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Garza JL, Cavallari JM, Cherniack MG. Associations between observed time sitting at work and musculoskeletal symptoms: a repeated-measures study of manufacturing workers. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:329-334. [PMID: 35238284 DOI: 10.1080/10803548.2022.2043638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
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.
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Affiliation(s)
- Jennifer L Garza
- Department of Medicine, University of Connecticut School of Medicine, USA
| | - J M Cavallari
- Department of Medicine, University of Connecticut School of Medicine, USA.,Department of Public Health Sciences, University of Connecticut School of Medicine, USA
| | - M G Cherniack
- Department of Medicine, University of Connecticut School of Medicine, USA
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Ndupu LB, Faghy M, Staples V, Lipka S, Bussell C. Exploring the predictors of physical inactivity in a university setting. BMC Public Health 2023; 23:59. [PMID: 36624482 PMCID: PMC9830702 DOI: 10.1186/s12889-022-14953-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Changes in lifestyle patterns and the dependence on technology have contributed to an increase in prevalence of inactivity. To address this there is a need to identify the predictors of physical inactivity using the Theoretical Domains Framework (TDF). METHODS One hundred and twenty-one university administrative staff and 114 PhD students completed a survey. Physical activity (PA) levels were assessed using the Global Physical Activity Questionnaire (GPAQ), with participants scoring below 600 MET-minutes/week of total PA regarded as inactive. The predictors of physical inactivity were assessed using the Determinants of Physical Activity Questionnaire (DPAQ). Multiple regression analyses were used to identify which domains of the TDF predicted physical inactivity in the study samples. RESULTS The results indicated that 64% of administrative staff (Mean = 411.3 ± 118.3 MET-minutes/week of total PA) and 62% of PhD students (Mean = 405.8 ± 111.0 MET-minutes/week of total PA) did not achieve the recommended PA levels. The physical skills domain (t 106 = 2.198, p = 0.030) was the significant predictor of physical inactivity amongst the administrative staff. Knowledge (t 99 = 2.018, p = .046) and intentions (t 99 = 4.240), p = 0.001) domains were the significant predictors of physical inactivity amongst PhD students. CONCLUSIONS The results of this study should be used as a theoretical starting point in carrying out behavioural diagnosis, which could inform the design of effective interventions to increase PA levels in universities and other settings.
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Affiliation(s)
- Lawrence Bismarck Ndupu
- grid.8096.70000000106754565School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, 20 Whitefrairs Street, Coventry, CV1 2DS UK
| | - Mark Faghy
- grid.57686.3a0000 0001 2232 4004Human Sciences Research Centre, University of Derby, Kedleston Road, Derby, Derbyshire DE22 1GB UK
| | - Vicki Staples
- grid.57686.3a0000 0001 2232 4004Human Sciences Research Centre, University of Derby, Kedleston Road, Derby, Derbyshire DE22 1GB UK
| | - Sigrid Lipka
- grid.57686.3a0000 0001 2232 4004Human Sciences Research Centre, University of Derby, Kedleston Road, Derby, Derbyshire DE22 1GB UK
| | - Chris Bussell
- grid.57686.3a0000 0001 2232 4004Human Sciences Research Centre, University of Derby, Kedleston Road, Derby, Derbyshire DE22 1GB UK
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Hochheim M, Ramm P, Wunderlich M, Amelung V. Association between chronic low back pain and regular exercise, sedentary behaviour and mental health before and during COVID-19 pandemic: insights from a large-scale cross-sectional study in Germany. BMC Musculoskelet Disord 2022; 23:860. [PMID: 36104661 PMCID: PMC9474280 DOI: 10.1186/s12891-022-05806-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Nonspecific chronic low back pain (CLBP) is a complex symptom with numerous possible causes and influencing factors. Understanding how modifiable factors affect the course of CLBP is important for preventing progression. As the COVID-19 pandemic has changed the lifestyle of many people, this study paper assessed whether it also changed the influence of modifiable lifestyle factors (regular exercise and sedentary behaviour) and mental health factors (anxiety and depression) on CLBP pain intensity and disability by comparing the strength of these associations before and during the pandemic. We hypothesised that the importance of regular physical activity and good mental health for CLBP patients would increase during the pandemic.
Methods
These questions were investigated in a cross-sectional study of insurance claims data and self-reported data from various questionnaires from 3,478 participants in a German CLBP health intervention (2014–2021) by calculating pre- and intra-pandemic odds ratios (OR) and 95% confidence intervals (CI) for each variable of interest and outcome. Potential confounders were also considered. Pandemic status was treated as an effect modifier. Based on the date of enrolment, participants were classified as “pre-pandemic” or “pandemic”.
Results
Regularly exercising ≥ 4 h/week significantly reduced the odds of high disability for men (OR 0.49, 95% CI 0.31 – 0.79, p = 0.003) and women (OR 0.30, 95% CI 0.14 – 0.563, p = 0.002) and reduced the probability of severe pain in women (OR 0.37, 95% CI 0.21 – 0.65, p < 0.001). Each one-point increase in PHQ-4 score for anxiety and depression increased the OR of high pain intensity by 1.25 points (95% CI 1.18 – 1.34, p < 0.001). A clear impact of COVID-19 lockdowns was observed. In individuals who exercised ≥ 4 h/week the OR of high disability was 0.57 (95% CI 0.36 – 0.92, p = 0.021) in the pre-pandemic group compared to 0.29 (95% CI 0.12 – 0.56, p = 0.002) in the pandemic group. The probability of high disability increased from an OR of 1.42 (95% CI 1.33 – 1.52, p < 0.001) per marginal increase in the PHQ-4 scale before the pandemic, to an OR of 1.73 (95% CI 1.58 – 1.89, p < 0.001) during the pandemic.
Conclusions
The magnitude of association of the factors that influenced high pain intensity and disability increased during the pandemic. On the one hand, the protective effect of regular exercising was greater in participants surveyed during lockdown. On the other hand, a higher risk through anxiety or depression during the lockdown was identified. An additional study with objective measures of sedentary behaviour and physical activity is needed to validate these results. More in-depth investigation of lockdown-induced associations between reduced daily physical activity, increased levels of anxiety and depression, and their effects on CLPB could also be worthwhile.
Trial registration
This study used routinely collected data from a CLBP intervention that was previously evaluated and registered in the German Registry of Clinical Trials under DRKS00015463 (04/09/2018). The original ethics approval, informed consent and self-reported questionnaire have remained unchanged and are still valid.
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Importance of the Working Environment for Early Retirement: Prospective Cohort Study with Register Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189817. [PMID: 34574740 PMCID: PMC8472036 DOI: 10.3390/ijerph18189817] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022]
Abstract
Background: This study investigates the role of physical work demands and psychosocial work factors for early retirement among older workers. Methods: Data from three Danish surveys on work environment and health among employed older workers (age 55–59) were merged with a national register containing information on labour market participation. Robust Poisson regression modelled the risk ratios (RR) and 95% confidence intervals (CI) for the association between physical and psychosocial work factors and early retirement, that is, not working after the age of 64. Results: Of the 2800 workers, 53% retired early. High physical work demands (RR 1.33, 95% CI 1.19–1.48), poor overall psychosocial working conditions (RR 1.43, 95% CI 1.26–1.61), and access to early retirement benefits (RR 1.79, 95% CI 1.53–2.10) predicted early retirement. Subgroup analyses revealed that poor overall psychosocial working conditions were a stronger predictor for early retirement among workers with seated jobs than those with physically active jobs. Conclusions: High physical work demands and poor psychosocial working conditions are factors that can push older workers out of the labour market prematurely. Poor psychosocial working conditions seem to be a particularly strong push factor among workers with seated work.
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Aasdahl L, Nilsen TIL, Meisingset I, Nordstoga AL, Evensen KAI, Paulsen J, Mork PJ, Skarpsno ES. Genetic variants related to physical activity or sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act 2021; 18:15. [PMID: 33482856 PMCID: PMC7821484 DOI: 10.1186/s12966-020-01077-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/16/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Research shows that part of the variation in physical activity and sedentary behaviour may be explained by genetic factors. Identifying genetic variants associated with physical activity and sedentary behaviour can improve causal inference in physical activity research. The aim of this systematic review was to provide an updated overview of the evidence of genetic variants associated with physical activity or sedentary behaviour. METHODS We performed systematic literature searches in PubMed and Embase for studies published from 1990 to April 2020 using keywords relating to "physical activity", "exercise", "sedentariness" and "genetics". Physical activity phenotypes were either based on self-report (e.g., questionnaires, diaries) or objective measures (e.g., accelerometry, pedometer). We considered original studies aiming to i) identify new genetic variants associated with physical activity or sedentary behaviour (i.e., genome wide association studies [GWAS]), or ii) assess the association between known genetic variants and physical activity or sedentary behaviour (i.e., candidate gene studies). Study selection, data extraction, and critical appraisal were carried out by independent researchers, and risk of bias and methodological quality was assessed for all included studies. RESULTS Fifty-four out of 5420 identified records met the inclusion criteria. Six of the included studies were GWAS, whereas 48 used a candidate gene approach. Only one GWAS and three candidate gene studies were considered high-quality. The six GWAS discovered up to 10 single nucleotide polymorphisms (SNPs) associated with physical activity or sedentariness that reached genome-wide significance. In total, the candidate gene studies reported 30 different genes that were associated (p < 0.05) with physical activity or sedentary behaviour. SNPs in or close to nine candidate genes were associated with physical activity or sedentary behaviour in more than one study. CONCLUSION GWAS have reported up to 10 loci associated with physical activity or sedentary behaviour. Candidate gene studies have pointed to some interesting genetic variants, but few have been replicated. Our review highlights the need for high-quality GWAS in large population-based samples, and with objectively assessed phenotypes, in order to establish robust genetic instruments for physical activity and sedentary behaviour. Furthermore, consistent replications in GWAS are needed to improve credibility of genetic variants. TRIAL REGISTRATION Prospero CRD42019119456 .
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Affiliation(s)
- Lene Aasdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway. .,Unicare Helsefort Rehabilitation Centre, Rissa, Norway.
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway.,Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway
| | - Ingebrigt Meisingset
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway
| | - Anne Lovise Nordstoga
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway
| | - Kari Anne I Evensen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway.,Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway.,Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.,Unit for Physiotherapy Services, Trondheim, Norway
| | - Julie Paulsen
- Department of Medical Genetics, St. Olavs Hospital, Trondheim, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway
| | - Eivind Schjelderup Skarpsno
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
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Joint association of physical work demands and leg pain intensity for work limitations due to pain in senior workers: cross-sectional study. BMC Public Health 2020; 20:1741. [PMID: 33208134 PMCID: PMC7672909 DOI: 10.1186/s12889-020-09860-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/09/2020] [Indexed: 12/22/2022] Open
Abstract
Background Leg pain, especially of the knees and hips, is common among senior workers and may limit the ability to perform physically demanding work. In light of the aging workforce, this study determined the joint association of physical work demands and leg pain intensity for work-limiting pain in senior workers. Methods Currently employed senior workers (≥50 years) participated in the SeniorWorkingLife study in 2018 (n = 12,879). Associations between the combination of physical work demands and leg pain intensity (interaction) with work-limiting pain (outcome) were modeled using binary logistic regression analyses while controlling for potential covariates. Results We found a significant interaction (P < 0.001) between physical work demands and leg pain intensity for work-limiting pain. The combination of higher physical work demands and higher leg pain intensity had the worst outcome in terms of the odds of experiencing work-limiting pain. For example, 70% of those with the combination of high physical work demands and leg pain intensity ≥7 (scale 0–10) experienced that the pain limited them to at least some degree in their work. Conclusions The combination of high physical work demands and high leg pain intensity are associated with limited ability to perform work among senior workers. These findings highlight the importance of prioritizing the physical work environment in physically demanding occupations, particularly among senior workers, for prolonging working life. Thus, adjusting the work demands, e.g. through use of assistive devices, and lowering the pain, e.g. through physical rehabilitation, may be necessary to sustain work ability to a high age in this group of workers. Trial registration This was registered as a cohort study in ClinicalTrials.gov (Identifier: NCT03634410) on the 18th of August 2018 (Retrospectively registered).
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Bláfoss R, Sundstrup E, Jakobsen MD, Brandt M, Bay H, Andersen LL. Physical workload and bodily fatigue after work: cross-sectional study among 5000 workers. Eur J Public Health 2020; 29:837-842. [PMID: 30982881 PMCID: PMC6761836 DOI: 10.1093/eurpub/ckz055] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Persistent bodily fatigue after working days may indicate an imbalance between work demands and capacity of the workers. This study aimed to investigate associations between physical exposures at work and bodily fatigue after work. Methods Danish workers with physical work (N=5377) answered questions about various physical exposures during work and bodily fatigue after work in the 2010 round of the Danish Work Environment Cohort Study. Associations were modeled using binary logistic regression controlled for various confounders. Results Mean age among the younger (<50 years) and older (≥50 years) workers was 36 and 56 years, respectively. Younger and older workers exposed to various physical exposures (e.g. ‘bending/twisting the back’) for more than a quarter of the workday were more fatigued after work. An exposure–response relationship was observed between the number of physical exposures and bodily fatigue, with odds ratios (OR) for fatigue in the body among younger workers being 1.01 (95%CI 0.63–1.63), 1.59 (95%CI 1.01–2.50), 2.37 (95%CI 1.54–3.66) and 2.84 (95%CI 1.85–5.36) for 1, 2, 3 and ≥4 types of combined physical exposures, respectively. Correspondingly, for older workers, ORs were 1.95 (95%CI 1.09–3.51), 4.06 (95%CI 2.32–7.12), 4.10 (95%CI 2.28–7.37) and 4.90 (95%CI 2.72–8.82) for 1, 2, 3 and ≥4 exposures, respectively. Conclusion While some of the single factor exposures were associated with increased bodily fatigue, the most marked associations were found when summing the number of different exposures. These results indicate that workplaces should focus on the sum of combined physical exposures rather than focusing solely on single exposures.
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Affiliation(s)
- Rúni Bláfoss
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Emil Sundstrup
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Markus D Jakobsen
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Mikkel Brandt
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Hans Bay
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Lars L Andersen
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark.,Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Maes I, Ketels M, Van Dyck D, Clays E. The occupational sitting and physical activity questionnaire (OSPAQ): a validation study with accelerometer-assessed measures. BMC Public Health 2020; 20:1072. [PMID: 32631292 PMCID: PMC7339490 DOI: 10.1186/s12889-020-09180-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/29/2020] [Indexed: 11/11/2022] Open
Abstract
Background The Occupational Sitting and Physical Activity Questionnaire (OSPAQ) was developed as an easy-to-use instrument for self-reported assessment of percentage sitting, standing, walking, and performing heavy labour in a workplace setting. This study aimed to evaluate the concurrent validity of all dimensions of the OSPAQ compared to accelerometer-assessed measures of occupational physical activities in a mixed sample of sedentary and physically active professions. Methods Data from the Flemish Employees’ Physical Activity (FEPA) study were used, including employees from the service and production sector. All participants filled in a questionnaire, underwent clinical measurements, and wore two Axivity AX3 accelerometers for at least 2 consecutive working days. Intraclass (ICC) and Spearman rho correlations (r) were analyzed to assess concurrent validity. Results The sample included 401 workers (16% sedentary profession) with a mean age of 39.2 (± 11) years. Concurrent validity was good and moderate for assessing percentage of sitting (ICC = 0.84; r = 0.53), and standing (ICC = 0.64; r = 0.53), respectively. The concurrent validity for walking was weak to moderate (ICC = 0.50; r = 0.49), and weak for performing heavy labour (ICC = 0.28; r = 0.35). Stronger validity scores were found in sedentary professions for occupational sitting and standing. In physically active professions, an underestimation of self-reported sitting and standing was found, and an overestimation of self-reported walking and heavy labour. No significant self-reported over- or underestimation was found for sitting and heavy labour in sedentary professions, but an underestimation of self-reported standing and an overestimation of self-reported walking was observed. Conclusions The OSPAQ has acceptable measurement properties for assessing occupational sitting and standing. Accelerometer-assessed measures of occupational walking and heavy labour are recommended, since a poor concurrent validity was found for both.
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Affiliation(s)
- Iris Maes
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Margo Ketels
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, University Hospital Ghent, entrance 42 (4K3), Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Els Clays
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, University Hospital Ghent, entrance 42 (4K3), Corneel Heymanslaan 10, 9000, Ghent, Belgium
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Bakker EA, Hartman YAW, Hopman MTE, Hopkins ND, Graves LEF, Dunstan DW, Healy GN, Eijsvogels TMH, Thijssen DHJ. Validity and reliability of subjective methods to assess sedentary behaviour in adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2020; 17:75. [PMID: 32539720 PMCID: PMC7294635 DOI: 10.1186/s12966-020-00972-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 05/12/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Subjective measures of sedentary behaviour (SB) (i.e. questionnaires and diaries/logs) are widely implemented, and can be useful for capturing type and context of SBs. However, little is known about comparative validity and reliability. The aim of this systematic review and meta-analysis was to: 1) identify subjective methods to assess overall, domain- and behaviour-specific SB, and 2) examine the validity and reliability of these methods. METHODS The databases MEDLINE, EMBASE and SPORTDiscus were searched up to March 2020. Inclusion criteria were: 1) assessment of SB, 2) evaluation of subjective measurement tools, 3) being performed in healthy adults, 4) manuscript written in English, and 5) paper was peer-reviewed. Data of validity and/or reliability measurements was extracted from included studies and a meta-analysis using random effects was performed to assess the pooled correlation coefficients of the validity. RESULTS The systematic search resulted in 2423 hits. After excluding duplicates and screening on title and abstract, 82 studies were included with 75 self-reported measurement tools. There was wide variability in the measurement properties and quality of the studies. The criterion validity varied between poor-to-excellent (correlation coefficient [R] range - 0.01- 0.90) with logs/diaries (R = 0.63 [95%CI 0.48-0.78]) showing higher criterion validity compared to questionnaires (R = 0.35 [95%CI 0.32-0.39]). Furthermore, correlation coefficients of single- and multiple-item questionnaires were comparable (1-item R = 0.34; 2-to-9-items R = 0.35; ≥10-items R = 0.37). The reliability of SB measures was moderate-to-good, with the quality of these studies being mostly fair-to-good. CONCLUSION Logs and diaries are recommended to validly and reliably assess self-reported SB. However, due to time and resources constraints, 1-item questionnaires may be preferred to subjectively assess SB in large-scale observations when showing similar validity and reliability compared to longer questionnaires. REGISTRATION NUMBER CRD42018105994.
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Affiliation(s)
- Esmée A Bakker
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Yvonne A W Hartman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Lee E F Graves
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - David W Dunstan
- Baker Heart & Diabetes Institute, Melbourne, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Genevieve N Healy
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Dick H J Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
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Skovlund SV, Bláfoss R, Sundstrup E, Andersen LL. Association between physical work demands and work ability in workers with musculoskeletal pain: cross-sectional study. BMC Musculoskelet Disord 2020; 21:166. [PMID: 32171283 PMCID: PMC7071559 DOI: 10.1186/s12891-020-03191-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 03/05/2020] [Indexed: 11/10/2022] Open
Abstract
Background Musculoskeletal pain is common in the working population and may affect the work ability, especially among those with high physical work demands. This study investigated the association between physical work demands and work ability in workers with musculoskeletal pain. Methods Workers with physically demanding jobs (n = 5377) participated in the Danish Work Environment Cohort Study in 2010. Associations between physical work ability and various physical work demands were modeled using cumulative logistic regression analyses while controlling for possible confounders. Results In the fully adjusted model, bending and twisting/turning of the back more than a quarter of the workday (reference: less than a quarter of the workday) was associated with higher odds of lower work ability in workers with low-back pain (OR: 1.38, 95% CI: 1.09–1.74) and neck-shoulder pain (OR: 1.29, 95% CI: 1.01–1.64). When adding up the different types of demands, being exposed to two or more physical work demands for more than a quarter of the workday was consistently associated with lower work ability. Conclusions Work that involves high demands of the lower back seems especially problematic in relation to work ability among physical workers with musculoskeletal pain. Regardless of the specific type of physical work demand, being exposed to multiple physical work demands for more than a quarter of the workday was also associated with lower work ability.
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Affiliation(s)
- Sebastian Venge Skovlund
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.
| | - Rúni Bláfoss
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Sports Science and Clinical Biomechanics, Research Unit for Muscle Physiology and Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Emil Sundstrup
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Lars L Andersen
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Sport Science, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Prince SA, Cardilli L, Reed JL, Saunders TJ, Kite C, Douillette K, Fournier K, Buckley JP. A comparison of self-reported and device measured sedentary behaviour in adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2020; 17:31. [PMID: 32131845 PMCID: PMC7055033 DOI: 10.1186/s12966-020-00938-3] [Citation(s) in RCA: 211] [Impact Index Per Article: 52.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/19/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Sedentary behaviour (SB) is a risk factor for chronic disease and premature mortality. While many individual studies have examined the reliability and validity of various self-report measures for assessing SB, it is not clear, in general, how self-reported SB (e.g., questionnaires, logs, ecological momentary assessments (EMAs)) compares to device measures (e.g., accelerometers, inclinometers). OBJECTIVE The primary objective of this systematic review was to compare self-report versus device measures of SB in adults. METHODS Six bibliographic databases were searched to identify all studies which included a comparable self-report and device measure of SB in adults. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses. RESULTS The review included 185 unique studies. A total of 123 studies comprising 173 comparisons and data from 55,199 participants were used to examine general criterion validity. The average mean difference was -105.19 minutes/day (95% CI: -127.21, -83.17); self-report underestimated sedentary time by ~1.74 hours/day compared to device measures. Self-reported time spent sedentary at work was ~40 minutes higher than when assessed by devices. Single item measures performed more poorly than multi-item questionnaires, EMAs and logs/diaries. On average, when compared to inclinometers, multi-item questionnaires, EMAs and logs/diaries were not significantly different, but had substantial amount of variability (up to 6 hours/day within individual studies) with approximately half over-reporting and half under-reporting. A total of 54 studies provided an assessment of reliability of a self-report measure, on average the reliability was good (ICC = 0.66). CONCLUSIONS Evidence from this review suggests that single-item self-report measures generally underestimate sedentary time when compared to device measures. For accuracy, multi-item questionnaires, EMAs and logs/diaries with a shorter recall period should be encouraged above single item questions and longer recall periods if sedentary time is a primary outcome of study. Users should also be aware of the high degree of variability between and within tools. Studies should exert caution when comparing associations between different self-report and device measures with health outcomes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019118755.
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Affiliation(s)
- Stephanie A Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada.
| | - Luca Cardilli
- Birmingham Community Healthcare NHS Foundation Trust, Community Cardiac Services, Birmingham, United Kingdom
- Centre for Active Living, University Centre Shrewsbury, University of Chester, Guildhall, Frankwell Quay, Shrewsbury, United Kingdom
| | - Jennifer L Reed
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Travis J Saunders
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
| | - Chris Kite
- Centre for Active Living, University Centre Shrewsbury, University of Chester, Guildhall, Frankwell Quay, Shrewsbury, United Kingdom
- School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
| | - Kevin Douillette
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
| | - Karine Fournier
- Health Sciences Library, University of Ottawa, Ottawa, Canada
| | - John P Buckley
- Centre for Active Living, University Centre Shrewsbury, University of Chester, Guildhall, Frankwell Quay, Shrewsbury, United Kingdom
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12
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Sagelv EH, Hopstock LA, Johansson J, Hansen BH, Brage S, Horsch A, Ekelund U, Morseth B. Criterion validity of two physical activity and one sedentary time questionnaire against accelerometry in a large cohort of adults and older adults. BMJ Open Sport Exerc Med 2020; 6:e000661. [PMID: 32153981 PMCID: PMC7047487 DOI: 10.1136/bmjsem-2019-000661] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives We compared the ability of physical activity and sitting time questionnaires (PAQ) for ranking individuals versus continuous volume calculations (physical activity level (PAL), metabolic equivalents of task (MET), sitting hours) against accelerometry measured physical activity as our criterion. Methods Participants in a cohort from the Tromsø Study completed three questionnaires; (1) The Saltin-Grimby Physical Activity Level Scale (SGPALS) (n=4040); (2) The Physical Activity Frequency, Intensity and Duration (PAFID) questionnaire (n=5902)) calculated as MET-hours·week-1 and (3) The International Physical Activity questionnaire (IPAQ) short-form sitting question (n=4896). We validated the questionnaires against the following accelerometry (Actigraph wGT3X-BT) estimates: vector magnitude counts per minute, steps∙day-1, time (minutes·day-1) in sedentary behaviour, light physical activity, moderate and vigorous physical activity (MVPA) non-bouted and ≥10 min bouted MVPA. Results Ranking of physical activity according to the SGPALS and quartiles (Q) of MET-hours∙week-1 from the PAFID were both positively associated with accelerometry estimates of physical activity (p<0.001) but correlations with accelerometry estimates were weak (SGPALS (PAL): r=0.11 to 0.26, p<0.001) and weak-to-moderate (PAFID: r=0.39 to 0.44, p<0.01). There was 1 hour of accelerometry measured sedentary time from Q1 to Q4 in the IPAQ sitting question (p<0.001) and also weak correlations (r=0.22, p<0.01). Conclusion Ranking of physical activity levels measured with PAQs appears to have higher validity than energy expenditure calculations. Self-reported sedentary time poorly reflects accelerometry measured sedentary time. These two PAQs can be used for ranking individuals into different physical activity categories supporting previous studies using these instruments when assessing associations with health outcomes.
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Affiliation(s)
- Edvard H Sagelv
- Faculty of Health Sciences, School of Sport Sciences, UiT Arctic University of Norway, Tromso, Troms, Norway
| | - Laila A Hopstock
- Faculty of Health Sciences, Department of Community Medicine, UiT Arctic University of Norway, Tromso, Troms, Norway
| | - Jonas Johansson
- Faculty of Health Sciences, Department of Community Medicine, UiT Arctic University of Norway, Tromso, Troms, Norway
| | - Bjørge H Hansen
- Faculty of Health and Sport Sciences, Department of Sport Science and Physical Education, University of Agder, Kristiansand, Vest-Agder, Norway
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, Cambridgeshire, UK.,Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Alexander Horsch
- Faculty of Science and Technology, Department of Computer Science, UiT Arctic University of Norway, Tromso, Troms, Norway
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Oslo, Norway.,Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Oslo, Norway
| | - Bente Morseth
- Faculty of Health Sciences, School of Sport Sciences, UiT Arctic University of Norway, Tromso, Troms, Norway
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13
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Sliepen M, Lipperts M, Tjur M, Mechlenburg I. Use of accelerometer-based activity monitoring in orthopaedics: benefits, impact and practical considerations. EFORT Open Rev 2020; 4:678-685. [PMID: 32010456 PMCID: PMC6986392 DOI: 10.1302/2058-5241.4.180041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Studies of the effectiveness of orthopaedic interventions do not generally measure physical activity (PA). Applying accelerometer-based activity monitoring in orthopaedic studies will add relevant information to the generally examined physical function and pain assessment.Accelerometer-based activity monitoring is practically feasible in orthopaedic patient populations, since current day activity sensors have battery time and memory to measure continuously for several weeks without requiring technical expertise.The ongoing development in sensor technology has made it possible to combine functional tests with activity monitoring.For clinicians, the application of accelerometer-based activity monitoring can provide a measure of PA and can be used for clinical comparisons before and after interventions.In orthopaedic rehabilitation, accelerometer-based activity monitoring may be used to help patients reach their targets for PA and to coach patients towards a more active lifestyle through direct feedback. Cite this article: EFORT Open Rev 2019;4:678-685. DOI: 10.1302/2058-5241.4.180041.
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Affiliation(s)
- Maik Sliepen
- Institut für Experimentelle Muskuloskelettale Medizin (IEMM), Universitätsklinikum Münster (UKM), Westfälische Wilhelms-Universität Münster (WWU), Germany
| | - Matthijs Lipperts
- AHORSE, Department of Orthopaedics, Zuyderland Medical Centre, The Netherlands
| | - Marianne Tjur
- Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark
| | - Inger Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark.,Centre of Research in Rehabilitation (CORIR), Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Denmark
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14
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Relationships between Physical Activity, Sedentary Behaviour and Cognitive Functions in Office Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234721. [PMID: 31783476 PMCID: PMC6926659 DOI: 10.3390/ijerph16234721] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/21/2019] [Accepted: 11/23/2019] [Indexed: 11/16/2022]
Abstract
Increasing evidence from animal experiments suggests that physical activity (PA) promotes neuroplasticity and learning. For humans, most research on the relationship between PA, sedentary behaviour (SB), and cognitive function has relied on self-reported measures of behaviour. Office work is characterised by high durations of SB combined with high work demands. While previous studies have shown that fitter office workers outperform their less fit colleagues in cognitive tests, the importance of PA and SB remains unknown. This study investigated associations between objectively measured PA and SB, using hip-worn accelerometers, and cognitive functions in 334 office workers. Time spent in moderate-to-vigorous PA (MVPA) was not associated with any cognitive outcome. However, time spent in SB tended to be positively associated with words recalled in free recall (β = 0.125). For the least fit participants, the average length of MVPA bouts was favourably related to Stroop performance (β = -0.211), while for the fitter individuals, a longer average length of MVPA bouts was related to worse recognition (β = -0.216). While our findings indicate that the length of MVPA bouts was associated with better Stroop performance in the least fit participants, our findings do not support the notion that more time spent in MVPA or less time in SB is associated with better cognitive function.
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15
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Perceived Stress among Different Occupational Groups and the Interaction with Sedentary Behaviour. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234595. [PMID: 31756951 PMCID: PMC6926860 DOI: 10.3390/ijerph16234595] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 12/19/2022]
Abstract
Sedentary lifestyle and low physical activity are associated with health issues, including both physical and mental health, non-communicable diseases, overweight, obesity and reduced quality of life. This study investigated differences in physical activity and other individual factors among different occupational groups, highlighting the impact of sedentary behaviour on perceived stress by occupation. Cross-sectional study included 571 full-time workers of Kaunas city, Lithuania. The outcome of this study was assessment of perceived stress. Time spent sedentary per day, occupation and other individual characteristics were self-reported using questionnaires. Two main occupational groups were analysed: white-collar and blue-collar workers. Multivariate logistic regression was used to assess the impact of sedentary behaviour on perceived stress among different occupational groups. The prevalence of high sedentary behaviour was 21.7 and 16.8 % among white-collar and blue-collar workers, respectively. Blue-collar workers had a higher risk of high perceived stress (OR 1.55, 95% CI 1.05-2.29) compared to white-collar workers; however, sedentary time did not have any impact on high perceived stress level. Meanwhile, white-collar male (OR 4.34, 95% CI 1.46-12.95) and white-collar female (OR 3.26, 95% CI 1.23-8.65) workers who spend more than three hours per day sedentary had a greater risk of high levels of perceived stress. These findings indicate sedentary behaviour effect on perceived stress among two occupational groups-white-collar and blue-collar workers-and other important factors associated with perceived stress.
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16
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Boudet G, Chausse P, Thivel D, Rousset S, Mermillod M, Baker JS, Parreira LM, Esquirol Y, Duclos M, Dutheil F. How to Measure Sedentary Behavior at Work? Front Public Health 2019; 7:167. [PMID: 31355172 PMCID: PMC6633074 DOI: 10.3389/fpubh.2019.00167] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 06/05/2019] [Indexed: 12/23/2022] Open
Abstract
Background: Prolonged sedentary behavior (SB) is associated with increased risk for chronic conditions. A growing number of the workforce is employed in office setting with high occupational exposure to SB. There is a new focus in assessing, understanding and reducing SB in the workplace. There are many subjective (questionnaires) and objective methods (monitoring with wearable devices) available to determine SB. Therefore, we aimed to provide a global understanding on methods currently used for SB assessment at work. Methods: We carried out a systematic review on methods to measure SB at work. Pubmed, Cochrane, Embase, and Web of Science were searched for peer-reviewed English-language articles published between 1st January 2000 and 17th March 2019. Results: We included 154 articles: 89 were cross-sectional and 65 were longitudinal studies, for a total of 474,091 participants. SB was assessed by self-reported questionnaires in 91 studies, by wearables devices in also 91 studies, and simultaneously by a questionnaire and wearables devices in 30 studies. Among the 91 studies using wearable devices, 73 studies used only one device, 15 studies used several devices, and three studies used complex physiological systems. Studies exploring SB on a large sample used significantly more only questionnaires and/or one wearable device. Conclusions: Available questionnaires are the most accessible method for studies on large population with a limited budget. For smaller groups, SB at work can be objectively measured with wearable devices (accelerometers, heart-rate monitors, pressure meters, goniometers, electromyography meters, gas-meters) and the results can be associated and compared with a subjective measure (questionnaire). The number of devices worn can increase the accuracy but make the analysis more complex and time consuming.
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Affiliation(s)
- Gil Boudet
- Faculté de Médecine, Institut de Médecine du Travail, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Pierre Chausse
- Cellule d'Accompagnement Technologique-Department of Technological Accompaniment, CNRS, LaPSCo, Université Clermont Auvergne, Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P EA 3533), Université Clermont Auvergne, Clermont-Ferrand, France.,Institut Universitaire de France, Paris, France
| | - Sylvie Rousset
- Unité de Nutrition Humaine, INRA, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Martial Mermillod
- Institut Universitaire de France, Paris, France.,LPNC, CNRS, Université Grenoble Alpes, Université Savoie Mont Blanc, Grenoble, France
| | - Julien S Baker
- School of Science and Sport, Institute of Clinical Exercise and Health Sciences, University of the West of Scotland, Hamilton, United Kingdom
| | - Lenise M Parreira
- Faculté de Médecine, Institut de Médecine du Travail, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Yolande Esquirol
- Occupational and Preventive Medicine, INSERM UMR-1027, Université Paul Sabatier Toulouse 3, CHU Toulouse, Toulouse, France
| | - Martine Duclos
- Sport Medicine and Functional Explorations, CRNH, INRA UMR-1019, University Hospital of Clermont-Ferrand, Université Clermont Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Frédéric Dutheil
- LaPSCo, Physiological and Psychosocial Stress, Preventive and Occupational Medicine, CNRS, University Hospital of Clermont-Ferrand, Université Clermont Auvergne, CHU Clermont-Ferrand, WittyFit, Clermont-Ferrand, France.,Faculty of Health, School of Exercise Science, Australian Catholic University, Melbourne, VIC, Australia
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17
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Gong WJ, Fong DYT, Wang MP, Lam TH, Chung TWH, Ho SY. Increasing socioeconomic disparities in sedentary behaviors in Chinese children. BMC Public Health 2019; 19:754. [PMID: 31196044 PMCID: PMC6567653 DOI: 10.1186/s12889-019-7092-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 05/31/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Sedentary behaviors are prevalent in Chinese children, however, the studies on their trends and socioeconomic disparities are scarce. We examined the time trends of daily television (TV) viewing and video game playing and the associated socioeconomic factors in Chinese children in Hong Kong, the most developed and westernized city in China. METHODS In a panel data study involving 538,300 primary four and 510,294 primary six students from 1999/2000 to 2008/09, data on socioeconomic status, sedentary behaviors (TV viewing and video game playing) and other lifestyle habits were collected using a self-administered questionnaire. Trends in sedentary behaviors over time were assessed. Their socioeconomic disparities were examined by interactions in generalized estimating equations with the adjustment for weight status and extracurricular physical activities. RESULTS The age and sex-standardized prevalence of ≥2 h daily TV viewing decreased from 51.4% (95% confidence interval [CI] 51.1-51.8%) in 1999/2000 to 43.8% (95% CI 43.4-44.2%) in 2008/09 (P for trend < 0.001), whereas that of ≥1 h daily video game playing increased from 8.2% (95% CI 7.9-8.4%) to 22.4% (95% CI 22.0-22.7%). Both sedentary behaviors were more prevalent in boys than girls, but the disparities decreased over time (Ratio of odds ratio [ROR] = 0.996 and 0.924 for TV viewing and video game playing, respectively). In contrast, both sedentary behaviors were increasingly more prevalent in children whose parents had lower education levels or non-managerial/professional occupations (ROR 1.006-1.082). CONCLUSIONS Children in lower socioeconomic families in Hong Kong were increasingly at risk of having sedentary behaviors over years and thus deserve more attention. Effective strategies targeting children and/or their parents of lower socioeconomic status are needed to reduce sedentary behaviors.
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Affiliation(s)
- Wei-Jie Gong
- School of Nursing, University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Daniel Yee-Tak Fong
- School of Nursing, University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Man-Ping Wang
- School of Nursing, University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Tai-Hing Lam
- School of Public Health, University of Hong Kong, 2/F Patrick Manson Building (North Wing), 7 Sassoon Road, Pokfulam, Hong Kong, China
| | - Thomas Wai-Hung Chung
- Student Health Service, Department of Health, 4/F Lam Tin Polyclinic, 99 Kai Tin Road, Kwun Tong, Kowloon, Hong Kong, China
| | - Sai-Yin Ho
- School of Public Health, University of Hong Kong, 2/F Patrick Manson Building (North Wing), 7 Sassoon Road, Pokfulam, Hong Kong, China
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18
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Andersen LL, Thorsen SV, Flyvholm MA, Holtermann A. Long-term sickness absence from combined factors related to physical work demands: prospective cohort study. Eur J Public Health 2019; 28:824-829. [PMID: 29741617 PMCID: PMC6148972 DOI: 10.1093/eurpub/cky073] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background The working environment plays an important role in public health. This study investigates the risk for long-term sickness absence (LTSA) from the combination of factors related to physical work demands. Methods Employees (n = 22 740) of the general population (the Danish Work Environment & Health study 2012) were followed for two years in the Danish Register for Evaluation of Marginalisation. Using Cox regression analyses we determined the risk of LTSA from four factors; (i) physical work demands, (ii) physical exertion during work, (iii) fatigue after work and (iv) work-limiting pain. Results During follow-up 10.2% experienced LTSA. Each of the four factors increased the risk of LTSA with hazard ratios (HR) ranging from 1.30 to 1.57. Scoring high on one (30.3% of the respondents), two (24.4%), three (19.9%) and all four factors (9.2%) gradually increased the risk of LTSA (HR’s of 1.39 [95% CI 1.16–1.66], 1.66 [95% CI 1.39–1.99], 1.90 [95% CI 1.57–2.29] and 3.02 [95% CI 2.47–3.68], respectively). Risk estimates remained robust in stratified analyses of age, sex and socioeconomic position. Population attributable fractions were high across all subgroups; 39% (general population), 36% (younger workers), 45% (older workers), 36% (men), 41% (women), 30% (higher socioeconomic position) and 45% (lower socioeconomic position). Conclusion The risk of LTSA gradually increased with number of factors related to high physical work demands, underlining the importance of targeting combined factors in risk assessment and preventive interventions.
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Affiliation(s)
- Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Sannie V Thorsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Mari-Ann Flyvholm
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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19
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Prince SA, Elliott CG, Scott K, Visintini S, Reed JL. Device-measured physical activity, sedentary behaviour and cardiometabolic health and fitness across occupational groups: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2019; 16:30. [PMID: 30940176 PMCID: PMC6444868 DOI: 10.1186/s12966-019-0790-9] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/08/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND With approximately 8 hours of one's waking day spent at work, occupational tasks and environments are important influencers on an individual's physical activity (PA) and sedentary behaviours. Little research has compared device-measured physical activity, sedentary behaviour and cardiometabolic outcomes between occupational groups. OBJECTIVE To compare device-measured movement (sedentary time [ST], light intensity physical activity [LPA], moderate-to-vigorous intensity physical activity [MVPA], and steps) across occupations. The secondary objective was to examine whether cardiometabolic and fitness outcomes differed by occupation. METHODS Five bibliographic databases were searched to identify all studies which included working age, employed adults from high-income countries, and reported on device-measured movement within occupations. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses and narrative syntheses. RESULTS The review includes 132 unique studies with data from 15,619 participants. Working adults spent ~ 60% of their working and waking time engaged in sedentary behaviour; a very small proportion (~ 4%) of the day included MVPA. On average, workers accumulated 8124 steps/day. Office and call center workers' steps/day were among the lowest, while those of postal delivery workers were highest. Office workers had the greatest ST and the lowest time in LPA both at work and during wakeful time. However, office workers had the greatest minutes sent in MVPA during wakeful hours. Laborers had the lowest ST and spent a significantly greater proportion of their work time in LPA and MVPA. Healthcare and protective services workers had higher levels of LPA at work compared to other occupations. Workers in driving-based occupations tended to have a higher body mass index and blood pressure. CONCLUSION This review identifies that occupational and wakeful time PA and ST differed between occupations. Future studies are needed to assess whether patterns differ by age and sex, describe leisure-time movement and movement patterns, and the relationship with cardiometabolic health. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017070448 .
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Affiliation(s)
- Stephanie A. Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | - Cara G. Elliott
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
| | - Kyle Scott
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Canada
| | - Jennifer L. Reed
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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20
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Rudolf K, Dejonghe LAL, Froböse I, Lammer F, Rückel LM, Tetz J, Schaller A. Effectiveness Studies in Health Promotion: A Review of the Methodological Quality of Studies Reporting Significant Effects on Physical Activity in Working Age Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050813. [PMID: 30845673 PMCID: PMC6427597 DOI: 10.3390/ijerph16050813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/18/2019] [Accepted: 03/01/2019] [Indexed: 12/13/2022]
Abstract
The methodology of intervention studies on physical activity (PA) promotion is of great importance regarding evidence development in complex interventions. The aim of this review was to provide an overview of the methodological quality of those studies which reported statistically significant effects of interventions promoting PA. PUBMED was searched for reviews on PA promotion to identify studies reporting effective interventions with participants of working age (16⁻67 years). Selected reviews were screened and data from primary studies with effective interventions were extracted to assess methodological quality. Forty-six reviews with 600 primary studies were identified, of which 33 met the inclusion criteria. Twenty-one studies were conducted as randomized controlled trials, 13 included an intervention control group, 25 measured PA by questionnaire, and 13 included objective measurements. Information on used statistics was often scarce, and long-term follow-up measurements were frequently missing. The overall methodological quality was moderate for randomized studies and low for non-randomized studies; information on methods and results was often lacking. To overcome these methodological issues, standardized guidelines for reporting study results should be considered, not only when publishing results but also when designing studies. This review provides a solid foundation for the development of practical advice for planning application-oriented studies in PA promotion.
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Affiliation(s)
- Kevin Rudolf
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Lea A L Dejonghe
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Ingo Froböse
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
- Center for Health and Physical Activity, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Florian Lammer
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Lisa-Marie Rückel
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Jessica Tetz
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Andrea Schaller
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
- IST-University of Applied Sciences, Erkrather Straße 220 a-c, 40233 Duesseldorf, Germany.
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Hallman DM, Krause N, Jensen MT, Gupta N, Birk Jørgensen M, Holtermann A. Objectively Measured Sitting and Standing in Workers: Cross-Sectional Relationship with Autonomic Cardiac Modulation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E650. [PMID: 30813282 PMCID: PMC6406480 DOI: 10.3390/ijerph16040650] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/14/2019] [Accepted: 02/18/2019] [Indexed: 12/11/2022]
Abstract
Excessive sitting and standing are proposed risk factors for cardiovascular diseases (CVDs), possibly due to autonomic imbalance. This study examines the association of objectively measured sitting and standing with nocturnal autonomic cardiac modulation. The cross-sectional study examined 490 blue-collar workers in three Danish occupational sectors. Sitting and standing during work and leisure were assessed during 1⁻5 days using accelerometers. Heart rate (HR) and heart rate variability (HRV) were obtained during nocturnal sleep as markers of resting autonomic modulation. The associations of sitting and standing still (h/day) with HR and HRV were assessed with linear regression models, adjusted for age, gender, body mass index, smoking, and physical activity. More sitting time during leisure was associated with elevated HR (p = 0.02), and showed a trend towards reduced HRV. More standing time at work was associated with lower HR (p = 0.02), and with increased parasympathetic indices of HRV (root mean squared successive differences of R-R intervals p = 0.05; high-frequency power p = 0.07). These findings, while cross-sectional and restricted to blue-collar workers, suggest that sitting at leisure is detrimental to autonomic cardiac modulation, but standing at work is beneficial. However, the small effect size is likely insufficient to mitigate the previously shown detrimental effects of prolonged standing on CVD.
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Affiliation(s)
- David M Hallman
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle 80637, Sweden.
| | - Niklas Krause
- Departments of Epidemiology and Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA.
| | - Magnus Thorsten Jensen
- Department of Cardiology, Copenhagen University Hospital, Herlev-Gentofte, 2900 Hellerup, Denmark.
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark.
| | | | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark.
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Shrestha N, Kukkonen‐Harjula KT, Verbeek JH, Ijaz S, Hermans V, Pedisic Z. Workplace interventions for reducing sitting at work. Cochrane Database Syst Rev 2018; 12:CD010912. [PMID: 30556590 PMCID: PMC6517221 DOI: 10.1002/14651858.cd010912.pub5] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND A large number of people are employed in sedentary occupations. Physical inactivity and excessive sitting at workplaces have been linked to increased risk of cardiovascular disease, obesity, and all-cause mortality. OBJECTIVES To evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, OSH UPDATE, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 9 August 2017. We also screened reference lists of articles and contacted authors to find more studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), cross-over RCTs, cluster-randomised controlled trials (cluster-RCTs), and quasi-RCTs of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies. The primary outcome was time spent sitting at work per day, either self-reported or measured using devices such as an accelerometer-inclinometer and duration and number of sitting bouts lasting 30 minutes or more. We considered energy expenditure, total time spent sitting (including sitting at and outside work), time spent standing at work, work productivity and adverse events as secondary outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. MAIN RESULTS We found 34 studies - including two cross-over RCTs, 17 RCTs, seven cluster-RCTs, and eight controlled before-and-after studies - with a total of 3,397 participants, all from high-income countries. The studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi-component interventions (four studies). One study included both physical workplace changes and information and counselling components. We did not find any studies that specifically investigated the effects of standing meetings or walking meetings on sitting time.Physical workplace changesInterventions using sit-stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short-term follow-up (up to three months) compared to sit-desks (95% confidence interval (CI) -116 to -84, 10 studies, low-quality evidence). The pooled effect of two studies showed sit-stand desks reduced sitting time at medium-term follow-up (3 to 12 months) by an average of 57 minutes per day (95% CI -99 to -15) compared to sit-desks. Total sitting time (including sitting at and outside work) also decreased with sit-stand desks compared to sit-desks (mean difference (MD) -82 minutes/day, 95% CI -124 to -39, two studies) as did the duration of sitting bouts lasting 30 minutes or more (MD -53 minutes/day, 95% CI -79 to -26, two studies, very low-quality evidence).We found no significant difference between the effects of standing desks and sit-stand desks on reducing sitting at work. Active workstations, such as treadmill desks or cycling desks, had unclear or inconsistent effects on sitting time.Workplace policy changesWe found no significant effects for implementing walking strategies on workplace sitting time at short-term (MD -15 minutes per day, 95% CI -50 to 19, low-quality evidence, one study) and medium-term (MD -17 minutes/day, 95% CI -61 to 28, one study) follow-up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI -66 to -15, one study, low-quality evidence) compared to long breaks (two 15-minute breaks per workday) at short-term follow-up.Information and counsellingProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short-term follow-up (MD -19 minutes per day, 95% CI -57 to 19, two studies, low-quality evidence). However, the reduction was significant at medium-term follow-up (MD -28 minutes per day, 95% CI -51 to -5, two studies, low-quality evidence).Computer prompts combined with information resulted in no significant change in sitting time at work at short-term follow-up (MD -14 minutes per day, 95% CI -39 to 10, three studies, low-quality evidence), but at medium-term follow-up they produced a significant reduction (MD -55 minutes per day, 95% CI -96 to -14, one study). Furthermore, computer prompting resulted in a significant decrease in the average number (MD -1.1, 95% CI -1.9 to -0.3, one study) and duration (MD -74 minutes per day, 95% CI -124 to -24, one study) of sitting bouts lasting 30 minutes or more.Computer prompts with instruction to stand reduced sitting at work on average by 14 minutes per day (95% CI 10 to 19, one study) more than computer prompts with instruction to walk at least 100 steps at short-term follow-up.We found no significant reduction in workplace sitting time at medium-term follow-up following mindfulness training (MD -23 minutes per day, 95% CI -63 to 17, one study, low-quality evidence). Similarly a single study reported no change in sitting time at work following provision of highly personalised or contextualised information and less personalised or contextualised information. One study found no significant effects of activity trackers on sitting time at work.Multi-component interventions Combining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low-quality evidence) and on time spent in prolonged sitting bouts (two studies, very low-quality evidence) at short-term follow-up. AUTHORS' CONCLUSIONS At present there is low-quality evidence that the use of sit-stand desks reduce workplace sitting at short-term and medium-term follow-ups. However, there is no evidence on their effects on sitting over longer follow-up periods. Effects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. There is a need for larger cluster-RCTs with longer-term follow-ups to determine the effectiveness of different types of interventions to reduce sitting time at work.
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Affiliation(s)
- Nipun Shrestha
- Victoria UniversityInstitute for Health and Sport (IHES)MelbourneVictoriaAustralia
| | - Katriina T Kukkonen‐Harjula
- South Karelia Social and Health Care District EksoteRehabilitationValto Käkelän katu 3 BLappeenrantaFinland53130
| | - Jos H Verbeek
- Finnish Institute of Occupational HealthCochrane Work Review GroupTYÖTERVEYSLAITOSFinlandFI‐70032
| | - Sharea Ijaz
- Population Health Sciences, Bristol Medical School, University of BristolNIHR CLAHRC West at University Hospitals Bristol NHS Foundation TrustLewins Mead, Whitefriars BuildingBristolUKBS1 2NT
| | - Veerle Hermans
- Vrije Universiteit BrusselFaculty of Psychology & Educational Sciences, Faculty of Medicine & PharmacyPleinlaan 2BrusselsBelgium1050
| | - Zeljko Pedisic
- Victoria UniversityInstitute for Health and Sport (IHES)MelbourneVictoriaAustralia
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23
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Shrestha N, Kukkonen‐Harjula KT, Verbeek JH, Ijaz S, Hermans V, Pedisic Z. Workplace interventions for reducing sitting at work. Cochrane Database Syst Rev 2018; 6:CD010912. [PMID: 29926475 PMCID: PMC6513236 DOI: 10.1002/14651858.cd010912.pub4] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND A large number of people are employed in sedentary occupations. Physical inactivity and excessive sitting at workplaces have been linked to increased risk of cardiovascular disease, obesity, and all-cause mortality. OBJECTIVES To evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, OSH UPDATE, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 9 August 2017. We also screened reference lists of articles and contacted authors to find more studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), cross-over RCTs, cluster-randomised controlled trials (cluster-RCTs), and quasi-RCTs of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies. The primary outcome was time spent sitting at work per day, either self-reported or measured using devices such as an accelerometer-inclinometer and duration and number of sitting bouts lasting 30 minutes or more. We considered energy expenditure, total time spent sitting (including sitting at and outside work), time spent standing at work, work productivity and adverse events as secondary outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. MAIN RESULTS We found 34 studies - including two cross-over RCTs, 17 RCTs, seven cluster-RCTs, and eight controlled before-and-after studies - with a total of 3,397 participants, all from high-income countries. The studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi-component interventions (four studies). One study included both physical workplace changes and information and counselling components. We did not find any studies that specifically investigated the effects of standing meetings or walking meetings on sitting time.Physical workplace changesInterventions using sit-stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short-term follow-up (up to three months) compared to sit-desks (95% confidence interval (CI) -116 to -84, 10 studies, low-quality evidence). The pooled effect of two studies showed sit-stand desks reduced sitting time at medium-term follow-up (3 to 12 months) by an average of 57 minutes per day (95% CI -99 to -15) compared to sit-desks. Total sitting time (including sitting at and outside work) also decreased with sit-stand desks compared to sit-desks (mean difference (MD) -82 minutes/day, 95% CI -124 to -39, two studies) as did the duration of sitting bouts lasting 30 minutes or more (MD -53 minutes/day, 95% CI -79 to -26, two studies, very low-quality evidence).We found no significant difference between the effects of standing desks and sit-stand desks on reducing sitting at work. Active workstations, such as treadmill desks or cycling desks, had unclear or inconsistent effects on sitting time.Workplace policy changesWe found no significant effects for implementing walking strategies on workplace sitting time at short-term (MD -15 minutes per day, 95% CI -50 to 19, low-quality evidence, one study) and medium-term (MD -17 minutes/day, 95% CI -61 to 28, one study) follow-up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI -66 to -15, one study, low-quality evidence) compared to long breaks (two 15-minute breaks per workday) at short-term follow-up.Information and counsellingProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short-term follow-up (MD -19 minutes per day, 95% CI -57 to 19, two studies, low-quality evidence). However, the reduction was significant at medium-term follow-up (MD -28 minutes per day, 95% CI -51 to -5, two studies, low-quality evidence).Computer prompts combined with information resulted in no significant change in sitting time at work at short-term follow-up (MD -10 minutes per day, 95% CI -45 to 24, two studies, low-quality evidence), but at medium-term follow-up they produced a significant reduction (MD -55 minutes per day, 95% CI -96 to -14, one study). Furthermore, computer prompting resulted in a significant decrease in the average number (MD -1.1, 95% CI -1.9 to -0.3, one study) and duration (MD -74 minutes per day, 95% CI -124 to -24, one study) of sitting bouts lasting 30 minutes or more.Computer prompts with instruction to stand reduced sitting at work on average by 14 minutes per day (95% CI 10 to 19, one study) more than computer prompts with instruction to walk at least 100 steps at short-term follow-up.We found no significant reduction in workplace sitting time at medium-term follow-up following mindfulness training (MD -23 minutes per day, 95% CI -63 to 17, one study, low-quality evidence). Similarly a single study reported no change in sitting time at work following provision of highly personalised or contextualised information and less personalised or contextualised information. One study found no significant effects of activity trackers on sitting time at work.Multi-component interventions Combining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low-quality evidence) and on time spent in prolonged sitting bouts (two studies, very low-quality evidence) at short-term follow-up. AUTHORS' CONCLUSIONS At present there is low-quality evidence that the use of sit-stand desks reduce workplace sitting at short-term and medium-term follow-ups. However, there is no evidence on their effects on sitting over longer follow-up periods. Effects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. There is a need for larger cluster-RCTs with longer-term follow-ups to determine the effectiveness of different types of interventions to reduce sitting time at work.
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Affiliation(s)
- Nipun Shrestha
- Victoria UniversityInstitute for Health and Sport (IHES)MelbourneAustralia
| | - Katriina T Kukkonen‐Harjula
- South Karelia Social and Health Care District EksoteRehabilitationValto Käkelän katu 3 BLappeenrantaFinland53130
| | - Jos H Verbeek
- Finnish Institute of Occupational HealthCochrane Work Review GroupTYÖTERVEYSLAITOSFinlandFI‐70032
| | - Sharea Ijaz
- Population Health Sciences, Bristol Medical School, University of BristolNIHR CLAHRC West at University Hospitals Bristol NHS Foundation TrustLewins Mead, Whitefriars BuildingBristolUKBS1 2NT
| | - Veerle Hermans
- Vrije Universiteit BrusselFaculty of Psychology & Educational Sciences, Faculty of Medicine & PharmacyPleinlaan 2BrusselsBelgium1050
| | - Zeljko Pedisic
- Victoria UniversityInstitute for Health and Sport (IHES)MelbourneAustralia
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24
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Rivière F, Aubert S, Omorou AY, Ainsworth BE, Vuillemin A. Taxonomy-based content analysis of sedentary behavior questionnaires: A systematic review. PLoS One 2018; 13:e0193812. [PMID: 29509791 PMCID: PMC5839579 DOI: 10.1371/journal.pone.0193812] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 02/19/2018] [Indexed: 11/18/2022] Open
Abstract
Background Health effects of sedentary behaviors (SB) may vary depending on their characteristics such as type, purpose, duration, and intensity of the behavior. While a growing number of questionnaires assess sedentary behaviors, it is unclear which characteristics of SB are measured. The aim of this review was to examine the content of self-report SB questionnaires. Methods Three databases were searched for sedentary behavior questionnaires published before January 1st, 2016. Based on the inclusion criteria, 82 articles out of 1369 were retrieved for a total of 60 questionnaires. For each questionnaire, the sedentary behavior characteristics identified were reported and analyzed. Results Most of the questionnaires assessed the time (n = 60), posture (n = 54), purpose (n = 46) and the types (n = 45) of SB performed. Fewer questionnaires assessed the environment (n = 20) social context (n = 11), status (n = 2), and associated behaviors (n = 2) related to sedentary behaviors. All the questionnaires except two assessed time spent in SB with 17 assessing frequency and 6 assessing breaks in SB. The most frequent characteristics identified in the questionnaires were the categories of sitting (90%), a day (95%), watching television (65%) and using a computer (55%). Many characteristics of SB were not measured. Conclusions By knowing the breadth of SB included in questionnaires, this review provides support to shape the design of new questionnaires designed to reduce the gaps in measuring sedentary behaviors.
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Affiliation(s)
- Fabien Rivière
- EA 4360 APEMAC, University of Lorraine, Paris Descartes University, Nancy, France
| | - Salomé Aubert
- Healthy Active Living and Obesity Research, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Abdou Yacoubou Omorou
- EA 4360 APEMAC, University of Lorraine, Paris Descartes University, Nancy, France
- INSERM, CIC-1433 Clinical Epidemiology, CHRU Nancy, France
| | - Barbara E. Ainsworth
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America
| | - Anne Vuillemin
- EA 4360 APEMAC, University of Lorraine, Paris Descartes University, Nancy, France
- Université Côte d’Azur, LAMHESS, Nice, France
- * E-mail:
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25
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Smith P, Ma H, Glazier RH, Gilbert-Ouimet M, Mustard C. The Relationship Between Occupational Standing and Sitting and Incident Heart Disease Over a 12-Year Period in Ontario, Canada. Am J Epidemiol 2018; 187:27-33. [PMID: 29020132 PMCID: PMC5860480 DOI: 10.1093/aje/kwx298] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 08/03/2017] [Indexed: 01/07/2023] Open
Abstract
While a growing body of research is examining the impacts of prolonged occupational sitting on cardiovascular and other health risk factors, relatively little work has examined the effects of occupational standing. The objectives of this paper were to examine the relationship between occupations that require predominantly sitting and those that require predominantly standing and incident heart disease. A prospective cohort study combining responses to a population health survey with administrative health-care records, linked at the individual level, was conducted in Ontario, Canada. The sample included 7,320 employed labor-market participants (50% male) working 15 hours a week or more and free of heart disease at baseline. Incident heart disease was assessed using administrative records over an approximately 12-year follow-up period (2003-2015). Models adjusted for a wide range of potential confounding factors. Occupations involving predominantly standing were associated with an approximately 2-fold risk of heart disease compared with occupations involving predominantly sitting. This association was robust to adjustment for other health, sociodemographic, and work variables. Cardiovascular risk associated with occupations that involve combinations of sitting, standing, and walking differed for men and women, with these occupations associated with lower cardiovascular risk estimates among men but elevated risk estimates among women.
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Affiliation(s)
- Peter Smith
- Institute for Work and Health, Toronto, Ontario, Canada
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Huiting Ma
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Richard H Glazier
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto and St. Michael’s Hospital, Toronto, Ontario, Canada
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Mahée Gilbert-Ouimet
- Institute for Work and Health, Toronto, Ontario, Canada
- Centre de Recherche du CHU de Québec, Hôpital du Saint-Sacrement, Quebec, Canada
| | - Cameron Mustard
- Institute for Work and Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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26
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Sundstrup E, Hansen ÅM, Mortensen EL, Poulsen OM, Clausen T, Rugulies R, Møller A, Andersen LL. Retrospectively assessed physical work environment during working life and risk of sickness absence and labour market exit among older workers. Occup Environ Med 2017; 75:114-123. [PMID: 28819019 PMCID: PMC5800344 DOI: 10.1136/oemed-2016-104279] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 07/07/2017] [Accepted: 07/27/2017] [Indexed: 12/13/2022]
Abstract
Objective To determine the prospective association between retrospectively assessed physical work environment during working life and prospectively assessed sickness absence and labour market exit among older workers. Methods Using Cox regression analyses we estimated the 4-year to 6-year prospective risk of register-based long-term sickness absence (LTSA), disability pension, early retirement and unemployment from exposure to different physical work environmental factors during working life among 5076 older workers (age 49–63 at baseline) from the Copenhagen Aging and Midlife Biobank cohort. Results Very hard physical work throughout working life was a risk factor for LTSA (HR 1.66,95% CI 1.32 to 2.07), disability pension (HR 2.21,95% CI 1.04 to 4.72) and early retirement (HR 1.57,95% CI 1.13 to 2.17). Both short-term (<10 years) and long-term (≥20 years) exposures to lifting or carrying of heavy burdens predicted the risk of LTSA (HRs 1.49–1.56) and disability pension (HRs 2.26–3.29). In contrast, exposure to dust was associated with LTSA and disability pension only following 20 or more exposure years. Conclusions Retrospectively assessed hard physical work during working life and exposure to several factors in the physical work environment, especially heavy lifting, were important for labour market exit and sickness absence. This study underscores the importance of reducing physical work exposures throughout the working life course for preventing sickness absence and premature exit from the labour market.
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Affiliation(s)
- Emil Sundstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Åse Marie Hansen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | | | - Thomas Clausen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Anne Møller
- Department of Occupational Medicine, Holbæk Hospital, Copenhagen, Denmark.,Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, Copenhagen, Denmark
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27
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Gupta N, Christiansen CS, Hanisch C, Bay H, Burr H, Holtermann A. Is questionnaire-based sitting time inaccurate and can it be improved? A cross-sectional investigation using accelerometer-based sitting time. BMJ Open 2017; 7:e013251. [PMID: 28093433 PMCID: PMC5253534 DOI: 10.1136/bmjopen-2016-013251] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To investigate the differences between a questionnaire-based and accelerometer-based sitting time, and develop a model for improving the accuracy of questionnaire-based sitting time for predicting accelerometer-based sitting time. METHODS 183 workers in a cross-sectional study reported sitting time per day using a single question during the measurement period, and wore 2 Actigraph GT3X+ accelerometers on the thigh and trunk for 1-4 working days to determine their actual sitting time per day using the validated Acti4 software. Least squares regression models were fitted with questionnaire-based siting time and other self-reported predictors to predict accelerometer-based sitting time. RESULTS Questionnaire-based and accelerometer-based average sitting times were ≈272 and ≈476 min/day, respectively. A low Pearson correlation (r=0.32), high mean bias (204.1 min) and wide limits of agreement (549.8 to -139.7 min) between questionnaire-based and accelerometer-based sitting time were found. The prediction model based on questionnaire-based sitting explained 10% of the variance in accelerometer-based sitting time. Inclusion of 9 self-reported predictors in the model increased the explained variance to 41%, with 10% optimism using a resampling bootstrap validation. Based on a split validation analysis, the developed prediction model on ≈75% of the workers (n=132) reduced the mean and the SD of the difference between questionnaire-based and accelerometer-based sitting time by 64% and 42%, respectively, in the remaining 25% of the workers. CONCLUSIONS This study indicates that questionnaire-based sitting time has low validity and that a prediction model can be one solution to materially improve the precision of questionnaire-based sitting time.
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Affiliation(s)
- Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Christiana Hanisch
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr, Berlin, Germany
| | - Hans Bay
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Hermann Burr
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr, Berlin, Germany
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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28
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Hallman DM, Gupta N, Heiden M, Mathiassen SE, Korshøj M, Jørgensen MB, Holtermann A. Is prolonged sitting at work associated with the time course of neck-shoulder pain? A prospective study in Danish blue-collar workers. BMJ Open 2016; 6:e012689. [PMID: 28186937 PMCID: PMC5128958 DOI: 10.1136/bmjopen-2016-012689] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/30/2016] [Accepted: 10/19/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study aimed to determine the extent to which objectively measured sitting time at work is associated with the course of neck-shoulder pain across 1 year in blue-collar workers. METHODS Data were analysed from 625 blue-collar workers in the Danish PHysical ACTivity cohort with Objective measurements (DPHACTO) cohort study (2012-2013). Objective data on sitting time were collected at baseline using accelerometry. Self-reported pain intensity (numeric rating scale 0-10) in the neck-shoulder region was registered for 1 year using repeated text messages (14 in total). Linear mixed models were used to determine the relationship between per cent time in sitting at work and trajectories of neck-shoulder pain, with and without adjustment for demographic, occupational and lifestyle factors, and baseline pain intensity. RESULTS More sitting time at work was associated with a faster decline in pain intensity over 12 months, as indicated by a statistically significant effect of sitting on pain trajectories in the crude (p=0.020) and fully adjusted models (p=0.027). CONCLUSIONS In blue-collar workers, more sitting time at work was associated with a favourable development of pain intensity over time. The relationship between sitting at work and pain needs further investigation before explicit recommendations and guidelines on sedentary behaviour among blue-collar workers can be developed.
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Affiliation(s)
- David M Hallman
- Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Marina Heiden
- Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Svend Erik Mathiassen
- Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Thomsen T, Aadahl M, Beyer N, Hetland ML, Løppenthin K, Midtgaard J, Christensen R, Esbensen BA. Motivational counselling and SMS-reminders for reduction of daily sitting time in patients with rheumatoid arthritis: a descriptive randomised controlled feasibility study. BMC Musculoskelet Disord 2016; 17:434. [PMID: 27756265 PMCID: PMC5070122 DOI: 10.1186/s12891-016-1266-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 09/24/2016] [Indexed: 12/12/2022] Open
Abstract
Background Patients with rheumatoid arthritis (RA) spend a high proportion of their waking time in sedentary behaviour (SB) and have an increased risk of cardiovascular disease. Reduction of SB and increase in light intensity physical activity has been suggested as a means of improvement of health in patients with mobility problems. Short-term intervention studies have demonstrated that SB can be reduced by behavioural interventions in sedentary populations. To evaluate descriptively the feasibility of recruitment, randomisation, outcome assessments, retention and the acceptability of an individually tailored, theory-based behavioural intervention targeting reduction in daily sitting time in patients with RA. Methods A randomised, controlled trial with two parallel groups. RA patients >18 years of age and Health Assessment Questionnaire (HAQ) score < 2.5 were consecutively invited and screened for daily leisure time sitting > 4 h. The 16-week intervention included 1) three individual motivational counselling sessions and 2) individual text message reminders aimed at reducing daily sitting time. The control group was encouraged to maintain their usual lifestyles. Outcomes were assessed at baseline and after the 16 week intervention. Daily sitting time was measured using an ActivPAL3TM activity monitor. The study was not powered to show superiority; rather the objective was to focus on acceptability among patients and clinical health professionals. Results In total, 107 patients were invited and screened before 20 met eligibility criteria and consented; reasons for declining study participation were mostly flares, lack of time and co-morbidities. One patient from the control group dropped out before end of intervention (due to a RA flare). Intervention participants completed all counselling sessions. All procedures regarding implementation of the trial protocol were feasible. The daily sitting time was reduced on average by 0.30 h in the intervention group unlike the control group that tended to increase it by 0.15 h after 16 weeks. Conclusions This study shows that an individually tailored behavioural intervention targeting reduction of SB was feasible and acceptable to patients with RA. Trial registration The Danish Data Protection Agency (ref.nb. 711-1-08 - 20 March 2011), the Ethics Committee of the Capital Region of Denmark (ref.nb. H-2-2012-112- 17 October 2012), clinicaltrials.gov (NCT01969604 - October 17 2013, retrospectively registered).
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Affiliation(s)
- T Thomsen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark. .,The DANBIO registry, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark.
| | - M Aadahl
- Research Centre for Prevention and Health, Rigshospitalet, The Capital Region of Denmark, Glostrup, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - N Beyer
- Musculoskeletal Rehabilitation Research Unit, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M L Hetland
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,The DANBIO registry, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark
| | - K Løppenthin
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark
| | - J Midtgaard
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,University Hospitals Centre for Health Research, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - R Christensen
- Musculoskeletal Statistics Unit, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - B A Esbensen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Ndr. Ringvej 57, DK-2600, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Sundstrup E, Hansen ÅM, Mortensen EL, Poulsen OM, Clausen T, Rugulies R, Møller A, Andersen LL. Influence of physical and psychosocial work environment throughout life and physical and cognitive capacity in midlife on labor market attachment among older workers: study protocol for a prospective cohort study. BMC Public Health 2016; 16:629. [PMID: 27449417 PMCID: PMC4957894 DOI: 10.1186/s12889-016-3290-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 07/02/2016] [Indexed: 11/12/2022] Open
Abstract
Background As average life span increases, elderly will account for an increasing proportion of the total population in most parts of the world. Thus, initiatives to retain older workers at the labor market are becoming increasingly important. This study will investigate the influence of physical and psychosocial work environment throughout working life and physical and cognitive capacity in midlife on labor market attachment among older workers. Methods/Design Approximately 5000 participants (aged 50–60 years) from the Copenhagen Aging and Midlife Biobank (CAMB) will be followed prospectively in a national register (DREAM), containing information on a week-to-week basis about social transfer payments for about 5 million Danish residents. Using Cox regression, we will model the risk of long-term sickness absence, disability pension, early retirement and unemployment within a 4 to 6 year period from the baseline measurement as a function of the following predictors: 1) physical work demands throughout working life, 2) psychosocial working conditions throughout working life, 3) physical capacity in midlife, 4) cognitive capacity in midlife. Estimates will be adjusted for age, sex, lifestyle, socioeconomic position, chronic disease and long-term sickness absence prior to baseline. Discussion The project will generate new knowledge on risk factors for loss of labor market attachment. The results will potentially contribute in identifying factors that could be targeted in future interventions for maintaining a longer and healthier working life among older workers.
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Affiliation(s)
- Emil Sundstrup
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.
| | - Åse Marie Hansen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Otto Melchior Poulsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Thomas Clausen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Anne Møller
- Department of Occupational Medicine, Holbæk Hospital, Holbæk, Denmark.,The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, Aalborg, Denmark
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Influencing Factors on the Overestimation of Self-Reported Physical Activity: A Cross-Sectional Analysis of Low Back Pain Patients and Healthy Controls. BIOMED RESEARCH INTERNATIONAL 2016; 2016:1497213. [PMID: 27298820 PMCID: PMC4889825 DOI: 10.1155/2016/1497213] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/15/2016] [Accepted: 04/26/2016] [Indexed: 12/17/2022]
Abstract
Introduction. The aim of the present study was to determine the closeness of agreement between a self-reported and an objective measure of physical activity in low back pain patients and healthy controls. Beyond, influencing factors on overestimation were identified. Methods. 27 low back pain patients and 53 healthy controls wore an accelerometer (objective measure) for seven consecutive days and answered a questionnaire on physical activity (self-report) over the same period of time. Differences between self-reported and objective data were tested by Wilcoxon test. Bland-Altman analysis was conducted for describing the closeness of agreement. Linear regression models were calculated to identify the influence of age, sex, and body mass index on the overestimation by self-report. Results. Participants overestimated self-reported moderate activity in average by 42 min/day (p = 0.003) and vigorous activity by 39 min/day (p < 0.001). Self-reported sedentary time was underestimated by 122 min/day (p < 0.001). No individual-related variables influenced the overestimation of physical activity. Low back pain patients were more likely to underestimate sedentary time compared to healthy controls. Discussion. In rehabilitation and health promotion, the application-oriented measurement of physical activity remains a challenge. The present results contradict other studies that had identified an influence of age, sex, and body mass index on the overestimation of physical activity.
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Shrestha N, Kukkonen‐Harjula KT, Verbeek JH, Ijaz S, Hermans V, Bhaumik S. Workplace interventions for reducing sitting at work. Cochrane Database Syst Rev 2016; 3:CD010912. [PMID: 26984326 PMCID: PMC6486221 DOI: 10.1002/14651858.cd010912.pub3] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Office work has changed considerably over the previous couple of decades and has become sedentary in nature. Physical inactivity at workplaces and particularly increased sitting has been linked to increase in cardiovascular disease, obesity and overall mortality. OBJECTIVES To evaluate the effects of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, OSH UPDATE, PsycINFO, Clinical trials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 2 June, 2015. We also screened reference lists of articles and contacted authors to find more studies to include. SELECTION CRITERIA We included randomised controlled trials (RCTs), cluster-randomised controlled trials (cRCTs), and quasi-randomised controlled trials of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies (CBAs) with a concurrent control group. The primary outcome was time spent sitting at work per day, either self-reported or objectively measured by means of an accelerometer-inclinometer. We considered energy expenditure, duration and number of sitting episodes lasting 30 minutes or more, work productivity and adverse events as secondary outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. MAIN RESULTS We included 20 studies, two cross-over RCTs, 11 RCTs, three cRCTs and four CBAs, with a total of 2180 participants from high income nations. The studies evaluated physical workplace changes (nine studies), policy changes (two studies), information and counselling (seven studies) and interventions from multiple categories (two studies). One study had both physical workplace changes and information and counselling components. We did not find any studies that had investigated the effect of periodic breaks or standing or walking meetings. Physical workplace changesA sit-stand desk alone compared to no intervention reduced sitting time at work per workday with between thirty minutes to two hours at short term (up to three months) follow-up (six studies, 218 participants, very low quality evidence). In two studies, sit-stand desks with additional counselling reduced sitting time at work in the same range at short-term follow-up (61 participants, very low quality evidence). One study found a reduction at six months' follow-up of -56 minutes (95% CI -101 to -12, very low quality evidence) compared to no intervention. Also total sitting time at work and outside work decreased with sit-stand desks compared to no intervention (MD -78 minutes, 95% CI -125 to -31, one study) as did the duration of sitting episodes lasting 30 minutes or more (MD -52 minutes, 95% CI -79 to -26, two studies). This is considerably less than the two to four hours recommended by experts. Sit-stand desks did not have a considerable effect on work performance, musculoskeletal symptoms or sick leave. It remains unclear if standing can repair the harms of sitting because there is hardly any extra energy expenditure.The effects of active workstations were inconsistent. Treadmill desks combined with counselling reduced sitting time at work (MD -29 minutes, 95% CI -55 to -2, one study) compared to no intervention at 12 weeks' follow-up. Pedalling workstations combined with information did not reduce inactive sitting at work considerably (MD -12 minutes, 95% CI -24 to 1, one study) compared to information alone at 16 weeks' follow-up. The quality of evidence was low for active workstations. Policy changesTwo studies with 443 participants provided low quality evidence that walking strategies did not have a considerable effect on workplace sitting time at 10 weeks' (MD -16 minutes, 95% CI -54 to 23) or 21 weeks' (MD -17 minutes, 95% CI -58 to 25) follow-up respectively. Information and counsellingCounselling reduced sitting time at work (MD -28 minutes, 95% CI -52 to -5, two studies, low quality evidence) at medium term (three months to 12 months) follow-up. Mindfulness training did not considerably reduce workplace sitting time (MD -2 minutes, 95% CI -22 to 18) at six months' follow-up and at 12 months' follow-up (MD -16 minutes, 95% CI -45 to 12, one study, low quality evidence). There was no considerable increase in work engagement with counselling.There was an inconsistent effect of computer prompting on sitting time at work. One study found no considerable effect on sitting at work (MD -17 minutes, 95% CI -48 to 14, low quality evidence) at 10 days' follow-up, while another study reported a significant reduction in sitting at work (MD -55 minutes, 95% CI -96 to -14, low quality evidence) at 13 weeks' follow-up. Computer prompts to stand reduced sitting at work by 14 minutes more (95% CI 10 to 19, one study) compared to computer prompts to step at six days' follow-up. Computer prompts did not change the number of sitting episodes that last 30 minutes or longer. Interventions from multiple categories Interventions combining multiple categories had an inconsistent effect on sitting time at work, with a reduction in sitting time at 12 weeks' (25 participants, very low quality evidence) and six months' (294 participants, low quality evidence) follow-up in two studies but no considerable effect at 12 months' follow-up in one study (MD -47.98, 95% CI -103 to 7, 294 participants, low quality evidence). AUTHORS' CONCLUSIONS At present there is very low to low quality evidence that sit-stand desks may decrease workplace sitting between thirty minutes to two hours per day without having adverse effects at the short or medium term. There is no evidence on the effects in the long term. There were no considerable or inconsistent effects of other interventions such as changing work organisation or information and counselling. There is a need for cluster-randomised trials with a sufficient sample size and long term follow-up to determine the effectiveness of different types of interventions to reduce objectively measured sitting time at work.
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Affiliation(s)
- Nipun Shrestha
- Health Research and Social Development ForumThapathaliKathmanduNepal24133
| | | | - Jos H Verbeek
- Finnish Institute of Occupational HealthCochrane Work Review GroupPO Box 310KuopioFinland70101
| | - Sharea Ijaz
- Finnish Institute of Occupational HealthCochrane Work Review GroupPO Box 310KuopioFinland70101
| | - Veerle Hermans
- Vrije Universiteit BrusselFaculty of Psychology & Educational Sciences, Faculty of Medicine & PharmacyPleinlaan 2BrusselsBelgium1050
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Objectively Measured Total and Occupational Sedentary Time in Three Work Settings. PLoS One 2016; 11:e0149951. [PMID: 26937959 PMCID: PMC4777435 DOI: 10.1371/journal.pone.0149951] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 02/08/2016] [Indexed: 11/19/2022] Open
Abstract
Background Sedentary behaviour increases the risk for morbidity. Our primary aim is to determine the proportion and factors associated with objectively measured total and occupational sedentary time in three work settings. Secondary aim is to study the proportion of physical activity and prolonged sedentary bouts. Methods Data were obtained using ActiGraph accelerometers from employees of: 1) a financial service provider (n = 49 men, 31 women), 2) two research institutes (n = 30 men, 57 women), and 3) a construction company (n = 38 men). Total (over the whole day) and occupational sedentary time, physical activity and prolonged sedentary bouts (lasting ≥30 minutes) were calculated by work setting. Linear regression analyses were performed to examine general, health and work-related factors associated with sedentary time. Results The employees of the financial service provider and the research institutes spent 76–80% of their occupational time in sedentary behaviour, 18–20% in light intensity physical activity and 3–5% in moderate-to-vigorous intensity physical activity. Occupational time in prolonged sedentary bouts was 27–30%. Total time was less sedentary (64–70%), and had more light intensity physical activity (26–33%). The employees of the construction company spent 44% of their occupational time in sedentary behaviour, 49% in light, and 7% in moderate intensity physical activity, and spent 7% in sedentary bouts. Total time spent in sedentary behavior was 56%, 40% in light, and 4% in moderate intensity physical behaviour, and 12% in sedentary bouts. For women, low to intermediate education was the only factor that was negatively associated with occupational sedentary time. Conclusions Sedentary behaviour is high among white-collar employees, especially in highly educated women. A relatively small proportion of sedentary time was accrued in sedentary bouts. It is recommended that worksite health promotion efforts should focus on reducing sedentary behaviour through improving light intensity physical activity.
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Picavet HSJ, Pas LW, van Oostrom SH, van der Ploeg HP, Verschuren WMM, Proper KI. The Relation between Occupational Sitting and Mental, Cardiometabolic, and Musculoskeletal Health over a Period of 15 Years--The Doetinchem Cohort Study. PLoS One 2016; 11:e0146639. [PMID: 26752695 PMCID: PMC4713474 DOI: 10.1371/journal.pone.0146639] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 12/21/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Sedentary behaviors are reported to impose health risks. Since occupational exposure is a major proportion of total sedentary time, we studied the association between occupational sitting and a number of health problems. METHODS From the longitudinal Doetinchem Cohort Study, we selected those working at baseline with complete data (n = 1,509). Participants were examined four times at 5 year-intervals between 1993 and 2012. We characterized occupational sitting as follows: 1) stable sitters and stable non sitters over a 15-year period, based on job characteristics and (2) having a job with a low, moderate or high amount of sitting, based on tertiles of self-reported number of hours per week of occupational sitting, measured at wave 5. Linear and logistic regression models were used. Outcomes were self-reported mental health, low-back or upper extremity pain, and objectively measured cardiometabolic health (overweight, hypertension, hypercholesterolemia). RESULTS Compared to stable non sitters, a lower risk of chronic upper extremity pain was observed for stable sitters (OR 0.75, 95% CI: 0.57; 1.00) as well as for those in the two upper tertiles for hours of occupational sitting (>4 hr/wk) (OR 0.65; 95%CI 0.50-0.86). For the other health outcomes studied, no significant associations were found with occupational sitting. CONCLUSION Our findings do not support the hypothesis that occupational sitting is associated with health problems. The finding that occupational sitting is associated with less upper extremity pain might be due to the association of occupational sitting with less physical load.
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Affiliation(s)
- H. Susan J. Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - L. Willemijn Pas
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Sandra H. van Oostrom
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Hidde P. van der Ploeg
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - W. M. Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Karin I. Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- * E-mail:
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Berglind D, Willmer M, Tynelius P, Ghaderi A, Näslund E, Rasmussen F. Accelerometer-Measured Versus Self-Reported Physical Activity Levels and Sedentary Behavior in Women Before and 9 Months After Roux-en-Y Gastric Bypass. Obes Surg 2015; 26:1463-70. [DOI: 10.1007/s11695-015-1971-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Prolonged Sitting is Associated with Attenuated Heart Rate Variability during Sleep in Blue-Collar Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:14811-27. [PMID: 26610534 PMCID: PMC4661681 DOI: 10.3390/ijerph121114811] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/02/2015] [Accepted: 11/17/2015] [Indexed: 11/17/2022]
Abstract
Prolonged sitting is associated with increased risk for cardiovascular diseases and mortality. However, research into the physiological determinants underlying this relationship is still in its infancy. The aim of the study was to determine the extent to which occupational and leisure-time sitting are associated with nocturnal heart rate variability (HRV) in blue-collar workers. The study included 138 blue-collar workers (mean age 45.5 (SD 9.4) years). Sitting-time was measured objectively for four days using tri-axial accelerometers (Actigraph GT3X+) worn on the thigh and trunk. During the same period, a heart rate monitor (Actiheart) was used to sample R-R intervals from the electrocardiogram. Time and frequency domain indices of HRV were only derived during nighttime sleep, and used as markers of cardiac autonomic modulation. Regression analyses with multiple adjustments (age, gender, body mass index, smoking, job-seniority, physical work-load, influence at work, and moderate-to-vigorous physical activity) were used to investigate the association between sitting time and nocturnal HRV. We found that occupational sitting-time was negatively associated (p < 0.05) with time and frequency domain HRV indices. Sitting-time explained up to 6% of the variance in HRV, independent of the covariates. Leisure-time sitting was not significantly associated with any HRV indices (p > 0.05). In conclusion, objectively measured occupational sitting-time was associated with reduced nocturnal HRV in blue-collar workers. This indicates an attenuated cardiac autonomic regulation with increasing sitting-time at work regardless of moderate-to-vigorous physical activity. The implications of this association for cardiovascular disease risk warrant further investigation via long-term prospective studies and intervention studies.
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Berglind D, Willmer M, Eriksson U, Thorell A, Sundbom M, Uddén J, Raoof M, Hedberg J, Tynelius P, Näslund E, Rasmussen F. Longitudinal assessment of physical activity in women undergoing Roux-en-Y gastric bypass. Obes Surg 2015; 25:119-25. [PMID: 24934315 DOI: 10.1007/s11695-014-1331-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Patients undergoing bariatric surgery do not seem to increase objectively measured physical activity (PA) after surgery, despite substantial weight loss. The aims of the present study were (i) to objectively characterize 3 months pre-surgery to 9 months postsurgery PA and sedentary behavior changes in women undergoing Roux-en-Y gastric bypass (RYGB) using tri-axial accelerometers and (ii) to examine associations between pre-surgery versus postsurgery PA and sedentary behavior with anthropometric measures taken in home environment. METHODS Fifty-six women, with an average pre-surgery body mass index (BMI) of 37.6 (SD 2.6) and of age 39.5 years (SD 5.7), were recruited at five Swedish hospitals. PA was measured for 1 week by the Actigraph GT3X+ accelerometer, and anthropometric measures were taken at home visits 3 months pre-surgery and 9 months postsurgery, thus limiting seasonal effects. RESULTS Average BMI loss, 9 months postsurgery, was 11.7 (SD 2.7) BMI units. There were no significant pre- to postsurgery differences in PA or sedentary behavior. However, pre-surgery PA showed negative association with PA change and positive association with postsurgery PA. Adjustments for pre-surgery BMI had no impact on these associations. CONCLUSIONS No significant differences were observed in objectively measured changes in PA or time spent sedentary from 3 months pre-surgery to 9 months postsurgery among women undergoing RYGB. However, women with higher pre-surgery PA decreased their PA postsurgery while women with lower pre-surgery PA increased their PA.
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Affiliation(s)
- Daniel Berglind
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, Widerströmska Huset, 171 77, Stockholm, Sweden
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Hallman DM, Mathiassen SE, Gupta N, Korshøj M, Holtermann A. Differences between work and leisure in temporal patterns of objectively measured physical activity among blue-collar workers. BMC Public Health 2015; 15:976. [PMID: 26415931 PMCID: PMC4587719 DOI: 10.1186/s12889-015-2339-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 09/23/2015] [Indexed: 12/03/2022] Open
Abstract
Background Leisure time physical activity (LTPA) is generally associated with favorable cardiovascular health outcomes, while occupational physical activity (OPA) shows less clear, or even opposite, cardiovascular effects. This apparent paradox is not sufficiently understood, but differences in temporal patterns of OPA and LTPA have been suggested as one explanation. Our aim was to investigate the extent to which work and leisure (non-occupational time) differ in temporal activity patterns among blue-collar workers, and to assess the modification of these patterns by age and gender. Methods This study was conducted on a cross-sectional sample of male (n = 108) and female (n = 83) blue-collar workers, aged between 21 and 65 years. Physical activity and sedentary behavior were assessed using accelerometers (Actigraph GT3X+) worn on the thigh and trunk for four consecutive days. Temporal patterns of OPA and LTPA were retrieved using Exposure Variation Analysis (EVA), and expressed in terms of percentage of work and leisure time spent in uninterrupted periods of different durations (<1 min, 1–5 min, 5–10 min, 10–30 min, 30–60 min and > 60 min) of sitting, standing, and walking. Repeated measures ANOVA and linear regression analyses were used to test a) possible differences between OPA and LTPA in selected EVA derivatives, and b) the modification of these differences by age and gender. Results OPA showed a larger percentage time walking in brief (<5 min) periods [mean (SD): 33.4 % (12.2)], and less time in prolonged (>30 min) sitting [7.0 % (9.3)] than LTPA [walking 15.4 % (5.0); sitting 31.9 % (15.3)], even after adjustment for the difference between work and leisure in total time spent in each activity type. These marked differences in the temporal pattern of OPA and LTPA were modified by gender, but not age. Conclusion We found that the temporal patterns of OPA and LTPA among blue-collar workers were markedly different even after adjustment for total physical activity time, and that this difference was modified by gender. We recommend using EVA derivatives in future studies striving to disentangle the apparent paradoxical cardiovascular effect of physical activity at work and during leisure.
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Affiliation(s)
- David M Hallman
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Kungsbäcksvägen 47, SE 801 76, Gävle, Sweden.
| | - Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Kungsbäcksvägen 47, SE 801 76, Gävle, Sweden.
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.
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Excessive sitting at work and at home: Correlates of occupational sitting and TV viewing time in working adults. BMC Public Health 2015; 15:899. [PMID: 26374514 PMCID: PMC4571074 DOI: 10.1186/s12889-015-2243-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 09/07/2015] [Indexed: 11/30/2022] Open
Abstract
Background Recent evidence links sedentary behaviour (or too much sitting) with poorer health outcomes; many adults accumulate the majority of their daily sitting time through occupational sitting and TV viewing. To further the development and targeting of evidence-based strategies there is a need for identification of the factors associated with higher levels of these behaviours. This study examined socio-demographic and health-related correlates of occupational sitting and of combined high levels of occupational sitting/TV viewing time amongst working adults. Methods Participants were attendees of the third wave (2011/12) of the Australian Diabetes, Obesity and Lifestyle (AusDiab) study who worked full-time (≥35 h/week; n = 1,235; 38 % women; mean ± SD age 53 ± 7 years). Logistic and multinomial logistic regression analyses were conducted (separately for women and men) to assess cross-sectional associations of self-reported occupational sitting time (categorised as high/low based on the median) and also the combination of occupational sitting time/TV viewing time (high/low for each outcome), with a number of potential socio-demographic and health-related correlates. Results Higher levels of occupational sitting (>6 h/day) were associated with higher household income for both genders. Lower levels of occupational sitting were associated with being older (women only); and, for men only, having a blue collar occupation, having a technical/vocational educational attainment, and undertaking more leisure-time physical activity (LTPA). Attributes associated with high levels of both occupational sitting and TV viewing time included white collar occupation (men only), lower levels of LTPA (both genders), higher BMI (men), and higher energy consumption (women). Conclusions Higher household income (both genders) and professional/managerial occupations (men only) were correlates of high occupational sitting time, relative to low occupational sitting time, while health-related factors (lower LTPA, higher BMI – men, and higher energy consumption – women) were associated with high levels of both occupational sitting and TV viewing time, relative to low occupational sitting and low TV viewing time. These findings suggest possible high-risk groups that may benefit from targeted interventions. Further research is needed on potentially modifiable environmental and social correlates of occupational sitting time, in order to inform workplace initiatives.
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van der Ploeg HP, Møller SV, Hannerz H, van der Beek AJ, Holtermann A. Temporal changes in occupational sitting time in the Danish workforce and associations with all-cause mortality: results from the Danish work environment cohort study. Int J Behav Nutr Phys Act 2015; 12:71. [PMID: 26031453 PMCID: PMC4453049 DOI: 10.1186/s12966-015-0233-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 05/22/2015] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Prolonged sitting has been negatively associated with a range of non-communicably diseases. However, the role of occupational sitting is less clear, and little is known on the changes of occupational sitting in a working population over time. The present study aimed to determine 1) temporal changes in occupational sitting time between 1990 and 2010 in the Danish workforce; 2) the association and possible dose-response relationship between occupational sitting time and all-cause mortality. METHODS This study analysed data from the Danish Work Environment Cohort Study (DWECS), which is a cohort study of the Danish working population conducted in five yearly intervals between 1990 and 2010. Occupational sitting time is self-reported in the DWECS. To determine the association with all-cause mortality, the DWECS was linked to the Danish Register of Causes of Death via the Central Person Register. RESULTS Between 1990 and 2010 the proportion of the Danish workforce who sat for at least three quarters of their work time gradually increased from 33.1 to 39.1%. All-cause mortality analyses were performed with 149,773 person-years of observation and an average follow-up of 12.61 years, during which 533 deaths were registered. None of the presented analyses found a statistically significant association between occupational sitting time and all-cause mortality. The hazard ratio for all-cause mortality was 0.97 (95% CI: 0.79; 1.18) when ≥24 hr/wk occupational sitting time was compared to <24 hr/wk for the 1990-2005 waves. CONCLUSIONS Occupational sitting time increased by 18% in the Danish workforce, which seemed to be limited to people with high socio-economic status. If this increase is accompanied by increases in total sitting time, this development has serious public health implications, given the detrimental associations between total sitting time and mortality. The current study was inconclusive on the specific role that occupational sitting might play in the increased all-cause mortality risk associated with the total volume of sitting.
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Affiliation(s)
- Hidde P van der Ploeg
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands.
| | | | - Harald Hannerz
- National Research Centre for the Working Environment, Amsterdam, Denmark.
| | - Allard J van der Beek
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands.
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Amsterdam, Denmark.
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41
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Donath L, Faude O, Schefer Y, Roth R, Zahner L. Repetitive daily point of choice prompts and occupational sit-stand transfers, concentration and neuromuscular performance in office workers: an RCT. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:4340-53. [PMID: 25903058 PMCID: PMC4410251 DOI: 10.3390/ijerph120404340] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 03/31/2015] [Accepted: 03/31/2015] [Indexed: 12/13/2022]
Abstract
Objective: Prolonged office sitting time adversely affects neuromuscular and cardiovascular health parameters. As a consequence, the present study investigated the effects of prompting the use of height-adjustable working desk (HAWD) on occupational sitting and standing time, neuromuscular outcomes and concentration in office workers. Methods: A single-blinded randomized controlled trial (RCT) with parallel group design was conducted. Thirty-eight office workers were supplied with HAWDs and randomly assigned (Strata: physical activity (PA), BMI, gender, workload) to a prompt (INT) or non-prompt (CON) group. INT received three daily screen-based prompts within 12 weeks. CON was only instructed once concerning the benefits of using HAWDs prior to the start of the study. Sitting and standing times were objectively assessed as primary outcomes for one entire working week using the ActiGraph wGT3X-BT at baseline (pre), after 6 (mid) and 12 weeks (post). Concentration (d2-test), postural sway during upright stance (under single, dual and triple task) and lower limb strength endurance (heel-rise) were collected as secondary outcomes. Results: With large but not statistically significant within group effects from pre to post, INT increased weekly standing time at work by 9% (p = 0.22, d = 0.8) representing an increase from 7.2 h (4.8) to 9.7 (6.6) h (p = 0.07). Concentration and neuromuscular performance did not change from pre to post testing (0.23 < p < 0.95; 0.001 < ηp² < 0.05). Conclusion: Low-frequent and low cost screen-based point of choice prompts (3 per day within 12 weeks) already result in notable increases of occupational standing time of approx. daily 30 min. These stimuli, however, did not relevantly affect neuromuscular outcomes.
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Affiliation(s)
- Lars Donath
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Yannick Schefer
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Ralf Roth
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
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Gupta N, Christiansen CS, Hallman DM, Korshøj M, Carneiro IG, Holtermann A. Is objectively measured sitting time associated with low back pain? A cross-sectional investigation in the NOMAD study. PLoS One 2015; 10:e0121159. [PMID: 25806808 PMCID: PMC4373888 DOI: 10.1371/journal.pone.0121159] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 02/06/2015] [Indexed: 11/19/2022] Open
Abstract
Background Studies on the association between sitting time and low back pain (LBP) have found contrasting results. This may be due to the lack of objectively measured sitting time or because socioeconomic confounders were not considered in the analysis. Objectives To investigate the association between objectively measured sitting time (daily total, and occupational and leisure-time periods) and LBP among blue-collar workers. Methods Two-hundred-and-one blue-collar workers wore two accelerometers (GT3X+ Actigraph) for up to four consecutive working days to obtain objective measures of sitting time, estimated via Acti4 software. Workers reported their LBP intensity the past month on a scale from 0 (no pain) to 9 (worst imaginable pain) and were categorized into either low (≤5) or high (>5) LBP intensity groups. In the multivariate-adjusted binary logistic regression analysis, total sitting time, and occupational and leisure-time sitting were both modeled as continuous (hours/day) and categorical variables (i.e. low, moderate and high sitting time). Results The multivariate logistic regression analysis showed a significant positive association between total sitting time (per hour) and high LBP intensity (odds ratio; OR=1.43, 95%CI=1.15-1.77, P=0.01). Similar results were obtained for leisure-time sitting (OR=1.45, 95%CI=1.10-1.91, P=0.01), and a similar but non-significant trend was obtained for occupational sitting time (OR=1.34, 95%CI 0.99-1.82, P=0.06). In the analysis on categorized sitting time, high sitting time was positively associated with high LBP for total (OR=3.31, 95%CI=1.18-9.28, P=0.03), leisure (OR=5.31, 95%CI=1.57-17.90, P=0.01), and occupational (OR=3.26, 95%CI=0.89-11.98, P=0.08) periods, referencing those with low sitting time. Conclusion Sitting time is positively associated with LBP intensity among blue-collar workers. Future studies using a prospective design with objective measures of sitting time are recommended.
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Affiliation(s)
- Nidhi Gupta
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, Copenhagen, Denmark
- * E-mail:
| | | | - David M. Hallman
- Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Mette Korshøj
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Isabella Gomes Carneiro
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, Copenhagen, Denmark
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Schneller MB, Pedersen MT, Gupta N, Aadahl M, Holtermann A. Validation of five minimally obstructive methods to estimate physical activity energy expenditure in young adults in semi-standardized settings. SENSORS 2015; 15:6133-51. [PMID: 25781506 PMCID: PMC4435146 DOI: 10.3390/s150306133] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 03/04/2015] [Accepted: 03/04/2015] [Indexed: 11/29/2022]
Abstract
We compared the accuracy of five objective methods, including two newly developed methods combining accelerometry and activity type recognition (Acti4), against indirect calorimetry, to estimate total energy expenditure (EE) of different activities in semi-standardized settings. Fourteen participants performed a standardized and semi-standardized protocol including seven daily life activity types, while having their EE measured by indirect calorimetry. Simultaneously, physical activity was quantified by an ActivPAL3, two ActiGraph GT3X+’s and an Actiheart. EE was estimated by the standard ActivPAL3 software (ActivPAL), ActiGraph GT3X+ (ActiGraph) and Actiheart (Actiheart), and by a combination of activity type recognition via Acti4 software and activity counts per minute (CPM) of either a hip- or thigh-worn ActiGraph GT3X+ (AGhip + Acti4 and AGthigh + Acti4). At group level, estimated physical activities EE by Actiheart (MSE = 2.05) and AGthigh + Acti4 (MSE = 0.25) were not significantly different from measured EE by indirect calorimetry, while significantly underestimated by ActiGraph, ActivPAL and AGhip + Acti4. AGthigh + Acti4 and Actiheart explained 77% and 45%, of the individual variations in measured physical activity EE by indirect calorimetry, respectively. This study concludes that combining accelerometer data from a thigh-worn ActiGraph GT3X+ with activity type recognition improved the accuracy of activity specific EE estimation against indirect calorimetry in semi-standardized settings compared to previously validated methods using CPM only.
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Affiliation(s)
- Mikkel B Schneller
- Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-2200 Copenhagen, Denmark.
- National Research Centre for the Working Environment, DK-2100 Copenhagen, Denmark.
| | - Mogens T Pedersen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-2200 Copenhagen, Denmark.
| | - Nidhi Gupta
- National Research Centre for the Working Environment, DK-2100 Copenhagen, Denmark.
| | - Mette Aadahl
- Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup University Hospital, DK-2600 Glostrup, Denmark.
| | - Andreas Holtermann
- National Research Centre for the Working Environment, DK-2100 Copenhagen, Denmark.
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Esbensen BA, Thomsen T, Hetland ML, Beyer N, Midtgaard J, Løppenthin K, Jennum P, Østergaard M, Sørensen J, Christensen R, Aadahl M. The efficacy of motivational counseling and SMS-reminders on daily sitting time in patients with rheumatoid arthritis: protocol for a randomized controlled trial. Trials 2015; 16:23. [PMID: 25623388 PMCID: PMC4324661 DOI: 10.1186/s13063-014-0540-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 12/22/2014] [Indexed: 01/14/2023] Open
Abstract
Background Patients with RA (Rheumatoid Arthritis) are more sedentary than the general population. Reduction of Sedentary Behaviour (SB) has been suggested as a mean for improvement of health in patients with chronic diseases and mobility problems. Short-term intervention studies have demonstrated that SB can be reduced by behavioural interventions in healthy populations. However, it remains unexplored whether it is valid for patients with RA also. Therefore, the aim of this trial is to investigate the efficacy of an individually tailored, theory-based motivational counseling intervention on reducing daily sitting time in sedentary patients with RA. Additionally, to explore whether a reduction in daily sitting time is associated with reduced pain and fatigue, self-reported physical function, self-efficacy, improved health-related quality of life (HR-QoL) and cardiovascular biomarker levels, and finally to assess the cost-effectiveness of the intervention. Methods/Design For this parallel group randomized trial, 150 patients with RA and at least 5 hours of sitting time per day, will be recruited from a rheumatology outpatient clinic, and block-randomized to the intervention group or the control group receiving usual care. The intervention includes: 1) individual motivational counseling (in total 3 sessions) on reduction of daily sitting time in combination with 2) individual Short Text Message Service (SMS) reminders over a 16-week intervention period. Primary outcome is change in daily sitting time (minutes) from baseline to 16 weeks measured objectively using an ActivPAL® Activity Monitor. Secondary outcomes include fatigue, pain, physical function, HR-QoL, self-efficacy, costs and cost-effectiveness. Furthermore, anthropometric measures will be included as well as measurement of blood pressure and serum lipids. All outcomes are assessed at baseline and repeated after 16 weeks. Follow-up assessments are made at 6 and 18 months post-intervention. Discussion The intervention is simple, non-invasive and may be implemented at low costs. If the study confirms the positive results expected, the intervention might be implemented in clinical practice and potentially transferred to other clinical populations. Trial registration ClinicalTrial.gov registration number: NCT01969604. Date of registration: 17 October 2013.
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Affiliation(s)
- Bente Appel Esbensen
- Nursing and Health Science Research Unit, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark. .,Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Glostrup Hospital University of Copenhagen, Glostrup, Denmark. .,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Tanja Thomsen
- Nursing and Health Science Research Unit, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark. .,Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Glostrup Hospital University of Copenhagen, Glostrup, Denmark. .,Department of Physio- and Occupational Therapy, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark.
| | - Merete L Hetland
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Glostrup Hospital University of Copenhagen, Glostrup, Denmark. .,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,DANBIO registry, Center for Rheumatology and Spine Diseases, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - Nina Beyer
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Department of Physical Therapy, Musculoskeletal Rehabilitation Research Unit, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - Julie Midtgaard
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Center for Health Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
| | - Katrine Løppenthin
- Nursing and Health Science Research Unit, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark. .,Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Glostrup Hospital University of Copenhagen, Glostrup, Denmark. .,Department of Clinical Neurophysiology, Danish Center for Sleep Medicine, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - Poul Jennum
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Department of Clinical Neurophysiology, Danish Center for Sleep Medicine, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Glostrup Hospital University of Copenhagen, Glostrup, Denmark. .,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Jan Sørensen
- Center for Applied Health Services Research, University of Southern Denmark, Odense, Denmark.
| | - Robin Christensen
- Department of Rheumatology, Bispebjerg and Frederiksberg Hospital, Musculoskeletal Statistics Unit, the Parker Institute, University of Copenhagen, Copenhagen, Denmark.
| | - Mette Aadahl
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Research Center for Prevention and Health, The Capital Region of Denmark, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark.
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Villumsen M, Samani A, Jørgensen MB, Gupta N, Madeleine P, Holtermann A. Are forward bending of the trunk and low back pain associated among Danish blue-collar workers? A cross-sectional field study based on objective measures. ERGONOMICS 2014; 58:246-258. [PMID: 25374330 DOI: 10.1080/00140139.2014.969783] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The aim of this cross-sectional study was to investigate the association between the duration of objectively measured forward bending of the trunk and low back pain (LBP) intensity among 198 Danish blue-collar workers (male = 115; female = 83). The duration of forward bending of ≥ 30°, ≥ 60° and ≥ 90° was divided into high (the highest tertile) and low-moderate (the remaining tertiles) categories. High (>5) and low ( ≤ 5) pain intensities were categorised from a self-reported 0-9 scale. Results of multi-adjusted logistic regressions indicated no significant positive associations between forward bending and LBP intensity. On the contrary, higher duration of forward bending of ≥ 30° was associated with lower LBP intensity during all day (OR = 0.40; 95% CI, 0.15-1.02; p = 0.05) and work (OR = 0.44; 95% CI, 0.17-1.15; p = 0.09). This indication of a negative association may be explained by fear-avoidance behaviour of the blue-collar worker, job crafting or healthy worker effect.
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Affiliation(s)
- Morten Villumsen
- a Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology , Aalborg University , Aalborg, Fredrik Bajers Vej 7, DK-9220 Aalborg , Denmark
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