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Health, Function, and Performance Benefits of Workplace Strength Training Programs

Pronk, Nico P. Ph.D., FACSM, FAWHP; Bender, Eric G. B.A.; Katz, Abigail S. Ph.D.

doi: 10.1249/FIT.0000000000000235
Columns: Worksite Health Promotion

Nico P. Pronk, Ph.D., FACSM, FAWHP, is vice president and chief science officer at HealthPartners in Minneapolis, MN, where he also is a senior research investigator at the HealthPartners Institute. Dr. Pronk is an adjunct professor of Social and Behavioral Sciences at the Harvard University School of Public Health, where he teaches and conducts research in worker health protection and promotion. He is past president of the International Association forWorksite Health Promotion (IAWHP), an ACSM affiliate society, coauthor of the IAWHP Online Certificate Course, editor of ACSM’s Worksite Health Handbook, 2nd Edition, and associate editor for the ACSM’s Health & Fitness Journal®.

Eric G. Bender, B.A., currently serves as the principal informatics analyst in the Health Promotion Department at HealthPartners in Minneapolis, MN. He has extensive experience with data systems in both the pharmaceutical and health care industries. As the lead informatics analyst, he uses his knowledge of health and well-being data sources within HealthPartners to aid the development and measurement of well-being programs offered to their clients.

Abigail S. Katz, Ph.D., performs health services research and analytics at HealthPartners in Minneapolis, MN. As analytics consultant, she leads strategic analytics and custom measurement initiatives for Health & Well-Being. In addition, she serves as research associate at the HealthPartners Institute, where her work focuses on population health improvement in employed populations and the association between organizational-level characteristics and individual-level health.

Disclosure: The authors declare no conflict of interest and do not have any financial disclosures.

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INTRODUCTION

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Physical activity has long been a mainstay for workplace health programs. Many companies have implemented walking campaigns, 10,000 Steps programs, exercise facilities and corporate gyms, and incentives for employees to engage in ongoing activities that allow them to adopt and maintain healthy levels of physical activity. The purpose of a physical activity program in the workplace traditionally has been about prevention and optimal management of chronic conditions such as heart disease, diabetes, and various forms of cancer. Hence, the emphasis has been on aerobic types of activity. However, one of the most prevalent conditions that affect workers is musculoskeletal disorders. Although general types of activity and exercise may prove helpful in addressing such chronic health issues, strength training has emerged as an effective tool to address a variety of health issues that burden workers. In particular, it seems to be helpful in alleviating musculoskeletal pain and may even be successful in reducing productivity loss while enhancing indicators of physical and emotional function.

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EVIDENCE OF EFFECTIVENESS FOR WORKPLACE-BASED STRENGTH TRAINING PROGRAMS

It has been observed that exercise performed against some type of resistance (and therefore considered strength training or muscle strengthening exercises) can have a positive impact on several health and fitness indicators. First and foremost, muscle strengthening exercises are effective in building strength and muscular endurance and this is, of course, one of the main outcomes to consider. Furthermore, and perhaps more importantly, workplace-based strength training programs also have been linked to evidence of effectiveness for the following outcomes (2–7):

  • Pain incidence (both short- and long-term effects for up to 3 years)
    • • Neck pain
    • • Shoulder pain
    • • Upper extremity pain
    • • Lower back pain
  • Blood pressure
  • Flexibility
  • Headache
  • Maintenance of work ability
  • Reduction in absenteeism.
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These outcomes seem to be especially strong when the exercises are performed among workers who are involved in sedentary work tasks and those who perform heavy physical tasks. In addition, outcomes seem to be strong when the muscle strengthening exercise sessions are supervised and when training periods are 10 weeks or longer with at least two sessions per week.

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A REAL-WORLD SCENARIO

One of the challenges associated with the implementation of programs at the workplace is the consideration that the leadership of the health and well-being program needs to be informed about the need, demand, and relevance of the program to be implemented among the employees. In other words, does this program adequately address the issue we are trying to solve? Hence, data and insights need to be [made] available so as to make such decisions; these include data about the population need as well as data about potential solutions to meet the need. Knowing what programmatic evidence exists helps identify those solutions that yield the most successful outcomes.

When it comes to workplace-based strength training, health assessments (HAs) may be used to get a feel for the need and potential impact of a strength training program. HA data may be used to consider whether beneficial outcomes are noted when comparing those who already engage in this activity against their less-engaged counterparts. According to the 2008 Department of Health and Human Services (DHHS) Physical Activity Guidelines for Americans, adults also should do muscle strengthening activities that are moderate or high intensity and involve all major muscle groups on 2 or more days a week because these activities provide additional health benefits. Therefore, employees engaged in muscle strengthening exercises may be defined as those who meet the DHHS recommendations of engaging in muscle strengthening exercises at least 2 days per week (1). See sidebar for examples of what type of exercises are included in muscle strengthening activities.

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A REAL-WORLD SCENARIO

To create a scenario based on a real-world application, we considered data from 10,956 HealthPartners employees who completed an HA in 2014 (HA response rate of 75%). The subjects in this data pool include only those who indicated on their HA that they did not have a disability that made it difficult for them to participate in strengthening exercises. The Table describes some descriptive characteristics categorized by the number of days per week they engaged in muscle strengthening exercises.

TABLE: De

TABLE: De

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MEANINGFUL WORKER AND COMPANY OUTCOMES

Whereas there may be lots of outcomes of interest to consider, we wanted to focus in on variables that relate to both the individual person and the larger organization. As a result, the indicators of choice included physical and emotional function, an indicator of general health, a productivity indicator, and the number of health risk factors present out of a list of 10 factors. The list to the right describes the variables briefly.

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Physical Function: We asked about the degree to which physical health concerns get in the way of the participant's life on a five-point scale with “1” being “not at all” and “5” being “completely.”

Emotional Function: We asked about the degree to which emotional health concerns get in the way of the participant's life on a five-point scale with “1” being “not at all” and “5” being “completely.”

General Self-Perceived Health Status: We asked participants the question: “in general, how's your health?” and rated them on a five-point scale from “1” being “excellent” to “very good” “2,” “good” “3”, “fair” “4”, and “5” being “poor.”

Work Productivity and Activity Impairment Scale (WPAI): We asked participants about the impact of their own self-perceived health and how it impacts their work. The WPAI generates a coefficient that can be converted to a percent of overall work impairment due to health-related issues. The lower the WPAI score, the lower the productivity loss.

Health Risk 10 (HR10): We asked participants about 10 well-accepted health risk factors and created high- and low-risk categories. Next, we counted, per individual, the number of high-risk factors they reported as being present — the lower the number of risks, the higher the level of health. The average HR10 is reported by group. The 10 risk factors considered include:

  • - Low physical activity
  • - Low consumption of fruits and vegetables
  • - Use of tobacco
  • - High-risk alcohol consumption
  • - Obesity
  • - Unhealthy sleep level
  • - Unhealthy stress/emotional health concerns
  • - Lower life satisfaction
  • - Poor self-perceived general health
  • - Self-reported health conditions (diabetes, heart disease, high blood pressure, high cholesterol).

The Figure shows the results and depicts that those who participated in strength training exercises on 2 or more days per week experienced higher levels of function (physical and emotional), self-perceived general health status, fewer health risk factors, and were more productive.

Figure

Figure

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CONCLUSIONS

Strength training has been shown to be effective for improving and sustaining health for working adults. In addition, workers who meet the DHHS guidelines for muscular strength tend to have healthier profiles than their nonstrength training counterparts. Benefits of such healthier profiles include higher levels of physical and emotional function, self-perceived general health status, and fewer health risk factors. Furthermore, higher levels of function seem to generate higher levels of productivity among such workers. As a result, both the worker and the company seem to benefit from behavioral strategies that encourage participation in muscle strengthening exercise on a regular basis. Finally, given that many exercises and activities are included in the definition of muscle strengthening activities, it may not be too difficult for most people to find ways to build strengthening activities into their daily routine. Even better, it may well be that some are already engaged in such exercises and should congratulate themselves on a job already well done!

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References

1. Andersen CH, Andersen LL, Gram B, et al Influence of frequency and duration of strength training for effective management of neck and shoulder pain: a randomized controlled trial. Br J Sports Med. 2012;46(14):1004–10.
2. Department of Health and Human Services. Physical Activity Guidelines for Americans. 2008. [cited 2016 April 20]. Available from: http://health.gov/paguidelines/guidelines/summary.aspx.
3. Gram B, Andersen C, Zebis MK, et al Effect of training supervision on effectiveness of strength training for reducing neck/shoulder pain and headache in office workers: cluster randomized controlled trial. Biomed Res Int. 2014;2014:693013.
4. Mortensen P, Larsen AI, Zebis MK, Pedersen MT, Sjogaard G, Andersen LL. Lasting effects of workplace strength training for neck/shoulder/arm pain among laboratory technicians: natural experiment with 3-year follow-up. Biomed Res Int. 2014;2014:845851.
5. Pedersen MT, Andersen CH, Zebis MK, Sjogaard G, Andersen LL. Implementation of specific strength training among industrial laboratory technicians: long-term effects on back, neck and upper extremity pain. BMC Musculoskeletal Dis. 2013;14:287.
6. Sundstrup E, Jakobsen MD, Brandt M, et al Workplace strength training prevents deterioration of work ability among workers with chronic pain and work disability: a randomized trial. Scan J Work Environ Health. 2014;40(3):244–51.
7. Zavanela PM, Crewther BT, Lodo L, Florindo AA, Miyabara EH, Aoki MS. Health and fitness benefits of a resistance training intervention performed in the workplace. J Strength Cond Res. 2012;26(3):811–7.
© 2016 American College of Sports Medicine.