Effects on exercise and fitness outcomes of workplace physical activity interventions targeting older employees: A systematic review and meta-analysis

Abstract

Background: “Active Ageing” policy to delay retirement mean that maintaining the health and fitness of older employees has become increasingly important. This systematic review summarises the characteristics and effect on exercise and fitness outcomes of workplace physical activity (PA) interventions targeting older employees. Methods: Five online databases were searched from inception to December 2018. Eligible studies were of any experimental design, included employees aged ≥50 years, had PA as an intervention component and reported PA-related outcomes. Results: Titles and abstracts of 7470 records were screened and 16 unique interventions were included (3,215 participants). Eleven studies were RCTs. Six interventions targeted multiple risk factors (n=1,586) involving screening for cardiovascular disease risk factors, but had a non-specific description of the PA intervention. Four interventions targeted nutrition and PA (n=1,127), and six intervention (n=195) focused only on PA. Seven interventions were short –term (<15 weeks), six interventions lasted 6-9 months and three interventions were long-term (10-12 months). Interventions overwhelmingly targeted aerobic PA compared to strength, balance and flexibility. No studies involved screening for falls/injury risk. Computation of effect sizes (ES) was only possible in a maximum of three RCTs per outcome. ESs were statistically non-significant for all outcomes. ESs were medium for PA behaviour (ES=0.25 95% CI: -0.07 to 0.56), muscle strength (ES=0.27, 95%CI: -0.26- 0.80), cardiorespiratory fitness (ES=0.28, 95%CI: -22 to 0.78) and flexibility (ES=0.50, 95% CI: -0.04- 1.05) and large for balance (ES=1.29, 95% CI: -0.56- 3.15). GRADE criteria-rated quality of evidence were ‘low’ due to high risk of bias, imprecision and inconsistency. Conclusions: The effect of workplace interventions for improving fitness outcomes of older employees is uncertain. There is a need for high-quality PA interventions that takes into account the broader PA recommendations for older adults. Such interventions should incorporate strength and balance training and screening of falls/injury risk in multi risk factors approaches.