Objective The Stand Back study evaluated the feasibility and effects of a multicomponent intervention targeting reduced prolonged sitting and pain self-management in desk workers with chronic low back pain (LBP).
Methods This randomised controlled trial recruited 27 individuals with chronic LBP, Oswestry Disability Index (ODI) >10% and desk jobs (sitting ≥20 hours/week). Participants were randomised within strata of ODI (>10%–<20%, ≥20%) to receive bimonthly behavioural counselling (in-person and telephone), a sit-stand desk attachment, a wrist-worn activity-prompting device and cognitive behavioural therapy for LBP self-management or control. Self-reported work sitting time, visual analogue scales (VAS) for LBP and the ODI were assessed by monthly, online questionnaires and compared across intervention groups using linear mixed models.
Results Baseline mean (SD) age was 52 (11) years, 78% were women, and ODI was 24.1 (10.5)%. Across the 6-month follow-up in models adjusted for baseline value, work sitting time was 1.5 hour/day (P<0.001) lower comparing intervention to controls. Also across follow-up, ODI was on average 8 points lower in intervention versus control (P=0.001). At 6 months, the relative decrease in ODI from baseline was 50% in intervention and 14% in control (P=0.042). LBP from VAS was not significantly reduced in intervention versus control, though small-to-moderate effect sizes favouring the intervention were observed (Cohen’s d ranged from 0.22 to 0.42).
Conclusion An intervention coupling behavioural counselling targeting reduced sedentary behaviour and pain self-management is a translatable treatment strategy that shows promise for treating chronic LBP in desk-bound employees.
Trial registration number NCT0224687; Pre-results.
- low back pain
- sedentary behavior
- physical function
- sit-stand desk
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Contributors BBG, ALH, AD and JMJ: conceived the idea. BBG, ALH and SJP: designed and delivered the intervention. BBG: wrote the manuscript and performed the statistical analysis. ALH, SJP, RJK, AD and JJ: reviewed the manuscript and provided critical feedback and approval for submission.
Funding This study was funded by the Virginia Kaufman Endowment Fund for pain research at the University of Pittsburgh Clinical and Translational Science Institute (CTSI) at the University of Pittsburgh. In addition, recruitment support through the University of Pittsburgh CTSI was funded by the National Institutes of Health (UL1TR000005). ALH reports receiving funding from the National Institutes of Health as a Postdoctoral Scholar awarded to the University of Pittsburgh Pepper Center. AD reports being site Principal Investigator and Program Director for funding from the National Institutes of Health and Principal Investigator for funding from the Patient Centered Outcomes Research Institute.
Competing interests BBG reports being a Principal Investigator on studies funded by the National Institutes of Health, and the American Heart Association, and the Tomayko Foundation, and a Co-Investigator on studies funded by the Agency for Healthcare and Quality Research and the National Institutes of Health. BBG was also the Principal Investigator of a separate, investigator-initiated study funded by the Humanscale company; Humanscale had no role and provided no funding or supplies to this research. JMJ reports being one the Scientific Advisory Board for Weight Watchers International, a Co-Investigator on a study funded by Weight Watchers International awarded to the University of Pittsburgh, a Co-Investigator on a study funded by Humanscale awarded to the University of Pittsburgh, and a Principal and Co-Investigator on studies funded by the National Institutes of Health awarded to the University of Pittsburgh. JMJ was also a Co-Investigator of a separate, investigator-initiated study funded by the Humanscale company; Humanscale had no role and provided no funding or supplies to this research.
Patient consent Obtained.
Ethics approval University of Pittsburgh Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.