Academic journal article Scandinavian Journal of Work, Environment & Health

Effects on Musculoskeletal Pain from “Take a Stand!” – a Cluster-Randomized Controlled Trial Reducing Sitting Time among Office Workers

Academic journal article Scandinavian Journal of Work, Environment & Health

Effects on Musculoskeletal Pain from “Take a Stand!” – a Cluster-Randomized Controlled Trial Reducing Sitting Time among Office Workers

Article excerpt

Worldwide, musculoskeletal pain is a leading cause of years lived with disability. In the 2010 Global Burden of Disease Study, lower-back pain (LBP) was found to be the number one cause of years lived with disability, neck pain the fourth, and other musculoskeletal disorders the sixth (1). Additionally, musculoskeletal pain is well documented to increase risk of disability pension retirement and long term sickness absence (2, 3).

The most common sites for musculoskeletal pain among office workers are pain in neck-shoulders and the lower back (2, 4). Annual prevalence of neck-shoulder pain in office workers has been found to be 27-48% (2, 4, 5) and, for 11-14%, the pain has limited sufferers' ability to perform daily activities (5). The annual prevalence of LBP has been found to be 16-25% (2, 6). The workday of office workers is characterized by desk-based work, which entails many hours of sitting. Several studies have found high sitting time to be a risk factor especially for neck-shoulder pain (5, 7-12).

As high sitting time is associated with musculoskeletal pain, it is relevant to test if addressing sitting time affects musculoskeletal pain. However, only very few studies have considered this. Thorp et al (13) conducted a 5-day cross-over intervention study among 23 overNational weight/obese office workers and found that transitioning between sitting and standing work in 30-minute bouts reduced lower-back discomfort, but not other musculo-skeletal discomfort.

The aim of this study was to evaluate the effects of a 3-month intervention aimed at reducing occupational sitting time on musculoskeletal pain.

Methods

Trial design

Take a Stand! was a cluster randomized controlled trial (RCT) conducted in Denmark and Greenland from November 2013 to June 2014 aiming to reduce sitting time among office workers. An RCT design was used as the intervention was delivered at office level. Primary outcomes of the intervention were sitting time at work, prolonged sitting periods, and sit-to-stand transitions at 1-month follow-up. Secondary outcomes were the sitting outcomes at three months, waist circumference and body fat percentage at three months and musculoskeletal pain at one month. Findings on sitting behavior and anthropometry are reported elsewhere (14). The local Ethics Committee in Denmark (H-6-2013-005) and in Greenland (project 20914-3, id: 2014-095402) approved the study, which was prospectively registered at www. clinicaltrials.gov (NCT01996176). Procedures were designed in accordance with the Helsinki Declaration.

The intervention and its effect on sitting time

The Take a Stand! intervention included five elements: (i) appointment of local ambassadors and management support, (ii) environmental changes, (iii) a lecture, (iv) a workshop aiming at ensuring local adaptation at individual, office and workplace level, and (v) e-mails and text messages. The intervention focused on four strategies to reduce sitting: using a sit-stand desk, breaking up prolonged periods of sitting, having standing and walking meetings, and setting common goals at office level. Control participants were instructed to behave as usual. A detailed description of the intervention is reported elsewhere (14).

Sitting time at work was reduced by 71 minutes after one month and 48 minutes after three months in the intervention compared to the control group. The reduced sitting time at work was primarily replaced by increased standing time. There were no changes in leisure sitting time or in time spend on physical activity during work or leisure. Further results on sitting outcomes are reported elsewhere (14).

Participants

Four workplaces participated in the trial. At each workplace, 4-6 offices (clusters) participated, totalling 317 participants. Eligible workplaces were office-based, with employees who sat most of the workday, and each workplace had to have at least four offices constituting welldefined spaces separated by walls, floors, or locations. …

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