Does your place of work provide a staff exercise service to boost productivity and reduce sickness?
The workplace is often a place where people sit for long periods of time with less than ideal ergonomic set ups. This is often exacerbated by hot desking and recent changes to working arrangements because of the pandemic.
Daily exercise is a solution to combating the negative effects of a sedentary lifestyle but also to the consequences of office-based work on musculoskeletal health.
We don’t know what type/frequency/intensity/duration is most effective for improving workplace health and reducing sickness but a new systematic review published in BMJ Open has set out to do just that.
This systematic review adhered to PRISMA guidance with the protocol being published in BMJ Open in 2020. This review included RCTs published in English or Spanish between the start of 2010 and end of 2020 which met the following criteria:
- involved at least one exercise based intervention at work
- the entire sample was office workers spending the majority of their work time sitting
- evaluated MSK disorders or pain in all body regions or specific areas of the body
Studies where the intervention is a ‘sit-to-stand’ desk or guidelines of ergonomics and health education without exercise were excluded.
The search took place on five data bases and included MeSH terms and keywords related to office workers, MSK pain and exercise interventions. The details are available in the protocol.
Abstracts and articles were reviewed in pairs using the software tool COVIDENCE with data extracted using the Cochrane Handbook for Systematic Reviews of Interventions recommendations. Risk of bias was assessed using the ROB 2 tool and disagreement about inclusion and risk of bias was agreed by consensus.
A total of seven articles were included within the review which involved a total of 967 participants. The sample sizes of included studies ranged from 30 to 549. All studies had a ‘high-risk’ of bias due to inability to blind assessors/participants. Outcome data was also a cause for concern with clear bias in the measurement and reporting.
Interventions in the included studies varied greatly from 10 – 15s of stretching every 6 mins during work hours to up to 1 hour of strengthening exercises with 2-3 sets of 10-15 reps combined with 5s of static neck stretched once a week. Other studies combined stretching and strengthening with 2.5 sessions a week of 15mins of vibration training.
On the whole there was a variety of stretching and strengthening exercises, predominantly focussing on core and upper body, used by the studies. The majority of studies investigated the medium and long term effects of the interventions with a couple looking at acute affects including a single day. The longest follow up was 1 year.
Effectiveness in Reducing MSK Disorders in Multiple Body Regions
Three studies specifically evaluated the effects of exercise on multiple body sites all of which focussing predominantly on stretching of the upper body. Pain intensity was reduced across all three studies with the most benefit occurring four months into the intervention.
Regards duration and frequency of exercise it appears that stretching of the upper limb and spine for 20 minutes three times a week appears affective at reducing pain across multiple-body sites.
Effectiveness of Exercise in reducing MSK Pain in the Neck and Shoulders
Two studies specifically evaluated neck and shoulder pain which showed mixed results. There doesn’t appear to be a significant benefit of stretching when it comes to improving neck and shoulder pain however taking regular breaks does.
Strengthening exercise do appear to be more effective than stretching at improving pain in the neck and shoulders when looking at similar systematic reviews.
Effectiveness of Workplace Interventions in Reducing Low Back Pain
Two studies concluded positive effects in reducing low back pain however there was no consistency on which type of exercise was most beneficial. One study included a 9-min daily route of stretch, strength and mobility exercises across 9 months whereas another included whole body vibration training.
It wouldn’t be too much of a logic-jump to assume that, as with the majority of back pain, any form of physical activity is beneficial in improving back pain. couple this with regular breaks and education then it’s likely to be even more beneficial.
Overall the results of this systematic review suggest work place exercise interventions can effectively reduce musculoskeletal disorders in different body regions. However the overall quality of study and lack of consistency in approach means firm conclusions can’t be made about what type/frequency/duration/intensity of exercise is most effect. Regardless of this though exercise in the workplace seems like a good idea.