Sedentary Behaviour in the workplace Flashcards
What is sedentary behaviour?
Any waking behaviour with energy expenditure <= 1.5 METs while in sitting or reclined position
Why are we sitting more?
- Mechanisation of work/leisure activities
- Computers
- Industrialisation of home duties
- Inc. pop = drive/commute longer
At risk ppl = office workers, transport drivers, mechanised trades (crane operator)
Lots of sitting is associated with…
- diabetes
- CV events
- death
- cancer
- obesity
- msk symptoms
Strategies to limit harmful effects of prolonged sitting?
- Elimination = work in standing
- Substitution/isolation = Postural variation
- Administrative/PPE = Dynamic sitting/active workstations, SSW, exercise, computer prompts
Benefits of working in standing?
- Higher caloric expenditure
- Reduced BMI
- Improved metabolic health
- Improved CV health
Problems with sit-stand workstations?
- Lack of known guidelines
- Compliance an issue
- Poor postures
- Workstation not adjusted between postures
Other strategies to encourage mvt in the workplace?
- Standing/walking meetings
- stand back of room for meetings
- go to colleague desk instead of phoning
- printers/bins away
- stand to greet
- take stairs
- stand and break every 30mins
- use speaker for calls so can stand and walk
- eat lunch away from desk
Problems with prolonged standing?
- general fatigue (higher HR, thigh muscle activity, 20% more energy than sitting)
- varicose veins and risk of CVD
- msk discomfort - back and legs
Does standing promote weight loss?
NO - but may slow weight gain
Standing and energy expenditure?
Takes 2hrs of standing to burn same energy as 30mins walking
Takes 6hrs of standing to burn same energy as 30mins running
Does standing increase carotid atherosclerosis?
YES
Does standing increase varicose veins?
YES
- LL vol. and circumference due to venous pooling
- Strain on the circulatory system
= VARICOSE VEINS
Standing and knee loading?
30 mins standing = same total knee joint load as walking, over half the load of running
Standing and LBP?
40-70% previously asymptomatic ppl experience LBP within 1hr of standing
Why does standing cause LBP?
- Greater compression loads on the spine
- Low-level muscle fatigue
- Increased coactivity of glute med
- Greater lumbar lordosis
How to predict risk of LBP with standing?
Active hip abduction test
Interventions to reduce LBP? (in desk-bound ppl)
- Behavioural counselling
- Sit-stand desk
- Wrist worn activity prompting device
- CBT for LBP self mgmt
- Supervisor support
Strategies to limit discomfort with standing?
- Elimination = Work in sitting
- Substitution/isolation = Postural variation, anti-fatigue matting
- Administrative/PPE = Shoes/inserts, compression stocking, exercise
Optimal sit-stand ratio?
None - ppl should sit before they get fatigued
Anti-fatigue matting?
Reduced perceived discomfort (less postural sway?)
BUT
- chair wheels don’t roll over
- trip hazard
- infection control concerns
Shoe soles?
Reduce feet tiredness, not back or leg discomfort
Compression stockings?
- Decrease leg discomfort, swelling, fatigue, aching
- Effectiveness depends on level of compression, presence of CV insufficiency
- Recommended for workers who stand for long periods (eg. flight attendants, nurses)
Exercise?
- Reduces severity of LBP during prolonged standing
Recommend sit-stand desk for LBP?
- If relieved by standing, recommend strategies to interrupt sitting before trialling desk
- Desk top height adjustable workstation NOT recommended
- Sit-stand desk may not be enough
Sit-stand desk for history of CVD or myocardial infarct?
Recommend avoid prolonged standing
Sit-stand desk for history of hip/knee OA?
Regular postural change better
Guidelines for transitioning from sit to stand?
- Start slowly (bouts of 10mins, changing posture every 30mins)
- Build up to 2hrs standing and light activity during work day
- Progress to 4hrs total across the day
- Continuous standing for <=1hr, and total/day <=4hrs
- Avoid asymmetrical postures
Does occupational sitting increase CVD?
NO
Does predominantly standing at work increase CVD?
YES
Can you decrease BMI with standing?
NO
Is postural variation a better alternative to standing?
YES
Tips for LBP?
Exercise and fidgeting
Tips for foot pain?
Matting/shoe insoles/exercise
Tips for leg pain?
Compression stockings