The Influence of Exercise Intensity on Psychosocial Outcomes in Musculoskeletal Disorders: A Systematic Review

Sim Klaps; Sarah Haesevoets; Jeanine Verbunt; Albère Köke; Lotte Janssens; Annick Timmermans; Jonas Verbrugghe

doi:10.1177/19417381221075354

The Influence of Exercise Intensity on Psychosocial Outcomes in Musculoskeletal Disorders: A Systematic Review

Sim Klaps, Sarah Haesevoets, Jeanine Verbunt, Albère Köke, Lotte Janssens, Annick Timmermans, Jonas Verbrugghe^*

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

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Abstract

CONTEXT: Psychosocial parameters play an important role in the onset and persistence of chronic musculoskeletal disorders (CMSDs). Exercise therapy is a valuable therapeutic modality as part of CMSD rehabilitation. Hereby, exercise intensity is an important factor regarding changes in pain and disability in multiple CMSDs. However, the impact of exercise intensity on psychosocial outcomes remains poorly explored.

OBJECTIVE: To identify the effects of different modes of exercise intensity on psychosocial outcomes in persons with CMSDs.

DATA SOURCES: A systematic search was conducted up to November 2020 using the following databases: PubMed/MEDline, PEDro, Cochrane Library, and Web of Science.

STUDY SELECTION: Studies reporting exercise therapy in CMSDs with a predefined display of exercise intensity and an evaluation of at least 1 psychosocial outcome were included.

STUDY DESIGN: Systematic review.

LEVEL OF EVIDENCE: Level 2a.

DATA EXTRACTION: Data regarding demographics, exercise intensity, and psychosocial outcomes were included in a descriptive analysis. Methodological quality was assessed using the PEDro scale and Critical Appraisal Skills Programme (CASP) checklist.

RESULTS: A total of 22 studies, involving 985 participants (with fibromyalgia, chronic low back pain, knee osteoarthritis, psoriatic arthritis, and axial spondyloarthritis) were included (mean PEDro score = 5.77/10). The most common psychosocial outcomes were quality of life (QoL) (n = 15), depression (n = 10), and anxiety (n = 9). QoL improved at any exercise intensity in persons with fibromyalgia. However, persons with fibromyalgia benefit more from exercising at low to moderate intensity regarding anxiety and depression. In contrast, persons with chronic low back pain benefit more from exercising at a higher intensity regarding QoL, anxiety, and depression. Other CMSDs only showed limited or conflicting results regarding the value of certain exercise intensities.

CONCLUSION: Psychosocial outcomes are influenced by the intensity of exercise therapy in fibromyalgia and chronic low back pain, but effects differ across other CMSDs. Future research is necessary to determine the exercise intensity that yields optimal exercise therapy outcomes in specific CMSDs.

Original language	English
Pages (from-to)	859-874
Number of pages	16
Journal	Sports Health
Volume	14
Issue number	6
Early online date	4 Mar 2022
DOIs	https://doi.org/10.1177/19417381221075354
Publication status	Published - Nov 2022

Keywords

AEROBIC EXERCISE
DISABILITY
EMOTIONAL DISTRESS
EXPOSURE IN-VIVO
FEAR-AVOIDANCE
FIBROMYALGIA
LOW-BACK-PAIN
PROGRAM
RHEUMATOID-ARTHRITIS
SELF-EFFICACY
chronic musculoskeletal disorder
exercise therapy
intensity
psychosocial parameters

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10.1177/19417381221075354

Full TextFinal published version, 1.1 MBLicence: Taverne

Cite this

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title = "The Influence of Exercise Intensity on Psychosocial Outcomes in Musculoskeletal Disorders: A Systematic Review",

abstract = "CONTEXT: Psychosocial parameters play an important role in the onset and persistence of chronic musculoskeletal disorders (CMSDs). Exercise therapy is a valuable therapeutic modality as part of CMSD rehabilitation. Hereby, exercise intensity is an important factor regarding changes in pain and disability in multiple CMSDs. However, the impact of exercise intensity on psychosocial outcomes remains poorly explored.OBJECTIVE: To identify the effects of different modes of exercise intensity on psychosocial outcomes in persons with CMSDs.DATA SOURCES: A systematic search was conducted up to November 2020 using the following databases: PubMed/MEDline, PEDro, Cochrane Library, and Web of Science.STUDY SELECTION: Studies reporting exercise therapy in CMSDs with a predefined display of exercise intensity and an evaluation of at least 1 psychosocial outcome were included.STUDY DESIGN: Systematic review.LEVEL OF EVIDENCE: Level 2a.DATA EXTRACTION: Data regarding demographics, exercise intensity, and psychosocial outcomes were included in a descriptive analysis. Methodological quality was assessed using the PEDro scale and Critical Appraisal Skills Programme (CASP) checklist.RESULTS: A total of 22 studies, involving 985 participants (with fibromyalgia, chronic low back pain, knee osteoarthritis, psoriatic arthritis, and axial spondyloarthritis) were included (mean PEDro score = 5.77/10). The most common psychosocial outcomes were quality of life (QoL) (n = 15), depression (n = 10), and anxiety (n = 9). QoL improved at any exercise intensity in persons with fibromyalgia. However, persons with fibromyalgia benefit more from exercising at low to moderate intensity regarding anxiety and depression. In contrast, persons with chronic low back pain benefit more from exercising at a higher intensity regarding QoL, anxiety, and depression. Other CMSDs only showed limited or conflicting results regarding the value of certain exercise intensities.CONCLUSION: Psychosocial outcomes are influenced by the intensity of exercise therapy in fibromyalgia and chronic low back pain, but effects differ across other CMSDs. Future research is necessary to determine the exercise intensity that yields optimal exercise therapy outcomes in specific CMSDs.",

keywords = "AEROBIC EXERCISE, DISABILITY, EMOTIONAL DISTRESS, EXPOSURE IN-VIVO, FEAR-AVOIDANCE, FIBROMYALGIA, LOW-BACK-PAIN, PROGRAM, RHEUMATOID-ARTHRITIS, SELF-EFFICACY, chronic musculoskeletal disorder, exercise therapy, intensity, psychosocial parameters",

author = "Sim Klaps and Sarah Haesevoets and Jeanine Verbunt and Alb{\`e}re K{\"o}ke and Lotte Janssens and Annick Timmermans and Jonas Verbrugghe",

note = "Publisher Copyright: {\textcopyright} 2022 The Author(s).",

year = "2022",

month = nov,

doi = "10.1177/19417381221075354",

language = "English",

volume = "14",

pages = "859--874",

journal = "Sports Health",

issn = "1941-7381",

publisher = "Sage Periodicals Press",

number = "6",

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TY - JOUR

T1 - The Influence of Exercise Intensity on Psychosocial Outcomes in Musculoskeletal Disorders

T2 - A Systematic Review

AU - Klaps, Sim

AU - Haesevoets, Sarah

AU - Verbunt, Jeanine

AU - Köke, Albère

AU - Janssens, Lotte

AU - Timmermans, Annick

AU - Verbrugghe, Jonas

PY - 2022/11

Y1 - 2022/11

N2 - CONTEXT: Psychosocial parameters play an important role in the onset and persistence of chronic musculoskeletal disorders (CMSDs). Exercise therapy is a valuable therapeutic modality as part of CMSD rehabilitation. Hereby, exercise intensity is an important factor regarding changes in pain and disability in multiple CMSDs. However, the impact of exercise intensity on psychosocial outcomes remains poorly explored.OBJECTIVE: To identify the effects of different modes of exercise intensity on psychosocial outcomes in persons with CMSDs.DATA SOURCES: A systematic search was conducted up to November 2020 using the following databases: PubMed/MEDline, PEDro, Cochrane Library, and Web of Science.STUDY SELECTION: Studies reporting exercise therapy in CMSDs with a predefined display of exercise intensity and an evaluation of at least 1 psychosocial outcome were included.STUDY DESIGN: Systematic review.LEVEL OF EVIDENCE: Level 2a.DATA EXTRACTION: Data regarding demographics, exercise intensity, and psychosocial outcomes were included in a descriptive analysis. Methodological quality was assessed using the PEDro scale and Critical Appraisal Skills Programme (CASP) checklist.RESULTS: A total of 22 studies, involving 985 participants (with fibromyalgia, chronic low back pain, knee osteoarthritis, psoriatic arthritis, and axial spondyloarthritis) were included (mean PEDro score = 5.77/10). The most common psychosocial outcomes were quality of life (QoL) (n = 15), depression (n = 10), and anxiety (n = 9). QoL improved at any exercise intensity in persons with fibromyalgia. However, persons with fibromyalgia benefit more from exercising at low to moderate intensity regarding anxiety and depression. In contrast, persons with chronic low back pain benefit more from exercising at a higher intensity regarding QoL, anxiety, and depression. Other CMSDs only showed limited or conflicting results regarding the value of certain exercise intensities.CONCLUSION: Psychosocial outcomes are influenced by the intensity of exercise therapy in fibromyalgia and chronic low back pain, but effects differ across other CMSDs. Future research is necessary to determine the exercise intensity that yields optimal exercise therapy outcomes in specific CMSDs.

AB - CONTEXT: Psychosocial parameters play an important role in the onset and persistence of chronic musculoskeletal disorders (CMSDs). Exercise therapy is a valuable therapeutic modality as part of CMSD rehabilitation. Hereby, exercise intensity is an important factor regarding changes in pain and disability in multiple CMSDs. However, the impact of exercise intensity on psychosocial outcomes remains poorly explored.OBJECTIVE: To identify the effects of different modes of exercise intensity on psychosocial outcomes in persons with CMSDs.DATA SOURCES: A systematic search was conducted up to November 2020 using the following databases: PubMed/MEDline, PEDro, Cochrane Library, and Web of Science.STUDY SELECTION: Studies reporting exercise therapy in CMSDs with a predefined display of exercise intensity and an evaluation of at least 1 psychosocial outcome were included.STUDY DESIGN: Systematic review.LEVEL OF EVIDENCE: Level 2a.DATA EXTRACTION: Data regarding demographics, exercise intensity, and psychosocial outcomes were included in a descriptive analysis. Methodological quality was assessed using the PEDro scale and Critical Appraisal Skills Programme (CASP) checklist.RESULTS: A total of 22 studies, involving 985 participants (with fibromyalgia, chronic low back pain, knee osteoarthritis, psoriatic arthritis, and axial spondyloarthritis) were included (mean PEDro score = 5.77/10). The most common psychosocial outcomes were quality of life (QoL) (n = 15), depression (n = 10), and anxiety (n = 9). QoL improved at any exercise intensity in persons with fibromyalgia. However, persons with fibromyalgia benefit more from exercising at low to moderate intensity regarding anxiety and depression. In contrast, persons with chronic low back pain benefit more from exercising at a higher intensity regarding QoL, anxiety, and depression. Other CMSDs only showed limited or conflicting results regarding the value of certain exercise intensities.CONCLUSION: Psychosocial outcomes are influenced by the intensity of exercise therapy in fibromyalgia and chronic low back pain, but effects differ across other CMSDs. Future research is necessary to determine the exercise intensity that yields optimal exercise therapy outcomes in specific CMSDs.

KW - AEROBIC EXERCISE

KW - DISABILITY

KW - EMOTIONAL DISTRESS

KW - EXPOSURE IN-VIVO

KW - FEAR-AVOIDANCE

KW - FIBROMYALGIA

KW - LOW-BACK-PAIN

KW - PROGRAM

KW - RHEUMATOID-ARTHRITIS

KW - SELF-EFFICACY

KW - chronic musculoskeletal disorder

KW - exercise therapy

KW - intensity

KW - psychosocial parameters

U2 - 10.1177/19417381221075354

DO - 10.1177/19417381221075354

M3 - (Systematic) Review article

C2 - 35243924

SN - 1941-7381

VL - 14

SP - 859

EP - 874

JO - Sports Health

JF - Sports Health

IS - 6

ER -