Health enhancing physical exercise training at work with focus on musculoskeletal health effects. Results from a systematic literature review.

Background: Physical inactivity is a significant risk factor for musculoskeletal disorders (MSDs), which are among the leading causes of work-related disability, absenteeism, and reduced productivity in industrialized nations. As populations age and retirement ages increase, maintaining musculoskeletal health is essential to sustaining workability. The workplace presents an optimal setting for implementing structured exercise interventions, as employees spend a substantial portion of their waking hours at work. This study systematically synthesizes high-quality evidence from randomized controlled trials (RCTs) examining workplace-initiated exercise programs.<br/><br/>Method: A systematic literature search was conducted following the PRISMA-Scr guidelines in Medline and Embase. Studies were included if they met the following criteria: (1) RCT design, (2) published between 2002 - 2022, (3) publication in English or Nordic languages, (4) wage-earners aged 18–65 years, (5) workplace-initiated physical exercise training interventions (e.g., strength training, aerobic training, functional training, circuit training), and (6) outcome measures including musculoskeletal pain, physical capacity, productivity, and workability. Data was extracted and categorized based on job profile and intervention type. <br/>Currently, we are updating the literature search to extend coverage to 2025, adding studies from the past three years. Additionally, we are expanding the search to include two additional databases, SPORTDiscus and Cochrane, to ensure a comprehensive assessment of the most recent evidence. The updated results will be presented at the conference.<br/><br/>Results: Up to 2022, a total of 72 articles representing 54 unique RCTs were included, covering diverse occupational settings such as sedentary, standing/walking, and heavy physical work. Among sedentary workers (e.g., office employees, technicians), 20 out of 39 studies showed significant improvements in physical capacity, and 22 reported reduced pain levels. In standing/walking professions (e.g., nurses, cleaners) 16 out of 24 studies exhibited positive effects on physical capacity with 10 reporting pain reductions. For heavy physical work (e.g., construction, slaughterhouse workers) 6 of 9 studies showed improved physical capacity, with 4 reporting decreased pain levels. Additionally, work-related parameters, including productivity and absenteeism, showed positive trends, particularly for the subgroups with adherence rates exceeding 70%.<br/><br/>Discussion: The findings overall confirm that structured workplace-based exercise interventions are effective in preventing and managing MSDs, enhancing physical capacity and reducing musculoskeletal pain across various occupational settings. This supports the <br/><br/>WHO recommendation advocating for workplace exercise training as a health-promoting strategy. However, key points for benefits seems to be program adherence and the integration of job-specific training elements. Most studies have focused on office workers and fewer studies within the physically heavy jobs. Until now also few studies are found on long-term effects, economic outcomes, and optimal strategies for intervention adherence.<br/>