Reducing occupational sedentary time: a systematic review and meta-analysis of evidence on activity-permissive workstations

Development, validation, acceptability and usability of a device-based system to measure sit-stand desk usage

We describe the development and testing (across three studies) of an open-source device designed to measure sit-stand desk usage: the Desk Positioning System (DPS). Accuracy of the DPS was assessed under prescribed (Study 1) and free-living (Study 2; video criterion) conditions, across multiple desk-types. Study 3 assessed usability and acceptability in the short-term (1-week) and longer-term (5-weeks). RESULTS: In Study 1, the DPS was 100% accurate at identifying most conditions (presence at desk 59/72 conditions, detecting desk height 166/168). In Study 2 (n = 10) the DPS demonstrated high accuracy (F1>0.95) and precision (>0.98) against the criterion (7866 observations). Study 3 participants (n = 23) reported high device acceptability in both the short- (mean [sd] 4.4/5 [SD 0.4]) and longer-term (4.6/5 [0.5]). Usability was above the 68-score industry benchmark at the short- (72.4/100 [14.2]) and longer-term (74.7/100 [18.5]). CONCLUSION: The DPS may provide an accurate, acceptable and useable way of understanding sit-stand desk usage.

Effects of workplace interventions on sedentary behaviour and physical activity: an umbrella review with meta-analyses and narrative synthesis

BACKGROUND

Physical inactivity is rising globally, exacerbating the burden of preventable deaths and diseases. Despite extensive research on promoting physical activity in the workplace, synthesising the existing literature is challenging due to the wide variety of interventions and outcomes. This study aims to provide a comprehensive synthesis of intervention effects to inform health promotion initiatives and guide future research efforts.

METHODS

In this umbrella review, we conducted systematic searches of six databases (Cochrane, MEDLINE, Embase, CINAHL, Scopus, and Web of Science) for systematic reviews and meta-analyses published between Jan 1, 2000, and May 31, 2024, evaluating workplace interventions targeting sedentary behaviour or physical activity in working adults aged 18 years and older without specific health conditions or mobility impairments. Outcomes encompassed any behavioural changes related to sedentary behaviour or physical activity. Evidence for each relevant combination of intervention and outcome categories was summarised using either meta-analysis or narrative synthesis, with primary study data extracted as needed. This study is registered with PROSPERO, CRD42020171774.

FINDINGS

We included 36 systematic reviews and meta-analyses covering 214 unique primary studies. Despite considerable heterogeneity in the evidence, several effect trends emerged with moderate-to-high confidence. First, sit-to-stand workstations produced the largest reductions in sedentary time, decreasing it by up to 75 min per day (95% CI -109 to -41) when used alone, with reductions increasing by up to 33% when paired with psychosocial strategies. However, these interventions did not significantly increase physical activity at any intensity. Second, self-monitoring combined with psychosocial strategies yielded the largest increases in step count, with average gains of 1056 steps per day (371 to 1740). Third, no specific strategy consistently increased moderate-to-vigorous physical activity, although the available evidence remains sparse. Additional trends were observed but with lower confidence levels. Analysis of publication bias suggested an inflated effect of environmental-level interventions on occupational sedentary time. Adjusting for this bias using the trim-and-fill method only slightly reduced the effect size, but this result should be interpreted with caution due to high heterogeneity (I2=84·80%).

INTERPRETATION

Current evidence highlights the modest effect of existing workplace interventions on physical activity. Some strategies, such as sit-to-stand workstations and gamified interventions, effectively reduce sedentary behaviour and encourage lighter forms of physical activity, but none consistently improves moderate-to-vigorous physical activity, which provides the greatest health benefits. With many countries falling short of the WHO target to reduce physical inactivity prevalence by 15% from 2010 levels by 2030, intensified efforts are needed to address this gap, meet global goals, and alleviate the health burden of physical inactivity.

FUNDING

None.

Resistance Exercise Training on Musculoskeletal, Metabolic and Psychological Health in Sedentary Office Workers - Systematic Review and Meta-analysis

PURPOSE

To consolidate the emerging evidence on the effectiveness of resistance training (RT) in reducing the health risks among sedentary office workers.

METHODS

Four electronic databases were searched for evidence from its inception till september 20, 2024. Studies were included if they examined any form of RT program targeting musculoskeletal, metabolic, or psychological health outcomes in office workers aged 18 years or older using PICOS criteria (Population - office workers, Intervention - RT program, Comparison - placebo or sham control and Outcomes - musculoskeletal, cardiometabolic and psychological health variables). Two reviewers independently screened the studies for risk of bias and assessed the certainty of the evidence.

RESULTS

Out of 60 identified studies, 17 studies were eligible for narrative synthesis, and 16 were included in the meta-analysis. Modest reductions in neck (SMD = -1.76, I2 = 88%, p < 0.00001) and shoulder discomfort (SMD = -13.29, I2 = 91%, p < 0.00001), while marginal improvement in shoulder (SMD = 4.13, I2 = 99%, p = 0.03) and neck extensor muscle strength (SMD = 9.07, I2 = 9%, p < 0.00001). The cardiometabolic and mental health risk markers remain unaltered. High uncertainty of evidence was observed due to high heterogeneity, risk of bias, inconsistency and publication bias.

CONCLUSION

Limited evidence demonstrate supervised RT programs of any dose has a potential to improve muscular strength and discomfort while potential cardiometabolic and mental health risk outcomes remain unaltered. However, more high-quality research trials are needed to understand the effects of RT on health benefits.

Pilot implementation and evaluation of the Sit-Stand e-Guide: an e-training program on the use of sit-stand workstations

The 'Sit-Stand e-Guide' e-training program, designed to promote appropriate use of sit-stand workstations (SSWs), was evaluated for usability, acceptability and impact on various outcomes among SSW users. Participants from a large municipal organisation (25% male; mean age 45 [SD = 10.6] years) completed questionnaires pre-training (T0, n = 57), immediately post-training (T1, n = 50), and four weeks (T2, n = 46: primary endpoint) and twelve months later (T3, n = 30). High usability, acceptability and usefulness scores were reported at T1. Median [IQR] knowledge (4.4/5 [0.9]) and confidence (4.6/5 [1.0]) significantly increased at T1 compared to baseline (2.8 [1.2]; 3.3 [1.4]) and maintained at T2 and T3. At T2, mean [SD] sitting time (5.3 [1.2] h/workday) and low back discomfort (2.4 [2.3]) significantly decreased compared to baseline (6.1 [1.3] h; 3.4 [2.5] discomfort), SSW usage increased (1.4 [1.4]-2.8 [1.7] transitions), with no significant changes in work performance. Some behavioural changes were sustained at T3. The Sit-Stand e-Guide was acceptable and effective; evaluation across diverse workplaces and workers is now needed.

Effectiveness and Durability of a Workplace Sedentary Behavior Intervention Based on the Total Worker Health® Approach

We used the Total Worker Health® approach to develop a multi-component workplace sedentary behavior intervention and tested intervention effectiveness in a cluster randomized trial. Participants (n = 198; 75% female) were recruited from three call-centers (two intervention and one usual practice control). All worksites received pedal stand active workstations. The usual practice site received no additional support, while the intervention group completed a six-month program of activities including computer-based training, behavioral self-monitoring, health and safety discussions, and pedaling competitions. Data collection included a survey, a physical health assessment, and accelerometer measures of sedentary behavior, physical activity, and sitting/standing time. Primary analyses were generalized estimating equations comparing changes between intervention and usual practice conditions over time, along with analyses of changes in both groups combined over time. Six-month results revealed less prolonged sitting and reductions in musculoskeletal pain in both groups (all p < 0.05), while the intervention group showed additional improvements in moderate physical activity (p < 0.001) and use of pedal stands (p < 0.01). At 12-months, the additional physical activity and pedal stand use in the intervention group regressed to baseline levels, while reductions in prolonged sitting in both groups were durable (p < 0.01). This study adds to previous research showing the effectiveness of the Total Worker Health® approach for workplace health and safety. Results also show that, while providing employees with health and safety resources is beneficial, providing ongoing support for the adoption and use of resources is more effective.

Impact of a 6-month sit-stand desk-based intervention on regional musculoskeletal discomfort and overall post-work fatigue in office workers: a cluster randomised controlled trial

Evaluate the impact of a 6-month sit-stand desk (SSD) intervention on office workers' regional musculoskeletal discomfort (MD) and overall post-work fatigue (PWF) compared to a control group. A two-arm (1:1) clustered randomised controlled trial including 38 participants (aged 24-60 years, 77% women) assigned to intervention or control groups. The intervention, spanning 6 months, involved psychoeducation, motivational prompts, and SSD. The control group maintained standard working conditions. MD was assessed using the Nordic Musculoskeletal Questionnaire, and PWF with the Need for Recovery Scale. ANCOVA was employed to compare groups, adjusting for covariates, with 5% significance. The intervention group reduced overall MD (p = 0.018) and PWF (p = 0.013), while the control group showed no changes. However, no time*group interactions were found (p > 0.05). A 6-month SSD intervention alleviated office workers' MD and PWF, suggesting benefits from increasing standing time by at least 30 minutes/day. Future investigations must explore individual heterogeneity in response to SSD.

TRIAL REGISTRATION

https://doi.org/10.17605/OSF.IO/JHGPW.

National implementation trial of BeUpstanding™: an online initiative for workers to sit less and move more

BACKGROUND

The online BeUpstanding™ program is an eight-week workplace-delivered intervention for desk-based workers to raise awareness of the benefits of sitting less and moving more and build a supportive culture for change. A workplace representative (the "champion") delivers the program, which includes a workshop where teams collectively choose their sit less/move more strategies. A toolkit provides the champion with a step-by-step guide and associated resources to support program uptake, delivery, and evaluation. Here we report on the main findings from the Australian national implementation trial of BeUpstanding.

METHODS

Recruitment (12/06/2019 to 30/09/2021) was supported by five policy and practice partners, with desk-based work teams from across Australia targeted. Effectiveness was measured via a single arm, repeated-measures trial. Data were collected via online surveys, toolkit analytics, and telephone calls with champions. The RE-AIM framework guided evaluation, with adoption/reach (number and characteristics); effectiveness (primary: self-reported workplace sitting time); implementation (completion of core components; costs); and, maintenance intentions reported here. Linear mixed models, correcting for cluster, were used for effectiveness, with reach, adoption, implementation, and maintenance outcomes described.

RESULTS

Of the 1640 website users who signed-up to BeUpstanding during the recruitment period, 233 were eligible, 198 (85%) provided preliminary consent, and 118 (50.6%) champions consented and started the trial, with 94% (n = 111 champions) completing. Trial participation was from across Australia and across industries, and reached 2,761 staff, with 2,248 participating in the staff survey(s): 65% female; 64% university educated; 17% from a non-English speaking background. The program effectively changed workplace sitting (-38.5 [95%CI -46.0 to -28.7] minutes/8-hour workday) and all outcomes targeted by BeUpstanding (behaviours and culture), with small-to-moderate statistically-significant effects observed. All participating teams (n = 94) completed at least 5/7 core steps; 72.4% completed all seven. Most champions spent $0 (72%) or >$0-$5 (10%) per team member; most (67/70 96%) intended to continue or repeat the program.

CONCLUSIONS

BeUpstanding can be adopted and successfully implemented by a range of workplaces, reach a diversity of staff, and be effective at creating a supportive culture for teams of desk-based workers to sit less and move more. Learnings will inform optimisation of the program for longer-term sustainability.

TRIAL REGISTRATION

ACTRN12617000682347.

What's Your Poison? Is Sitting Always Health Hindering and Moving Always Health Promoting?

The clear public messaging from international health authorities is that individuals should "sit less and move more." While it is acknowledged that this guidance needs to be tailored to the age of people and also to their health, and abilities, the guidance is not tailored to their current level of physical behaviors. This opinion piece aims to highlight that although people with excessive sitting and insufficient moderate-to-vigorous physical activity should sit more and move less, for other people their health would be promoted by sitting more and moving less. Thus, physical behaviors are not always "poison" or "medicine," but rather the health impact of changes in physical behaviors depends on people's initial levels. Policy, research, and practice implications of this realization are presented. Only tailoring messaging to age and health status could be far from optimal for people with very different current levels of physical behaviors. Policy, research, and practice will be enhanced when the potential for physical behaviors to be either health hindering or health promoting is adequately considered.

Physical Inactivity Increases Impairment of Daily Activities Due to Pain in Workers: An Ordinal Regression Logistic and Correspondence Analysis

Background: The evidence for the health benefits of physical activity is growing; however, the prevalence of unhealthy lifestyles continues to contribute to the increase in chronic non-communicable diseases. We know that occupational-time physical activity does not provide the same benefits as leisure-time physical activity, which has been shown to reduce mortality and pain. We also know that multiple factors influence pain; however, there are no studies that specifically analyze the impact of type of working time and occupational-time physical activity on the impairment of daily activities due to pain. We aimed to study the influence of both personal and occupational factors on the impairment of daily activities due to pain, assessing whether leisure-time physical activity acts as a protective factor. Methods: A cross-sectional, population-based design was used based on the 2017 National Health Survey in Spain (ENSE). Sociodemographic, leisure-time physical activity, and work-related variables were collected. The outcome variable was the impairment of daily activities due to pain. Ordinal logistic regression was applied, and the analysis was complemented with simple correspondence analysis. Results: A total of 1,441 workers between 18 and 65 years of age were studied. Significant differences were found between sexes for all variables except age and leisure-time physical activity. Logistic regression revealed significant associations between sex, primary and secondary education levels, no leisure-time physical activity, and overweight with impairment of daily activities due to pain. Simple correspondence analysis showed that the categories doing leisure-time physical activity several times a week as well as several times a month are closer to the categories of little or no pain. Conclusion: Female gender, low educational level, overweight, and lack of leisure-time physical activity were associated with increases in impairment of daily activities due to pain. Occupational-time physical activity and work shift were not related to impairment of daily activities due to pain. Implications for Occupational Health Practice: Occupational Health Nursing interventions through education and counseling on the importance of leisure-time physical activity promotion programs potentially can reduce the impairment of daily activities due to pain in working populations.

Stand-Capable Workstations Reduce Occupational Sedentary Time Among Administrative Workers

OCCUPATIONAL APPLICATIONSIn this study, we found that workers who use stand-biased desks stood more and sat less during their workday compared to workers who use traditional desks. Stand-biased users also experienced significantly less lower back discomfort compared to both traditional and sit-stand workstation users. Based on these findings, we recommend that the use of stand-biased workstations be considered when designing or renovating work office workspaces. The health risks of sedentary behavior are inherent in most office work, but these risks can be alleviated with intentional equipment choices. Using stand-biased desks can encourage workers to move more throughout the workday without their productivity or comfort being disturbed.

Effectiveness of interventions on sedentary behaviors in office workers: a systematic review and meta-analysis

OBJECTIVES

Various interventions have sought to break sedentariness among office workers, but their pooled effect on sitting time reduction remains unknown. Also, it is essential to compare the effectiveness of different intervention types.

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

A literature search was conducted in the PubMed, EMBASE, Scopus, Web of Science, MEDLINE (via EBSCO), PsycINFO, and Cochrane Library databases from inception to May 2, 2023. Two independent reviewers screened eligibility, extracted data, and assessed the risk of bias using the Cochrane risk of bias tool 2.0. Randomized controlled trials aiming to reduce sitting at work were included. The primary outcome was sitting time at work per day. The secondary outcomes included cardiometabolic risk factors, psychological well-being, and work engagement. A random effects model was performed to synthesize continuous data as mean differences with 95% confidence intervals (95% CIs).

RESULTS

Twenty-four studies with 3169 participants were included. All intervention types in combination significantly reduced workplace sitting by 38 min per workday (95% CI: -47.32 to -28.72; P < 0.001; I2 = 49.78%). Interventions using environmental support (ES), motivational strategies (MS), or multiple components (multi) had all shown a significant reduction in work-time sedentary behavior (SB) relative to control groups. Regarding secondary outcomes, no significant effects were observed in physical or psychological outcomes besides high-density lipoprotein.

CONCLUSIONS

Findings suggest that SB reduction interventions are generally effective for reducing workplace sitting. Multi interventions with both ES and MS are recommended for future clinical applications. Future studies should aim not only to reduce SB but also to attain the benefits of SB reduction interventions on physical and psychological well-being.

Effect of Active Workstations on Neurocognitive Performance and Typing Skills: A Randomized Clinical Trial

BACKGROUND

Extended sedentary behavior is a risk factor for chronic disease and mortality, even among those who exercise regularly. Given the time constraints of incorporating physical activity into daily schedules, and the high likelihood of sitting during office work, this environment may serve as a potentially feasible setting for interventions to reduce sedentary behavior.

METHODS AND RESULTS

A randomized cross-over clinical trial was conducted at an employee wellness center. Four office settings were evaluated on 4 consecutive days: stationary or sitting station on day 1 (referent), and 3 subsequent active workstations (standing, walking, or stepper) in randomized order. Neurocognitive function (Selective Attention, Grammatical Reasoning, Odd One Out, Object Reasoning, Visuospatial Intelligence, Limited-Hold Memory, Paired Associates Learning, and Digit Span) and fine motor skills (typing speed and accuracy) were tested using validated tools. Average scores were compared among stations using linear regression with generalized estimating equations to adjust standard errors. Bonferroni method adjusted for multiple comparisons. Healthy subjects were enrolled (n=44), 28 (64%) women, mean±SD age 35±11 years, weight 75.5±17.1 kg, height 168.5±10.0 cm, and body mass index 26.5±5.2 kg/m2. When comparing active stations to sitting, neurocognitive test either improved or remained unchanged, while typing speed decreased without affecting typing errors. Overall results improved after day 1, suggesting habituation. We observed no major differences across active stations, except decrease in average typing speed 42.5 versus 39.7 words per minute with standing versus stepping (P=0.003).

CONCLUSIONS

Active workstations improved cognitive performance, suggesting that these workstations can help decrease sedentary time without work performance impairment.

REGISTRATION

URL: https://www.clinicaltrials.gov; Unique identifier: NCT06240286.

Temporal changes in cumulative mortality risks of cancer, by occupation, in the working population of Japan from 1995 to 2020: a benchmark for radiation risk comparison

The purpose of this study was to provide benchmark data for discussing the tolerability of cancer risk associated with occupational radiation exposure. It focused on differences in cancer mortality risk by occupation among Japan's working population and examined baseline cancer mortality risks and its variations from 1995 through 2020. Data were collected every five years from national vital statistics sources. By focusing on the same types of cancer among radiation induced effects, cumulative mortality risks were calculated for colorectal, lung, and breast cancer (females only) for those aged 15-74. The average cumulative mortality risk for the working population in Japan has decreased by 30%-60% over the past 25 years. Service workers and male managers were at an average risk, among all workers, while clerical workers and transportation and manufacturing workers had about half the average risk. The risks were higher for professionals and female managers, about 1.5-2 times the average for professionals and up to 5 times the average for female managers. The decrease in the average cancer mortality risk in the working population as a baseline suggests that risk tolerance in society might have changed over time. Since differences in mortality by occupation were confirmed, the usefulness of occupational data as a benchmark needs further investigation, as high-risk/low-risk occupations vary by country and region. The results of this study contribute to put radiation risks into perspective with the background risk of cancer.

Improving movement behavior in office workers: effects of two multi-level cluster-RCT interventions on mental health

BACKGROUND

We have previously reported on the design and efficacy of two cluster-randomized multi-level workplace interventions, attempting to decrease sedentary behavior (SED) or increase moderate to vigorous physical activity (MVPA) among office workers to improve mental health outcomes. The aim of this study was to investigate intervention effects on mental health outcomes, i.e., mental wellbeing, depression or anxiety symptoms, and stress immediately after the 6-month intervention period.

METHODS

Teams of 263 office workers were cluster-randomized to one of two interventions or a waitlist control group. The PA intervention (iPA) focused on increasing MVPA and the SED intervention (iSED) on reducing SED. Both multi-level interventions targeted individual office workers and their social, physical, and organizational work environment, incorporating counseling based on cognitive behavioral therapy and motivational interviewing. Mental health outcomes were assessed using validated questionnaires before and immediately after the intervention. Intervention effects were analyzed using linear mixed effects models.

RESULTS

Participants were mostly female and highly educated, with a mean age of 42 years and had favorable levels of mental health at baseline. Mental wellbeing improved for the iSED group (β = 8, 95% CI 1 to 15, p = 0.030) but not for the iPA group (β = 6, 95% CI -1 to 12, p = 0.072) compared to the control group. No effects were found for depression or anxiety symptoms or stress.

CONCLUSIONS

The multi-level interventions improved mental wellbeing among this population of office workers, reaching statistical significance in the iSED group. The size of the effect can be regarded meaningful, considering favorable mental health and high PA level at baseline. Thus, workplace interventions that provide support on multiple levels appear to have potential for improving mental wellbeing, but not reducing ill-health variables, among healthy office workers. More research is needed to understand the mechanisms through which such improvements can be achieved and to identify the most effective intervention components.

TRIAL REGISTRATION

ISRCTN92968402 (27 February 2018).

Are there compensatory behaviors in response to a sit-stand desk intervention?

OBJECTIVES

Office workers represent one of the most sedentary groups. Alarmingly, more than one-third of their sitting time during workdays occurs in prolonged bouts. Sit-stand desk (SSD) interventions have been found to be effective in reducing sitting time, but heterogeneity exists amongst studies, which may be due to compensations outside the workplace. This study aimed to assess the impact of a 6-month SSD intervention on office workers' sitting and standing times during the work shift and outside work (leisure time).

METHODS

A 2-arm (1:1) clustered randomized controlled trial was conducted with 38 participants randomly assigned to either the intervention or control group. The intervention included a psychoeducational session, motivational prompts, and environmental modification (SSD implemented in the workplace). The waiting-list control group maintained the usual work conditions and only received the initial session. We employed repeated measures analysis of covariance to compare changes between groups while adjusting for relevant covariates, with significance set at 5%.

RESULTS

In the intervention group, there was a significant reduction in sitting time at work by 32.97 minutes, along with a notable increase in standing time by 27.88 minutes (P < .05). Although nonsignificant (P > .05), there was an increase in sitting time in the leisure context of about 23.07 minutes.

CONCLUSIONS

This study underscores the effectiveness of SSD as a key strategy to mitigate sitting time among office workers. However, future interventions should consider integrating comprehensive behavioral strategies beyond the workplace to sustain potential increases in sitting time during leisure time and avoid compensatory behaviors.

Do worksite health promotion programs (WHPP) influence presenteeism among employees? A systematic review1

BACKGROUND

Worksite health promotion programs (WHPP) aiming to reduce presenteeism are rapidly increasing. However, program-efficacy seems impaired by lack of conceptual understanding and theoretical frameworks related to presenteeism.

OBJECTIVES

To study (1) the concept of presenteeism, (2) the causes of the phenomenon and (3) which WHPP affect presenteeism.

METHODS

We followed the PRISMA 2020 guidelines for mapping relevant literature in seven databases. The main search-terms were "worksite", "WHPP", "presenteeism", "employee productivity" and "interventions". Reviews and review of reviews were included and analysed according to research questions and ecological theory.

RESULTS

Of 2196 studies identified, 14 reviews were included, comprising 1390 single studies. Conceptually, presenteeism was poorly defined, mostly related to productivity/performance limitations due to ill health. Factors causing presenteeism addressed individual health or lifestyle (78%), and, to a lesser extent work and organisational factors (management/job stress) (22%). Forty-five highly diverse WHPP were identified, about 90% focusing health outcomes. 22/45 WHPP affected presenteeism/productivity positively. Multi-component WHPP implemented at multi levels accounted for 55%. Single-component programs, implemented at individual level, were mostly targeting health-risk subgroups. No specific WHPP seems preferable. Methodological quality seems highly associated with worksite intervention-efficacy.

CONCLUSION

Increased telework opportunities due to COVID-19 experiences has affected working conditions worldwide, for better and worse, requiring adaptions at employee, management, organisational and socio-cultural levels. Our results showed high program diversity, several adaptable to future needs (e.g., digital solutions), however hampered by narrow focus on individual health. Future research should focus on theory-based high quality multilevel WHPP comprising contextual, work, and organisational factors.

Wearable Leg Movement Monitoring System for High-Precision Real-Time Metabolic Energy Estimation and Motion Recognition

Comprehensive and quantitative assessment of human physical activity in daily life is valuable for healthcare, especially for those who suffer from obesity and neurological disorders or are at high risk of dementia. Common wearable devices, e.g., smartwatches, are insufficient and inaccurate for monitoring highly dynamic limb movements and assessing human motion. Here, we report a new wearable leg movement monitoring system incorporating a custom-made motion sensor with machine learning algorithm to perceive human motion accurately and comprehensively during diverse walking and running actions. The system enables real-time multimodal perceptions of personal identity, motion state, locomotion speed, and energy expenditure for wearers. A general law of extracting real-time metabolic energy from leg movements is verified although individual gaits show differences. In addition, we propose a novel sensing configuration combining unilateral lower leg movement velocity with its angular rate to achieve high accuracy and good generalizability while simplifying the wearable system. Advanced performances in personal identification (accuracy of 98.7%) and motion-state recognition (accuracy of 93.7%) are demonstrated. The wearable system also exhibites high-precision real-time estimations of locomotion speed (error of 3.04% to 9.68%) and metabolic energy (error of 4.18% to 14.71%) for new subjects across various time-varying conditions. The wearable system allows reliable leg movement monitoring and quantitative assessment of bodily kinematic and kinetic behaviors during daily activities, as well as safe identity authentication by gait parameters, which would greatly facilitate smart life, personal healthcare, and rehabilitation training.

The effects of active workstations on reducing work-specific sedentary time in office workers: a network meta-analysis of 23 randomized controlled trials

BACKGROUND

Active workstations have been proposed as a feasible approach for reducing occupational sedentary time. This study used a network meta-analysis (NMA) to assess and compare the overall efficacy of active workstation interventions according to type and concomitant strategy for reducing work-specific sitting time in office workers.

METHODS

PubMed, Web of Science, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from database inception until May 2022 to obtain randomized controlled trials (RCTs) assessing the efficacy of active workstations with or without concomitant strategies for reducing occupational sedentary time in office workers. The risk of bias of the RCTs included in this study was assessed according to the Cochrane Handbook. An NMA with STATA 15.1 was used to construct a network diagram, league figures, and the final surface under the cumulative ranking curve (SUCRA) values. The certainty of evidence was assessed using the grading of recommendations, assessment, development, and evaluation (GRADE) approach.

RESULTS

A total of 23 eligible studies including eight different types of interventions with 1428 office workers were included. NMA results showed that compared to a typical desk, multicomponent intervention (standardized mean difference (SMD) =  - 1.50; 95% confidence interval (CI) - 2.17, - 0.82; SUCRA = 72.4%), sit-stand workstation + promotion (Reminders of rest breaks, posture variation, or incidental office activity) (SMD =  - 1.49; 95%CI - 2.42, - 0.55; SUCRA = 71.0%), treadmill workstation + promotion (SMD =  - 1.29; 95%CI - 2.51, - 0.07; SUCRA = 61.6%), and sit-stand workstation (SMD =  - 1.10, 95%CI - 1.64, - 0.56; SUCRA = 50.2%) were effective in reducing occupational sedentary time for office workers.

CONCLUSIONS

Multicomponent intervention, sit-stand workstation + promotion, treadmill workstation + promotion, and sit-stand workstation appear to be effective in reducing work-specific sedentary time for office workers. Furthermore, multicomponent interventions and active workstations + promotion better reduced work-specific sedentary time than active workstation alone. However, the overall certainty of the evidence was low.

TRIAL REGISTRATION

Our study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO); registration number: CRD42022344432.

Effectiveness of Multicomponent Interventions in Office-Based Workers to Mitigate Occupational Sedentary Behavior: Systematic Review and Meta-Analysis

BACKGROUND

Sedentary time in workplaces has been linked to increased risks of chronic occupational diseases, obesity, and overall mortality. Currently, there is a burgeoning research interest in the implementation of multicomponent interventions aimed at decreasing sedentary time among office workers, which encompass a comprehensive amalgamation of individual, organizational, and environmental strategies.

OBJECTIVE

This meta-analysis aims at evaluating the effectiveness of multicomponent interventions to mitigate occupational sedentary behavior at work compared with no intervention.

METHODS

PubMed, Web of Science, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from database inception until March 2023 to obtain randomized controlled trials (RCTs) assessing the efficacy of multicomponent interventions on occupational sedentary behavior among office-based workers. Two reviewers independently extracted the data and assessed the risk of bias by using the Cochrane Collaboration's risk of bias tool. The average intervention effect on sedentary time was calculated using Stata 15.1. Mean differences (MDs) with 95% CIs were used to calculate the continuous variables. Subgroup analyses were performed to determine whether sit-stand workstation, feedback, and prompt elements played an important role in multicomponent interventions. Further, the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system was used to evaluate the certainty of evidence.

RESULTS

A total of 11 RCTs involving 1894 patients were included in the analysis. Five studies were rated as low risk of bias, 2 as unclear risk of bias, and 4 as high risk. The meta-analysis results showed that compared with no intervention, multicomponent interventions significantly reduced occupational sitting time (MD=-52.25 min/8-h workday, 95% CI -73.06 to -31.44; P<.001) and occupational prolonged sitting time (MD=-32.63 min/8-h workday, 95% CI -51.93 to -13.33; P=.001) and increased occupational standing time (MD=44.30 min/8-h workday, 95% CI 23.11-65.48; P<.001), whereas no significant differences were found in occupational stepping time (P=.06). The results of subgroup analysis showed that compared with multicomponent interventions without installment of sit-stand workstations, multicomponent interventions with sit-stand workstation installment showed better effects for reducing occupational sitting time (MD=-71.95 min/8-h workday, 95% CI -92.94 to -51.15), increasing occupational standing time (MD=66.56 min/8-h workday, 95% CI 43.45-89.67), and reducing occupational prolonged sitting time (MD=-47.05 min/8-h workday, 95% CI -73.66 to -20.43). The GRADE evidence summary showed that all 4 outcomes were rated as moderate certainty.

CONCLUSIONS

Multicomponent interventions, particularly those incorporating sit-stand workstations for all participants, are effective at reducing workplace sedentary time. However, given their cost, further research is needed to understand the effectiveness of low-cost/no-cost multicomponent interventions.

Providing office workers with height-adjustable workstation to reduce and interrupt workplace sitting time: protocol for the Stand Up for Healthy Aging (SUFHA) cluster randomized controlled trial

BACKGROUND

Sedentary behavior (SB) has been linked to several negative health outcomes. Therefore, reducing SB or breaking up prolonged periods of SB improves functional fitness, food consumption, job satisfaction, and productivity. Reducing SB can be achieved by introducing a health-enhancing contextual modification promoted by a sit-stand desk in the workplace. The primary goal will be to test the effectiveness of this intervention in reducing and breaking up SB, while improving health outcomes in office-based workers during a 6-month intervention.

METHODS

A two-arm (1:1), superiority parallel-group cluster RCT will be conducted to evaluate the effectiveness of this intervention in a sample of office-based workers from a university in Portugal. The intervention will consist of a psychoeducation session, motivational prompts, and contextual modification promoted by a sit-stand desk in the workplace for 6 months. The control group will work as usual in their workplace, with no contextual change or prompts during the 6-month intervention. Three assessment points will be conducted in both groups, pre-intervention (baseline), post-intervention, and a 3-month follow-up. The primary outcomes include sedentary and physical activity-related variables, which will be objectively assessed with 24 h monitoring using the ActivPAL for 7 days. The secondary outcomes include (a) biometric indices as body composition, body mass index, waist circumference, and postural inequalities; and (b) psychosocial variables such as overall and work-related fatigue, overall discomfort, life/work satisfaction, quality of life, and eating behavior. Both the primary and secondary outcomes will be assessed at each assessment point.

DISCUSSION

This study will lean on the use of a sit-stand workstation for 6 months, prompted by an initial psychoeducational session and ongoing motivational prompts. We will aim to contribute to this topic by providing robust data on alternating sitting and standing postures in the workplace.

TRIAL REGISTRATION

The trial was prospectively registered, and the details are at: https://doi.org/10.17605/OSF.IO/JHGPW ; Registered 15 November 2022. OSF Preregistration.

Increasing movement during office work at sit-stand workstations: A novel seating device to facilitate transitions

A novel active office chair (Movably Pro) was designed to facilitate frequent sit-stand movement 1) through auditory and tactile prompts and 2) with minimal-to-no work surface adjustment when transitioning. The purpose of this study was to compare lumbopelvic kinematics, discomfort, and task performance between the novel chair and traditional sitting/standing. Sixteen participants completed three separate 2-h sedentary exposures. Although participants transitioned every 3 min between sitting and standing with the novel chair, productivity was not affected. When standing in the novel chair, the lumbopelvic angles fell in between traditional sitting and standing (p < 0.01). Movement and/or postural changes that occurred with the novel chair reduced low back and leg discomfort for pain developers (PDs) (p < 0.01). All participants classified as PDs in traditional standing were non-PDs with the novel chair. This intervention was effective in reducing sedentary time without the time loss associated with desk movement.

New principles, the benefits, and practices for fostering a physically active lifestyle

The modern environment has led to an increased risk and incidence of sedentary lifestyles. When physical activity (PA) becomes insufficient, pathophysiological pathways are invoked and the future risk for chronic diseases and premature mortality increases. As a consequence, since the 1970s governmental agencies and medical societies have published guidelines to promote PA. The 2018 Guidelines for Physical Activity for Americans contain important updated guidelines, but many of these guidelines are not yet sufficiently known by the public or health providers. In addition, to make use of these guidelines, they need to be integrated with optimal behavioral interventions. Accordingly, this narrative review critically assesses five tenets that stem from the 2018 Guidelines and illustrates how these tenets can be integrated with tools and techniques for motivating individuals to initiate and maintain a more physically active lifestyle. The first tenet indicates that there is no lower threshold of PA that must be obtained before health benefits begin to accrue. Second, it is no longer required that PA be obtained in bouts of 10 min or more to "count". Bouts of lesser duration also count. Pending further study, new accelerometry data suggest that vigorous intermittent PA of just 1-2 min may also benefit health, such as that acquired by stair climbing or carrying heavy groceries. This has led to a new concept of promoting "lifestyle physical activity". Third, excessive sitting is health damaging if it is not accompanied by sufficient daily life PA or accrues over long uninterrupted bouts. Fourth, it is essential to incorporate resistance exercises for optimal health and to promote successful aging. Fifth, a wealth of new evidence indicates that PA strongly protects and promotes all aspects of brain health and may improve cognition even after a single bout of exercise.

Office job sitting demand scale: Evidence of construct and predictive validity

Drawing on sedentary behavior and Job Demands-Resources theory, we developed a new scale for assessing office job sitting demand, conceptualized as job demand, and validated it using two independent samples. In Study 1 (N = 252), we developed the items and tested the Office Job Sitting Demand scales' factor structure through exploratory factor analysis. In Study 2 (N = 248), we tested the scales' factorial validity through confirmatory factor analysis. Indicators of measurement invariance showed no differences between participants who engage in leisure-time sport and participants who do not. Moreover, we tested convergent, discriminant, and criterion validity. We found significant positive associations with exhaustion, work pressure, and musculoskeletal complaints. The construct was unrelated to proactive vitality management and relaxation. Our results illustrate the relation between this new job demand in the workplace with employee well-being. Based on our findings, this newly developed instrument is valid and reliable and can be used to assess office job sitting demand to prevent burnout and health complaints.

The physical activity at work (PAW) study: a cluster randomised trial of a multicomponent short-break intervention to reduce sitting time and increase physical activity among office workers in Thailand

Background

Sedentary behaviour increases the risks of non-communicable diseases. The objective of this trial was to evaluate the effect of the Physical Activity at Work multicomponent intervention to reduce sedentary behaviour in Thai office workers.

Methods

Offices under the Ministry of Public Health Thailand, were randomly allocated to the intervention and control group in a 1:1 ratio, stratified by office size. The intervention included individual (pedometer and lottery-based financial incentives), social (group movement breaks), environmental (posters), and organisational (leader encouragement) components. At baseline and 6-month follow-up, participants wore ActiGraphTM on the waist for ten days. The primary outcome was the between-group difference in sedentary time at 6-month, analysed using a linear mixed-effects model. Other outcomes were physical activity, biomarkers, productivity, and musculoskeletal health. Trial registration: The PAW study was registered at the Thai Clinical Trials Registry (ID TCTR20200604007) on 02 June 2020.

Findings

282 office workers were recruited and randomly allocated to the control group (142 participants, nine offices) and the intervention group (140 participants, nine offices). The mean age was 38.6 years (SD = 10.4), and 81% were women. There was no evidence of intervention effects on sedentary time during waking hours (-26.8; 95% CI = -69.2 to 15.7 min), physical activity levels, or biomarkers between groups at 6-month. In the adjusted analysis, increases in time spent in moderate-to-vigorous physical activity (5.45; 95% CI = -0.15 to 11.1 min) and step count (718; 95% CI = -45 to 1481 steps) during waking hours were observed, although there was no evidence of a difference between groups.

Interpretation

The intervention did not significantly reduce sedentary time in Thai office workers. Suboptimal intervention uptake due to Covid-19 pandemic restrictions and loss of statistical power associated with recruitment constraints may explain this result. Further investigations are needed to evaluate the processes of the trial.

Funding

The Thai Health Promotion Foundation and the International Decision Support Initiative (iDSI).

Longitudinal Effects of a sit-stand desk intervention - persistence, Fade-Out, and psychological momentum: a Randomized Controlled Trial

BACKGROUND

This study examined whether the effects of a sit-stand desk (SSD) intervention on employees' musculoskeletal complaints (i.e., intensity and prevalence) and activation (i.e., vigilance and vitality) persist or fade out and whether velocity and acceleration of health improvements can predict medium-term (six-month) and long-term (24-month) improvements. Drawing from dynamic models of self-regulation, as well as the psychological momentum theory, we hypothesized that velocity and acceleration of health improvements in the early stages of the intervention would predict medium-term health improvements, which sustain long-term.

METHODS

We used data from a six-month seven-wave randomized controlled trial with employees in mostly sedentary occupations and supplemented this by follow-up data from the same participants 18 months later, resulting in eight waves.

RESULTS

Bayesian structural equational modeling revealed no significant intervention effect after 24 months implying a fade-out. But more importantly, velocity and, partially, acceleration of health improvements at earlier stages predicted medium-term improvements in musculoskeletal complaints and long-term improvements in vigilance.

CONCLUSION

The findings of this study suggest that positive intervention effects fade out over time and health effects benefit from prompt progresses at the beginning of the intervention, warranting exploration in prolonged longitudinal studies.

Impacts of life-events on sitting, TV viewing and computer use among women from disadvantaged neighbourhoods

BACKGROUND

Little is known about how life events such as changes in parental or employment status influence sedentary behaviour (SB). Women from disadvantaged neighbourhoods are at particular risk of poor health, therefore, in this population group this study aimed to determine between changes in parental and employment status with sitting, television viewing (TV), and computer time.

METHODS

Women (18-45 years) from socioeconomically disadvantaged neighbourhoods self-reported their employment status, number of children, sitting, TV, and computer time [(baseline (n = 4349), three (n = 1912) and 5 years (n = 1560)]. Linear (sitting) and negative binomial (TV and computer time) multilevel models adjusted for confounders were used to estimate the SB association with changes in life events.

RESULTS

Compared to women who never had children during the study period, less sitting and computer time was observed for women when number of children remained unchanged, had their first child or additional child, and fewer children (< 18 years). Less TV was observed for women when number of children remained unchanged. Compared to women who remained employed full-time during the study period, sitting and computer time decreased among women when they decreased or increased their working hours or when remained employed part-time/not working. TV time increased among women when they decreased their working hours.

CONCLUSION

Among women, declines in SB were observed amongst those experiencing life events. Interventions to decrease SB may consider targeting women with no children, and future research should further explore how changes in employment type (e.g., non-manual to manual jobs) impact SB.

Evidence base of economic evaluations of workplace-based interventions reducing occupational sitting time: an integrative review

OBJECTIVE

To review the evidence on the economic evaluations of workplace-based interventions that are designed to reduce prolonged periods of occupational sitting.

DESIGN

An integrative review.

DATA SOURCES

The search was conducted in 11 databases, including PubMed, Scopus, PsychINFO, NHS-EED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, Cochrane library, Sportdiscus, Research Paper in Economics (RePeC), the International Health Economic Association (IHEA) and EconLit. The databases were searched for articles published from inception to January 2022. Subsequent citation searches were also conducted in Google Scholar. The items of the Consensus Health Economic Criteria (CHEC) checklist were used for quality appraisal of the included studies.

RESULTS

This review included five randomised control trails, including 757 office-based workers in high-income countries. The median quality appraisal score based on the CHEC items was 14 points (a range of 9-18). The mean duration of interventions was 33 weeks (a range of 4-52 weeks). Overall, the studies reported economic benefit when implemented to reduce occupational sitting time but no effect on absenteeism. From the societal perspective, the interventions (eg, the use of a sit-stand desk) were cost-effective.

CONCLUSION

The economic impact of workplace interventions implemented to reduce occupational sitting time is evident; however, the existing evidence is limited, which precludes strong conclusions. Cost-effectiveness is not often evaluated in the studies exploring workplace interventions that address occupational sitting time. Workplace interventions are still in the development and testing phase; thus, the challenge for future studies is to include economic evaluation of interventions addressing sedentary behaviour in workplaces.

PROSPERO REGISTRATION NUMBER

CRD42021226275.

How effective and how expensive are interventions to reduce sedentary behavior? An umbrella review and meta-analysis

A reduction in sedentary behavior (SB) can contribute to the prevention of chronic diseases. This is the first umbrella review that summarizes the effectiveness and monetary costs of different types of interventions to reduce SB across all age groups and populations in different settings. We comprehensively searched seven databases for systematic reviews and meta-analyses and conducted an umbrella review of the effects of interventions to reduce SB. Additionally, we performed a meta-analysis of primary studies included in the umbrella review. Furthermore, we analyzed health economic aspects of interventions to reduce SB. We included 40 systematic reviews in our umbrella review, with 136 primary studies suitable for further meta-analyses. We found that interventions targeting the physical environment reduce SB most effectively in the majority of populations and settings. Workplace interventions reduced SB by -89.83 min/day (95% CI -124.58 to -55.09; p ≤ 0.0001). Twenty-two of 169 primary studies (13.0%) contained health economic information. The intervention costs per participant ranged from €0 to €3587. Our findings demonstrate that physical environment interventions most effectively reduce SB in a majority of populations and settings. Health economic information was reported in few studies and was mostly restricted to acquisition costs.

Effects of a Job Crafting Intervention Program on Work Performance Among Japanese Employees: An Analysis of Secondary Outcomes of a Randomized Controlled Trial

OBJECTIVE

This study reports a randomized controlled trial of the effect of a job crafting intervention program on work performance and job crafting (as secondary outcomes) among Japanese employees.

METHODS

Participants who satisfied the inclusion criteria were randomly allocated to an intervention (n = 138) or a control group (n = 143). Outcomes were measured at baseline and at 3-month and 6-month follow-up in both groups.

RESULTS

For the whole sample, the job crafting intervention program showed a nonsignificant effect on work performance and job crafting. However, the program showed a significant effect on these outcomes among younger participants (under 36years old).

CONCLUSIONS

The job crafting intervention program may not be sufficiently effective to improve work performance and job crafting for the whole sample of participants. However, it may be efficacious for younger workers.

Systematic Review of the Influence of Physical Work Environment on Office Workers' Physical Activity Behavior

BACKGROUND

Many American workers spend over 7 hours a day at work in primarily sedentary office work. Physical activity is a key aspect of optimizing health and preventing disease; yet, 80% of American adults do not meet the recommended guidelines for physical activity. In this systematic review, the relationship between physical work environment and physical activity among office workers was explored.

METHODS

Of the 321 studies screened, 26 studies met the eligibility criteria and were included for evaluation in this systematic review.

RESULTS

Of the 26 studies, four were cross-sectional studies, 14 were quasi-experimental studies, and eight were randomized control trials. Physical activity during the workday was measured using self-report surveys and electromechanical devices such as accelerometers. Physical work environments examined by the studies included different types of desks (n = 16), office arrangements (n = 5), and building design (n = 5). In nine studies, office environments and building work environments designed to promote activity using active design principles such as stairs and flexible workspaces were associated with increased physical activity. Sit-stand desks reduced overall sitting time, but had a minimal effect on physical activity.

CONCLUSION/APPLICATION TO PRACTICE

Offices and buildings designed for activity had the largest impact on physical activity among office workers. To increase physical activity in office workers, focus should be placed on opportunities to increase incidental movement that can increase physical activity throughout the workday. Occupational health nurses should advocate workspace designs that can increase physical activity in workers.

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

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

Univariable and Multivariable Two-Sample Mendelian Randomization Investigating the Effects of Leisure Sedentary Behaviors on the Risk of Lung Cancer

Leisure sedentary behaviors (LSB) are widespread, and observational studies have provided emerging evidence that LSB play a role in the development of lung cancer (LC). However, the causal inference between LSB and LC remains unknown. Methods: We utilized univariable (UVMR) and multivariable two-sample Mendelian randomization (MVMR) analysis to disentangle the effects of LSB on the risk of LC. MR analysis was conducted with genetic variants from genome-wide association studies of LSB (408,815 persons from UK Biobank), containing 152 single-nucleotide polymorphisms (SNPs) for television (TV) watching, 37 SNPs for computer use, and four SNPs for driving, and LC from the International Lung Cancer Consortium (11,348 cases and 15,861 controls). Multiple sensitivity analyses were further performed to verify the causality. Results: UVMR demonstrated that genetically predisposed 1.5-h increase in LSB spent on watching TV increased the odds of LC by 90% [odds ratio (OR), 1.90; 95% confidence interval (CI), 1.44-2.50; p < 0.001]. Similar trends were observed for squamous cell lung cancer (OR, 1.97; 95%CI, 1.31-2.94; p = 0.0010) and lung adenocarcinoma (OR, 1.64; 95%CI 1.12-2.39; p = 0.0110). The causal effects remained significant after adjusting for education (OR, 1.97; 95%CI, 1.44-2.68; p < 0.001) and body mass index (OR, 1.86; 95%CI, 1.36-2.54; p < 0.001) through MVMR approach. No association was found between prolonged LSB spent on computer use and driving and LC risk. Genetically predisposed prolonged LSB was additionally correlated with smoking (OR, 1.557; 95%CI, 1.287-1.884; p < 0.001) and alcohol consumption (OR, 1.010; 95%CI, 1.004-1.016; p = 0.0016). Consistency of results across complementary sensitivity MR methods further strengthened the causality. Conclusion: Robust evidence was demonstrated for an independent, causal effect of LSB spent on watching TV in increasing the risk of LC. Further work is necessary to investigate the potential mechanisms.

Investigating the Immediate Influence of Moderate Pedal Exercises during an Assembly Work on Performance and Workload in Healthy Men

Physical inactivity has increased in prevalence among adults in industrialized and developing countries owing to the fact that the majority of job situations require individuals to remain seated for extended periods of time. This research aims to evaluate the influence of cycling on a stationary bike while executing a keyboard assembly task on the task completion time, error percentage, and physiological and subjective measurements. The physiological measures were electroencephalography (EEG) and electrocardiographic (ECG) signal responses, whereas the subjective measures were subjective workload ratings and subjective body discomforts. Two variables were evaluated, namely assembly methods (with versus without pedal exercises at a moderate intensity) and session testing (pre- versus post-test). Thus, the repeated measures design (i.e., assembly method by session testing of participants) was used. According to the completion time, error %, participant self-reports, and ECG and EEG statistical analysis data, the participants' performances in the keyboard assembly task did not decrease while they performed pedaling exercises (p > 0.05). Additionally, when participants completed the assembly task while executing the pedaling exercises, the mean inter-beat (RR) intervals significantly reduced (p < 0.05) while the mean heart rate increased (p < 0.05), which mean that pedaling exercises caused physical workloads on the participants. Participant performance was unaffected by performing a workout while performing the assembly activity. Thus, administrations should encourage their employees to engage in short sessions of moderate-intensity exercise similar to the suggested exercise in the study to improve a person's physical health during work without interfering with the effectiveness of work.

Sedentary Behavior Counseling Intervention in Aging People With Type 2 Diabetes: A Feasibility Study

This study examined the feasibility and effect of sedentary behavior (SB) counseling on total sitting time (TST) and glycemic control in people with type 2 diabetes (T2D). Community-dwelling sedentary adults with T2D (n = 10; 8 women; age 65.6 ± 7.31) completed SB counseling (motivational interviewing-informed education about SB) aided by an activity monitor with a vibrotactile feature (activPAL3TM). The monitor was worn for 7 days, on weeks 1 and 13 (without the vibrotactile feature) and during weeks 5 and 9 (with the vibrotactile feature). Intervention feasibility was determined by study retention rates and activity monitor tolerability, and differences between pre- and post-intervention average daily TST. Paired t-test were performed. The effect size (ES) was calculated using Cohen d. All participants attended all study sessions with only 20% reporting moderate issues tolerating the activity monitor. TST time decreased from 11.8 hours ± 1.76 at baseline to 10.29 hours ± 1.84 at 3 months’ assessment (P < .05) with a large ES (Cohen d = .88). HbA1c was decreased by 0.51% (P < .05) at the end of the intervention. This study found that the intervention was feasible for sedentary adults with type 2 diabetes.

A systematic review and meta-analysis of the effect of treadmill desks on energy expenditure, sitting time and cardiometabolic health in adults

Background

As the health risks of sedentary working environments become more clear, greater emphasis on the implementation of walking interventions to reduce sitting time is needed. In this systematic review and meta-analysis, we investigate the role of treadmill-desk interventions on energy expenditure, sitting time, and cardiometabolic health in adults with sedentary occupations.

Methods

Relevant studies published in English were identified using CINAHL, EMBASE, MEDLINE, Web of Science, Scopus, and PubMed databases up to December 2020. Random effects meta-analysis models were used to pool study results.

Results

Thirteen relevant studies (six workplaces and seven laboratories) were found with a total of 351 participants. Pooled analysis of laboratory studies showed a significant increase in energy expenditure (105.23 kcal per hour, 95% confidence interval [CI]: 90.41 to 120.4), as well as metabolic rate (5.0 mL/kg/min, 95% CI: 3.35 to 6.64), among treadmill desk users compared to sitting conditions. No evidence of significant differences in blood pressure were found. In workplace studies, we observed a significant reduction in sitting time over a 24-h period (− 1.73 min per hour, 95% CI: − 3.3 to − 0.17) among users of treadmill desks, compared to a conventional desk. However, there were no evidence of statistically significant changes in other metabolic outcomes.

Conclusions

Treadmill desks offer a feasible and effective intervention to increase energy expenditure and metabolic rate and reduce sitting time while performing work-related tasks. Future studies are needed to increase generalizability to different workplace settings and further evaluate their impact on cardiometabolic health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12094-9.

Effects on variation in shoulder, forearm and low back muscle activity from combining seated computer work with other productive office tasks: results from a simulation study

The effect on muscle activity variation of combining different office tasks is not known. We recorded electromyography from the upper trapezius (UT), wrist extensor (WE) and lumbar erector spinae (LES) in 24 office workers during five productive tasks, and breaks. Minute-to-minute variance was then estimated, by simulations, in a reference 'job' consisting of 85% sitting computer work and 15% breaks, and in 'jobs' where sitting computer work was replaced by different proportions of the other office tasks and breaks. Replacing sitting computer work with sitting non-computer work increased estimated variance by, in median, 23% (UT), 19% (WE) and 0% (LES). Replacing it with other tasks, in particular, standing computer and non-computer work, was less effective in increasing variance. Thus, some combinations of office tasks have a slight potential to increase muscle activity variation in the shoulder and lower arm, but not the lumbar back, while others will be ineffective. Practitioner summary: The need for exposure variation is often emphasised in office ergonomics. We estimated the effect on muscle activity in the shoulder, forearm and lumbar back of combining sitting computer work with other available tasks and breaks, finding that introduction of sitting non-computer tasks and non-desk work slightly increased variation; other tasks were essentially non-effective.

Efficacy, characteristics, behavioural models and behaviour change strategies, of non-workplace interventions specifically targeting sedentary behaviour; a systematic review and meta-analysis of randomised control trials in healthy ambulatory adults

BACKGROUND

Sedentary behaviour (SB) research has grown exponentially but efficacy for interventions to reduce sedentary behaviour is often contaminated by interventions primarily or co-targeting other behaviours and outcomes. The primary aim of this research therefore, was to systematically review the efficacy of interventions specifically targeting sedentary behaviour reduction, as a sole primary outcome, from randomised control trials in healthy ambulatory adults. This research also sought to identify the successful interventions characteristics, behaviour change techniques (BCT's) and underlying theories, and their relation to intervention effectiveness.

METHODS

We followed PRISMA reporting guidelines for this systematic review. Six electronic databases were searched and a grey literature review conducted. Only randomised or cluster randomised controlled trials, from 2000 to 2020, in adult populations with a sole primary outcome of change in sedentary behaviour were included. Data codebooks were developed, data were extracted, and a narrative synthesis and meta-analysis was conducted using mixed methods random effects models.

RESULTS

Of 5589 studies identified, 7 studies met the inclusion criteria. Six studies reported activPAL3 measures of mean daily sitting time, and four reported mean daily standing time, stepping time and number of sedentary breaks. Pooled analysis of weighted mean differences revealed a reduction in mean daily sitting time of -32.4mins CI (-50.3, -14.4), an increase in mean daily standing time of 31.75mins CI (13.7, 49.8), and mean daily stepping time of 9.5mins CI (2.8, 16.3), and an increase in rate of sedentary breaks per day of 3.6 (CI 1.6, 5.6). BCTs used exclusively in two of the three most effective interventions are 'feedback on behaviour' and 'goal setting behaviour' whilst all three most effective interventions included 'instruction on how to perform the behaviour' and 'adding objects to the environment', BCTs which were also used in less effective interventions.

CONCLUSIONS

Although limited by small sample sizes and short follow up periods, this review suggests that interventions specifically designed to change sedentary behaviour, reduce overall daily sitting time by half an hour, with an equivalent increase in standing time, in the short to medium term. Effective characteristics and behaviour change strategies are identified for future development of high quality interventions targeting change in sedentary behaviour.

PROSPERO REGISTRATION

PROSPERO 2020 CRD42020172457 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172457.

Protocol for a pilot trial to assess the feasibility of the Move More @ Work intervention to encourage employees to take the opportunity to move (be physically active) after every 30 min of sitting

Background

Prolonged sitting increases the risk of cardio-metabolic disease. Office-based employees are particularly susceptible to high rates of this sedentary behaviour during work hours. Laboratory studies indicate that regularly interrupting periods of prolonged sitting with short bouts (2 min) of physical activity can improve markers of cardio-metabolic health. This method of interrupting sitting time is yet to be tested in an occupational setting and may provide an alternative to providing sit-to-stand desks. Drawing on the Behaviour Change Wheel and evidence on the barriers and motivators to performing regular activity breaks, the Move More @ Work intervention was developed. The objectives of this pilot study are to examine the feasibility, and preliminary outcomes, of this intervention designed to encourage participants to perform 1–2 min of activity after every 30 min of continuous sitting throughout the work day. The study will inform if progress to a full effectiveness trial is warranted.

Methods

An interrupted time series design consisting of a 4-week baseline (control period), a 12-week intervention, and a 12-week follow-up will be utilised. At least 57 university employees who self-report spending > 5 h per day sitting at work on at least 3 days per week will be recruited to participate. The intervention consists of (1) a structured consultation with a Move More @ Work coach, containing a number of behaviour change techniques to create an individualised plan of how to incorporate the activity breaks into the working day, and (2) strategies to create a supportive workplace culture for performing the activity breaks. Feasibility will be assessed by recruitment and retention rates, and acceptability of the intervention. Pilot outcomes are the number of regular activity breaks taken during the workday, cardio-metabolic risk score and self-reported health, and work-related productivity outcomes.

Discussion

If the Move More @ Work intervention is shown to be feasible, acceptable, and shows evidence of effectiveness, this will provide justification for the progression to a full scale evaluation of the intervention. In the longer-term, this intervention may provide an alternative means of improving health outcomes through interrupting sedentary time than that offered by current sedentary behaviour interventions.

Trial registration

Australian New Zealand Clinical Trials Registry, ACTRN12620000354987. Registered on 12 March 2020

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-021-00903-2.

A Cluster-Randomised Crossover Pilot Feasibility Study of a Multicomponent Intervention to Reduce Occupational Sedentary Behaviour in Professional Male Employees

Professional male office employees have been identified as those most at risk of prolonged sedentary time, which is associated with many long-term adverse health conditions. The aim of the study was to assess the acceptability and feasibility of a gender-sensitive multicomponent intervention, guided by the socio-ecological model, to reduce occupational sedentary behaviour by increasing physical activity in professional men. The main elements of the intervention comprised: a Garmin watch with associated web-based platform/smartphone application, an under-desk pedal machine, and management participation and support. A cluster-randomised crossover pilot feasibility trial recruiting professional males was conducted in two workplaces. Mixed methods were used to assess the primary outcomes of recruitment, retention, and acceptability and feasibility of the intervention. Secondary outcomes included objectively measured sedentary behaviour, standing and physical activity. Focus groups were used to explore the acceptability of the intervention in a real-world setting. Twenty-two participants were recruited (mean age 42.9 years (SD 11.0)). Recruitment and retention rates were 73.3% and 95%, respectively. Overall, participants found the intervention acceptable and feasible, and expressed enjoyment of the intervention, however desk set-up issues with the pedal devices were noted. The manual recording of the pedalling bouts was overly burdensome. Preliminary data indicate that the intervention may reduce occupational sedentary behaviour and increase physical activity. This intervention should be further tested in a definitive trial following consideration of the findings of this pilot feasibility trial.

Recent Trends in Sedentary Time: A Systematic Literature Review

This paper systematically reviews and synthesizes the relevant literature on sedentary time research. A bibliometric analysis was conducted to evaluate the publications from 2010 to 2020 in the Web of Science (WoS) core collection database. Derwent Data Analyzer software was used for the cleaning, mining, and visualization of the data. Historical trends of the topics, main contributors, leading countries, leading institutions, leading research areas, and journals were explored. A total of 3020 publications were studied. The United States, the United Kingdom, and Australia are the three most productive countries. The Australian institution Baker Heart and Diabetes Institute led the list of productive institutions, and Ekelund U published the most papers. Sedentary time raised the concerns of scholars from 106 research areas, and public health was the dominant field. Physical activity, accelerometer, children, and obesity were the most frequently used keywords. The findings suggest that sedentary time is rapidly emerging as a global issue that has detrimental effects on public health. The hotspots shifted in the past 10 years, and COVID-19 was the most popular topic of sedentary time research.

Sedentary behaviour and health in adults: an overview of systematic reviews

The purpose of this overview of systematic reviews was to determine the relationship between different types and patterns of sedentary behaviour and selected health outcomes in adults and older adults. Five electronic databases were last searched in May, 2019, with a 10-year search limit. Included reviews met the a priori population (community-dwelling adults aged 18 years and older), intervention/exposure/comparator (various types and/or patterns of sedentary behaviour), and outcomes criteria. Eighteen systematic reviews were included in the evidence synthesis. High levels of sedentary behaviour are unfavourably associated with cognitive function, depression, function and disability, physical activity levels, and physical health-related quality of life in adults. Reducing or breaking up sedentary behaviour may benefit body composition and markers of cardiometabolic risk. Total sedentary behaviour and TV viewing were most consistently associated with unfavourable health outcomes, while computer and Internet use may be favourably associated with cognitive function for older adults. The quality of evidence within individual reviews (as assessed by review authors) varied from low to high, while the certainty of evidence was low to very low. These findings have important public health implications, suggesting that adults should avoid high levels of sedentary behaviour and break-up periods of prolonged sitting. (PROSPERO registration nos.: CRD42019123121 and CRD42019127157.) Novelty High levels of sedentary behaviour are unfavourably associated with important health outcomes in adults. Reducing or breaking up sedentary behaviour may benefit body composition and markers of cardiometabolic risk. Computer and Internet use may be favourably associated with cognitive function in older adults.

Behavioral Medicine for Sedentary Behavior, Daily Physical Activity, and Exercise to Prevent Cardiovascular Disease: A Review

PURPOSE OF REVIEW

Behavioral medicine is a multidisciplinary field that has a key role in reducing risk factors for cardiovascular disease (CVD). The purpose of this review is to describe the role of behavioral medicine for CVD prevention, using physical activity behaviors (e.g., sedentary behavior, daily physical activity, or exercise) as an exemplar. Application of behavioral medicine to improve dietary behaviors is also briefly discussed.

RECENT FINDINGS

Behavioral medicine interventions that address physical activity behaviors are associated with improved cardiovascular risk factors. Interventions framed in behavior change theory that integrate behavior change techniques to reduce sedentary behavior and promote daily physical activity and exercise have similarly been applied to improve certain dietary behaviors and show promise for reducing CVD risk factors. Behavioral medicine has an important role in improving various physical activity behaviors for all populations, which is essential for preventing or managing CVD. Further investigation into behavioral medicine interventions that address personal, environmental, and social factors that influence participation in physical activity behaviors, as well as the adoption of a more optimal dietary pattern, is warranted.

Effects of two types of dynamic office workstations (DOWs) used at two intensities on cognitive performance and office work in tasks with various complexity

This study examines the possible effects on objective work performance while using two types of dynamic office workstations (DOWs). 20 participants each used one type with three intensities (seated, light, moderate) and completed a task battery assessing cognitive performance and office work with two levels of complexity. Repeated measures MANOVA showed a significant interaction effect for work performance between the type of workstation and intensity for the simple level and a significant main effect for intensity for the complex level. Comparing the types of DOWs to each other, accuracy of text processing differed when working sedentary. Using both devices with light and moderate intensity had a significant detrimental effect on mouse tasks compared to working sedentary, but none comparing the intensities. No further results indicated neither a detrimental nor an enhancing effect of using DOWs on cognitive performance and office-work related tasks, regardless of the intensity of use or the task complexity. Practitioner Summary: By using DOWs, light physical activity can be integrated while working at a desk. Results showed that using different types of DOWs with different intensities does have a detrimental effect on tasks requiring a high motor control, but not on cognitive or further office work-related tasks of various complexity. Abbreviations: DOW: dynamic office workstation; aLT: activeLife Trainer; DB: deskbike; RPE: rated perceived exertion; MANOVA: multivariate analysis of variance; ANOVA: analysis of variance.

Associations between Daily Work Hassles and Energy-Balance Behaviors in Female African American Workers: An Ecological Momentary Assessment Study

Objective

Despite their high rate of labor force participation, African American women earn less and are overrepresented in service jobs that tend to have fewer benefits, longer work hours, and less flexibility. The aim of our study was to examine associations between work-related daily hassles and energy balance behaviors among female African American workers.

Design

A secondary analysis of a 7-day intensive longitudinal study using ecological momentary assessment (EMA).

Setting

Metropolitan area of Chicago, Illinois, United States; July 2012 through January 2013.

Participants

A convenience sample of 70 female African American workers.

Methods

EMA was used to collect information over seven days on work hassles and energy balance behaviors: empty calorie food intake; moderate-to-vigorous physical activity (MVPA); sedentary behavior; sleep duration; and sleep disturbance. Within-person associations between daily work hassles and each of these daily energy balance behaviors were analyzed using person fixed-effects regression.

Results

A total of 334 person-day observations from 70 female African American workers were included in the final analysis. Reporting at least one daily work hassle was associated with same-day higher empty calorie food intake (OR: 2.2, 95% CI: 1.0, 4.6) and more daily minutes of sedentary behavior (b: 35.8, 95% CI; .2, 71.3). However, no significant associations were found between prior-day work hassles and either food intake or sedentary behavior. Daily work hassles were not related to MVPA, sleep duration, or sleep disturbance.

Conclusions

Our study showed that daily work hassles were associated with female African American workers' empty calorie food intake and sedentary behaviors. Strategies to eliminate daily work hassles may help to improve their energy balance behaviors.

Does It Work for Everyone? The Effect of the Take a Stand! Sitting-Intervention in Subgroups Defined by Socio-Demographic, Health-Related, Work-Related, and Psychosocial Factors

OBJECTIVE

Take a Stand! was a multicomponent workplace-based intervention reducing sitting among office-workers. This study tested whether the effect of Take a Stand! differed across subgroups.

METHODS

A cluster-randomized controlled trial with objectively measured sitting-time as primary outcome evaluated Take a Stand! Main analysis was reanalyzed in strata defined by four levels of preselected factors: socio-demographic (eg, sex); health-related (eg, smoking); work-related (eg, workhours); and psychosocial (eg, motivation to change sitting).

RESULTS

No notable differences in the effect were observed: across all assessed subgroups sitting time was ∼60 minutes less after 1 month and ∼40 minutes less after 3 months in intervention as compared with control group.

CONCLUSION

There was no differential effect of Take a Stand! indicating that the intervention was effective in all groups. This knowledge is advantageous when disseminating similar interventions to different populations of office workers.

Effects of a single dose of tablets containing lactononadecapeptide on cognitive function in healthy adults: a randomized, double-blind, cross-over, placebo-controlled trial

Lactononadecapeptide (LNDP; NIPPLTQTPVVVPPFLQPE) is a memory-improving peptide. The current study aimed to determine the effects of a single dose of tablets containing LNDP on cognitive function in healthy Japanese men aged 30-59 years. A randomized, double-blind, cross-over, placebo-controlled trial was conducted in participants randomly assigned to receive LNDP or placebo tablets. The Uchida-Kraepelin test was used to induce cognitive load in participants as a model of work load. Cognitive function was evaluated using the Japanese version of the CNS Vital Signs. Composite memory and verbal memory were significantly higher following consumption of LNDP than placebo tablets. Carryover effects were observed in attention and concentration domains so that period 1 data was analyzed. LNDP consumption led to higher processing speed, executive function, and cognitive flexibility than placebo. Thus, supplementation with a single dose of LNDP tablets may improve cognitive functions including memory, attention, concentration, and information processing in daily life.

Assessment and Treatment of Emotion Regulation Impairment in Autism Spectrum Disorder Across the Life Span: Current State of the Science and Future Directions

Emotion regulation (ER) is the ability to modify arousal and emotional reactivity to achieve goals and maintain adaptive behaviors. ER impairment in autism spectrum disorder (ASD) is thought to underlie many problem behaviors, co-occurring psychiatric symptoms, and social impairment, and yet is largely unaddressed both clinically and in research. There is a critical need to develop ER treatment and assessment options for individuals with ASD across the life span, given the multitude of downstream effects on functioning. This article summarizes the current state of science in ER assessment and treatment and identifies the most promising measurement options and treatments.

The active workplace study: Protocol for a randomized controlled trial with sedentary workers

OBJECTIVES

Sedentary behavior is pervasive in the workplace and is harmful to health. Research on the effectiveness of comprehensive workplace interventions to reduce sedentary behavior and improve worker health and safety is crucial as sedentary jobs become more common.

METHODS

We developed a Total Worker Health intervention targeting sedentary behavior in call centers, and are evaluating intervention effectiveness in a randomized controlled trial. Four worksites will be randomly assigned to an intervention or control condition. The intervention condition includes the provision of active workstations along with programs and procedures at environmental, organizational, and individual levels. Control worksites will receive active workstations with no additional support, following common organizational practices.

RESULTS

Outcomes include objectively measured physical activity, biological markers of health, and self-report survey data at baseline, after the 6-month intervention or control period, and at a 12-month follow-up.

CONCLUSIONS

The aims of the study are to determine whether a Total Worker Health intervention has stronger impacts on workplace sedentary behavior, uninterrupted bouts of sitting, and worker health and safety compared to a usual practice control condition. The study will inform future workplace sedentary behavior intervention and dissemination research, along with organizational best practices for reducing sedentary behavior in the workplace.

Effects of sedentary behaviour interventions on biomarkers of cardiometabolic risk in adults: systematic review with meta-analyses

CONTEXT/PURPOSE

Observational and acute laboratory intervention research has shown that excessive sedentary time is associated adversely with cardiometabolic biomarkers. This systematic review with meta-analyses synthesises results from free living interventions targeting reductions in sedentary behaviour alone or combined with increases in physical activity.

METHODS

Six electronic databases were searched up to August 2019 for sedentary behaviour interventions in adults lasting for ≥7 days publishing cardiometabolic biomarker outcomes covering body anthropometry, blood pressure, glucose and lipid metabolism, and inflammation (54 studies). The pooled effectiveness of intervention net of control on 15 biomarker outcomes was evaluated using random effects meta-analyses in the studies with control groups not providing other relevant interventions (33 studies; 6-25 interventions analysed).

RESULTS

Interventions between 2 weeks and <6 months in non-clinical populations from North America, Europe and Australia comprised much of the evidence base. Pooled effects revealed small, significant (p<0.05) beneficial effects on weight (≈ -0.6 kg), waist circumference (≈ -0.7 cm), percentage body fat (≈ -0.3 %), systolic blood pressure (≈ -1.1 mm Hg), insulin (≈ -1.4 pM) and high-density lipoprotein cholesterol (≈ 0.04 mM). Pooled effects on the other biomarkers (p>0.05) were also small, and beneficial in direction except for fat-free mass (≈ 0.0 kg). Heterogeneity ranged widely (I2=0.0-72.9).

CONCLUSIONS

Our review of interventions targeting sedentary behaviour reductions alone, or combined with increases in physical activity, found evidence of effectiveness for improving some cardiometabolic risk biomarkers to a small degree. There was insufficient evidence to evaluate inflammation or vascular function. Key limitations to the underlying evidence base include a paucity of high-quality studies, interventions lasting for ≥12 months, sensitive biomarkers and clinical study populations (eg, type 2 diabetes).

PROSPERO TRIAL REGISTRATION NUMBER

CRD42016041742.