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Gait Posture. 2017 Oct;58:310-318. doi: 10.1016/j.gaitpost.2017.08.024. Epub 2017 Aug 24.

Associations of prolonged standing with musculoskeletal symptoms-A systematic review of laboratory studies.

Author information

1
Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, van der Boechorststraat 7, 1081BT Amsterdam, The Netherlands; School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845, Australia. Electronic address: p.coenen@vumc.nl.
2
School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845, Australia. Electronic address: Sharon.Parry@curtin.edu.au.
3
Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia. Electronic address: lisa.willenberg@burnet.edu.au.
4
Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia. Electronic address: joyce.shi91@gmail.com.
5
Alfred Hospital, 55 Commercial Rd, Melbourne, VIC 3004, Australia. Electronic address: L.Romero@alfred.org.au.
6
Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Australia. Electronic address: d.blackwood@curtin.edu.au.
7
School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845, Australia; The University of Queensland, School of Public Health, Corner of Herston Road and Wyndham Street, Brisbane, QLD 4006, Australia; Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria 3004, Australia. Electronic address: g.healy@sph.uq.edu.au.
8
The University of Queensland, School of Public Health, Corner of Herston Road and Wyndham Street, Brisbane, QLD 4006, Australia; Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria 3004, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3800, Australia; School of Exercise and Nutrition Sciences, Deakin University, Locked Bag 20000, Geelong, VIC 3220, Australia; Department of Medicine, Monash University, Melbourne, Victoria 3800, Australia; School of Sport Science, Exercise and Health, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia; Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring Street, Melbourne, VIC 3000, Australia. Electronic address: David.Dunstan@baker.edu.au.
9
School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845, Australia. Electronic address: L.Straker@curtin.edu.au.

Abstract

While prolonged standing has shown to be detrimentally associated with musculoskeletal symptoms, exposure limits and underlying mechanisms are not well understood. We systematically reviewed evidence from laboratory studies on musculoskeletal symptom development during prolonged (≥20min) uninterrupted standing, quantified acute dose-response associations and described underlying mechanisms. Peer-reviewed articles were systematically searched for. Data from included articles were tabulated, and dose-response associations were statistically pooled. A linear interpolation of pooled dose-response associations was performed to estimate the duration of prolonged standing associated with musculoskeletal symptoms with a clinically relevant intensity of ≥9 (out of 100). We included 26 articles (from 25 studies with 591 participants), of which the majority examined associations of prolonged standing with low back and lower extremity symptoms. Evidence on other (e.g., upper limb) symptoms was limited and inconsistent. Pooled dose-response associations showed that clinically relevant levels of low back symptoms were reached after 71min of prolonged standing, with this shortened to 42min in those considered pain developers. Regarding standing-related low back symptoms, consistent evidence was found for postural mechanisms (i.e., trunk flexion and lumbar curvature), but not for mechanisms of muscle fatigue and/or variation in movement. Blood pooling was the most consistently reported mechanism for standing-related lower extremity symptoms. Evidence suggests a detrimental association of prolonged standing with low back and lower extremity symptoms. To avoid musculoskeletal symptoms (without having a-priori knowledge on whether someone will develop symptoms or not), dose-response evidence from this study suggests a recommendation to refrain from standing for prolonged periods >40min. Interventions should also focus on underlying pain mechanisms.

KEYWORDS:

Exposure limit; Musculoskeletal symptoms; Standing; Systematic review

PMID:
28863296
DOI:
10.1016/j.gaitpost.2017.08.024
[Indexed for MEDLINE]

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