Stand-up desk research 

PERFORMING ROUTINE ACTIVITIES OF DAILY LIVING AT A STAND-UP TABLE: A LOW-INTENSITY AUTO-EXERCISE PILOT PROJECT TO IMPROVE BALANCE 

N. Bohnen & M. Muller 

    Recent advances in metabolic research of non-exercise physical activity. Most people spend most of the their day sitting with relatively idle muscles. Recent advances in diabetes mellitus and obesity research have touted the benefits of “upright” standing or low-intensity walking activities while performing routine activities of daily living. For example, Levine noted that human energy expenditure can be modified by changes in posture and movement associated with routines of daily life (Levine and Miller, 2007). Levine et al. have developed an “office of the future” by creating a “walk-and-work” or "walk-and-stand" desk for office workers instead of seated office work (Levine and Miller, 2007). Although Levine’s work has a focus on office workers, there are many activities of daily living like talking on the phone, watching television, reading the newspaper or using the home computer that can be done just as enjoyably upright. Hamilton et al. found that more standing, less sitting, promoted “optimal metabolism” (Hamilton et al. , 2007). These authors found that sitting has negative effects on fat and cholesterol metabolism because of lack of lipase enzyme activation when muscles are idle. In contrast, standing and other non-exercise activities can double the metabolic rate in most adults even if they do no formal exercise at all.  These metabolic effects come on top of physical conditioning benefits, including training of postural reflexes.

    This new line of evidence from metabolic research makes it evident that non-exercise physical activities people can do standing instead of sitting provides a novel way to obtain health benefits that otherwise require commitment to regular exercise programs. From a neurological perspective, standing not only promotes a healthier metabolism but also provides direct conditioning of postural reflexes that may improve balance impairments.   Our laboratory is in the process of preparing a study to provide research participants a height-adjustable stand-up desk that will allow them to perform routine activities of daily living upright but also will give them firm support to allow them to lean against and maintain standing for a longer period of time. This simple intervention can be done in the volunteer’s home environment and not only offer metabolic benefits but also may improve postural imbalance.

    The commercially available electric height-adjustable table provides a heavy base of support to allow leaning to the table.  The table can be easily lowered to a sitting level using a small button. This will provide flexibility to the user.  

    It will be important to ensure appropriate safety measures, as unprepared and untrained upright standing is not without risks in those with balance problems. There is a rare risk of falling. the use an electric table with a heavy base of support will allow holding or leaning to the table in case the user needs extra support.  In addition, the set-up of the table in the home will require the use of a safety belt attached to the table top as well as a stable but soft cushioned non-mobile chair to provide additional protection for falls.   Although standing is a low-intensity level of activity, there is a risk of fatigue.  Therefore, a slow supervised titration period in weekly increments of 15 minutes will be needed. The participant also needs to be trained in a more dynamic standing technique by regularly shifting weight from one leg to the other. The use of an “anti-fatigue” mat will facilitate this more dynamic standing technique and also reduce the risk of muscle achiness or fatigue.

Routine activities that can be easily performed in the standing position include:

-   Reading the newspaper

-   Checking the mail

-   Paying bills

-   Watching TV

-   Playing cards

-   Using a laptop or home computer

-   Talking on the phone

Further information can be obtained by emailing us at pdresearch@umich.edu

References

Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes 2007; 56: 2655-67.

Levine JA, Miller J. The energy expenditure of using a "walk-and-work" desk for office-workers with obesity. Br J Sports Med 2007.




    Stand-up electric height adjustable table
     

    Ergonomic tips

    Posture 

    • Position monitors with upper edge at or below user's eyebrows
    • Assume mild flexion in neck
    • Avoid wrist extension when using keyboard