Do Sit-Stand Desks Have a Role in Spine Care?
Lead author Bethany Barone Gibbs, PhD, FAHA and A. Nick Shamie, MD Comment
Office workers who alternated between sitting and standing significantly increased the number of calories they burned without causing pain, according to a study published online ahead of print in Occupational Medicine. The increases in energy expenditure were relatively modest (7.8% increase with sit-stand desks and 11.5% with continuous standing), but may be sufficient to help people prevent weight gain when combined with other low-impact activities.
“Our acute study shows that standing or alternating [between sitting and standing] doesn't cause any additional pain,” said lead author Bethany Barone Gibbs, PhD, FAHA. “In fact, other longer-term studies are showing that using a sit-stand desk may actually reduce pain,” explained Dr. Barone Gibbs, who is Assistant Professor of Health and Physical Activity, Clinical, and Translational Science in the Physical Activity and Weight Management Research Center at the University of Pittsburgh.
In terms of spine care, “we all know that sitting down puts significant pressure on the discs and spine,” commented A. Nick Shamie, MD, Chief of Orthopaedic Spine Surgery and Professor of Orthopaedic Surgery and Neurosurgery at UCLA School of Medicine. “In addition, intradiscal pressure is extremely high when a patient is seated and bends forward to pick something off of the floor,” he noted.
Dr. Shamie said that the study findings validate his advice to orthopaedic spine surgery patients to get up and walk around for 5-10 minutes every half-hour postoperatively.
The study involved 18 participants (9 men, 9 women; aged 22-57 years) who performed standardized deskwork at different positions for three separate one-hour sessions: 60 minutes sitting, 60 minutes standing, and 60 minutes spent alternating between sitting and standing for 30 minutes each. Standardized deskwork included typing articles from a magazine, copying definitions from a dictionary and math exercises. Subjects completed experimental sessions in a random order, at least 48 hours apart, and within 4 weeks.
All participants had earned at least a high school degree and worked sedentary office jobs with a mean daily sitting time of 8.8 hours.
Sit-Stand Desks Burn 50-60 Calories Per Day
Patients who alternated between sitting and standing burned an extra 5.5 ± 12.4 kcal/h (7.8% increase), and those who stood the entire hour burned 8.2 ± 15.9 kcal/h (11.5% increase) (P<0.001 for both interventions compared with exclusively sitting).
Thus, alternating between sitting and standing to achieve a total of 4 hours per day of standing was estimated to burn an additional 56.9 kcal/day for an 88.9 kg man and 48.3 kcal/day for a 75.5 kg woman. In addition, both the sit-stand and standing positions were associated with significant increases in heart rate compared with sitting, by 7.5 ± 6.8 and 13.7 ± 8.8 bpm, respectively (both P<0.001).
How to Encourage Patients to Stand More
Physicians can encourage patients to “find a way to perform some work or daily tasks while standing—such as using a laptop at a counter or high-top table, standing/walking meetings, or standing/moving while talking on the phone,” Dr. Barone Gibbs said. “Also, physicians should encourage patients to avoid long periods of sitting, which can exacerbate pain.”
“Sit-stand desks are an easy way to get a boost in energy expenditure that fits into America’s current office culture,” Dr. Barone Gibbs said. “It is important that we understand standing at work isn't going to burn as many calories as going for a brisk walk or a long run. However, our findings add to a growing field of research that shows the benefits of sit-stand desks, including increases in productivity and energy, and lower pain, blood sugar, and potentially blood pressure.”
Dr. Shamie noted the importance of making sure that a patient is ready to accept the recommendation to stand more during the day, adding that compliance is a big issue for patients.
“When the opportune moment arises, educate patients on how beneficial standing during the day is not only for your back, but also in terms of burning calories,” Dr. Shamie said. “For example, an orthopaedic surgeon could emphasize the effects of weight loss on relieving pressure on the joints and spine.”