Pre-existing low-back symptoms impact adversely on sitting time reduction in office workers

  • Pieter Coenen
  • Genevieve N. Healy
  • Elisabeth A. H. Winkler
  • David W. Dunstan
  • Neville Owen
  • Marj Moodie
  • Anthony D. LaMontagne
  • Elizabeth A. Eakin
  • Leon M. StrakerEmail author
Original Article



Initiatives to reduce office-workplace sitting are proliferating, but the impact of pre-existing musculoskeletal symptoms on their effectiveness has not been determined. We assessed the influence of musculoskeletal symptoms on the outcomes of a workplace sitting intervention.


Baseline and 3-month data from a cluster-randomized controlled trial of a workplace sitting intervention (Stand Up Victoria; trial registration number ACTRN12611000742976) were used. Office workers (n = 231) from 14 work teams within one organisation were randomised (by worksite) to a multicomponent program with individual-, organisational-, and environmental-level (sit-stand workstations) change strategies; or, to a control condition (no intervention). Musculoskeletal symptoms in the low-back, upper and lower extremities (present/absent) were assessed through self-report. Linear regression models tested the moderation by baseline musculoskeletal symptoms of intervention effects on workplace sitting and standing time and on sitting and standing bout durations, assessed by the activPAL3™ activity monitor.


There were significant reductions in sitting and increased standing at work (p < 0.05). However, effects varied significantly by the presence of pre-existing low-back (but not other) symptoms, with greater benefit being seen in those without symptoms. Effects on sitting time and sitting bout duration were weaker in those with low-back symptoms compared to those without by 34.6 [95% CI (0.9; 68.3)] min/8-h workday and 5.1 [95% CI (0.2; 9.9)] min, respectively. Comparable effects were seen for standing.


Low-back symptoms may impact on the extent to which office workers change their workplace sitting and standing time. A prudent next step to improve the effectiveness of workplace sitting-reduction initiatives such as Stand Up Victoria may be to assess and address the needs of those who displayed comparatively limited behaviour change, namely those with pre-existing low-back discomfort.


Office work Musculoskeletal symptoms Sitting Standing Randomized controlled trial 



The Stand Up Victoria study was funded by a National Health and Medical Research Council (NHMRC) Project Grant (#1002706), project funding from the Victorian Health Promotion Foundation’s Creating Healthy Workplaces program and, and by the Victorian Government’s Operational Infrastructure Support Program. GH was supported by a NHMRC Career Development Fellowship (NHMRC #108029). EW was supported by a NHMRC Centre for Research Excellence Grant on Sitting Time and Chronic Disease Prevention–Measurement, Mechanisms and Interventions (#1057608). DD was supported by a NHMRC Senior Research Fellowship (NHMRC #1078360). NO was supported by a NHMRC Program Grant (NHMRC #569940), a NHMRC Senior Principal Research Fellowship (NHMRC #1003960), a NHMRC Centre for Research Excellence Grant (NHMRC #1057608) and by the Victorian Government’s Operational Infrastructure Support Program. MM was supported by a NHMRC Centre for Research Excellence in Obesity Policy and Food Systems (NHMRC #1041020). EE is supported by a NHMRC Senior Research Fellowship (NHMRC #511001). LS was supported by a NHMRC Senior Research Fellowship (NHMRC #1019980). We acknowledge and thank all the participants of the Stand Up Victoria study, as well as other staff involved at the Department of Human Services.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

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Supplementary material 1 (DOCX 91 kb)
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Supplementary material 2 (DOCX 15 kb)
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Supplementary material 3 (DOCX 16 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Pieter Coenen
    • 1
    • 2
  • Genevieve N. Healy
    • 1
    • 3
    • 4
  • Elisabeth A. H. Winkler
    • 3
  • David W. Dunstan
    • 3
    • 4
    • 5
    • 6
    • 7
    • 8
    • 9
  • Neville Owen
    • 3
    • 4
    • 12
  • Marj Moodie
    • 10
  • Anthony D. LaMontagne
    • 11
    • 12
  • Elizabeth A. Eakin
    • 3
  • Leon M. Straker
    • 1
    Email author
  1. 1.School of Physiotherapy and Exercise ScienceCurtin UniversityPerthAustralia
  2. 2.Department of Public and Occupational HealthVU University Medical Center, Amsterdam Public HealthAmsterdamThe Netherlands
  3. 3.School of Public HealthThe University of QueenslandBrisbaneAustralia
  4. 4.Baker IDI Heart and Diabetes InstituteMelbourneAustralia
  5. 5.School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
  6. 6.School of Exercise and Nutrition SciencesDeakin UniversityGeelongAustralia
  7. 7.Department of MedicineMonash UniversityMelbourneAustralia
  8. 8.School of Sport Science, Exercise and HealthThe University of Western AustraliaPerthAustralia
  9. 9.Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneAustralia
  10. 10.Deakin Health EconomicsCentre for Population Health Research, Deakin UniversityGeelongAustralia
  11. 11.Centre for Population Health Research, School of Health and Social DevelopmentDeakin UniversityGeelongAustralia
  12. 12.Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneAustralia

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