Impact of Sit-to-Stand and Treadmill Desks on Patterns of Daily Waking Physical Behaviors Among Overweight and Obese Seated Office Workers: Cluster Randomized Controlled Trial.

BACKGROUND: Sit-to-stand and treadmill desks may help sedentary office workers meet the physical activity guideline to "move more and sit less," but little is known about their long-term impact on altering the accumulation patterns of physical behaviors. OBJECTIVE: This study explores the impact of sit-to-stand and treadmill desks on physical behavior accumulation patterns during a 12-month multicomponent intervention with an intent-to-treat design in overweight and obese seated office workers. METHODS: In total, 66 office workers were cluster randomized into a seated desk control (n=21, 32%; 8 clusters), sit-to-stand desk (n=23, 35%; 9 clusters), or treadmill desk (n=22, 33%; 7 clusters) group. Participants wore an activPAL (PAL Technologies Ltd) accelerometer for 7 days at baseline, 3-month follow-up (M3), 6-month follow-up (M6), and 12-month follow-up (M12) and received periodic feedback on their physical behaviors. Analyses of physical behavior patterns included total day and workday number of sedentary, standing, and stepping bouts categorized into durations ranging from 1 to 60 and >60 minutes and usual sedentary, standing, and stepping bout durations. Intervention trends were analyzed using random-intercept mixed linear models accounting for repeated measures and clustering effects. RESULTS: The treadmill desk group favored prolonged sedentary bouts (>60 min), whereas the sit-to-stand desk group accrued more short-duration sedentary bouts (<20 min). Therefore, compared with controls, sit-to-stand desk users had shorter usual sedentary bout durations short-term (total day ΔM3: -10.1 min/bout, 95% CI -17.9 to -2.2; P=.01; workday ΔM3: -20.3 min/bout, 95% CI -37.7 to -2.9; P=.02), whereas treadmill desk users had longer usual sedentary bout durations long-term (total day ΔM12: 9.0 min/bout, 95% CI 1.6-16.4; P=.02). The treadmill desk group favored prolonged standing bouts (30-60 min and >60 min), whereas the sit-to-stand desk group accrued more short-duration standing bouts (<20 min). As such, relative to controls, treadmill desk users had longer usual standing bout durations short-term (total day ΔM3: 6.9 min/bout, 95% CI 2.5-11.4; P=.002; workday ΔM3: 8.9 min/bout, 95% CI 2.1-15.7; P=.01) and sustained this long-term (total day ΔM12: 4.5 min/bout, 95% CI 0.7-8.4; P=.02; workday ΔM12: 5.8 min/bout, 95% CI 0.9-10.6; P=.02), whereas sit-to-stand desk users showed this trend only in the long-term (total day ΔM12: 4.2 min/bout, 95% CI 0.1-8.3; P=.046). The treadmill desk group accumulated more stepping bouts across various bins of duration (5-50 min), primarily at M3. Thus, treadmill desk users had longer usual stepping bout durations in the short-term compared with controls (workday ΔM3: 4.8 min/bout, 95% CI 1.3-8.3; P=.007) and in the short- and long-term compared with sit-to-stand desk users (workday ΔM3: 4.7 min/bout, 95% CI 1.6-7.8; P=.003; workday ΔM12: 3.0 min/bout, 95% CI 0.1-5.9; P=.04). CONCLUSIONS: Sit-to-stand desks exerted potentially more favorable physical behavior accumulation patterns than treadmill desks. Future active workstation trials should consider strategies to promote more frequent long-term movement bouts and dissuade prolonged static postural fixity. TRIAL REGISTRATION: ClinicalTrials.gov NCT02376504; https://clinicaltrials.gov/ct2/show/NCT02376504.

A good beginning: study protocol for a group-randomized trial to investigate the effects of sit-to-stand desks on academic performance and sedentary time in primary education.

BACKGROUND: Sedentary behavior is associated with health risks and academic under-achievement in children. Still, children spend a large part of their waking hours sitting at a desk at school. Recent short-term studies demonstrated the potential of sit-to-stand desks to reduce sitting time in primary education. The program of "A Good Beginning" was conceived to assess the long-term effects of sit-to-stand desks on sitting time in primary education, and to examine how sit-to-stand desks versus regular desks relate to academic performance, and measures of executive functioning, health and wellbeing. The present paper describes the design of this group-randomized trial, which started in 2017 and will be completed in 2019. METHODS: Children of two grade-three groups (age 8-9) following regular primary education in Leiden, The Netherlands, were recruited. A coin toss determined which group is the experimental group; the other group is the control group. All children in the experimental group received sit-to-stand desks. They are invited and motivated to reduce sedentary time at school, however, it is their own choice to sit or stand. Children in the control group use regular desks. Otherwise, both groups receive regular treatment. Outcomes are assessed at baseline (T0) and at five follow-up sessions (T1-T5) alternately in winter and summer seasons over three academic years. Primary outcome measures are academic performance, and the proportion of sitting time at school, measured with a 3D accelerometer. Secondary outcome measures are a number of measures related to executive functioning (e.g., N-back task for working memory), health (e.g., height and weight for BMI), and wellbeing (e.g., KIDSCREEN-52 for Quality of Life). DISCUSSION: A Good Beginning is a two-and-a-half-year research program, which aims to provide a better understanding of the long-term effects of sit-to-stand desks on sedentary time at school and the relation between sitting time reduction and academic performance, executive functioning, health and wellbeing. The findings may serve as useful information for policy making and practical decision making for school and classroom environments. TRIAL REGISTRATION: The program of "A Good Beginning" is registered at the Netherlands Trial Register (NTR, https://www.trialregister.nl), number NL6166, registration date 24 November 2016.

A Qualitative Study of the Feasibility and Acceptability of Implementing 'Sit-To-Stand' Desks in Vocational Education and Training.

While it has been shown that interrupting a person's sedentary behaviour has the potential to improve cognitive, physical and mental health, a large part of time that students spend in school is sedentary. As research has shown that approximately 80% of vocational education and training (VET) students have an unhealthy sedentary lifestyle, implementing "sit-to-stand" (StS) desks could interrupt sedentary behaviour and promote healthier behaviour. Therefore, the acceptability and feasibility of using such desks in the VET setting should be investigated. Using semi-structured focus group interviews analysed via deductive content analysis, the opinions of 33 students for the following topics were assessed: (1) usage of the standing option of the desks (2) reasons for standing in class (3) experienced effect of standing behind the desk, and (4) fostering future StS desks usage. Although VET students are aware of the potential benefits of using StS desks, they need to be actively stimulated and motivated by teachers to use them. In addition, time is needed to get into the habit of standing. Thus, for successful implementation of StS desks in the VET setting, all stakeholders (i.e., students, teachers, schoolboards) should be actively involved in stimulating the healthy behaviour of VET students.

Teachers' Perspective on Strategies to Reduce Sedentary Behavior in Educational Institutions.

Standing desks and physical activity breaks can counteract the negative consequences of sedentarism at school. However, the implementation of these strategies should not restrict the pedagogical process. The aim of this study was to assess teachers' perspectives on strategies to reduce sedentary behavior (SB) of students in the classroom. An online survey was conducted, and the answers were analyzed using descriptive statistics and frequency distribution. The relationships between the variables were assessed using Spearman's coefficient and a chi-square test. Most teachers believed that a student-furniture mismatch was present. The most common reasons given for not using standing desks were concerns about desks being uncommon and their potential to disrupt the class. However, the majority of the teachers believed it feasible to perform physical activity (PA) breaks during classes. Further intervention studies are needed to determine for which courses the use of standing desks are feasible, for what time periods standing desks should be used, and the appropriate number and layout of standing desks in classrooms.

Stand Out in Class: restructuring the classroom environment to reduce sedentary behaviour in 9-10-year-olds - study protocol for a pilot cluster randomised controlled trial.

BACKGROUND: Sedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. Excessive sedentary behaviour adversely affects health in children and adults. As sedentary behaviour tracks from childhood into adulthood, the reduction of sedentary time in young people is key for the prevention of chronic diseases that result from excessive sitting in later life. The sedentary school classroom represents an ideal setting for environmental change, through the provision of sit-stand desks. Whilst the use of sit-stand desks in classrooms demonstrates positive effects in some key outcomes, evidence is currently limited by small samples and/or short intervention durations, with few studies adopting randomised controlled trial (RCT) designs. This paper describes the protocol of a pilot cluster RCT of a sit-stand desk intervention in primary school classrooms. METHODS/DESIGN: A two-arm pilot cluster RCT will be conducted in eight primary schools (four intervention, four control) with at least 120 year 5 children (aged 9-10 years). Sit-stand desks will replace six standard desks in the intervention classrooms. Teachers will be encouraged to ensure all pupils are exposed to the sit-stand desks for at least 1 h/day on average using a rotation system. Schools assigned to the control arm will continue with their usual practice, no environmental changes will be made to their classrooms. Measurements will be taken at baseline, before randomisation, and at the end of the schools' academic year. In this study, the primary outcomes of interest will be school and participant recruitment and attrition, acceptability of the intervention, and acceptability and compliance to the proposed outcome measures (including activPAL-measured school-time and school-day sitting, accelerometer-measured physical activity, adiposity, blood pressure, cognitive function, academic progress, engagement, and behaviour) for inclusion in a definitive trial. A full process evaluation and an exploratory economic evaluation will also be conducted to further inform a definitive trial. DISCUSSION: The primary output of this study will be acceptability data to inform the development of a definitive cluster RCT designed to examine the efficacy of this intervention on health- and education-related outcomes in UK primary school children. TRIAL REGISTRATION: ISRCTN12915848 (retrospectively registered, date registered 9 November 2016).