05/15/2012

I’ve been following  the growing research on the effects of the posture of sitting, and more extensively, sit to stand workstations (STSWS).   Of course, part of this path started by listening to my own patients’ complaints of musculoskeletal issues. Most of these patients spend hours seated at a desk, with few breaks to stand and move around. My advice over the years for occupational (seated) dysfunctions has always been to stand at least every fifteen minutes during the work day, and that simple advice had a dramatic impact on common complaints. Yet for many, this advice for better health had a consequence: less productivity.  (Which is why Google employees use STSWS.)  So is sitting detrimental to our overall health?  And do STSWS help improve our health?

 

broken chair looks like a human figureA very interesting study from Cornell University in 2004 (yes, old, but interesting) on height-adjustable workstations concluded that“alternating between a sitting and standing posture at work appears to benefit health and productivity”and “results agree with previous research demonstrating beneficial effects of using height-adjustable worksurfaces.”That was 2004, and since then, especially in the last few years, more extensive studies appeared with a focus on what sitting does to our overall health.

A large (and eye opening) study published in the American Journal of Epidemiology in 2010 (Leisure Time Spent Sitting in Relation to Total Mortality in a Prospective Cohort of US Adults), focused on the obesity epidemic and how long periods of sitting affect overall mortality rates:

“The time spent sitting was independently associated with total mortality, regardless of physical activity level.”

Regardless of physical activity.  Scary.  And:

“After adjustment for smoking, body mass index, and other factors, time spent sitting (6 vs. <3 hours/day) was associated with mortality in both women (relative risk ¼ 1.34, 95% confidence interval (CI): 1.25, 1.44) and men (relative risk ¼ 1.17, 95% CI: 1.11, 1.24).”

If the results of this study don’t get you off your chair, let me continue.

The New York Times published this piece in 2011, which included activity and obesity studies by Dr. James Levine, a researcher at the Mayo Clinic in Rochester, Minn, and cited the American Journal of Epidemiology study mentioned in the previous paragraph:

“Over a lifetime, the unhealthful effects of sitting add up. Alpa Patel, an epidemiologist at the American Cancer Society, tracked the health of 123,000 Americans between 1992 and 2006. The men in the study who spent six hours or more per day of their leisure time sitting had an overall death rate that was about 20 percent higher than the men who sat for three hours or less. The death rate for women who sat for more than six hours a day was about 40 percent higher. Patel estimates that on average, people who sit too much shave a few years off of their lives.”

Wow. Pretty convincing stuff.  But perhaps more intriguing in the New York Times piece is Dr. Levine’s mention of movement, and how it correlates to the mortality rate.  In layman’s terms, moving more often, even while sitting, improves overall metabolic and muscular health. This is a concept I’ve long promoted; we move or we die.  And I love his quote at the end:

“Go into cubeland in a tightly controlled corporate environment and you immediately sense that there is a malaise about being tied behind a computer screen seated all day,” he said. “The soul of the nation is sapped, and now it’s time for the soul of the nation to rise.” 

From a bio-mechanical perspective, standing, just like sitting, has obvious negative connotations to gravity.  Standing postures are often not ideal in most people.  That is, the person might have a kyphotic posture, or varus/valgus hips and knees.  If a patient with poor standing posture decides to purchase a STSWS, she has to consider the standing posture, and its affect on the body.  She may not be able to stand for long periods, and shorter intervals of both standing and sitting might be better.  Yet given the research, even those with poor standing postures would seem to benefit in having a workstation that allowed a convenient way to stand and continue working.

I certainly wanted to find out if I could benefit from a STSWS, so I purchased one.  Given the amount of time I sit writing, I figured I was a pretty good candidate.  Although I don’t have chronic dysfunctions that might come from seated postures, I do feel unproductive when sitting for too long.  And yes, my back does complain.  I have replaced my old desk with the new workstation, and have used it for about sixty days.  I begin my day sitting, and when I get fatigued, I push a button to lift my desk to a standing position.  I then work like that, standing, until I feel the need to sit again.  Now, this is not a “plug” for any particular manufacturer of sit to stand desks, but I must say I now recommend this type of setup to many of my patients.  I mention it on my web site and as part of my consulting for patients with sedentary jobs.  As the first study concluded in 2004, I feel the following benefits:

  • increased productivity- I get more done
  • less muscular strain
  • increased concentration
  • increased circulation

That said, if you are considering a STSWS, get good advice/assessment on your current posture.  If you have a scoliotic curve or other known issue, a good rehabilitation program will help you maintain a stable standing posture.  And, keep in mind everyone is different; you may not be able to stand for very long, which is fine.

Just push the button and sit for awhile.