Is objectively measured sitting time associated with low back pain? A cross-sectional investigation in the NOMAD study

Traditional versus dynamic sitting: Lumbar spine kinematics and pain during computer work and activity guided tasks

Dynamic sitting may mitigate low back pain during prolonged seated work. The current study compared pelvis and lumbar spine kinematics, pain, and work productivity, in traditional and dynamic sitting. Sixteen participants completed three 20-min blocks of computer work and activity guided tasks in a traditional office chair or backless and multiaxial rotating seat pan while kinematics were measured from accelerometers on the low back. Pain ratings were recorded on a visual analogue scale every 10 min. Similar pelvis and lumbar kinematics emerged when performing computer work in traditional and dynamic sitting. Pelvis and lumbar sagittal and frontal plane shifts and fidgets were largest for dynamic sitting in the activity guided tasks. Buttocks pain was higher in dynamic sitting, but low back pain and work productivity were unaffected. Dynamic sitting increased spine movement during activity guided tasks, without negatively impacting lumbar kinematics, low back pain, or productivity during seated computer work.

The "sweet- and sour-spot" of occupational physical activity for back pain: a prospective accelerometer study among eldercare workers

OBJECTIVES

Both high and low levels of occupational physical activity are associated with back pain. Thus, there might be a "sweet- and sour-spot" of occupational physical activity for back pain. Our aim was to investigate if there exists an occupational physical activity "sweet- (lowest risk) and sour-spot" (highest risk) for back pain.

METHODS

A total of 396 eldercare workers from 20 Danish nursing homes participated. Occupational physical activity was measured between 1-4 working days using thigh-worn accelerometry. Back pain intensity was reported monthly on a scale from 0-10 over 1-year. A zero-inflated mixed-effects model was developed regressing occupational physical activity against back pain, adjusted for confounders. The "sweet- and sour-spot" were defined as the occupational physical activity compositions (sitting, standing, light, and moderate-to-vigorous) associated with the 5% lowest and highest risk for back pain, respectively.

RESULTS

The composition associated with the lowest risk of back pain - the "sweet-spot"- consisted of 71% worktime spent sitting, 18% spent standing, 5% spent on light physical activity and 6% spent on moderate-to-vigorous physical activity. The composition associated with highest risk for back pain -the "sour-spot"- consisted of 8% worktime spent sitting, 66% spent standing, 4% spent on light physical activity, and 21% spent on moderate-to-vigorous physical activity.

CONCLUSIONS

The "sweet-spot" of occupational physical activity for back pain among eldercare workers involves more sitting and light physical activity time, while the "sour-spot" involves more standing and moderate-to-vigorous physical activity time. Research on the occupational physical activity "sweet- and sour-spot" is needed.

Prevalence of low back pain and associated factors among bank workers at Hawassa city, Northern Zone, Sidama Region, Southern Ethiopia

BACKGROUND

Lower back pain (LBP) is a public health threat that affects people who frequently experience sedentary working conditions. Few studies reported on low back pain among bank workers in Ethiopia, particularly in the study area. Therefore, this study aimed to determine the magnitude and associated factors of low back pain among bank workers in Hawassa City, Sidama Region, Ethiopia.

METHODS

This institutional-based cross-sectional study was conducted from April 20, 2023, to June 30, 2023. A multistage sampling technique was employed to select participants, and data were collected using a structured self-administered questionnaire, entered into Epidata version 4.6, and transferred to SPSS version 25 for further analysis. Bivariate and multivariate logistic regression analyses were performed to identify the independent predictors of lower back pain.

RESULTS

Of the 627 total study participants, six hundred seven bank workers participated in the study, with a response rate of 96.8%. The overall magnitude of lower back pain among the study population was 55.2%, with a 95% confidence interval (CI 51.1-59). Based on the multivariate binary logistic regression analysis, being in a manager position (AOR = 3.85; 95% CI = (1.2,12), a level 2 banker (AOR = 3.8; 95% CI = (1.9,8.9), age 30-39 years (AOR = 4; 95% CI = (2,12.4), an age ≥ 40 years (AOR = 5.4; 95% CI= (3.04,16.3), working in sufficient space (AOR = 0.4; 95% CI = (0.3,0.9), and physical activity (AOR = 0.2; 95% CI = (0.1,0.8)) were significantly associated with low back pain.

CONCLUSION

The prevalence of low back pain among the bank workers was high in the study area. Being in a managerial position, being a level two banker, being aged 30-39 years, being aged ≥ 40 years, working in sufficient space, and engaging in physical activity were significantly associated. Therefore, it is essential to establish a health screening team, create awareness programs for the benefit of physical activity, provide sufficient working space, and give special attention to elderly and senior bankers and bank managers to reduce the risk of developing low back pain.

Supporting athletes during a challenging situation: recommendations from a global insight of COVID-19 home-based training experience

BACKGROUND

For athletes, overcoming obstacles in challenging situations like pandemic home training is crucial. Strategies and approaches in this context are not well-documented. Our study aims to investigate such a scenario from a performance standpoint, based on a major global crisis: the COVID-19 pandemic and lockdown.

METHODS

This cross-sectional study surveyed athletes without disabilities using online questionnaires (35 languages) from May to July 2020. Questions included aspects of alternative routines, training monitoring, recovery, sleep patterns, injury occurrence/prevention based on structured answers, and an open-ended question on lockdown training experiences.

RESULTS

Of the 11,762 athletes from 142 countries, 63% were male, including at World-Class, International, National, State and Recreational levels. During lockdown, 25% athletes used innovative or modern ways to maintain or improve fitness e.g., virtual reality and tracking devices (favoring World-Class level, 30%). Many athletes, regardless of gender (43%) watched video competitions to improve/maintain their mental skills and performance [World-Class (47%) and International (51%)]. Contact frequency between athletes and their coaches was mainly at least once a week (36%), more among higher-level (World-Class/International) than lower-level athletes (27 vs. 16%). Higher-level athletes (≥ 54%) monitored training load and were assisted by their coaches (21%). During lockdown, stretching (67%) was considered one of the primary means of recovery, especially for higher-level athletes (> 70%). Compared to pre-lockdown, about two-thirds of athletes reported "normal" or "improved" sleep quality and quantity, suggesting a low sleep quality pre-lockdown. On average, 40% utilized injury prevention exercises (at least) once a week [World-Class (51%) and International (39%)]. Most injury occurrences during lockdown involved the knee (18%), ankle (16%), and back (9%). Four key themes emerged regarding lockdown experiences: remote training adaptation (e.g., shifting training focus), training creativity (e.g., using household items), performance enhancement opportunities (e.g., refocusing neglected aspects), and mental and motivation challenges.

CONCLUSIONS

Both male and female athletes, particularly those of higher levels, displayed some adaptalibity during the COVID-19 lockdown, employing innovative approaches and technology for training. Many athletes implemented load monitoring, recovery, and attentive of injury prevention, while optimizing their sleep quality and quantity. Athletes demonstrated their abilities to navigate challenges, and utilized different coping strategies in response to the lockdown's constraints.

Active time at work following the introduction of a standing and a cycling workstation into worker's office space

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.

Daily activity patterns in older adults receiving initial support: the association between daily steps and sitting in bouts of at least 60 min

BACKGROUND

Aging has a significant impact on health, underlining the importance of maintaining physical function and reducing time spent sitting among older adults. To understand how to reduce prolonged sitting or increase physical activity, factors related to the daily living and observed daily activity patterns should be explored. This study aimed to investigate the association between daily steps, self-rated health, physical activity, sedentary behavior, motivation to exercise and fear of falling among older adults receiving initial support.

METHOD

Cross-sectional design with total population questionnaire data from adults aged ≥ 60 years (n = 917), living at home with initial support from municipal care in southern Sweden. The older adults were offered to participate in a follow-up study measuring daily activity patterns with accelerometers (n = 72). Linear regression was used to analyze associations between daily steps and possible predictors.

RESULTS

The linear model ([Formula: see text]0.478) showed that sitting in unbroken bouts of > 60 min (β = -0.313, p < 0.05), walking independently outdoors (β = 0.301, p < 0.05), intending to increase physical activity (β = -0.294, p < 0.05), sex (β = 0.279, p < 0.05), relative autonomy index (β = 0.258, p < 0.05), fear of falling (β = -0.238, p < 0.05), and self-rated health (β = 0.213, p < 0.05) predicted daily steps.

CONCLUSION

The model of predictors brings new understanding regarding daily steps among community-dwelling older adults. The association between sitting in bouts of > 60 min and daily steps is interesting as 35% of participants had a number of sitting bouts that on average, showed 30% less steps taken. Minimizing long sitting bouts and maintaining physical functioning to promote independence when walking outdoors can be tools for clinical practitioners devising interventions to break prolonged sitting among community-dwelling older adults. Future research should prioritize studying older adults' outdoor walking independence, including its relation to walking with or without assistive devices and its impact on physical activity and sedentary behavior.

The Effect of an Active Break Intervention on Nonspecific Low Back Pain and Musculoskeletal Discomfort during Prolonged Sitting among Young People-Protocol for a Randomized Controlled Trial

BACKGROUND

The most recent evidence has shown that the pandemic of COVID-19 caused an increasing problem with spinal pain in the population of teenagers and young adults. This may be explained by prolonged sitting times in flexed positions with electronic devices. Positions maintained for a prolonged time cause overloading of soft tissue and discogenic symptoms. This study aims to evaluate the effectiveness of the active break program in reducing musculoskeletal discomfort and LBP (low back pain) among young people.

METHODS

This will be a randomized controlled study. The participants will be recruited from Bachelor's course students of the Physical Education Department aged 18-25 years. The participants will be assigned to an experimental group (with an active break) and a control group. The group with an active break with lumbar and hip extension exercises will be recommended to take a break for every 30 min of sitting. The control group will receive self-care recommendations. The primary outcomes will be pain intensity (Visual Analogue Scale), disability index (Oswestry Disability Index), and perceived musculoskeletal discomfort during prolonged sitting (Borg scale), assessed at baseline and after the intervention, and the Global Perceived Effect, only assessed after the 12-week intervention. The secondary outcome will be a Post-Intervention Questionnaire (a 5-item self-completed questionnaire), only assessed after the 12-week intervention.

RESULTS

Our main research outcome-exercise protocols and interventions-will lead to the development of recommendations and protocols for the LBP population. It is important to determine the effect of interventions that are feasible and effective in addressing LBP and perceived musculoskeletal discomfort in young people.

CONCLUSIONS

This is the first study examining the effect of active breaks with proposed lumbar and hip extension exercises on reducing or decreasing LBP in students based on a search of the literature. Exercises and recommendations will be the basis for developing proprietary preventative and therapeutic programs, which will be implemented in selected educational institutions.

Stress and Work Performance Responses to a Multicomponent Intervention for Reducing and Breaking up Sitting in Office Workers: A Cluster Randomized Controlled Trial

OBJECTIVE

The aim of the study is to explore the potential of a sitting reduction workplace intervention for improving stress and work performance.

METHODS

A cluster randomized controlled trial evaluated an intervention to reduce and break up occupational sitting in 12 clusters ( n = 89 office workers) over 8 weeks. Outcomes were physiological stress (cortisol concentrations), perceived stress, and work performance.

RESULTS

Linear mixed model group × time interaction effects were nonsignificant. Exploratory analyses showed a trend, with a large effect, for lower cortisol concentrations over the day in the intervention group relative to controls at 8 weeks (-0.85; 95% confidence interval, -1.70 to 0.03 nmol·L -1 ; P = 0.06, d = 0.79). The intervention group had higher vigor and cognitive liveliness at 8 weeks relative to controls ( P ≤ 0.05).

CONCLUSIONS

This exploratory study suggests that there could be meaningful changes in physiological stress and work-related outcomes that should be investigated in future studies.

A multicomponent intervention to reduce daily sitting time in office workers: the SMART Work & Life three-arm cluster RCT

Background

Office workers spend 70-85% of their time at work sitting. High levels of sitting have been linked to poor physiological and psychological health. Evidence shows the need for fully powered randomised controlled trials, with long-term follow-up, to test the effectiveness of interventions to reduce sitting time.

Objective

Our objective was to test the clinical effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable workstation, compared with usual practice at 12-month follow-up.

Design

A three-arm cluster randomised controlled trial.

Setting

Councils in England.

Participants

Office workers.

Intervention

SMART Work & Life is a multicomponent intervention that includes behaviour change strategies, delivered by workplace champions. Clusters were randomised to (1) the SMART Work & Life intervention, (2) the SMART Work & Life intervention with a height-adjustable workstation (i.e. SMART Work & Life plus desk) or (3) a control group (i.e. usual practice). Outcome measures were assessed at baseline and at 3 and 12 months.

Main outcome measures

The primary outcome was device-assessed daily sitting time compared with usual practice at 12 months. Secondary outcomes included sitting, standing, stepping time, physical activity, adiposity, blood pressure, biochemical measures, musculoskeletal issues, psychosocial variables, work-related health, diet and sleep. Cost-effectiveness and process evaluation data were collected.

Results

A total of 78 clusters (756 participants) were randomised [control, 26 clusters (n = 267); SMART Work & Life only, 27 clusters (n = 249); SMART Work & Life plus desk, 25 clusters (n = 240)]. At 12 months, significant differences between groups were found in daily sitting time, with participants in the SMART Work & Life-only and SMART Work & Life plus desk arms sitting 22.2 minutes per day (97.5% confidence interval -38.8 to -5.7 minutes/day; p = 0.003) and 63.7 minutes per day (97.5% confidence interval -80.0 to -47.4 minutes/day; p < 0.001), respectively, less than the control group. Participants in the SMART Work & Life plus desk arm sat 41.7 minutes per day (95% confidence interval -56.3 to -27.0 minutes/day; p < 0.001) less than participants in the SMART Work & Life-only arm. Sitting time was largely replaced by standing time, and changes in daily behaviour were driven by changes during work hours on workdays. Behaviour changes observed at 12 months were similar to 3 months. At 12 months, small improvements were seen for stress, well-being and vigour in both intervention groups, and for pain in the lower extremity and social norms in the SMART Work & Life plus desk group. Results from the process evaluation supported these findings, with participants reporting feeling more energised, alert, focused and productive. The process evaluation also showed that participants viewed the intervention positively; however, the extent of engagement varied across clusters. The average cost of SMART Work & Life only and SMART Work & Life plus desk was £80.59 and £228.31 per participant, respectively. Within trial, SMART Work & Life only had an incremental cost-effectiveness ratio of £12,091 per quality-adjusted life-year, with SMART Work & Life plus desk being dominated. Over a lifetime, SMART Work & Life only and SMART Work & Life plus desk had incremental cost-effectiveness ratios of £4985 and £13,378 per quality-adjusted life-year, respectively.

Limitations

The study was carried out in one sector, limiting generalisability.

Conclusions

The SMART Work & Life intervention, provided with and without a height-adjustable workstation, was successful in changing sitting time.

Future work

There is a need for longer-term follow-up, as well as follow-up within different organisations.

Trial registration

Current Controlled Trials ISRCTN11618007.

Do Sit-Stand Tables Affect Physical Behavior and Body Composition Similarly in Normal-Weight and Overweight Office Workers? A Pilot Study

OCCUPATIONAL APPLICATIONSSedentary behavior is a significant health concern among office workers. We completed the same 6-month sit-stand table intervention at work for groups of normal-weight and overweight workers, and compared it to not having sit-stand tables. The intervention caused the intended decrease in sitting time in both groups and a corresponding increase in standing. We did not find compensation effects on physical behavior outside of work. Furthermore, the intervention did not change the composition of fat, lean, and bone mass in either group. Thus, strategies including initiatives to increase physical activity are likely needed to have effects on body composition; and an intervention needs to be sustained for longer than six months for any changes in body composition to be observed.

Does it matter for health if steps are taken during work or leisure? A prospective accelerometer study using register-based long-term sickness absence

BACKGROUND

Walking is known to be good for health. However, it is unknown whether it matters if steps are taken during work or leisure. Therefore, we aimed to examine the prospective association between accelerometer-measured steps taken during work or leisure and register-based long-term sickness absence (LTSA).

METHODS

We included 937 blue- and white-collar workers from the PODESA cohort who wore a thigh-based accelerometer over four days to measure number of steps during work and leisure. Steps were divided into domain based on diary data. First event of LTSA was retrieved from a national register with four years' follow-up. We used Cox proportional hazard models to analyze the association between domain-specific and total daily steps and LTSA, adjusted for age, sex, job type, smoking, and steps in the other domain (e.g., work/leisure).

RESULTS

We found more steps at work to be associated with a higher LTSA risk [Hazard Ratio (HR):1.04; 95% CI: 1.00-1.08 per 1000 steps]. No significant association was found between steps during leisure and LTSA (HR: 0.97; 95% CI: 0.91-1.02), nor between total daily steps and LTSA (HR: 1.01; CI 95% 0.99-1.04).

CONCLUSIONS

More steps at work were associated with higher risk of LTSA, while steps during leisure was not clearly associated with LTSA risk. These findings partly support 'the physical activity paradox' stating that the association between physical activity and health depends on the domain.

Associations between observed time sitting at work and musculoskeletal symptoms: a repeated-measures study of manufacturing workers

Time sitting at work is known to affect health overall, but its specific effects on musculoskeletal symptoms are unclear. We evaluated the relationship between observed time sitting at work and self-reported musculoskeletal symptoms among 195 manufacturing workers. Longer time sitting at work was significantly associated with lower prevalence of neck/shoulder (prevalence ratio [PR] = 0.70, 95% confidence interval [CI] [0.68, 0.72]; p < 0.001) and arm/wrist/hand (PR = 0.46, 95% CI [0.31, 0.69]; p < 0.001) musculoskeletal symptoms. Associations remained largely unchanged after adjusting for job type or occupational postures and load. Time sitting at work was associated with musculoskeletal symptoms, and should be taken into consideration as part of interventions to prevent musculoskeletal disorders (MSDs) and promote health of manufacturing workers.

The Correlation of Frequency of Work-Related Disorders with Type of Work among Polish Employees

Musculoskeletal disorders have a significant negative impact on the quality of life of the population. These conditions, as well as other work-related disorders, generate costs associated with treatment and work absence, which makes it a growing problem in industrialized countries. Available data from studies on individual populations of workers indicate a higher incidence of certain symptoms in these groups. Due to the lack of studies on the general population, we aimed to perform the preliminary study evaluating the occurrence of pain and work-related conditions depending on the type of occupational work among Polish employees to identify further possible areas for research. Data was collected using an electronic self-administered questionnaire, which was distributed in groups bringing together various professionals. The data obtained from 379 participants have been analyzed and divided according to performed work into sedentary, forced posture, standing, physical and requiring physical activity. Our study reveals a correlation between the frequency of work-related disorders and type of work performed in the Polish population. A significant correlation between the type of occupational work and prevalence of ankle, knee and shoulder pain, as well as heavy legs or upper limb paresthesia was found. According to our findings, female employees may be more vulnerable to lower limb symptoms. A place of residence also seems to affect the prevalence of upper back pain and heavy legs. The analysis also showed a correlation between the occurrence of hip, knee and ankle pain and the level of education of the participants. Surprisingly, lower extremity paresthesia was significantly more common among participants undertaking additional physical activity, compared to non-physically active respondents.

Risk factors for lumbar disc herniation in adolescents and young adults: A case-control study

Background

There is a limited understanding of the risk factors for lumbar disc herniation (LDH) in younger people, even though the evidence suggests that LDH is more prevalent in this population. This study aimed to comprehensively analyze the risk factors for LDH in adolescents and young adults.

Methods

The medical records of all patients were retrospectively reviewed with inclusion criteria of being younger than 25 years. Magnetic resonance imaging (MRI) was used to confirm LDH from September 2016 to September 2021. Furthermore, 104 healthy people in the same age range were enrolled as the control group from physical examination centers. Gender, BMI, smoking, drinking, genetic history, sitting posture, daily sitting time, traumatic history of the lower back, scoliosis, and daily exercise time were examined for all enrolled people. These factors were statistically analyzed to determine the high-risk factors.

Results

A total of 208 young individuals were enrolled in the present study. The mean age of the study group and the control group was 21.06 ± 3.27 years (range: 11-25 years) and 21.26 ± 2.23 years (range: 15-25 years), respectively. The result of the chi-squared test demonstrated that there was a significant difference in BMI of more than 30 (p < 0.001), genetic history (p = 0.004), sitting posture (p < 0.001), daily sitting time of more than 6 h (p < 0.001), and the history of low back trauma (p = 0.002). Additionally, multivariate logistic regression showed that these were high-risk factors for LDH, particularly the duration of daily sitting time (more than 6 h).

Conclusions

BMI of more than 30, genetic history, sitting posture, daily sitting time of more than 6 h, and a history of low back trauma are the high-risk factors for adolescents and young adults with LDH. Therefore, providing them with the proper guidance and education, particularly about the protection of the lower back and the reduction of spinal load, could play a key role in preventing and reducing LDH.

Innovative seated vertical lumbar traction allows simultaneous computer work while inducing spinal height changes similar to supine lying

BACKGROUND

Lumbar intervertebral disc height loss has been associated with spinal height change (SHC) and low back pain (LBP), including stenosis. Non-invasive methods to improve disc height loss require forms of lying down, which are unconducive to computer work.

OBJECTIVE

Intermittent vertical traction (VT) integrated with seated computer work may provide ergonomic alternatives for increasing SHC to promote LBP relief. The primary aim was to develop and introduce a safe VT prototype and dosage to induce and measure SHC. Prototype comfort and LBP ratings were exploratory secondary aims.

METHODS

Forty-one participants were stadiometry-measured for pre- and post-intervention SHC from seated VT at 35% body weight removed, supine lying (SL), and sitting at a computer (SIT) without VT. Pain ratings were recorded for those self-reporting LBP. VT prototype evaluations were compiled from a 3-question, 7-point Likert-style survey.

RESULTS

SHC increased by 3.9 ± 3.4 mm in VT, 1.7 ± 3.4 mm in SIT, and 4.3 ± 3.1 mm in SL (P< 0.000). Post hoc findings were significant between VT and SIT (P< 0.000), and SL and SIT (P< 0.000). VT and SL LBP ratings both decreased, but not SIT.

CONCLUSION

Intermittent seated VT is a promising alternative for postural relief during seated computer work, producing SHC similar to lying down without compromising workflow.

The prevalence and risk factors of work related musculoskeletal disorders among electronics manufacturing workers: a cross-sectional analytical study in China

OBJECTIVES

To describe the prevalence of self-reported musculoskeletal disorders among workers in the electronics manufacturing industry and to investigate the relations between work-related musculoskeletal disorders (WMSDs) and work-related variables.

METHODS

An interview-based questionnaire survey was carried out in thirty electronics manufacturing factories in China in 2018. The prevalence of WMSDs was estimated using the modified Nordic Musculoskeletal Questionnaire (NMQ). A multivariate logistic regression model was applied to evaluate the effects of risk factors on WMSDs on multiple body parts.

RESULTS

The 12-month prevalence of WMSDs among participants was 40.6%, and the common body sites affected were the neck (26.8%), shoulder (22.8%), upper back (14.9%), and lower back (14.8%). The results of logistic regression showed that female adults, > 5 job tenure and work-related factors (including awkward posture, lifting or carrying weights, excessive repetition, prolonged sitting, monotonous work and working under conditions of cold or temperature variations) led to a higher risk of WMSDs on most body parts. Upper back, wrist/hand and elbow pain levels were significantly higher for workers with vibration. However, more frequently, physical exercise was a protective factor against WMSDs on most body parts except the upper back, leg and knee.

CONCLUSIONS

The study indicates a high prevalence of musculoskeletal pain among the electronics manufacturing industry in China. Different personal and work factors are related to the occurrence of WMSD on different body parts. Preventive measures should be implemented based on the characteristics of WMSD in the electronic manufacturing industry. Furthermore, the training and intervention guidance of ergonomic hazards in the workplace need to be strengthened by understanding the impact of bad posture, avoiding long-term sitting posture and increasing physical activities.

Device-measured sitting time and musculoskeletal pain in adults with normal glucose metabolism, prediabetes and type 2 diabetes-The Maastricht Study

BACKGROUND

Detrimental associations of sedentary behaviour (time spent sitting) with musculoskeletal pain (MSP) conditions have been observed. However, findings on those with, or at risk of, type 2 diabetes (T2D) have not been reported. We examined the linear and non-linear associations of device-measured daily sitting time with MSP outcomes according to glucose metabolism status (GMS).

METHODS

Cross-sectional data from 2827 participants aged 40-75 years in the Maastricht Study (1728 with normal glucose metabolism (NGM); 441 with prediabetes; 658 with T2D), for whom valid data were available on activPAL-derived daily sitting time, MSP [neck, shoulder, low back, and knee pain], and GMS. Associations were examined by logistic regression analyses, adjusted serially for relevant confounders, including moderate-to-vigorous intensity physical activity (MVPA) and body mass index (BMI). Restricted cubic splines were used to further examine non-linear relationships.

RESULTS

The fully adjusted model (including BMI, MVPA, and history of cardiovascular disease) showed daily sitting time to be significantly associated with knee pain in the overall sample (OR = 1.07, 95%CI: 1.01-1.12) and in those with T2D (OR = 1.11, 95%CI: 1.00-1.22); this was not statistically significant in those with prediabetes (OR = 1.04, 95%CI: 0.91-1.18) or NGM (OR = 1.05, 95%CI: 0.98-1.13). There were no statistically significant associations between daily sitting time and neck, shoulder, or low back pain in any of the models. Furthermore, the non-linear relationships were statistically non-significant.

CONCLUSION

Among middle-aged and older adults with T2D, daily sitting time was significantly associated with higher odds of knee pain, but not with neck, shoulder, or low back pain. No significant association was observed in those without T2D for neck, shoulder, low back, or knee pain. Future studies, preferably those utilising prospective designs, could examine additional attributes of daily sitting (e.g., sitting bouts and domain-specific sitting time) and the potential relationships of knee pain with mobility limitations.

The relationship between objectively measured sitting time, posture, and low back pain in sedentary employees during COVID-19

Purpose

The purpose of this study was to examine the relationship between objectively measured sitting time, posture, and low back pain (LBP) in adults with full-time (≥ 40 h/week) sedentary "desk" jobs. Physical activity (PA) and sedentary behavior (SB) between work environments (home vs. office) were also compared during COVID-19.

Methods

Participants (N = 53; M _age = 41 ± 12years) were full-time employees in sedentary jobs during COVID-19. A survey with demographic, work environment, and LBP questions was completed; Thomas Test assessed poor hip posture. ActivPAL devices were worn for ≥ 4 valid days (≥ 10 h/d) to assess waking sitting time (min/d). Binomial logistic regressions examined sitting as a predictor of poor posture and LBP; ANOVAs compared PA and SB between work environments.

Results

Objectively measured sitting (min/day) predicted poor hip posture (β = - 0.01, p < 0.046) but was not significant for LBP (β = 0.002, p < 0.43). Participants who worked from home had significantly higher sitting time (569 ± 111 vs. 477 ± 46 min/d; p < 0.04), higher muscle strengthening PA (2.2 ± 2 vs. 0.5 ± 1.2d/week p < 0.02), but no difference in aerobic PA (p < 0.15), than those who worked from an office.

Conclusion

Given the shift to remote work during COVID-19, employees are at high risk for postural compensations that lead to LBP due to high SB and poor work ergonomics at home. There is a need to develop home-based behavioral and exercise interventions to reduce sitting, help improve posture, and invest in proper ergonomic homework equipment.

Agreement between an expert-rated mini job exposure matrix of occupational biomechanical exposures to the lower body and technical measurements or observation: a method comparison study

OBJECTIVES

Investigating the agreement between an expert-rated mini job exposure matrix (JEM) of lower body exposures and technical measurements of worktime spent standing/walking and observation-based estimates of time spent kneeling/squatting and total load lifted per workday.

METHODS

We chose 16 job titles from the 121 job groups in the lower body JEM and included them in the mini JEM. New expert ratings for the mini JEM were performed by the same five occupational physicians who performed the ratings for the lower body JEM. For each job title and type of exposure, the exposure estimates were a mean of the five independent ratings. Technical measurements of standing/walking for all 16 job titles, and for 8 job titles workplace observations were performed of kneeling/squatting and total load lifted per workday. Data were collected from September to December 2015 and supplemented by data from the NOMAD and DPhacto studies collected between 2011 and 2013. All data were collected in Denmark. Agreement between expert-based and measured/observed lower body exposures by job titles was evaluated using Spearman's rank correlation, Bland-Altman plots evaluated systematic deviations and limits of agreement (LoA).

RESULTS

Standing/walking showed a rank correlation of 0.55, kneeling/squatting 0.83 and total load lifted per workday 0.71. The mini JEM estimates did not systematically deviate from the technical measurements/observations for time spent standing/walking (mean difference 0.20 hours/workday, LoA -1.63, 2.03 hours/workday) and kneeling/squatting (mean difference -0.35 hours/workday, LoA -1.21, 0.51 hours/workday). For total load lifted per workday, the mini JEM systematically overestimated the exposures compared with the observations (mean difference -909 kg/workday, LoA -3000, 1147 kg/workday).

CONCLUSIONS

There was moderate to very high agreement between an expert-rated mini JEM of standing/walking, kneeling/squatting, and lifting exposures and corresponding technical measurements/observations. This method comparison study supports the use of the expert-based lower body JEM in large-scale occupational epidemiological studies.

Sedentary behaviour, physical activity, and sleep among office workers during the COVID-19 pandemic: a comparison of Brazil and Sweden

Background

The COVID-19 pandemic has affected the physical behaviours of office workers worldwide, but studies comparing physical behaviours between countries with similar restrictions policies are rare. This study aimed to document and compare the 24-hour time-use compositions of physical behaviours among Brazilian and Swedish office workers on working and non-working days during the pandemic.

Methods

Physical behaviours were monitored over 7 days using thigh-worn accelerometers in 73 Brazilian and 202 Swedish workers. Daily time-use compositions were exhaustively described in terms of sedentary behaviour (SED) in short (< 30 min) and long (≥30 min) bouts, light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and time-in-bed. We examined differences between countries using MANOVA on data processed according to compositional data analysis. As Swedish workers had the possibility to do hybrid work, we conducted a set of sensitivity analyses including only data from days when Swedish workers worked from home.

Results

During working days, Brazilian office workers spent more time SED in short (294 min) and long (478 min) bouts and less time in LPA (156 min) and MVPA (50 min) than Swedish workers (274, 367, 256 and 85 min, respectively). Time spent in bed was similar in both groups. Similar differences between Brazilians and Swedes were observed on non-working days, while workers were, in general, less sedentary, more active and spent more time-in-bed than during working days. The MANOVA showed that Brazilians and Swedes differed significantly in behaviours during working (p <  0.001, ηp2 = 0.36) and non-working days (p <  0.001, ηp2 = 0.20). Brazilian workers spent significantly more time in SED relative to being active, less time in short relative to long bouts in SED, and more time in LPA relative to MVPA, both during workdays and non-workdays. Sensitivity analyses only on data from days when participants worked from home showed similar results.

Conclusions

During the COVID-19 pandemic Brazilian office workers were more sedentary and less active than Swedish workers, both during working and non-working days. Whether this relates to the perception or interpretation of restrictions being different or to differences present even before the pandemic is not clear, and we encourage further research to resolve this important issue.

Does occupational forward bending of the back increase long-term sickness absence risk? A 4-year prospective register-based study using device-measured compositional data analysis

OBJECTIVE

Forward bending of the back is common in many jobs and a risk factor for sickness absence. However, this knowledge is based on self-reported forward bending that is generally imprecise. Thus, we aimed to investigate the dose-response relation between device-measured forward bending at work and prospective register-based risk of long-term sickness absence (LTSA).

METHODS

At baseline, 944 workers (93% from blue-collar jobs) wore accelerometers on their upper back and thigh over 1-6 workdays to measure worktime with forward bending (>30˚ and >60˚) and body positions. The first event of LTSA (≥6 consecutive weeks) over a 4-year follow-up were retrieved from a national register. Compositional Cox proportional hazard analyses were used to model the association between worktime with forward bending of the back in an upright body position and LTSA adjusted for age, sex, body mass index (BMI), occupational lifting/carrying, type of work, and, in an additional step, for leisure time physical activity (PA) on workdays.

RESULTS

During a mean worktime of 457 minutes/day, the workers on average spent 40 and 10 minutes on forward bending >30˚ and >60˚ in the upright position, respectively. Five more minutes forward bending >30˚ and >60˚ at work were associated with a 4% [95% confidence interval (CI) 1.01-1.07] and 8% (95% CI 1.01-1.16) higher LTSA risk, respectively. Adjustment for leisure-time PA did not influence the results.

CONCLUSION

We found a dose-response association between device-measured forward bending of the back and prospective LTSA risk. This knowledge can be integrated into available feasible methods to measure forward bending of the back for improved workplace risk assessment and prevention.

The Effect of a Pelvic Support Chair on Sagittal Lumbosacral Alignment in Sitting Position in Patients with Lower Back Pain

Background

A slouched lumbar posture during sitting is risk factor for the low back pain (LBP). Various chairs have been used to maintain sagittal lumbar lordosis and sacral alignment during sitting. We aimed to demonstrate the effect of a pelvic-support chair on the lumbar lordosis and sacral tilt in patients with LBP.

Methods

We recruited 29 patients with non-specific LBP and 11 healthy subjects in South Korea from Apr 2017 to Mar 2018. The sagittal lumbosacral alignment was examined radiographically in three sitting postures: usual, erect, and sitting in a pelvic-support chair. Five angles [the lumbar lordosis, upper lumbar (ULA), lower lumbar (LLA), lumbosacral (LSA), and sacral slope (SS) angles] were compared between the subjects with LBP and healthy subjects in the three sitting conditions.

Results

There were significant differences in the lumbar lordosis, ULA, LLA, LSA, and SS according to sitting condition (P<.05). All five angles were significantly greater when participants sat erect or in a pelvic-support chair than in their usual sitting position (P<.05). ULA and SS were significantly greater when sitting erect than in a pelvic-support chair (P<.05). LLA was significantly greater in controls than in patients with LBP (P=.042).

Conclusion

The sagittal alignment of the lumbosacral region differed significantly among usual, erect, and pelvic-support chair sitting in patients with LBP and controls. Decreased lordotic curve of the lumbar spine in the usual sitting position can be changed in both patients with LBP and healthy subjects by sitting with pelvic support chair.

Postural strategies among office workers during a prolonged sitting bout

Sedentary behavior has increased steadily over prior decades, primarily due to increased computer use at work and at home. The total sedentary time per day has been associated with increased risk of cardiometabolic diseases; increased sitting time at work has been associated with musculoskeletal discomfort particularly in the low back. Office workers spend many hours sitting, thus efforts to increase movement through changes of posture (sit to stand) or moving while sitting have been proposed as ways to mitigate the negative effects of prolonged sitting. Yet, few studies have investigated differences in the movement patterns of office workers while sitting performing their actual work. Therefore, the aim of this study was to characterize movement patterns during a prolonged sitting bout and to determine their association with musculoskeletal pain. Twenty-eight office workers participated in this field study that used a pressure sensitive mat to quantify seat pan pressure (4 regions) and trunk sway parameters over a 2-hour bout of computer work. Data were stratified by breakers who stood up at least once within the 2-hour test and prolongers who remained sitting throughout the test. Overall, there was a decreasing trend in trunk sway parameters (mean COP position, sway path, sway area, sway velocity, maximum displacement, and in-chair movements) over time (p < 0.05), with significant changes in sitting strategies. There were significant differences in trunk sway parameters and perceived musculoskeletal discomfort between breakers and prolongers with breakers having more consistent movement while sitting over the prolonged sitting bout (p < 0.05) and lower discomfort ratings. This may indicate that interrupting prolonged bouts of sitting with short periods of standing can maintain sitting movement patterns and reduce the development of musculoskeletal discomfort. Trunk sway monitoring and promoting periodic standing may be useful tools for maintaining in chair movements that may reduce or prevent the onset of musculoskeletal discomfort during prolonged sitting.

Physical Activity Advice for Prevention and Rehabilitation of Low Back Pain- Same or Different? A Study on Device-Measured Physical Activity and Register-Based Sickness Absence

Purpose We lack knowledge on whether the advice of "being physically active" should be the same for prevention and rehabilitation of low back pain (LBP). Sickness absence is a key outcome for LBP prevention and rehabilitation. We investigated the associations between physical activity and long-term sickness absence (LTSA) among employees with and without LBP. Methods Between 2011 and 2013, 925 Danish employees wore a Actigraph GTX3 accelerometer for 1-5 workdays to measure physical activity and reported LBP in past 7 days. Employees were followed for 4 years to determine their first register-based LTSA event (≥ 6 consecutive weeks). Results Among employees with LBP, increasing moderate-to-vigorous-intensity physical activity at work by 20 min and decreasing the remaining behaviors at work (ie., sitting, standing and light-intensity activity) by 20 min was associated with 38% (95% CI 17%; 63%) higher LTSA risk. Increasing light-intensity activity at work by 20 min and decreasing 20 min from the remaining behaviors was associated with 18% (95% CI 4%; 30%) lower risk. During leisure, increasing moderate-to-vigorous-intensity activity by 20 min or standing by 40 min was associated with 26% (95% CI 3%; 43%) lower and 37% (95% CI 0%; 87%) higher risk, respectively. Among employees without LBP, we found no such associations. Conclusions The physical activity advice ought to be different for LBP prevention and rehabilitation to reduce LTSA risk, and specified by domain and activity intensity. At work, employees with LBP should be advised to spend time on light-intensity physical activity and limit their time on moderate-to-vigorous-intensity physical activity. During leisure, employees should spend time on moderate-to-vigorous-intensity physical activity.

Is it possible to discriminate workers with a higher prevalence of low back pain considering daily exposure time in a work-related lumbar posture? A diagnostic accuracy study

The study aimed to develop and validate a cut-off for daily postures to discriminate workers with low back pain. The self-reported episode of low back pain in the last year and during the previous week and the total spent time in occupational postures of 529 workers were used to screen workers who more likely would report low back pain. The receiver operating characteristics curve verified the ability of daily time in each posture in discriminating workers with low back pain in a training sample. Then, the chi-squared test and measurements of the diagnostic accuracy were performed in the testing sample. The daily time spent in a given posture was not able to accurately discriminate against workers with low back pain. Total time spent walking was the only daily posture that discriminated workers with low back pain in the last year in the testing sample, albeit with low accuracy. Practitioner Summary: The daily time spent in a given posture was not able to accurately distinguish workers with low back pain. Total spent time in walking presented modest diagnostic accuracy and should be interpreted cautiously. The spent time in a particular posture did not detect workers with LBP in the last week.

Standing time and daily proportion of sedentary time are associated with pain-related disability in a one month accelerometer measurement in adults with overweight or obesity

OBJECTIVES

The association between the subjective experience of pain-related disability (PRD) and device-measured physical activity (PA) and sedentary behavior (SB) in overweight and obese adults is not well known. The aim of this study was to investigate the associations of pain markers with accelerometer-measured SB duration and different intensities of PA among physically inactive middle-aged adults with overweight or obesity.

METHODS

This cross-sectional analysis included 72 subjects (27 men) with mean age of 57.9 (SD 6.7) years and mean BMI of 31.6 (SD 4.1) kg/m2. SB and standing time (ST), breaks in sedentary time, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were measured for four consecutive weeks (mean 25 days, SD 4) with a hip-worn triaxial accelerometer. Headache, musculoskeletal pain, back pain, and PRD were assessed by visual analog scales (VAS) and using the Oswestry disability index (ODI). RAND-36 questionnaire was applied to assess health-related quality of life. The associations were studied by linear models.

RESULTS

ST was positively and SB proportion was negatively associated with PRD when adjusted for age, sex, BMI, accelerometry duration, MVPA, pain medication use, and general health perceptions assessed by RAND-36. No associations were found between ST and back pain. SB or different PA intensities were not associated with pain experience at specific sites.

CONCLUSIONS

Longer daily ST, but not LPA or MVPA is associated with higher level of PRD. Correspondingly, higher proportion of SB is associated with lower level of PRD. This suggests that individuals with PRD prefer to stand, possibly to cope with pain. These results may highlight the importance of habitual standing behaviors in coping with experienced PRD in adults with overweight or obesity.

Effect of a 6-month sedentary behavior reduction intervention on well-being and workplace health in desk workers with low back pain

BACKGROUND: Research suggests reducing sedentary behavior improves low back pain; however, the impact on presenteeism, health, productivity, and sleep in desk workers with chronic low back pain is not known. OBJECTIVE: Evaluate the effect of a sedentary behavior intervention on multiple dimensions of workplace health. METHODS: 24 participants with chronic low back pain and desk jobs were randomized to either a sedentary behavior reduction intervention group or control. Outcomes included a modified Global Physical Activity Questionnaire (GPAQ), the Stanford Presenteeism Scale (SPS), Profile of Mood States (POMS), Health and Work Questionnaire (HWQ), SF-36 Health Survey (SF-36), and Pittsburgh Sleep Quality Index (PSQI). Six-month changes in outcomes were compared across intervention groups using ANCOVA regression, adjusting for baseline values. Cohen’s d effect sizes were calculated for outcomes to explain the magnitude of group differences. RESULTS: The intervention group reported 1.5 hours/day less sitting time (p < 0.001) compared to controls at 6 months. SF-36 subscales of energy/fatigue, social functioning, and pain improved, and sleep disturbance was reduced among intervention participants. Productivity, concentration, and presenteeism were unchanged. CONCLUSIONS: A sedentary behavior reduction intervention may improve well-being and workplace health without impacting productivity and concentration in desk workers with chronic low back pain.

The association between sedentary behavior and low back pain in adults: a systematic review and meta-analysis of longitudinal studies

Background

Low back pain (LBP) is a common musculoskeletal problem globally. While spending a longer time in sedentary behaviors is linked to several health problems; the quantitative association between different amounts of sedentary time and LBP is still unknown. This study aims to systematically review studies that examined the association between sedentary behavior and LBP development and LBP-related outcomes.

Methods

This systematic review and meta-analysis retrieved journal articles published from inception to March 2020 and were obtained by searching bibliographical databases. We included longitudinal study designs, including adult (aged ≥18) individuals with nonspecific LBP, and reporting estimates of the association between sedentary behavior and LBP development and LBP-related outcomes (i.e., pain intensity and disability).

Results

Sixteen longitudinal studies with 100,002 participants were included in this review (eight studies included in quantitative syntheses with 83,111 participants). The results of meta-analyses showed that a sedentary time of 3-<6 (Odds ratio (OR) 0.95, 95% CI [0.85-1.07]), 6-8 (OR 0.95, 95% CI [0.88-1.02]), and >8 (OR 0.92, 95% CI [0.85-1.00]) hours per day (h/d) was not associated with LBP development. A sedentary time of ≥3 h/d was associated with poor LBP-related disability (OR 1.24, 95% CI [1.02-1.51]), but not with pain intensity.

Conclusion

A meta-analyses of longitudinal studies indicated that sedentary behavior of different durations was not associated with LBP development. However, the results showed that sedentary behavior ≥3 h/d was associated with worse LBP-related disability. These conclusions are tentative as the evidence was derived from mostly fair-quality studies using subjective measures of sedentary behavior.

Systematic review registration

PROSPERO (registration number CRD42018107078).

Intensity of occupational physical activity in blue-collar workers: do self-reported rating and device-worn measurements agree?

PURPOSE

High intensity occupational physical activity (OPA) seem to aggravate health and increase risk of sick leave and early retirement. Most intensity of OPA monitoring has been self-reported, e.g. by rating of perceived exertion (RPE). However, no studies have investigated the precision and risk of bias in RPE reporting during free-living OPA. This study investigated the agreement between OPA intensity in percentage of the heart rate reserve (%HRR) estimated from RPE and device-measured heart rate (HR), and potential bias factors on this agreement.

METHODS

The CR10 scale measured RPE at work. The Actiheart monitor measured HR during 24-h a day for 2-4 days. Both RPE and device-worn HR were converted to %HRR. The difference between both %HRR and their limits of agreement was determined in a Bland Altman plot. To detect bias factors, the difference between both %HRR was regressed on age, sex, cardiorespiratory fitness, occupational lifting, medication, consequences of musculoskeletal disorders and the interactions between these factors with device-work %HRR.

RESULTS

Six hundred and twenty-three participants were included in the analysis. Mean difference between RPE-based and device-worn %HRR was 54.6% (SD 19.5). The limits of agreement were wide (11.6-90.1%HRR). Age (0.48%HRR, 95% CI 0.18-0.79) occupational lifting (9.84%HRR, 95% CI 3.85-15.83) and cardiorespiratory fitness (0.41%HRR, 95% CI 0.03-0.79) significantly biased the agreement between the estimations of OPA intensity.

CONCLUSION

RPE overestimated OPA intensity, and was biased by several factors. Device-worn %HRR should be preferred when evaluating OPA intensity among workers with physically demanding jobs.

Association between sedentary behavior and low back pain; A systematic review and meta-analysis

Background: Sedentariness is a substantial risk for many chronic diseases. We aimed to investigate the correlation of sedentary behavior and its indicators with low back pain (LBP) among adults and children.

Methods: Original articles published up to April 28, 2020, using PubMed, Embase, Web of Science and Scopus were evaluated. Odds ratio (OR, 95% CI) was considered the overall effect size for desired associations.

Results: We reviewed 49 English articles with analytical observational study design, of which, 27 studies with cross sectional/survey design were retained in the meta-analysis. Among adults, sedentary lifestyle was a considerable risk factor for LBP (OR=1.24, 1.02-1.5); prolonged sitting time (OR=1.42, 1.09-1.85) and driving time (OR=2.03, 1.22-3.36) were the significant risk factors. Sedentary behavior was associated with LBP in office workers (OR=1.23). Moreover, excess weight (OR=1.35, 1.14-1.59) and smoking (OR=1.28, 1.03-1.60) were associated with LBP. Among children, sedentary lifestyle was a remarkable risk factor for LBP (OR=1.41, 1.24- 1.60); prolonged TV watching (OR=1.23, 1.08-1.41) and computer/mobile using and console playing time (OR=1.63, 1.36-1.95) were significant risk factors for LBP. Consumption of coffee, however, has yield conflicting results to be considered as a risk factor. Moreover, the researches on the correlation between sedentariness and high-intensity LBP are scarce and inconclusive.

Conclusion: Sedentary behavior, whether in work or leisure time, associates with a moderate increase in the risk of LBP in adults, children and adolescents.

The relationship between low back pain and the basic lumbar posture at work: a retrospective cross-sectional study

PURPOSE

This study aimed to analyze the relationship between work-related lumbar posture (sitting, standing, walking, alternating posture) and LBP in workers.

METHODS

This is a retrospective study comprising 529 records of adult workers from a database of a private company. Predominant work-related lumbar posture was classified based on time spent in each posture. A total of 22 personal, occupational, clinical, and psychosocial covariates were evaluated. LBP symptoms in the last 12 months and during the last 7 days were the outcomes of the study. The multivariate analysis model evaluated the independent relationship between the work-related lumbar posture classification and other potential exposure factors with LBP.

RESULTS

The adjusted logistic regression model indicated that predominant walking reduced the likelihood to report LBP during the last 12 months when compared to standing (OR = 0.54; 95% CI 0.30, 0.99; p = 0.048), but there is no association between work-related postures and recent LBP. The adjusted analyses also revealed an association between LBP during the last 12 months and female sex, blue-collar task, frequently feeling tiredness, pain at any other body region previous 12 months, previous LBP, and monotonous work. Recent LBP was associated with female sex, pain at any other body region last 7 days, and previous LBP.

CONCLUSIONS

Standing posture increases the likelihood to report LBP during the last 12 months when compared to walking. LBP over previous year and during the previous 7 days was associated with personal and clinical factors.

Physical Activity in the Workplace: Does Just Working Meet Activity Recommendations?

Background: The physical activity (PA) health paradox hypothesizes that occupational physical activity (OPA) and leisure time PA have differential cardiovascular health effects due to increased cardiovascular load without adequate recovery; however, research describing worker PA lacks high-quality objective OPA measurement. This study aimed to objectively describe PA profiles of men reporting high OPA and make comparisons to aerobic PA and OPA recommendations. Methods: Male food service, material moving, health care, or maintenance workers wore activity (ActiGraph^® and activPAL^®) and heart rate monitors for 7 days. Participants recorded work, non-work, and sleep times in a diary. PA was operationalized as time spent in sedentary behavior, upright time, light, moderate, vigorous, and moderate-to-vigorous PA during work and non-work hours. PA profiles were described and compared with Centers for Disease Control and Prevention aerobic PA guidelines (≥21.4 minute/day) and OPA recommendations (<30 minute/hour upright and intensity of <30% heart rate reserve). Findings: Nineteen male workers (68% White, age = 46.6±7.9 years) were more active on workdays than non-workdays (sedentary: 492.3 vs. 629.7 minute/day; upright: 462.4 vs. 325.2 minute/day; moderate-to-vigorous PA: 72.4 vs. 41.5 minute/day, respectively; all p < .05). Most participants (17/19) achieved aerobic PA guidelines across all days with more achieving on workdays (19/19) than non-workdays (13/19). OPA often exceeded recommended limits with participants accumulating 39.6±12.2 minutes/work hour upright and 30.3±25.9% of working time >30% heart rate reserve. Conclusions/Application to Practice: Male workers reporting high OPA typically met aerobic PA guidelines but exceeded recommended OPA limits. The long-term health implications of such activity profiles should be investigated.

Musculoskeletal pain and sedentary behaviour in occupational and non-occupational settings: a systematic review with meta-analysis

BACKGROUND

Sedentary behaviour (SB; time spent sitting) is associated with musculoskeletal pain (MSP) conditions; however, no prior systematic review has examined these associations according to SB domains. We synthesised evidence on occupational and non-occupational SB and MSP conditions.

METHODS

Guided by a PRISMA protocol, eight databases (MEDLINE, CINAHL, PsycINFO, Web of Science, Scopus, Cochrane Library, SPORTDiscus, and AMED) and three grey literature sources (Google Scholar, WorldChat, and Trove) were searched (January 1, 2000, to March 17, 2021) for original quantitative studies of adults ≥ 18 years. Clinical-condition studies were excluded. Studies' risk of bias was assessed using the QualSyst checklist. For meta-analyses, random effect inverse-variance pooled effect size was estimated; otherwise, best-evidence synthesis was used for narrative review.

RESULTS

Of 178 potentially-eligible studies, 79 were included [24 general population; 55 occupational (incuding15 experimental/intervention)]; 56 studies were of high quality, with scores > 0.75. Data for 26 were meta-synthesised. For cross-sectional studies of non-occupational SB, meta-analysis showed full-day SB to be associated with low back pain [LBP - OR = 1.19(1.03 - 1.38)]. Narrative synthesis found full-day SB associations with knee pain, arthritis, and general MSP, but the evidence was insufficient on associations with neck/shoulder pain, hip pain, and upper extremities pain. Evidence of prospective associations of full-day SB with MSP conditions was insufficient. Also, there was insufficient evidence on both cross-sectional and prospective associations between leisure-time SB and MSP conditions. For occupational SB, cross-sectional studies meta-analysed indicated associations of self-reported workplace sitting with LBP [OR = 1.47(1.12 - 1.92)] and neck/shoulder pain [OR = 1.73(1.46 - 2.03)], but not with extremities pain [OR = 1.17(0.65 - 2.11)]. Best-evidence synthesis identified inconsistent findings on cross-sectional association and a probable negative prospective association of device-measured workplace sitting with LBP-intensity in tradespeople. There was cross-sectional evidence on the association of computer time with neck/shoulder pain, but insufficient evidence for LBP and general MSP. Experimental/intervention evidence indicated reduced LBP, neck/shoulder pain, and general MSP with reducing workplace sitting.

CONCLUSIONS

We found cross-sectional associations of occupational and non-occupational SB with MSP conditions, with occupational SB associations being occupation dependent, however, reverse causality bias cannot be ruled out. While prospective evidence was inconclusive, reducing workplace sitting was associated with reduced MSP conditions. Future studies should emphasise prospective analyses and examining potential interactions with chronic diseases.

PROTOCOL REGISTRATION

PROSPERO ID # CRD42020166412 (Amended to limit the scope).

Sitting for Too Long, Moving Too Little: Regular Muscle Contractions Can Reduce Muscle Stiffness During Prolonged Periods of Chair-Sitting

In modern Western societies, sedentary behavior has become a growing health concern. There is increasing evidence that prolonged sitting periods can be associated with musculoskeletal disorders. While it is generally recognized that back muscle activity is low during chair-sitting, little is known about the consequences of minor to no muscle activity on muscle stiffness. Muscle stiffness may play an important role in musculoskeletal health. This study investigated the effects of regular muscle contractions on muscle stiffness in a controlled experiment in which participants sat for 4.5 h. Neuromuscular electrical stimulation in the lumbar region of the back was applied to trigger regular muscle contractions. Using stiffness measurements and continuous motion capturing, we found that prolonged sitting periods without regular muscle contractions significantly increased back muscle stiffness. Moreover, we were able to show that regular muscle contractions can prevent those effects. Our results highlight the importance of consistent muscle activity throughout the day and may help explain why prolonged periods of chair-sitting increase the susceptibility to common pathological conditions such as low back pain.

Manual handling of heavy loads and low back pain among different occupational groups: results of the 2018 BIBB/BAuA employment survey

Background

In Germany and other European countries, many occupations still involve manual handling of loads (MHL), an activity that puts the musculoskeletal system at risk of low back pain (LBP). This study aims to describe the current prevalence of MHL in different occupational groups stratified by gender in Germany, the association between MHL and LBP and the adjusted prevalence of LBP in different respond-categories of MHL.

Methods

Data was collected in telephone interviews conducted as part of the 2018 BIBB/BAuA Employment Survey, which covers work-related topics like working conditions, education, health status and job satisfaction. The analyses were limited to full-time workers (> 35 h/week) aged between 15 and 67. The frequency of MHL was analysed descriptively. BLOSSFELD classification was used to group the participants in occupational categories. The analysis of the association between MHL and the prevalence of LBP over the last 12 months was based on robust log-linear Poisson regression that results in prevalence ratios (PR). The main regression model was adjusted for gender, age, working hours, and working conditions. Adjusted estimates for the prevalence of LBP were calculated based on regression analysis.

Results

The sample consists of n = 14,331 participants (men: n = 8828, 61.6%; women: n = 5503, 38.4%; median age 49 years). Of these, 52.8% say they were exposed to MHL at work. MHL is most common in agricultural occupations, skilled and unskilled occupations. In the regression model, participants who said they were “often” exposed to MHL reported more frequently LBP than those participants who said they were “never” exposed to MHL. The PR as estimate for the association is 1.41 (95%CI [1.32; 1.49]). Postestimation of the prevalence of LBP began with 47.3% (95%CI [43.8%; 51.1%]) for participants who said they were “never” exposed to MHL and rose to 66.5% (95%CI [62.4%; 71.0%]) for participants who indicated they were “often” exposed to MHL.

Conclusions

The 2018 BIBB/BAuA Employment Survey emphasizes that MHL is still common in the German workforce and shows a significant association to LBP. Prevention policies for avoiding MHL remain vital.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-021-04819-z.

Effect of a dynamic seat pan design on spine biomechanics, calf circumference and perceived pain during prolonged sitting

This study investigates the effects of a dynamic seat pan design on sitting biomechanics, perceived pain and seat movement compared to a control. Thirty male participants were recruited for two experimental sessions consisting of a 2-h sitting exposure (standardized typing task). Spine angles, back muscle activity, perceived pain and calf circumference were measured pre and post exposure. Sitting in the dynamic condition resulted in lower pain ratings (p = 0.031), decreased calf circumference (p < 0.001), lower average seat pressure (p < 0.001), and greater seat contact area (p = 0.003) compared to the control. Spine angles and low back EMG for all 6 muscles showed no significant differences between chair conditions. These results suggest this dynamic seat pan design is effective at decreasing several negative components associated with sitting for the occupant. Future work should examine the longer-term effects of dynamic office chair features in the field setting with a more generalizable population.

Low Back Pain Exacerbation Is Predictable Through Motif Identification in Center of Pressure Time Series Recorded During Dynamic Sitting

Background: Low back pain (LBP) is a common health problem - sitting on a chair for a prolonged time is considered a significant risk factor. Furthermore, the level of LBP may vary at different times of the day. However, the role of the time-sequence property of sitting behavior in relation to LBP has not been considered. During the dynamic sitting, small changes, such as slight or big sways, have been identified. Therefore, it is possible to identify the motif consisting of such changes, which may be associated with the incidence, exacerbation, or improvement of LBP. Method: Office chairs installed with pressure sensors were provided to a total of 22 office workers (age = 43.4 ± 8.3 years) in Japan. Pressure sensors data were collected during working days and hours (from morning to evening). The participants were asked to answer subjective levels of pain including LBP. Center of pressure (COP) was calculated from the load level, the changes in COP were analyzed by applying the Toeplitz inverse covariance-based clustering (TICC) analysis, COP changes were categorized into several states. Based on the states, common motifs were identified as a recurring sitting behavior pattern combination of different states by motif-aware state assignment (MASA). Finally, the identified motif was tested as a feature to infer the changing levels of LBP within a day. Changes in the levels of LBP from morning to evening were categorized as exacerbated, did not change, or improved based on the survey questions. Here, we present a novel approach based on social spider algorithm (SSA) and probabilistic neural network (PNN) for the prediction of LBP. The specificity and sensitivity of the LBP inference were compared among ten different models, including SSA-PNN. Result: There exists a common motif, consisting of stable sitting and slight sway. When LBP level improved toward the evening, the frequency of motif appearance was higher than when LBP was exacerbated (p < 0.05) or the level did not change. The performance of the SSA-PNN optimization was better than that of the other algorithms. Accuracy, precision, recall, and F1-score were 59.20, 72.46, 40.94, and 63.24%, respectively. Conclusion: A lower frequency of a common motif of the COP dynamic changes characterized by stable sitting and slight sway was found to be associated with the exacerbation of LBP in the evening. LBP exacerbation is predictable by AI-based analysis of COP changes during the sitting behavior of the office workers.

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.

Day-to-day pattern of work and leisure time physical behaviours: are low socioeconomic status adults couch potatoes or work warriors?

Background

Most studies on day-to-day patterns of physical behaviours (i.e. physical activities and sedentary behaviour) are based on adults with high socioeconomic status (SES) and without differentiating between work and leisure time. Thus, we aimed to characterise the day-to-day leisure time physical behaviours patterns among low SES adults and investigate the influence of work physical behaviours.

Methods

This cross-sectional study included 963 adults from low SES occupations (e.g. manufacturing, cleaning and transportation). The participants wore accelerometers for 1–7 days to measure physical behaviours during work and leisure time, expressed as time-use compositions consisting of time spent sedentary, standing or being active (walking, running, stair climbing, or cycling). Compositional multivariate multilevel models were used to regress daily leisure time-use composition against work time-use compositions. Interaction between weekday and (1) type of day, (i.e., work/non-work) and (2) the work time-use composition were tested. Compositional isotemporal substitution was used to interpret the estimates from the models.

Results

Each weekday, workers consistently spent most leisure time being sedentary and most work time standing. Leisure time physical behaviours were associated with type of day (p < 0.005, more sedentary on workdays vs. non-workdays), weekday (p < 0.005, more sedentary on Friday, Saturday and Sunday), standing work (p < 0.005, more sedentary and less standing and active leisure time on Sunday), and active work (p < 0.005, less sedentary and more standing and active leisure time on Sunday). Sedentary leisure time increased by 18 min, while standing and active leisure time decreased by 11 and 7 min, respectively, when 30 min were reallocated to standing at work on Sunday. Conversely, sedentary leisure time decreased by 25 min, and standing and active leisure time increased by 15 and 10 min, respectively, when 30 min were reallocated to active time at work on Sunday.

Conclusions

While low SES adults’ leisure time was mostly sedentary, their work time was predominantly standing. Work physical behaviours differently influenced day-to-day leisure time behaviours. Thus, public health initiatives aiming to change leisure time behaviours among low SES adults should consider the influence of work physical behaviours.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11409-0.

Low back and neck pain: objective and subjective measures of workplace psychosocial and physical hazards

OBJECTIVE

This study explored the role of occupational physical activity (OPA), physical demands and psychosocial work-related factors on low back pain (LBP) and neck-shoulder pain (NSP) amongst workers with physically demanding professions.

METHODS

Data from 331 participants within the service and manufacturing sector in the Flemish Employees' Physical Activity (FEPA) study were used, with objective measures of OPA and subjective measures of physical and psychosocial work environment. A modified Nordic questionnaire collected data on LBP and NSP.

RESULTS

LBP (> 30 days over a year) was reported by 25% of participants, NSP (> 30 days over a year) by 30% and the composite measure of LBP/NSP simultaneously by 17%. Objective measures of OPA were not significantly associated with any pain groups. In the final model, self-reported physical demands were associated with NSP (OR 2.03, 95% CI 1.30-3.18) and LBP/NSP (OR 2.00, 95% CI 1.16-3.45) but not LBP. Job control was negatively associated with LBP (OR 0.59, 95% CI 0.35-0.99) and LBP/NSP (OR 0.54, 95% CI 0.3-0.98).

CONCLUSION

Objective measures were not associated with LBP or NSP. Self-reported measures provided insights into potential workplace hazards such as physical demands and job control which can be used to inform future strategies to prevent the development of LBP and NSP.

Heart rate during work and heart rate variability during the following night: a day-by-day investigation on the physical activity paradox among blue-collar workers

Objectives:

Contrary to leisure-time physical activity, occupational physical activity (OPA) may have harmful health effects, called the physical activity paradox. A proposed mechanism is that OPA can elevate the heart rate (HR) for several hours per day. We aimed to investigate the association between the mean intensity of OPA and HR variability (HRV) indices the following night.

Methods:

Three cohorts (NOMAD, DPhacto, and Physical Workload and Fitness) involving blue-collar workers from different sectors were merged in this study. HR monitors (Actiheart) recorded 24-hour inter-beat intervals (IBI) for up to four consecutive days. The relative intensity of the mean HR during work was estimated by HR reserve (%HRR), and time-domain indices of HRV were analyzed during the following night. Data were analyzed using a multilevel growth model to test the association between mean %HRR during work and HRV indices at night in a day-by-day analysis adjusted for age, BMI, alcohol consumption, smoking, and occupation.

Results:

The dataset included a sample of 878 Danish blue-collar workers, with a mean %HRR during work of 31%, and 42% worked at an intensity ≥30%HRR. The multilevel model showed negative within- and between-subject associations between %HRR during work and HRV indices at night.

Conclusions:

Our results indicate a higher %HRR during work to associate with lower HRV indices the following night and a higher HR, reflecting an imbalanced autonomic cardiac modulation. This finding supports a high mean HR during work to be a potential underlying mechanism for the harmful health effect of OPA.

Time-Based Data in Occupational Studies: The Whys, the Hows, and Some Remaining Challenges in Compositional Data Analysis (CoDA)

Data on the use of time in different exposures, behaviors, and work tasks are common in occupational research. Such data are most often expressed in hours, minutes, or percentage of work time. Thus, they are constrained or ‘compositional’, in that they add up to a finite sum (e.g. 8 h of work or 100% work time). Due to their properties, compositional data need to be processed and analyzed using specifically adapted methods. Compositional data analysis (CoDA) has become a particularly established framework to handle such data in various scientific fields such as nutritional epidemiology, geology, and chemistry, but has only recently gained attention in public and occupational health sciences. In this paper, we introduce the reader to CoDA by explaining why CoDA should be used when dealing with compositional time-use data, showing how to perform CoDA, including a worked example, and pointing at some remaining challenges in CoDA. The paper concludes by emphasizing that CoDA in occupational research is still in its infancy, and stresses the need for further development and experience in the use of CoDA for time-based occupational exposures. We hope that the paper will encourage researchers to adopt and apply CoDA in studies of work exposures and health.

Postural balance effects from exposure to multi-axial whole-body vibration in mining vehicle operation

Twenty participants (18 males and 2 females) completed postural stability assessments before and after 4-h exposure to whole body vibration (WBV) in four experimental conditions: (a) vertical-dominant WBV with vertical passive air suspension, (b) multi-axial WBV with vertical passive air suspension, (c) multi-axial WBV with multi-axial active suspension, and (d) no WBV condition. Center of pressure (COP)-based postural sway measures significantly increased following multi-axial WBV exposure. Increase in COP velocity and displacement following multi-axial WBV was significantly higher than the increase in all the other exposure conditions. However, no significant differences between the WBV conditions were observed in functional limits of stability and anticipatory postural adjustments. While our results show standing balance to be impaired following the multi-axial WBV exposure of off-road mining vehicles, dynamic stability across a broader range of conditions needs to be understood to causally link postural stability decrements to increased fall-risks associated with off-road vehicle operators.

Prolonged sitting and physical inactivity are associated with limited hip extension: A cross-sectional study

BACKGROUND

It is possible that physical inactivity and prolonged sitting could lead to changes in muscle properties or bony limitations which may reduce passive hip extension.

OBJECTIVES

This study explored the association between passive hip extension and sitting/physical activity patterns.

DESIGN

Cross sectional study.

METHOD

The modified Thomas Test is a clinical test used to characterise hip flexion contracture. This test was used to measure passive hip extension across 144 individuals. In addition, sitting behaviours and physical activity patterns were quantified using the Global Physical Activity Questionnaire. Cut off points were defined for low/high physical activity (150 min per week), prolonged sitting (>7 h per day) and minimal sitting (<4 h per day). ANOVA testing was then used to compare passive hip extension between three groups, defined using the specified thresholds: low activity & prolonged sitting, high activity & minimal sitting and high activity & prolonged sitting.

RESULTS

A total of 98 participants were allocated to one of the three groups which were shown to differ significantly in passive hip extension (P < 0.001). Importantly, there was 6.1° more passive hip extension in the high activity & minimal sitting group when compared to the low activity & prolonged sitting group.

CONCLUSION

This study is the first to demonstrate an association between passive hip extension and prolonged sitting/physical inactivity. It is possible that these findings indicate a physiological adaptation in passive muscle stiffness. Further research is required to understand whether such adaptation may play a role in the aetiology of musculoskeletal pain linked to prolonged sitting.

Physical Activity, Sedentary Behavior, Anxiety, and Pain Among Musicians in the United Kingdom

Context and Aims

Although some exercise-based interventions have been associated with lower levels of pain and performance-related musculoskeletal disorders (PRMDs) among musicians, the evidence is still mixed. Furthermore, little is known about musicians’ general engagement in physical activity (PA), their knowledge of PA guidelines, or the relevant training they receive on pain prevention and the sources of such training. Similarly, little is known about the relationship between PA and PRMDs and other risk factors for PRMDs.

Methods

Following a cross-sectional correlational study design, both standardized and ad hoc measurements were used to investigate self-reported PA [International Physical Activity Questionnaire – Short Form (IPAQ-SF)], knowledge of PA guidelines, and barriers to engaging in PA [Centers for Disease Control (CDC); Determinants of Physical Activity Questionnaire (DPAQ)]; sedentary behavior [Sedentary Behavior Questionnaire (SBQ)]; pain [36-Item Short Form Survey Instrument (SF-36)] and PRMDs (frequency and severity); reported physical exertion (RPE); anxiety [Hospital Anxiety and Depression Scale (HADS)]; practice behaviors (e.g., practice time; taking breaks frequency; warming up); and relevant training among conservatoire students in the United Kingdom. The entire set of questionnaires was administered both online and via hard copies between June 2017 and April 2018.

Results

Demographic information was obtained from 111 respondents, mostly undergraduate students (UGs) from seven conservatoires. They reported high levels of engagement in PA, despite poor knowledge of PA guidelines. Teachers were the most frequently mentioned source of pain prevention information (by 43% of respondents), and 62% agreed that they had received advice on why they should engage in cardio PA. Sedentary behavior was comparable to normative data. Levels of bodily pain and PRMDs were low, but 43% showed “abnormal” clinical anxiety and found playing their instruments “somewhat hard” (RPE) on average. Bodily pain interfering with practice and performance was positively correlated with frequency and severity of PRMDs, anxiety, and RPE. Frequency and severity of PRMDs were also associated with sedentary behavior at the weekend. Anxiety was associated with RPE. No association was found between PA and PRMDs.

Conclusion

The relationship between PA and PRMDs and pain remains unclear and needs further investigation. While health education needs to be improved, other pathways may need to be taken. Given the high levels of anxiety, the ideology of Western classical music itself may need to be challenged.

Associations of objectively measured total duration and maximum bout length of standing at work with lower-extremity pain intensity: a 2-year follow-up of construction and healthcare workers

Background

Musculoskeletal disorders are among the major reasons for years lived with disability. Approximately one third of the European working population report lower-extremity discomfort and many attribute these discomforts to work-related factors. Employees in the healthcare and construction sectors reports high levels of lower-extremity pain and commonly relate the pain to their profession. These workers spend a large part of their workday standing. Periods of prolonged standing is suggested to increase lower-extremity symptoms, but this cannot be concluded on, since limited evidence is available from longitudinal studies using objective measures. This study aimed to determine possible associations between objectively measured total duration and maximum bout length of static- and dynamic standing at work and lower-extremity pain intensity (LEPi) among Norwegian construction- and healthcare workers.

Methods

One-hundred and twenty-three construction and healthcare workers wore two accelerometers for up to four consecutive days, to establish standing behavior at baseline. The participants reported LEPi (Likert scale 0–9) for the preceding 4 weeks at baseline and after 6, 12, 18, and 24 months. We investigated associations between standing at work and average and change in LEPi using linear mixed models with significance level p ≤ 0.05.

Results

Total duration of static- and dynamic standing showed weak associations with average LEPi, for the total sample and for construction workers. Maximum bout of static- and dynamic standing was associated with average LEPi in construction workers, but not in healthcare workers. Furthermore, we found no associations between standing and change in LEPi over the 2-year follow-up in any of our analyses.

Conclusions

This study indicate that objectively measured standing is associated with average LEPi over 2-years follow-up in construction workers, and that maximal bout of standing have a stronger association to LEPi than total duration. For every 10 min added to the maximal length of continuous standing during an average workday, we found approximately one unit increase in pain on a 0–9 scale. The lack of significant findings in analyses on healthcare workers suggest that the association between standing and LEPi depend on work-tasks, gender and/or other sector-specific factors.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-020-03868-0.

Thigh-worn accelerometry for measuring movement and posture across the 24-hour cycle: a scoping review and expert statement

Introduction

The Prospective Physical Activity Sitting and Sleep consortium (ProPASS) is an international collaboration platform committed to harmonise thigh-worn accelerometry data. The aim of this paper is to (1) outline observational thigh-worn accelerometry studies and (2) summarise key strategic directions arising from the inaugural ProPASS meeting.

Methods

(1) We performed a systematic scoping review for observational studies of thigh-worn triaxial accelerometers in free-living adults (n≥100, 24 hours monitoring protocols). (2)Attendees of the inaugural ProPASS meeting were sent a survey focused on areas related to developing ProPASS: important terminology (Q1); accelerometry constructs (Q2); advantages and distinct contribution of the consortium (Q3); data pooling and harmonisation (Q4); data access and sharing (Q5 and Q6).

Results

(1) Eighty eligible articles were identified (22 primary studies; n~17 685). The accelerometers used most often were the ActivPAL3 and ActiGraph GT3X. The most commonly collected health outcomes were cardiometabolic and musculoskeletal. (2) None of the survey questions elicited the predefined 60% agreement. Survey responses recommended that ProPASS: use the term physical behaviour or movement behaviour rather than 'physical activity' for the data we are collecting (Q1); make only minor changes to ProPASS's accelerometry construct (Q2); prioritise developing standardised protocols/tools (Q4); facilitate flexible methods of data sharing and access (Q5 and Q6).

Conclusions

Thigh-worn accelerometry is an emerging method of capturing movement and posture across the 24 hours cycle. In 2020, the literature is limited to 22 primary studies from high-income western countries. This work identified ProPASS's strategic directions-indicating areas where ProPASS can most benefit the field of research: use of clear terminology, refinement of the measured construct, standardised protocols/tools and flexible data sharing.

Effects of Prolonged Sitting with Slumped Posture on Trunk Muscular Fatigue in Adolescents with and without Chronic Lower Back Pain

Background and Objectives: This study investigated the effects of prolonged sitting on trunk muscular fatigue and discomfort in participants with and without chronic lower back pain (LBP). Material and Methods: This study included 15 patients with LBP and 15 healthy controls. All participants were instructed to sit on a height-adjustable chair with their knee and hip joints bent at 90° for 30 min, in slumped sitting postures. Surface electromyography was used to assess the median frequency of the internal obliques (IO)/transversus abdominis (TrA) and multifidus (MF) muscles. Perceived discomfort was measured using a Borg category ratio-scale. Median frequency of the trunk muscles and perceived discomfort after 30 min of sitting were compared with baseline. Result: There were no significant differences within the group and between both groups in the median frequency of bilateral IO and MF muscles. The LBP group showed significantly greater perceived discomfort after prolonged sitting, as compared to the control group. Conclusions: Prolonged sitting with slumped posture could increase the risk of experiencing lower back discomfort.

Associations Between Musculoskeletal Conditions Risk, Sedentary Behavior, Sleep, and Markers of Mental Health: A Cross-Sectional Observational Study in Heavy Goods Vehicle Drivers. Musculoskeletal Conditions Risk in HGV Drivers

OBJECTIVE

To explore the risk of having musculoskeletal conditions (MSKs) associated with sitting and sleeping time during workdays, presenteeism, work engagement anxiety, and depression in a sample of UK heavy goods vehicle drivers.

METHODS

Eighty-eight male drivers participated in this cross-sectional study. Binary logistic regression analyses were performed to explore the associations between two-or-more MSKs and common health risk factors.

RESULTS

Possessing two or more MSKs is associated with prolonged sitting time (odds ratio [OR] 4.34) and working hours per day (OR 3.10) and per week (OR 3.12), severe sleep deprivation (OR 33.19), presenteeism (OR 4.22), and borderline or abnormal scores of depression (OR 11.69) and anxiety (OR 4.44), compared with the reference categories.

CONCLUSION

Workplace policies and health promotion interventions to improve heavy goods vehicle drivers working environment are required to minimize the risk of MSK's across this sector.

Home-based fundamental approach to alleviate low back pain using myofascial release, stretching, and spinal musculature strengthening during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has caused global adoption of stay-at-home mandates in an effort to curb viral spread. This lockdown has had the unintended consequence of decreasing physical activity, and incidence of low back pain (LBP) is likely to rise as sedentary behavior increases.

OBJECTIVE

In this article, we aim to provide a fundamental, novel approach to alleviate LBP including desk worker associated LBP exacerbated during the COVID-19 pandemic.

METHODS

Individuals can alleviate their LBP through a simplistic, self-therapeutic approach: myofascial release and stretching of key musculature involved in LBP following a simple technique and associated time domain, as well as a 360-degree strengthening of the muscles surrounding the lower back. Additional muscular strength will support the lower back and lend resilience to aid in the mitigation of pain caused by poor work-related postural positions.

RESULTS

We demonstrate several exercises and movements aimed at alleviating LBP. Additionally, we provide a summary graphic which facilitates ease of use of the exercise plan and represents a novel methodology for simple distribution of evidence-based pain reduction strategies.

CONCLUSIOS

Through mitigation of sedentary behavior and adoption of the techniques described herein, LBP can be decreased and, in some cases, cured.