Exploratory Workshop Exploratory Workshop The Future of Research in Sport Participation in the Lifespan (EThe Future of Research in Sport Participation in the Lifespan (EW10W10--170)170)Rome, Italy Rome, Italy -- September 14September 14--17, 201117, 2011Convened by: Laura Capranica, Jan Cabri and Romain MeeusenConvened by: Laura Capranica, Jan Cabri and Romain Meeusen

Exercise training in worklife for health

Prof. Gisela Sjøgaard

Institute of Sport Science and Clinical Biomechanics

Faculty og Health Sciences

University of Southern Denmark

Odense, Denmark

Standing Committees:European Medical Research Councils (EMSC), Humanities: (SCH), Social Sciences (SCSS)European Science Foundation ▪ 1 quai Lezay Marnésia ▪ BP90015 ▪ FR-67080 Strasbourg Cedex

Tel: +33 (0)3 88 76 71 36 or 46 ▪ Fax: +33 (0)3 88 37 05 32 ▪ Email: ew-office@esf.org ▪http://www.esf.org/workshops

Topic:Sport physiology

University of Southern Denmark 20.000 students

Institute of Sports Science and Clinical Biomechanics 2011

Institute of Sports Science and Clinical Biomechanics 2011

Teaching

Research (Research Units)

Research (Research Units) Centres of

Innovation

All bachelor-, master- and postgraduate programmes at the Faculty

of Health Science

Sport, Health and Civil Society

Physical Activity and Health in Work Life

Head of Research, prof. Gisela Sjøgaard

Physical Activity and Health in Work Life

Head of Research, prof. Gisela Sjøgaard

Musculoskeletal Function and Physioterapy

Head of Research, prof. Ewa Roos

Musculoskeletal Function and Physioterapy

Head of Research, prof. Ewa Roos

Exercise EpidemiologyHead of Research , prof.Lars Bo

Andersen

Exercise EpidemiologyHead of Research , prof.Lars Bo

Andersen

Clinical BiomechanicsHead of Research, prof. Jan Hartvigsen

Clinical BiomechanicsHead of Research, prof. Jan Hartvigsen

Research in Childhood Health (RICH)

Clinical Locomotion Science

Muscle Physiology and Biomechanics

Head of Research, prof. Per Aagaard

Muscle Physiology and Biomechanics

Head of Research, prof. Per Aagaard

Movement, Sport and SocietyHead of Research, prof. Bjarne IbsenMovement, Sport and Society

Head of Research, prof. Bjarne Ibsen

Team Danmark Testcenter

Art and Science

1. phasePark Theme:

Fitness og training

Odense University HospitalOdense University Hospital

2. phasePark theme:

Play, learning and Tech.

innovation

3. phasePark theme:

Therapy, treatment and

sensing

Active Living-building

Active Living-building

Active Living Park 2012Active Living Park 2012

Exploratory Workshop Exploratory Workshop The Future of Research in Sport Participation in the Lifespan (EThe Future of Research in Sport Participation in the Lifespan (EW10W10--170)170)

Standing Committees:European Medical Research Councils (EMSC), Humanities: (SCH), Social Sciences (SCSS)

Educational Opportunities for Young ResearchersPhD programs offered by Southern Denmark UniversityOf 3 years, 180 ECTS, hereof 150 dedicated to research- The Graduate Programme of Physical activity and Musculoskeletal Function- Research Education Program in Sport Sciences, REPS

Main research in the area of sport:Studies of the human body, the musculoskeletal system, sport, exercise, active living and movement. Attention is particularly paid to physical activity and exercise in health promotion, prevention, treatment of diseases and rehabilitation.

Inter-University Cooperation - European Master in Health and Physical activity- Intensive Program (IP): Children and Physical Activity

Future plans / developments - “Doctoral studies in Adapted Physical activity” in collaboration with Beijing University- Development Project – Bachelor in Physical Activity and Lifestyle Counselling- Joint research educational efforts with the European Biomove, UK, and Move, NL

Research Education Program in Sport SciencesREPS

http://reps.dk/

REPS is a partnership between the sport departments at the universities of

•Southern Denmark•Copenhagen•Aarhus •Aalborg

The objective is to strengthen and coordinate the training of researchers in Denmark within the fields of exercise and sport and exercise.

The Research Education Program comprises four strategic areas:

1. Physical activity, public health and welfare2. Barriers to physical activity3. Optimizing sporting performance4. Sport, identity and age

National and international PhD courses, seminars, and journal clubs on special topics, featuring input from international experts.

Courses are mono-, multi-, and interdisciplinary withInternational guest lectures andPhD students attending from many foreign countries

Nordic Network participantsThe Danish Research Education Program in Sport Sciences (REPS), Danmark: Institut for Idræt, Københavns UniversitetInstitut for Idræt, Aarhus UniversitetInstitut for Idræt og Biomekanik, Syddansk UniversitetInstitut for Idræt, Aalborg Universitet

Nationella forskarskolan i idrottsvetenskap, Sverige :Idrottshögskolan, Göteborgs UniversitetIdrottsvetenskap, Malmö HögskoleGymnastik- och idrottshögskolan, StockholmKarlstads UniversitetVäxjö UniversitetUmeå centrum för idrottsvetenskap, Umeå Universitet Hälsoakademin, Örebro Universitet

The Norwegian School of Sport Sciences / Norges Idrettshøgskole, Oslo, Norge

Faculty of Sport and Health Sciences, University of Jyväskylä, Finland

Faculty of Sport and Health Sciences, University of Reykjavik, Island

European College og Sports Science

www.ecss.de

European Events of Sport Science

Movement Culture, Sport, and Physical Activity Terminological and philosophical aspects

International PhD Course2012 Mai

University of Southern Denmark, Odense, Denmark

Themes•Introduction: Sport, body culture, fitness, physical activity

– between sport and health •Body culture •Movement culture •Term of sport in the perspective of doping •Philosophical dimensions of sport – is it only about ethics •Measuring the body

Ph.D.-students will have the opportunity to present their projects

Course Leaders: Professor Jørn Hansen and Professor Henning Eichberg

Credits 3 ECTS

Physical activity and health in work lifeInternational PhD course

2012 Mai 21-25University of Southern Denmark, Odense, Denmark

Themes:• Prevalence of life style diseases in the working population in an inactivity perspective• Physical exercise as treatment of medical disorders• Physical activity patterns, their quantification and physiological responses • Intervention with physical activity (RCT studies) on health outcomes • Change projects with focus on motivation and cultural/political change• Economic consequences of physical activity change for the individual, company and society.

Organizers:Gisela Sjøgaard, Karen Søgaard , Bibi Gram, Christoffer H. Andersen, Just JustesenUniversity of Southern Denmark, Odense, DK

Co-organizers:Bente Rona Jensen, Mogens Theisen Pedersen, University of Copenhagen, DK

Credits: 5 ECTS

Exploratory Workshop Exploratory Workshop The future of Research in Sport Participation in the Lifespan (EThe future of Research in Sport Participation in the Lifespan (EW10W10--170)170)

Standing Committees:European Medical Research Councils (EMSC), Humanities: (SCH), Social Sciences (SCSS)

Main Topic of this Presentation

Exercise training in worklife for health

The hazard of sedentary lifestyle is widely acknowledged, and physical activity at work and leisure time have been considered to provide similar health promoting benefits.

Accordingly, the international recommendations for health-promoting sports and physical activity do not distinguish between occupational and leisure time physical activity. However, the effects of occupational physical activity on health are characterized by conflicting findings.

Worksite IPETHome

Musculoskeletal health Cardiovascular health

Metabolic Health Mental healthWell-being

Low sick-leave

Physical activity

Work

Tasks

Leisure time

Sport Transport

Eur Heart J 28: 492-498, 2007Lancet 265: 1111-1120, 1953Med Sci Sports Exerc 20(5): 426-438, 1988

Long term sickness absence, LTSA

Increased 100% with PA at work – Decreased 25% with PA at leisure

Rel

ativ

e ris

k

MaleFemale

low medium high low medium high

PA at work PA at leisure

A. Holtermann, J. V. Hansen, H. Burr, K. Sogaard, and G. Sjogaard. The health paradox of occupational and leisure-time physical activity. Br.J.Sports Med., 2011.

Søgaard, Sjøgaard, Finsen, Olsen, Christensen: J Electromyogr. Kinesiol. 2001, 11(3): 197-206

Musculoskeletal injuries/disorders in Denmark per year:

~ 500.000 sports injuries with medical care250.000 acute to hospital250.000 therapist, general practitionaire, etc

~ 33.000 work injuries/disorders reported25.000 reported accidents

8.000 reported disorders

Research on Exercise training in worklife for health since ~ year 2000

Please, analyze the state-of-the-art related to the topic of your presentation

2009

2011

Research concepts

• Plausability: a measure of biological mechanisms that can underlie an effect

• Efficacy: a measure of the ability of a treatment to improve whatever condition it is indicated for

• Effectiveness: a measure of how well a treatment works in the “real world” with the target population

Muscle biochemistry, activity, blood flow and oxygenationmeasured at rest and during stress and repetitive tasks

EMG + MMG NIRS Microdialysis Ultrasound EMG + MMG NIRS Microdialysis Ultrasound Muscle biosy Muscle biosy

Physical exercise training to conquer pain in the neck/shoulder

May 2011 21

May 2011 22

BICbicycle exercise

50 – 70 %VO2max

**********

**********

********

**********

SRTspecific resistance training

12 - 10 - 8 RM3 sets ~30 s3 exercises

Physical Therapy, 88: 703-711, 2008

CON 67 ± 11 33 ± 11MYA 69 ± 11 31 ± 11CON 5057 ± 1120 4000 ± 1104MYA 5193 ± 1110 3501 ± 977CON 4.2 ± 0.74 3.2 ± 0.72MYA 4.1 ± 0.87 2.8 ± 0.70CON 0.89 ± 0.15 0.84 ± 0.17MYA 0.83 ± 0.14 0.86 ± 0.20

Fiber typeI II

Fibertype& (%)

CSA& (µm2)

CAF&

CAFA

Fibertype and –size

Andersen LL, Suetta C, Andersen JL, Kjær M and Sjøgaard G. Pain 139: 588.593, 2008.

Case-Control

Megafiber

Average size > 10.000 um2

~ 1% of all type I fibers in MYA

~ ½ of all subjects in MYA

CAFA ↓ 37 % lower potential for oxidative metabolism

Andersen LL, Suetta C, Andersen JL, Kjær M and Sjøgaard G. Increased proportion og megafibres in chronically painful muscles. Pain 139: 588.593, 2008.

myonuclei

embryonic myosin

laminin

combined

Significantly higher number of biopsies with embryonic myosinin MYA compared with CON, indicating ongoing regenerative processes in MYA

Significantly higher number of myonuclei associated with type I fibres in MYA compared with CON, supporting hightened myogenic activity

Mackey AL, Andersen LL, Frandsen U, Suetta C, Sjøgaard G.J Appl Physiol. 2010 (109) 1920-1929

Novel immunohistochemical staining developped for analysis of Satellite Cells, SC, the stem cell of the muscle

A. L. Mackey, L. L. Andersen, U. Frandsen, C. Suetta, and G. Sjogaard. Distribution of myogenic progenitor cells and myonuclei is altered in women with vs. those without chronically painful trapezius muscle. J.Appl.Physiol 109 (6):1920-1929, 2010.

P AX type I fibres PAX type II fibres

Satte

lite

cells

per

mus

cle

fiber

0.00

0.02

0.04

0.06

0.08

0.10

0.12

0.14CO N M YA

*

*

There was a significant group by fiber type interaction for PAX (F=12.3, P<0.001). Post hoc analyses showed higher PAX in type I fibers of MYA compared with CON (0.098 ± 0.039 vs 0.079 ± 0.031, P<0.05). Conversely, PAX was lower in type II fibers of MYA compared with CON (0.047 ± 0.017 vs 0.066 ± 0.035, P<0.05)

MYA demonstrated compared with CON:~20% more SCs per fibre associated with type I fibres (MYA 0.098 ± 0.039 vs. CON 0.079 ± 0.031; P<0.05) ~40% fewer SCs associated with type II fibres (MYA 0.047 ± 0.017 vs. CON 0.066 ± 0.035; P<0.05).

Case-Control

P. K. Nielsen, L. L. Andersen, H. B. Olsen, L. Rosendal, G. Sjøgaard, K. Søgaard.Muscle Nerve 41 (6):836-844, 2010.

Case-Control RCT

7 % increaseType II fiber area increase ~ 20% with SRT

L. L. Andersen, J. L. Andersen, C. Suetta, M. Kjaer, K. Søgaard, G. Sjøgaard. J.Appl.Physiol 107 (5):1413-1419, 2009.

C7acromion

perfusate

dialysate

EMG electrodes

accelerometer

Light source and detector NIRS

G. Sjøgaard, L. Rosendal, J. Kristiansen, A. K. Blangsted, J. Skotte, B. Larsson, B. Gerdle, B. Saltin, and K. Søgaard. Muscle oxygenation and glycolysis in females with trapezius myalgia during stress and repetitive work using microdialysis and NIRS. Eur.J.Appl.Physiol 108:657-669, 2010.

PEG STRESS

Lactate

Pyruvate

Glucose

Potassium

Bloodflow

0.3

0.4

0.5

0.6

100 150 200 250 300 350 400Time (min)

Out

flow

/inflo

w ra

tio

3.5

4.0

4.5

5.0

5.5

100 150 200 250 300 350 400

Con

c. (m

mol

/l)

80

100

120

140

160

180

100 150 200 250 300 350 400

Con

c. (

mol

/l)

1.8

2.2

2.6

3.0

3.4

3.8

4.2

100 150 200 250 300 350 400

Con

c. (m

mol

/l)

3.6

3.8

4.0

4.2

100 150 200 250 300 350 400

Con

c. (m

mol

/l)

¶

* * *

*

* * * *

* *

*

§

§

¶

&

*

*

*

#

##

##

#

#

#

*

*

microdialysis Case-Control

-1.5

-1.0

-0.5

0.0

0.5

1.0

1.5

10 20 30 40 50

CON

MYA

OHb during PEG and Recovery[µM]

[min]

G. Sjogaard et al. Muscle oxygenation and glycolysis in females with trapezius myalgia during stress and repetitive work using microdialysis and NIRS. Eur.J.Appl.Physiol 108:657-669, 2010.

Case-Control

-3.5

-3.0

-2.5

-2.0

-1.5

-1.0

-0.5

0.0

0.5BIC SRT REF BIC SRT REF

NIRS change from rest (uM OHb)

Oxygenation of the trapezius muscle during PEGBefore After

Nadir 0 – 5 min Mean 35 – 40 min

K. Sogaard, A. K. Blangsted, P. K. Nielsen, L. Hansen, L. L. Andersen, P. Vedsted, and G. Sjogaard. Eur.J.Appl.Physiol, 2011 E-pub.

RCT

Acute Change in Pain with each training session

P

ain

(mm

)

-15

-10

-5

0

5

10

15

BIC first half of the training periodBIC second half of the training periodSRT first half of the training periodSRT second half of the training period

**

*

immediately 2 hrsafter after

**

immediately 2 hrsafter after

Long-term change in pain

Session wks post-intervention

0 5 10 15 20 25

0

10

20

30

40

50

60

70 SRTBICREF

*

1 2 3 4 5 6 7 8 9 10

**

Session

0 5 10 15 20 255

10

15

20

25

30

BIC

traini

ng lo

ad (W

att)

0

20

40

60

80

100

120

140

Wor

st P

ain

(mm

)

SRT

traini

ng lo

ad (k

g)

Andersen LL, Kjaer M, Søgaard K, Hansen L, Kryger A and Sjøgaard G. Effect of two contrasting types of physical exercises on chronic neck muscle pain. Arthritis Rheum in press: 2007.

Intensity of neck/shoulder symptoms last three months

0.0

0.5

1.0

1.5

2.0

2.5

3.0(0-9)

Neck Left RightShoulder

Neck Left RightShoulder

Neck Left RightShoulder

Specific resistance training(n=102)

All-round physical exercise(n=131)

Reference(n=123)

Baseline Follow-up one year

MANOVA showed statistically significant differences between those who performed “physical activity” and the Ref

A. K. Blangsted, K. Søgaard, E. A. Hansen, H. Hannerz, and G. Sjøgaard. Scand J Work Environ Health 34 (1):55-65, 2008.

Exploratory Workshop Exploratory Workshop The future of Research in Sport Participation in the Lifespan (EThe future of Research in Sport Participation in the Lifespan (EW10W10--170)170)

Standing Committees:European Medical Research Councils (EMSC), Humanities: (SCH), Social Sciences (SCSS)

Open Questions

How to chose optimal sports participation or design intelligent physical exercise training programs aiming at prevention or rehabilitation of specific health aspects ?

Can we take in to consideration:

• Work exposure: repetitions, accumulated load, peak load, static force, vibration, standing etc

• Physical capacity and physical activity level of the individual

• Health risk factors, intensity and location of MSD, productivity at work, sick leave

• Preferences and barrieres to sports of the individual

Exploratory Workshop Exploratory Workshop The future of Research in Sport Participation in the Lifespan (EThe future of Research in Sport Participation in the Lifespan (EW10W10--170)170)

Standing Committees:European Medical Research Councils (EMSC), Humanities: (SCH), Social Sciences (SCSS)

Actual Forms of InterplayIn particular the workplace is an important arena for motivation of life long sport participation and health enhancing physical activity for the adults, who spend a large part of the day at work

Strong support and involvement of all stakeholders is warrented, including

•Management at the worksite•Workers/colleagues•Unions• Sport organization•Government

Exploratory Workshop Exploratory Workshop The future of Research in Sport Participation in the Lifespan (EThe future of Research in Sport Participation in the Lifespan (EW10W10--170)170)

Standing Committees:European Medical Research Councils (EMSC), Humanities: (SCH), Social Sciences (SCSS)

Enhancing Synergies

Large scale randomized controlled trials are to be conducted in order to contribute with highest possible evidence

Interdisciplinary research competences are requested:Medicine, biology/physiology, social sciences, psychology etc.

International collaboration for intervention studies to obtain sufficiently large cohorts

Deliver science back to society for strategic actions