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Medina‐Inojosa JR, Gomez Ibarra MA, Medina‐Inojosa BJ, Supervia M, Jenkins S, Johnson L, Suarez NP, Bonikowske A, Somers VK, Lopez‐Jimenez F. Effect of Active Workstations on Neurocognitive Performance and Typing Skills: A Randomized Clinical Trial. J Am Heart Assoc 2024; 13:e031228. [PMID: 38572691 PMCID: PMC11262529 DOI: 10.1161/jaha.123.031228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 02/06/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Extended sedentary behavior is a risk factor for chronic disease and mortality, even among those who exercise regularly. Given the time constraints of incorporating physical activity into daily schedules, and the high likelihood of sitting during office work, this environment may serve as a potentially feasible setting for interventions to reduce sedentary behavior. METHODS AND RESULTS A randomized cross-over clinical trial was conducted at an employee wellness center. Four office settings were evaluated on 4 consecutive days: stationary or sitting station on day 1 (referent), and 3 subsequent active workstations (standing, walking, or stepper) in randomized order. Neurocognitive function (Selective Attention, Grammatical Reasoning, Odd One Out, Object Reasoning, Visuospatial Intelligence, Limited-Hold Memory, Paired Associates Learning, and Digit Span) and fine motor skills (typing speed and accuracy) were tested using validated tools. Average scores were compared among stations using linear regression with generalized estimating equations to adjust standard errors. Bonferroni method adjusted for multiple comparisons. Healthy subjects were enrolled (n=44), 28 (64%) women, mean±SD age 35±11 years, weight 75.5±17.1 kg, height 168.5±10.0 cm, and body mass index 26.5±5.2 kg/m2. When comparing active stations to sitting, neurocognitive test either improved or remained unchanged, while typing speed decreased without affecting typing errors. Overall results improved after day 1, suggesting habituation. We observed no major differences across active stations, except decrease in average typing speed 42.5 versus 39.7 words per minute with standing versus stepping (P=0.003). CONCLUSIONS Active workstations improved cognitive performance, suggesting that these workstations can help decrease sedentary time without work performance impairment. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT06240286.
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Affiliation(s)
- Jose R. Medina‐Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular MedicineMayo ClinicRochesterMNUSA
- Division of Epidemiology, Department of Quantitative Health SciencesMayo ClinicRochesterMNUSA
| | - Miguel A. Gomez Ibarra
- Division of Preventive Cardiology, Department of Cardiovascular MedicineMayo ClinicRochesterMNUSA
| | - Betsy J. Medina‐Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular MedicineMayo ClinicRochesterMNUSA
| | - Marta Supervia
- Division of Preventive Cardiology, Department of Cardiovascular MedicineMayo ClinicRochesterMNUSA
- Department of Physical Medicine and RehabilitationGregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Dr. EsquerdoMadridSpain
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences‐INEFUniversidad Politecnica de MadridMadridSpain
| | - Sarah Jenkins
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health SciencesMayo ClinicRochesterMNUSA
| | - Lynne Johnson
- Dan Abraham Healthy Living CenterMayo ClinicRochesterMNUSA
| | - Nathalie P. Suarez
- Division of Preventive Cardiology, Department of Cardiovascular MedicineMayo ClinicRochesterMNUSA
| | - Amanda Bonikowske
- Division of Preventive Cardiology, Department of Cardiovascular MedicineMayo ClinicRochesterMNUSA
| | - Virend K. Somers
- Division of Preventive Cardiology, Department of Cardiovascular MedicineMayo ClinicRochesterMNUSA
| | - Francisco Lopez‐Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular MedicineMayo ClinicRochesterMNUSA
- Dan Abraham Healthy Living CenterMayo ClinicRochesterMNUSA
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Odhiambo LA, Marion AJ, Harmatz AE, Yala JA, Callihan TR, Bundy K, Zullo MD. Facilitators and barriers to using a DeskCycle as a sedentary behavior intervention in the work environment. PLoS One 2024; 19:e0299537. [PMID: 38483888 PMCID: PMC10939269 DOI: 10.1371/journal.pone.0299537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Sedentary behavior is a public health threat with extensive health burden on society. High levels of sedentary behavior have been associated with cardiovascular diseases, diabetes, obesity, and cancer. Individuals working in desk-related occupations are more likely to be sedentary for most of the day. Health researchers have responded by implementing and promoting interventions and wellness programs in work environments to reduce this behavior. This study examined the feasibility and experience of using the DeskCycle to reduce sedentary behavior among female workers in an academic office environment. METHODS This was an intervention study where participants used the DeskCycle in two consecutive eight-week phases and uploaded DeskCycle use data daily. A questionnaire was administered after week 2 and week 8 (pre-post) of DeskCycle use in each phase to assess dimensions of feasibility, including an open-ended question for user experience. RESULTS The participants (N = 78) had an average age of 44.4 (±11.3) years and were primarily non-Hispanic White (88.5%). DeskCycle daily use varied from Phase I: 84% to 64.9% (weeks 1-7), and 49.4% in week 8, to Phase II: 73.5% to 52.2% (week 1-7), and 40.2% in week 8. In Phase I, 96.6% (week 2) and 87% (week 8) agreed that the DeskCycle decreased sedentary behavior, and in Phase II, 74.3% (week 2) and 76.9% (week 8) agreed. The analysis of open-ended responses found challenges with the desk set up, cycling interfering with typing, and thinking critically, as barriers to DeskCycle use, while enjoying cycling and cycling improving mood were reported as facilitators. CONCLUSIONS Using a DeskCycle in an academic office environment to reduce sedentary behavior is feasible in female office workers. Consideration should be given to the type of tasks performed while cycling.
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Affiliation(s)
- Lorriane A. Odhiambo
- Department of Biostatistics, Data Science and Epidemiology, Augusta University, Augusta, GA, United States of America
| | - Alexander J. Marion
- Medical College of Georgia, Augusta University, Augusta, GA, United States of America
| | - Alison E. Harmatz
- College of Public Health, Kent State University, Kent, OH, United States of America
| | - Joy A. Yala
- College of Public Health, Kent State University, Kent, OH, United States of America
| | - Thomas R. Callihan
- College of Public Health, Kent State University, Kent, OH, United States of America
| | - Kristina Bundy
- College of Public Health, Kent State University, Kent, OH, United States of America
| | - Melissa D. Zullo
- College of Public Health, Kent State University, Kent, OH, United States of America
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Dupont F, Arabi Kugathasan T, Reid RER, Mathieu ME. Active time at work following the introduction of a standing and a cycling workstation into worker's office space. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2024; 30:161-167. [PMID: 37975262 DOI: 10.1080/10803548.2023.2284012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Objectives. Active workstations have been proposed to counteract sedentary behavior at work. This study describes office workers' use of and perceptions toward standing and cycling workstations, and assesses whether the two active workstations were sufficient to break sitting time and replace it with 2-4 h of light activity per workday. Methods. This mixed-method study utilized video recording, semi-structured interviews and a questionnaire. The quantitative data covered time spent sitting, standing and on a cycling workstation. The qualitative data were analyzed based on preferences, barriers and facilitators. Results. Participants (n = 15) used active workstations 125.3 (74.5) min/day and spent 79.0 (63.6) min/day using standing versus 46.3 (47.6) min/day using cycling workstations (p = 0.153, d = 0.58). Following the interviews, the standing workstation was preferred over cycling. The ergonomics of the cycling workstation were not optimal and caused discomfort in use. Seven participants broke their sitting time and accumulated 2+ h of light physical activity per workday. Those participants meeting recommendations were older, had a higher body fat percentage and engaged in less physical activity per week. Conclusion. With a preference for standing workstations, our results showed that 47% of workers used standing and cycling workstations to accumulate 2+ h of active time per day.
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Affiliation(s)
| | | | - Ryan E R Reid
- Department of Computer Science, Saint Francis Xavier University, Canada
| | - Marie-Eve Mathieu
- Faculty of Medicine, Université de Montréal, Canada
- Research Center, Sainte-Justine University Hospital Center, Canada
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Odhiambo LA, Marion AJ, Callihan TR, Harmatz AE, Yala JA, Bundy K, Zullo MD. The Effectiveness of the DeskCycle in Reducing Sedentary Behavior Among Female Office Workers. J Occup Environ Med 2023; 65:e538-e544. [PMID: 37167959 DOI: 10.1097/jom.0000000000002882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of the DeskCycle in reducing sedentary behavior among female office workers at an educational institution. METHODS This was a randomized control trial with a crossover design (N = 80). The intervention was conducted in two 8-week phases and included the DeskCycle and an informational handout with benefits and suggestions about the frequency of use. The primary outcome was weekly average nonsedentary time. Secondary outcomes included weight and mood. RESULTS DeskCycle users reported significantly higher weekly average nonsedentary time compared with nonusers (phase I: 402.3 ± 72.4 vs 169.3 ± 17.5, P < 0.00; phase II: 282 ± 45 vs 216 ± 23, P = 0.00). There were no significant differences in weight or mood. CONCLUSIONS The DeskCycle is effective in reducing sedentary behavior, suggesting workers in sedentary office occupations could integrate it into their workday, where possible, to prevent negative health outcomes.
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Affiliation(s)
- Lorriane A Odhiambo
- From the Institute of Public and Preventive Health, Augusta University, Augusta, Georgia (L.A.O.); Medical College of Georgia, Augusta University, Augusta, Georgia (A.J.M.); and College of Public Health, Kent State University, Kent, Ohio (T.R.C., A.E.H., J.A.Y., K.B., M.D.Z.)
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Rovniak LS, Cho J, Freivalds A, Kong L, De Araujo-Greecher M, Bopp M, Sciamanna CN, Rothrock L. Effects of Desk Pedaling Work Rate on Concurrent Work Performance among Physically Inactive Adults: A Randomized Experiment. Med Sci Sports Exerc 2023; 55:20-31. [PMID: 35977110 PMCID: PMC9771969 DOI: 10.1249/mss.0000000000003026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Under-desk pedaling devices could help reduce health risks associated with the global decline in work-related energy expenditure. However, the optimal pedaling work rate to facilitate concurrent work performance among physically inactive adults is unclear. We examined the effects of two light-intensity pedaling work rates on physically inactive adults' work performance. METHODS We recruited equal numbers of older (45-65 yr) versus younger (20-44 yr), male versus female, and overweight/obese (body mass index [BMI], 25-35 kg·m -2 ) versus normal weight (BMI, 18.5-24.9 kg·m -2 ) participants. Using a Graeco-Latin square design, participants ( n = 96) completed a laboratory experiment to evaluate the effects of using an under-desk pedaling device at two seated light-intensity work rates (17 and 25 W), relative to a seated nonpedaling condition on objectively measured typing, reading, logical reasoning, and phone task performance. Ergonomic comfort under each pedaling work rate was also assessed. Equivalence tests were used to compare work performance under the pedaling versus nonpedaling conditions. RESULTS Treatment fidelity to the 17- and 25-W pedaling work rates exceeded 95%. Mean work performance scores for each pedaling and nonpedaling condition were equivalent under alpha = 0.025. Age, sex, and BMI did not significantly moderate the effect of pedaling on work performance. Participants reported greater ergonomic comfort while completing work tasks at the 17-W relative to the 25-W work rate. CONCLUSIONS Physically inactive adults obtained similar work performance scores under the 17- and 25-W pedaling and the nonpedaling conditions, suggesting that either pedaling work rate could help reduce health risks of sedentary work time. The 17-W work rate yielded greater ergonomic comfort and may be an appropriate starting point for introducing diverse inactive workers to under-desk pedaling.
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Affiliation(s)
- Liza S. Rovniak
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA
| | - Jay Cho
- Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA
| | - Andris Freivalds
- Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA
| | - Lan Kong
- Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA
| | | | - Melissa Bopp
- Department of Kinesiology, Pennsylvania State University, University Park, PA
| | - Christopher N. Sciamanna
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA
| | - Ling Rothrock
- Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA
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Mohammadian M, Choobineh A, Razeghi M, Nejad NH, Karamooz-Ravari MR, Sheykhshoaei M, Kazemi R, Daneshmandi H. Designing and Usability testing of a New Prototype Active Footrest for Knee Extension Exercise Among Office Workers. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2492-2500. [PMID: 34789065 DOI: 10.1080/10803548.2021.2008183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The active factor along with light exercise can reduce static muscle work and increase muscle flexibility and endurance. Accordingly, this study aimed to design and prototype a new active footrest, implemented in conventional sitting workstations and to test its usability among office workers. METHODS The steps taken to design and prototype the active footrest were a) selection of an exercise appropriate for goals of ergonomic interventions, b) idea development, c) selection of the best conceptual design, d) design with SOLIDWORKS version 2016 software, and e) fabrication of a prototype. Afterward, the usability of the active footrest prototype was assessed among 20 office workers (10 females) using field data by the System Usability Scale. RESULTS Upon the completion of the design steps, the active footrest prototype was prototyped by taking into account design criteria (e.g. functionality, inclusive design, easy application, and reduction of additional body movement), anthropometric data and mechanical properties. The participants rated the usability of the active workstation as 89 ± 8.21 (out of 100) and indicating good usability results. CONCLUSION In this study, an active footrest was designed and prototyped to perform knee extension exercise with the capability of being implemented in conventional sitting workstations.
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Affiliation(s)
| | - Alireza Choobineh
- Research Center for Health Sciences, Shiraz University of Medical Sciences, Iran
| | - Mohsen Razeghi
- Department of Physiotherapy, Shiraz University of Medical Sciences, Iran
| | - Naser Hashemi Nejad
- Occupational Health and Safety at Work Department, Kerman University of Medical Sciences, Iran
| | - M R Karamooz-Ravari
- Department of Design and Manufacturing Engineering, Graduate University of Advanced Technology, Iran
| | - Morteza Sheykhshoaei
- Department of Design and Manufacturing Engineering, Graduate University of Advanced Technology, Iran
| | - Reza Kazemi
- Ergonomics Department, Shiraz University of Medical Sciences, Iran
| | - Hadi Daneshmandi
- Research Center for Health Sciences, Shiraz University of Medical Sciences, Iran
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Schwartz J, Oh P, Perotto MB, Rhodes RE, Firth W, Bredin SSD, Gaytán-González A, Warburton DER. A Critical Review on New Approaches for Chronic Disease Prevention in Brazil and Canada: From Wholistic Dietary Guidelines to Physical Activity Security. Front Cardiovasc Med 2021; 8:730373. [PMID: 34527714 PMCID: PMC8435680 DOI: 10.3389/fcvm.2021.730373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/10/2021] [Indexed: 01/12/2023] Open
Abstract
In light of new evidence on the prevention of chronic diseases and the elevated rates of overweight and obesity in Brazil and Canada, this critical review aims to interpret and synthesize current aspects regarding dietary and physical activity initiatives in both countries and make future recommendations. The pioneering work presented in the last Brazilian dietary guidelines has been called a model that can be applied globally, given its conceptualization of healthy eating that translates easily to practical guidance. The new Canadian Food Guide has incorporated similar aspects, also putting the country as a leader in dietary guidance. With these new recommendations, citizens in both Brazil and Canada have access to impactful evidence-informed nutritional guidelines. Both documents propose eating patterns that focus not only on health benefits, such as chronic disease prevention, but also incorporate well-being concerning cultural, economic, sociodemographic, biological, and ecological dimensions. A similar approach is required for physical activity to allow individuals to have attainable health and life goals and thereby fully enjoy their lives, regardless of geographical location, health status, and socioeconomic condition, a concept recently described as physical activity security. The wholistic dietary guidelines from both countries represent a change in paradigm in public health. Likewise, national evidence-based policies are warranted to reduce disparities in physical activity, allowing healthier and more active lifestyles for everyone.
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Affiliation(s)
- Juliano Schwartz
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Maira B. Perotto
- West Toronto Diabetes Education Program, LAMP Community Health Centre, Toronto, ON, Canada
| | - Ryan E. Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Wanda Firth
- Hearts & Health in Motion Program, Nova Scotia Health, QEII Health Sciences Centre, Halifax, NS, Canada
| | - Shannon S. D. Bredin
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
| | - Alejandro Gaytán-González
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
- Institute of Applied Sciences for Physical Activity and Sport, University of Guadalajara, Guadalajara, Mexico
| | - Darren E. R. Warburton
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
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Hervieux V, Tremblay A, Biron C. Active meetings on stationary bicycle: An intervention to promote health at work without impairing performance. APPLIED ERGONOMICS 2021; 90:103269. [PMID: 32956981 DOI: 10.1016/j.apergo.2020.103269] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 08/31/2020] [Accepted: 09/04/2020] [Indexed: 06/11/2023]
Abstract
Workers who experienced prolonged sitting have higher risk of mortality from all causes compared to non-sedentary workers. However, work can also be a health enhancement opportunity and it also can be designed to improve health and well-being. This research presents a novel intervention designed to reduce sedentary behavior in the workplace. Seven teams of employees (N = 30) conducted two meetings: one in a sitting position and one on a stationary bike. Repeated measures for heart rate, perceptions of stress, well-being, focus, attention and fatigue were collected before, during and after both meetings. Heart rate was significantly higher during active meeting. Results also indicated a significant effect of active meeting on stress. Well-being, focus and attention were similar during both meetings. Fatigue was perceived to be reduced in the hours following the active meeting. This suggests that active meetings can promote health without impairing performance which offers new perspectives for interventions.
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Affiliation(s)
- Valérie Hervieux
- Department of Management, Laval University, Quebec city, Canada; Centre d'expertise en gestion de la santé et sécurité du travail (CGSST), Laval University, Quebec city, Canada; VITAM - Centre de Recherche en santé durable de l'Université Laval, Quebec city, Canada.
| | - Angelo Tremblay
- Department of Kinesiology, Laval University, Quebec city, Canada; Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec city, Canada
| | - Caroline Biron
- Department of Management, Laval University, Quebec city, Canada; Centre d'expertise en gestion de la santé et sécurité du travail (CGSST), Laval University, Quebec city, Canada; VITAM - Centre de Recherche en santé durable de l'Université Laval, Quebec city, Canada
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Rovniak LS, Adams MA, Sciamanna CN, Kong L, Sullivan N, Costalas S, Bopp M, Kuzmik A. Effects of Bluetooth-Enabled Desk Ellipticals on Office Work Performance: Rationale, Design, and Protocol for a Randomized Trial With Overweight and Obese Adults. JMIR Res Protoc 2020; 9:e16275. [PMID: 31934871 PMCID: PMC6996735 DOI: 10.2196/16275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/22/2019] [Accepted: 10/26/2019] [Indexed: 11/28/2022] Open
Abstract
Background Workplaces that provide opportunities for physical activity without requiring extra time for activity could help counteract the obesity epidemic. Desk ellipticals can contribute to activity-supportive workplace environments; however, the feasibility of engaging employees in pedaling ellipticals during simultaneous office work has not been well evaluated. Objective We aim to present the rationale and methods from an ongoing randomized trial with overweight and obese employees that will evaluate (1) the effects of pedaling a compact desk elliptical on work performance and (2) the influence of different incentive types and schedules on desk pedaling quantity. Methods Overweight and obese medical center employees are being recruited in dyads for a 2 (gift card type: healthier food vs Amazon) by 3 (gift card schedule: immediate incentive contingent on individual pedaling quantity; immediate incentive partially contingent on dyads’ joint pedaling quantity; and delayed noncontingent pedaling incentive) cluster randomized within-subjects factorial trial. All participants receive a Bluetooth-enabled desk elliptical for 4 weeks and access to a mobile app that provides real-time pedaling feedback. The primary aims are to assess (1) change in employee work performance from pre- to postelliptical installation via employee and supervisor ratings and (2) effects of gift card type and schedule on quantity of objectively measured desk pedaling completed. Results Data collection is ongoing. We expect to complete main outcome analyses in 2020. Conclusions This trial represents one of the earliest attempts to assess the effects of desk pedaling and pedaling-incentive types in real-world offices. It could help bridge the research-to-practice gap by providing evidence on whether desk pedaling can be sustained without compromising work performance. International Registered Report Identifier (IRRID) DERR1-10.2196/16275
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Affiliation(s)
- Liza S Rovniak
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Marc A Adams
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Christopher N Sciamanna
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Lan Kong
- Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Nicole Sullivan
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Sara Costalas
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Melissa Bopp
- Department of Kinesiology, Pennsylvania State University, State College, PA, United States
| | - Ashley Kuzmik
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
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Baker R, Coenen P, Howie E, Williamson A, Straker L. The musculoskeletal and cognitive effects of under-desk cycling compared to sitting for office workers. APPLIED ERGONOMICS 2019; 79:76-85. [PMID: 31109464 DOI: 10.1016/j.apergo.2019.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 01/14/2019] [Accepted: 04/23/2019] [Indexed: 06/09/2023]
Abstract
Alternate work positions are being considered as a way to address sedentary behaviour for office workers. This study evaluated the effect of two hours of just-sitting versus sitting while under-desk cycling on musculoskeletal discomfort and cognitive function (sustained attention and creative problem solving). To consider mechanisms, muscle fatigue, kinematics and mental state were also measured. Discomfort increased significantly across all body areas with knee and ankle discomfort greater (in a clinically meaningful manner) in under-desk cycling. Sustained attention reaction time was the only cognitive measure to show a difference between conditions (slower for under-desk cycling [β-34.82 CI (-62.12 to -7.53)]). There was no evidence of muscle fatigue, while kinematic differences between conditions were identified. Mental state deteriorated over time in both conditions. This study found no clear benefit of under-desk cycling compared to just-sitting for musculoskeletal health and cognitive function measures.
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Affiliation(s)
- Richelle Baker
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Australia
| | - Pieter Coenen
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Australia; Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Erin Howie
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Australia; Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - Ann Williamson
- School of Aviation, Faculty of Science, University of New South Wales, Sydney, Australia
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Australia.
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Sui W, Smith ST, Fagan MJ, Rollo S, Prapavessis H. The effects of sedentary behaviour interventions on work-related productivity and performance outcomes in real and simulated office work: A systematic review. APPLIED ERGONOMICS 2019; 75:27-73. [PMID: 30509536 DOI: 10.1016/j.apergo.2018.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 08/29/2018] [Accepted: 09/05/2018] [Indexed: 06/09/2023]
Abstract
This review examined the impact of environmental, behavioral, and combined interventions to reduce occupational sedentary behaviour on work performance and productivity outcomes. Productivity outcomes were defined as variables assessing work-related tasks (e.g., typing, mouse), whereas performance outcomes were categorized as any variables assessing cognition that did not mimic work-related tasks. Nine databases were searched for articles published up to January 2018. Sixty-three studies were identified that met the inclusion criteria: 45 examined a productivity outcome (i.e., typing, mouse, work-related tasks, and absenteeism), 38 examined a performance outcome (i.e., memory, reading comprehension, mathematics, executive function, creativity, psychomotor function, and psychobiological factors), and 30 examined a self-reported productivity/performance outcome (i.e., presenteeism or other self-reported outcome). Overall, standing interventions do not appear to impact productivity/performance outcomes, whereas walking and cycling interventions demonstrate mixed null/negative associations for productivity outcomes. Hence, standing interventions to reduce occupational sedentary behaviour could be implemented without negatively impacting productivity/performance outcomes.
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Affiliation(s)
- Wuyou Sui
- Exercise Health and Psychology Lab, Room 408, Arthur Sonia Labatt Health Science Building, University of Western Ontario, London, Ontario, N6A 5B9, Canada.
| | - Siobhan T Smith
- Exercise Health and Psychology Lab, Room 408, Arthur Sonia Labatt Health Science Building, University of Western Ontario, London, Ontario, N6A 5B9, Canada.
| | - Matthew J Fagan
- Exercise Health and Psychology Lab, Room 408, Arthur Sonia Labatt Health Science Building, University of Western Ontario, London, Ontario, N6A 5B9, Canada.
| | - Scott Rollo
- Exercise Health and Psychology Lab, Room 408, Arthur Sonia Labatt Health Science Building, University of Western Ontario, London, Ontario, N6A 5B9, Canada.
| | - Harry Prapavessis
- Exercise Health and Psychology Lab, Room 408, Arthur Sonia Labatt Health Science Building, University of Western Ontario, London, Ontario, N6A 5B9, Canada.
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Shrestha N, Kukkonen‐Harjula KT, Verbeek JH, Ijaz S, Hermans V, Pedisic Z. Workplace interventions for reducing sitting at work. Cochrane Database Syst Rev 2018; 12:CD010912. [PMID: 30556590 PMCID: PMC6517221 DOI: 10.1002/14651858.cd010912.pub5] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND A large number of people are employed in sedentary occupations. Physical inactivity and excessive sitting at workplaces have been linked to increased risk of cardiovascular disease, obesity, and all-cause mortality. OBJECTIVES To evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, OSH UPDATE, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 9 August 2017. We also screened reference lists of articles and contacted authors to find more studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), cross-over RCTs, cluster-randomised controlled trials (cluster-RCTs), and quasi-RCTs of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies. The primary outcome was time spent sitting at work per day, either self-reported or measured using devices such as an accelerometer-inclinometer and duration and number of sitting bouts lasting 30 minutes or more. We considered energy expenditure, total time spent sitting (including sitting at and outside work), time spent standing at work, work productivity and adverse events as secondary outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. MAIN RESULTS We found 34 studies - including two cross-over RCTs, 17 RCTs, seven cluster-RCTs, and eight controlled before-and-after studies - with a total of 3,397 participants, all from high-income countries. The studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi-component interventions (four studies). One study included both physical workplace changes and information and counselling components. We did not find any studies that specifically investigated the effects of standing meetings or walking meetings on sitting time.Physical workplace changesInterventions using sit-stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short-term follow-up (up to three months) compared to sit-desks (95% confidence interval (CI) -116 to -84, 10 studies, low-quality evidence). The pooled effect of two studies showed sit-stand desks reduced sitting time at medium-term follow-up (3 to 12 months) by an average of 57 minutes per day (95% CI -99 to -15) compared to sit-desks. Total sitting time (including sitting at and outside work) also decreased with sit-stand desks compared to sit-desks (mean difference (MD) -82 minutes/day, 95% CI -124 to -39, two studies) as did the duration of sitting bouts lasting 30 minutes or more (MD -53 minutes/day, 95% CI -79 to -26, two studies, very low-quality evidence).We found no significant difference between the effects of standing desks and sit-stand desks on reducing sitting at work. Active workstations, such as treadmill desks or cycling desks, had unclear or inconsistent effects on sitting time.Workplace policy changesWe found no significant effects for implementing walking strategies on workplace sitting time at short-term (MD -15 minutes per day, 95% CI -50 to 19, low-quality evidence, one study) and medium-term (MD -17 minutes/day, 95% CI -61 to 28, one study) follow-up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI -66 to -15, one study, low-quality evidence) compared to long breaks (two 15-minute breaks per workday) at short-term follow-up.Information and counsellingProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short-term follow-up (MD -19 minutes per day, 95% CI -57 to 19, two studies, low-quality evidence). However, the reduction was significant at medium-term follow-up (MD -28 minutes per day, 95% CI -51 to -5, two studies, low-quality evidence).Computer prompts combined with information resulted in no significant change in sitting time at work at short-term follow-up (MD -14 minutes per day, 95% CI -39 to 10, three studies, low-quality evidence), but at medium-term follow-up they produced a significant reduction (MD -55 minutes per day, 95% CI -96 to -14, one study). Furthermore, computer prompting resulted in a significant decrease in the average number (MD -1.1, 95% CI -1.9 to -0.3, one study) and duration (MD -74 minutes per day, 95% CI -124 to -24, one study) of sitting bouts lasting 30 minutes or more.Computer prompts with instruction to stand reduced sitting at work on average by 14 minutes per day (95% CI 10 to 19, one study) more than computer prompts with instruction to walk at least 100 steps at short-term follow-up.We found no significant reduction in workplace sitting time at medium-term follow-up following mindfulness training (MD -23 minutes per day, 95% CI -63 to 17, one study, low-quality evidence). Similarly a single study reported no change in sitting time at work following provision of highly personalised or contextualised information and less personalised or contextualised information. One study found no significant effects of activity trackers on sitting time at work.Multi-component interventions Combining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low-quality evidence) and on time spent in prolonged sitting bouts (two studies, very low-quality evidence) at short-term follow-up. AUTHORS' CONCLUSIONS At present there is low-quality evidence that the use of sit-stand desks reduce workplace sitting at short-term and medium-term follow-ups. However, there is no evidence on their effects on sitting over longer follow-up periods. Effects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. There is a need for larger cluster-RCTs with longer-term follow-ups to determine the effectiveness of different types of interventions to reduce sitting time at work.
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Affiliation(s)
- Nipun Shrestha
- Victoria UniversityInstitute for Health and Sport (IHES)MelbourneVictoriaAustralia
| | - Katriina T Kukkonen‐Harjula
- South Karelia Social and Health Care District EksoteRehabilitationValto Käkelän katu 3 BLappeenrantaFinland53130
| | - Jos H Verbeek
- Finnish Institute of Occupational HealthCochrane Work Review GroupTYÖTERVEYSLAITOSFinlandFI‐70032
| | - Sharea Ijaz
- Population Health Sciences, Bristol Medical School, University of BristolNIHR CLAHRC West at University Hospitals Bristol NHS Foundation TrustLewins Mead, Whitefriars BuildingBristolUKBS1 2NT
| | - Veerle Hermans
- Vrije Universiteit BrusselFaculty of Psychology & Educational Sciences, Faculty of Medicine & PharmacyPleinlaan 2BrusselsBelgium1050
| | - Zeljko Pedisic
- Victoria UniversityInstitute for Health and Sport (IHES)MelbourneVictoriaAustralia
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Hadgraft NT, Brakenridge CL, Dunstan DW, Owen N, Healy GN, Lawler SP. Perceptions of the acceptability and feasibility of reducing occupational sitting: review and thematic synthesis. Int J Behav Nutr Phys Act 2018; 15:90. [PMID: 30227861 PMCID: PMC6145345 DOI: 10.1186/s12966-018-0718-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/28/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Reducing workplace sedentary behaviour (sitting) is a topic of contemporary public health and occupational health interest. Understanding workers' perspectives on the feasibility and acceptability of strategies, and barriers and facilitators to reducing workplace sitting time, can help inform the design and implementation of targeted interventions. The aim of this qualitative synthesis was to identify and synthesise the evidence on factors perceived to influence the acceptability and feasibility of reducing sitting at work, without, and with, an associated intervention component. METHODS A systematic search of the peer-reviewed literature was conducted across multiple databases in October 2017 to identify studies with a qualitative component relating to reducing workplace sitting time. Relevant data were extracted and imported into NVivo, and analysed by three of the authors by coding the results sections of papers line-by-line, with codes organised into sub-themes and then into overarching themes. Studies with and without an associated intervention were analysed separately. RESULTS Thirty-two studies met the inclusion criteria, 22 of which had collected qualitative data during and/or following a workplace intervention. Sample sizes ranged from five through to 71 participants. Studies predominately involved desk-based workers (28/32) and were most frequently conducted in Australia, USA or the United Kingdom (26/32). Similar themes were identified across non-intervention and intervention studies, particularly relating to barriers and facilitators to reducing workplace sitting. Predominately, work and social environment attributes were identified as barriers/facilitators, with desk-based work and work pressures influencing the perceived feasibility of reducing sitting, particularly for low-cost interventions. Support from co-workers and managers was considered a key facilitator to reducing sitting, while social norms that discouraged movement were a prominent barrier. Across all studies, some consistent perceptions of benefits to reducing sitting were identified, including improved physical health, enhanced emotional well-being and associated work-related benefits. CONCLUSION Common barriers and facilitators to reducing workplace sitting time were identified across the literature, most prominently involving the social environment and job-related demands. These findings can inform the design and implementation of workplace sitting reduction strategies. To increase the generalisability of findings, further research is needed in a more diverse range of countries and industries.
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Affiliation(s)
- Nyssa T Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia
| | - Charlotte L Brakenridge
- School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia.,RECOVER Injury Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.,Institute of Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia.,Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC, Australia.,School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA, Australia
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Genevieve N Healy
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia.,Curtin University, School of Physiotherapy and Exercise Science, Perth, WA, Australia
| | - Sheleigh P Lawler
- School of Public Health, The University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia.
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Shrestha N, Kukkonen‐Harjula KT, Verbeek JH, Ijaz S, Hermans V, Pedisic Z. Workplace interventions for reducing sitting at work. Cochrane Database Syst Rev 2018; 6:CD010912. [PMID: 29926475 PMCID: PMC6513236 DOI: 10.1002/14651858.cd010912.pub4] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND A large number of people are employed in sedentary occupations. Physical inactivity and excessive sitting at workplaces have been linked to increased risk of cardiovascular disease, obesity, and all-cause mortality. OBJECTIVES To evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, OSH UPDATE, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 9 August 2017. We also screened reference lists of articles and contacted authors to find more studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), cross-over RCTs, cluster-randomised controlled trials (cluster-RCTs), and quasi-RCTs of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies. The primary outcome was time spent sitting at work per day, either self-reported or measured using devices such as an accelerometer-inclinometer and duration and number of sitting bouts lasting 30 minutes or more. We considered energy expenditure, total time spent sitting (including sitting at and outside work), time spent standing at work, work productivity and adverse events as secondary outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. MAIN RESULTS We found 34 studies - including two cross-over RCTs, 17 RCTs, seven cluster-RCTs, and eight controlled before-and-after studies - with a total of 3,397 participants, all from high-income countries. The studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi-component interventions (four studies). One study included both physical workplace changes and information and counselling components. We did not find any studies that specifically investigated the effects of standing meetings or walking meetings on sitting time.Physical workplace changesInterventions using sit-stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short-term follow-up (up to three months) compared to sit-desks (95% confidence interval (CI) -116 to -84, 10 studies, low-quality evidence). The pooled effect of two studies showed sit-stand desks reduced sitting time at medium-term follow-up (3 to 12 months) by an average of 57 minutes per day (95% CI -99 to -15) compared to sit-desks. Total sitting time (including sitting at and outside work) also decreased with sit-stand desks compared to sit-desks (mean difference (MD) -82 minutes/day, 95% CI -124 to -39, two studies) as did the duration of sitting bouts lasting 30 minutes or more (MD -53 minutes/day, 95% CI -79 to -26, two studies, very low-quality evidence).We found no significant difference between the effects of standing desks and sit-stand desks on reducing sitting at work. Active workstations, such as treadmill desks or cycling desks, had unclear or inconsistent effects on sitting time.Workplace policy changesWe found no significant effects for implementing walking strategies on workplace sitting time at short-term (MD -15 minutes per day, 95% CI -50 to 19, low-quality evidence, one study) and medium-term (MD -17 minutes/day, 95% CI -61 to 28, one study) follow-up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI -66 to -15, one study, low-quality evidence) compared to long breaks (two 15-minute breaks per workday) at short-term follow-up.Information and counsellingProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short-term follow-up (MD -19 minutes per day, 95% CI -57 to 19, two studies, low-quality evidence). However, the reduction was significant at medium-term follow-up (MD -28 minutes per day, 95% CI -51 to -5, two studies, low-quality evidence).Computer prompts combined with information resulted in no significant change in sitting time at work at short-term follow-up (MD -10 minutes per day, 95% CI -45 to 24, two studies, low-quality evidence), but at medium-term follow-up they produced a significant reduction (MD -55 minutes per day, 95% CI -96 to -14, one study). Furthermore, computer prompting resulted in a significant decrease in the average number (MD -1.1, 95% CI -1.9 to -0.3, one study) and duration (MD -74 minutes per day, 95% CI -124 to -24, one study) of sitting bouts lasting 30 minutes or more.Computer prompts with instruction to stand reduced sitting at work on average by 14 minutes per day (95% CI 10 to 19, one study) more than computer prompts with instruction to walk at least 100 steps at short-term follow-up.We found no significant reduction in workplace sitting time at medium-term follow-up following mindfulness training (MD -23 minutes per day, 95% CI -63 to 17, one study, low-quality evidence). Similarly a single study reported no change in sitting time at work following provision of highly personalised or contextualised information and less personalised or contextualised information. One study found no significant effects of activity trackers on sitting time at work.Multi-component interventions Combining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low-quality evidence) and on time spent in prolonged sitting bouts (two studies, very low-quality evidence) at short-term follow-up. AUTHORS' CONCLUSIONS At present there is low-quality evidence that the use of sit-stand desks reduce workplace sitting at short-term and medium-term follow-ups. However, there is no evidence on their effects on sitting over longer follow-up periods. Effects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. There is a need for larger cluster-RCTs with longer-term follow-ups to determine the effectiveness of different types of interventions to reduce sitting time at work.
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Affiliation(s)
- Nipun Shrestha
- Victoria UniversityInstitute for Health and Sport (IHES)MelbourneAustralia
| | - Katriina T Kukkonen‐Harjula
- South Karelia Social and Health Care District EksoteRehabilitationValto Käkelän katu 3 BLappeenrantaFinland53130
| | - Jos H Verbeek
- Finnish Institute of Occupational HealthCochrane Work Review GroupTYÖTERVEYSLAITOSFinlandFI‐70032
| | - Sharea Ijaz
- Population Health Sciences, Bristol Medical School, University of BristolNIHR CLAHRC West at University Hospitals Bristol NHS Foundation TrustLewins Mead, Whitefriars BuildingBristolUKBS1 2NT
| | - Veerle Hermans
- Vrije Universiteit BrusselFaculty of Psychology & Educational Sciences, Faculty of Medicine & PharmacyPleinlaan 2BrusselsBelgium1050
| | - Zeljko Pedisic
- Victoria UniversityInstitute for Health and Sport (IHES)MelbourneAustralia
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