The MedXFit-study - CrossFit as a workplace health intervention: a one-year, prospective, controlled, longitudinal, intervention study

Abstract

Introduction: Workplace health interventions aim to motivate employees toward healthy behaviors to improve fitness and health in the long-term. We investigated whether CrossFit® is an effective training concept to achieve these goals in inactive employees with sedentary occupations.

Methods: The study followed a prospective, controlled intervention design. Employees were invited to participate in intervention group (IG) or control group (CG) on their own preferences. Inclusion criteria were a predominantly sedentary occupation and execution of less than two muscle and/or mobility enhancing training sessions per week at the time of enrolling. The IG did at least two times a week a CrossFit training of 1 h. Mobility, strength, well-being, and back-issues were measured at the beginning, after 6, and 12 months. Participants in the CG were free to choose any other activities offered at the same time (e.g., circuit training, meditation, full body stability training). Adherence, respectively, behavioral change and maintenance qualities were evaluated based on the COM-B system and presence of behavior maintenance motives.

Results: 89 employees were enrolled into the trial, from where 21 dropped out due to external factors (24%). From the remaining participants, 10 out of 39 (26%) in the IG and 1 out of 29 (4%) in the CG stopped for intrinsic reasons, leading to a non-adherence to the intervention of 22 percentage points. Motivation for behavioral change and maintenance in the IG was primarily driven by enhanced physical and psychological capability. Development of physical capability was evident by significant improvements (p < 0.001) in the IG compared to the CG for mobility (d = 3.3), maximal isometric strength (min. d = 1.7, max. d = 2.5), as well as reduction in pain intensity (p = 0.003, r = 0.4) and frequency (p = 0.009, r = 0.35) after 12 months. Significant improvements between the 6-month and the 12-month measurement in mobility and 6 out of 8 strength measures within the IG indicated the effectiveness of CrossFit beyond the beginner phase.

Conclusion: CrossFit is a motivating training concept that led to long-term health and fitness improvements in inactive employees doing sedentary work and should be given greater consideration in workplace health promotion.

Keywords: back pain; behavioral change and maintenance; exercise; functional fitness; military; mobility; strength; well-being.

Figure 1

Schematic overview of the MedXFit-study adapted from Brandt et al. (22).

Figure 2

Participant flow over the course of the study.

Figure 3

Functional Movement Screen scores in the intervention and control group over the course of 12 months.

Figure 4

Maximum isometric strength in the intervention group over the course of 12 months. TE, trunk extension; TF, trunk flexion; TLFl, trunk lateral flexion left; TLFr, trunk lateral flexion right; UPush, upper body push; UPull, upper body pull; HEl, hip extension left; HEr, hip extension right.

Figure 5

WHO-5 scores in the intervention and control group over the course of 12 months.

Figure 6

Distribution of back-issues (pain intensity, perceived limitation, pain frequency) at baseline (t0) and after 12 months (t2) in the intervention and control group.

Figure 7

Likelihood of behavioral change and maintenance over the course of the MedXFit-study depending on capability, opportunity, motivation, and maintenance motives [cf. (13, 35)].