Clinical trial NCT03678623: The Impact of Prolonged Standing on Musculoskeletal Pain
Official title: Exploring the Impact of Standing on the Musculoskeletal System of Sedentary-workers
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Musculoskeletal Pain
Occupational Exposure
Office Workers
Keywords: Musculoskeletal Pain
Occupational Exposure
Predictive value of tests
Back muscles
Lead sponsor: Universidade da Coruña
Sponsor class: OTHER
Collaborators: name: The University of Queensland
First posted: 2018-09-19
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CROSSOVER
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Office-based workers, defined as individuals working in an office environment with their main tasks involving use of a computer, reading, phoning, making presentations and participating in meetings, who perform more than 30 hours per week mostly sitting at a computer.

Brief summary: This is a cross-sectional and prospective cohort study using a biopsychosocial approach to investigate office workers at risk of standing-induced musculoskeletal pain. The purpose of this study is to determine which factors are associated with developing or worsening of musculoskeletal pain (changes in the Visual Analogue Scale from baseline) during a 60 minute standing paradigm.

Detailed description: Background/rationale

There is growing national and international evidence for the negative health impact of sedentary behaviour at work. A strategy being increasingly adopted to reduce prolonged sitting is to spend some of the work day in standing. However, for some adults, prolonged standing is associated with the development of musculoskeletal pain. We are investigating which factors are associated with developing of musculoskeletal pain during standing when using a height-adjustable desk. Previous studies have used an induced-pain paradigm to understand risk factors for developing musculoskeletal pain during a prolonged standing task that simulates the work environment (standing paradigm). Identifying those office workers who are at risk of developing musculoskeletal pain during standing will provide information to guide health professionals and individuals in making decisions about optimal workstation design.

Objectives and hypothesis

* Cross-sectional study: Identify which factors are associated (demographic, physical, psychological and work-related factors) with standing-induced musculoskeletal pain in office workers during a standing paradigm.
* Prospective cohort study: Identify incidence/prevalence and risk factors of low back pain, and disability associated with low back pain in office workers in a 1-year prospective cohort.

Methods

* Setting, locations and relevant dates: testing is conducted in the University of Queensland (Brisbane, Australia). Data collection commenced in May of 2018 until 30th of April of 2019 (cross-sectional study); and follow-up is from June of 2018 until 30th of April of 2020 (prospective cohort study).
* Participants: recruitment is through posting flyers on campus of The University of Queensland; through the weekly electronic university staff newsletter at this University; and through Facebook announcements. Interested participants were directed to an online questionnaire (hosted by Survey Monkey) to determine eligibility. Participants meeting the eligibility criteria were contacted via email to schedule an appointment.
* Variables: see "outcomes measures".
* Study size: a convenience sample of 40 office workers will be recruited. Based on previous studies that have compared developers and non-developers of standing-induced low back pain, this sample size was considered sufficient to detect a significant difference in some of the physical outcome measures such as lumbar lordosis (Sorensen et al. 2015a); trunk muscle activation (Ringheim et al. 2015) and active hip abduction (Nelson-Wong et al. 2008).
* Statistical analysis: subjects will be separated into Pain Developers (PDs) and Non-Pain Developers (NPDs). A Chi-square analysis or a Fisher's Exact test will be conducted to test for differences in the distribution of qualitative and proportional variables in PDs and NPDs. Independent groups t-tests, will be conducted to test for differences in quantitative variables between PDs and NPDs. A Pearson correlation coefficient and one-way analysis of variance test will be conducted to test for differences for average Visual Analogue Score (VAS). A simple linear regression analysis will be performed to examine the degree to which biopsychosocial variables predict PDs. Statistical analyses will be performed in SPSS version 24 (IBM, Armonk, NY).Statistical significance for all tests will be set at p ≤ 0.05.

Eligibility criteria: Inclusion Criteria:

* Office-based workers who perform more than 30 hours per week mostly sitting at a computer,
* With aged 18 or above.

Exclusion Criteria:

* not office-based workers,
* pregnant or less than six months postpartum,
* had experienced any major trauma or had surgery to the spine or lower limb over the last 12 months,
* had been diagnosed with any neurological or systematic pathology (such as rheumatoid arthritis, multiple sclerosis or ankyloses spondylitis).

Primary outcomes:
measure: Standing Tolerance Test (STT)
timeFrame: Baseline
Secondary outcomes:
measure: Demographic characteristics:
timeFrame: Baseline
measure: Occupational characteristics: Occupational Sitting and Physical Activity Questionnaire (OSPAQ)
timeFrame: Baseline
measure: Occupational characteristics: questions about using sit-stand workstation
timeFrame: Baseline
measure: Occupational characteristics: Abbreviated Job Content Questionnaire (JCQ) & Job Satisfaction
timeFrame: Baseline
measure: International Physical Activity Questionnaire (IPAQ)-Short Form
timeFrame: Baseline
measure: Quality of life related to health: SF12 questionnaire
timeFrame: Baseline
measure: Prevalence of musculoskeletal pain: Nordic Musculoskeletal Questionnaire (NMQ)
timeFrame: Baseline
measure: Symptom intensity level of musculoskeletal pain: Visual Analogue Scale (VAS)
timeFrame: Baseline
measure: Disability due to low back pain:
timeFrame: Baseline
measure: Catastrophizing thoughts related with pain
timeFrame: Baseline
measure: Thoracic and lumbar curve
timeFrame: Baseline
measure: Motor Control Impairment test: Active hip abduction test
timeFrame: Baseline
measure: Motor Control Impairment test: Active straight leg raise test
timeFrame: Baseline
measure: Motor Control Impairment test: Prone knee flexion test
timeFrame: Baseline
measure: Endurance tests of the trunk muscles (McGill's protocol): Sorensen test
timeFrame: Baseline
measure: Endurance tests of the trunk muscles (McGill's protocol): Abdominal endurance test
timeFrame: Baseline
measure: Endurance tests of the trunk muscles (McGill's protocol): Side bridge test
timeFrame: Baseline
measure: Endurance tests of the trunk and hip muscles: Supine Bridge Test
timeFrame: Baseline
measure: Endurance tests of the hip muscles: Abductor Hip Endurance Test
timeFrame: Baseline
Other outcomes:
Locations:
city: Brisbane
country: Australia
facility: The University of Queensland
state: Queensland
Study officials:
affiliation: The University of Queensland
name: Venerina Johnston, PhD
role: STUDY_CHAIR
References:
citation: Neuhaus M, Eakin EG, Straker L, Owen N, Dunstan DW, Reid N, Healy GN. Reducing occupational sedentary time: a systematic review and meta-analysis of evidence on activity-permissive workstations. Obes Rev. 2014 Oct;15(10):822-38. doi: 10.1111/obr.12201. Epub 2014 Jul 11.
citation: Coenen P, Parry S, Willenberg L, Shi JW, Romero L, Blackwood DM, Healy GN, Dunstan DW, Straker LM. Associations of prolonged standing with musculoskeletal symptoms-A systematic review of laboratory studies. Gait Posture. 2017 Oct;58:310-318. doi: 10.1016/j.gaitpost.2017.08.024. Epub 2017 Aug 24.
citation: Sorensen CJ, Johnson MB, Callaghan JP, George SZ, Van Dillen LR. Validity of a Paradigm for Low Back Pain Symptom Development During Prolonged Standing. Clin J Pain. 2015 Jul;31(7):652-9. doi: 10.1097/AJP.0000000000000148.
citation: Marshall PW, Patel H, Callaghan JP. Gluteus medius strength, endurance, and co-activation in the development of low back pain during prolonged standing. Hum Mov Sci. 2011 Feb;30(1):63-73. doi: 10.1016/j.humov.2010.08.017. Epub 2011 Jan 11.
citation: Nelson-Wong E, Gregory DE, Winter DA, Callaghan JP. Gluteus medius muscle activation patterns as a predictor of low back pain during standing. Clin Biomech (Bristol). 2008 Jun;23(5):545-53. doi: 10.1016/j.clinbiomech.2008.01.002. Epub 2008 Feb 20.
citation: Zamkova MA, Krivitskaia EI. [The effect of radiation by erythema-uviol lamps on the working capacity of students]. Gig Sanit. 1966 Apr;31(4):41-4. No abstract available. Russian.
citation: Sorensen CJ, Norton BJ, Callaghan JP, Hwang CT, Van Dillen LR. Is lumbar lordosis related to low back pain development during prolonged standing? Man Ther. 2015 Aug;20(4):553-7. doi: 10.1016/j.math.2015.01.001. Epub 2015 Jan 14.
citation: Ringheim I, Austein H, Indahl A, Roeleveld K. Postural strategy and trunk muscle activation during prolonged standing in chronic low back pain patients. Gait Posture. 2015 Oct;42(4):584-9. doi: 10.1016/j.gaitpost.2015.09.008. Epub 2015 Sep 15.