Association between university aerobics course enrollment and changes in health-related physical fitness among college students: a retrospective cohort study.

Background: University aerobics is widely offered, but evidence comparing its real-world fitness outcomes with standard physical education (PE) using institutional records is limited. We examined whether enrollment in university aerobics was associated with greater 12-week improvement in health-related physical fitness than enrollment in standard PE and whether attendance was associated with fitness change. Methods: This retrospective cohort study used PE, attendance, and fitness-testing records for 240 undergraduates (120 aerobics, 120 standard PE), randomly sampled at 30 students per class from eight existing class sections (four aerobics and four standard PE). Week-0 and week-12 post-session measurements of vital capacity, 50-m sprint, sit-and-reach, standing long jump, sex-specific endurance run, and BMI were used to construct a sex-standardized composite fitness Results: The adjusted follow-up composite fitness score was 0.274 points higher in the aerobics group than in the standard PE group (cluster-robust 95% CI [0.225, 0.323]; Conclusion: Enrollment in the studied aerobics sections was associated with greater fitness improvement than enrollment in the available standard PE sections. Because course enrollment was non-randomized, only eight sections were available, the comparison condition was incompletely characterized, and relevant pre-exposure confounders were unavailable, the findings should be considered hypothesis-generating rather than causal.