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Redefining the Desk Job
Len Kravitz, Ph.D.

Introduction
The traditional training focus of personal trainers has been the development of moderate-to-vigorous exercise programs to improve the physiological health and musculoskeletal strength of clients. The 2016 February IFJ featured a research review indicating that higher levels of physical activity and/or exercise reduces the risks of nearly three dozen harmful conditions and life-threatening diseases (Morton and Kravitz, 2016). However, over the last few decades the fitness industry and physical activity researchers have made a paradigm shift towards also improving the amount of lifestyle activity and physical movement throughout the day to improve health (Pate, O'Neill and Lobelo, 2008). Exercise professionals now include strategies for combating sedentary behaviors (e.g., sitting, television viewing, couch time) as well as traditional exercise programing. Indeed, one of the outcomes of present-day technology is that many people spend the majority of their workday at a seated workstation. A relatively new area of research, presented in this column, is exploring workstation alternatives to the traditional office chair and desktop.

The Work Chair: Dependable but Lethal
Levine (2010) suggests that our bodies are made to move, and yet we live in a chair-dependency society. He continues, sitting is not bad in moderation, but our modernization lifestyle has led to it becoming excessive and harmful. Tudor-Locke et al. (2014) explain that occupations within the last 50 years in the U.S. have shifted towards desk-based sedentary behavior, which has been shown to also be associated with trends in weight gain. Levine adds that the research denotes that daily, sustained chair-dependency is associated with shorter life spans, metabolic diseases and cardiovascular disease. His solution is simple: people should get up more during the waking day. Levine asserts that repeated, frequent bouts of “low-intensity meandering-style activity” are an effective way to combat the ill effects of daylong sitting.

What are the Workstation Alternatives?
The main alternatives to a traditional computer-based workstation are 1) replacing the office chair with a stability ball, 2) changing the desk height, by mechanical or electronic means, to allow for periodic standing (i.e., an adjustable sit-stand desk), or continuous standing with a fixed standing desk, 3) changing the desk height to accommodate a treadmill (i.e., a treadmill desk), and 4) incorporating an under-desk elliptical/stepper/pedaling device (i.e., a pedal desk) (Tudor-Locke et al., 2014). The pedal desk design requires little to no desk adjustment as the worker can either pedal and sit or just sit and work. The use of a stability ball and standing desk workstation are classified as 'static workstations' because any movement with them is mostly body weight shifts and postural adjustments (Tudor-Locke et al.). Treadmill and pedal desks are categorized as 'active workstations' because they promote low-intensity rhythmic movement.

Do Workstation Alternatives Increase Energy Expenditure?
Tudor-Locke et al. (2014) completed a research review on the efficacy of alternative workstation for increasing energy expenditure. From a standpoint of energy expenditure the data indicate that traditional sitting in an office chair, compared to a stability ball and standing desk varies very little (ranging from .99 kcal/min to 1.46 kcal/min). Tudor-Locke et al. suggest that in regards to weight loss outcomes, the stability ball and sit-stand desk do not have a meaningful difference from a traditional seated chair workstation. However, as proclaimed by Levine (2010), the positive physiological and metabolic health outcomes of a standing desk station far outweigh the lethal consequences of prolonged chair sitting. The little energy expenditure research completed on a pedal desk (pedaling at 45 revolutions per minute) indicates an average energy expenditure of about 2.14 kcal/min. In contrast, treadmill desks with users walking 1-2 miles/hour can increase the energy expenditure by more than 100 kcal/hour as compared to traditional seated workstations. Thus, depending how much a person is able to walk on a daily basis at a treadmill desk, the influence on body weight could me quite consequential.

How Do Workstation Alternatives Effect Work Performance?
At this time, there is no well-defined evidence if alternative workstations positively or negatively affect a person's work performance. Most of the productivity research has been completed with active workstations compared to traditional seated workstations. In an active workstation a person is completing a dual task performance: walking, pedaling or stepping while reading, thinking, speaking, typing or texting. This is not an automatic process and it requires quite a bit of information processing (Tudor-Locke et al., 2014). Tudor-Locke et al. continue that it is not clearly known how the divided attention of walking safely on a treadmill while performing office work ultimately affects a worker's productivity. The researchers note that the majority of studies with workstation alternatives focus primarily on a simulated task performance (such as reading, clicking, math problems, mouse pointing and speaking). These studies do not show any significant difference with the active workstation and the traditional seated workstations except with mouse-related tasks (such as dragging and menu selection). Tudor-Lock et al. explain that mouse-related tasks represent fine motor skills, which may be more impaired by extraneous movement of an active workstation.

Will Workers Continue to Use a Workstation Alternative?
No doubt, before recommending a workstation alternative for a client, personal trainers want to know if this is something a client will accept and maintain. Tudor-Lock et al. (2014) describe an acceptable workstation alternative as one that is perceived tolerable by the worker. It is not burdensome, inconvenient or uncomfortable. At this time, there is no standardized approach to confidently research this question. Researchers tend to use questionnaires, interviews and focus groups and report the results as exploratory findings (Tudor-Lock et al.). That stated, the studies completed using stability balls commonly report that sitting on a stability ball is associated with increased discomfort. However, as personal trainers know from their experience, proper sitting posture and familiarization with a stability ball often takes quite a bit of time for some clients to learn (due to the unstable nature of the ball). If individuals are not guided progressively, this seated task will likely become awkward and perhaps uncomfortable.

Studies report that the sit-stand workstation alternatives are easy to use and enjoyably used. Tudor-Locke et al. (2014) report that the thrust of the published research suggests that workers report improved perceptions of energy, health, happiness, posture and productivity. As well, many people report much less body soreness, less back pain, less shoulder pain and decreased wrist and elbow pain with sit-stand workstations. Tudor-Locke et al., add that people really enjoy the option to alternatively change from a sitting to standing workstation.

In regards to treadmill desks, users report that the active workstation may help them with their creativity and that they are good way to break up the workday (Tudor-Locke et al., 2014). The one major divisive research question about active workstations is whether people feel more fatigued by the end of the day. The research is very mixed and inconclusive at this time. However, once again, as most personal trainers know, how the active workstation is gradually introduced and progressed will certainly make a difference in a person's perceived level of fatigue. Tudor-Locke et al. summarize that the research on pedal desk workstations indicates that they are easy to use, comfortable and do not affect productivity or quality of work. The authors note that the pedal desk workstation may be best for any persons with balance challenges. Tudor-Locke et al. also summarize that in terms of overall preference by users, the sit-stand workstations and pedal desks are equally preferred, with the treadmill desk the least frequently favored.

Lastly, and perhaps very importantly, no studies have reported that users have acute or chronic injuries associated with active workstation alternatives (Tudor-Locke et al., 2014). This is probably attributable to the low-intensity nature of these alternative workstations and the workers self-directed ability to alternate from a traditional seated station to an alternative workstation.

Final Thoughts
Helping clients combat sedentary behavior has become a priority for most exercise professionals. Changing the way people sit at work is definitely one major area to target (see Figure 1 for some considerations in choosing an alternative workstation). It is quite likely that several new alternative workstations will be introduced within the next few years.

Table 1. Things to Consider when Choosing an Alternative Workstation
Goodbye to chairs!
Space Limitations?
Noise?
Clothing to wear?
Insurance if get hurt while in use?
Durability and Maintenance?
Electrical Power Access?
Footwear?
Cost?
Comfort/Fit?
Source: Tudor-Locke et al., 2014

@bio:Len Kravitz, PhD, is the program coordinator of exercise science and a researcher at the University of New Mexico, where he won the Outstanding Teacher of the Year award. He has received the prestigious Can-Fit-Pro Lifetime Achievement Award and American Council on Exercise Fitness Educator of the Year.

References:
Levine, J.A. (2010). Health-chair reform. Your chair: comfortable but deadly. Diabetes, 59, 2715-2716.
Morton, G. & Kravitz, L. (2016). 35 Ailments, One Prescription, IDEA Fitness Journal, 13(2), 31-40.
Pate, R.R., O'Neill, J.R., and Lobelo, F. (2008). The evolving definition of “sedentary.” Exercise and Sport Science Reviews, 36(4), 173-178.
Tuduor-Locke, C., Schuna Jr., J.M., Frensham, I.J. and Proenca, M. (2014). International Journal of Obesity, 38, 755-765.