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      Evaluation of sit-stand workstations in an office setting: a randomised controlled trial

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          Abstract

          Background

          Excessive sitting time is a risk factor for cardiovascular disease mortality and morbidity independent of physical activity. This aim of this study was to evaluate the impact of a sit-stand workstation on sitting time, and vascular, metabolic and musculoskeletal outcomes in office workers, and to investigate workstation acceptability and feasibility.

          Methods

          A two-arm, parallel-group, individually randomised controlled trial was conducted in one organisation. Participants were asymptomatic full-time office workers aged ≥18 years. Each participant in the intervention arm had a sit-stand workstation installed on their workplace desk for 8 weeks. Participants in the control arm received no intervention. The primary outcome was workplace sitting time, assessed at 0, 4 and 8 weeks by an ecological momentary assessment diary. Secondary behavioural, cardiometabolic and musculoskeletal outcomes were assessed. Acceptability and feasibility were assessed via questionnaire and interview. ANCOVA and magnitude-based inferences examined intervention effects relative to controls at 4 and 8 weeks. Participants and researchers were not blind to group allocation.

          Results

          Forty-seven participants were randomised (intervention n = 26; control n = 21). Relative to the control group at 8 weeks, the intervention group had a beneficial decrease in sitting time (−80.2 min/8-h workday (95 % CI = −129.0, −31.4); p = 0.002), increase in standing time (72.9 min/8-h workday (21.2, 124.6); p = 0.007) and decrease in total cholesterol (−0.40 mmol/L  (−0.79, −0.003); p = 0.049). No harmful changes in musculoskeletal discomfort/pain were observed relative to controls, and beneficial changes in flow-mediated dilation and diastolic blood pressure were observed. Most participants self-reported that the workstation was easy to use and their work-related productivity did not decrease when using the device. Factors that negatively influenced workstation use were workstation design, the social environment, work tasks and habits.

          Conclusion

          Short-term use of a feasible sit-stand workstation reduced daily sitting time and led to beneficial improvements in cardiometabolic risk parameters in asymptomatic office workers. These findings imply that if the observed use of the sit-stand workstations continued over a longer duration, sit-stand workstations may have important ramifications for the prevention and reduction of cardiometabolic risk in a large proportion of the working population.

          Trial registration

          ClinicalTrials.gov NCT02496507.

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          Most cited references31

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          Sedentary behaviors and subsequent health outcomes in adults a systematic review of longitudinal studies, 1996-2011.

          To systematically review and provide an informative synthesis of findings from longitudinal studies published since 1996 reporting on relationships between self-reported sedentary behavior and device-based measures of sedentary time with health-related outcomes in adults. Studies published between 1996 and January 2011 were identified by examining existing literature reviews and by systematic searches in Web of Science, MEDLINE, PubMed, and PsycINFO. English-written articles were selected according to study design, targeted behavior, and health outcome. Forty-eight articles met the inclusion criteria; of these, 46 incorporated self-reported measures including total sitting time; TV viewing time only; TV viewing time and other screen-time behaviors; and TV viewing time plus other sedentary behaviors. Findings indicate a consistent relationship of self-reported sedentary behavior with mortality and with weight gain from childhood to the adult years. However, findings were mixed for associations with disease incidence, weight gain during adulthood, and cardiometabolic risk. Of the three studies that used device-based measures of sedentary time, one showed that markers of obesity predicted sedentary time, whereas inconclusive findings have been observed for markers of insulin resistance. There is a growing body of evidence that sedentary behavior may be a distinct risk factor, independent of physical activity, for multiple adverse health outcomes in adults. Prospective studies using device-based measures are required to provide a clearer understanding of the impact of sedentary time on health outcomes. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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            Breaks in sedentary time: beneficial associations with metabolic risk.

            Total sedentary (absence of whole-body movement) time is associated with obesity, abnormal glucose metabolism, and the metabolic syndrome. In addition to the effects of total sedentary time, the manner in which it is accumulated may also be important. We examined the association of breaks in objectively measured sedentary time with biological markers of metabolic risk. Participants (n = 168, mean age 53.4 years) for this cross-sectional study were recruited from the 2004-2005 Australian Diabetes, Obesity and Lifestyle study. Sedentary time was measured by an accelerometer (counts/minute(-1) or = 100) was considered a break. Fasting plasma glucose, 2-h plasma glucose, serum triglycerides, HDL cholesterol, weight, height, waist circumference, and resting blood pressure were measured. MatLab was used to derive the breaks variable; SPSS was used for the statistical analysis. Independent of total sedentary time and moderate-to-vigorous intensity activity time, increased breaks in sedentary time were beneficially associated with waist circumference (standardized beta = -0.16, 95% CI -0.31 to -0.02, P = 0.026), BMI (beta = -0.19, -0.35 to -0.02, P = 0.026), triglycerides (beta = -0.18, -0.34 to -0.02, P = 0.029), and 2-h plasma glucose (beta = -0.18, -0.34 to -0.02, P = 0.025). This study provides evidence of the importance of avoiding prolonged uninterrupted periods of sedentary (primarily sitting) time. These findings suggest new public health recommendations regarding breaking up sedentary time that are complementary to those for physical activity.
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              Statistics notes: Analysing controlled trials with baseline and follow up measurements.

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                Author and article information

                Contributors
                (+44)151 231 4249 , l.e.graves@ljmu.ac.uk
                R.C.Murphy@ljmu.ac.uk
                S.Shepherd@ljmu.ac.uk
                J.A.Cabot@2011.ljmu.ac.uk
                N.D.Hopkins@ljmu.ac.uk
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                19 November 2015
                19 November 2015
                2015
                : 15
                : 1145
                Affiliations
                [ ]Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
                [ ]Research Institute for Sport and Exercise Science, Physical Activity Exchange, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT UK
                Article
                2469
                10.1186/s12889-015-2469-8
                4653846
                26584856
                5485ce0a-c849-4d5b-acbc-11ffb043b60c
                © Graves et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 June 2015
                : 3 November 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Public health
                sitting,intervention,desks,workplace,cardiovascular,metabolic,qualitative
                Public health
                sitting, intervention, desks, workplace, cardiovascular, metabolic, qualitative

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