589685
research-article2015
WHSXXX10.1177/2165079915589685Workplace Health & SafetyWorkplace Health & Safety
Workplace Health & Safety
ARTICLE
Effects of an 8-Week Outdoor Brisk Walking
Program on Fatigue in Hi-Tech Industry Employees
A Randomized Control Trial
Li-Ling Wu, MS1, Kuo-Ming Wang, MS1, Po-I Liao, MS1, Yu-Hsiu Kao, PhD1, and Yi-Ching Huang, PhD1
Abstract: Over 73% of hi-tech industry employees
in Taiwan lack regular exercise. They are exposed
to a highly variable and stressful work environment
for extended periods of time, and may subsequently
experience depression, detrimental to workers’
physiological and mental health. In this cross-sectional
survey, the authors explored the effect of an 8-week brisk
walking program on the fatigue of employees in the hi-
tech industry. The participants, from a hi-tech company
in northern Taiwan, were randomly assigned to an
experimental group (EG; 41 subjects, Mage = 33.34 ± 6.40)
or control group (CG; 45 subjects, Mage = 29.40 ± 3.60).
Following the 8-week brisk walking program, the EG
showed significantly lower scores for subjective fatigue,
working motivation, attention, and overall fatigue. The
authors confirmed that the 8-week outdoor brisk walking
program significantly improved the level of fatigue among
employees of the hi-tech industry. The finding serves as
an important reference for health authorities in Taiwan
and provides awareness of workplace health promotion
in the hi-tech industry.
Keywords: hi-tech industry, employees, brisk walking,
fatigue, health promotion
T
he disadvantages of working in the high technology
(hi-tech) industry include long work hours, high work
stress, and overtime (C. Y. Chen, Wu, & Hsu, 2010).
Employees in the hi-tech industry, exposed to a highly
variable and stressful work environment, are prone to
develop anxiety due to job performance expectations and
fatigue. Anxiety and fatigue may subsequently cause
depression and become detrimental to workers’ physiological
and mental health (C. Y. Chen et al., 2010). Fatigue has been
defined as a subjective feeling related to cognition, mood,
and behavior (Williamson et al., 2011). Prolonged fatigue
DOI: 10.1177/2165079915589685. From 1National Taipei University of Nursing and Health Sciences. Address correspondence to: Yi-Ching Huang, Department of Exercise and Health Science,
National Taipei University of Nursing and Health Sciences, No. 365, Min Te Road 112, Taipei, Taiwan, Republic of China; email: yiching@ntunhs.edu.tw.
For reprints and permissions queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.
Copyright © 2015 The Author(s)
436
October 2015
may affect workers’ cognitive function, physiological health,
and psychological health, subsequently diminishing job
performance and, in severe cases, causing physiological
illnesses and injuries (Ericson-Lidman, Norberg, & Strandberg,
2007; Olson, 2007). Shephard (2005) indicated that regular
exercise or physical activity can reduce the negative effects
(e.g., anxiety) of a sedentary lifestyle, decreasing fatigue and
preventing depression. However, an investigation conducted
by the Taiwan Ministry of Health and Welfare (2014) with
6,000 full-time workers in the hi-tech industry found that
73.4% did not engage in regular exercise. Hence, hi-tech
workers need exercise opportunities that are simple,
requiring no complicated skills and performed anywhere at
any time.
Brisk walking originated in the United States and has gained
popularity in Germany, England, and Japan. This rhythmic,
dynamic, aerobic activity is simple, requires no complicated
skills or expensive equipment, and can be performed anywhere
at any time (Morris & Hardman, 1997). In recent years, brisk
walking has become a fitness trend in Taiwan (Taiwan Health
and Exercise Association [THEA], 2008). Studies have shown that
a daily 30-minute brisk walk improves body composition, blood
lipids, and psychological health. J. L. Lin, Chang, Huang, and
Lee (2009) found that a 30-minute brisk exercise intervention
can decrease fatigue among sedentary female workers in a
hospital. Puetz, Flowers, and O’Connor (2008) examined the
effect of a brisk exercise intervention on 36 sedentary healthy
adults reporting chronic or persistent feelings of fatigue. The
results showed that brisk walking reduced feelings of fatigue by
65%.
Currently, a majority of studies on brisk walking conducted
in Taiwan or other countries examined its physiological
implications (e.g., body composition, blood lipids, and
cardiovascular disease; Kim &Yang, 2005; Tully, Cupples, Chan,
McGlade, & Young, 2005), and its effect on chronic disease and
in the elderly population (Lin, Yen, et al., 2009; F. T. Lin, Chang,
Lee, & Yang, 2011).
vol. 63  ■  no. 10
Applying Research to Practice
In a time of economic recession, the design of a cost-
effective program to promote the health of employees
has become a workplace challenge. To prevent
occupational health hazards and improve working
conditions, employers must offer occupational health care
services for employees using experienced occupational
health care professionals and consultants. This study
provides an example of a brisk walking intervention for
employee health promotion; the implications of this
research are significant.
Among these studies, randomized control trials are absent, and
no study has investigated the health benefits of brisk walking
among workers. As mentioned earlier, workers in the hi-tech
industry are more susceptible to physiological and psychological
disorders and experience more fatigue than those in other
occupations. Therefore, exploring the effect of brisk walking on
worker fatigue may be beneficial for organizations as well as
workers. The hypothesis of this study was that an 8-week outdoor
brisk walking program would significantly improve fatigue among
workers in the hi-tech industry. Health authorities in Taiwan and
international health care providers may use these findings to
improve the health status of hi-tech workers in other countries.
Method
A randomized control trial was used in this cross-sectional
survey. Convenience sampling was used to select participants
from a hi-tech company in northern Taiwan. Participants were
asked to sign a consent form and requested not to change their
exercise habits or activities of daily living during the research
process. The experimental group (EG) received a brisk walking
intervention (i.e., 45-60 minutes per session, twice a week for 8
consecutive weeks), and the control group (CG) received no
exercise intervention.
The inclusion criteria for this study included the following:
no regular exercise within 3 months of study initiation (i.e., less
than two exercise sessions per week, less than 30 minutes per
session, and heart rate during physical activity less than [220
− age] × 60%), no physical disability, no severe heart disease or
hypertension, no severe knee or lower back pain. One hundred
four voluntary participants met the criteria and attended the
initial meeting. The participants were randomly assigned to the
EG and the CG. Each group was comprised of 52 workers; if
workers participated in less than 80% of the activities, they were
removed from the study. Thus, a total of 41 workers in the EG
completed the brisk walking program and evaluations; a total of
45 workers in the CG completed the evaluations.
Instruments
Instruments for this study included structured questionnaires
and Checklist Individual Strength (CIS) questionnaires.
Workplace Health & Safety
The structured questionnaire included demographic
information: age, gender, marital status, education, occupation,
years of work experience, average work hours, health history,
smoking status, exercise habits, club participation, exercise
partner, self-reported health condition, self-reported happiness,
height, weight, body mass index (BMI), body fat percentage,
and waist circumference.
The CIS questionnaire, Chinese version CIS adapted by
Wang, Huang, Young, and Chuang (2000), was used in this
study. The CIS questionnaire measures four dimensions,
including subjective fatigue (eight items), reduction in
motivation (four items), reduction in activity (three items), and
reduction in concentration (five items). The workers indicated
on a 7-point Likert-type scale to what extent the particular
statement applies to them. The CIS included 11 positively
phrased items and 9 negatively phrased items. The workers
responded according to how they had felt during the preceding
2 weeks. Scores were calculated by adding the scores, ranging
from 20 to 140, from the four dimensions. Higher scores
indicated a higher level of subjective fatigue experience.
Cronbach’s alpha for the CIS Chinese version was .88.
An independent samples t test indicated that the scores for
the group who reported fatigue were significantly different (p <
.0001) from those who did not report fatigue. The Chinese CIS
questionnaire has demonstrated satisfactory reliability and
validity and significantly differentiates fatigued individuals from
non-fatigued individuals (Wang et al., 2000).
Brisk Walking Program
The brisk walking program was designed and implemented
by professional trainers. The basic movement for brisk walking
was adapted from the guidelines provided by the THEA (2008):
When walking at a quick pace, workers should take slow, long
deep breaths; level the head with a slightly lifted chest and
keep the lower abdomen tucked in; bend arms 90° at the
elbow, close the hands in relaxed fists, and place them near the
waist; when swinging the arms forward, workers should keep
the hands level at lower than the chest; the knees should not be
locked but remain relaxed.
The workers who participated in brisk walking were
instructed to imagine that they were walking as if they were in a
hurry to catch a bus. This instruction was used successfully in
other studies (Taylor, Katomeri, & Ussher, 2005; Taylor & Oliver,
2009) to be sure participants walked with moderate intensity.
Interventions
Before the intervention, the researchers designed a standard
operating procedure (SOP) to confirm that all workers in the EG
could measure their pulses properly. They were asked to attend
a one-on-one meeting, with qualified occupational health
nurses and exercise specialists, to help them learn to properly
measure the pulse.
The SOP to measure the pulse included the following:
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•• Measure resting heart rate: Find the radial pulse, the
pulse on the inside of the wrist. Use the pads of the
index (first) and middle fingers, not your thumb. To
measure the pulse, use a watch or a clock with a second
hand. The resting heart rate is calculated by measuring
the number of beats in 15 seconds multiplied by 4.
•• Confirm all workers can measure radial pulses
successfully each time: Workers must measure and record
pulses with supervision from qualified occupational
health nurses and exercise specialists. If anyone has
difficulty measuring the pulse, nurses and specialists will
guide them individually to confirm that all participants
can measure pulses correctly.
•• During the intervention: After covering half the walking
distance, staff shout out when to begin to measure pulses
for 15 seconds. All workers stop walking and measure
their pulses in pairs for 15 seconds. Occupational health
nurses and exercise specialists supervised and recorded
the heart rate of each worker, multiplying the rate by 4 to
calculate their heart rate per minute.
To maintain the quality of the intervention, the number of
participants was limited to 22 per class, so the 41 workers in the
EG were divided into Class A (19 persons) and Class B (22
persons). Participants in each class walked briskly on 2 separate
days per week, Class A was scheduled for Mondays and
Wednesday, Class B was scheduled for Tuesdays and Thursday
(see the appendix).
A professional trainer managed the exercise program
according to participants’ heart rates to maintain heart rates
between 60% and 90% of HRmax. Each brisk walking session
covered the same distance with duration between 45 minutes and
60 minutes. The warm-up and cool-down sessions lasted 10 to 20
minutes. The program continued for 8 weeks. The venues for the
brisk walking program were scheduled during the hour after
work, and mainly outdoor walking tracks or sidewalks were
used. When raining, brisk walking took place at the indoor sports
court in the office building. The participants in the CG performed
regular daily activity without any aerobic exercise or continued
exercising at less than two sessions per week.
During each session, after covering half the distance, the
workers were grouped in pairs to measure one another’s pulse
rate supervised by occupational health nurses. The pulse rate
was multiplied by 4 to calculate their heart rates per minute.
The HRmax was then calculated with a formula and recorded
after each measurement. Pulse rate was measured at the halfway
point of the session to ensure that workers’ heart rate was
between 60% and 90% of HRmax. The brisk walking card was
stamped each time to record the number of sessions and the
heart rate of workers.
Data Analysis
Descriptive statistical analyses were used to describe the
participants’ variable distributions using means, standard
438
October 2015
deviations, frequencies, and percentages; independent samples t
test and chi-square test were used to examine the differences
between the EG (Classes A and B) and CG pretest scores. The
paired t test was used to assess differences between the fatigue
pretest and posttest for both the EG (Classes A and B) and CG.
For effectiveness, ANCOVA was used (i.e., the pretest was used
as a covariate), and the adjusted means at posttest were the
focus. The significance level for all statistics was set at p < .05.
Ethical Considerations
This study was reviewed and approved by the Taipei City
Hospital Institutional Review Board (Case TCHIRB-1020210-E).
All participants were informed about the purpose, process,
benefits, and risks of this intervention before their applications
were accepted, and participants could freely decide if they
wanted to participate or withdraw their applications. Those who
wished to participate were required to complete two copies of
the Consent to Participate in Research form.
Results
Eighty-six workers participated in the study; 41 participants
were in the EG, and 45 participants were in the CG. The
independent samples t test and Pearson’s chi-square test
demonstrated no significant differences between the EG and CG
with respect to gender, marital status, education level,
occupation, years of work experience, average working hours,
health history, smoking status, exercise habits, club
participation, exercise partner, self-reported health conditions,
self-reported happiness, height, weight, BMI, body fat
percentage, and waist circumference. Only average age was
significantly different (p = .01; Tables 1 and 2).
Difference in Fatigue Status
Between Pretest and Posttest
The Chinese version of the CIS questionnaire measured four
dimensions: subjective fatigue, motivation, activity, and
concentration. The levels of fatigue at pretest between the two
groups were not significantly different (Table 3). The results
following the brisk walking intervention were as follows:
Subjective fatigue
After the 8-week brisk walking intervention, the posttest
subjective fatigue score between the EG and CG did not differ
significantly (p > .05). However, the pretest/posttest changes in
subjective fatigue in the EG and CG did vary significantly (p <
.0001; Tables 4 and 5).
Reduction in motivation
After the 8-week brisk walking intervention, the posttest
reduction in motivation between the EG and CG showed a
statistical difference (p < .01). The pretest/posttest changes
between the EG and CG also varied significantly (p < .01; Tables
4 and 5).
vol. 63  ■  no. 10 Workplace Health & Safety

Table 1.  Chi-Square Test of Demographic Characteristics

Variables EG (n = 41) CG (n = 45) p value

N (%) N (%)  
Gender .084
 Male 16 (39.0) 27 (60.0)  
 Female 25 (61.0) 18 (40.0)  
Marital status .082
 No 27 (65.9) 37 (82.2)  
 Yes 14 (34.1) 8 (17.8)  
Education level .171
 College 35 (85.4) 33 (73.3)  
  Master’s degree 6 (14.6) 12 (26.7)  
Occupation .088
 Director 9 (22.0) 2 (4.4)  
  Design engineer 21 (51.2) 27 (60.0)  
 Engineer 2 (4.9) 3 (6.6)  
  Support service 9 (22.0) 13 (28.9)  
Work experience .064
  <1 year 7 (17.1) 7 (15.6)  
  2-4 years 14 (34.1) 27 (60.0)  
  5-7 years 9 (22.0) 6 (13.3)  
  >8 years 11 (26.9) 5 (11.0)  
Average working hours .297
  <9 hours 12 (29.3) 18 (40.0)  
  >9 hours 29 (70.7) 27 (60.0)  
Medical history .401
 No 35 (85.4) 36 (80.0)  
 Yes 6 (14.6) 9 (20.0)  
Mediation .262
 No 38 (92.7) 44 (97.8)  
 Yes 3 (7.3) 1 (2.2)  
Smoking status .378
 No 36 (87.8) 42 (93.3)  
 Yes 5 (12.2) 3 (6.7)  

Note. EG = experimental group; CG = control group.

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 Workplace Health & Safety October 2015

Table 2.  Homogeneity Test of Pretest in Healthy Status Between Both Groups

EG (n = 41) CG (n = 45)
Variables M ± SD M ± SD p value Statistics
a
Age 33.34 ± 6.40 29.40 ± 3.59 .01
a
Height 164.39 ± 8.76 168.62 ± 8.76 .28
a
Weight 64.06 ± 13.66 66.55 ± 14.66 .419
a
BMI 23.59 ± 3.89 23.25 ± 3.93 .689
a
Body fat % 28.08 ± 7.07 25.08 ± 8.00 .07
a
Waist circumference 78.60 ± 10.38 79.08 ± 11.39 .839
b
Total exercise days a week .359
  None or <1 time 27 (65.8%) 24 (53.3%)  
  1-2 times a week 13 (31.7%) 18 (40%)  
 Irregularly 1 (2.4%) 3 (6.6%)  
b
Exercise club .862
 No 35 (85.4%) 39 (86.7%)  
 Yes 6 (14.6%) 6 (13.3%)  
b
Exercise friends .600
 No 26 (63.4%) 25 (55.5%)  
 Sometimes 11 (26.8%) 18 (40%)  
 Often 4 (9.7%) 2 (4.4%)  
b
Perceived health status .449
 Bad 30 (73.2%) 30 (66.6%)  
 Ordinary 9 (22.0%) 15 (33.3%)  
 Well 2 (4.8%) 0 (0%)  
b
Perceived happiness status .424
 Bad 5 (12.2%) 2 (4.4%)  
 Ordinary 23 (56.1%) 23 (51.1%)  
 Well 13 (31.7%) 20 (4.4%)  

Note. EG = experimental group; CG = control group; BMI = body mass index.

a
Independent t test.
b
Chi-square test.

Reduction in activity Reduction in concentration

After the 8-week brisk walking intervention, the posttest
reduction in activity between the EG and CG did not differ
significantly (p > .05). However, the pretest/posttest changes
between the EG and CG varied significantly (p < .01; Tables 4
and 5).
After the 8-week brisk walking intervention, the posttest
reduction in concentration between the EG and CG was not
significantly different (p > .05). However, the pretest/posttest
changes between the EG and CG demonstrated a statistical
difference (p < .01; Tables 4 and 5).

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vol. 63  ■  no. 10 Workplace Health & Safety

Table 3.  Comparison of Pretest Results Between Both Groups

EG (n = 41) CG (n = 45) 95% CI

Variables M ± SD M ± SD [Low, high] t p
Subjective fatigue 32.37 7.55 29.96 8.32 [−1.01, 5.82] 1.40 .16
Reduction in motivation 14.54 3.92 14.18 3.79 [−1.30, 2.01] 0.43 .67
Reduction in activity 9.73 3.47 8.73 2.86 [−.036, 2.36] 1.46 .15
Reduction in concentration 19.12 4.52 18.02 4.01 [−0.73, 2.93] 1.20 .24
Overall fatigue 75.71 16.02 70.67 16.67 [−1.98, 12.07] 1.08 .80

Note. EG = experimental group; CG = control group; CI = confidence interval.

Table 4.  Comparison of Posttest Results Between Both Groups

EG (n = 41) CG (n = 45) 95% CI

Variables M ± SD M ± SD (Low, high) t p
Subjective fatigue 26.54 7.51 29.82 9.02 [−6.87, 0.29] −1.83 .07
Reduction in motivation 12.32 3.30 14.24 3.69 [−3.43, −0.42] −2.54 .01
Reduction in activity 8.83 2.80 9.84 2.99 [−2.26, 0.23] −1.62 .11
Reduction in concentration 16.93 4.92 18.09 4.14 [−3.10, 0.78] −1.19 .24
Overall fatigue 64.51 16.170 72.07 17.56 [−14.82, −0.29] −2.07 .04

Note. EG = experimental group; CG = control group; CI = confidence interval.

Table 5.  Changes in Fatigue Status for Samples in Pretest/Posttest

EG (n = 41) CG (n = 45)
Change amount Change amount 95% CI
Variables M ± SD M ± SD (Low, high) paired t p
Subjective fatigue −5.83 6.72 −0.13 6.76 [−8.59, −2.80] −3.91 <.0001
Reduction in motivation −2.22 3.26 0.07 3.90 [−3.83, −0.74] −2.93 .004
Reduction in activity −0.90 4.06 1.11 2.77 [−3.49, −0.54] −2.71 .008
Reduction in concentration −2.20 4.49 0.07 3.48 [−3.97, −0.54] −2.62 .01
Overall fatigue −11.20 13.35 1.40 12.80 [−18.20, −6.98] −4.47 <.0001

Note. EG = experimental group; CG = control group; CI = confidence interval.

Overall fatigue Effects of Brisk Walking Exercise on Fatigue Status

After the 8-week brisk walking intervention, the posttest overall Statistical process control was used to compare the 8-week
fatigue between the EG and CG showed a significant difference (p brisk walking intervention effects to eliminate any predominant
< .05). The pretest/posttest changes between the EG and CG also differences between the groups before the intervention.
demonstrated a statistical difference (p < .001; Tables 4 and 5). Therefore, pretest results for both groups were used as the

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 Workplace Health & Safety
Table 6.  ANCOVA in Posttest Between Both Groups
EG (n = 41)
Change amount
Variables M ± SE
Subjective fatigue 25.80 1.03
Reduction in motivation 12.40 0.49
Reduction in activity 8.72 0.44
Reduction in concentration 16.59 0.60
Overall fatigue 64.06 2.00
Note. Covariate: the pretest fatigue score and age were used as covariates. EG = experimental group; CG = control group; SE = standard error.
covariate for ANCOVA when comparing the groups on the
effects of the exercise intervention. Before ANCOVA, the
homogeneity of the within-class regression coefficient was
calculated to determine if the slope of each group was the
same, a fitness determinant of the homogeneity hypothesis. At
pretest, the mean age of the EG was significantly higher than
that of the CG. No significant between-group difference was
identified for the other demographic variables. The pretest
fatigue score and age were used as covariates to eliminate their
effects (Table 6).
Subjective fatigue
After eliminating the effects of pretest scores and age, the
posttest subjective fatigue scores for the EG and CG varied
significantly (F = 10.11, p < .01). The adjusted score for the EG
was 25.80, which was significantly lower than that of the CG
(30.49). This finding indicated that the 8-week outdoor brisk
walking intervention improved subjective fatigue for the EG.
Reduction in motivation
After removing the effects of pretest scores and age, the
posttest motivation scores for the EG and CG varied significantly
(F = 6.45, p < .05). The adjusted score for the EG was 12.40,
which was significantly lower than that of the CG (14.17). This
finding indicated that the 8-week outdoor brisk walking
intervention had a positive effect on motivation for the EG.
Reduction in activity
After eliminating the effects of pretest scores and age,
posttest activity scores for the EG and CG did not vary
significantly (F = 3.66, p > .05). The adjusted score for the EG
was 8.72 and 9.94 for the CG. This finding showed that the
8-week outdoor brisk walking intervention did not affect the
activity for the EG and CG.
Reduction in concentration
After eliminating the effects of pretest scores and age, the
posttest concentration scores for the EG and CG varied
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October 2015
CG (n = 45)
Change amount
M ± SE F p
30.49 0.98 10.11 .0021
14.17 0.46 6.45 .0130
9.94 0.42 3.66 .0592
18.40 0.57 4.39 .0392
73.39 1.90 12.99 .0005
significantly (F = 4.39, p < .05). The adjusted score for the EG
was 16.59, which was significantly lower than that of the CG
(18.4). This finding indicated that the 8-week outdoor brisk
walking intervention improved concentration for the EG.
Overall fatigue
After eliminating the effects of pretest scores and age, the
posttest overall fatigue scores for the EG and CG varied
significantly (F = 12.99, p < .001). The adjusted score for the EG
was 64.06, which was significantly lower than that of the CG
(73.39). This finding indicated that the 8-week outdoor brisk
walking intervention improved the degree of overall fatigue of
workers in the Taiwanese hi-tech industry.
Discussion
The hypothesis of this study was that the 8-week outdoor
brisk walking program would significantly improve the level of
fatigue of workers in the hi-tech industry; study findings
answered the hypothesis and demonstrated intervention
benefits.
Lee (2006) examined the effect of brisk walking on middle-
aged women. The women were assigned either moderate
intensity, brisk walking, or CG with no exercise; they engaged
in brisk walking three times per week. Puetz et al. (2008)
examined the effect of exercise on sedentary healthy adults with
chronic or persistent fatigue. The healthy adults were assigned
to moderate intensity exercise, low intensity exercise, or no
exercise groups. Twenty-minute brisk walking occurred three
times per week. The groups that received the brisk walking
intervention showed less fatigue; the CG without the brisk
walking intervention did not demonstrate less fatigue. These
findings are consistent with the results of this study.
Workers in the hi-tech industry are exposed to a highly
variable and stressful work environment for extended periods of
time, and thus are prone to fatigue due to overwork. Several
studies have proposed that exercise can lessen fatigue. Exercise
intensity does not have to be high or strong to alleviate fatigue;
vol. 63  ■  no. 10
less frequency and time can prevent muscle ache or discomfort
(H. L. Chen, Fang, Chuang, & Chu, 2013; Wu & Ko, 2012). Wu
and Ko (2012) also suggested that a rest day after exercise is
optimal because rest promotes recovery following a workout
and therefore prevents discomfort. This study further
demonstrated that a moderate intensity brisk walking program
at a frequency of twice each week for more than 45 minutes per
session at 60% to 90% of the HRmax reduces fatigue for workers
in the hi-tech industry.
In previous studies, CIS was primarily used to distinguish
fatigued patients from healthy patients. CIS has also been used
to measure fatigue, making it a useful instrument in assessing
population groups experiencing fatigue (Vercoulen, Alberts, &
Bleijenberg, 1999; Vercoulen et al., 1994). H. L. Chen et al.
(2013) used CIS and an exercise behavior questionnaire to
examine the association between exercise behavior and level of
fatigue among elementary school teachers. The results showed
a negative correlation between fatigue and exercise behavior,
indicating that elementary school teachers who performed
regular exercise were less likely to be fatigued, which is
consistent with the findings of this study. The results confirmed
the notion that exercise improves fatigue.
A literature review showed that CIS has been used primarily
to categorize fatigue and evaluate its prevalence rate (Bültmann,
Kant, Beurskens, & van den Brandt, 2002) or to identify the
level of fatigue among different occupational groups (Aratake
et al., 2007). Few studies have used CIS to determine the effect
of exercise intervention on fatigue (H. L. Chen et al., 2013). CIS
is comprised of physiological, psychological, working
motivations, and productivity evaluation dimensions; however,
limited studies have examined the influence of exercise on
these dimensions. It has been proposed that severe fatigue in
workers can lead to muscle ache, weakness, decreased memory
and concentration, impaired judgment, poor reaction time and
movement, and impaired work performance (Ericson-Lidman
et al., 2007; Olson, 2007). This study used CIS to measure the
effect of an outdoor brisk walking intervention on the four
dimensions (i.e., subjective fatigue, reduction in motivation,
reduction in activity, and reduction in concentration) of fatigue
and found noticeable improvement in EG.
Workplace Health & Safety
Limitations of This Study
Potential limitations of this study included the following:
•• Budget constraints and workforce limitations that resulted
in the posttest being completed immediately after the
8 weeks of brisk walking intervention; the participants
were not monitored later. As a result, it is not known
whether the improvement in fatigue status from this period
of training continued after the study was terminated.
•• Because of budget constraints, the researchers did not
use pulse monitor equipment to detect pulse changes.
Although the researchers confirmed that all participants
assessed their pulses accurately by individual oversight,
some objective personal errors may have occurred.
•• The researchers adopted a randomized controlled trial
design; however, it was only conducted in Taipei City,
and the size of the valid sample was only 86. Thus, the
findings cannot be extended to the rest of the population
in Taiwan.
Conclusion
Brisk walking is an acceptable form of exercise for a large
portion of the population. It does not require formal training or
special equipment, and individuals can walk in their own
locality and time.
Studies typically recommend regular exercise of three
30-minute sessions weekly. This study has shown that a twice
weekly 60-minute session is also beneficial. Specifically, workers
can exercise in the natural environment near the office with
coworkers, facilitating bonding between workers and
development of a regular exercise routine. Brisk walking is
suitable for hi-tech workers who sit for long periods of time,
minimally exercise, and perform stressful work, as walking
promotes healthy lifestyles over time. The researchers confirmed
that the 8-week outdoor brisk walking program can significantly
reduce fatigue among hi-tech employees. These findings serve
as a reference for health authorities in Taiwan and provide
awareness about workplace health promotion in the hi-tech
industry.
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Appendix

Warm up Walking Cool down

Week Day Class (minutes) (minutes) (minutes) Place
Week 1 Monday A 10 60  5 Walking tracks or sidewalks
Tuesday B 10 60  5 Walking tracks or sidewalks
Wednesday A 10 60  5 Walking tracks or sidewalks
Thursday B 10 60  5 Walking tracks or sidewalks
Week 2 Monday A 10 60  5 Walking tracks or sidewalks
Tuesday A, B 10 60  5 Walking tracks or sidewalks
Wednesday A 10 60  5 Walking tracks or sidewalks
Week 3 Monday A 10 55  5 Walking tracks or sidewalks
Tuesday B 10 55  5 Walking tracks or sidewalks
Wednesday A 10 55 10 Walking tracks or sidewalks
Thursday B 10 55 10 Indoor sports court
Week 4 Monday A 10 55  5 Walking tracks or sidewalks
Tuesday B 10 55  5 Walking tracks or sidewalks
Wednesday A 10 55 10 Walking tracks or sidewalks
Thursday B 10 55 10 Walking tracks or sidewalks
Week 5 Monday A 15 50 5 Walking tracks or sidewalks
Tuesday B 15 50 5 Walking tracks or sidewalks
Wednesday A 15 50 10 Walking tracks or sidewalks
Thursday B 15 50 10 Walking tracks or sidewalks
Week 6 Monday A 15 50 10 Walking tracks or sidewalks
Tuesday A, B 15 50 10 Walking tracks or sidewalks
Thursday A 15 50 10 Walking tracks or sidewalks
Week 7 Monday A 15 45 10 Indoor sports court
Tuesday B 15 45 10 Walking tracks or sidewalks
Wednesday A 15 45 10 Walking tracks or sidewalks
Thursday B 15 45 10 Walking tracks or sidewalks
Week 8 Monday A 15 45 10 Walking tracks or sidewalks
Tuesday B 15 45 10 Walking tracks or sidewalks
Wednesday A 15 45 10 Indoor sports court
Thursday B 15 45 10 Walking tracks or sidewalks

Note. Class A: 19 persons; Class B: 22 persons.

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vol. 63  ■  no. 10
Conflict of Interest
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
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Author Biographies
Li-Ling Wu is an occupational health nurse for a hi-tech industry.
Kuo-Ming Wang is an assistant professor in the Department of
Exercise and Health Sciences, National Taipei University of
Nursing and Health Sciences.
Po-I Liao is a physician in the Taiwan Adventist Hospital.
Yu-Hsiu Kao is an associate professor in the Graduate Institute
of Health Allied Education, National Taipei University of Nursing
and Health Sciences.
Yi-Ching Huang is a professor in the Department of Exercise and
Health Sciences, National Taipei University of Nursing and
Health Sciences.
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