Efficacy of Exercise Therapy in Persons with Burnout. A Systematic Review and Meta-Analysis.

An increasing amount of scientific work suggests positive effects of exercise-related interventions in patients with burnout. Exercise therapy could therefore be a useful intervention procedure in the treatment of burnout. The aim of this meta-analysis is to examine empirical findings for exercise therapy used to treat burnout in the occupational setting, including the variety of the application and variety of the exercise modality itself. Electronic databases (PubMed, Cochrane Library, Scopus, PubPsych, PsycInfo) were searched (January 2018) for randomized controlled trials reporting on exercise therapy intervention studies in persons with burnout. The burnout scores from the various measurement instruments as well as standardized mean differences (SMDs) with 95% confidence intervals (CI) were calculated and seen as the main outcomes and measures. Four out of six studies with a total sample of 248 participants could be used for meta-analysis. A statement on the combined effect size can only be made with caution due to the length of the confidence interval of [-0.41; 0.09]. With an I² value of 0%, no heterogeneity is present in this meta-analysis. Ultimately there was no clear difference found between intervention and control conditions. This paper does not support the widespread assumption that exercise therapy seems to be a successful means to alleviate burnout symptoms. However, the different types of physical activity and treatment modalities used in the included studies impede clear conclusions. Future studies should deal with the specific efficacy of different exercise modalities and their combination with further cognitive behavioural or mindfulness-based interventions.

Blood lactate diagnostics in exercise testing and training.

A link between lactate and muscular exercise was seen already more than 200 years ago. The blood lactate concentration (BLC) is sensitive to changes in exercise intensity and duration. Multiple BLC threshold concepts define different points on the BLC power curve during various tests with increasing power (INCP). The INCP test results are affected by the increase in power over time. The maximal lactate steady state (MLSS) is measured during a series of prolonged constant power (CP) tests. It detects the highest aerobic power without metabolic energy from continuing net lactate production, which is usually sustainable for 30 to 60 min. BLC threshold and MLSS power are highly correlated with the maximum aerobic power and athletic endurance performance. The idea that training at threshold intensity is particularly effective has no evidence. Three BLC-orientated intensity domains have been established: (1) training up to an intensity at which the BLC clearly exceeds resting BLC, light- and moderate-intensity training focusing on active regeneration or high-volume endurance training (Intensity < Threshold); (2) heavy endurance training at work rates up to MLSS intensity (Threshold ≤ Intensity ≤ MLSS); and (3) severe exercise intensity training between MLSS and maximum oxygen uptake intensity mostly organized as interval and tempo work (Intensity > MLSS). High-performance endurance athletes combining very high training volume with high aerobic power dedicate 70 to 90% of their training to intensity domain 1 (Intensity < Threshold) in order to keep glycogen homeostasis within sustainable limits.