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Spinal curvatures and pelvic orientation are postural dependent. Compared with relaxed standing (a), there is a posterior pelvic tilt (e.g. diminished sacral slope (S.S.)) and a decrease in lumbar lordosis in unsupported upright sitting (b). The effect is even more pronounced in slouched sitting (c).
Source publication
Prolonged sitting is widely accepted as a risk factor for development and/or persistence of low back pain (LBP), with several etiological mechanisms being proposed so far. Cumulative intervertebral disc injuries were often mentioned in relation to LBP and sitting in older literature. Recent studies more frequently report on posterior lumbo-pelvic l...
Context in source publication
Context 1
... older literature on injurious effects of sitting, intervertebral discs were given the most attention. Because of posterior pelvic tilt, the spine (particularly the lower segments) is in slightly flexed position even during upright sitting posture (Fig. 1). During flexion, the load is unequally distributed between the anterior (increased compressive load) and posterior (tensile load in case of full flexion) part of the intervertebral disc 20 . This combination forces the disc's nucleus to move backwards (Fig. 2), which contributes to the development of radial fissures in posterior ...
Citations
... In the present study, the participants left their chairs only in 1.77% of the observations, indicating that they encountered the risk factors of prolonged sitting. Considering the static features of sitting, fatigue in cartilage and bone tissues, muscles, ligaments and the related tissues as well as insufficient restoration can result in health problems in the long run [48][49][50][51][52]. In a study by Mork and Westgaard [41], the participants maintained standing or walking postures in 5% of their working time, which was in agreement with the findings of the present study. ...
... Therefore, other mechanisms may as well underlie the association between working from home and MSP. For example, previous studies suggest that home workers had reduced physical activity and prolonged sedentary behavior during the pandemic in comparison with before the pandemic (Fukushima et al. 2021;Loef et al. 2022), which in turn may have contributed to the development of MSP (Kastelic et al. 2018;Lim and Pranata 2021;Søgaard and Sjøgaard 2017). More research is needed to examine the interactions between these factors, and the contributions of these factors to the onset of MSP among home workers. ...
Objective
This study investigates the associations between working from home and the presence of MSP during the COVID-19 pandemic. Working from home often involves a lot of sedentary computer screen work and the home working environment might not be optimally equipped, which can lead to health problems, including musculoskeletal pain (MSP).
Methods
Longitudinal data from 16 questionnaire rounds of the Lifelines COVID-19 cohort during the first year of the COVID-19 pandemic (March 2020-February 2021) were used. In total, 40,702 Dutch workers were included. In every round, participants reported whether they worked on location, from home, or hybrid. Logistic Generalized Estimating Equations were used to study the association of work situation with the presence of MSP and the presence of severe MSP.
Results
Working from home was associated with higher risks of having MSP in the lower back (OR: 1.05, 95% CI 1.02–1.08), in the upper back (OR: 1.24, 95% CI 1.18–1.31), and in the neck, shoulder(s) and/or arm(s) (OR: 1.18, 95% CI 1.13–1.22). Hybrid working was associated with higher risks of having pain in the upper back (OR: 1.09, 95% CI 1.02–1.17) and in the neck, shoulder(s) and/or arm(s) (OR: 1.14, 95% CI 1.09–1.20). Both home and hybrid workers had higher risks of severe MSP in the different body areas.
Conclusion
Home workers, and to a smaller extent hybrid workers, had higher risks of having MSP than location workers during the first year of the COVID-19 pandemic. The results indicate the importance of measures to prevent MSP in future policies involving working from home.
... Home workers might experience increased musculoskeletal pain as a result of multiple factors, such as an unfavorable working environment at home with continuous repetitive movements and increased psychosocial risks (12,21). Furthermore, reduced physical activity and increased sedentary behaviors can potentially explain part of the association between working from home and musculoskeletal pain (4) by causing physiological changes such as altering muscle activity and strength, increasing strain on the musculoskeletal system, and augmenting pain sensitivity (22)(23)(24)(25)(26). ...
Introduction
Working from home during the COVID-19 pandemic has been associated both with physical inactivity and musculoskeletal pain. However, it has not been examined whether physical activity and sedentary behavior are underlying mechanisms in the association between working from home and musculoskeletal pain. Therefore, we examined their mediating role in this association.
Methods
Data were used from 24 questionnaire rounds of the Lifelines COVID-19 cohort (March 2020–January 2022). Longitudinal information on work situation (location, home, hybrid), physical activity, sedentary behavior, and musculoskeletal pain was collected among 28,586 workers. Analysis of physical activity/sedentary behavior as mediators of the association between working from home and musculoskeletal pain was performed using multilevel structural equation modeling.
Results
Home workers more often had pain in the upper back [odds ratio (OR) = 1.17, 95%-confidence interval (CI) = 1.02–1.34] and arm, neck, and/or shoulder (ANS) (OR = 1.32, 95%-CI = 1.19–1.47) than location workers. Furthermore, home workers were more often sedentary for >9 h per work day than location workers (OR = 2.82, 95%-CI = 2.56–3.09), and being more sedentary was associated with musculoskeletal pain (upper back: OR = 1.17, 95%-CI = 1.06–1.30; ANS: OR = 1.25, 95%-CI = 1.16–1.34). Corresponding indirect effects were OR = 1.18 (95%-CI = 1.04–1.33) and OR = 1.26 (95%-CI = 1.12–1.35). No indirect effect was found for physical activity. Similar indirect effects were observed for hybrid workers.
Conclusion
Home and hybrid workers were more likely to have pain in the upper musculoskeletal system during the COVID-19 pandemic than location workers, which was partly mediated by increased sedentary behavior, but not by reduced physical activity. Measures to reduce sedentary time in home workers may contribute to preventing musculoskeletal pain.
... Adipose tissue is metabolically active, releasing proinflammatory cytokines and adipokines that may potentiate inflammatory changes in tissues leading to noxious pain stimuli [51]. Also, sedentary behaviour may directly or indirectly, through its association with obesity, lead to a reduction in physical activity levels [18] and modulate the biomechanical loading pathway of some bodily pain, such as somatic joint pain related to older age [52,53]. In the context of this study, it is important to note that our analysis accounted for the potential confounding bias of adiposity (waist circumference) and physical activity. ...
Abstract Background Bodily pain is a common presentation in several chronic diseases, yet the influence of sedentary behaviour, common in ageing adults, is unclear. Television-viewing (TV) time is a ubiquitous leisure-time sedentary behaviour, with a potential contribution to the development of bodily pain. We examined bodily pain trajectories and the longitudinal relationships of TV time with the bodily pain severity; and further, the potential moderation of the relationships by type 2 diabetes (T2D) status. Method Data were from 4099 participants (aged 35 to 65 years at baseline) in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab), who took part in the follow-ups at 5 years, 12 years, or both. Bodily pain (from SF36 questionnaire: a 0 to 100 scale, where lower scores indicate more-severe pain), TV time, and T2D status [normal glucose metabolism (NGM), prediabetes, and T2D] were assessed at all three time points. Multilevel growth curve modelling used age (centred at 50 years) as the time metric, adjusting for potential confounders, including physical activity and waist circumference. Results Mean TV time increased, and bodily pain worsened (i.e., mean bodily pain score decreased) across the three time points. Those with T2D had higher TV time and more-severe bodily pain than those without T2D at all time points. In a fully adjusted model, the mean bodily pain score for those aged 50 years at baseline was 76.9(SE: 2.2) and worsened (i.e., bodily pain score decreased) significantly by 0.3(SE: 0.03) units every additional year (p
... In the present study, the participants left their chairs only in 1.77% of the observations, indicating that they encountered the risk factors of prolonged sitting. Considering the static features of sitting, fatigue in cartilage and bone tissues, muscles, ligaments and the related tissues as well as insufficient restoration can result in health problems in the long run [48][49][50][51][52]. In a study by Mork and Westgaard [41], the participants maintained standing or walking postures in 5% of their working time, which was in agreement with the findings of the present study. ...
Purpose:
A posture maintained for a long period can be harmful to the health of office workers. This study aimed to estimate the recommended ergonomic duration for maintaining different sitting postures.
Materials and methods:
Forty healthy male and female students participated in this experiment designed to measure perceived discomfort caused by maintaining common static sitting postures of office workers in a simple ergonomic setup for four minutes. The Borg CR10 scale was given to the participants to assess the discomfort in different body parts, before and after each experiment. Based on the mean group discomfort level of 2, the recommended holding time of each posture was estimated.
Results:
The recommended holding time and its discomfort score for each studied posture were tabulated. The shortest holding time of a posture was obtained for the moderate neck flexion (1.61 minutes), and the longest holding time was obtained for legs posture with 90-degree knee flexion (6.45 minutes).
Conclusions:
The recommended holding time in this study may help to assess the risk of Musculoskeletal Disorders in office workers and train the individuals involved in office tasks in proper sitting behavior.
... Sitting for a long time can cause low back pain [7]. Sitting for a long time, as a result, the flexibility of the muscles around the hip is reduced, causing stress around the waist -pelvis and increasing the risk of injury to the lower back [8]. Sitting without a backrest or desk leads to people using poor sitting postures, which increases the risk of musculoskeletal disorders [9], [10]. ...
... Adipose tissue is metabolically active, releasing pro-in ammatory cytokines and adipokines that may potentiate in ammatory changes in tissues leading to noxious pain stimuli [49]. Also, sedentary behaviour may directly or indirectly, through its association with obesity, lead to a reduction in physical activity levels [18] and modulate the biomechanical loading pathway of some bodily pain, such as somatic joint pain related to older age [50,51]. In the context of this study, it is important to note that our analysis accounted for the potential confounding bias of adiposity (waist circumference) and physical activity. ...
Background: Bodily pain is a common presentation in several chronic diseases, yet the influence of sedentary behaviour, common in ageing adults, is unclear. Television-viewing (TV) time is a ubiquitous leisure-time sedentary behaviour, with a potential contribution to the development of bodily pain. We examined the longitudinal relationships of TV time with bodily pain trajectories; and further, the potential moderation by type 2 diabetes (T2D) status.
Method: Data were from 4099participants (aged 35 to 65 years at baseline) in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab), who took part in the follow-ups at 5 years, 12 years, or both. Bodily pain (from SF36 questionnaire: a 0 to 100 scale, where lower scores indicate more-severe pain), TV time, and T2D status [normal glucose metabolism (NGM), prediabetes, and T2D] were assessed at all three time-points. Multilevel growth curve modelling used age (centred at 50 years) as the time metric, adjusting for potential confounders, including physical activity and waist circumference.
Results: Mean TV time increased, and bodily pain worsened across the three-time points. Those with T2D had higher TV time and more-severe bodily pain than those without T2D at all time points. In a fully adjusted model, the mean bodily pain score for those aged 50 years at baseline was 76.9(SE: 2.2) and worsened significantly by 0.3(SE: 0.03) units every additional year (p <0.001). Those with initially more-severe pain had a higher rate of increase in pain severity. For every one-hour increase in daily TV time, there was a significant increase in pain severity [by 0.69(SE: 0.17) units each additional hour; p <0.001], accounting for the linear change in age and confounders. Above 2.5 hours/day of TV time, the association was significantly more-pronounced in those with T2D than in those without (prediabetes or NGM).
Conclusion: Increments in TV time predicted increased severity of bodily pain over 12 years in middle-aged and older Australian adults, and this was more pronounced in those with T2D. While increasing physical activity is a mainstay of the prevention and management of chronic health problems, these new findings highlight the potential of reducing sedentary behaviours in this context.
... This review did not specifically investigate the potential mechanisms that underpin the association of occupational and non-occupational SB with MSP conditions. Nevertheless, some previous studies have speculated the potential mechanisms of the association between SB and MSP conditions such as LBP [37,137]. For instance, studies that have investigated biomechanical and physiological mechanisms of LBP suggest occupational sitting increases spinal load and accumulation of metabolites that accelerate degenerative changes in vertebral discs [36,37]. ...
Background
Sedentary behaviour (SB; time spent sitting) is associated with musculoskeletal pain (MSP) conditions; however, no prior systematic review has examined these associations according to SB domains. We synthesised evidence on occupational and non-occupational SB and MSP conditions.
Methods
Guided by a PRISMA protocol, eight databases (MEDLINE, CINAHL, PsycINFO, Web of Science, Scopus, Cochrane Library, SPORTDiscus, and AMED) and three grey literature sources (Google Scholar, WorldChat, and Trove) were searched (January 1, 2000, to March 17, 2021) for original quantitative studies of adults ≥ 18 years. Clinical-condition studies were excluded. Studies’ risk of bias was assessed using the QualSyst checklist. For meta-analyses, random effect inverse-variance pooled effect size was estimated; otherwise, best-evidence synthesis was used for narrative review.
Results
Of 178 potentially-eligible studies, 79 were included [24 general population; 55 occupational (incuding15 experimental/intervention)]; 56 studies were of high quality, with scores > 0.75. Data for 26 were meta-synthesised. For cross-sectional studies of non-occupational SB, meta-analysis showed full-day SB to be associated with low back pain [LBP – OR = 1.19(1.03 – 1.38)]. Narrative synthesis found full-day SB associations with knee pain, arthritis, and general MSP, but the evidence was insufficient on associations with neck/shoulder pain, hip pain, and upper extremities pain. Evidence of prospective associations of full-day SB with MSP conditions was insufficient. Also, there was insufficient evidence on both cross-sectional and prospective associations between leisure-time SB and MSP conditions. For occupational SB, cross-sectional studies meta-analysed indicated associations of self-reported workplace sitting with LBP [OR = 1.47(1.12 – 1.92)] and neck/shoulder pain [OR = 1.73(1.46 – 2.03)], but not with extremities pain [OR = 1.17(0.65 – 2.11)]. Best-evidence synthesis identified inconsistent findings on cross-sectional association and a probable negative prospective association of device-measured workplace sitting with LBP-intensity in tradespeople. There was cross-sectional evidence on the association of computer time with neck/shoulder pain, but insufficient evidence for LBP and general MSP. Experimental/intervention evidence indicated reduced LBP, neck/shoulder pain, and general MSP with reducing workplace sitting.
Conclusions
We found cross-sectional associations of occupational and non-occupational SB with MSP conditions, with occupational SB associations being occupation dependent, however, reverse causality bias cannot be ruled out. While prospective evidence was inconclusive, reducing workplace sitting was associated with reduced MSP conditions. Future studies should emphasise prospective analyses and examining potential interactions with chronic diseases.
Protocol registration
PROSPERO ID # CRD42020166412 (Amended to limit the scope)
... In a sitting posture with trunk exion, in addition to the tensile load exerted to the posterior spinal ligaments, sacroiliac joint ligaments, etc., the disc's nucleus moves backwards. The long-term consequence of this backward movement may contribute to the development of radial ssures in the posterior annulus brosus (23,(32)(33)(34). According to these ndings, it is recommended to maintain the natural curvature of the back while sitting. ...
... Moreover, the side effects of prolonged sitting are not limited to intervertebral disc damage. Low and relatively static muscle activity during sitting can cause muscle discomfort and pain (20,(34)(35)(36). ...
... Consequently, a sitting posture that maintains the natural curvature of the spine causes the faster perception of muscle discomfort and pain due to the increased activity of the spinal muscles. However, injuries such as disc protrusion or ligaments and ligamentous tissues damage may occur years after (34). Therefore, in this study, which considered discomfort experiments as criteria for determining the recommended holding times of sitting postures, maintaining the natural curvature of the spine was resulted in higher discomfort in the subjects and the recommended holding time of this posture was less than that of slumped one. ...
Purpose: A posture maintained for a prolonged period can be harmful to the health of office workers. This study aimed to estimate the recommended ergonomic duration for maintaining different sitting postures.
Materials and Methods: Forty healthy male and female students participated in this experiment designed to measure perceived discomforts caused by the maintained common static sitting postures of office workers in a simple ergonomic set up for 4 minutes. The Borg CR10 scale was given to the participants to assess the discomfort in different body parts, before and after each experiment. Based on the mean group discomfort level of 2, the recommended holding time of each posture was estimated.
Results: The recommended holding time and its discomfort score for each studied posture was tabulated. The moderate neck flexion had the highest score of discomfort among different neck postures with recommended MHT of 1.61 minutes. The lowest discomfort score was obtained for neutral neck posture (recommended MHT = 2.37 min). The moderate forward trunk inclination (30°) showed the highest discomfort score with MHT of 1.78 minutes among different trunk postures. The lowest discomfort score was obtained for the backward trunk position (back supported) with recommended MHT of 5.92 minutes. Among the most common knee postures, while working at the workstation, the lowest discomfort score was obtained for the knee flexed about 90 degrees, with the recommended MHT of 5 minutes. The lower limbs position with crossing one leg over the other (leg crossing) received the highest discomfort score (recommended MHT = 1.88 min).
Conclusions: The recommended holding time in this study may help assess the risk of MSDs in office work and training proper sitting behavior to individuals involved in office tasks.
Purpose:
Common ergonomic office workstations are designed for a few optimum postures. Nonetheless, sitting is a dynamic activity and the ideal sitting posture is rarely maintained in practice. Therefore, the present study aimed to investigate the sitting behavior of office workers in an actual working environment using ergonomically adjusted workstations to examine if they promote maintaining appropriate sitting postures.
Materials and methods:
Sitting behaviors (frequency of postures and position changes in different body parts) were explored among 26 office workers during a 60-minute sitting duration, using the posture recording and classification method developed by Graf. et al. The Rapid Upper Limb Assessment (RULA) method was also used to assess postural load. Then, the results of the RULA method were compared with the results from investigating the sitting behavior of office workers.
Results:
Common ergonomic workstations were effective in eliminating some awkward postures. However, some important risk factors, such as holding postures with an inappropriate lumbar spine curve (86% of the observations) and maintaining a posture for a long time (for 7-12 minutes) were observed in the participants' sitting behaviors, while they were neglected in the RULA method.
Conclusions:
The common ergonomic workstations could not guarantee the users' appropriate sitting behaviors.
