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Sitting and Standing while Working – a Look at Current Ergonomic Research

This article highlights advances and current trends in standing  research.

In the wake of the wealth of research published on the dangers of sedentary sitting for extended periods, there is a growing trend towards spending more time standing. But this approach itself carries its own set of health implications.

I have attempted here to describe two relevant studies into this topic, along with my own evaluation of their strengths or weaknesses, and any clinical implications worth considering from their results.

The first study by Grunseit, A.C et al. (2013) investigates users’ experiences of adopting a mixed sit-stand behaviour through the provision of sit-stand desks in a real world setting.

Salli_Comfort_Sit_Stand

Salli Comfort Sit-Stand Desk

‘ Thinking on your feet’ study – using sit-stand desks

There is growing evidence that prolonged sitting can have a deleterious effect on cardiovascular health. There is some evidence to suggest that the adoption of sit-stand desks in a workplace can significantly reduce the amount of workplace sitting. This study added to the body of evidence by measuring the user experience of sit- stand desks in a real world setting.

Nineteen healthy subjects of working age with desk based jobs took part in the study.  Self reported sitting time was measured using the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) and the Workforce Sitting Questionnaire (WSQ) both at baseline and 3 months after the intervention. Interviews were also used in order to qualitatively measure satisfaction with sit-stand desks, barriers to use etc.

The key findings of this study were:

  • Median sitting time proportion at work reduced from 85% to 60%.
  • Reasons reported for using sit-stand desks included:
    • potential health benefits
    • a perception of improved work productivity
  • The subjects using electric desks reported changing desk height more frequently compared to those using the manually height adjustable desks.
  • More infrequent users reported that they may have used the desks more often if they had been provided with a greater level of instruction on desk setup and use.

The strengths/weaknesses of this study are:

  • Naturalistic setting
  • Small subject numbers

The clinical implications of this study are:

  • There is growing evidence that sit-stand desks can reduce sitting time
  • Growing evidence suggests that education may play an important role in the acceptance of sit- stand desks.

The second study from Nelson-Wong, E et al. (2010) demonstrates the ongoing efforts to investigate how we might be able to alleviate some of the negative health impact of continuous standing over a long period. In particular this study experiments with the slope of the surface being stood upon.

Standing, low back pain & other disorders – study into sloped standing surfaces

Long periods of continuous standing at work have been associated with the development of musculoskeletal disorders such as low back pain in a range of adults of working age. A number of different interventions have been designed to alleviate or prevent low back pain associated with standing including: anti-fatigue mats, differently shaped shoe insoles and different floor surfaces. To date these interventions have yielded mixed results and it still is not clear which users will benefit from which interventions. The aim of this study was to assess subjective comfort associated with standing on a sloped surface and to investigate how the surface inclination affects spinal/pelvic postures and related muscle activity.

Sixteen healthy young adults took part in the study. To compare the effects of different slopes on standing comfort, subjects were required to stand for 2 hours next to a standing table on 2 different surfaces. On the first day they stood on a flat surface, whilst on the second day they stood on a sloped surface. The 16 degree inclined and declined surfaces were created by a platform called the eQuilibrium. To assess low back pain subjects were asked to record low back pain symptoms on a  visual analogue scale with ‘no-pain’ at one end and ‘worst pain imaginable’ at the other end. Muscle activation of the superficial trunk flexors and extensors, and hip adductors (Thoracic Erector Spinae, Lumbar Erector Spinae, Rectus Abdominis  Internal Oblique, External Oblique and Gluteus Medius) were monitored throughout standing  through surface (EMG) Electrodes. The movement of the trunk and lower body was measured using an optoelectronic motion analysis system.

The key findings of these studies are:

  • Subjects who had developed low back pain during flat level surface standing reported significantly less pain when they stood on the sloped surface.
  • 87% of the subjects verbally reported that they would adopt sloped standing at a workstation for > than 50% of the time if they worked in an occupation that required prolonged standing work.
  • The inclined surface resulted in an increase in lumbar extension and anterior tilt of the pelvis.
  • The declined surface created the opposite postural shift with an increase in lumbar flexion and a posterior tilt of the pelvis.

The strengths/weaknesses of this study are:

  • Small number of subjects.
  • Short recording period.
  • The level surface was always tested before the sloped surface and so there may have been an ordering effect.
  • Healthy subjects were used and it is not known whether these findings would translate to subjects suffering from clinically diagnosed low back pain.

The clinical implications of this study are:

More research needs to be done to investigate the short and long term effects of slope standing on low back pain. More work is also necessary to better understand how slope standing alters the biomechanics of the body and why this may influence low back pain. Whilst it is too early to safely adopt the practice of slope standing, this work does raise awareness about the importance of considering different floor surfaces when prescribing sit-stand desks.

Concluding remarks

It has been suggested by some small Occupational Health studies that standing all day could be associated with a number of musculoskeletal disorders, and so it would seem that a sensible approach is to alternate between sitting and standing.  I have hoped here to demonstrate the effort now going into researching the best real world applications of this notion.

As well as a standing up more during the day it may also be beneficial to be more active while sitting. Advances in ergonomic chair design mean that this is now a key design principle, and now a range of designs allow variations in movement through a range of technologies.

At  Fluto we are able to offer more information on ergonomic  issues and products – including the latest ergonomic chairs and height adjustable desks. We can also provide tailored advice as to which products will best suit your situation.

Grunseit, A.C et al. (2013) “Thinking on your feet”: A qualitative evaluation of sit-stand desks in an Australian workplace. BMC Public Health, 13:365

Nelson-Wong, E et al. (2010) The impact of a sloped surface on low back pain during prolonged standing work: A biomechanical analysis Applied Ergonomics, 41: 787–795.

Dr Timothy Peter Hunter (PhD) is a Chartered Physiotherapist, has over seven years experience working in the field of Physiotherapy and Clinical Rehabilitation Research. Tim has an in depth understanding of back pain prevention and pain management. He is passionate about reducing the incidence of back pain and improving workplace performance by promoting the use of ergonomic furniture.

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