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Physical activity and exercise are widely recommended as part of treatment for these conditions, yet the specific effects of Nordic walking (NW) remain underexplored. The aims of this randomised controlled trial (RCT) are to improve physical fitness, functional capacity and respiratory health and increase regular physical activity and quality of life of older adults with asthma and\/or COPD and\/or OSA through a supervised 3-month group-based NW intervention combined with resistance, balance and mobility training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This single-blinded, parallel-group RCT will recruit 100 adults aged 55\u201380 years diagnosed with asthma and\/or COPD and\/or OSA in the Northern Savo region of Finland. Participants will be randomly allocated to either an intervention group or a control group.<\/jats:p>\n                    <jats:p>The intervention group will participate in a 12-week supervised exercise programme consisting of progressive NW sessions twice per week and resistance, balance and mobility training once per week. The primary outcome is a change in cardiorespiratory endurance. Secondary outcomes include functional capacity, physical activity level, spirometry parameters and quality of life. The control group will continue their usual physical activity and receive physical activity guidance after 12 weeks. Measurements were conducted at baseline, three and 9\u2009months. Data will be analysed according to the intention-to-treat principle. Group differences over time will be examined using appropriate parametric or non-parametric methods depending on data distribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval was obtained from the Regional Medical Research Ethics Committee of Eastern Finland Collaborative Area (892\/13.00\/2023). Findings will be disseminated through publications in peer-reviewed journals and presentations at scientific conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      The trial is registered at\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" specific-use=\"clinicaltrial results\" xlink:href=\"ISRCTN12097135\">ISRCTN12097135<\/jats:ext-link>\n                      , registration date: 7 June 2024.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-118045","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T11:10:48Z","timestamp":1781089848000},"page":"e118045","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Measured and 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