Reducing sedentary behaviour to decrease chronic low back pain: the stand back randomised trial.

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.
Competing Interests: 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.
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