Evaluation of Longitudinal Impact of Structured Physical Activity on Dermatological Health Outcomes and Its Associated Economic, Productivity, and Healthcare Utilization Implications

Abstract

Keywords: Barrier Function, Dermatology, Dermatology Life Quality Index, Exercise, Economic Burden, Healthcare Utilization, Skin Health, Transepidermal Water Loss, Work Productivity

Background: The skin is the largest organ of the body and its barrier systems are complex and may be altered by exercise due to the increase in the vascular blood flow, endocrine functions, and metabolism. Moreover, dermatological diseases are associated with a significant financial cost in terms of direct health care expenditure, loss of productivity and reduced health related quality of life, which can be mitigated by routine physical exercise. Hence the purpose of the study was to assess the longitudinal association between structured physical activity and dermatological health outcomes and the economic and healthcare utilization consequences.

Methodology: Our study was a prospective cohort study that followed 385 healthy persons aged 25-55 years over 12 months. The participants of the study were divided into four separate groups including inactive controls (n=96), moderate cardiovascular exercisers (n=97), high-intensity interval participants (n=96), and multimodal training practitioners (n=96). Primary outcomes included transepidermal water loss, cutaneous hydration and dermal elasticity measures using standardized equipment at baseline, six months, and 12 months. Secondary outcomes were related to healthcare use in dermatology, out-of-pocket spending, work productivity impairment measured with the Work Productivity and Activity Impairment (WPAI) questionnaire, and dermatology-specific quality of life measured with the Dermatology Life Quality Index (DLQI).

Results: After twelve months, cutaneous hydration increased by 17.2, 15.8, and 20.4% among moderate cardiovascular exercisers, high intensity interval exercisers, and multimodal training exercisers respectively (p<0.001). Dermal elasticity enhanced by 19.1%, 16.7%, and 22.3% respectively (p<0.001). The trans epidermal water loss reduced substantially in all exercise groups (p<0.01). Active participants were found to have 44-56% fewer visits to dermatology clinics, 37-73% reduced use of prescription medications, and PKR 17,500-23,900 in annual per-patient cost reductions compared to sedentary controls. The impairment of work productivity was reduced by 40-58% within exercise groups and the DLQI scores were significantly increased. Cutaneous complications related to exercise occurred in 13.2% of active participants and were mostly mild and short-term.

Conclusion: Multimodal cardiovascular-resistance training proved to be the best in all areas. These findings justify exercise as a cost-effective and primary intervention to improve dermatological health with a high benefit to the individual and healthcare system.