Stand up desk have grown exponentially in popularity in recent years. While there is still argument about whether they are the future way of working or just a fad, few have had a deeper look at the evidence. Below I have attempted to answer the questions I receive most often about stand up desks with respect to the available evidence for their use.
The most common question I get asked: "Should we get our workers stand up desks?". The simple answer is YES. However, as you will see below it is not that simple.
Why get a stand up/sit down workstation?
The health argument:
There is some dispute regarding the negative health outcomes from prolonged sitting. In a sample of over 17 thousand workers Katzmarzyk et. al. (2008) found that daily time spent sitting was associated with increased risk of cardiovascular disease mortality, with this association being independent of physical activity levels and BMI. While a later systematic review suggested that while several studies have demonstrated a link between sitting and negative health outcomes the evidence level is still low, the recent expert statement by Buckley et. al. (2015) suggested that the level of consistent evidence accumulated to date warrants action to mitigate these chronic health risks.
Take Home Points:
- The weight of evidence suggests that prolonged sustained sitting carries chronic disease health risks, and action should be taken to mitigate these risks.
So what's wrong with sitting?
In an evolutionary sense, our bodies are designed to be dynamic and not for being in prolonged sustained postures. Sustained postures, particularly sitting, reduce the bodies circulatory and metabolic demand. The sitting position (particularly unsupported sitting) also promotes a flexion position of the lumbar spine increasing the pressure in the intervertebral discs, which may increase the risk of back pain.
So should I sit or stand?
I often get asked which position is best. I give this answer: "The best position to be in is the next one." In other words, neither sitting or standing should be sustained for long periods. The effects of prolonged sitting are noted above. Standing results in an increased metabolic and circulatory demand and also allows maintenance of the correct curves in the spine. However, there is also a greater risk of muscle fatigue in the lower limbs and back in standing. So the answer is alternating between sitting and standing. Therefore, having a desk that allows for simple transitions from sitting to stand is the key. Hence the term sit/stand workstation is more appropriate than stand up desk.
Take Home Points:
- Sitting affects the bodies circulation and metabolism.
- Standing carries some risks to so varying positions between sitting and standing is the key.
Does implementing stand up desks create any risk to workers health?
Just as prolonged sitting can cause musculoskeletal pain, so can prolonged standing. Clinically, we regularly treat workers whom have newly received a sit/stand workstation and are experiencing back pain. This is supported by several studies that suggest complaints of back and lower limb pain can be experienced during the first few weeks of use.
While typically these reports of discomfort are minor, it is important for a workplace to adopt a risk management approach when implementing any new equipment.
The key is providing education on correct use and providing workers with appropriate guidelines for transitioning to increased standing time. For workers with a history of musculoskeletal conditions, individual use guidelines should be considered.
Take Home Points:
- Prolonged standing can result in mild back and lower limb pain.
- Education and guidelines prior to use of a sit/stand workstation are vital to reduce the likelihood of this.
Will implementing stand up desks affect productivity and work performance?
In review examining a number of the impacts of introducing sit/stand workstations, Karikolis and Callaghan (2014) found in 4 of the 8 studies examined that there was no negative effect on productivity while 3 studies demonstrated a positive effect. The take away point being a sit/stand workstation while not have a negative affect on productivity and may even improve the productivity of some workers.
Ebara et. al. (2008) found that the stand up position does not affect typing performance.
Take Home Points:
- Sit/stand workstations do not affect worker productivity and may even increase it.
If we implement sit/stand workstations, will workers use them?
It is important for a capital expense such as new furniture to deliver the desired outcome. Several studies have investigated if providing a worker with a sit/stand workstation will result in reduced sitting time. A randomised cross over trial by Dutta et. al. (2014) found a 21% reduction in sitting time among sedentary workers with sit/stand workstations. Interestingly workers also reported feeling less sluggish, more relaxed, calmer and felt a higher sense of wellbeing. Lars et.al. (2015) also found a reduction in sitting time on average of 30 minutes per day.
For maximal benefit from sit/stand workstations a multi-component implementation approach is advocated. Workers who are provided education on correct use including the benefits and risks of using a sit/stand workstation, as well as given prompts on changing their posture regularly have been shown to adopt greater compliance with usage and greater reductions in sitting time. Wilks et. al (2006) found workers who are given instruction from a physiotherapist are twice as likely to use the sit/stand feature at least once per day.
Take Home Points:
- Providing workers with education, guidelines and regular prompts will increase compliance with use of a sit/stand workstation.
Which sit/stand workstation should we get?
The key points to consider when choosing the right options for your workplace are cost, ease of implementation, ease of transition from sit to stand and ability to adjust for optimal ergonomics.
An electric sit/stand desk that raises and lowers with the push of a button is preferable, as this reduces the need for manual effort to transition between sitting and standing. However, these are typically more expensive. If these are outside your budget, a sit/stand desk that you can place on top of your existing desk may be a better option. These typically arrive in a box with no assembly required, and can be set up onto you desk in minutes. If you go with this option, it is important that your workers are trained in how to lift and lower the desk in a way that does not increase injury risk.
Summary:
If you are an employer who is genuinely is interested in improving the health and wellness of your workforce, then sit/stand workstations should be investigated.
Sit/stand workstations should not be implemented without appropriate education on safe use, and workers should be given guidelines on safe transitioning to spending more time in standing. Without this, workers are more likely to experience musculoskeletal pain associated with increased standing time and therefore may utilise the desk less than workers provided with education.
If you have any more questions about transitioning your workforce to sit/stand workstations email me at ryan@employhealth.com.au or click HERE.
