Implications of sit-stand and active workstations to counteract the adverse effects of sedentary work: A comprehensive review

Sedentary time and its association with risk of cardiovascular diseases in adults: an updated systematic review and meta-analysis of observational studies

BACKGROUND

Epidemiological studies assessing the association between sedentary time and cardiovascular diseases (CVD) risks have been published at a rapid pace in recent years, which makes the periodic review of knowledge essential. Furthermore, much of the early and ongoing work used screen time as a marker of total sedentary time, which may weaken the association between sedentary time and CVD risks.

OBJECTIVE

To update evidence on CVD risks associated with different types of sedentary time, especially total sedentary time and screen time, and to explore as a marker of total sedentary time, whether screen time had similar CVD risks with total sedentary time.

METHODS

PRISMA guideline was followed for the performing and reporting of this systematic review and meta-analysis. Three independent researchers searched eight electronic databases and two clinical trial registries for all studies published between January 2015 and December 2021 that assessed the association between sedentary time and CVD risks in adults. A standardized form was used for data extraction and collection. Wilmot and colleagues' modified tool was used for quality assessment. The categorical association was assessed by comparing the pooled effect sizes for CVD risks associated with the highest and the lowest sedentary time categories across included studies. Stata 16.0 and Review Manager 5.3 were used for all statistical analyses, P ≤ 0.05 was considered as statistically significant.

RESULTS

Seventeen prospective cohort studies and two cross-sectional studies with 145,1730 participants and over 48,668 CVD cases and deaths were included. Two included studies measured sedentary time with the accelerometer, 16 studies with self-reported questions, and one study with both the accelerometer and self-reported questions. CVD outcomes were self-reported in two included studies and objectively adjudicated through medical records or death certifications in 17 studies. Compared with the lowest total sedentary time category (median duration, 2.75 h/d), participants in the highest category (median duration, 10.5 h/d) had an increased risk of CVD morbidity (pooled RR, 1.24; 95% CI, 1.21-1.27). Compared with the lowest total sedentary time category (median duration, 2.98 h/d), participants in the highest category (median duration, 10.2 h/d) had an increased risk of CVD mortality (pooled HR, 1.29; 95% CI, 1.13-1.47). The association between screen time and CVD risks was similar to total sedentary time with the cut-off point of 5-6 h/d. The associations between occupational sitting time, leisure sedentary time, and CVD risks stayed inconclusive.

CONCLUSION

Total sedentary time and screen time are both associated with cardiovascular health. As a marker of total sedentary time, screen time over 5-6 h/d had similar CVD risks with total sedentary time over 10-11 h/d.

Does treadmill workstation use affect user's kinematic gait symmetry?

The effects of treadmill workstation use on kinematic gait symmetry and computer work performance remain unclear. The purpose of this pilot study was to analyze the effects of treadmill workstation use on lower body motion symmetry while performing a typing task when compared to overground and treadmill walking. The lower body motion of ten healthy adults (6 males and 4 females) was recorded by a motion capture system. Hip, knee, and ankle joint rotations were computed and compared for each condition. Despite comparable lower body kinematic gait asymmetries across conditions, asymmetric knee flexion motions at early gait cycle were only found in treadmill workstation users (left knee significantly more flexed than the right one). This demonstrates that the interaction between walking and another task is dependent on the task cognitive content. Our findings suggest that lower body kinematic gait symmetry may be influenced by the use of treadmill workstations.

Office-workers maintain decreased workplace sitting time long-term following participation in a sit-stand desk intervention study

Previous studies report decreased workplace sitting time when standing desk interventions are provided to office workers. It is unclear whether decreased sedentary behaviours are maintained long-term. This was a follow-up to a previous intervention study to investigate whether observed sitting time decreases of 30-50% were sustained 12-24 months later. A secondary aim was to compare overall physical activity between office workers with and without standing desks. Although sitting time increased over the follow-up period, this did not reach significance and reductions in workplace sitting remained significantly lower (23.5% decrease) from baseline values. There were no differences in the physical activity measures between workers with and without access to standing desks, although this was a small sample size and further research is needed. Individuals who are motivated to try standing desks at work can benefit through decreased sitting time long-term, however this may not extend to increased overall physical activity levels. Practitioner summary: Providing standing desk options to office-based employees can have long-lasting impacts with reducing sitting time at work. Office workers who choose to stand at work do not appear to compensate with overall activity level reduction outside of work.Abbreviations: LBP: low back pain; OSPAQ: occupational sitting and physical activity questionnaire; VAS: visual analog scale; ANOVA: analysis of variance; BMI: body mass index; ICC: intraclass correlation coefficient.

Computer workstation ergonomics: Current evidence for evaluation, corrections, and recommendations for remote evaluation

STUDY DESIGN

Literature Review INTRODUCTION: Computer use in the workplace has increased substantially since the start of the information age in the mid-1980s through 2020. Desktops, laptops, and tablets are essential tools for communication and project management. As a result of the COVID-19 pandemic, many workers have transitioned to work from home (WFH) to sustain public health emergency guidelines, and it is anticipated that many WFH jobs will be maintained post-pandemic. The transition to WFH occurred rapidly without time to establish ideal workstations. Ergonomic assessments that were typically performed in person needed to be performed using virtual technology.

PURPOSE OF THE STUDY

The purpose of this review is (1) to describe the components of a computer workstation evaluation; (2) to offer suggestions for identifying computer workstation problems that may be contributing to the client's musculoskeletal (MSK) pain and symptoms; (3) to provide suggestions that may improve the safety and comfort at the computer workstation, and (4) to suggest a method of completing the workstation analysis virtually, without onsite in-person evaluation.

METHODS AND RESULTS

There is a paucity of peer-reviewed literature regarding computer workstation evaluations to be performed in person, let alone using a virtual method. The components of computer workstation evaluations have been recommended by regulatory agencies that survey injuries in the workplace. Prior to 2020, these evaluations were done in person at the office workstation. Modifications in data collection were needed to transition the analysis to a reliable virtual format. The remote method described provides a consistent approach that engages the client in the process.

Ergonomic Stressors Among Pregnant Healthcare Workers: Impact on pregnancy outcomes and recommended safety practices

Workplace environment can have a considerable impact on the physical, psychological and maternal health of pregnant healthcare workers. This article aimed to summarise the impact of work-related ergonomic stressors on pregnancy outcomes for healthcare workers, along with potential interventions to resolve these stressors. A narrative review analysis using the Pearl Growing Strategy was conducted between February 2019 and June 2020 to identify English-language articles published between 2000 and 2020. A total of 89 studies were identified from the SCOPUS (Elsevier, Amsterdam, Netherlands), MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA) databases and Google Scholar (Google LLC, Menlo Park, California, USA). The results indicated that poor work-related ergonomics had detrimental effects on pregnancy outcomes, resulting in spontaneous abortions, preterm delivery, low birth weight babies and infertility. Policymakers and employers should conduct ergonomic assessments and implement appropriate practices to ensure the safety of pregnant healthcare workers.

Concurrent and discriminant validity of ActiGraph waist and wrist cut-points to measure sedentary behaviour, activity level, and posture in office work

Background

Sedentary Behaviour (SB) gets an increasing attention from ergonomics and public health due to its associated detrimental health effects. A large number of studies record SB with ActiGraph counts-per-minute cut-points, but we still lack valid information about what the cut-points tell us about office work. This study therefore analysed the concurrent and discriminant validity of commonly used cut-points to measure SB, activity level, and posture.

Methods

Thirty office workers completed four office tasks at three workplaces (conventional chair, activity-promoting chair, and standing desk) while wearing two ActiGraphs (waist and wrist). Indirect calorimetry and prescribed posture served as reference criteria. Generalized Estimation Equations analysed workplace and task effects on the activity level and counts-per-minute, and kappa statistics and ROC curves analysed the cut-point validity.

Results

The activity-promoting chair (p < 0.001, ES ≥ 0.66) but not the standing desk (p = 1.0) increased the activity level, and both these workplaces increased the waist (p ≤ 0.003, ES ≥ 0.63) but not the wrist counts-per-minute (p = 0.74) compared to the conventional chair. The concurrent and discriminant validity was higher for activity level (kappa: 0.52–0.56 and 0.38–0.45, respectively) than for SB and posture (kappa ≤0.35 and ≤ 0.19, respectively). Furthermore, the discriminant validity for activity level was higher for task effects (kappa: 0.42–0.48) than for workplace effects (0.13–0.24).

Conclusions

ActiGraph counts-per-minute for waist and wrist placement were – independently of the chosen cut-point – a measure for activity level and not for SB or posture, and the cut-points performed better to detect task effects than workplace effects. Waist cut-points were most valid to measure the activity level in conventional seated office work, but they showed severe limitations for sit-stand desks. None of the placements was valid to detect the increased activity on the activity-promoting chair. Caution should therefore be paid when analysing the effect of workplace interventions on activity level with ActiGraph waist and wrist cut-points.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10387-7.

Effect of workstation configuration on musculoskeletal discomfort, productivity, postural risks, and perceived fatigue in a sit-stand-walk intervention for computer-based work

OBJECTIVE

Compare musculoskeletal discomfort, productivity, postural risks, and perceived fatigue for a sit-stand-walk intervention between two workstation configurations - one, individually customized for office workers according to ergonomic guidelines (Ergo-Fit); another, self-adjusted by office workers according to their preference (Self-Adjusted).

METHODS

36 participants performed a 60-min computer typing task in both configurations using a within-participants, counterbalanced design. Musculoskeletal discomfort and perceived fatigue were reported through surveys; productivity was operationalized by typing speed and typing error; postural risks were assessed by RULA for seated work, and REBA for standing work.

RESULTS

Musculoskeletal discomfort and perceived fatigue did not vary significantly between configurations. Postural risks for seated and standing work were significantly lower for Ergo-Fit configuration; productivity was significantly higher for Self-Adjusted configuration.

CONCLUSION

Use of Ergo-Fit configuration for a sit-stand-walk intervention can facilitate postural transitions and increase physical activity, while enabling neutral postures in seated and standing work to minimize postural risks.

Increasing standing tolerance in office workers with standing-induced back pain

Sit-stand desks are popular however many people have standing-induced low back pain (LBP). People with LBP have fewer standing weight shifts compared with back-healthy people. Participants were classified as standing-tolerant or intolerant. Participants were provided sit-stand desks for 12 weeks. Participants were assigned to intervention (graded standing exposure and exercise) or control (no instruction) conditions. Participants reported weekly sitting time and average/worst LBP. Standing weight shifts and LBP were re-assessed post-intervention. All groups decreased sitting time (range: 30-50%) over 12 weeks. Sitting time and average LBP were correlated in all standing-intolerant individuals, worst LBP and sitting time were correlated for intervention group only. All standing-intolerant individuals increased standing weight shifts and decreased LBP after 12-weeks. Standing-intolerant individuals benefitted from 12-weeks of sit-stand desk use regardless of intervention. Motivated individuals with standing-induced LBP may increase standing tolerance with sit-stand desk use. Additional benefits may exist when structured guidance is provided. Practitioner summary: Many people are standing-intolerant due to low back pain (LBP). This lab and field-based study showed some benefits from structured approaches to gradually progress standing time when transitioning to standing work. Using a sit-stand desk for 12 weeks resulted in decreased LBP and sitting time in standing-intolerant people. Abbreviations: LBP: low back pain; OSPAQ: Occupational Sitting and Physical Activity Questionnaire; VAS: visual analog scale; GRF: ground reaction force; WeekVASMAX: worst low back pain reported on visual analog scale for prior week; WeekVASAVE: average low back pain reported on visual analog scale for prior week; ICC: intraclass correlation coefficient; LabVASMAX: worst low back pain reported on visual analog scale during lab-based standing; LabVASAVE: average low back pain reported on visual analog scale during lab-based standing; FvR,L: vertical ground reaction force for right and left force plate; BWSSMALL: small (10-29% body weight) body weight shift; BWSLARGE: large (> 30% body weight) body weight shift; ActivPALSED: ActivePAL data for sedentary time; ActivPALSTND: ActivePAL data for standing time; ANOVA: analysis of variance; Standing Intolerant-INT: standing intolerant participants assigned to intervention condition; Standing Intolerant-CON: standing intolerant participants assigned to control condition; Standing Tolerant-INT: standing tolerant participants assigned to intervention condition; Standing Tolerant-CON: standing tolerant participants assigned to control condition; SI: standing intolerant; ST: standing tolerant; INT: intervention; CON: control.

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

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

Workplace interventions for increasing standing or walking for decreasing musculoskeletal symptoms in sedentary workers

BACKGROUND

The prevalence of musculoskeletal symptoms among sedentary workers is high. Interventions that promote occupational standing or walking have been found to reduce occupational sedentary time, but it is unclear whether these interventions ameliorate musculoskeletal symptoms in sedentary workers.

OBJECTIVES

To investigate the effectiveness of workplace interventions to increase standing or walking for decreasing musculoskeletal symptoms in sedentary workers.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, OSH UPDATE, PEDro, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to January 2019. We also screened reference lists of primary studies and contacted experts to identify additional studies.

SELECTION CRITERIA

We included randomised controlled trials (RCTs), cluster-randomised controlled trials (cluster-RCTs), quasi RCTs, and controlled before-and-after (CBA) studies of interventions to reduce or break up workplace sitting by encouraging standing or walking in the workplace among workers with musculoskeletal symptoms. The primary outcome was self-reported intensity or presence of musculoskeletal symptoms by body region and the impact of musculoskeletal symptoms such as pain-related disability. We considered work performance and productivity, sickness absenteeism, and adverse events such as venous disorders or perinatal complications as secondary outcomes.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened titles, abstracts, and full-text articles for study eligibility. These review authors independently extracted data and assessed risk of bias. We contacted study authors to request additional data when required. We used GRADE considerations to assess the quality of evidence provided by studies that contributed to the meta-analyses.

MAIN RESULTS

We found ten studies including three RCTs, five cluster RCTs, and two CBA studies with a total of 955 participants, all from high-income countries. Interventions targeted changes to the physical work environment such as provision of sit-stand or treadmill workstations (four studies), an activity tracker (two studies) for use in individual approaches, and multi-component interventions (five studies). We did not find any studies that specifically targeted only the organisational level components. Two studies assessed pain-related disability. Physical work environment There was no significant difference in the intensity of low back symptoms (standardised mean difference (SMD) -0.35, 95% confidence interval (CI) -0.80 to 0.10; 2 RCTs; low-quality evidence) nor in the intensity of upper back symptoms (SMD -0.48, 95% CI -.096 to 0.00; 2 RCTs; low-quality evidence) in the short term (less than six months) for interventions using sit-stand workstations compared to no intervention. No studies examined discomfort outcomes at medium (six to less than 12 months) or long term (12 months and more). No significant reduction in pain-related disability was noted when a sit-stand workstation was used compared to when no intervention was provided in the medium term (mean difference (MD) -0.4, 95% CI -2.70 to 1.90; 1 RCT; low-quality evidence). Individual approach There was no significant difference in the intensity or presence of low back symptoms (SMD -0.05, 95% CI -0.87 to 0.77; 2 RCTs; low-quality evidence), upper back symptoms (SMD -0.04, 95% CI -0.92 to 0.84; 2 RCTs; low-quality evidence), neck symptoms (SMD -0.05, 95% CI -0.68 to 0.78; 2 RCTs; low-quality evidence), shoulder symptoms (SMD -0.14, 95% CI -0.63 to 0.90; 2 RCTs; low-quality evidence), or elbow/wrist and hand symptoms (SMD -0.30, 95% CI -0.63 to 0.90; 2 RCTs; low-quality evidence) for interventions involving an activity tracker compared to an alternative intervention or no intervention in the short term. No studies provided outcomes at medium term, and only one study examined outcomes at long term. Organisational level No studies evaluated the effects of interventions solely targeted at the organisational level. Multi-component approach There was no significant difference in the proportion of participants reporting low back symptoms (risk ratio (RR) 0.93, 95% CI 0.69 to 1.27; 3 RCTs; low-quality evidence), neck symptoms (RR 1.00, 95% CI 0.76 to 1.32; 3 RCTs; low-quality evidence), shoulder symptoms (RR 0.83, 95% CI 0.12 to 5.80; 2 RCTs; very low-quality evidence), and upper back symptoms (RR 0.88, 95% CI 0.76 to 1.32; 3 RCTs; low-quality evidence) for interventions using a multi-component approach compared to no intervention in the short term. Only one RCT examined outcomes at medium term and found no significant difference in low back symptoms (MD -0.40, 95% CI -1.95 to 1.15; 1 RCT; low-quality evidence), upper back symptoms (MD -0.70, 95% CI -2.12 to 0.72; low-quality evidence), and leg symptoms (MD -0.80, 95% CI -2.49 to 0.89; low-quality evidence). There was no significant difference in the proportion of participants reporting low back symptoms (RR 0.89, 95% CI 0.57 to 1.40; 2 RCTs; low-quality evidence), neck symptoms (RR 0.67, 95% CI 0.41 to 1.08; two RCTs; low-quality evidence), and upper back symptoms (RR 0.52, 95% CI 0.08 to 3.29; 2 RCTs; low-quality evidence) for interventions using a multi-component approach compared to no intervention in the long term. There was a statistically significant reduction in pain-related disability following a multi-component intervention compared to no intervention in the medium term (MD -8.80, 95% CI -17.46 to -0.14; 1 RCT; low-quality evidence).

AUTHORS' CONCLUSIONS

Currently available limited evidence does not show that interventions to increase standing or walking in the workplace reduced musculoskeletal symptoms among sedentary workers at short-, medium-, or long-term follow up. The quality of evidence is low or very low, largely due to study design and small sample sizes. Although the results of this review are not statistically significant, some interventions targeting the physical work environment are suggestive of an intervention effect. Therefore, in the future, larger cluster-RCTs recruiting participants with baseline musculoskeletal symptoms and long-term outcomes are needed to determine whether interventions to increase standing or walking can reduce musculoskeletal symptoms among sedentary workers and can be sustained over time.

The effect of sit-stand schedules on office work productivity: A pilot study

BACKGROUND

Sit-stand workstations have been introduced in the workplaces to address the adverse sedentary effect inherent to typical office jobs. Existing field or laboratory studies showed that standing interventions are not a detriment to work productivity or performance. The effect of gradient standing proportion on these measures is still unknown.

OBJECTIVE

The current naturalistic pilot study aimed to examine the controlled sit-stand ratio effect on office performances.

METHODS

Eleven musculoskeletal symptom free office employees from a large government agency volunteered in this study. They were all equipped with electronic sit-stand desks. Computer usage (N=11) and productivity (N=3) were collected using software and organizational metrics, respectively, for four typical workdays of four different sit-stand ratios (7 : 1, 3 : 1, 2 : 1, and 1 : 1).

RESULTS

There were no statistically significant schedule effects on any computer usage measures. While not significant, time using computer, keystrokes, word count, and keyboard errors were all less as standing time increased. Sit-stand ratio and job productivity did not observe a clear cause and effect relationship.

CONCLUSIONS

The amount of time spent standing in typical office jobs might not affect computer usage and productivity. Further study with a larger sample is needed for a stronger evidence.

Evidence of Workplace Interventions-A Systematic Review of Systematic Reviews

Work environment factors are highly correlated with employees' health and well-being. Our aim was to sum up current evidence of health promotion interventions in the workplace, focusing on interventions for the prevention of musculoskeletal disorders, psychological and behavioral disorders as well as interventions for older employees and economic evaluations. We conducted a comprehensive literature search including systematic reviews published from April 2012 to October 2017 in electronic databases and search engines, websites of relevant organizations and institutions. It consisted of simple and specific terms and word combinations related to workplace health promotion based on the search strategy of a previous review. After full-text screening, 74 references met the eligibility criteria. Using the same search strategy, there was a higher proportion of relevant high-quality studies as compared with the earlier review. The heterogeneity of health promotion interventions regarding intervention components, settings and study populations still limits the comparability of studies. Future studies should also address the societal and insurer perspective, including costs to the worker such as lost income and lost time at work of family members due to caregiving activities. To this end, more high-quality evidence is needed.

Computer-based Prompt's impact on postural variability and sit-stand desk usage behavior; a cluster randomized control trial

Sit-to-stand workstations have been deployed in office environments to reduce sedentary behavior and improve worker's health. However, efforts to initiate and sustain long-term usage of sit-stand workstations has been a challenge, with primarily anecdotal evidence suggesting many employees cease using their sit-stand workstations once the newness diminishes. To objectively determine sit-stand workstation usage and what impact computer-based prompts would have on sit-stand desk use and sustainability, 200 office workers (118 control and 82 treatment) in two different geographic locations were continuously monitored over a 4 ½ month period, which consisted of a 6-week baseline and a 3-month experimental period. During the 3-month experimental period, computer-based prompts elicited a 229% increase in daily standing transitions which was sustained over the entire 3 months with 40% of the participants adhering to a pre-determined sit to stand schedule. These findings indicate that the use of computer-based prompts can be used to motivate employees to change their behavior regarding the use of sit-to-stand workstations.

The effect of sit-stand desks on office worker behavioral and health outcomes: A scoping review

This scoping review examines the effects of sit-stand desks (SSDs) on six domains: behavior (e.g. time sitting and standing), physiological, work performance, psychological, discomfort, and posture. Fifty-three articles met criteria. We determined the percentage of significant results for each domain. Forty-seven studies were experimental trials. Sample sizes ranged from six to 231 participants. Follow-up time-frames ranged from one day to one year. Sixty-one percent of behavioral (24 studies), 37% of physiological (28 studies), 7% of work performance (23 studies), 31% of psychological (11 studies), 43% of discomfort (22 studies), and 18% of posture domain results (4 studies) were significant. We conclude that SSDs effectively change behaviors, but these changes only mildly effect health outcomes. SSDs seem most effective for discomfort and least for productivity. Further study is needed to examine long-term effects, and to determine clinically appropriate dosage and workstation setup.

Association of Personality on Changes in Weekday Sitting Time: Cross-Sectional and Prospective Evaluation

Background

The purpose of this study was to examine the prospective association of personality typology on changes in sitting (sedentary) time.

Methods

Young adults (N = 126; M_age = 21.6 yrs) completed self-report assessments of personality and sitting time at baseline and at an approximate 5-month follow-up. At baseline, personality was assessed via the Neuroticism-Extraversion-Openness Five Factor Inventory (NEO-FFI) questionnaire. At both baseline and the follow- up period, sitting time was self-reported using the International Physical Activity Questionnaire (IPAQ) short form.

Results

Both extraversion (β = −5.8; 95% CI: −11.7, 0.21; p = 0.05) and conscientiousness (β = −5.7; 95% CI: −11.3, −0.2; p = 0.04) were inversely associated with baseline sitting time. Regarding the prospective results, the only personality trait associated with changes in sitting time was openness to experience. Independent of changes in physical activity as well as other potential confounders, for every 1 unit increase in openness to experience, there was an associated 6.6 min/day increased change score in sitting time over the 5-month follow-up period (β = 6.6; 95% CI: 0.13, 13.0; p = 0.04).

Conclusion

Personality was differentially associated with sitting time based on the study design, with the personality trait of openness to experience being prospectively associated with increases in sitting time.

Use of Active Workstations in Individuals with Overweight or Obesity: A Systematic Review

OBJECTIVE

This systematic review aims to collect existing literature and summarize the impact of active workstations on the health and work outcomes of participants with overweight or obesity.

METHODS

Five databases were examined (until March 2018), and the keywords "desk," "workstation," "work station," and "work stations" were used with any one of the following terms: "active," "bik*," "cycling," "height adjustable," "stepping," "stand up," "standing," "treadmill*," "walk*," "elliptical," "bicycl*," "pedaling," "stability ball," "stability balls," "exercise ball," "exercise balls," "swiss ball," "swiss balls," "sit-to-stand," and "sit stand."

RESULTS

Nineteen studies (two with school-aged children) were included in this review. Nine studies used treadmill, three used cycling, one used stepping, and twelve used standing desks. A decrease in sedentary time and an increase in physical activity level and energy expenditure were observed for most of the active workstations. Both the treadmill and the cycle desk improved glycemic control, but the treadmill desk was the only workstation for which improved work performance and help in body-weight management (body fat percentage, body weight, waist and hip circumference) were reported.

CONCLUSIONS

Active workstations are a promising solution for decreasing occupational sedentariness. Overall, active workstations have a positive impact on energy expenditure and physical activity in individuals with overweight and obesity.

The effects of sedentary behaviour interventions on work-related productivity and performance outcomes in real and simulated office work: A systematic review

This review examined the impact of environmental, behavioral, and combined interventions to reduce occupational sedentary behaviour on work performance and productivity outcomes. Productivity outcomes were defined as variables assessing work-related tasks (e.g., typing, mouse), whereas performance outcomes were categorized as any variables assessing cognition that did not mimic work-related tasks. Nine databases were searched for articles published up to January 2018. Sixty-three studies were identified that met the inclusion criteria: 45 examined a productivity outcome (i.e., typing, mouse, work-related tasks, and absenteeism), 38 examined a performance outcome (i.e., memory, reading comprehension, mathematics, executive function, creativity, psychomotor function, and psychobiological factors), and 30 examined a self-reported productivity/performance outcome (i.e., presenteeism or other self-reported outcome). Overall, standing interventions do not appear to impact productivity/performance outcomes, whereas walking and cycling interventions demonstrate mixed null/negative associations for productivity outcomes. Hence, standing interventions to reduce occupational sedentary behaviour could be implemented without negatively impacting productivity/performance outcomes.

The effects of introducing electric adjustable height desks in an office setting on workplace physical activity levels: A randomised control field trial

BACKGROUND

Electric adjustable height desks (EAHD) have been promoted as an opportunity for desk based workers to stand at work but there is limited evidence that they have an effect on light physical activity.

OBJECTIVE

The main objective was to determine if there would be a change in light physical activity with the introduction of EAHD. The secondary objective was to assess if there was an associated change in leisure time activity.

METHODS

Activity levels were measured by step counts, self-reported activity levels and pre- and post-trial recall levels. Statistical analysis of the data was performed with the software R. Generalised linear models were fitted to the data. A Poisson regression was used for count data. Statistical hypotheses were deemed significant if their p values were less than 0.05.

RESULTS

There was a significant (p < 0.001) effect on step counts associated with allocation of EAHD and a significant (p < 0.001) increase in self-reported activity for the Intervention (EAHD) group. Having an EAHD was associated with increased activity during leisure (p = 0.039).

CONCLUSIONS

Activity levels, especially light physical activity, were significantly increased with the allocation of an electric adjustable height desk. This pilot study showed that the environmental change of introduction of electric adjustable height desks into an office workplace can increase physical activity and reduce sitting durations. There is limited evidence that the increase in work activity has a positive impact on leisure time activity.

Worker acceptability of the Pennington Pedal Desk™ occupational workstation alternative

BACKGROUND

Active workstation alternatives (e.g., treadmill desks and pedal desks) have the potential to elevate workplace energy expenditure by replacing occupational sedentary behavior with opportunities to generate low-intensity non-exercise physical activity, but only to the extent that workers find them acceptable and congruent with their primary working tasks and therefore can frequently use them for extended periods of time.

OBJECTIVE

To assess workers' acceptability of the Pennington Pedal Desk™.

METHODS

Full-time sedentary workers (N = 42; 76% female; mean+SD age 39.6±11.3 years; BMI 25.7±5.4 kg/m2) used the pedal desk for 15 minutes while they: 1) searched the internet, 2) composed an email, and 3) completed acceptability ratings using an online Likert scale anchored from 1/strongly disagree to 5/strongly agree. Garmin Vector power meter pedals and EDGE 510 GPS bike computer (Garmin ®, USA) continuously captured revolutions per minute (RPM) and power.

RESULTS

Participants indicated that they would use the pedal desk for 4 (median) hours per work day and 97.6% of participants were somewhat or completely confident that they could type proficiently while using the pedal desk. Participants pedaled at 54.8±11.2 RPM and 23.1±8.6 watts (mean+SD).

CONCLUSIONS

Participants rated the Pennington Pedal Desk™ workstation positively and indicated potential for extended daily use.

Current and ceased users of sit stand workstations: a qualitative evaluation of ergonomics, safety and health factors within a workplace setting

Background

Many workplaces have implemented sit-stand workstations (SSW), which enable a worker to transition between sitting and standing as they perform their work activities. The factors which determine the initial adoption, sustainability or cessation of use for a SSW, remain largely unexamined. This study investigates the experiences of workers who had previously used or were currently using a SSW.

Methods

The study setting was within an Australian university. Participants who were current or past SSW users, as well as workplace key informants, were interviewed for the study. All interviews were recorded, transcribed and analysed. Transcripts were coded by two researchers for concepts and themes regarding uptake and sustainability of SSW. Discussion and validation of themes was undertaken by the team of three researchers.

Results

A total of 24 interviews were conducted. Twenty-two interviews were with ceased and current users (16 current and six ceased users) and two interviews were with workplace key informants. Analysis of the interviews with current and ceased users identified three main themes: Personal considerations for use/sustainability; Posture; and Usability. Analysis of the interviews with key informants identified two themes: Considerations and concerns and Policies and procedures. Little information was provided to workers when first using a SSW. Workers who were able to adopt their working style to the new workstations were able to sustain ongoing use of a SSW. Key informants were concerned that employees believed using a SSW would provide a health benefit in its own right without an understanding of the possible risks that might be associated with use.

Conclusions

Sustainable usage of this type of SSW is achievable, however, it requires some element of adaptation at the individual worker level. Participants spoke about how the use of the SSW in a standing position was typically associated with the time of day, specific task selection and musculoskeletal comfort or fatigue factors. The provision of education to new SSW users with relevant supporting information by a subject matter expert should enable the worker to obtain a more holistic understanding of the safety and health risks and benefits embedded in the use of a SSW.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6296-6) contains supplementary material, which is available to authorized users.

Lower limb blood flow and mean arterial pressure during standing and seated work: Implications for workplace posture recommendations

Sit-stand workstations are a popular workplace intervention. Organizations often require a medical professional's guidance for implementation. Therefore, it is important to understand potential negative outcomes associated with standing work, such as lower limb discomfort and peripheral vascular issues. The objective of this study was to compare changes in lower limb discomfort, blood pressure and blood flow accumulation during a light-load repetitive upper limb work task accomplished from seated and standing postures. At the Jewish Rehabilitation Hospital (Laval, Quebec, Canada), 16 participants were outfitted with Laser Doppler Flow (LDF) electrodes to measure blood flow in the lower limb, and a sphygmomanometer to measure lower limb mean arterial blood pressure (MAP). Participants completed simulated work over 34 min in standing and seated conditions. Repeated measures ANOVAs (Posture x Time) were used to assess the differences. There were significant effects for both Posture (p = 0.003) and Time (p = 0.007) for LDF-measured of blood flow accumulation in the soleus and the foot, with a mean increase of 77% blood flow over time in the standing posture, when compared to seated work. There was a significant 'Posture × Time' (p = 0.0034) interaction effect and a significant Posture (p = 0.0001) effect for MAP, with higher values in the standing posture by a mean of 37.2 mmHg. Posture had a significant effect (p < 0.001) on lower limb discomfort, with standing posture reporting higher levels. These results suggest that recommendations for using static standing work postures should be tempered, and physicians' guidance on workstation changes should consider the impacts on the lower limb.

Stand Up to Work: assessing the health impact of adjustable workstations

Purpose

Sedentary behavior is linked to health risks, and prolonged sitting is prevalent among office workers. Adjustable workstations (AWS) promote health by allowing transitions between sitting and standing. Stand Up to Work compares workers with AWS to traditional desks (TD). The paper aims to discuss these issues.

Design/methodology/approach

Employees were randomly selected from one office floor to receive AWS, two identical floors maintained TD. Participants received workplace wellness and ergonomic training, completed self-administered questionnaires, and responded to repeated micropolling at baseline (T0), 3 (T1), 6 (T2), and 12 (T3) months in Atlanta, 2015-2016. Groups were compared using two-sample t-tests and nonparametric Wilcoxon tests.

Findings

Compared to TD (n = 24), participants with AWS (n = 24) reported significantly less sedentary behavior at T1 and T2 after AWS installation (p<0.05), with a retention rate at T2 of 80 and 65 percent for the AWS and TD group, respectively. In all, 47 percent of participants with AWS reported decline in upper back, shoulder, and neck discomfort (p=0.04); 88 percent of AWS participants reported convenience to use, 65 percent reported increased productivity, and 65 percent reported positive impact outside the workplace. Individuals with normal or underweight body mass index (BMI) reported a significantly greater decline in percent of time sitting compared to participants with overweight or obese BMI at all three time points.

Originality/value

AWS are beneficial in reducing sedentary behavior in and outside the workplace. Behavioral changes were sustained over time and associated with less self-reported muscle pain, more self-reported energy, and awareness of standing. When considering total worker health, employers should include options for AWS to promote reducing sedentary behavior.

Sit-stand workstations and impact on low back discomfort: a systematic review and meta-analysis

BACKGROUND

Sit-stand workstations are proposed solutions to reduce sedentary time at work. Numerous companies are using them to mitigate health concerns such as musculoskeletal discomfort.

OBJECTIVE

To review the literature on sit-stand workstations and low back discomfort.

METHOD

We conducted a meta-analysis on literature published before 17 November 2016 that addressed the relationship between sit-stand workstations and musculoskeletal discomfort, focusing on the low back.

RESULTS

Twelve articles were identified and eight that presented results in means (SD) were included. Among a pain-free population, the standardised mean difference was -0.230 for low back discomfort with use of sit-stand workstations. When applying the SMD to studies using the 10-point pain scale, the effect estimates ranged between -0.30 and -0.51.

CONCLUSION

sit-stand workstations may reduce low back pain among workers. Further research is needed to help quantify dosage parameters and other health outcomes. Practitioner Summary: In a sedentary population, changing posture may reduce the chance of developing low back pain. The literature lacks studies on specific populations such as those who have pre-existing low back pain and also does not adequately address the dosage of sit-stand time required to help reduce pain.

Impact of a workplace 'sit less, move more' program on efficiency-related outcomes of office employees

Background

Few studies have examined the impact of ‘sit less, move more’ interventions on workplace performance. This study assessed the short and mid-term impacts of and patterns of change within, a 19-week workplace web-based intervention (Walk@WorkSpain; W@WS; 2010–11) on employees´ presenteeism, mental well-being and lost work performance.

Methods

A site randomised control trial recruited employees at six Spanish university campuses (n = 264; 42 ± 10 years; 171 female), assigned by worksite and campus to an Intervention (IG; used W@WS; n = 129; 87 female) or an active Comparison group (A-CG; pedometer, paper diary and self-reported sitting time; n = 135; 84 female). A linear mixed model assessed changes between the baseline, ramping (8 weeks), maintenance (11 weeks) and follow-up (two months) phases for the IG versus A-CG on (i) % of lost work productivity (Work Limitations Questionnaire; WLQ); (ii) three scales for presenteeism (WLQ) assessing difficulty meeting scheduling demands (Time), performing cognitive and inter-personal tasks (Mental-Interpersonal) and decrements in meeting the quantity, quality and timeliness of completed work (Output); and (iii) mental well-being (Warwick-Edinburgh Mental Well-being Scale). T-tests assessed differences between groups for changes on the main outcomes. In the IG, a multivariate logistic regression model identified patterns of response according to baseline socio-demographic variables, physical activity and sitting time.

Results

There was a significant 2 (group) × 2 (program time points) interaction for the Time (F [3]=8.69, p = 0.005), Mental-Interpersonal (F [3]=10.01, p = 0.0185), Output scales for presenteeism (F [3]=8.56, p = 0.0357), and for % of lost work performance (F [3]=10.31, p = 0.0161). Presenteeism and lost performance rose significantly in both groups across all study time points; after baseline performance was consistently better in the IG than in the A-CG. Better performance was linked to employees being more active (Time, p = 0.041) and younger (Mental-interpersonal, p = 0.057; Output, p = 0.017). Higher total sitting time during nonworking days (Mental-interpersonal, p = 0.019) and lower sitting time during workdays (WLQ Index, p = 0.013) also improved performance.

Conclusion

Versus an active comparison condition, a ‘sit less, move more` workplace intervention effectively reduced an array of markers of lost workday productivity.

Trial registration

NCT02960750; Date of registration: 07/11/2016.

Effects of Sitting and Standing Work Postures on Short-Term Typing Performance and Discomfort

The study evaluated effects of sitting and standing work postures on objective short-term computer typing performance and perceived discomfort. A randomized, repeated measures, study design was used to assess typing performance and perceived discomfort for 12 participants on a 15-minute computer-typing task. Typing performance was measured by number of characters typed and number of errors. Perceived discomfort was measured for the whole body, as well as for upper body and lower body, using a visual analog scale. Results suggest that for a short-term computer typing task, compared to a sitting work posture a standing work posture leads to fewer typing errors without impacting typing speed. Overall levels of perceived discomfort for the whole body are similar for sitting and standing work postures. However, for perceived discomfort there is an interaction of work posture and body region - upper body discomfort is higher in the sitting work posture while lower body discomfort is higher in the standing work posture.