Health and Fitness Benefits But Low Adherence Rate: Effect of a 10-Month Onsite Physical Activity Program Among Tertiary Employees

Impact of a Self-Autonomous Evaluation Station and Personalized Training Algorithm on Quality of Life and Physical Capacities in Sedentary Adults: Randomized Controlled Trial

BACKGROUND

Physical inactivity is a major risk factor for noncommunicable diseases and a leading cause of premature death. The World Health Organization (WHO) recommends at least 150 minutes of moderate intensity physical activity (PA) weekly, regardless of age, gender, or personal habits. However, in both sports performance and clinical settings, personalized training (PT) regimens have shown superior efficacy over general guidelines.

OBJECTIVE

We hypothesized that an automatic PT program, informed by initial physical evaluations, would increase overall quality of life, quality of sleep, and physical capabilities and reduce fatigue and depression compared with adherence to WHO recommendations.

METHODS

This 5-month, randomized, single-blinded controlled trial involved 112 sedentary or minimally active participants, divided randomly into PT and free training (FT) groups. Physical capabilities and subjective measures such as quality of life, sleep, depression, and fatigue were evaluated for both groups. After 1 month, both groups were asked to perform 150 minutes of PA per week for 4 months; the PT group could either follow a "virtual coach" on a mobile app to follow some personalized PA or do what they would like, while the FT group was to follow the general PA recommendations of the WHO.

RESULTS

We did not find any group×time interaction for PA duration or intensity, physical qualities, and subjective measures. However, considering both groups together, there was a significant pretest and posttest time effect for duration of PA (18.2 vs 24.5 min/d of PA; P<.001), intensity (2.36 vs 3.11; P<.001), and workload (46.8 vs 80.5; P<.001). Almost all physical qualities were increased pretest and posttest (ie, estimated VO2max 26.8 vs 29 mL min-1 kg-1; P<.001; flexibility 25.9 vs 26.9 cm; P=.049; lower limb isometric forces 328 vs 347 N m; P=.002; reaction time 0.680 vs 0.633 s; P<.001; power output on cyclo-ergometer 7.63 vs 7.82 W; P<.003; and balance for the left and right leg 215 vs 163 mm2; P<.003 and 186 vs 162 mm2; P=.048, respectively). Finally, still considering the PT and FT groups together, there were significant pretest to posttest improvements in the mental component of quality of life using the 12-item Short Form Health Survey (41.9 vs 46.0; P<.006), well-being using the Warwick-Edinburgh Mental Well-Being Scale (48.3 vs 51.7; P<.002), depression using the Center for Epidemiologic Studies Depression Scale (15.5 vs 11.5; P=.02), and fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (37.1 vs 39.5; P=.048).

CONCLUSIONS

The individualized training was not more effective than the general recommendations. A slight increase in PA (from 18 to 24 min/d) in sedentary or poorly active people is enough for a significant increase in physical capabilities and a significant improvement in quality of life, well-being, depression, and fatigue.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04998266; https://clinicaltrials.gov/study/NCT04998266.

Dropout and compliance to physical exercise in menopausal osteopenic women: the European "happy bones" project

Introduction

Decline in muscle mass and bone density seem to be two of the most disabling side effects of menopause that negatively affect women's quality of life. Promoting physical activity protocols in the workplace can represent a focal point in the prevention and management of several diseases. The study aims to evaluate the compliance and drop-out of menopausal osteopenic women engaged in combined training performed inside and outside the workplace. Strength and balance were analyzed to evaluate the effect of this protocol on osteoporosis prevention and the risk of falling.

Methods

73 menopausal women were enrolled in 5 European countries. They performed 72 lessons of a combined training proposed in the working place (IW) or sport center (SC).

Results

Out of the total 39 women enrolled in the IW, 12.8% had to leave the program, while out of the 34 women enrolled in SC, 41.2% did not complete the training. According to the compliance results, 47% of women that completed the trained IW and 85% in the SC recorded high compliance (p = 0.019). Moreover, the strength of the lower limbs (p < 0.001) and static balance (p = 0.001) significantly improved in the whole group.

Discussion

In conclusion, proposing well-structured training in the workplace for menopausal women seems to reduce drop-out. Strength and balance results suggest its positive impact on bone health and risk of falls, despite where it is performed.

The effects of green space and physical activity on muscle strength: a national cross-sectional survey with 128,759 Chinese adults

Background

Muscle strength is closely related to chronic noncommunicable diseases; specifically, a decline in handgrip strength (HS) is predominant globally. Exposure to green space-built environment components used for health intervention-reportedly decreases the risk of certain diseases and all-cause mortality. However, evidence in this area is limited.

Objective

We aimed to explore the association between green space exposure and muscle strength and ascertain the combined effect of physical activity and green space exposure on muscle strength.

Method

Data from 128,759 participants (aged 20-79  years) were obtained using a complex stratified multistage probability cluster sampling design. The green space was assessed as normalized difference vegetation index (NDVI) data for a 500-m buffer zone based on the geolocation information of sampling sites. We used a questionnaire to investigate transportation, occupation, physical activity, leisure-time exercise behaviors, and sedentary time within a usual week of the preceding year. The outcome was low relative HS, defined as HS-to-body weight ratio, and the percentage of men and women with relative HS in the lower third. We defined adequate physical activity as 150  min of moderate-intensity or 75  min of vigorous physical activity per week and calculated the weighted proportion of participants with insufficient physical activity. Categorical variables of NDVI and physical activity were used as exposure variables and their interrelationship was evaluated in a generalized linear mixed model (GLMM) to estimate the odds ratios (ORs) and 95% confidence intervals (95% CI). We measured interaction on an additive or multiplicative scale using a GLMM to test the interaction between green space exposure and physical activity. All analyses were performed for the total sample and subgroups (urban and rural).

Result

The high NDVI group had a lower risk of low relative HS than the low NDVI group (OR [95% CI]: 0.92 [0.88-0.95]). The sufficient physical activity group had a lower risk of low relative HS than the insufficient physical activity group (OR [95% CI]: 0.85 [0.81-0.88]). There was an interactive effect on the additive scale (relative excess risk owing to interaction: 0.29, 95% CI 0.22-0.36, p < 0.001) between green space exposure and physical activity.

Conclusion

High NDVI and adequate physical activity were protective factors against low relative HS in Chinese adults. Increasing green space exposure and physical activity together may have a greater potentiating effect on muscle strength improvement than these two protective factors individually. Green spaces should be incorporated into city design or built environments.

An Enjoyable Workplace Combined Exercise Program for Health Promotion in Trained Employees: Yoga, Pilates, and Circuit Strength Training

Corporate wellness has become an important public health priority through the designing and implementation of different workplace exercise interventions. The objectives of this study were to investigate: (a) the effectiveness of a 4-month workplace combined yoga, Pilates, and circuit strength training program (outside work shift) on health indices, functional capacity, and physical fitness in office employees; and (b) the employees' enjoyment following the program. Fifty physically active office employees (26-55 years old) were equally divided into training (TG) and control groups (CG). The TG followed a 4-month (3 times/week, 50-60 min/training) combined yoga, Pilates, and circuit strength training program. Health indices (body composition, body mass, circumferences, musculoskeletal pains), functional capacity (flexibility, balance), and physical fitness (strength, aerobic capacity) were measured before and after the 4-month time period. After the completion of the program, the TG participants' enjoyment was assessed. The TG significantly improved (p < 0.001) all health, functional capacity (11.3-82.0%), and physical fitness indices (33.9%), except for aerobic capacity, which did not change (p > 0.05). Furthermore, a great percentage of employees (84%) reported high levels of enjoyment. This program could be effectively and safely used in workplace settings as an enjoyable intervention to improve specific health, functional capacity, and physical fitness indices in office employees.

Cognitive work on a walking desk does not lead to compensatory appetitive responses in healthy young adults

CONTEXT

In addition to the low energy expenditure induced by sedentary behaviors such as sitting, it has been shown that intense cognitive work can lead to an increase in food intake. Walking Desk provide the opportunity for office workers to replace prolonged sitting at work with light intensity physical activity.

OBJECTIVE

To compare the effects of sitting vs standing vs walking during a cognitive task on energy intake, appetite sensations, food reward and overall energy balance.

METHODS

Fifteen normal weight (BMI: 24.1 ± 1.2 kg m-2) young men (23.4 ± 2.1 years) randomly performed three conditions: sitting desk (SitD), standing desk (StD) and walking desk (WD), while performing a 45-min cognitive task. Energy expenditure was measured by indirect calorimetry, regular appetite sensations were assessed using visual analogue scales, energy intake measured during an ad libitum meal and the relative energy intake calculated. Pre and post-test meal food reward was evaluated through the Leeds Food Preference Questionnaire.

RESULTS

Relative energy intake decreased by 150 kcal in WD compared with SitD, however it did not reach statistical significance. There were no differences in appetite sensations nor food reward between the three conditions. Energy expenditure was significantly higher in WD (141.8 ± 13 kcal) than in SitD (78.7 ± 5 8 kcal) and StD (85.9 ± 8 kcal) (p ≤ 0.05).

CONCLUSION

Walking desk use can decrease sedentary time while working without any appetitive compensation. The small reduction in energy balance with walking while working could induce significant health benefits if repeated over time. Future longer studies need to clarify whether active desks can contribute to the prevention or management of weight gain.

Aqua Walking as an Appropriate and Healthy Winter and Summer Physical Practice? An Exploratory Study

(1) Background: Aqua-walking in a natural environment is a health promoting physical activity that is gaining popularity and appropriate for a variety of populations, however, to date, there is little scientific evidence supporting the efficacy and safety of this activity for older adults. The objective was to propose a preliminary exploration of psychometric and metabolic responses to an acute Aqua walking session either during winter or summer in older adults Aqua walking exercisers. (2) Methods: Heart rate, body temperature, glycemia, and blood pressure were monitored in 37 (30 women, 7 men) participants aged 52 to 83 years old in two Aqua walking sessions (water at 13 °C and 18.5 °C, respectively). Anthropometry (body weight, waist, and hip circumferences), body composition, physical activity level, sedentary time, sleep quality, quality of life, physical self-perception, and perceived health and feelings on various parameters were also assessed. (3) Results: Present results revealed a greater quality of life, physical self-perception, and perceived health in aging Aqua walking exercisers compared to those found in the literature in younger populations. None of the metabolic or psychometric measurements were found to be different between classically calibrated Aqua walking sessions performed in winter compared to summer. By contrast, there was a time effect during the sessions for body temperature (p < 0.001), SBP (p = 0.17), perceived mental and physical well-being (p = 0.006 and p < 0.001, respectively), and anxiety (p < 0.001). Leg discomfort also showed a time effect (p = 0.0009) and interaction effect (p = 0.025). (4) Conclusion: Aqua walking appears here to be an accessible practice that can be performed all year long with a range of physical and mental benefits for older adults. Future studies should investigate the metabolic responses of Aqua walking in different populations.

Association between relative handgrip strength and hypertension in Chinese adults: An analysis of four successive national surveys with 712,442 individuals (2000-2014)

OBJECTIVES

This study aimed to identify the 15-year trends of handgrip strength-to-weight (relative HS) and assess the association between relative HS and hypertension among Chinese adults aged 20-69.

METHODS

Using a complex, stratified, multistage probability cluster sampling, we analyzed data collected from 712,442 adults aged 20-69 years in four successive national surveys (2000-2014). We used a handheld dynamometer to measure strength and divided by body weight to calculate the relative HS. Blood pressure was recorded with a sphygmomanometer and hypertension was defined as resting systolic blood pressure at least 140 mmHg or diastolic at least 90 mmHg. The Mann-Kendall trend test examined trends in relative HS over time. We also computed odd ratios (OR) and 95% confidence intervals (95% CI) by tertile of relative HS and examined the association between relative HS and hypertension.

RESULTS

The relative HS level decreased with the increase of age in both male and females (p trend <0.001). In each of four surveys, one interquartile decrease in relative HS was associated with an increased risk of hypertension by 44% (OR = 1.44, 95%CI: 1.40-1.47), 58% (OR = 1.58, 95%CI: 1.54-1.62), 48% (OR = 1.48, 95%CI: 1.45-1.52), 43% (OR = 1.43, 95%CI: 1.40-1.47), respectively.

CONCLUSION

In the Chinese adult population, the relative HS level decreased from 2000 to 2014 across all ages in both males and females. A lower relative HS was associated with a higher risk of hypertension. The findings provided evidence for the association between muscle strength and hypertension in large-scaled population.

Effects of cycling workstation to get tertiary employee moving on their overall health: study protocol for a REMOVE trial

BACKGROUND

Sedentary behaviour (SB) and low levels of physical activity (PA) are predictors of morbidity and mortality. Tertiary employees spend a considerable amount of their daily time seated and new efficient strategies to both reduce sedentary time and increase physical activity are needed. In that context, the REMOVE study aims at evaluating the health effects of a 24-week cycling desk intervention among office workers.

METHODS

A prospective, open-label, multicentre, two-arm parallel, randomized controlled trial (RCT) will be conducted in office-sitting desk workers. Office workers (N = 80) who have 0.8 full time equivalent hours (FTE) and 75% of this time in a sitting position will be recruited from tertiary worksites in Clermont-Ferrand, France. Subjects will be randomly assigned to one of the two following interventions: (i) PPM6: performance of two 30 min of cycling desk (using portable pedal exercise machine-PPM) per working day for 6 months or (ii) CTL_PPM3: 3 months with no intervention (control) followed by 3 months during which workers will be asked to complete two 30 min of PPM per working day. At baseline (T0), at 3 months (T1) and at 6 months (T2) after the start of the interventions, primary outcomes; 7-day PA and SB (3D-accelerometers), secondary outcomes; body composition (bioelectrical impedance), physical fitness (aerobic fitness, upper and lower limb strength), metabolic outcomes (fasting blood samples), self-perceived stress, anxiety, quality of life at work and job strain (questionnaires), tertiary outcomes; resting metabolic rate and cycling energy expenditure (indirect calorimetry) and eating behaviours (questionnaires) will be measured. An ergonomic approach based on observations and individual interviews will be used to identify parameters that could determine adherence.

DISCUSSION

The REMOVE study will be the first RCT to assess the effects of cycling workstations on objectively measured PA and SB during working and non-working hours and on key physiological and psychological health outcomes. This study will provide important information regarding the implementation of such cycling workstations in office workers and on the associated potential health benefits.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04153214 . Registered on November 2019, version 1.

Health-Promoting Effects of a Concurrent Workplace Training Program in Inactive Office Workers (HealPWorkers): A Randomized Controlled Study

PURPOSE

To the best of our knowledge, no previous study has examined the health-promoting effects of a daily supervised concurrent workplace training program in inactive office workers. The main objective of this study was to examine the effectiveness of a 6-month workplace training program on health indices, musculoskeletal pains, functional capacity, and physical fitness in office workers.

DESIGN

Randomized controlled study.

SETTING

Four workplaces in the Region of Thessaly, Greece.

PARTICIPANTS

A total of 36 office workers (≥6 hours/d, 5 days/wk) were randomly assigned to either a training group (TG; n = 18) or a control group (CG; n = 18).

INTERVENTION

The TG participated, every working day, in a 6-month supervised concurrent (flexibility, strength, balance, aerobic) training program (120 training sessions, 2 workouts/d of 15-20 minutes) that was implemented, in small groups, at the workplace during the work shift. The CG did not participate in any training.

MEASURES

Health indices (body composition, blood pressure, respiratory function), musculoskeletal pains, functional capacity (flexibility, balance), and physical fitness (maximal strength, cardiorespiratory fitness) were measured before and after the completion of the program. After the completion of the program, participants' enjoyment was assessed.

ANALYSIS

Two-way analysis of variance (group × time) with repeated measures on the "time" factor.

RESULTS

The statistical power, for all parameters, ranged from 0.85 to 0.94. Training group significantly increased lean body mass (3.81%); respiratory function (4.20%-4.53%); cervical, handgrip, back, and leg maximal strength (8.75%-26.55%); and functional capacity (19.71%-188.20%; P < .001-.01; Cohen's effect size: 0.80-7.21), while significant reductions were observed on body fat (7.58%), blood pressure (4.99%-8.05%), heart rate (12.80%), and musculoskeletal pains (33.33%-100%; P < .001; Cohen's effect size: 0.81-6.21). In CG, all the above variables did not change. Furthermore, a great percentage of workers (94.4%) reported high levels of enjoyment.

CONCLUSION

The program "HealPWorkers" is an enjoyable exercise modality that may be safely and effectively used, to work settings, for the improvement of worker's health, overall fitness, and functional capacity.

Eccentric Cycling Training Improves Health-Related Quality of Life in Adolescents with Obesity

INTRODUCTION

While eccentric (ECC) training appears to be more efficient than concentric (CON) training at improving body composition in adolescent with obesity, its impact on health-related quality of life (HRQOL) has never been studied.

OBJECTIVE

The aim of this study is to compare the effects of 2 cycling training modalities, i.e., ECC vs. CON, in adolescents with obesity on HRQOL and health perception (HP).

METHODS

A total of 24 adolescents with obesity, aged 12-16 years, were randomized to either a 12-week ECC or a CON cycling training program performed at the same oxygen consumption (VO2). Anthropometric measurements, body composition, maximal incremental tests, HRQOL (Vécu et Santé Percue de l'Adolescent [VSP-A], Medical Outcome Study Short Form [SF-36]), and HP were assessed at before and after training.

RESULTS AND CONCLUSION

Both CON and ECC cycling trainings promoted significant improvements in BMI, VO2peak, total fat mass, and fat-free mass, with better improvements in body composition parameters in the ECC group (p < 0.05). The VSP-A total score increased after CON (p < 0.01) and ECC (p < 0.001) training, with better enhancement for the ECC group (p < 0.05). The SF-36 physical score increased after both CON (p < 0.01) and ECC (p < 0.001) trainings. The global HP score increased only after ECC training (p < 0.001). Except for the energy-vitality item, no significant correlation was found between changes in HRQOL and its subdomains and anthropometric, body composition, and functional parameters. Both ECC and CON cycling trainings are associated with positive changes in HRQOL and HP. However, ECC seems to induce greater improvements in HRQL and HP than CON cycling training, which is probably not due to the anthropometric, body composition, and functional changes.

Health-related quality of life and perceived health status of adolescents with obesity are improved by a 10-month multidisciplinary intervention

BACKGROUND

Although multidisciplinary weight management interventions have been shown effective in improving body composition and cardio-respiratory fitness, their effects on HRQOL and perceived health status remain uncertain in adolescents with obesity.

OBJECTIVE

To assess the impact of a 10-month multidisciplinary weight management intervention on HRQOL and health perception in adolescents with obesity, exploring whether these changes were associated with changes in body weight and body composition.

METHODS

Thirty-six adolescents with obesity (28 girls and 8 boys; mean age: 13 ± 1.32 years) enrolled in a multidisciplinary weight management intervention composed of nutritional counseling, physical activity and health-related therapeutic education. Validated self-report questionnaires were used to assess HRQOL (SF-36) and health perception (HP questionnaire) at baseline (T0) after5 months (T1) and after 10 month of intervention (T2). In addition, anthropometric parameters and body composition (DXA) were measured at T0, T1 and T2.

RESULTS

Items of the SF-36 significantly improved at T1 and T2, such as physical functioning (P < .01), general health (P < .01), physical (P < .001) and mental score (T1: P < .05, T2: P < .01). Dimensions of health perception improved significantly such as physical condition (P < .01 at T2), adiposity (P < .001 at T1 and T2), healthy balanced diet (P < .01 at T1 and P < .001 at T2), general health (P < .05), and perceived general health (T1: P < .01, T2: P < .001). Body weight, BMI, and fat mass (in Kg and in %) were significantly decreased (P < .001) at T1 and T2. No relationship was observed between variations of weight, BMI and Fat mass and variations of HRQOL and health perception.

CONCLUSION

A 10-month multidisciplinary weight-management intervention was associated with positive changes in HRQOL and perceived health status, which might not be explained by body weight and adiposity improvements.

Physical Activity, Inactivity, and Sedentary Behaviors: Definitions and Implications in Occupational Health

Based on the increasing evidence linking excessive sedentary behaviors and adverse health outcomes, public health strategies have been developed and constantly improved to reduce sedentary behaviors and increase physical activity levels at all ages. Although the body of literature in this field has grown, confusion still exists regarding the correct definition for sedentary behaviors. Thus, there is a need to provide a clear definition in order to distinguish sedentary behaviors from physical activity and inactivity. This paper will briefly review the most recent and accepted definitions of these concepts and illustrate their relationships. Nowadays, since most working adults spend a high proportion of their waking hours in increasingly sedentary tasks, there will be a particular focus on the field of occupational health. Finally, simple modifications in the workplace will be suggested in order to decrease sedentary behaviors.