Evidence of worksite physical exercise training to promote health in jobs ranging from low to high occupational physical demands

Transcription

1 Evidence of worksite physical exercise training to promote health in jobs ranging from low to high occupational physical demands Gisela Sjøgaard Professor Institute of Sport Science and Clinical Biomechanics Faculty of Health Sciences University of Southern Denmark

2 Introduction Conflicting results have been presented regarding the effectiveness of worksite physical exercise training on health promotion This is true within jobs with low as well as high occupational physical demands Evidence is in particular lacking for jobs with high loads 2

3 Methods In Denmark several research groups combined forces conducted 9 studies with RCT design using the same basic intervention of offering One hour per week supervised physical exercise training at the worksite during working hours according to the concept Intelligent Physical Exercise Training that is based on evidenced sports sciences training principles tailored to work exposure, employee health, and physical capacity The studies enrolled ~ 2500 workers, lasted wks Questionnaire surveys and health checks were performed at baseline and follow-up. 3

4 The interventions

5

6 Dynamic resistance training

7 Bicycle exercise

8 Strengthening exercises: Reverse flyers Shrugs Static pull in 8 directions Endurance exercises: ( Bodyblade 8

9 Individual exercise protocol 3 exercises per body region

10 The job groups included: Methods office workers, computer workers, industrial technicians, cleaning personnel, health care workers, construction workers, fighter pilots. 10

11 Results: Musculoskeletal disorders I Neck pain was reduced among office and computer workers, industrial technicians, health care workers fighter pilots Andersen LL, Kjaer M, Søgaard K, Hansen L, Kryger A and Sjøgaard G. Arthritis Rheum 59: 84-91, Blangsted AK, Søgaard K, Hansen EA, Hannerz H and Sjøgaard G. Scand J Work Environ Health 34: 55-65, Zebis MK, Andersen LL, Pedersen MT, Mortensen P, Andersen CH, Pedersen MM, Boysen M, Roessler KK, Hannerz H, Mortensen OS and Sjogaard G. BMC Musculoskelet Disord 12: 205, Christensen JR, Faber A, Ekner D, Overgaard K, Holtermann A, Søgaard K. BMC Public Health. Aug 27;11:671, 2011 Lange B, Toft P, Myburgh C, Sjøgaard G. Clin J Pain, 29: 50-59,

12 Results: Musculoskeletal disorders II Hand, forearm, or elbow pain was reduced among office and computer workers industrial technicians Andersen LL, Christensen KB, Holtermann A, Poulsen OM, Sjøgaard G, Pedersen MT and Hansen EA. Man Ther 15: , Andersen LL, Jakobsen MD, Pedersen MT, Mortensen OS, Sjogaard G and Zebis MK. BMJ Open 2: e000412, Low back pain was reduced among office and computer workers Pedersen MT, Blangsted AK, Andersen LL, Jorgensen MB, Hansen EA and Sjogaard G. J Occup Environ Med 51: ,

13 Results: Cardio-metabolic risk indicator Increased aerobic capacity (absolute/relative) Office and computer workers Pedersen MT, Blangsted AK, Andersen LL, Jorgensen MB, Hansen EA and Sjogaard G. J Occup Environ Med 51: , Health care workers Christensen JR, Faber A, Ekner D, Overgaard K, Holtermann A, Søgaard K. BMC Public Health. 11:671, 2011 Construction workers Gram B, Holtermann A, Sogaard K and Sjogaard G. Scand J Work Environ Health 38: ,

14 Results: Other physical capacities Increased muscle strength office/computer workers cleaners Pedersen MT, Blangsted AK, Andersen LL, Jorgensen MB, Hansen EA and Sjogaard G. J Occup Environ Med 51: , Improved balance control cleaners Jorgensen MB, Ektor-Andersen J, Sjogaard G, Holtermann A and Sogaard K. BMC Public Health 11: 776,

15 Results In all job groups significant improvements were documented regarding health outcomes and/or health risk indicators. The improvements were in the order of % and considered of clinical relevance These outcomes were job group specific and dependent on the individual training program 15

16 Discussion Three essential factors characterized these interventions which made them distinct from a number of unsuccessful interventions: 1) Physical exercise training was performed during working hours one hour per week, usually divided into 2-3 training sessions. Regular adherence was only ~ 60% (31 86) 2) Sports exercise training specialists were involved in designing specific exercise training programs individually for each job group, they were evidence based and of general high intensity. Supervision of training performance quality is expensive 3) Training sessions were regularly supervised by expert trainees in the field, training diaries filled in, and adherence was monitored. Self-monitoring features can increase motivation 16

17 Take home message It is remarkable that in every study group outcomes of improved health were documented and the effect sizes were of clinical relevance. It is concluded that worksite exercise training does enhance health if a program with evidenced efficacy is implemented by expert trainees with support of the employer. Preliminary cost effectiveness estimates indicate acceptable cost relative to societal savings on health expenses. 17