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

    255519.pdf (3.684Mb)
    Access Status
    Open access
    Authors
    Coenen, P.
    Parry, Sharon
    Willenberg, L.
    Shi, J.
    Romero, L.
    Blackwood, Diana
    Healy, Genevieve
    Dunstan, D.
    Straker, Leon
    Date
    2017
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Coenen, P. and Parry, S. and Willenberg, L. and Shi, J. and Romero, L. and Blackwood, D. and Healy, G. et al. 2017. Associations of prolonged standing with musculoskeletal symptoms—A systematic review of laboratory studies. Gait and Posture. 58: pp. 310-318.
    Source Title
    Gait and Posture
    DOI
    10.1016/j.gaitpost.2017.08.024
    ISSN
    0966-6362
    School
    Library and Information Services
    URI
    http://hdl.handle.net/20.500.11937/56624
    Collection
    • Curtin Research Publications
    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 (=20 min) 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 71 min of prolonged standing, with this shortened to 42 min 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 > 40 min. Interventions should also focus on underlying pain mechanisms.

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