INTRODUCTION: Sit-stand workstations are a popular intervention to reduce sedentary behavior (SB) in office settings. However, the extent and distribution of SB in office workers long-term accustomed to using sit-stand workstations as a natural part of their work environment are largely unknown. In the present study, we aimed to describe patterns of SB in office workers with long-term access to sit-stand workstations and to determine the extent to which these patterns vary between days and workers. METHODS: SB was objectively monitored using thigh-worn accelerometers for a full week in 24 office workers who had been equipped with a sit-stand workstation for at least 10 months. A comprehensive set of variables describing SB was calculated for each workday and worker, and distributions of these variables between days and workers were examined. RESULTS: On average, workers spent 68% work time sitting [standard deviation (SD) between workers and between days (within worker): 10.4 and 18.2%]; workers changed from sitting to standing/walking 3.2 times per hour (SDs 0.6 and 1.2 h-1); with bouts of sitting being 14.9 min long (SDs 4.2 and 8.5 min). About one-third of the workers spent >75% of their workday sitting. Between-workers variability was significantly different from zero only for percent work time sitting, while between-days (within-worker) variability was substantial for all SB variables. CONCLUSIONS: Office workers accustomed to using sit-stand workstations showed homogeneous patterns of SB when averaged across several days, except for percent work time seated. However, SB differed substantially between days for any individual worker. The finding that many workers were extensively sedentary suggests that just access to sit-stand workstations may not be a sufficient remedy against SB; additional personalized interventions reinforcing use may be needed. To this end, differences in SB between days should be acknowledged as a potentially valuable source of variation.

This study aimed at determining the extent to which individuals with neck-shoulder pain and non-symptomatic individuals differ in muscle activation patterns, when performing computer work, as quantified by exposure variation analysis (EVA). As a secondary aim, we also aimed to quantify the day-to-day reliability of EVA variables describing trapezius muscle activation in a non-symptomatic control group. Thirteen touch-typing computer users (pain: n=5, non-symptomatic: n=8) completed three pre-selected computer tasks in the laboratory.

Upper trapezius muscle activity was recorded using electromyography and analyzed using EVA with five amplitude and five duration categories. Individuals with neck-shoulder pain spent less time at low amplitudes and exhibited longer uninterrupted periods of muscle activation compared to their non-symptomatic counterparts. Thus, non-symptomatic workers tended to switch between exposure levels more often than individuals with pain. For a majority of EVA variables, ICCs ranged from 0.6 to 0.9, and between-days coefficients of variation were between 0.4 and 2.2.

The aim of this study was to determine the extent of upper arm, neck and trunk posture variation that can be obtained by combining seated and standing computer work, compared to performing only seated computer work. Posture data were recorded for two hours during each of three days of ordinary work from 24 office workers that had been using a sit-stand station for two months. Periods with sitting and standing computer work were identified using on-site observations, and posture means and minute-to-minute variance were determined for both. Expected minute-to-minute posture variability in different temporal combinations of sitting and standing computer work were determined by simulation, and expressed in terms of a Job Variance Ratio, i.e. the relative increase in variability compared to sitting-only work. For all three postures, mean values differed between sitting and standing computer work, and both showed a notable minute-to-minute variability. For most workers, posture variability was larger when combining sitting and standing than when sitting only, and simulations suggested to introduce more standing than what the worker currently practiced. The results indicate that introducing a sit-stand table could, for most office workers, have a positive effect on upper arm, neck and trunk posture variability.

The purpose of this study was to quantify upper-trapezius muscle activation patterns using exposure variation analysis (EVA) in healthy computer workers and those with chronic neck-shoulder pain. Eight healthy and five chronic pain participants were asked to complete three computer-based tasks (TYPE, CLICK, and FORM) in two pacing conditions (self-paced and control-paced). EVA was used to quantify variation using five amplitude classes and five duration classes. Performance in each task was also quantified. Healthy workers and those with chronic pain did not differ in performance, and they both exhibited similarly low levels of muscle activation amplitude. Pain participants, however, were found to spend less time in lower duration classes across tasks and conditions. These results indicate that individuals with chronic neck-shoulder pain utilize movement strategies involving sustained durations of continuous muscle activation. This may be suggestive of decreased temporal variation in muscle activation patterns in those with chronic pain.

The objectives of this study were to assess the sex-specific relationships between motor and sensory adaptations to repetitive arm motion-induced neck/shoulder fatigue, and measure how additional sensory stimulation affected these adaptations. Twenty-three participants performed two sessions of a repetitive pointing task until scoring 8 on the Borg CR10 scale for neck/shoulder exertion or for a maximum of 45min, with and without sensory stimulation (i.e. light touch) applied on the fatiguing shoulder. Just before reaching the task termination criteria, all participants showed changes in mean and variability of arm joint angles and experienced a five-fold increase in anterior deltoid (AD) sensory threshold in the stimulus-present condition. Women with the greatest increases in AD sensory thresholds demonstrated the greatest increases in shoulder variability (r= .66) whereas men with the greatest increases in upper trapezius sensory thresholds demonstrated greatest changes in shoulder angle (r= -.60) and coordination (r= .65) variability. Thus, sensory stimulation had no influence on time-to-termination but affected how men and women differently adapted, suggesting sex differences in the sensorimotor fatigue response mechanisms.

Motor variability (MV) has been suggested to be a determinant of the risk for developing musculoskeletal disorders in repetitive work. In this study we examined whether individuals consistently differed in the extent of motor variability when performing a standardized short-cycle manual task. On three separate days, arm kinematics was recorded in 14 healthy subjects performing a pipetting task, transferring liquid from a pick-up tube to eight target tubes with a cycle time of 2.8 s. Cycle-to-cycle standard deviations (SD) of a large selection of shoulder and elbow kinematic variables, were processed using principal component analysis (PCA). Thereafter, between-subjects and between-days (within-subject) variance components were calculated using a random effects model for each of four extracted principal components. The results showed that MV differed consistently between subjects (95% confidence intervals of the between-subjects variances did not include zero) and that subjects differed consistently in MV between days. Thus, our results support the notion that MV may be a consistent personal trait, even though further research is needed to verify whether individuals rank consistently in MV even across tasks. If so, MV may be a candidate determinant of the risk of developing fatigue and musculoskeletal disorders in repetitive occupational work.

Background: Cervical range of motion (ROM) is commonly assessed in clinical practice and research. In a previous study we decomposed active cervical sagittal ROM into contributions from lower and upper levels of the cervical spine and found level- and direction-specific impairments in women with chronic non-specific neck pain. The present study aimed to validate these results and investigate if the specific impairments can be explained by the neutral posture (defining zero flexion/extension) or a movement strategy to avoid large gravitationally induced torques on the cervical spine.

Methods: Kinematics of the head and thorax was assessed in sitting during maximal sagittal cervical flexion/extension (high torque condition) and maximal protraction (low torque condition) in 120 women with chronic non-specific neck pain and 40 controls. We derived the lower and upper cervical angles, and the head centre of mass (HCM), from a 3-segment kinematic model. Neutral head posture was assessed using a standardized procedure.

Findings: Previous findings of level- and direction-specific impairments in neck pain were confirmed. Neutral head posture was equal between groups and did not explain the direction-specific impairments. The relative magnitude of group difference in HCM migration did not differ between high and low torques conditions, lending no support for our hypothesis that impairments in sagittal ROM are due to torque avoidance behaviour.

Interpretation: The direction- and level-specific impairments in cervical sagittal ROM can be generalised to the population of women with non-specific neck pain. Further research is necessary to clarify if torque avoidance behaviour can explain the impairments.