Preperitoneal analgesia under direct visualization: laparoscopic-guided deep rectus sheath block improves postoperative pain control after laparoscopic cholecystectomy: a randomized controlled trial.

In contemporary society, psychological resilience has emerged as a pivotal resource for individuals coping with stress, adversity, and challenges, playing a central role in maintaining mental health and enhancing quality of life []. Globally, mental disorders affect over 1 billion people – 14% of the population – with anxiety and depression accounting for more than two-thirds of cases. Between 2011 and 2021, the age-standardized prevalence increased by 0.9%, with the largest rise (1.8%) among young adults aged 20–29 years []. These figures underscore the urgent need for effective interventions, such as exercise, to enhance psychological resilience. Enhancing resilience is not only essential for personal development but also a critical public health concern, particularly among adolescents, older adults, and individuals with chronic conditions []. Physical activity, characterized by its high accessibility and cost-effectiveness, is widely regarded as an effective avenue for promoting mental health and bolstering psychological resilience. However, translating this potential into evidence-based, generalizable, and efficacious intervention programs remains a key scientific challenge. Core to this challenge is elucidating the moderating factors underlying the effects of exercise interventions, such as intervention duration, participant age characteristics, and the study design itself. Psychological resilience is widely conceptualized as a dynamic and malleable psychological process, involving the effective integration of cognitive, emotional, and behavioral resources during an individual's interaction with their environment []. In the field of sport and health psychology, a substantial body of empirical research has corroborated a positive association between regular physical activity and higher levels of psychological resilience [, ]. The underlying mechanisms are multifaceted, encompassing the enhancement of self-efficacy and satisfaction of basic psychological needs [], improvements in executive function and emotion regulation capacity [], and mediation through pathways such as elevated self-esteem and increased social support []. For specific populations, such as cancer patients, adolescents, and older adults, structured exercise interventions—including aerobic training and mind–body integration practices—have demonstrated significant efficacy in enhancing psychological resilience [, –]. Furthermore, integrated interventions combining exercise with cognitive-behavioral therapy or mindfulness training have broadened the scope of resilience-promoting strategies [, ]. Collectively, these studies provide a foundational framework for understanding how exercise fosters resilience and highlight the value of interdisciplinary approaches in promoting health and well-being across the lifespan []. Despite the prevailing evidence supporting the positive impact of exercise on psychological resilience, significant limitations and knowledge gaps persist in this field of research. First, existing research often adopts a narrow focus, either concentrating on specific types of physical activity or being confined to particular populations (e.g., athletes), thereby lacking systematic comparisons and evaluations of the effects of different exercise intervention programs []. Second, the absence of a consensus on the definition and measurement of psychological resilience introduces theoretical inconsistencies. This conceptual ambiguity contributes to heterogeneity across studies, complicating the direct comparison and synthesis of findings []. Particularly critical is the insufficient and unsystematic examination of key variables that may significantly moderate the effects of exercise interventions. These variables include intervention duration and intensity, participant age and developmental stage, and the type of study design employed. For instance, it remains unclear whether the effects differ between short-term and long-term interventions, whether the same intervention yields consistent effects across children, adolescents, and older adults, and whether different study designs introduce systematic bias in effect size estimations. The inadequate understanding of these moderating factors severely constrains the precise optimization and personalized implementation of exercise interventions and impedes the advancement of relevant theoretical models.