title: Reducing office workers’ sitting time: rationale and study design for the Stand Up Victoria cluster randomized trial A prospective study of computer users: I. Study design and incidence of musculoskeletal symptoms and disorders. Comparisons of Musculoskeletal Complaints and Data Entry Between a Sitting and a Sit-Stand Workstation Paradigm Breaking Up Prolonged Sitting Reduces Postprandial Glucose and Insulin Responses Participatory Workplace Interventions Can Reduce Sedentary Time for Office Workers—A Randomised Controlled Trial Multicomponent intervention to reduce daily sedentary time: a randomised controlled trial Increasing passive energy expenditure during clerical work Point-of-choice prompts to reduce sitting time at work: a randomized trial. Office ergonomics training and a sit-stand workstation: effects on musculoskeletal and visual symptoms and performance of office workers. Workplace sitting and height-adjustable workstations: a randomized controlled trial. Postural load during VDU work: a comparison between various work postures. Reducing sitting time in office workers: short-term efficacy of a multicomponent intervention. Alternating bouts of sitting and standing attenuate postprandial glucose responses. The application of an occupational health guideline reduces sedentary behaviour and increases fruit intake at work: results from an RCT
abstract: Background Excessive time spent in sedentary behaviours ( sitting or lying with low energy expenditure ) is associated with an increased risk for type 2 diabetes , cardiovascular disease and some cancers . Desk-based office workers typically accumulate high amounts of daily sitting time , often in prolonged unbroken bouts . The St and Up Victoria study aims to determine whether a 3-month multi-component intervention in the office setting reduces workplace sitting , particularly prolonged , unbroken sitting time , and results in improvements in cardio-metabolic biomarkers and work-related outcomes , compared to usual practice . Methods / Design A two-arm cluster-r and omized controlled trial ( RCT ) , with worksites as the unit of r and omization , will be conducted in 16 worksites located in Victoria , Australia . Work units from one organisation ( Department of Human Services , Australian Government ) will be allocated to either the multi-component intervention ( organisational , environmental [ height-adjustable workstations ] , and individual behavioural strategies ) or to a usual practice control group . The recruitment target is 160 participants ( office-based workers aged 18–65 years and working at least 0.6 full time equivalent ) per arm . At each assessment ( 0- [ baseline ] , 3- [ post intervention ] , and 12-months [ follow-up ] ) , objective measurement via the activPAL3 activity monitor will be used to assess workplace : sitting time ( primary outcome ) ; prolonged sitting time ( sitting time accrued in bouts of ≥30 minutes ) ; st and ing time ; sit-to-st and transitions ; and , moving time . Additional outcomes assessed will include : non-workplace activity ; cardio-metabolic biomarkers and health indicators ( including fasting glucose , lipids and insulin ; anthropometric measures ; blood pressure ; and , musculoskeletal symptoms ) ; and , work-related outcomes ( presenteeism , absenteeism , productivity , work performance ) . Incremental cost-effectiveness and identification of both workplace and individual-level mediators and moderators of change will also be evaluated . Discussion St and Up Victoria will be the first cluster- RCT to evaluate the effectiveness of a multi-component intervention aim ed at reducing prolonged workplace sitting in office workers . Strengths include the objective measurement of activity and assessment of the intervention on markers of cardio-metabolic health . Health- and work-related benefits , as well as the cost-effectiveness of the intervention , will help to inform future occupational practice .Trial registration BACKGROUND A prospect i ve study of computer users was performed to determine the occurrence of and evaluate risk factors for  neck or shoulder ( N/S ) and h and or arm ( H/A ) musculoskeletal symptoms ( MSS ) and disorders ( MSD ) . METHODS Individuals ( n = 632 ) newly hired into jobs requiring > or = 15 hr/week of computer use were followed for up to 3 years . At study entry , workstation dimensions and worker postures were measured and medical and psychosocial risk factors were assessed . Daily diaries were used to document work practice s and incident MSS . Those reporting MSS were examined for specific MSD . Incidence rates of MSS and MSD were estimated with survival analysis . Cox regression models were used to evaluate associations between participant characteristics at entry and MSS and MSD . RESULTS The annual incidence of N/S MSS was 58 cases/100 person-years and of N/S MSD was 35 cases/100 person-years . The most common N/S MSD was somatic pain syndrome . The annual incidence of H/A MSS was 39 cases/100 person-years and of H/A MSD was 21 cases/100 person-years . The most common H/A disorder was deQuervain 's tendonitis . Forty-six percent of N/S and 32 % of H/A MSS occurred during the first month of follow-up . Gender , age , ethnicity , and prior history of N/S pain were associated with N/S MSS and MSD . Gender , prior history of H/A pain , prior computer use , and children at home were associated with either H/A MSS or MSD . CONCLUSIONS H/A and N/S MSS and MSD were common among computer users . More than 50 % of computer users reported MSS during the first year after starting a new job Background : Seated working positions are often regarded as a cause for discomfort in the musculoskeletal system . Performing work in different working positions — that is , alternating between sitting and st and ing ( sit-st and workstation paradigm)—could help reduce physical complaints . Objective : The questions were whether performing office work partly in a st and ing position leads to reduced complaints and whether st and ing would change the efficiency of data entry office work . Method : We investigated the effect of a sit-st and workstation paradigmd during experimental data entry office work on physical and psychological complaints and data entry efficiency by conducting a r and omized controlled trial with 60 male participants ages 18 to 35 years . Results : In this experiment , musculoskeletal complaints were reduced by a sit-st and workstation paradigm . A trend could be identified indicating a small but nonsignificant loss of efficiency in data entry while st and ing . Conclusion : A sit-st and workstation paradigm reduces musculoskeletal complaints without considerably affecting data entry efficiency under the presented study conditions ( young male participants , short duration , fixed and controlled sit-st and workstation paradigm , simulated experimental working condition ) . Application : According to the present data , implementing a sit-st and workstation paradigm can be an effective workplace health intervention to reduce musculoskeletal complaints . This experiment encourages further studies on the effectiveness of a sit-st and workstation paradigm . Experimental research and field studies that prove the reduction of complaints when introducing a sit-st and workstation paradigm in the workplace could be the basis for evidence -based recommendations regarding such interventions OBJECTIVE Observational studies show breaking up prolonged sitting has beneficial associations with cardiometabolic risk markers , but intervention studies are required to investigate causality . We examined the acute effects on postpr and ial glucose and insulin levels of uninterrupted sitting compared with sitting interrupted by brief bouts of light- or moderate-intensity walking . RESEARCH DESIGN AND METHODS Overweight/obese adults ( n = 19 ) , aged 45–65 years , were recruited for a r and omized three-period , three-treatment acute crossover trial : 1 ) uninterrupted sitting ; 2 ) seated with 2-min bouts of light-intensity walking every 20 min ; and 3 ) seated with 2-min bouts of moderate-intensity walking every 20 min . A st and ardized test drink was provided after an initial 2-h period of uninterrupted sitting . The positive incremental area under curves ( iAUC ) for glucose and insulin ( mean [ 95 % CI ] ) for the 5 h after the test drink ( 75 g glucose , 50 g fat ) were calculated for the respective treatments . RESULTS The glucose iAUC ( mmol/L ) ⋅ h after both activity-break conditions was reduced ( light : 5.2 [ 4.1–6.6 ] ; moderate : 4.9 [ 3.8–6.1 ] ; both P < 0.01 ) compared with uninterrupted sitting ( 6.9 [ 5.5–8.7 ] ) . Insulin iAUC ( pmol/L ) ⋅ h was also reduced with both activity-break conditions ( light : 633.6 [ 552.4–727.1 ] ; moderate : 637.6 [ 555.5–731.9 ] , P < 0.0001 ) compared with uninterrupted sitting ( 828.6 [ 722.0–950.9 ] ) . CONCLUSIONS Interrupting sitting time with short bouts of light- or moderate-intensity walking  lowers postpr and ial glucose and insulin levels  in overweight/obese adults . This may improve glucose metabolism and potentially be an important public health and clinical intervention strategy for reducing cardiovascular risk Background Occupational sedentary behaviour is an important contributor to overall sedentary risk . There is limited evidence for effective workplace interventions to reduce occupational sedentary time and increase light activity during work hours . The purpose of the study was to determine if participatory workplace interventions could reduce total sedentary time , sustained sedentary time ( bouts > 30 minutes ) , increase the frequency of breaks in sedentary time and promote light intensity activity and moderate/vigorous activity ( MVPA ) during work hours . Methods A r and omised controlled trial ( ANZCTR number : ACTN12612000743864 ) was conducted using clerical , call centre and data processing workers ( n = 62 , aged 25–59 years ) in 3 large government organisations in Perth , Australia . Three groups developed interventions with a participatory approach : ‘ Active office ’ ( n = 19 ) , ‘ Active Workstation ’ and promotion of incidental office activity ; ‘ Traditional physical activity ’ ( n = 14 ) , pedometer challenge to increase activity between productive work time and ‘ Office ergonomics ’ ( n = 29 ) , computer workstation design and breaking up computer tasks . Accelerometer ( ActiGraph GT3X , 7 days ) determined sedentary time , sustained sedentary time , breaks in sedentary time , light intensity activity and MVPA on work days and during work hours were measured before and following a 12 week intervention period . Results For all participants there was a significant reduction in sedentary time on work days ( −1.6 % , p = 0.006 ) and during work hours ( −1.7 % , p = 0.014 ) and a significant increase in number of breaks/sedentary hour on work days ( 0.64 , p = 0.005 ) and during work hours ( 0.72 , p = 0.015 ) ; there was a concurrent significant increase in light activity during work hours ( 1.5 % , p = 0.012 ) and MVPA on work days ( 0.6 % , p = 0.012 ) . Conclusions This study explored novel ways to modify work practice s to reduce occupational sedentary behaviour . Participatory workplace interventions can reduce sedentary time , increase the frequency of breaks and improve light activity and MVPA of office workers by using a variety of interventions . Trial Registration Australian New Zeal and Clinical Trials Registry ACTN12612000743864 Objectives To test the efficacy of a multicomponent technology intervention for reducing daily sedentary time and improving cardiometabolic disease risk among sedentary , overweight university employees . Design Blinded , r and omised controlled trial . Setting A large south-eastern university in the USA . Participants 49 middle-aged , primarily female , sedentary and overweight adults working in sedentary jobs enrolled in the study . A total of 40 participants completed the study . Interventions Participants were r and omised to either : ( 1 ) an intervention group ( N=23 ; 47.6 + 9.9 years ; 94.1 % female ; 33.2 + 4.5 kg/m2 ) ; ( 2 ) or wait-list control group ( N=17 ; 42.6 + 8.9 years ; 86.9 % female ; 31.7 + 4.9 kg/m2 ) . The intervention group received a theory-based , internet-delivered programme , a portable pedal machine at work and a pedometer for 12 weeks . The wait-list control group maintained their behaviours for 12 weeks . Outcome measures Primary ( sedentary and physical activity behaviour measured objective ly through StepWatch ) and secondary ( heart rate , blood pressure , height , weight , waist circumference , per cent body fat , cardiorespiratory fitness , fasting lipids ) outcomes were measured at baseline and postintervention ( 12 weeks ) . Exploratory outcomes including intervention compliance and process evaluation measures were also assessed postintervention . Results Compared to controls , the intervention group reduced daily sedentary time ( mean change ( 95%CI ) : −58.7 min/day ( −118.4 to 0.99 ; p<0.01 ) ) after adjusting for baseline values and monitor wear time . Intervention participants logged on to the website 71.3 % of all intervention days , used the pedal machine 37.7 % of all working intervention days and pedalled an average of 31.1 min/day . Conclusions These findings suggest that the intervention was engaging and result ed in reductions in daily sedentary time among full-time sedentary employees . These findings hold public health significance due to the growing number of sedentary jobs and the potential of these technologies in large-scale worksite programmes . Trial Registration Clinical Trials.gov # NCT01371084 Sitting on a therapy ball or st and ing may be a passive means of increasing energy expenditure throughout the workday . The purpose of this study was to determine the energy expenditure and liking of performing clerical work in various postures . Subjects included 24 men and women employed in sedentary clerical occupations .  Energy expenditure was measured while word processing in three st and ardized postures ; sitting in an office chair , sitting on a therapy ball , and st and ing . Adults ranked their comfort , fatigue , and liking of each posture and were asked to perform their choice of 20 min of additional clerical work in one of the postures . Energy expenditure was 4.1 kcal/h greater ( p ≤ 0.05 ) while performing clerical work while sitting on a therapy ball and st and ing than while sitting in an office chair . There was no difference in energy expenditure between the therapy ball and st and ing postures ( p ≥ 0.48 ) . Subjects also liked sitting on a therapy ball  as much as sitting in an office chair and liked sitting on a therapy ball  more than st and ing ( p ≤ 0.05 ) . More subjects chose to perform additional clerical work while seated on a therapy ball than while st and ing ( p = 0.03 ) . In conclusion , sitting on a therapy ball or st and ing rather than sitting in an office chair while performing clerical work increases passive energy expenditure BACKGROUND Prolonged sitting is prevalent in the workplace and is associated with adverse health markers . PURPOSE Investigate the effects of point-of-choice ( PoC ) prompting software , on the computer used at work ( PC ) , to reduce long uninterrupted sedentary periods and total sedentary time at work . DESIGN Assessor-blinded , parallel group , active-controlled r and omized trial . SETTING / PARTICIPANTS A convenience sample of office workers from Glasgow , United Kingdom . Data were collected April to June 2010 , and analyzed October 2010 to June 2011 . INTERVENTION The education group ( n=14 ) received a brief education session on the importance of reducing long sitting periods at work .  The PoC group ( n=14 ) received the same education along with prompting software on their PC for 5 workdays , which reminded them to st and up every 30 minutes . MAIN OUTCOME MEASURES Sitting time was measured objective ly using the activPAL ™ activity monitor for 5 workdays at baseline and 5 workdays during the intervention . The number and time spent sitting in events > 30 minutes ' duration were the main outcome measures . RESULTS At baseline , participants spent 5.7±1.0 hours/day ( 76%±9 % ) of their time at work sitting . Of that time , 3.3±1.3 hours/day was spent sitting in 3.7±1.4 events > 30 minutes . There was a significant difference between the groups in the change ( intervention to baseline ) of both the number ( ANCOVA ; -6.8 % , p=0.014 ) and duration ( -15.5 % , p=0.007 ) of sitting events > 30 minutes . During the intervention , compared with baseline , the PoC group reduced the number ( paired t-test ; -0.11 events/hour , p=0.045 ) and duration ( -12.2 % , p=0.035 ) of sitting events > 30 minutes . However , there was no significant difference in total sitting time between groups ( -4.4 % , p=0.084 ) . CONCLUSIONS Point-of-choice prompting software on work computers recommending taking a break from sitting plus education is superior to education alone in reducing long uninterrupted sedentary periods at work . TRIAL REGISTRATION This trial was registered at Clinical Trials.govNCT01628861 Work Related Musculoskeletal Disorders ( WMSDs ) among office workers with intensive computer use is widespread and the prevalence of symptoms is growing . This r and omized controlled trial investigated the effects of an office ergonomics training combined with a sit-st and workstation on musculoskeletal and visual discomfort , behaviors and performance .  Participants performed a lab-based customer service job for 8 h per day , over 15 days and were assigned to :  Ergonomics Trained ( n = 11 ) or Minimally Trained ( n = 11 ) . The training consisted of : a 1.5-h interactive instruction , a sit/st and practice period , and ergonomic reminders . Ergonomics Trained participants experienced minimal musculoskeletal and visual discomfort across the 15 days , varied their postures , with significantly higher performance compared to the Minimally Trained group who had a significantly higher number of symptoms , suggesting that training plays a critical role . The ability to mitigate symptoms , change behaviors and enhance performance through training combined with a sit-st and workstation has implication s for preventing discomforts in office workers BACKGROUND Desk-based office employees sit for most of their working day . To address excessive sitting as a newly identified health risk , best practice frameworks suggest a multi-component approach . However , these approaches are re source intensive and knowledge about their impact is limited . PURPOSE To compare the efficacy of a multi-component intervention to reduce workplace sitting time , to a height-adjustable workstations-only intervention , and to a comparison group ( usual practice ) . DESIGN Three-arm quasi-r and omized controlled trial in three separate administrative units of the University of Queensl and , Brisbane , Australia . Data were collected between January and June 2012 and analyzed the same year . SETTING / PARTICIPANTS Desk-based office workers aged 20 - 65 ( multi-component intervention , n=16 ; workstations-only , n=14 ; comparison , n=14 ) . INTERVENTION The multi-component intervention comprised installation of height-adjustable workstations and organizational-level ( management consultation , staff education , manager e-mails to staff ) and individual-level ( face-to-face coaching , telephone support ) elements . MAIN OUTCOME MEASURES Workplace sitting time ( minutes/8-hour workday ) assessed objective ly via activPAL3 devices worn for 7 days at baseline and 3 months ( end-of-intervention ) . RESULTS At baseline , the mean proportion of workplace sitting time was approximately 77 % across all groups ( multi-component group 366 minutes/8 hours [ SD=49 ] ; workstations-only group 373 minutes/8 hours [ SD=36 ] , comparison 365 minutes/8 hours [ SD=54 ] ) . Following intervention and relative to the comparison group , workplace sitting time in the multi-component group was reduced by 89 minutes/8-hour workday ( 95 % CI=-130 , -47 minutes ; p<0.001 ) and 33 minutes in the workstations-only group ( 95 % CI=-74 , 7 minutes , p=0.285 ) . CONCLUSIONS A multi-component intervention was successful in reducing workplace sitting . These findings may have important practical and financial implication s for workplaces targeting sitting time reductions . CLINICAL TRIAL REGISTRATION Australian New Zeal and Clinical Trials Registry 00363297 The aim of this study was to compare the postural load during VDU work in the following work postures : ( 1 )  Supporting and not supporting the forearms on the table top  , ( 2 )  Sitting and st and ing positions  , and ( 3 )  Sightline to the centre of the screen at an angle of 15 degrees and 30 degrees below the horizontal . The muscle load from the upper part of musculus trapezius and from the lumbar part of musculus erector spinae ( L3 level ) was measured by electromyography ( EMG ) .  Postural angles of head , upper arm and back were measured by inclinometers . The load on m. trapezius when using the keyboard was significantly less in sitting with supported forearms compared to sitting and st and ing without forearm support . Further , the time and number of periods when the trapezius load was below 1 % MVC was significantly greater with support versus no support . The load on the right erector spinae lumbalis was also significantly less and the time when the load was below 1 % MVC was significantly longer in a sitting work position with support versus st and ing without support . In addition , when using a mouse supporting the forearms reduced the static trapezius load in sitting . The results from this study document clearly the importance of giving the operator the possibility of supporting the forearms on the table top OBJECTIVE To investigate the short-term efficacy of a multicomponent intervention to reduce office workers ' sitting time . METHODS Allocation for this non-r and omized controlled trial ( n=43 participants ; 56 % women ; 26 - 62 years ; Melbourne , Australia ) was by office floor , with data collected during July-September 2011 . The 4-week intervention emphasized three key messages : " St and Up , Sit Less , Move More " and comprised organizational , environmental , and individual elements . Changes in minutes/day at the workplace spent sitting ( primary outcome ) , in prolonged sitting ( sitting time accumulated in bouts ≥ 30 min ) , st and ing , and moving were objective ly measured ( activPAL3 ) . RESULTS Relative to the controls , the intervention group significantly reduced workplace sitting time ( mean change [ 95%CI ] : -125 [ -161 , -89 ] min/8-h workday ) , with changes primarily driven by a reduction in prolonged sitting time ( -73 [ -108 , -40 ] min/8-h workday ) . Workplace sitting was almost exclusively replaced by st and ing ( + 127 [ + 92 , + 162 ] min/8-h workday ) with non-significant changes to stepping time ( -2 [ -7 , + 4 ] min/8-h workday ) and number of steps ( -70 [ -350 , 210 ] ) . CONCLUSIONS This multicomponent workplace intervention demonstrated that substantial reductions in sitting time are achievable in an office setting . Larger studies with longer timeframes are needed to assess sustainability of these changes , as well as their potential longer-term impacts on health and work-related outcomes PURPOSE This study aim ed to examine whether reductions in sitting time through alternating 30-min bouts of sitting and st and ing can reduce postpr and ial glucose , insulin , and triglyceride responses . METHODS Twenty-three overweight/obese sedentary office workers ( 17 males and six females ; mean ± SD : age , 48.2 ± 7.9 yr ; body mass index , 29.6 ± 4.0 kg · m(-2 ) ) undertook two short-term ( 5 d ) experimental conditions in an equal , r and omized ( 1:1 ) order . In a simulated office environment , participants performed typical occupational tasks for 8 h · d(-1 ) while in a 1 ) seated work posture ( control condition ) or 2 ) interchanging between a seated and st and ing work posture every 30 min using an electric , height-adjustable workstation ( intervention condition ) . Fasting and postpr and ial blood sample s after a mixed test drink were collected hourly for 4 h on days 1 and 5 of each condition to assess serum insulin , plasma glucose , and triglycerides . Dietary intake  ( kJ · d(-1 ) ) and physical activity  were st and ardized during each condition . The trial was registered with the Australian New Zeal and Clinical Trials Registry ( ACTRN12611000632998 ) . RESULTS After adjustment for time ( days 1 and 5 ) , incremental area under the analyte time curve differed significantly between conditions for plasma glucose ( P = 0.007 ) but not for serum insulin or plasma triglycerides . Adjusted mean glucose incremental area under the analyte time curve was lowered by 11.1 % after the intervention condition ( 6.38 mM · h(-1 ) ( confidence interval , 5.04 - 7.71 ) ) relative to the control condition ( 7.18 mM · h(-1 ) ( confidence interval , 5.85 - 8.52 ) ) . No temporal changes ( days 1 vs 5 ) between conditions were observed . CONCLUSIONS Alternating st and ing and sitting in 30-min bouts results in modest beneficial effects on postpr and ial glucose responses in overweight/obese office workers Objective To evaluate the effectiveness of a draft occupational health practice guideline aim ed at preventing weight gain on employees ' physical activity , sedentary behaviour and dietary behaviour and on body weight-related outcomes . Methods A r and omised controlled trial was performed comparing guideline -based care to usual care among 16 occupational physicians and 523 employees in the Netherl and s between 2009 and 2011 . Occupational physicians in the intervention group followed the draft guideline by providing advice to employers on how to assess and intervene on the obesogenic work environment and conducted five face-to-face behavioural change counselling sessions with employees to improve their lifestyle . Data of employees were collected by question naire and physical measurements at baseline and 6-months follow-up . Linear and logistic regression analyses were performed to determine effects . Results The intervention showed significant effects on sedentary behaviour at work ( β −28 min/day , 95 % CI −2 to −54 ) and on fruit intake ( β 2.1 pieces/week ; 95 % CI 0.6 to 3.6 ) . No significant intervention effects were found for physical activity , sedentary behaviour in leisure time or during weekend days , snack intake and body weight-related outcomes . Conclusion Guideline -based care result ed in a more favourable sedentary behaviour at work and increased fruit intake but did not improve employees '  physical activity , snack intake or body weight-related outcomes . Trial registration number IS RCT N/73545254 and NTR/1190
target: Non-significant changes were reported for most health- and work-related outcomes .
  Findings suggest that activity-permissive workstations can be effective to reduce occupational sedentary time , without compromising work performance .
background: Excessive sedentary time is detrimentally linked to obesity , type 2 diabetes , cardiovascular disease and premature mortality .
  Studies have been investigating the use of activity-permissive workstations to reduce sedentary time in office workers , a highly sedentary target group .
  This review systematic ally summarizes the evidence for activity-permissive workstations on sedentary time , health-risk biomarkers , work performance and feasibility indicators in office workplaces .