05 November 2014

'Standing breaks' at work may reduce back pain

Research indicates that regular breaks across the workday lead to improvements in fatigue and musculoskeletal symptoms, compared to sitting all day.


The evils of too much sitting include body aches, pains and fatigue, but a new study suggests that 30-minute stints of standing at work may relieve aching backs without harming productivity.

Regular breaks

Australian office workers alternated between sitting and standing every 30 minutes for a week and felt less fatigued and less back pain and lower-leg pain than when they stayed seated the whole day.

"Our results confirm what we expected – that introducing regular breaks across the workday leads to improvements in fatigue and musculoskeletal symptoms compared to sitting all day," said Alica A. Thorp, a postdoctoral research fellow at the Baker IDI Heart and Diabetes Institute in Melbourne, Australia, who led the study.

Prolonged sitting has been linked with a variety of health problems, but office workers often have little choice about their work environment. Past research has found office workers spend about 75 percent of their work day sitting in a chair, Thorp's team writes in Occupational and Environmental Medicine.

Read: Sedentary behaviour a risk for health problems

The researchers set out to study various effects on health – including joint and muscle pain – and on workers' focus and productivity of taking standing "breaks" during the day.

For the study, 17 men and six women were randomly assigned to one of two groups. Everyone used an electric adjustable-height workstation, but one group sat while working over the course of an eight-hour day and the other alternated every 30 minutes between sitting and standing.

Overweight and obese

The workers did this for five days, then during a second five-day work week, the groups switched roles.

The participants were mostly middle-aged, 15 were overweight and the rest were obese.

People in the sit-stand group, who adjusted the height of the table as they stood up to work, wore a physical activity monitor on their right thigh to gauge their sitting, standing and walking times.

Read: The anatomy of walking

On day five of each work week, everyone filled out questionnaires measuring their fatigue levels, musculoskeletal discomfort, feelings about their own productivity and how well they liked the adjustable workstation.

People had an average fatigue score of 52.7 when they sit-stood while working, compared to 67.8 when they sat all day. A score of 66 or more was considered an "elevated level" of fatigue compared to what a healthy person would feel.

People in the sit-stand group also had 32 percent fewer musculoskeletal symptoms in the lower back and 14 percent fewer in their ankles and feet compared to when they sat all day.

Better productivity

Workers reported better focus and concentration while seated, although work productivity did not differ significantly between the two study groups. There was also a trend toward better productivity and less impatience and irritability in the sit-stand group, the researchers said.

The workstation was also much more pleasant overall for the sit-stand groups, who rated their enjoyment of it at 81 out of 100, versus a score of 64 for the sitting-only groups.

"While we didn't see a statistically significant improvement in productivity, the finding that intermittent standing across the workday did not adversely affect worker's productivity is important," Thorp told Reuters Health in an email.

"Given that we observed a significant reduction in fatigue levels over five consecutive days, it is possible that over a longer period of time this would have translated into a significant improvement in productivity," she said.

Read: Sedentary jobs driving obesity epidemic

Dorothy Dunlop, a professor of medicine at Northwestern University Feinberg School of Medicine, said the study was a "wake-up call" about the importance of physical activity for health, though too small to gauge productivity or concentration.

"I think this is a promising study which adds important evidence supporting the benefits of reduced sedentary behaviour," said Dunlop, who wasn't involved in the research. "To my knowledge, it's the first study showing well-documented reductions in sedentary behaviour are clearly tied to better outcomes," she said.

Preventing disability

"The Holy Grail will be finding interventions that can be sustained over a long period of time and produce good long-term outcomes . . . but this is a strong starting point," said Dunlop, who studies physical activity as a way to prevent disability in older adults.

"I think the evidence we're starting to accumulate shows standing is more beneficial than sitting and moving is more beneficial than standing," said Dunlop. "We want people to get up and move."

To get moving in an office job, Dunlop suggested also walking over to talk to colleagues rather than emailing, taking stairs instead of elevators or standing during a phone call or meeting.

Read: Active seniors may outlive sedentary peers

Another small study of the psychology of work environments recently found that productivity may be enhanced in meetings where everyone is standing.

Policy changes

Dunlop noted, however, that more work was needed before a policy change on continuous sitting in office jobs.

In addition to musculoskeletal problems, the Australian study was primarily focused on risk factors for diabetes and heart disease, so the researchers recruited only overweight and obese participants to see if their risk for those conditions was worsened by sitting.

The study cannot say whether the back pain benefits would be the same for normal-weight people or for those with back disorders more severe than the mild aches caused by sitting for too long.

In general, though, Thorp said office workers should take an exercise cue from the study, but cautioned against standing for more than an hour, which can also cause fatigue and musculoskeletal problems. She added that she hoped the study would help lead to public policy changes in Australia that reduce workplace sedentary time.

"The message for sedentary workers should be to alternate regularly between sitting and standing across the work day for health," Thorp said.

SOURCE: Occupational and Environmental Medicine, online August 28, 2014.

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