Movement is Medicine

When reading a Post of Physio Network on LinkedIn, I had to think of the similarities I encountered in the scientific literature between bed-rest/hospitalization and remote-work as they both impact our physical activity or ‘movement’ and are actually not so different in terms of the effects on the body:

Interesting…

One week in the hospital may lead to a significant loss of muscle mass and strength (= physical deconditioning) in the lower limbs. 

Did you know that strength and muscle mass are suggested to be predictors of health (1; 2)? In other words, being 'generally strong' and carrying 'a general amount of muscle mass' will benefit your health and quality of life.

Why does this make sense? Well, if your legs are lacking in (muscular) strength, the risk of falls is massively increased and with it the likelihood of injuries. Ultimately, chances for disabilities and a loss of independency will rise proportionally. In fact, for adults aged >65, falls are one of the main causes for injuries and often lead to hospital admissions (3) - resulting in further physical deconditioning (= loss of muscle mass and strength) which then again increases the risk for all of the above…

When muscle loss is accelerated due to bed-rest/hospitalization, some authors refer to this as a “catabolic crisis” (4). Similarly, this can be observed with astronauts, who experience severe physical deconditioning due to microgravity (5). In fact, prolonged bed-rest studies have been conducted to simulate microgravity conditions (6).

Concerningly, authors have discussed potential similarities between bed-rest and remote-work with its imminent consequences (physical inactivity, increased sedentariness, lack of exercise, poor dietary behavior [7 for a more in-depth discussion]) regarding the physiological mechanisms and effects on the body including their risks for health (4).

While physical activity levels are still slightly higher when working from home compared to bed-rest, the effects might show in a more delayed response as recently mentioned in an article (8). However, this will still accelerate the age-related loss in muscle mass (sarcopenia) and with it, its economic burden.

How may physical deconditioning affect you as an employee or employer? Complaints in the musculoskeletal system, i.e. symptoms such as back pain, neck pain, lower-back pain, are classified as one of the leading causes for absence at work (9). It has been reported that these symptoms have increased since shifting to working from home predominantly (10; 11) and our own survey supports these findings. On the one hand, a painful back/neck due to working conditions with little opportunities to do something about it is ‘not so pleasant’ for employees. On the other hand, employees that are less productive and/or on sick-leave represent a large financial burden for employers and the economy.

When selecting an adequate countermeasure to prevent physical deconditioning (whether in space or on earth), to maintain and improve physical fitness as a strong predictor of health, Resistance Training, with strong scientific support, can be classified as one of the best choices due to its effectiveness, safety and time-efficiency when using appropriate methods (12). Hence, it is a widely used modality by astronauts in space (5) and has become an essential portion of public health guidelines (13; 14). Indeed, 20 minutes of (‘minimal dose’) high effort resistance training per week were shown to be sufficient for improving strength levels when performed adequately (15).

In general, the scientific literature helps in identifying risks, barriers and cause-effect relationships as well as in providing frameworks to work with. “Evidence-based” has become a fancy marketing term, however, the main challenge lies in translating findings into pragmatic solutions that are feasible, applicable, time-efficient and promote engagement. 

Even the most effective form of exercise has no efficacy when it’s not done (adequately)! Remote-work will persist in the future and while technology has already adapted, value-based health care needs to catch up to prevent our musculoskeletal systems to adapt to increased sedentariness and physical inactivity. I envision a future where innovative corporate health schemes will become an inevitable part of employee benefits, just like being able to work remotely. 

Are you still looking for a solution to establish a health-promoting work environment? Feel free to get in touch! I have dedicated a large portion of my career into filtering out the most efficient training methods for corporate environments and created an innovative concept that can be implemented both 100%-remotely or with physical attendance whilst removing barriers of engagement as well as the requirement for large facilities with expensive equipment.

Please share this post if you think your friend, colleague or employer should read this and to further raise health awareness.

References:

1. Barry, V.W., Baruth, M., Beets, M.W., Durstine, J.L., Liu, J. & Blair, S.N. (2014). Fitness vs. Fatness on All-Cause Mortality: A Meta-Analysis. Progress in Cardiovascular Diseases, 56, 382-390. doi: 10.1016/j.pcad.2013.09.002.

2. Li, R., Xia, J., Zhang, X.I., Gathirua-Mwangi, W.G. Guo, J., Li, Y., et al. (2018). Associations of Muscle Mass and Strength with All-Cause Mortality among US Older Adults. Medicine and Science in Sports and Exercise, 50(3), 458-567. doi: 10.1249/MSS.0000000000001448.

3. Center for Diseases Control and Prevention (CDC) (2010). Web-based Injury Statistics Query and Reporting System (WISQARS). [Internet] available at: http://www.cdc.gov/injury/wisqars/ [accessed at 07.07.2021].

4. Kirwan, R., McCullough, D., Butler, T., de Heredia, F.P., Davies, I.G. & Stewart, C. (2020). Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. GeroScience 42, 1547-1578. doi: 10.1007/s11357-020-00272-3.

5. Steele J., Androulakis-Korakakis, P., Perrin, C., Fisher, J., Gentil, P., Scott, C., et al. (2019). Comparisons of Resistance Training and “Cardio” Exercise Modalities as Countermeasures to Microgravity-Induced Physical Deconditioning: New Perspectives and Lessons Learned From Terrestrial Studies. Frontiers in Physiology, 10, 1150. doi: 10.3389/fphys.2019.01150.

6. Hargens, A. R., & Vico, L. (2016). Long-duration bed rest as an analog to microgravity. Journal of Applied Physiology, 120(8), 891-903. doi: 10.1152/japplphysiol.00935.2015.

7. Armed x Fit Coaching (2020). CHB 2.2: Literature Review: Deriving direct effects of remote working to individual’s health [Internet] available at: https://www.armedxfit.com/blog/chb-2-2-literature-review [accessed at 07.07.2021]

8. Armed x Fit Coaching (2020). CHB 2.3: Some (bad) things take time.. [Internet] available at: https://www.armedxfit.com/blog/chb-2-3-some-bad-things-take-time [accessed at 07.07.2021]

9. Beroepsziekten (2020). Beroepsziekten in Cijfers 2020. [Internet] available at: https://www.beroepsziekten.nl/sites/default/files/documents/beroepsziekten-in-cijfers-2020.pdf [accessed at 15.12.2020]

10. Kakar, R.S. & Lomond, K. (2020). Can COVID-19 Lead to Another Pandemic of Back Pain? Archives of Physical Medicine and Rehabilitation, 101(12), E132. doi: 10.1016/j.apmr.2020.10.019.

11. Smith, T.O., Durrant, K., Birt, L., Belderson, P., Chipping, J., Yates, M., et al. (2020). Accessing health services for musculoskeletal diseases during early COVID-19 lockdown: Results from a UK population survey. Rheumatology Advances in Practice, 4(2), 1-3. doi: 10.1093/rap/rkaa047.

12. Maestroni, L., Read, P., Bishop, C., Papadopoulos, K., Suchomel, T. J., Comfort, P., et al. (2020). The Benefits of Strength Training on Musculoskeletal System Health: Practical Applications for Interdisciplinary Care. Sports Medicine, 50(8), 1431-1450. doi: 10.1007/s40279-020-01309-5.

13. Steele, J., Fisher, J., Skivington, M., Dunn, C., Arnold, J. & Tew, G., et al. (2017). A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training. BMC Public Health, 17, 300. doi: 10.1186/s12889-017-4209-8.

14. World Health Organization (2018). Physical activity. [Internet] available at: https://www.who.int/news-room/fact-sheets/detail/physical-activity#:~:text=Adults%20aged%2018–64%20years,%2D%20and%20vigorous%2Dintensity%20activity [accessed at 15.12.2020]

15. Steele, J., Fisher, J., Giessing, J., Androulakis-Korakakis, P., Wolf, M., Kroeske, B., et al. (2021). Long-term time-course of strength adaptation to minimal dose resistance training: Retrospective longitudinal growth modelling of a large cohort through training records. https://doi.org/10.31236/osf.io/eq485