A detailed description of the short-term musculoskeletal and cognitive effects of prolonged standing for office computer work

The effects of work on cognitive functions: a systematic review

Introduction

Cognitive functions play a crucial role in individual's life since they represent the mental abilities necessary to perform any activity. During working life, having healthy cognitive functioning is essential for the proper performance of work, but it is especially crucial for preserving cognitive abilities and thus ensuring healthy cognitive aging after retirement. The aim of this paper was to systematically review the scientific literature related to the effects of work on cognitive functions to assess which work-related factors most adversely affect them.

Method

We queried the PubMed and Scopus electronic databases, in February 2023, according to the PRISMA guidelines (PROSPERO ID number = CRD42023439172), and articles were included if they met all the inclusion criteria and survived a quality assessment. From an initial pool of 61,781 papers, we retained a final sample of 64 articles, which were divided into 5 categories based on work-related factors: shift work (n = 39), sedentary work (n = 7), occupational stress (n = 12), prolonged working hours (n = 3), and expertise (n = 3).

Results

The results showed that shift work, occupational stress, and, probably, prolonged working hours have detrimental effects on cognitive functioning; instead, results related to sedentary work and expertise on cognitive functions are inconclusive and extremely miscellaneous.

Discussion

Therefore, workplace health and well-being promotion should consider reducing or rescheduling night shift, the creation of less demanding and more resourceful work environments and the use of micro-breaks to preserve workers' cognitive functioning both before and after retirement.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023439172, identifier CRD42023439172.

Influence of short bouts of stair climbing on young adults during prolonged sitting on posture, discomfort, and musculoskeletal performance outcomes: a counterbalanced pilot randomised crossover trial

Prolonged sitting is postulated to influence musculoskeletal performance (cervical flexor endurance, balance, and agility), discomfort and alter cervical spine angles during work-based computer use. Stair climbing breaks may be a great addition at typical and home offices however remain unexplored for its impact on musculoskeletal performance. In our counterbalanced pilot crossover trial, 24 adults were randomised to three interventions: (1) prolonged sitting, (2) interrupted by 2 min of self-paced, and (3) externally paced stair climbing for 2 h. Cervical spine angles were measured every 30 min while balance, agility, endurance, and discomfort were assessed before and after 120 min. Stair climbing interruptions have favourable effects on agility (F = 8.12, p = 0.009, ηp2 = 0.26) and musculoskeletal discomfort, but failed to improve other musculoskeletal outcomes associated with prolonged sitting. Brief stair climbing interruptions are effective in improving discomfort and agility while pragmatic trials are warranted for translated effects.

Sitting vs. standing: an urgent need to rebalance our world

During their activities of daily living, humans run, walk, stand, sit and lie down. Recent changes in our environment have favored sedentary behavior over more physically active behavior to such a degree that our health is in danger. Here, we sought to address the problem of excessive time spent seated from various theoretical viewpoints, including postural control, human factors engineering, human history and health psychology. If nothing is done now, the high prevalence of sitting will continue to increase. We make a case for the standing position by demonstrating that spending more time upright can mitigate the physiological and psychological problems associated with excessive sitting without lowering task performance and productivity. The psychological literature even highlights potential benefits of performing certain tasks in the standing position. We propose a number of recommendations on spending more time (but not too much) in the standing position and on more active, nonambulatory behaviors. There is a need to inform people about (i) harmful consequences of excessive sitting and (ii) benefits of spending more time performing active, nonambulatory behaviors. One clear benefit is to reduce detrimental health consequences of excessive sitting and to provide potential additional benefits in terms of productivity and performance.

Changes in Desk-Based Workers' Sitting, Standing, and Stepping Time: Short- and Longer-Term Effects on Musculoskeletal Pain

PURPOSE

Sitting at work can be associated with musculoskeletal pain, but the effect of reductions in sitting is not well understood. We examined relationships with musculoskeletal pain of changes in sitting, standing, stepping, and short and long bouts of these behaviors.

METHODS

Analyses pooled data from 224 desk workers (68.4% women; mean ± SD age = 45.5 ± 9.4 yr; body mass index = 28.1 ± 6.1 kg⋅m -2 ) in intervention trial. Device-assessed (activPAL3) sitting, standing, and stepping time and multisite musculoskeletal pain (Nordic Questionnaire; 12 body areas) were assessed at baseline, 3 months, and 12 months. Compositional data analyses in linear mixed-effects regressions examined relationships within 16 waking hours of the behaviors and their short and long bouts, with changes from baseline in acute and chronic multisite musculoskeletal pain at 3 and 12 months. Analyses were adjusted for initial group randomization and relevant covariates.

RESULTS

At 3 months, increased standing relative to changes in other compositions was significantly associated with increased multisite musculoskeletal pain (acute: β = 1.54, 95% confidence interval [CI] = 0.10 to 2.98; chronic: β = 1.49, 95% CI = 0.12 to 2.83). By contrast, increased stepping relative to changes in other compositions was significantly associated with reduced multisite musculoskeletal pain (acute: β = -1.49, 95% CI = -2.97 to -0.02; chronic: β = -1.87, 95% CI = -3.75 to -0.01). Neither sitting reduction relative to changes in other compositions nor changes in short bouts relative to long bouts of the behaviors were significantly associated with multisite musculoskeletal pain changes. At 12 months, there were no significant associations for any of the compositional changes.

CONCLUSIONS

In the short term, while increasing standing with reduced sitting time can be unfavorable, concurrently increasing stepping could potentially reduce musculoskeletal pain. In the longer term, musculoskeletal pain may not be increased by moderate reductions in sitting time through spending more time standing or stepping.

Movement Behavior and Health Outcomes among Sedentary Adults: A Cross-Sectional Study

BACKGROUND

Sedentary behavior, which is highly prevalent among office workers, is associated with multiple health disorders, including those of the musculoskeletal and cardiometabolic systems. Although prior studies looked at postures or physical activity during work or leisure time, few analyzed both posture and movement throughout the entire day.

OBJECTIVE

This cross-sectional pilot study examined the movement behavior of sedentary office workers during both work and leisure time to explore its association with musculoskeletal discomfort (MSD) and cardiometabolic health indicators.

METHODS

Twenty-six participants completed a survey and wore a thigh-based inertial measuring unit (IMU) to quantify the time spent in different postures, the number of transitions between postures, and the step count during work and leisure time. A heart rate monitor and ambulatory blood pressure cuff were worn to quantify cardiometabolic measures. The associations between movement behavior, MSD, and cardiometabolic health indicators were evaluated.

RESULTS

The number of transitions differed significantly between those with and without MSD. Correlations were found between MSD, time spent sitting, and posture transitions. Posture transitions had negative correlations with body mass index and heart rate.

CONCLUSIONS

Although no single behavior was highly correlated with health outcomes, these correlations suggest that a combination of increasing standing time, walking time, and the number of transitions between postures during both work and leisure time was associated with positive musculoskeletal and cardiometabolic health indicators among sedentary office workers and should be considered in future research.

Defining the lumbar and trunk-thigh neutral zone from the passive stiffness curve: application to hybrid sit-stand postures and chair design

Minimal data exist on the neutral position for the lumbar spine, trunk, and thighs when adopting a hybrid posture. This study examined sex differences in the neutral zone lumbar stiffness and the lumbar and trunk-thigh angle boundaries of the neutral zone, and determined if the standing lumbar angle fell within the neutral zone. Passive lumbar flexion and extension moment-angle curves were generated for 31 participants (13 M, 18 F), pooled from two datasets, with trunk-thigh angles available for 10 participants. The neutral zone was defined as the low stiffness zone from both the flexion and extension curves. Males demonstrated significantly greater extensor stiffness. Neutral lumbar and trunk-thigh angles ranged on average -22.2 to 0.2° and 124.2 to 159.6° for males and -17.8 to -1.3° and 143.2 to 159.5° for females, respectively. Standing lumbar angles fell outside the neutral zone for 44% of participants. These neutral zone boundaries may inform kinematics for hybrid chair designs.Practitioner summary: Adoption of a neutral spinal posture may be achieved through hybrid chair design, yet minimal data exists on a physiologically defined neutral zone. Using measures of in vivo lumbar stiffness, the lumbar and trunk-thigh angular boundaries of the neutral zone were defined for both males and females.Abbreviations: EMG: electromyography; MVC: maximal voluntary contraction.

Alternations of vitamin D and cognitive function in first-diagnosed and drug-naïve BD patients: Physical activity as a moderator

BACKGROUND

The pathophysiological mechanism of cognitive impairments of bipolar disorder (BD) has not yet been completely revealed. It is well known that Vitamin D and physical activity (PA) are associated with BD. However, specific links between Vitamin D and cognitive deficits in BD are still unclear.

METHOD

The serum levels of vitamin D were measured. The cognitive performances of 102 first-diagnosed and drug-naïve BD patients were evaluated for analysis. The repeatable battery for the assessment of neuropsychological status (RBANS) and the Stroop Color-Word test was used in this study. PA was collected by international physical activity questionnaire.

RESULT

Patients with BD had high levels of serum vitamin D. Furthermore, immediate and delayed memory was negatively associated with vitamin D levels in patients' group. The serum levels of vitamin D in patients with low PA were positively associated with memory. However, increased PA attenuated the protective effect of vitamin D on executive cognition.

CONCLUSION

It is concluded that the increased levels of vitamin D were observed in the serum of patients with BD. Thus, it is found that more PA is less beneficial to cognition of patients with BD than longer resting.

Task type, preference, and occupation affect standing desk utilization in office workers

BACKGROUND

Adjustable height sit-stand desks are becoming the norm in many workplaces. It is not known how task type, worker preference, and occupation impact utilization of the adjustable height feature.

OBJECTIVE

This survey-based study aimed to determine how task type, preference and occupation affect office workers' sitting and standing behaviors at work.

METHODS

Office workers (n = 123) from different occupations completed surveys about actual and preferred positions (sit, stand, either/both) during 39 common tasks from 4 different categories, as well as barriers to use. Each position was analyzed by task type, behavior, and occupation.

RESULTS

There were differences between actual and preferred behavior for each position, with participants sitting more and standing less than preferred across all task categories. There were differences between task categories with participants sitting less for generative and routine, and standing more for communication tasks. The highest rates of either/both responses were for routine tasks. Engineers reported the lowest standing rates, and also indicated standing more than preferred. Information Tech and Engineering had the highest either/both responses. Finance reported the highest sitting rates. Personal, task-based and workplace limitations were cited as barriers to preferred use.

CONCLUSION

Office workers would prefer to stand more at work. Occupation-specific needs and preferences, as well as types of tasks should be considered when providing workplace standing options.

How many days of indoor positioning system data are required to characterise typical movement behaviours of office workers?

Indoor Positioning Systems (IPS) appear to offer great potential to study the movement and interaction of people and their working environment, including office workplaces. But little is known about appropriate durations for data collection. In this study, location observations collected from 24 office workers on a 1220 m² office floor over a 3-month period, were analysed to determine how many days are required to estimate their typical movement and spatial behaviours. The analysis showed that up to 8 days of data was sufficient to characterise participants' typical daily movement behaviours and 10 days were required to estimate their typical spatial mobility. However, the results also indicate that 5 weeks of data collection are required to gather the necessary 10 days of data from each participant. These findings will help researchers and workplace professionals to understand the capabilities and requirements of IPS when considering their use in indoor work environments.

Non-exercise activity thermogenesis in the workplace: The office is on fire

From the second half of the previous century, there has been a shift toward occupations largely composed of desk-based behaviors. This, inevitably, has led to a workload reduction and a consequent lower energy expenditure. On this point, small increments of the non-exercise activity thermogenesis (NEAT) could be the rationale to reach health benefits over a prolonged period. Different published researches suggest solutions to reverse sitting time and new alternative workstations have been thought to increase total physical activity. Therefore, the purpose of this narrative review is to summarize the current state of the research regarding the "NEAT approach" to weight-gain prevention in work environments. This review analyzes the main evidence regarding new alternative workstations such as standing, walking workstations, seated pedal, and gymnastic balls to replace a standard office chair.

Musculoskeletal Deficits and Cognitive Impairment: Epidemiological Evidence and Biological Mechanisms

PURPOSE OF REVIEW

Cognitive impairment is associated with obesity, sarcopenia, and osteoporosis. However, no critical appraisal of the literature on the relationship between musculoskeletal deficits and cognitive impairment, focusing on the epidemiological evidence and biological mechanisms, has been published to date. Herein, we critically evaluate the literature published over the past 3 years, emphasizing interesting and important new findings, and provide an outline of future directions that will improve our understanding of the connections between the brain and the musculoskeletal system.

RECENT FINDINGS

Recent literature suggests that musculoskeletal deficits and cognitive impairment share pathophysiological pathways and risk factors. Cytokines and hormones affect both the brain and the musculoskeletal system; yet, lack of unified definitions and standards makes it difficult to compare studies. Interventions designed to improve musculoskeletal health are plausible means of preventing or slowing cognitive impairment. We highlight several musculoskeletal health interventions that show potential in this regard.

Nonlinear analysis of postural changes related to the movement interventions during prolonged standing task

This study assessed the effects of movement-based interventions on the complexity of postural changes during prolonged standing. Twenty participants, equally distributed in gender and standing work experience (SWE), completed three simulated prolonged standing sessions: without movement (control), leg exercise and footrest. The amount and complexity of variability in the centre of pressure (COP) and lumbar curvature angle were quantified using linear and nonlinear tools. Lower leg swelling and back/leg discomfort were also monitored. Participants in the SWE group showed significantly greater postural complexity during the standing. Regular leg exercise resulted in significantly higher postural complexity and lower leg discomfort and swelling. The footrest led to significant changes in amount of COP variability. Both interventions significantly reduced back discomfort. Overall, the nonlinear analysis of postural changes provided different findings compared to linear ones, considering the standing time, interventions and standing job experience. Nonlinear results were consistent with leg discomfort and swelling. Practitioner summary: The effect of movement-based interventions on dynamics of postural alterations over prolonged standing were characterised using nonlinear techniques. The effect of standing work experience was also considered. Previous experience of standing jobs and leg movements increase the complexity of postural behaviour over standing period.

Use of an inflatable mat to reduce body discomfort development when performing computer work at a standing desk

This study aimed to determine the effects of inflatable mat design on body discomfort, task performance, and musculoskeletal exposures during standing computer work. Twenty-seven healthy adults completed three 2-hour standing trials on different mediums (concrete floor, foam mat, and inflatable mat) on different days in an experimental laboratory. Both mats were associated with reduced discomfort in all lower-body regions and increased typing performance compared to the concrete floor. Perceived discomfort in lower extremities (except thighs) was further alleviated while standing on the inflatable mat than on the foam mat. Use of the inflatable mat led to increased lower-body muscle activity, a flexed lower back, and a wide range of sagittal knee movements. As standing time increased, body discomfort increased, typing accuracy decreased, and there were increased variations in muscle activity and postural movements in the lower body. The inflatable mat shows potential to improve the ergonomic experience during prolonged standing. Practitioner summary: Incorporating standing postures in office-based workplaces can reduce sitting time and may mitigate the health hazards associated with sedentary behaviour. With adequate weight-shifting movements, using an inflatable mat for standing could be an effective way to lessen discomfort and accumulated musculoskeletal strain due to constrained standing, without jeopardising task productivity. Abbreviations: APDF: amplitude probability distribution function. AVR: average rectified value. CI: confidence interval. CMRR: common mode rejection ratio. COP: center of pressure. CV: coefficient of variation. EA: electrical activity. EMG: electromyography. FL: fibularis longus. GM: gluteus medius. LBP: lower back pain. LES: lumbar erector spinae. MVC: maximum voluntary contraction. PD: pain developer. rANOVA: repeated-measures analysis of variance. SOL: soleus. VAS: visual analog scale. WPM: words per minute.

Stop motion: using high resolution spatiotemporal data to estimate and locate stationary and movement behaviour in an office workplace

Prolonged periods of stationary behaviour, a common occurrence in many office workplaces, are linked with a range of physical disorders. Investigating the physical context of this behaviour may be a key to developing effective interventions. This study aimed to estimate and locate the stationary and movement behaviours of office workers (n = 10) by segmenting spatiotemporal data collected over 5 days in an office work-based setting. The segmentation method achieved a balanced accuracy ≥85.5% for observation classification and ≥90% for bout classification when compared to reference data. The results show the workers spent the majority of their time stationary (Mean = 86.4%) and had on average, 28.4 stationary and 25.9 moving bouts per hour. While these findings accord with other studies, the segmented data was also visualised, revealing that the workers were stationary for periods ≥5 min at multiple locations and these locations changed across time. Practitioner Summary: This study applied a data segmentation method to classify stationary and moving behaviours from spatiotemporal data collected in an office workplace. The segmented data revealed not only what behaviours occurred but also their location, duration, and time. Segmenting spatiotemporal data may add valuable physical context to aid workplace research.

Schedules of standing and sitting directed by musculoskeletal discomfort in workers transitioning to sit-stand workstations: a cross-sectional study

Sit-stand workstations are growing in popularity, however limited guidelines exist regarding optimal schedules of sitting and standing. This was the first known study to observe sit-stand workstation schedules when postural change is based on maintaining musculoskeletal discomfort within 'acceptable' levels. Fourteen healthy adults new to sit-stand workstations completed computer-based work at a sit-stand desk for half a workday. Participants changed between standing and sitting postures each time discomfort reached the maximum acceptable threshold. On average, the amount of standing and sitting was greatest in the first standing (median 40 minutes, interquartile range 40 minutes) and sitting (median 30 minutes, interquartile range 115 minutes) bouts. Average durations spent standing and sitting were lower in all consecutive bouts. Stand-sit ratios indicated an equal amount of standing to sitting or somewhat less standing. The schedules had substantial inter-participant variability. Future studies should consider that optimal schedules may vary with regard to time and be individual-specific.

Determining the interactions between postural variability structure and discomfort development using nonlinear analysis techniques during prolonged standing work

PURPOSE

Nonlinear analysis techniques provide a powerful approach to explore dynamics of posture-related time-varying signals. The aim of this study was to investigate the fundamental interactions between postural variability structure and discomfort development during prolonged standing.

METHODS

Twenty participants, with equal distribution for gender and standing work experience (SWE), completed a simulated long-term standing test. Low back and legs discomfort, center of pressure, lumbar curvature, and EMG activity of trunk and leg muscles were monitored. Nonlinear measures including largest lyapunov exponent, multi-scale entropy, and detrended fluctuation analysis were applied to characterize the variability structure (i.e., complexity) in each signal. The size (i.e., amount) of variability was also computed using traditional linear metrics.

RESULTS

With progress of low back and legs discomfort over standing periods, significant lower levels were perceived by the participants having SWE. The amount of variability in all signals (except external oblique EMG activity) were significantly increased with the time progress for all participants. The structure of variability in most signals demonstrated a lower complexity (more regularity) with fractal properties that deviated from 1/f noise. The SWE group showed a higher complexity levels.

CONCLUSIONS

Overall, the findings verified variations in structure and amount of the postural variability. However, nonlinear analysis identified postural strategies according to the perceived discomfort in a different way. These results provide supports for future application of nonlinear tools in evaluating standing tasks and related ergonomics interventions as it allows further insight into how discomfort development impact the structure of postural changes.

Reliability and validity of the novel self-reported spine functional scale (SSFS) in healthy participants

OBJECTIVES

To develop the novel self-reported spine functional scale (SSFS) and conduct reliability and validity analysis, so that the public can better understand their own spine function in a more simple and scientific way, so as to effectively prevent spinal disorders and improve the quality of life through targeted rehabilitation therapeutic measures.

METHODS

This study was approved by an institutional review board, and all subjects gave informed consent to participate.

RESULTS

(1) Using Spearman correlation analysis to evaluate the content validity, each item was significantly correlated with the total score, and the project design was reasonable. The exploratory factor analysis method is used to evaluate the structural validity of the scale, and the standing position and the lying position of the posture evaluation can be attributed to the factor 2, which is called posture evaluation: the cervical flexor strength, the flat support, the prone back, and the supine knee. The back arch of the wall and the angel on the wall is attributed to factor 1, called the overall spine function test, and the cumulative contribution rate of the two factors was 46.057%. Confirmatory factor analysis showed that the two-factor model fits well (χ2/df = 2.440, RMSEA = 0.04 < 0.05, GFI = 0.945, AGFI = 0.920, CFI = 0.967, IFI = 0.967, TLI = 0.951, GFI, AGFI, CFI, IFI, and TLI are > 0.90) and the validity is ideal. (2) The test-retest reliability shows that the test-retest reliability of each entry, each dimension, and the total score is greater than 0.5, and the test-retest reliability is high. The Cronbach α coefficient was used to evaluate the overall internal consistency of the scale, α > 0.70, indicating that the scale has high reliability. After deleting each item one by one, the α coefficient is 0.692-0.717, and there is no significant increase. (3) Sex and occupation did not affect the level of spinal function (P > 0.05), and there was interaction. Different BMI levels significantly affected the score of spinal function (P < 0.05). The rate of spinal dysfunction in overweight and obese subjects was significantly higher than the normal group; the overall score of spinal function was worse than the normal group.

DISCUSSION

The reliability and validity analyses of this study verified the reliability and scientificity of SSFS in the young healthy population. Body weight had a significant influence on SSFS score, and the performance levels were different for the two sexes.

CONCLUSION

The novel Self-Reported Spine Functional Scale (SSFS) has high reliability and validity and is applicable to the self-assessment and maintenance of spinal health and the prevention of related spinal disorders in the young healthy population. Body weight has a significant influence on the SSFS score in healthy young people. Overweight and obese males were found to be more likely to have spinal dysfunction, while underweight males displayed poor cervical flexor muscle strength. Underweight females were found to have better overall spinal function and stronger cervical flexor muscle strength.

Health Issues Due to the Global Prevalence of Sedentariness and Recommendations towards Achieving a Healthier Behaviour

Sedentariness has progressed in recent years. Here, we summarize the high prevalence of objectively measured sedentariness and the list of health problems associated with sedentariness. According to the literature, a minimum sedentary time of 8 h/d may avoid the harmful effects of sedentariness. Our review of the literature shows that many countries worldwide exceed this threshold. The coronavirus disease 2019 pandemic has increased the proportion of time spent seated in chairs and/or other types of furniture. Furthermore, prolonged sedentariness will continue to increase because it is assumed that people, at least those in desk jobs, perform their work better when sitting than when standing. Many practical solutions should be implemented to help people reduce their sedentary time. People need to be aware that prolonged sedentariness causes health problems. They need to measure the amount of time spent being sedentary to self-guide their behaviour. They should adopt a new lifestyle to avoid prolonged sedentariness and prolonged standing. In addition, we point out that they should frequently change their posture to avoid fatigue and health issues. For global public health, there is an urgent need to adopt an intermediate healthy/healthier behaviour between too much time spent in the sitting and standing positions.

The effects of prolonged sitting, standing, and an alternating sit-stand pattern on trunk mechanical stiffness, trunk muscle activation and low back discomfort

Sit-stand desks continue to be a popular intervention for office work. While previous studies have reported changes in subjective measures, there is limited understanding of how sit-stand work differs from prolonged sitting or standing work, from a biomechanical standpoint. The objective of this study was to investigate the effects of prolonged sitting, prolonged standing, and a sit-stand paradigm on changes in trunk stiffness, low back discomfort, and trunk muscle activation. Twelve healthy participants performed 2 h of computer-based tasks in each protocol, on three different days. The sit-stand protocol was associated with a significant increase in trunk stiffness and a decrease in muscle activation of lumbar multifidus and longissimus thoracis pars thoracis, compared to both prolonged sitting and standing. Both sitting and standing were associated with increased low back discomfort. These findings may be worth exploring in more detail, for why alternating sit-stand patterns may help alleviate low back pain. Practitioner summary: We explored changes in objective and subjective measures related to low back discomfort following prolonged sitting, standing, and alternating sit-stand patterns. Alternating sit-stand pattern was associated with increased trunk stiffness and decreased back muscle activity. Hence, sit-stand desks may have benefits in terms of preventing/mitigating low back pain. Abbreviations: DOF: degree of freedom; EMG: electromyogram; ILL: iliocostalis lumborum pars lumborum; LTL: longissimus thoracis pars lumborum; LTT: longissimus thoracis pars thoracis; LBP: low back pain; LM: lumbar multifidus; MVEs: maximum isometric voluntary exertions; RANOVA: repeated-measure analysis of variance; RMS: root mean square.

Movement at work: A comparison of real time location system, accelerometer and observational data from an office work environment

Office workers can spend significant periods of time being stationary whilst at work, with potentially serious health consequences. The development of effective health interventions could be aided by a greater understanding of the location and environmental context in which this stationary behaviour occurs. Real time location systems (RTLS) potentially offer the opportunity to gather this much needed information, but they have not been extensively trialled in office workplaces, nor rigorously compared against more familiar devices such as accelerometers. The aim of this paper was to determine whether an RTLS can measure and spatially locate the non-stationary and stationary behaviours of adults working in an office work environment. Data collected from a series of comparison studies undertaken in a commercial office building suggests that RTLS can measure the velocity at which people are moving and locate them, when stationary, with an accuracy of 0.668 m (SD 0.389). This opens up significant opportunities to further understand how people move within buildings, the indoor physical environmental influences on that movement, and the development of effective interventions to help people to move more whilst at work.

The effects of ergonomic intervention on the musculoskeletal complaints and fatigue experienced by workers in the traditional metal casting industry

This research aimed to evaluate the effects of ergonomic intervention on the musculoskeletal complaints and fatigue experienced by workers of the traditional metal casting industry that manually pour molten metal into molds. The workers' physical complaints are typically in the form of musculoskeletal complaints, which include (1) an activity aspect, (2) a physical aspect, and (3) a motivational aspect. The method used in this research was stratified random sampling. The subjects (n = 127) were divided into three groups, namely, the process cement department (PCD) group, the loam department (LD) group, and the black sand department (BSD) group. The evaluation was carried out using questionnaires based on musculoskeletal complaints and fatigue. Meanwhile, an assessment of musculoskeletal complaints and fatigue was conducted one month before the ergonomic intervention, and then during follow-ups at one and eight months after the ergonomic intervention. The results showed that the average reduction in musculoskeletal complaints and fatigue experienced by the workers in the LD group was lower than that of the workers in the PCD and BSD groups at one and eight months after the ergonomic intervention. The positive effects of the ergonomic intervention on musculoskeletal complaints were evident in terms of the back, waist, left and right thighs, right knee, right ankle, and left foot (p < 0.05). The positive effects of the ergonomic intervention on the level of activity-based fatigue were felt in the body and legs, and the feeling of wanting to lie down decreased. The motivational fatigue experienced by the workers manifested as difficulty in thinking, concentrating, and controlling behavior, while the physical fatigue experienced by the workers was in the form of headaches, back pain, excessive thirst, and feeling unwell (p < 0.05). It can be concluded that ergonomic intervention can reduce both musculoskeletal complaints and fatigue, especially by conducting a morning briefing, using ergonomic ladles when pouring molten metal into molds, and consuming nutritious food during break times.

Prevalence of mobile device-related lower extremity discomfort: a systematic review

Mobile device users often experience musculoskeletal discomfort due to the intensive use of these devices in static body postures. Prolonged sitting and standing at work and in free time are risk factors for various diseases and all-cause mortality. Prolonged static postures are the main cause of lower extremity discomfort. A systematic search of the articles was conducted in four different electronic databases. All selected papers were appraised using a critical appraisal tool. Fourteen studies were selected for the review. The prevalence of musculoskeletal complaints ranged from 0.4 to 72.9%. Mobile device-related lower extremity discomfort ranged from 0.4 to 9.6%. The most common body posture among mobile device users in the selected studies was sitting. There is some evidence for the association between lower extremity pain and mobile device use. Experts should take this review as a basis to provide appropriate and effective ergonomic measures, especially for working mobile device users.

Effects of Time in Sitting and Standing on Pleasantness, Acceptability, Fatigue, and Pain When Using a Sit-Stand Desk: An Experiment on Overweight and Normal-Weight Subjects

BACKGROUND

Sit-stand desks have been suggested as an initiative to increase posture variation among office workers. However, there is limited evidence of what would be preferable combinations of time sitting and standing. The aim of this study was to determine and compare perceived pleasantness, acceptability, pain, and fatigue for 5 time patterns of sitting and standing at a sit-stand desk.

METHODS

Thirty postgraduate students were equally divided into a normal-weight (mean body mass index 22.8 kg/m2) and an overweight/obese (mean body mass index 28.1 kg/m2) group. They performed 3 hours of computer work at a sit-stand desk on 5 different days, each day with a different time pattern (A: 60-min sit/0-min stand; B: 50/10; C: 40/20; D: 30/30; E: 20/40). Pleasantness, acceptability, pain, and fatigue ratings were obtained at the beginning and at the end of the 3-hour period.

RESULTS

High ratings of pleasantness were observed for time patterns B, C, and D in both groups. All participants rated acceptability to be good for time patterns A to D. A minor increase in perceived fatigue and pain was observed in time pattern E.

CONCLUSION

For new sit-stand desk users, regardless of body mass index, 10 to 30 minutes of standing per hour appears to be an amenable time pattern.

Prevalence of mobile device-related musculoskeletal pain among working university students: a cross-sectional study

The aim of the present study was to investigate usage patterns of mobile devices and their impact on users' musculoskeletal system among working university students in Slovenia at the Faculty of Chemistry and Chemical Technology of the University of Ljubljana. An Internet-based survey was sent to students' e-mail addresses and students provided information about usage patterns and reported on musculoskeletal pain (MSP) that may relate to mobile device usage in the past 12 months. A total of 535 students (63% females and 37% males) aged 18 years or older completed the survey and fulfilled the inclusion criteria. The results showed that the prevalence of MSP was 39.6%. Most musculoskeletal symptoms were reported in the back (57.1%) and shoulder (50%). Statistically significant differences in exposure to mobile devices and MSP between genders were found (p < 0.05). This study highlights the importance of knowledge of mobile device ergonomics among working students.

Using Internet of Things to Reduce Office Workers' Sedentary Behavior: Intervention Development Applying the Behavior Change Wheel and Human-Centered Design Approach

Background

Sedentary behavior (SB) is associated with various adverse health outcomes. The prevalence of prolonged sitting at work among office workers makes a case for SB interventions to target this setting and population. Everyday mundane objects with embedded microelectronics and ubiquitous computing represent a novel mode of delivering health behavior change interventions enabled by internet of things (IoTs). However, little is known about how to develop interventions involving IoT technologies.

Objective

This paper reports the design and development of an IoT-enabled SB intervention targeting office workers.

Methods

The process was guided by the behavior change wheel (BCW), a systematic framework for theory-informed and evidence-based development of behavior change interventions, complemented by the human-centered design (HCD) approach. Intervention design was shaped by findings from a diary-probed interview study (n=20), a stakeholder design workshop (n=8), and a series of theoretical mapping and collaborative technical design activities.

Results

The resulting intervention named WorkMyWay targets a reduction in office workers’ prolonged stationary behaviors at work and an increase in regular breaks by modifying behavioral determinants in 11 theoretical domains with 17 behavior change techniques. The delivery technology consists of a wearable activity tracker, a light-emitting diode reminder device attached to a vessel (ie, water bottle or cup), and a companion Android app connected to both devices over Bluetooth. The delivery plan consists of a 2-week baseline assessment, a 30-min face-to-face action planning session, and 6-week self-directed use of the delivery technology.

Conclusions

This is the first study to demonstrate that it is possible to develop a complex IoT-enabled intervention by applying a combination of the BCW and HCD approaches. The next step is to assess the feasibility of WorkMyWay prior to testing intervention efficacy in a full-scale trial. The intervention mapping table that links individual intervention components with hypothesized mechanisms of action can serve as the basis for testing and clarifying theory-based mechanisms of action in future studies on WorkMyWay.

Does Reducing Sedentarity With Standing Desks Hinder Cognitive Performance?

OBJECTIVE

The goal of this study was to determine if using a standing desk would affect the productivity of workers, based on the type of work they perform.

BACKGROUND

Standing desks are a promising new health intervention in the workplace, but users and employers often require more specific recommendations related to productivity, such as the type of work that is more suited for the standing desk.

METHOD

Thirty-seven young and healthy adults performed eight cognitive tasks in a 2 × 2 × 2 within-subject design of the following independent variables: posture (sitting/standing), task difficulty (easy/hard), and input device (computer mouse/tactile screen) in a counterbalanced order.

RESULTS

Our results revealed that using a standing desk had no negative effect on performance or perception, but it did lead to increased brain activity in the alpha band for the parietal region (β = 0.186, p = .001).

CONCLUSION

We conclude that users of standing desks can freely stand for any level of task difficulty for work that involves working memory. However, more research is needed to generalize these results to other types of cognitive abilities and prolonged use of standing desks.

APPLICATION

Our results simplify recommendations for workers as they do not need to worry about the type of work they are performing when using a standing desk.

Controversies in the Science of Sedentary Behaviour and Health: Insights, Perspectives and Future directions from the 2018 Queensland Sedentary Behaviour Think Tank

The development in research concerning sedentary behaviour has been rapid over the past two decades. This has led to the development of evidence and views that have become more advanced, diverse and, possibly, contentious. These include the effects of standing, the breaking up of prolonged sitting and the role of moderate-to-vigorous physical activity (MVPA) in the association between sedentary behaviour and health outcomes. The present aim is to report the views of experts (n = 21) brought together (one-day face-to-face meeting in 2018) to consider these issues and provide conclusions and recommendations for future work. Each topic was reviewed and presented by one expert followed by full group discussion, which was recorded, transcribed and analysed. The experts concluded that (a). standing may bring benefits that accrue from postural shifts. Prolonged (mainly static) standing and prolonged sitting are both bad for health; (b). ‘the best posture is the next posture’. Regularly breaking up of sitting with postural shifts and movement is vital; (c). health effects of prolonged sitting are evident even after controlling for MVPA, but high levels of MVPA can attenuate the deleterious effects of prolonged sitting depending on the health outcome of interest. Expert discussion addressed measurement, messaging and future directions.

Health and Fitness Benefits But Low Adherence Rate: Effect of a 10-Month Onsite Physical Activity Program Among Tertiary Employees

OBJECTIVE

The aim of this study was to assess the effects of a 10-month structured physical activity intervention implemented within the workplace on overall health indicators among tertiary (office workers) employees.

METHODS

In this quasi-experimental study, 224 employees followed a 10-month worksite physical activity program. Overall health was assessed at baseline, after 5 months, and by the end of the intervention.

RESULTS

Fat mass percentage decreased significantly. There was a time effect favoring push-ups, abdominal strength, flexibility, heart rate postexercise, heart rate +30 seconds, and heart rate +60 seconds postexercise. Anxiety, depression, and eating habits also improved. In total, 45% of participants completed the whole intervention.

CONCLUSION

Although a structured on-site physical activity program supports improved health indicators, adherence remains a concern and requires specialists to develop new strategies.

Breaking up prolonged sitting with moderate-intensity walking improves attention and executive function in Qatari females

Background

Cultural, environmental and logistical factors promote a sedentary lifestyle within Qatar, particularly for females. Sedentary behaviour is acutely associated with poor cognitive function and fatigue, and chronically may be implicated with cognitive decline (i.e. Alzheimer’s disease).

Purpose

To examine the effects of breaking up sitting with short-duration frequent walking bouts on cognitive function and fatigue in Qatari females.

Method

Eleven sedentary (sitting ≥7 h/day) females completed three visits; the first being familiarisation. In a cross-over randomised manner, experimental visits two and three were identical, except participants either remained seated for 5-h (SIT) or interrupted their sitting every 30-min with a 3-min moderate-intensity walk (WALK) on a motorised treadmill. The Computerised Mental Performance Assessment System (COMPASS) assessed cognition at baseline (-15-min), and then at 2.5-h and 5-h into the experimental conditions. Specific COMPASS tasks employed were; serial-3 subtractions (2-min), serial-7 subtractions (2-min), simple reaction time (RT; 50 stimuli), rapid visual information processing [RVIP (5-min)], choice reaction time (CRT; 50 stimuli), and Stroop (60 stimuli); and a visual analogue scale for fatigue (VAS-F) was completed at the same time intervals.

Results

There was a significant condition effect for CRT (f = 26.7, p = 0.007). On average CRT was 101 s (95% CI = -47 to -156 s) quicker in WALK compared to SIT. There was a significant time effect for CRT (f = 15.5, p = 0.01). On average CRT was 134 s slower at 5-h compared to baseline (p = 0.006; 95% CI = -64 to -203 s), and 114 s slower at 5-h compared to 2.5-h (p = 0.01; 95% CI = -44 to -183 s). There was a significant interaction effect for RT in the Stroop incongruent task (f = 10.0, p = 0.03). On average RT was 210 s quicker at 2.5-h in WALK compared to SIT (p = 0.01; 95% CI = -76 to -346 s).

Conclusion

Breaking up prolonged sitting with moderate-intensity walking offers an ecologically valid intervention to enhance some aspects of cognitive function, whilst not affecting fatigue in sedentary Qatari females. Whilst these findings are promising, the long-term effects of breaking up sitting on cognitive function requires testing before population level recommendations can be made.

Feasibility and impact of sit-stand workstations with and without exercise in office workers at risk of low back pain: A pilot comparative effectiveness trial

The aim of this study was to compare the feasibility and impact of sit-stand workstations plus advice, with or without exercise, on back pain and sitting time in office workers at risk of low back pain (LBP). Eligible participants (n = 29/169; 17% overall) were randomized to receive a sit-stand workstation and advice with (n = 16) or without (n = 13) progressive resistance exercise training for 4-weeks. Feasibility (recruitment, acceptability, adherence) and impact (LBP severity during a standardized standing task, workplace-sitting time) were assessed. Intervention acceptability (87.5% very satisfied) was good and adherence (60% completed all 12 exercise sessions) was satisfactory. Maximum LBP severity (mean difference of -1.3 (-2.0, -0.6) and workplace sitting time (82.7-99.3 min/8-hr workday reduction) were similarly reduced in both groups. The introduction of a sit-stand workstation with advice was feasible and achieved similar outcomes for LBP and workplace sitting time when administered with or without exercise.

Are Office-Based Workplace Interventions Designed to Reduce Sitting Time Cost-Effective Primary Prevention Measures for Cardiovascular Disease? A Systematic Review and Modelled Economic Evaluation

OBJECTIVES

To assess the cost-effectiveness of workplace-delivered interventions designed to reduce sitting time as primary prevention measures for cardiovascular disease (CVD) in Australia.

METHODS

A Markov model was developed to simulate the lifetime cost-effectiveness of a workplace intervention for the primary prevention of CVD amongst office-based workers. An updated systematic review and a meta-analysis of workplace interventions that aim to reduce sitting time was conducted to inform the intervention effect. The primary outcome was workplace standing time. An incremental cost-effectiveness ratio (ICER) was calculated for this intervention measured against current practice. Costs (in Australia dollars) and benefits were discounted at 3% annually. Both deterministic (DSA) and probabilistic (PSA) sensitivity analyses were performed.

RESULTS

The updated systematic review identified only one new study. Only the multicomponent intervention that included a sit-and-stand workstation showed statistically significant changes in the standing time compared to the control. The intervention was associated with both higher costs ($6820 versus $6524) and benefits (23.28 versus 23.27, quality-adjusted life year, QALYs), generating an ICER of $43,825/QALY. The DSA showed that target age group for the intervention, relative risk of CVD relative to the control and intervention cost were the key determinants of the ICER. The base case results were within the range of the 95% confidence interval and the intervention had a 85.2% probability of being cost-effective.

CONCLUSIONS

A workplace-delivered intervention in the office-based setting including a sit-and-stand desk component is a cost-effective strategy for the primary prevention of CVD. It offers a new option and location when considering interventions to target the growing CVD burden.

Variation in upper extremity, neck and trunk postures when performing computer work at a sit-stand station

Sit-stand tables are introduced in offices to increase variation in gross body posture, but the extent to which upper body posture variation is also affected has not previously been addressed. Neck, trunk, and upper arm postures (means and minute-to-minute variances) were determined during periods of sitting and standing from 24 office workers using sit-stand tables to perform computer work. Posture variability resulting from different temporal compositions of sitting and standing computer work was then predicted for the neck, trunk and upper arm by simulations. Postural variability during computer work could be increased up to three-fold when 20-60% of the work was performed standing (i.e. 40-80% performed sitting), compared to performing computer work only sitting. The exact composition of sit-stand proportions leading to maximum variability, as well as the potential size of the increase in variability, differed considerably between workers. Guidelines for sit-stand table use should note these large inter-individual differences.

Evaluating Short-Term Musculoskeletal Pain Changes in Desk-Based Workers Receiving a Workplace Sitting-Reduction Intervention

This paper explores changes in musculoskeletal pain among desk-based workers over three months of a workplace-delivered, sitting-reduction intervention. Participants (n = 153, 46% female; mean ± SD aged 38.9 ± 8.0 years) were cluster-randomized (n = 18 work teams) to receive an organizational change intervention, with or without an activity tracker. A modified Nordic Musculoskeletal Questionnaire assessed pain intensity (0–9; none–worst possible) in the neck, upper and lower back, upper and lower extremities, and in total. The activPAL3 (7 days, 24 h/day protocol) measured sitting and prolonged sitting in ≥30 min bouts at work. Mixed models adjusting for cluster and intervention arm examined changes in pain (n = 104), and their associations with reductions in sitting and prolonged sitting (h/10 h at work) (n = 90). Changes in pain were nonsignificant (p ≥ 0.05) and small for total pain (−0.06 [95% CI: −0.27, 0.16]) and for each body area (−0.26 [−0.66, 0.15] for upper back to 0.09 [−0.39, 0.56] for lower back). Sitting reduction was associated with reduced lower back pain (−0.84 [−1.44, −0.25] per hour, p = 0.005); other effects were small and non-significant. No substantial average changes in pain were seen; some improvement in lower back pain might be expected with larger sitting reductions. Larger samples and diverse interventions are required for more definitive evidence.