An investigation into four different sit–stand workstation use schedules

Twelve office workers participated in a study investigating effects of four sit/stand schedules (90-min sit/30-min stand, 80/40, 105/15, and 60/60) via several objective and subjective measures (muscle fatigue, foot swelling, spinal shrinkage, and self-reported discomfort). Results showed that there were no significant differences in shoulder and low back static muscle activities between sitting and standing. Muscle fatigue was developed during workday under all schedules. The longest standing schedule seemed to have a tendency of reducing muscle fatigue. None of the schedules helped or worsened foot swelling and spinal shrinkage. More active break-time activities seemed reducing muscle fatigue and foot swelling. While the self-reported bodily discomfort levels were generally low, the preferred schedules among the participants were varied, although the least standing schedule was the least preferred. We may conclude that effects of using sit–stand workstation to improve musculoskeletal health may be limited but promoting more active break-time activities can help.

Practitioner Summary: Sit–stand workstations are used to reduce work-related musculoskeletal disorders. This study shows that office workers prefer sit/stand durations in the range between 1:1 and 3:1. Longer standing may have the potential to reduce muscle fatigue. However, active break-time activities may be more effective in reducing muscle fatigue and foot swelling.     

Muscle activity patterns and spinal shrinkage in office workers using a sit–stand workstation versus a sit workstation

Reducing sitting time by means of sit–stand workstations is an emerging trend, but further evidence is needed regarding their health benefits. This cross-sectional study compared work time muscle activity patterns and spinal shrinkage between office workers (aged 24–62, 58.3% female) who used either a sit–stand workstation (Sit–Stand group, n = 10) or a traditional sit workstation (Sit group, n = 14) for at least the past three months. During one typical workday, muscle inactivity and activity from quadriceps and hamstrings were monitored using electromyography shorts, and spinal shrinkage was measured using stadiometry before and after the workday. Compared with the Sit group, the Sit–Stand group had less muscle inactivity time (66.2 ± 17.1% vs. 80.9 ± 6.4%, p = 0.014) and more light muscle activity time (26.1 ± 12.3% vs. 14.9 ± 6.3%, p = 0.019) with no significant difference in spinal shrinkage (5.62 ± 2.75 mm vs. 6.11 ± 2.44 mm). This study provides evidence that working with sit–stand workstations can promote more light muscle activity time and less inactivity without negative effects on spinal shrinkage.

Practitioner Summary: This cross-sectional study compared the effects of using a sit–stand workstation to a sit workstation on muscle activity patterns and spinal shrinkage in office workers. It provides evidence that working with a sit–stand workstation can promote more light muscle activity time and less inactivity without negative effects on spinal shrinkage.     

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

Due to concerns about excessive sedentary exposure for office workers, alternate work positions such as standing are being trialled. However, prolonged standing may have health and productivity impacts, which this study assessed. Twenty adult participants undertook two hours of laboratory-based standing computer work to investigate changes in discomfort and cognitive function, along with muscle fatigue, movement, lower limb swelling and mental state. Over time, discomfort increased in all body areas (total body IRR [95% confidence interval]: 1.47[1.36–1.59]). Sustained attention reaction time (β = 18.25[8.00–28.51]) deteriorated, while creative problem solving improved (β = 0.89[0.29–1.49]). There was no change in erector spinae, rectus femoris, biceps femoris or tibialis anterior muscle fatigue; low back angle changed towards less lordosis, pelvis movement increased, lower limb swelling increased and mental state decreased. Body discomfort was positively correlated with mental state. The observed changes suggest replacing office work sitting with standing should be done with caution.

Practitioner Summary: Standing is being used to replace sitting by office workers; however, there are health risks associated with prolonged standing. In a laboratory study involving 2 h prolonged standing discomfort increased (all body areas), reaction time and mental state deteriorated while creative problem-solving improved. Prolonged standing should be undertaken with caution.     

Are hybrid sit–stand postures a good compromise between sitting and standing?

Potential alternatives for conventional sitting and standing postures are hybrid sit-stand postures (i.e. perching). The purposes of this study were (i) to identify where lumbopelvic and pelvic angles deviate from sitting and standing and (ii) to use these breakpoints to define three distinct postural phases: sitting, perching, and standing, in order to examine differences in muscle activations and ground reaction forces between phases. Twenty-four participants completed 19 1-min static trials, from sitting (90°) to standing (180°), sequentially in 5°trunk–thigh angle increments. The perching phase was determined to be 145–175° for males and 160–175° for females. For both sexes, knee extensor activity was lower in standing compared to perching or sitting (p < .01). Anterior–posterior forces were the highest in perching (p < .001), requiring ～15% of body-weight. Chair designs aimed at reducing the lower limb demands within 115–170° trunk–thigh angle may improve the feasibility of sustaining the perched posture.

Practitioner summary: Individuals who develop low back pain in sitting or standing may benefit from hybrid sit-stand postures (perching), yet kinematic and kinetic changes associated with these postures have not been investigated. Perching can improve lumbar posture at a cost of increased lower limb demands, suggesting potential avenues for chair design improvement.

Abbreviations: A/P: anterior-posterior; M/L: medial-lateral; LBP: low back pain; EMG: electromyography; TES: thoracic erector spinae; LES: lumbar erector spinae; VMO: vastus medialis obliquus; MVC: maximum voluntary contraction; ASIS: anterior superior iliac spine; PSIS: posterior superior iliac spine; BW: body weight; RMSE: root mean square error; SD: standard deviation; ROM: range of motion     

Biomechanical investigation of prolonged driving in an ergonomically designed truck seat prototype

A postural evaluation during a prolonged driving task was conducted to determine the ergonomic validity of a new freely adjustable truck seat prototype. Twenty participants were recruited to perform two 2-h simulated driving sessions. Postures were assessed using motion capture, accelerometers and pressure pads. Subjective discomfort was also monitored in 15-min increments using ratings of perceived discomfort (RPD) and the Automotive Seating Discomfort Questionnaire. Participants had a more neutral spine posture during the first hour of the drive and reported lower RPDs while sitting in the prototype. Pairing the gluteal backrest panel with the adjustable seat pan helped reduce the average sitting pressure. The industry-standard truck seat may lead to the development of poor whole body posture, and the proposed ergonomic redesign of a new truck seat helped improve sitting posture and reduce perceived discomfort.

Practitioner Summary: A new freely adjustable truck seat prototype was compared to an Industry standard seat to assess hypothesised improvements to sitting posture and discomfort for long haul driving. It was found that the adjustable panels in the prototype helped promote spine posture, reduce sitting pressure and improved discomfort ratings.     

Effect of alternating postures on cognitive performance for healthy people performing sedentary work

Prolonged sitting is a risk factor for several diseases and the prevalence of worksite-based interventions such as sit-to-stand workstations is increasing. Although their impact on sedentary behaviour has been regularly investigated, the effect of working in alternating body postures on cognitive performance is unclear. To address this uncertainty, 45 students participated in a two-arm, randomised controlled cross-over trial under laboratory conditions. Subjects executed validated cognitive tests (working speed, reaction time, concentration performance) either in sitting or alternating working postures on two separate days (ClinicalTrials.gov Identifier: NCT02863731). MANOVA results showed no significant difference in cognitive performance between trials executed in alternating, standing or sitting postures. Perceived workload did not differ between sitting and alternating days. Repeated measures ANOVA revealed significant learning effects regarding concentration performance and working speed for both days. These results suggest that working posture did not affect cognitive performance in the short term.

Practitioner Summary: Prior reports indicated health-related benefits based on alternated (sit/stand) body postures. Nevertheless, their effect on cognitive performance is unknown. This randomised controlled trial showed that working in alternating body postures did not influence reaction time, concentration performance, working speed or workload perception in the short term.     

Medium-term effects of a two-desk sit/stand workstation on cognitive performance and workload for healthy people performing sedentary work: a secondary analysis of a randomised controlled trial

Implementing sit/stand workstations in sedentary work environments is a common way to reduce sedentary time, but their medium-term effect on cognitive performance is unclear. To address this circumstance, eighteen office workers participated in a two-arm, randomised controlled cross-over trial (ClinicalTrials.gov Identifier: NCT02825303), either working at a traditional (sit) or an interventional (sit/stand) workplace for 23 weeks. Cognitive performance (working speed, reaction time, concentration performance, accuracy), workload and relevant covariates (salivary cortisol level, heart rate, physical activity, sitting time) were measured pre- and post-intervention under laboratory conditions. MANOVA and RMANOVA results did not show differences in performance parameters and workload, respectively, between sit/stand and traditional workplace users. Differences in text editing accuracy and cortisol levels for sit/stand workstation users indicate potential connectivity to cognitive parameters which should be further examined with large-scale studies. Practitioner summary: Medium-term effects of working at sit/stand workstations on cognitive performance and workload are unexplored. This randomised controlled trial suggests that cognitive performance and workload are unaffected for sit/stand workstation users after 23?weeks of use. However, accuracy appeared to improve and physiological stress appeared to be altered.

Abbreviations: BMI: body mass index; IPAQ: International physical activity questionnaire; MET: metabolic equivalent of task; MANOVA: multivariate ANOVA; NASA TLX: NASA task load index; RMANOVA: repeated measures ANOVA     

A parametric investigation on seat/occupant contact forces and their relationship with initially perceived discomfort using a configurable seat

The present work investigates the contact forces between sitters and seat as well as their correlations with perceived discomfort. Twelve different economy class aeroplane seat configurations were simulated using a multi-adjustable experimental seat by varying seat pan and backrest angles, as well as seat pan compressed surface. Eighteen males and 18 females, selected by their body mass index and stature, tested these configurations for two sitting postures. Perceived discomfort was significantly affected by seat parameters and posture and correlated both with normal force distribution on the seat-pan surface and with normal forces at the lumbar and head supports. Lower discomfort ratings were obtained for more evenly distributed normal forces on the seat pan. Shear force at the seat pan surface was at its lowest when sitters were allowed to self-select their seat-pan angle, supporting that a shear force should be reduced but not zeroed to improve seating comfort.

Practitioner Summary: The effects of seat-pan and backrest angle, anthropometric dimensions and sitting posture on contact forces and perceived discomfort were investigated using a multi-adjustable experimental seat. In addition to preferred seat profile parameters, the present work provides quantitative guidelines on contact force requirement for improving seating comfort.     

Lift performance and lumbar loading in standing and seated lifts

This study investigated the effect of posture on lifting performance. Twenty-three male soldiers lifted a loaded box onto a platform in standing and seated postures to determine their maximum lift capacity and maximum acceptable lift. Lift performance, trunk kinematics, lumbar loads, anthropometric and strength data were recorded. There was a significant main effect for lift effort but not for posture or the interaction. Effect sizes showed that lumbar compression forces did not differ between postures at lift initiation (Standing 5566.2?±?627.8 N; Seated 5584.0?±?16.0) but were higher in the standing posture (4045.7?±?408.3 N) when compared with the seated posture (3655.8?±?225.7 N) at lift completion. Anterior shear forces were higher in the standing posture at both lift initiation (Standing 519.4?±?104.4 N; Seated 224.2?±?9.4 N) and completion (Standing 183.3?±?62.5 N; Seated 71.0?±?24.2 N) and may have been a result of increased trunk flexion and a larger horizontal distance of the mass from the L5-S1 joint.

Practitioner Summary: Differences between lift performance and lumbar forces in standing and seated lifts are unclear. Using a with-in subjects repeated measures design, we found no difference in lifted mass or lumbar compression force at lift initiation between standing and seated lifts.     

The effect of age on in-vivo spine stiffness,postures and discomfort responses during prolonged sitting exposures

Many industrialised working populations are ageing and prolonged sitting exposures are prevalent across occupational sectors. The purpose of this work was to determine the effect of age and sex on passive spine stiffness, postures and discomfort in response to seated work. A total of 34 participants were recruited, with 17 older adults with an average age of (standard deviation) 63.7 (±3.9) years and 17 younger adults aged 23.8 (±5.0) years. Participants were asked to sit continuously for 90?min while typing. Baseline passive spine stiffness was higher in older adults at 40% flexion compared to younger adults (p?=?.0233). Older adults sat in less normalised flexion, at 33.4% (±16.4) compared to 60.9% (±20.2) in the younger group (p?=?.0003). Discomfort was higher among older adults in the neck, right shoulder and middle back regions (p?<?.0086). An understanding of age-specific responses to workplace exposures is essential to determine whether age-specific interventions are warranted.

 

Practitioner summary: Older adults had higher passive spine stiffness and sat with less flexion during prolonged sitting. Discomfort was higher among older adults and occurred earlier in the simulation compared to younger participants, indicating that interventions, such as walking breaks may need to be implemented earlier during sitting for aged workers.     

The changes of lumbar muscle flexion-relaxation phenomenon due to antero-posteriorly slanted ground surfaces

Uneven ground surface is a common occupational injury risk factor in industries such as agriculture, fishing, transportation and construction. Studies have shown that antero-posteriorly slanted ground surfaces could reduce spinal stability and increase the risk of falling. In this study, the influence of antero-posteriorly slanted ground surfaces on lumbar flexion-relaxation responses was investigated. Fourteen healthy participants performed sagittally symmetric and asymmetric trunk bending motions on one flat and two antero-posteriorly slanted surfaces (?15° (uphill facing) and 15° (downhill facing)), while lumbar muscle electromyography and trunk kinematics were recorded. Results showed that standing on a downhill facing slanted surface delays the onset of lumbar muscle flexion-relaxation phenomenon (FRP), while standing on an uphill facing ground causes lumbar muscle FRP to occur earlier. In addition, compared to symmetric bending, when performing asymmetric bending, FRP occurred earlier on the contralateral side of lumbar muscles and significantly smaller maximum lumbar flexion and trunk inclination angles were observed.

Practitioner Summary: Uneven ground surface is a common risk factor among a number of industries. In this study, we investigated the influence of antero-posteriorly slanted ground surface on trunk biomechanics during trunk bending. Results showed the slanted surface alters the lumbar tissue load-sharing mechanism in both sagittally symmetric and asymmetric bending.     

A randomised control trial of the cognitive effects of working in a seated as opposed to a standing position in office workers

Sedentary behaviour is increasing and has been identified as a potential significant health risk, particularly for desk-based employees. The development of sit-stand workstations in the workplace is one approach to reduce sedentary behaviour. However, there is uncertainty about the effects of sit-stand workstations on cognitive functioning. A sample of 36 university staff participated in a within-subjects randomised control trial examining the effect of sitting vs. standing for one hour per day for five consecutive days on attention, information processing speed, short-term memory, working memory and task efficiency. The results of the study showed no statistically significant difference in cognitive performance or work efficiency between the sitting and standing conditions, with all effect sizes being small to very small (all ds < .2). This result suggests that the use of sit-stand workstations is not associated with a reduction in cognitive performance.

Practitioner Summary: Although it has been reported that the use of sit-stand desks may help offset adverse health effects of prolonged sitting, there is scant evidence about changes in productivity. This randomised control study showed that there was no difference between sitting and standing for one hour on cognitive function or task efficiency in university staff.     

Associations of office workers’ objectively assessed occupational sitting,standing and stepping time with musculoskeletal symptoms

We examined the association of musculoskeletal symptoms (MSS) with workplace sitting, standing and stepping time, as well as sitting and standing time accumulation (i.e. usual bout duration of these activities), measured objectively with the activPAL3 monitor. Using baseline data from the Stand Up Victoria trial (216 office workers, 14 workplaces), cross-sectional associations of occupational activities with self-reported MSS (low-back, upper and lower extremity symptoms in the last three months) were examined using probit regression, correcting for clustering and adjusting for confounders. Sitting bout duration was significantly (p < 0.05) associated, non-linearly, with MSS, such that those in the middle tertile displayed the highest prevalence of upper extremity symptoms. Other associations were non-significant but sometimes involved large differences in symptom prevalence (e.g. 38%) by activity. Though causation is unclear, these non-linear associations suggest that sitting and its alternatives (i.e. standing and stepping) interact with MSS and this should be considered when designing safe work systems.

Practitioner summary: We studied associations of objectively assessed occupational activities with musculoskeletal symptoms in office workers. Workers who accumulated longer sitting bouts reported fewer upper extremity symptoms. Total activity duration was not significantly associated with musculoskeletal symptoms. We underline the importance of considering total volumes and patterns of activity time in musculoskeletal research.     

A comfort assessment of existing cervical orthoses

Purpose: Identify location and intensity of discomfort experienced by healthy participants wearing cervical orthoses.

Method: Convenience sample of 34 healthy participants wore Stro II, Philadelphia, Headmaster, and AspenVista^® cervical orthoses for four-hour periods. Participants reported discomfort level (scale 0–6) and location.

Results: Participants reported mean discomfort for all orthoses over the four-hour test between ‘a little discomfort’ and ‘very uncomfortable’ (mean discomfort score = 1.64, SD = 1.50). Seven participants prematurely stopped tests due to pain and six reported maximum discomfort scores. Significant linear increase in discomfort with duration of wear was found for all orthoses. Significantly less discomfort was reported with Stro II than Headmaster and Philadelphia. Age correlated with greater perceived discomfort. Orthoses differed in the location discomfort was experienced.

Conclusion: Existing cervical orthoses cause discomfort influenced by design and duration of wear with orthoses’ design the more significant factor. This work informed the design of a new orthosis and future orthoses developments.

Practitioner Summary: The purpose of this study was to gain greater knowledge about the discomfort caused by wearing of existing neck orthoses in order to inform the design and development of a new neck orthosis. This study gathers empirical data from a surrogate population and concludes that orthosis design is more influential than the duration of wear.     

Lumbar posture and trunk muscle activation during a typing task when sitting on a novel dynamic ergonomic chair

Low back pain (LBP) is a common musculoskeletal disorder and prolonged sitting often aggravates LBP. A novel dynamic ergonomic chair (‘Back App’), which facilitates less hip flexion while sitting on an unstable base has been developed. This study compared lumbar posture and trunk muscle activation on this novel chair with a standard backless office chair. Twelve painfree participants completed a typing task on both chairs. Lumbar posture and trunk muscle activation were collected simultaneously and were analysed using paired t-tests. Sitting on the novel dynamic chair significantly (p < 0.05) reduced both lumbar flexion and the activation of one back muscle (Iliocostalis Lumborum pars Thoracis). The discomfort experienced was mild and was similar (p > 0.05) between chairs. Maintaining lordosis with less muscle activation during prolonged sitting could reduce the fatigue associated with upright sitting postures. Studies with longer sitting durations, and in people with LBP, are required.

Practitioner Summary: Sitting on a novel dynamic chair resulted in less lumbar flexion and less back muscle activation than sitting on a standard backless office chair during a typing task among pain-free participants. Facilitating lordotic sitting with less muscle activation may reduce the fatigue and discomfort often associated with lordotic sitting postures.     

Stability ball versus office chair: comparison of muscle activation and lumbar spine posture during prolonged sitting

OBJECTIVE: The objective of the study was to evaluate the differences between sitting on a stability ball and in an office chair in terms of trunk muscle activation and lumbar spine posture. BACKGROUND: Stability balls have become increasingly popular as an alternative to office chairs to help reduce the prevalence of low back pain; however, little research has been conducted on their use as office chairs. METHODS: The 14 participants (7 men, 7 women) were required to sit on both a stability ball and an office chair for 1 hour each while performing various computer workstation tasks throughout the sitting periods. The activation of eight muscles and lumbar spine posture were measured and analyzed. RESULTS: Increased muscle activation in thoracic erector spinae (p = .0352), decreased pelvic tilt (p = .0114), and increased perceived discomfort (p < .0001) while sitting on the stability ball were observed. CONCLUSIONS: The small changes in biological responses when sitting on a stability ball as compared with an office chair, combined with the increased reported discomfort while on the ball, suggests its use for prolonged sitting may not be advantageous. APPLICATION: Prolonged sitting on a stability ball does not greatly alter the manner in which an individual sits, yet it appears to increase the level of discomfort. Therefore, it is important to fully explore a new chair design and consult scientific research before implementing its use.     

The impact of office chair features on lumbar lordosis,intervertebral joint and sacral tilt angles: a radiographic assessment

Abstract

Background: The purpose of this study was to determine which office chair feature is better at improving spine posture in sitting. Method: Participants (n = 28) were radiographed in standing, maximum flexion and seated in four chair conditions: control, lumbar support, seat pan tilt and backrest with scapular relief. Measures of lumbar lordosis, intervertebral joint angles and sacral tilt were compared between conditions and sex. Results: Sitting consisted of approximately 70% of maximum range of spine flexion. No differences in lumbar flexion were found between the chair features or control. Significantly more anterior pelvic rotation was found with the lumbar support (p = 0.0028) and seat pan tilt (p < 0.0001). Males had significantly more anterior pelvic rotation and extended intervertebral joint angles through L1–L3 in all conditions (p < 0.0001). Conclusion: No one feature was statistically superior with respect to minimising spine flexion, however, seat pan tilt resulted in significantly improved pelvic posture.

Practitioner Summary: Seat pan tilt, and to some extent lumbar supports, appear to improve seated postures. However, sitting, regardless of chair features used, still involves near end range flexion of the spine. This will increase stresses to the spine and could be a potential injury generator during prolonged seated exposures.     

Stabilisation times after transitions to standing from different working postures

Transitioning to standing after maintaining working postures may result in imbalance and could elicit a fall. The objective of this study was to quantify the magnitude of imbalance using a stabilisation time metric. Forty-five male participants completed three replications of conditions created by one of four working postures (bent at waist, squat, forward kneel, reclined kneel) and three durations within posture. Participants transitioned to quiet standing at a self-selected pace. Stabilisation time, based on changes in centre of pressure velocity, was used to indicate the initiation of steady state while standing. Stabilisation time was significantly affected by static postures but not duration within posture. The largest stabilisation times resulted from transitions initiated from a bent at waist posture. The smallest were associated with the kneeling postures, which were not significantly different from each other. Findings may lead to recommendations for redesign of tasks, particularly in high-risk environments such as construction.

Statement of Relevance: Task performance on the jobsite often requires individuals to maintain non-erect postures. This study suggests that working posture affects stabilisation during transition to a standing position. Bending at the waist and squatting resulted in longer stabilisation times, whereas both kneeling postures evaluated resulted in greater imbalance but for a shorter duration.     

Posture analysis among Flemish secondary school teachers: difference between the use of chalkboards and electronic school boards during classroom teaching

The aim of this study was to (i) make a posture analysis of teachers during theoretical classroom teaching; (ii) to estimate the risk for the development of musculoskeletal problems (MSP); (iii) test the hypotheses that an electronic school board (EB) has more ergonomic advantages for teachers. Thirty-five secondary school teachers, of which 15 used an EB and 20 used chalkboards, were selected by convenience sampling and filmed during 30 min of a theoretical course. Posture analysis of back, arms, legs and risk assessment was performed using the Ovako Working Posture Analysis System. Most of the teachers’ postures did not indicate a higher risk for MSP. However, some postures may be harmful when accumulated for several hours of teaching a day; especially, long periods of standing and standing with a bended back. Results also indicated that currently the use of an EB does not improve teachers’ posture.

Practitioner Summary: The relationship between objectively measured physical work load and risk for injuries among teachers was not analysed so far. In this study teachers’ posture was analysed using the OWAS method. Prolonged standing and forward bending were identified as risk postures. Also, using an electronic school board currently does not improve posture.     

Predictive discomfort of supine humans in whole-body vibration and shock environments

This work presents a predictive model to evaluate discomfort associated with supine humans during transportation, where whole-body vibration and repeated shock are predominant. The proposed model consists of two parts: (i) static discomfort resulting from body posture, joint limits and ambient discomfort; and (ii) dynamic discomfort resulting from the relative motion between the body segments as a result of transmitted vibration. Twelve supine subjects were exposed to single and 3D random vibrations and 3D shocks mixed with vibrations. The subjects’ reported discomfort and biodynamic response were analysed under different support conditions, including a rigid surface, a stretcher and a stretcher with a spinal backboard. The results demonstrated good correlations between the predictive discomfort and the reported discomfort for the different conditions under consideration, with R² = 0.69–0.94 for individual subjects and R² = 0.94 for the group mean. The results also indicated a strong relationship between the head-neck and trunk angular velocities and discomfort during supine transportation.

Practitioner Summary: The quantification of discomfort of supine humans under vibration and shocks by using a predictive model is an important contribution to this field, whereby the efficacy of different transport systems can be compared. The predictive discomfort model can be used as design criteria for ergonomic enhancement in supine transportation of humans.