Changes in Physical Activity Behaviour and Health Risk Factors Following a Randomised Controlled Pilot Workplace Exercise Intervention

The MedXFit-study - CrossFit as a workplace health intervention: a one-year, prospective, controlled, longitudinal, intervention study

Introduction

Workplace health interventions aim to motivate employees toward healthy behaviors to improve fitness and health in the long-term. We investigated whether CrossFit® is an effective training concept to achieve these goals in inactive employees with sedentary occupations.

Methods

The study followed a prospective, controlled intervention design. Employees were invited to participate in intervention group (IG) or control group (CG) on their own preferences. Inclusion criteria were a predominantly sedentary occupation and execution of less than two muscle and/or mobility enhancing training sessions per week at the time of enrolling. The IG did at least two times a week a CrossFit training of 1 h. Mobility, strength, well-being, and back-issues were measured at the beginning, after 6, and 12 months. Participants in the CG were free to choose any other activities offered at the same time (e.g., circuit training, meditation, full body stability training). Adherence, respectively, behavioral change and maintenance qualities were evaluated based on the COM-B system and presence of behavior maintenance motives.

Results

89 employees were enrolled into the trial, from where 21 dropped out due to external factors (24%). From the remaining participants, 10 out of 39 (26%) in the IG and 1 out of 29 (4%) in the CG stopped for intrinsic reasons, leading to a non-adherence to the intervention of 22 percentage points. Motivation for behavioral change and maintenance in the IG was primarily driven by enhanced physical and psychological capability. Development of physical capability was evident by significant improvements (p < 0.001) in the IG compared to the CG for mobility (d = 3.3), maximal isometric strength (min. d = 1.7, max. d = 2.5), as well as reduction in pain intensity (p = 0.003, r = 0.4) and frequency (p = 0.009, r = 0.35) after 12 months. Significant improvements between the 6-month and the 12-month measurement in mobility and 6 out of 8 strength measures within the IG indicated the effectiveness of CrossFit beyond the beginner phase.

Conclusion

CrossFit is a motivating training concept that led to long-term health and fitness improvements in inactive employees doing sedentary work and should be given greater consideration in workplace health promotion.

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.

CrossFit Motivates a 41-Year-Old Obese Man to Change His Lifestyle and Achieve Long-Term Health Improvements: A Case Report

The purpose of this case report was to demonstrate how CrossFit (CF) as a workplace health intervention (WHI) led to long-term lifestyle changes and health improvements in an inactive, sedentary individual. Therefore, we analysed the case of a 41-year-old obese man (BMI: 41.3 kg/m²) with elevated blood pressure and poor fitness. To evaluate the factors that facilitated his behavioural change, we collected quantitative and qualitative data (from 2015 to 2022) and analysed it based on the COM-B framework. Given the already great training opportunities at his workplace, we assumed that improvements in capability and motivation led to behavioural change and maintenance. Essential for this behavioural change was the fact that CF combined health-promoting training with intrinsically motivating aspects which are typical for classic sports such as challenge, a feeling of competence, and social interaction. In conjunction with rapid fitness improvements (capability), a positive feedback cycle between capability, motivation, and behaviour developed which enabled physical activity to become habitual. As a result, blood pressure was normalized, BMI (32.9 kg/m²) and resting heart rate decreased (-20 bpm), and mobility (FMS score: +89%), strength (+14 to 71%), and well-being (WHO-5 score: +12%) increased. In conclusion, CF should be considered an effective, efficient, and safe WHI with great potential for behavioural changes and maintenance.

How do previously inactive individuals restructure their time to ‘fit in’ morning or evening exercise: a randomized controlled trial

The objective of this study was to investigate changes in sedentary and active behaviors when previously inactive adults start exercising in the morning or evening. One-hundred adults with overweight or obesity (BMI ≥ 25 kg/m2) were recruited for a 12-week intervention and randomized to one of three groups: (i) morning exercise (AMEx; 0600–0900); (ii) evening exercise (PMEx; 1600–1900); or (iii) waitlist control. AMEx and PMEx were prescribed self-paced aerobic exercise to achieve a weekly total of 250 min via a combination of supervised and unsupervised training. Sedentary and active behavior times were measured at baseline, mid- and post-intervention using the multimedia activity recall for children and adults. Time spent engaging in physical activity was significantly increased from baseline at both mid- (+ 14–22 min·day−1) and post-intervention (+ 12–19 min·day−1), for AMEx and PMEx. At 12-weeks, participants in both morning and evening exercise groups reported increased time spent Sleeping (+ 36 and + 20 min·day−1, respecitively), and reduced time spent watching TV/playing videogames (− 32 and − 25 min·day−1, respectively). In response to an exercise stimulus, previously inactive adults make encouraging modifications in how they use their time, and the patterns of change are similar with morning and evening exercise.

Workplace interventions for increasing physical activity in employees: A systematic review

Background

There is scattered evidence of the impact of workplace interventions in improving employees' physical activity. This systematic review was performed to evaluate the strategies of workplace interventions and their effectiveness, as reported in primary studies.

Method

Primary experimental trials, both randomized controlled trials (RCTs) and non‐RCTs, which examined interventions to increase healthy adult employees' physical activity were included in this review. Studies in English or Persian published between 2009 and 2019 with access to full text of resources were considered. Google Scholar, PubMed, Web of Science, Scopus and Cochrane Library, ProQuest (Thesis) and World Health Organization Clinical Trial Registration Databases and Persian databases such as SID, Magiran, IranMedex, Irandoc were searched. All the stages of review were conducted based on PRISMA. RoB and ROBINS‐I were used to assess the risk of bias of the primary studies.

Results

Thirty‐nine studies, with a total of 18 494 participants, met the inclusion criteria. Of these, 22 were RCTs, 17 were non‐RCTs. Effective interventions were reported in 15 RCTs and 14 non‐RCTs. Four main strategies of interventions were identified, consisting of motivation and support; monitoring and feedback; information and education; and activity. Thirteen different behavior change techniques (BCT) were identified with self‐determination theory (SDT) being the most frequent behavior change theory used.

Conclusion

It seems that a multi‐strategy intervention that one of the strategies of which is physical activity in the workplace (Activity), the use of behavioral change theories, especially SDT, may be indicative of a more effective intervention. It is recommended that BCTs be considered when designing physical activity interventions.

Does the Time-of-Day of Exercise Influence the Total Volume of Exercise? A Cross-Sectional Analysis of Objectively Monitored Physical Activity Among Active Individuals

BACKGROUND

To improve compliance and adherence to exercise, the concept of temporal consistency has been proposed. Before- and after-work are periods when most working adults may reasonably incorporate exercise into their schedule. However, it is unknown if there is an association between the time-of-day that exercise is performed and overall physical activity levels.

METHODS

Activity was assessed over 1 week in a sample of 69 active adults (n = 41 females; mean age = 34.9 [12.3] y). At the end of the study, participants completed an interviewer-assisted questionnaire detailing their motivation to exercise and their exercise time-of-day preferences.

RESULTS

Participants were classified as "temporally consistent" (n = 37) or "temporally inconsistent" (n = 32) exercisers based on their accelerometry data. The "temporally consistent" group was further analyzed to compare exercise volume between "morning-exercisers" (n = 16) and "evening-exercisers" (n = 21). "Morning-exercisers" performed a greater volume of exercise than "evening-exercisers" (419 [178] vs 330 [233] min by self-report; 368 [224] vs 325 [156] min actigraph-derived moderate to vigorous physical activity, respectively).

CONCLUSIONS

Our findings suggest that active individuals use a mixture of temporal patterns to meet PA guidelines. Time-of-day of exercise should be reported in intervention studies so the relationship between exercise time-of-day, exercise behavior, and associated outcomes can be better understood.