Exercise is more than medicine: The working age population's well-being and productivity

Abstract

Background: Physical activity (PA) includes muscle activity during exercise, manual work, and leisure time activities including sport. Conflicting results exist regarding health effects of PA that may deteriorate with manual work and elite sports, but improve when performed in moderation in accordance with international guidelines and may additionally enhance well-being and productivity.

Methods: In Denmark 15 randomized controlled trials have been conducted, introducing exercise at the workplace enrolling >3500 workers. The interventions lasted from 10 to 52 weeks and offered ~1 h weekly supervised exercise during working hours according to the concept of intelligent physical exercise training (IPET) that is based on evidenced sports sciences training principles and tailored to work exposure, employee health status, and physical capacity. Questionnaire surveys and health checks including blood and muscle sampling were performed at baseline and follow-up. The job groups included: office and computer workers, dentists, industrial technicians, cleaning personnel, health care workers, construction workers, and fighter/helicopter pilots.

Results: In all job groups significant improvements were documented regarding health outcomes. These were job group specific: neck pain was reduced among office and computer workers, dentists, industrial laboratory technicians, health care workers as well as fighter pilots. Cardio-respiratory fitness-a health risk indicator for cardio-metabolic diseases-was improved among office and computer workers, health care workers, and construction workers. Additionally, other improvements were evidenced such as increased muscle strength and balance control. Importantly, productivity increased with improved muscle strength and decreased body mass index.

Conclusion: IPET does enhance health if an exercise program with evidenced efficacy is implemented by expert trainees with support of the employer. Accordingly, in every study group outcomes of improved health were documented and the effect sizes were of clinical relevance. Cost effectiveness estimates indicate acceptable cost relative to savings on health expenses and lost productivity.

Keywords: Physical activity; Physical exercise training; Workplace health promotion.

Fig. 1

Exercise is a specific subset of physical activity (PA) which for decades has been considered to provide health benefits irrespective of the site where it is performed.

Fig. 2

The contrasting effect of the muscle activation pattern was demonstrated by analysis of physical activity (PA) levels in the Danish National Work Environment Cohort. Drawn based on recalculated data from Ref. .

Fig. 3

Physiological measures for which cut-points were set for tailoring the individual physical exercise training categories that should be accomplished according to the programs. CRF = cardiorespiratory fitness; BMI = body mass index; LDL = low density lipoprotein; HDL = high density lipoprotein.

Fig. 4

The most common physical training exercises for the strength and functional training categories. The neck/shoulder exercises could be performed using elastic bands (shown in the figure—arrows showing direction of the force performed) or by using dumbbells. Likewise for the other exercises, resistance could be increased by using elastic bands or dumbbells additional to working against gravity on body weight segments. For the reverse flies the elastic band in the figure is attached to a door handle or the like approx. 40 cm from the hands.