Decrease in musculoskeletal pain after 4 and 12 months of an aerobic exercise intervention: a worksite RCT among cleaners

Background: Prevalence of musculoskeletal pain is high in jobs with high physical work demands. An aerobic exercise intervention targeting cardiovascular health was evaluated for its long term side effects on musculoskeletal pain. Objective: The objective was to investigate if aerobic exercise affects level of musculoskeletal pain from baseline to 4- and 12-months follow-up. Methods: One-hundred-and-sixteen cleaners aged 18–65 years were cluster-randomized. The aerobic exercise group ( n = 57) received worksite aerobic exercise (30 min twice a week) and the reference group ( n = 59) lectures in health promotion. Strata were formed according to closest manager (total 11 strata); clusters were set within strata (total 40 clusters, 20 in each group). Musculoskeletal pain data from eight body regions was collected at baseline and after 4- and 12-months follow-up. The participants stated highest pain in the last month on a scale from 0, stating no pain, up to 10, stating worst possible pain. A repeated-measure 2 × 2 multi-adjusted mixed-models design was applied to compare the between-groups differences in an intention to treat analysis. Participants were entered as a random effect nested in clusters to account for the cluster-based randomization. Results: Clinically significant reductions (>30%, f 2 > 0.25) in the aerobic exercise group, compared to the reference group, in pain intensity in neck, shoulders, arms/wrists were found at 12-months follow-up, and a tendency ( p = 0.07, f 2 = 0.18) to an increase for the knees. At 4-months follow-up the only significant between-group change was an increase in hip pain. Conclusions: This study indicates that aerobic exercise reduces musculoskeletal pain in the upper extremities, but as an unintended side effect may increase pain in the lower extremities. Aerobic exercise interventions among workers standing or walking in the majority of the working hours should tailor exercise to only maintain the positive effect on musculoskeletal pain.

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Musculoskeletal Pain and Impact on Performance in Orchestra Musicians and Actors

Medical Problems of Performing Artists ◽

10.21091/mppa.2004.2009 ◽

2004 ◽

Vol 19 (2) ◽

pp. 55-61

Author(s):

K Engquist ◽

P Ørbaek ◽

K Jakobsson

Keyword(s):

Musculoskeletal Pain ◽

Odds Ratio ◽

Reference Group ◽

Study Groups ◽

Physical Work ◽

Prevalence Odds Ratio ◽

Cross Sectional ◽

Body Regions ◽

Increased Risk ◽

The Impact

We studied the prevalence of musculoskeletal pain and its impact on performance in orchestra musicians and in a reference group of actors, who share the mental stress in a performance situation, but without having the physical work load from an instrument. Swedish musicians (n = 103) from symphony and chamber orchestras and actors (n = 106) participated in a cross-sectional questionnaire study. Musculoskeletal pain was assessed by a further developed Standardized Nordic Questionnaire. The impact of pain on performance (pain affecting playing capacity, decreased playing time, and change of technique) and trouble-related sick leave also was assessed. Pain intensity was assessed by visual analogue scales. Musculoskeletal pain in the neck and shoulders was the most frequently reported problem, with similar prevalence among musicians and actors, around 25% for present pain and 20% for chronic pain (1-year prevalence). Around 10% of the musicians and 5% of the actors reported pain in the hands. Oral pain was reported by 12% of the musicians and 18% of the actors. The number of affected body regions and the intensity of pain were similar in the study groups. The musicians had an increased risk for pain affecting playing capacity. For the neck, the prevalence odds ratio (POR) was 3.0 (95%CI 1.2-7.2; adjusted for age and gender). String instrumentalists had higher risk estimates than nonstring instrumentalists. A gender difference was not observed. Pain in the oral region affecting playing capacity was less common in musicians, with a prevalence odds ratio of 0.4 (95%CI 0.1-0.8). Even though the prevalence of musculoskeletal pain was similar in the two groups of performing artists, the consequences for the work situation were more serious among musicians.

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Aerobic exercise training for migraine prevention: A trigger-based analysis

Headache Medicine ◽

10.48208/headachemed.2019.4 ◽

2019 ◽

pp. 10-15

Author(s):

Arão Belitardo Oliveira ◽

Diego Belandrino Swerts ◽

Mario Fernando Prieto Peres

Keyword(s):

Aerobic Exercise ◽

Exercise Intervention ◽

Exercise Group ◽

Aerobic Exercise Training ◽

Controlled Clinical Trial ◽

Clinical Effects ◽

Exercise Interventions ◽

Headache Diary ◽

Migraine Triggers ◽

Post Hoc

Background: Although aerobic exercise has been recommended for migraine management, no study has yet explored the effects of regular aerobic exercise on migraine triggers profile. Objective: To evaluate the effects of a 12-week aerobic exercise intervention on migraine triggers profile. Methods: We conducted a secondary, post hoc analysis of a randomized, controlled clinical trial. Triggers were recorded in a paper-based headache diary with a formal list including 8 common migraine triggers. Results: Twenty-five patients concluded the protocol and were analysed (exercise: n = 12; waitlist: n = 13). In the whole cohort, the most common triggers were stress/irritability (60 %), sleep deprivation (60 %), fasting (28 %), and foods (28 %). Most patients (52 %) had ≥ 3 triggers. The exercise group showed a higher baseline proportion of patients with ≥ 3 triggers (69 %) compared to waitlist group (25 %) (p = 0.041). After intervention period, there was no difference in the proportion of patients with ≥ 3 triggers between waitlist (16.6 %) and exercise (30 %) groups (p = 0.502). The exercise group showed greater numeric reductions (from group’s sum) than waitlist group for triggers stress/irritability (-14 vs -9), fatigue (-12 vs -6), and menstruation (-9 vs -5). This seemed to reflect the reduced number of attacks in the exercise group [mean (CI95 %): -2.5 (-3.7, -1), p = 0.002] vs waitlist [0.9 (2.4, -0.8), p = 0.341]. Conclusion: Tracking migraine triggers during exercise interventions may help to unravel specific clinical effects of regular exercise. Trial registration: #NCT01972607.

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Brain Structure, Cardiorespiratory Fitness, and Executive Control Changes after a 9-Week Exercise Intervention in Young Adults: A Randomized Controlled Trial

Life ◽

10.3390/life11040292 ◽

2021 ◽

Vol 11 (4) ◽

pp. 292

Author(s):

Lina Zhu ◽

Qian Yu ◽

Fabian Herold ◽

Boris Cheval ◽

Xiaoxiao Dong ◽

...

Keyword(s):

Young Adults ◽

Aerobic Exercise ◽

Cardiorespiratory Fitness ◽

Executive Control ◽

Brain Structure ◽

Grey Matter ◽

Exercise Intervention ◽

Exercise Group ◽

Control Group ◽

Younger Adults

Cardiorespiratory fitness (CRF) is assumed to exert beneficial effects on brain structure and executive control (EC) performance. However, empirical evidence of exercise-induced cognitive enhancement is not conclusive, and the role of CRF in younger adults is not fully understood. Here, we conducted a study in which healthy young adults took part in a moderate aerobic exercise intervention program for 9 weeks (exercise group; n = 48), or control condition of non-aerobic exercise intervention (waitlist control group; n = 72). Before and after the intervention period maximal oxygen uptake (VO2max) as an indicator of CRF, the Flanker task as a measure of EC performance and grey matter volume (GMV), as well as cortical thickness via structural magnetic resonance imaging (MRI), were assessed. Compared to the control group, the CRF (heart rate, p < 0.001; VO2max, p < 0.001) and EC performance (congruent and incongruent reaction time, p = 0.011, p < 0.001) of the exercise group were significantly improved after the 9-week aerobic exercise intervention. Furthermore, GMV changes in the left medial frontal gyrus increased in the exercise group, whereas they were significantly reduced in the control group. Likewise, analysis of cortical morphology revealed that the left lateral occipital cortex (LOC.L) and the left precuneus (PCUN.L) thickness were considerably increased in the exercise group, which was not observed in the control group. The exploration analysis confirmed that CRF improvements are linked to EC improvement and frontal grey matter changes. In summary, our results support the idea that regular endurance exercises are an important determinant for brain health and cognitive performance even in a cohort of younger adults.

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Aerobic exercise improves hippocampal blood flow for hypertensive Apolipoprotein E4 carriers

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x21990342 ◽

2021 ◽

pp. 0271678X2199034

Author(s):

Carolyn S Kaufman ◽

Robyn A Honea ◽

Joseph Pleen ◽

Rebecca J Lepping ◽

Amber Watts ◽

...

Keyword(s):

Blood Flow ◽

Aerobic Exercise ◽

Genetic Risk ◽

Exercise Intervention ◽

Late Onset ◽

Control Group ◽

Carrier Status ◽

Or Education ◽

Exercise Interventions ◽

Apolipoprotein E4

Cerebrovascular dysfunction likely contributes causally to Alzheimer’s disease (AD). The strongest genetic risk factor for late-onset AD, Apolipoprotein E4 ( APOE4), may act synergistically with vascular risk to cause dementia. Therefore, interventions that improve vascular health, such as exercise, may be particularly beneficial for APOE4 carriers. We assigned cognitively normal adults (65–87 years) to an aerobic exercise intervention or education only. Arterial spin labeling MRI measured hippocampal blood flow (HBF) before and after the 52-week intervention. We selected participants with hypertension at enrollment (n = 44). For APOE4 carriers, change in HBF (ΔHBF) was significantly ( p = 0.006) higher for participants in the exercise intervention (4.09 mL/100g/min) than the control group (−2.08 mL/100g/min). There was no difference in ΔHBF between the control (−0.32 mL/100g/min) and exercise (−0.54 mL/100g/min) groups for non-carriers (p = 0.918). Additionally, a multiple regression showed an interaction between change in systolic blood pressure (ΔSBP) and APOE4 carrier status on ΔHBF ( p = 0.035), with reductions in SBP increasing HBF for APOE4 carriers only. Aerobic exercise improved HBF for hypertensive APOE4 carriers only. Additionally, only APOE4 carriers exhibited an inverse relationship between ΔSBP and ΔHBF. This suggests exercise interventions, particularly those that lower SBP, may be beneficial for individuals at highest genetic risk of AD. ClinicalTrials.gov Identifier: NCT02000583

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Effectiveness of Standardized Physical Therapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome: Randomized Controlled Trial

Physical Therapy ◽

10.2522/ptj.20150652 ◽

2016 ◽

Vol 96 (6) ◽

pp. 787-796 ◽

Cited By ~ 4

Author(s):

David Høyrup Christiansen ◽

Poul Frost ◽

Deborah Falla ◽

Jens Peder Haahr ◽

Lars Henrik Frich ◽

...

Keyword(s):

Physical Therapy ◽

Outcome Measures ◽

Exercise Intervention ◽

Controlled Trial ◽

Exercise Group ◽

Subacromial Impingement Syndrome ◽

Decompression Surgery ◽

Subacromial Decompression ◽

Randomized Controlled

Background Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function. Objective The purpose of this study was to evaluate the effectiveness at 3 and 12 months of a standardized physical therapy exercise intervention compared with usual care in patients with difficulty returning to usual activities after subacromial decompression surgery. Design A multicenter randomized controlled trial was conducted. Setting The study was conducted in 6 public departments of orthopedic surgery, 2 departments of occupational medicine, and 2 physical therapy training centers in Central Denmark Region. Patients One hundred twenty-six patients reporting difficulty returning to usual activities at the postoperative clinical follow-up 8 to 12 weeks after subacromial decompression surgery participated. Intervention A standardized exercise program consisting of physical therapist–supervised individual training sessions and home training was used. Outcome Measures The primary outcome measure was the Oxford Shoulder Score. Secondary outcome measures were the Constant Score and the Fear-Avoidance Beliefs Questionnaire. Results At 3 and 12 months, follow-up data were obtained for 92% and 83% of the patients, respectively. Intention-to-treat analyses suggested a between-group difference on the Oxford Shoulder Score favoring the exercise group at 3 months, with an adjusted mean difference of 2.0 (95% confidence interval=−0.5, 4.6), and at 12 months, with an adjusted mean difference of 5.8 (95% confidence interval=2.8, 8.9). Significantly larger improvements for the exercise group were observed for most secondary and supplementary outcome measures. Limitations The nature of the exercise intervention did not allow blinding of patients and care providers. Conclusion The standardized physical therapy exercise intervention resulted in statistically significant and clinically relevant improvement in shoulder pain and function at 12 months compared with usual care.

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A Systematic Review of the Effects of Exercise on Hormones in Women with Polycystic Ovary Syndrome

Journal of Functional Morphology and Kinesiology ◽

10.3390/jfmk5020035 ◽

2020 ◽

Vol 5 (2) ◽

pp. 35

Author(s):

Grei Shele ◽

Jessica Genkil ◽

Diana Speelman

Keyword(s):

Systematic Review ◽

Polycystic Ovary Syndrome ◽

Aerobic Exercise ◽

Exercise Intervention ◽

Polycystic Ovary ◽

Healthy Weight ◽

Ovary Syndrome ◽

Exercise Interventions ◽

The Impact ◽

Androgen Levels

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is characterized by menstrual irregularity and elevated serum androgens, and is often accompanied by insulin resistance. The etiology of PCOS is unknown. Lifestyle interventions and weight loss, where appropriate, remain first-line treatments for women with PCOS. Regular physical activity is recommended for women with PCOS to maintain a healthy weight and cardiovascular fitness. Purpose: To review the evidence for the impact of various exercise interventions on hormone levels in women with PCOS. Methods: A systematic review of original studies indexed in PubMed that utilized an exercise intervention in women with PCOS and reported hormone values pre- and post-intervention. Studies in which the effects of the exercise intervention could be determined were included. Results: Vigorous aerobic exercise improves insulin measures in women with PCOS. Resistance or strength training may improve androgen levels, though additional studies are warranted. Studies with yoga are limited but suggest improvements in androgens. Limited information is available on the impact of exercise on adipokines and anti-Müllerian hormone, warranting further investigation. Conclusions: Recommended guidelines for women with PCOS include vigorous aerobic exercise and resistance training to improve measures of insulin sensitivity and androgen levels.

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Effect of exercise on sleep and bi-directional associations with accelerometer-assessed physical activity in men with obesity

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2020-0361 ◽

2020 ◽

Author(s):

Tatiana Plekhanova ◽

Alex V. Rowlands ◽

Melanie Davies ◽

Charlotte L. Edwardson ◽

Andrew Hall ◽

...

Keyword(s):

Physical Activity ◽

Sleep Quality ◽

Aerobic Exercise ◽

Sleep Duration ◽

Exercise Intervention ◽

Vigorous Physical Activity ◽

Sleep Onset ◽

Onset Time ◽

Post Intervention

This study examined the effect of exercise training on sleep duration and quality and bidirectional day-to-day relationships between physical activity (PA) and sleep. Fourteen inactive men with obesity (49.2±7.9 years, BMI 34.9±2.8 kg/m²) completed a baseline visit, eight-week aerobic exercise intervention, and one-month post-intervention follow-up. PA and sleep were assessed continuously throughout the study duration using wrist-worn accelerometry. Generalised estimating equations (GEE) were used to examine associations between PA and sleep. Sleep duration increased from 5.2h at baseline to 6.6h during the intervention period and 6.5h at one-month post-intervention follow-up (p<0.001). Bi-directional associations showed that higher overall activity volume and moderate-to-vigorous physical activity (MVPA) were associated with earlier sleep onset time (p<0.05). Later timing of sleep onset was associated with lower overall volume of activity, most active continuous 30 minutes (M30CONT), and MVPA (p<0.05). Higher overall activity volume, M30CONT, and MVPA predicted more wake after sleep onset (WASO) (p<0.001), whereas greater WASO was associated with higher overall volume of activity, M30CONT, and MVPA (p<0.001). An aerobic exercise intervention increased usual sleep duration. Day-to-day, more PA predicted earlier sleep onset, but worse sleep quality and vice versa. Novelty: • Greater levels of physical activity in the day were associated with an earlier sleep onset time that night, whereas a later timing of sleep onset was associated with lower physical activity the next day in men with obesity • Higher physical activity levels were associated with worse sleep quality, and vice versa

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Effect of exercise on shoulder function and morbidity following mastectomy with axillary dissection in patients with breast cancer: a prospective randomized clinical study

International Surgery Journal ◽

10.18203/2349-2902.isj20183855 ◽

2018 ◽

Vol 5 (10) ◽

pp. 3217

Author(s):

Sri Aurobindo Prasad Das ◽

Sathasivam Sureshkumar ◽

Vijayakumar C. ◽

Vikram Kate ◽

Srinivasan K.

Keyword(s):

Breast Cancer ◽

Range Of Motion ◽

Exercise Intervention ◽

Exercise Group ◽

Breast Cancer Surgery ◽

Exercise Interventions ◽

Randomized Clinical Study ◽

Shoulder Range Of Motion ◽

Drain Removal ◽

Significant Difference

Background: There are no guidelines for the exercises performed in physical rehabilitation after breast cancer surgery and, specifically, for how to minimize these postoperative complications. Hence this study was conducted to study the effect of exercise intervention on upper extremity range of motion, strength, lymphedema, pain and activities of daily living (ADL).Methods: A total of 75 patients were included in the study in accordance to inclusion criteria. They were randomized into exercise group (n=38) and no exercise group (n=37). Patients in the exercise group were given a set of 19 active or active assisted range of motion exercises and strengthening exercises with frequent follow up. The other group were did not receive any strict exercise, they were given a few free hand exercise when they had some shoulder complaints based on treating physician discretion. Apart from demographic data other parameters studied were pain, numbness, active shoulder range of motion, muscle strength, lymphedema and ADL. These were evaluated before surgery, 24 hours after drain removal and 3 weeks /6 weeks/ 3 months of post-surgery.Results: Demographic parameters were comparable between the groups. Pain score, shoulder ROM were better in the exercise group compared to no exercise group and this difference was found to be significant (p <0.001). More patients in no exercise group experienced numbness. There was no statistically significant difference in the grip strength between the two groups. The incidence of lymphedema was higher in no exercise group compared to exercise group and this was extremely significant. (p < 0.001). Patients in no exercise group had higher disability scores for ADL which was significant compared to exercise group.Conclusions: Exercise interventions resulted in significantly reduced pain, improved shoulder ROM and lowered ADL impairment. Exercise intervention significantly reduced the incidence of lymphedema, but there was no effect on strength.

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Musculoskeletal pain intensity in different body regions and risk of disability pension among female eldercare workers: prospective cohort study with 11-year register follow-up

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04655-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Rúni Bláfoss ◽

Jonas Vinstrup ◽

Sebastian Venge Skovlund ◽

Rubén López-Bueno ◽

Joaquin Calatayud ◽

...

Keyword(s):

Risk Factor ◽

Pain Intensity ◽

Labour Market ◽

Musculoskeletal Pain ◽

Dose Response ◽

Disability Pension ◽

Low Back ◽

Body Regions ◽

Very High

Abstract Background Musculoskeletal pain is a risk factor for leaving the labour market temporarily and permanently. While the presence of multi-site pain increases the risk of disability pension, we lack detailed knowledge about pain intensity as a risk factor. This study investigated the association between musculoskeletal pain intensity in different body regions and risk of future disability pension among eldercare workers. Methods Eight thousand seven hundred thirty-one female eldercare workers replied to a questionnaire on work and health in 2005 and were followed for 11 years in the Danish Register for Evaluation of Marginalization. Time-to-event analyses estimated hazard ratios (HR) for disability pension from pain intensities (0–9 numeric rating scale (NRS)) in the low-back, neck/shoulders, and knees during the previous 3 months. Analyses were mutually adjusted for pain regions, age, education, lifestyle, psychosocial work factors, and physical exertion at work. Results During 11-year follow-up, 1035 (11.9%) of the eldercare workers received disability pension. For all body regions among all eldercare workers, dose-response associations were observed between higher pain intensity and risk of disability pension (p < 0.001). The risk for disability pension was increased when reporting “very high” pain levels (≥7 points on the 0–9 NRS) in the low-back (HR 2.19, 95% CI 1.70–2.82), neck/shoulders (HR 2.34, 95% CI 1.88–2.92), and knees (HR 1.89, 95% CI 1.44–2.47). Population attributable risks (PAR) were 15.5, 23.2, and 9.6% for pain > 2 on NRS in the low-back, neck/shoulders, and knees, respectively, indicating that 15.5, 23.2, and 9.6% fewer eldercare workers would likely receive disability pension if the pain intensity was reduced to 2 or less. For workers ≤45 years and > 45 years, PAR was highest for neck/shoulder pain (27.6%) and low-back pain (18.8%), respectively. Conclusions The present study found positive dose-response associations between pain intensity in the low-back, neck/shoulders, and knees, and risk of disability pension during 11-year follow-up. Moderate to very high levels of musculoskeletal pain in eldercare workers should, therefore, be considered an early warning sign of involuntary premature exit from the labour market. These findings underscore the importance of preventing, managing, and reducing musculoskeletal pain to ensure a long and healthy working life.

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Aerobic Exercise Interventions for Patients in Opioid Maintenance Treatment: A Systematic Review

Substance Abuse Research and Treatment ◽

10.1177/1178221820918885 ◽

2020 ◽

Vol 14 ◽

pp. 117822182091888

Author(s):

Danielle E Jake-Schoffman ◽

Meredith S Berry ◽

Marissa L Donahue ◽

Demetra D Christou ◽

Jesse Dallery ◽

...

Keyword(s):

Physical Activity ◽

Aerobic Exercise ◽

Maintenance Treatment ◽

Exercise Intervention ◽

Adjunctive Treatment ◽

Bibliographic Databases ◽

Opioid Use ◽

Opioid Maintenance Treatment ◽

Exercise Interventions ◽

Supervised Exercise

Background: Opioid maintenance treatment (OMT) is the standard for treatment of opioid use disorder, but some individuals on OMT experience disrupted sleep, heightened sensitivity to pain, and continued relapse to non-medical opioid use. An adjunctive treatment that has potential to address these shortcomings of OMT is aerobic exercise. Objective: The aim of the present review was to identify and evaluate components of aerobic exercise interventions targeting OMT patients. Methods: For this PROSPERO-registered review (ID CRD42020139626), studies were identified via electronic bibliographic databases, funded research ( NIH RePORTER) and clinical trials databases ( ClinicalTrials.gov), and reference sections of relevant manuscripts. Studies that evaluated the effects of an aerobic exercise intervention using a comparison condition or pretest-posttest design in adult OMT patients were included. Results: Of 2971 unique records, three primary studies and one supplemental manuscript comprised the final sample. All studies were randomized trials involving supervised exercise interventions enrolling small samples of middle-aged OMT patients. Exercise interventions included a variety of aerobic and non-aerobic activities (e.g. flexibility exercises), and none controlled the dose of aerobic exercise. Few studies used objective measures of physical activity or cardiorespiratory fitness and there were no significant effects of adjunctive exercise on substance use outcomes, but tests of the latter were likely underpowered. Conclusions: Though early in the accumulation of evidence, interventions targeting aerobic exercise for OMT patients appear feasible, acceptable to patients, and beneficial. Longer-term studies that employ larger samples, include assessments of behavioral and biological mechanisms of change, more rigorous measurement of physical activity, and controlled doses of aerobic activity are warranted.

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