Detailed Search Results
| Author/Association: | Haufe S, Kerling A, Protte G, Bayerle P, Stenner HT, Rolff S, Sundermeier T, Kuck M, Ensslen R, Nachbar L, Lauenstein D, Bothig D, Bara C, Hanke AA, Terkamp C, Stiesch M, Hilfiker-Kleiner D, Haverich A, Tegtbur U |
| Title: | Telemonitoring-supported exercise training, metabolic syndrome severity, and work ability in company employees: a randomised controlled trial [with consumer summary] |
| Source: | The Lancet Public Health 2019 Jul;4(7):e343-e352 |
| Method: | clinical trial |
| Method Score: | 8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
| Consumer Summary: | RESEARCH IN CONTEXT: EVIDENCE BEFORE THIS STUDY: Metabolic syndrome not only increases morbidity and cardiovascular mortality, but is also associated with loss of productivity and sickness absence in the working population, thereby increasing costs for the public-health system and the employer. Physical activity has an impact on metabolic syndrome severity and work ability, yet the influence of regular exercise on work ability in employees diagnosed with metabolic syndrome is not known. We searched PubMed for articles published from inception up to Dec 14, 2018, with the search terms "exercise", "physical activity", "work ability", "productivity", "sickness absence", and "metabolic syndrome" in various combinations. We found several cross-sectional and prospective studies for the effects of exercise and physical activity on metabolic syndrome severity or work ability. However, we could not identify a randomised study testing regular exercise training on work ability changes in employees diagnosed with metabolic syndrome. ADDED VALUE OF THIS STUDY: To our knowledge, this is the first prospective randomised trial to investigate the effects of exercise training on both metabolic syndrome severity and self-reported ability to work in employees at increased cardiometabolic risk. Our results show that regular and telemonitoring-supported physical activity decreased metabolic syndrome severity while increasing work ability, and this effect was independent of sex and occupation. Improvements in exercise capacity, depression severity, and the mental component score of the Quality of Life questionnaire after the 6-month intervention were associated with increased work ability. IMPLICATIONS OF ALL THE AVAILABLE EVIDENCE: Sparse data are available regarding the effects of physical activity interventions on work ability in individuals with increased disease risk. Using a randomised controlled design, our study provides evidence for regular exercise as an effective measure for improving physical and mental health, which translates into a higher ability to work for company employees with various types of occupation. The fact that participants were equipped with a wearable activity-monitoring device that transferred data to a central database provided the opportunity to supervise and guide training activities for many participants, irrespective of their residence or workplace. The custom-designed smartphone application to receive health-promoting lectures and regular information about possible training facilities and courses close to the participant's home and workplace might also have contributed to a close investigator-participant relationship, with good adherence and outcomes. Our results suggest that offering similar interventions to a broader workplace population could not only reduce individual disease risk, but also ease the burden in public health care and employers' costs arising from metabolic syndrome conditions. |
| Abstract: | BACKGROUND: Metabolic syndrome is a predisposing factor for cardiovascular and metabolic disease, but also has socioeconomic relevance by affecting the health and productivity of workers. We tested the effect of regular telemonitoring-supported physical activity on metabolic syndrome severity and work ability in company employees. METHODS: This was a prospective, randomised, parallel-group, and assessor-blind study done in workers in the main Volkswagen factory (Wolfsburg, Germany). Volunteers with diagnosed metabolic syndrome according to American Heart Association/National Heart, Lung, and Blood Institute criteria were randomly assigned (1:1) to a 6-month lifestyle intervention focusing on regular exercise (exercise group), or to a waiting-list control group, using a computer-based assignment list with variable block length. Participants in the exercise group received individual recommendations for exercise at face-to-face meetings and via a smartphone application, with the aim of doing 150 min physical activity per week. Activities were supervised and adapted using activity-monitor data, which were transferred to a central database. Participants in the control group continued their current lifestyle and were informed about the possibility to receive the supervised intervention after study completion. The primary outcome was the change in metabolic syndrome severity (metabolic syndrome z score) after 6 months in the intention-to treat population. This trial is registered with ClinicalTrials.gov, number NCT03293264, and is closed to new participants. FINDINGS: 543 individuals were screened between Oct 10, 2017, and Feb 27, 2018, of whom 314 (mean age 48 years (SD 8)) were randomly assigned to receive the intervention (n = 160; exercise group) or to a waiting list (n = 154; control group). The mean metabolic syndrome z score for the exercise group was significantly reduced after the 6-month intervention period (0.93 (SD 0.63) before and 0.63 (0.64) after the intervention) compared with the control group (0.95 (0.55) and 0.90 (0.61); difference between groups -0.26 (95% CI -0.35 to -0.16), p < 0.0001). We documented 11 adverse events in the exercise group, with only one event (a twisted ankle) regarded as directly caused by the intervention. INTERPRETATION: A 6-month exercise-focused intervention using telemonitoring systems reduced metabolic syndrome severity. This form of intervention shows significant potential to reduce disease risk, while also improving mental health, work ability, and productivity-related outcomes for employees at high risk for cardiovascular and metabolic disease. FUNDING: Audi BKK health insurance and the German Research Foundation through the Cluster of Excellence REBIRTH. Full text (sometimes free) may be available at these link(s):  help |
