participants.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This comparative effectiveness study using a partially repeated measures design surveyed group fitness class attendees from February 1 to 28, 2025, at a fitness studio in Los Angeles, California, regarding perceived exercise intensity, music loudness, and hearing protection behaviors.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Participants attended 1-hour group fitness classes under typical (louder) and reduced music volume conditions (\u22653-dBA reduction).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Perceived exertion was compared between louder and quieter class conditions using multivariable mixed-effects linear regression to account for repeated measurements from participants. A noninferiority framework was applied, with noninferiority defined as the lower bound of the 97.5% CI.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 189 participants completed 239 surveys, and 21 participants contributed surveys in both sound conditions. The median (range) age was 28 (17-59) years, and 165 (87.3%) were female. The mean sound levels were 91.4 dBA (95% CI, 91.1-91.9 dBA) for louder classes (n\u2009=\u2009122) and 88.5 dBA (95% CI, 88.0-88.9 dBA) for quieter classes (n\u2009=\u2009117). The lower bound of the 97.5% CI for the difference in perceived exertion (Borg CR-10) between louder and quieter classes (\u03b2\u2009=\u2009\u22120.66; 97.5% CI, \u22121.09 to \u22120.22) did not exceed the CI for the noninferiority threshold of \u22121.5, indicating noninferiority in perceived exertion in quieter classes compared to louder classes. Continuous unit-based modeling of sound intensity confirmed noninferiority for decrements up to 4 dBA. Twenty-eight individuals (14.8%) reported ever experiencing postclass tinnitus, and 4 participants (2.1%) reported consistently using hearing protection during classes.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this comparative effectiveness study, reducing music volume in group fitness classes did not lead to meaningful reductions in perceived exertion and may reduce the risk of noise-induced hearing loss. These findings support implementing safer sound practices in fitness environments and underscore the need for increased awareness and education on hearing protection.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoto.2026.0028","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T16:30:35Z","timestamp":1772728235000},"page":"465","source":"Crossref","is-referenced-by-count":2,"title":["Lower Music Volume Levels in Fitness Class and Perceived Exercise Intensity"],"prefix":"10.1001","volume":"152","author":[{"given":"Kaitlin","family":"Hori","sequence":"first","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choo Phei","family":"Wee","sequence":"additional","affiliation":[{"name":"Southern California Clinical and Translational Science Institute, University of Southern California, Los 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