Muscle-strengthening exercise and public health assessment and monitoring

Muscle-strengthening exercise and public health assessment and monitoring

Participation in muscle-strengthening exercise (MSE), e.g., using weight machines, free weights, or bodyweight, improves health and independently reduces the risks associated with many non-communicable diseases. While MSE is included in national/global physical activity guidelines, participation in MSE is low. Moreover, methods assessing MSE participation vary considerably leading to a potential misunderstanding of the relationship between MSE and health. Therefore, this thesis by publication aims to (i) review the assessment of MSE within public health surveillance (Study 1), (ii) examine relationships between MSE and health (Study 2 and 3), and (iii) describe the development, reliability/validity testing (Study 4) of a new survey instrument to assess multiple MSE participation components and influencing factors (Study 5). Study 1 comprised a systematic review of MSE surveillance studies (k=156). Secondary data analyses explored the relationship between adult MSE participation and five chronic health conditions (Study 2, N = 16,301); and hypertension (Study 3, N = 10,519). Study 4 describes the development of the Muscle-Strengthening Exercise Questionnaire (MSEQ) and its test-retest reliability (n = 85) and concurrent validity (n = 54). Factors influencing adult MSE participation (N = 435) were analysed in Study 5. Study 1 identified the under-representation of key MSE guideline components and highlighted the need for standardisation. Studies 2 and 3 showed, compared to doing none, adults who reported any MSE (~19%) had a reduced prevalence of having a chronic condition. Study 4 showed ‘acceptable’ reliability and validity of five key MSE components. Study 5 identified five behavioural factors that significantly influenced the odds of meeting the MSE guidelines. Overall, the data presented in this thesis increases the body of knowledge regarding the relationship between MSE and health. Moreover, this PhD has developed a new valid and reliable questionnaire to assess population-level MSE participation. Current findings could aid campaigns targeting populations most at risk of chronic disease and increase MSE uptake and adherence at the population level.

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