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

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

A case study detailing key considerations for implementing a telehealth approach to office ergonomics

Telehealth approaches to delivering ergonomics assessment hold great potential to improve service delivery in rural and remote settings. This case study describes a telehealth-based ergonomics service delivery process, and compares in-person and telehealth-based ergonomics approaches at an Alberta-based non-profit advocacy group. This project demonstrates that telehealth approaches to ergonomics do not lead to significantly different scoring outcomes for assessment of ergonomics issues, when compared to in-person assessments. This project also outlines the importance of live real-time video conferencing to improving communication, attaining key assessment information, and demonstrating ergonomic adjustments. However, some key considerations of bandwidth and hardware capabilities need to be taken into account. Key communication strategies are outlined to improve rapport, maintain employee confidentiality, and reduce client anxiety around telehealth ergonomics assessments. This project provides further support for telehealth approaches to office ergonomics, and outlines some key implementation strategies and barriers that should be considered.

First steps for integrating sex and gender considerations into basic experimental biomedical research

In recent decades there has been an increasing recognition of the need to account for sex and gender in biology and medicine, in order to develop a more comprehensive understanding of biological phenomena and to address gaps in medical knowledge that have arisen due to a generally masculine bias in research. We have noted that as basic experimental biomedical researchers, we face unique challenges to the incorporation of sex and gender in our work, and that these have remained largely unarticulated, misunderstood, and unaddressed in the literature. Here, we describe some of the specific challenges to the incorporation of sex and gender considerations in research involving cell cultures and laboratory animals. In our view, the mainstreaming of sex and gender considerations in basic biomedical research depends on an approach that will allow scientists to address these issues in ways that do not undermine our ability to pursue our fundamental scientific interests. To that end, we suggest a number of strategies that allow basic experimental researchers to feasibly and meaningfully take sex and gender into account in their work.

Development of discomfort and vascular and muscular changes during a prolonged standing task

Background: Some proposed mechanisms for the development of back discomfort and musculoskeletal disorders relate to fatigue of trunk musculature, but these phenomena require further investigation. Hydrostatic pressure changes in vascular tissue are thought to drive development of lower limb discomfort and vascular disorders; however, specific vascular outcomes during standing work have not been investigated experimentally. Objectives: The goals of this experiment were to evaluate the effects of standing work on indicators of discomfort and on biological variables related to risk for trunk musculoskeletal andlower limb vascular disorders. Methods: Ten university-aged female volunteers, who did not work in jobs requiring prolonged standing, moved small objects between two containers for 32 minutes while standing. Electromyography from the erector spinae and rectus abdominis, lower limb blood flow data, brachial and ankle blood pressure, heart rate, and discomfort ratings were collected every 4 minutes. Results: There were no significant changes in electromyography outcomes for either muscle group. Foot and soleus blood flow (p < 0.05) and ankle blood pressure (p < 0.05) increased over time. There were strong correlations (> 0.8) between lower limb discomfort (feet and knees) and blood flow in the foot and soleus. Conclusions: Blood pooling may explain the discomfort associated with the simulated standing work evaluated here, and this vascular indicator should be tracked when attempting to alleviate lower limb symptoms in various working postures. Additional work is needed to determine which musculoskeletal indicators might explain back discomfort during standing.