Participant will receive a personalized exercise plan tailored to their fitness level.

Each session consists of:

Warm-up (10 minutes): Low-intensity walking (Borg scale 10-11) to increase heart rate, improve blood flow, and prepare joints.

Main phase (40 minutes):

Aerobic exercises: Controlled jumping jacks, step-ups, alternating knee lifts, lateral steps, and leg lifts.

Mobility exercises: Thoracic extensions, cat-to-cows, overhead stretching with a stick, and hip internal rotations (1-3 sets, 30-60 seconds per exercise).

Resistance training: Gradual progression of 8 exercises targeting major muscle groups, such as squats, bicep curls, shoulder presses, and rows (1-3 sets, 10-15 reps, RPE 13-15).

Cool-down (10 minutes): Breathing exercises and stretching (1-3 sets, 10-30 seconds per stretch).

Beck Depression Inventory (BDI): measures depression severity using a numerical score. It consists of 21 items, each rated on a 4-point scale (0 to 3) based on symptom severity.

Total score range: 0 to 63 (higher scores indicate more severe depression).

Interpretation:

0-13: Minimal depression 14-19: Mild depression 20-28: Moderate depression 29-63: Severe depression

The final score is obtained by summing the responses.

State-Trait Anxiety Inventory (STAI-Y): measures anxiety levels using a numerical score. It consists of 20 items assessing temporary (state) anxiety on a 4-point scale (1 = not at all to 4 = very much so).

Total score range: 20 to 80 (higher scores indicate greater anxiety).

Interpretation:

20-37: Low anxiety 38-44: Moderate anxiety 45-80: High anxiety

The final score is obtained by summing the responses.

he Physical Activity Enjoyment Scale (PACES) is a self-report questionnaire used to measure an individual's enjoyment of physical activity. It assesses positive and negative feelings related to exercise to evaluate motivation and adherence potential.

It include 18 items rated on a 7-point Likert scale (from 1 = strongly disagree to 7 = strongly agree). Some items are reverse-scored. After adjusting reverse-scored items, all scores are summed to give a total score ranging from 18 to 126, with higher scores indicating greater enjoyment of physical activity.

A higher total score suggests a more positive emotional response to exercise, which is often linked to better adherence and motivation.

The TSK is a self-report questionnaire designed to assess fear of movement or re-injury due to physical activity, commonly used in patients with chronic pain.

Scoring and Interpretation:

The standard TSK has 17 items, each rated on a 4-point Likert scale (1 = strongly disagree to 4 = strongly agree). Some items are reverse-scored. The total score ranges from 17 to 68, with higher scores indicating greater fear of movement. Scores above 37 often suggest clinically significant kinesiophobia.

The PCS is a 13-item self-report questionnaire designed to assess exaggerated negative thoughts and feelings related to actual or anticipated pain. It evaluates three components: rumination, magnification, and helplessness.

Scoring and Interpretation:

Each item is rated on a 5-point scale (0 = not at all to 4 = all the time), yielding a total score from 0 to 52. Higher scores indicate greater levels of pain catastrophizing, which are associated with increased pain perception, emotional distress, and poorer treatment outcomes.

The TAS-20 is a 20-item self-report questionnaire designed to assess alexithymia, a difficulty in identifying and describing emotions. It measures three dimensions: difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking.

Scoring and Interpretation:

Each item is rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). After reverse-scoring appropriate items, the total score ranges from 20 to 100.

• 51: Non-alexithymic

52-60: Possible alexithymia

• 61: Alexithymic Higher scores indicate greater difficulty with emotional awareness and expression.

The GPAQ is a tool developed by the WHO to assess physical activity levels across three domains: work, transport, and leisure. It captures frequency, duration, and intensity of activity, as well as sedentary behavior.

Scoring and Interpretation:

Responses are converted into MET-minutes/week (Metabolic Equivalent Tasks) for each domain. Total physical activity is classified into low, moderate, or high levels based on WHO guidelines. Higher MET scores indicate greater physical activity engagement.

The BPI is a self-report tool used to assess pain severity and the impact of pain on daily functioning. It evaluates both the intensity of pain and how it interferes with aspects of life such as mood, walking, work, and sleep.

Scoring and Interpretation:

Pain severity and interference are each rated on 0-10 scales. Scores are averaged separately for severity and interference:

Severity: 0 = no pain, 10 = worst possible pain.

Interference: 0 = no interference, 10 = complete interference. Higher scores indicate more severe pain and greater disruption to daily life.

The NRS is a simple, self-reported tool where individuals rate their current pain intensity on a scale from 0 (no pain) to 10 (worst imaginable pain).

Scoring and Interpretation:

Patients select a number that best represents their pain level.

0: No pain

1-3: Mild pain

4-6: Moderate pain

7-10: Severe pain It's commonly used to monitor pain over time or in response to treatment.

The MAF is a self-report tool designed to assess fatigue across multiple dimensions, including severity, distress, impact on daily activities, and timing, over the past week.

Scoring and Interpretation:

The MAF includes 16 items, with most rated on a 10-point scale. It yields a Global Fatigue Index (GFI) ranging from 1 to 50, where higher scores indicate greater fatigue. The GFI provides a comprehensive view of how fatigue affects quality of life.

The MOS Sleep Scale consists of 12 items assessing sleep quality, disturbances, and patterns, using a 5-point Likert scale. The scores are summed to produce subscale scores for sleep disturbance, sleep adequacy, and sleep problems. Higher scores on the disturbance subscale indicate greater sleep difficulties, while higher scores on the adequacy subscale suggest better sleep quality. Scores are interpreted based on the overall sleep impact, with higher scores reflecting poorer sleep quality.

The SF-36 consists of 36 items assessing eight health domains: Physical Functioning, Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, and Mental Health. Responses are scored on a 0-100 scale, with higher scores indicating better health status. Domain scores are then combined to create a Physical Component Summary (PCS) and a Mental Component Summary (MCS), which provide an overall measure of physical and mental well-being.

The FIQ consists of 21 items, assessing the impact of fibromyalgia on physical functioning, work, pain, fatigue, and sleep. Responses are rated on a scale from 0 to 10, with higher scores indicating greater impairment. The total score ranges from 0 to 100, with higher scores reflecting a greater impact of fibromyalgia on the individual's daily life and well-being.

The Arm Curl Test measures upper body strength and endurance, typically performed by having participants repeatedly curl a weighted dumbbell (5 pounds for women, 8 pounds for men) for as many repetitions as possible in 30 seconds.

Scoring and Interpretation: The score is the total number of successful curls completed within 30 seconds. A higher number of curls indicates better upper body strength and endurance. Scores are interpreted based on age and gender norms, with higher scores reflecting better physical fitness.

BMI is calculated by dividing a person's weight in kilograms by their height in meters squared (kg/m²).

Underweight: BMI < 18.5

Normal weight: BMI 18.5-24.9

Overweight: BMI 25-29.9

Obesity: BMI ≥ 30

A higher BMI typically indicates an increased risk for health issues related to weight, while a lower BMI may signal malnutrition or underweight.