Increasing standing tolerance in office workers with standing-induced back pain.

ABSTRACT

Sit-stand desks are popular however many people have standing-induced low back pain (LBP). People with LBP have fewer standing weight shifts compared with back-healthy people. Participants were classified as standing-tolerant or intolerant. Participants were provided sit-stand desks for 12 weeks. Participants were assigned to intervention (graded standing exposure and exercise) or control (no instruction) conditions. Participants reported weekly sitting time and average/worst LBP. Standing weight shifts and LBP were re-assessed post-intervention. All groups decreased sitting time (range 30-50%) over 12 weeks. Sitting time and average LBP were correlated in all standing-intolerant individuals, worst LBP and sitting time were correlated for intervention group only. All standing-intolerant individuals increased standing weight shifts and decreased LBP after 12-weeks. Standing-intolerant individuals benefitted from 12-weeks of sit-stand desk use regardless of intervention. Motivated individuals with standing-induced LBP may increase standing tolerance with sit-stand desk use. Additional benefits may exist when structured guidance is provided. Practitioner summary: Many people are standing-intolerant due to low back pain (LBP). This lab and field-based study showed some benefits from structured approaches to gradually progress standing time when transitioning to standing work. Using a sit-stand desk for 12 weeks resulted in decreased LBP and sitting time in standing-intolerant people. Abbreviations LBP low back pain; OSPAQ Occupational Sitting and Physical Activity Questionnaire; VAS visual analog scale; GRF ground reaction force; WeekVASMAX worst low back pain reported on visual analog scale for prior week; WeekVASAVE average low back pain reported on visual analog scale for prior week; ICC intraclass correlation coefficient; LabVASMAX worst low back pain reported on visual analog scale during lab-based standing; LabVASAVE average low back pain reported on visual analog scale during lab-based standing; FvR,L vertical ground reaction force for right and left force plate; BWSSMALL small (10-29% body weight) body weight shift; BWSLARGE large (> 30% body weight) body weight shift; ActivPALSED ActivePAL data for sedentary time; ActivPALSTND ActivePAL data for standing time; ANOVA analysis of variance; Standing Intolerant-INT standing intolerant participants assigned to intervention condition; Standing Intolerant-CON standing intolerant participants assigned to control condition; Standing Tolerant-INT standing tolerant participants assigned to intervention condition; Standing Tolerant-CON standing tolerant participants assigned to control condition; SI standing intolerant; ST standing tolerant; INT intervention; CON control.