An internet-delivered exercise intervention for workplace health promotion in overweight sedentary employees: A randomized trial

doi:10.1016/j.ypmed.2010.07.008

Preventive Medicine

Volume 51, Issues 3–4, September–October 2010, Pages 234-239

https://doi.org/10.1016/j.ypmed.2010.07.008 Get rights and content

Abstract

Objective

To evaluate the effect of structured vs. non-structured internet-delivered exercise recommendations on aerobic exercise capacity and cardiovascular risk profile in overweight sedentary employees.

Methods

140 employees of an automobile company (11% female, median age 48 years (range 25–60), BMI 29.0 kg/m² (25.0–34.8)) were randomized in a 3:2 ratio to an intervention group receiving structured exercise schedules or a control group choosing workouts individually via an interactive website. The 12-week intervention took place in Munich, Germany, during summer 2008. Main outcome measure was performance at the lactate anaerobic threshold (P_AT/kg) during ergometry.

Results

77 participants completed the study. The intervention group (n = 50) improved significantly in P_AT/kg ((mean (SD)) 1.68 (0.31) vs. 1.81 (0.33) W/kg; p = 0.002), VO₂peak (3.21 (0.63) vs. 3.35 (0.74) L/min; p = 0.04), and waist circumference (100.5 (7.9) vs. 98.0 (7.8) cm; p = 0.001). The control group (n = 27) improved significantly in P_AT/kg (1.59 (0.38) vs. 1.80 (0.49); p < 0.001) and waist circumference (101.9 (8.7) vs. 98.3 (8.5) cm; p < 0.001), but not in VO₂peak. No significant between group differences in these outcome measures were noted.

Conclusion

Structured, internet-delivered exercise recommendations are not superior to internet-delivered non-structured exercise recommendations in a workplace setting. Both lifestyle intervention strategies are, however, limited by high dropout rates.

Introduction

Obesity and physical inactivity are important risk factors for developing cardio-metabolic disorders (Haslam & James, 2005, Kodama et al., 2009, LaMonte et al., 2005b). Facing their dramatic increase in recent decades there is clear scientific consensus to promote physical activity (Haskell et al., 2007, Marcus et al., 2006). Although large trials on structured lifestyle interventions have shown beneficial effects on preventing metabolic diseases such as type 2 diabetes mellitus (Knowler et al., 2002, Tuomilehto et al., 2001), their transfer into a real-life setting often depends on sufficient human or financial resources. The internet has been discussed as a promising tool to reduce these limitations by replacing procedures that can be standardized within an intervention and by reaching large numbers of subjects at low costs (van den Berg et al., 2007, Vandelanotte et al., 2007). Therefore, efforts have been intensified during recent years to determine the effectiveness of internet-delivered lifestyle interventions (Marcus et al., 2009). In fact, commercial internet-delivered exercise programs are already ubiquitously available, but there is still limited scientific evidence for their efficacy in primary prevention.

An opportunity to reach large cohorts of sedentary subjects at increased metabolic risk is the workplace. As internet access is widely available there (Marcus et al., 2006), this study investigated the application of an internet platform in a large company to deliver exercise recommendations for health promotion. The aim was to improve exercise capacity and metabolic risk profile determined by objective measurements in overweight, sedentary employees. It was hypothesized that delivering a structured exercise intervention via an internet platform is superior regarding these goals than a non-structured program.

Section snippets

Participants

For participant recruitment data were used from a health survey conducted several weeks prior to initiation of the study in employees of a large German automobile manufacturer. Study inclusion criteria were: overweight and obesity defined as a body mass index (BMI) of 25–35 kg/m², sedentary life-style (self-reported physical activity < 1×/week), age 20–60 years, and ≥ 2 metabolic syndrome risk factors (National Cholesterol Education Program (NCEP) Expert Panel, 2002). The company's health care

Participants

A total of 1,380 employees were contacted per e-mail. Within 2 weeks, the required 140 participants had registered and were subsequently randomized. Of these, 105 actually entered baseline examinations and were used for the study population (median age 48 years (range 25–60), 11% female, BMI 29.0 kg/m² (25.0–34.8)). 35 participants did not show up for baseline examination. If available, reasons given for withdrawing the registration were lack of time, lack of further interest or medical problems

Discussion

This study provides evidence that internet-delivered exercise recommendations at a work site intervention lead to significant improvements in both exercise capacity and metabolic risk profile in overweight, sedentary employees. However, no additional positive effects on these parameters were seen by providing a structured exercise schedule, as similar improvements can also be obtained by a non-structured website only providing standard advice.

Low physical fitness is an independent predictor of

Funding

This research was part of the SPRINT project (www.projekt-sprint.de). SPRINT is a joint project of the Technische Universität München and its corporate partners and was funded by the German Ministry for Research and Education (contract number FKZ 01FD0609). Study design, data collection, analysis and interpretation, writing of the report and submission of the results were not influenced by the funding source. This study was not financially supported by the BMW group; however, free access to

Conflict of interest statement

The authors declare that there are no conflicts of interest.

Acknowledgments

The authors greatly appreciate the logistical support of the BMW group, in particular A. Richter, MD, and J. Bischof, MD. Without their assistance this study would not have been possible. Furthermore, the authors gratefully acknowledge editorial assistance by C. Krcmar.

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An internet-delivered exercise intervention for workplace health promotion in overweight sedentary employees: A randomized trial

Abstract

Objective

Methods

Results

Conclusion

Introduction

Section snippets

Participants

Participants

Discussion

Funding

Conflict of interest statement

Acknowledgments

Prev. Med.

Lancet

Am. J. Med.

Prev. Med.

Am. J. Prev. Med.

Compendium of physical activities: An update of activity codes and MET intensities

Med. Sci. Sports Exerc.

Circulation

Evaluating Active U: An Internet-mediated physical activity program

BMC Public Health

Eight-month follow-up of physical activity and central adiposity: Results from an Internet-delivered randomized control trial intervention

J. Phys. Act. Health

Individual anaerobic threshold for evaluation of competitive athletes and patients with left ventricular dysfunction

Effects of physical activity on life expectancy with cardiovascular disease

Arch. Intern. Med.

European guidelines on cardiovascular disease prevention in clinical practice: Executive summary

Eur. Heart J.

Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association

Circulation

Using internet and mobile phone technology to deliver an automated physical activity program: Randomized controlled trial

J. Med. Internet Res.

The effects of training on heart rate; a longitudinal study

Ann. Med. Exp. Biol. Fenn.

Online, Set, Go - Design and empirical test of an IT-based physical activity intervention

Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin

N Engl J. Med.