Floor Sitting for Quality of Life

Overseen By Loree T Pham

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Beth Pyatak

Disqualifiers: Injuries, Mental states, Prior knowledge

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

40 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on sitting habits rather than medication use.

What data supports the effectiveness of the treatment Daily Floor Sitting Practice for improving quality of life?

The ability to move from sitting to standing is important for maintaining independence and quality of life, as shown in studies about sit-to-stand tests. While not directly about floor sitting, these findings suggest that practices improving sitting and standing balance could enhance daily functioning and well-being. ^{1 2 3 4 5}

Is floor sitting safe for humans?

There is no specific safety data on floor sitting, but studies on sitting behavior suggest that prolonged sitting can be associated with health risks. However, interventions to reduce sitting time, like using dynamic seating or in-seat exercises, have been found to improve comfort and reduce discomfort. ^{6 7 8 9 10}

How does the treatment of daily floor sitting practice differ from other treatments for improving quality of life?

Daily floor sitting practice is unique because it involves a simple, culturally relevant activity that encourages natural movement patterns and postures, particularly in contexts like India where floor sitting is common. Unlike other treatments that may require equipment or medication, this practice focuses on enhancing quality of life through regular, mindful engagement in a basic physical activity. ^{11 12 13 14 15}

What is the purpose of this trial?

The goal of this clinical trial is to evaluate the impact of different sitting environments on general well-being and movement patterns in healthy young adults aged 18-35. The main questions it aims to answer are: Does floor sitting lead to increased movement and postural changes compared to chair sitting? Over a month-long period, how does sustained floor sitting influence overall well-being, posture, and movement habits? Researchers will compare the effects of chair sitting and floor sitting in a controlled lab environment (Aim 1) and observe the longer-term effects of habitual floor sitting in participants natural environments (Aim 2) to see if consistent floor sitting promotes more dynamic movement and comfort. Participants will: Undergo two 30-minute experimental sitting sessions, one in a chair and the other on the floor, while engaging in typical desk activities (Aim 1). Participate in a month-long study where they integrate an hour of floor sitting into their daily routines, recording their experiences and any changes in sitting habits through daily diaries and in-depth interview (Aim 2).

Research Team

Elizabeth A Pyatak

Principal Investigator

University of Southern California

Eligibility Criteria

This trial is for healthy English-speaking young adults aged 18-35 who lead a sedentary lifestyle. Participants should be willing and able to follow the study procedures, which include daily sitting practices and keeping a diary.

Inclusion Criteria

I speak English.

I am willing and able to follow the study's procedures.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Experimental Sitting Sessions

Participants undergo two 30-minute experimental sitting sessions, one in a chair and the other on the floor, while engaging in typical desk activities.

1 day

1 visit (in-person)

Extended Floor Sitting Intervention

Participants integrate an hour of floor sitting into their daily routines for a month, recording their experiences and any changes in sitting habits through daily diaries and in-depth interviews.

4 weeks

Follow-up

Participants are monitored for any long-term changes in movement patterns and posture after the intervention.

2-4 weeks

Treatment Details

Interventions

• Daily Floor Sitting Practice

Trial Overview The study compares the effects of sitting on the floor versus in a chair on well-being, posture, and movement. It involves two controlled lab sessions of different sitting styles followed by a month-long period of integrating floor sitting into daily life.

Participant Groups

Group I: Floor Sitting Experimental Arm Experimental Treatment 1 Intervention

Participants in this arm will undergo a 30-minute session of floor sitting on a cushioned mat. They will engage in the same desk activities as the chair sitting arm to maintain consistency across conditions.

Group II: Extended Floor Sitting Intervention Experimental Treatment 1 Intervention

Participants in this arm will engage in daily floor sitting as part of their usual activities at home to assess the long-term effects of floor sitting on well-being and health.

Group III: Chair Sitting Experimental Arm Experimental Treatment 1 Intervention

Participants in this arm will undergo a 30-minute session of chair sitting in a non-swivel chair. Activities during this session include engaging in typical desk activities to simulate a natural office environment.

Who Is Running the Clinical Trial?

Beth Pyatak

Lead Sponsor

Trials

1

Recruited

40+

Findings from Research

The Level of Sitting Scale (LSS) has been validated as an effective tool for measuring sitting ability in children with neuromotor disorders, based on a study of 114 participants.

There is a significant inverse relationship between LSS scores and the amount of seating support provided, indicating that higher LSS scores (better sitting ability) correspond to less reliance on seating supports.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Validation of the relation between the type and amount of seating support provided and Level of Sitting Scale (LSS) scores for children with neuromotor disorders. Field, DA., Roxborough, LA.[2012]

The Manchester Active Position Seat (MAPS) was developed as a portable system to objectively measure changes in sitting balance, showing a similar pattern of position change compared to a traditional forceplate in a feasibility study with adult subjects.

While MAPS effectively tracked the direction of movement when subjects changed postures, the accuracy of its measurements, particularly at greater distances from the center, needs improvement for it to be a reliable clinical tool.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measurement of sitting balance using the Manchester Active Position Seat (MAPS): a feasibility study. Powell, ES., Pyburn, RE., Hill, E., et al.[2017]

In a study of 63 older adults, instrumented Sit-To-Stand (STS) test durations were found to have stronger associations with health and functional status compared to manually recorded STS times, indicating that technology can provide more accurate assessments of mobility.

The dynamic phases of the STS movement, measured by the instrumented method, were particularly informative for understanding health and daily physical activity, highlighting the importance of assessing movement quality in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Instrumented Sit-to-Stand Test (iSTS) Has Greater Clinical Relevance than the Manually Recorded Sit-to-Stand Test in Older Adults. van Lummel, RC., Walgaard, S., Maier, AB., et al.[2022]

The study involving 756 desk-based employees showed that both the SMART Work and Life (SWAL) intervention and the SWAL intervention with a height adjustable desk significantly reduced daily sitting time at the 12-month follow-up, with the desk intervention being three times more effective.

Participants using the height adjustable desk experienced greater improvements not only in sitting time but also in lower extremity pain and overall wellbeing, indicating that incorporating such desks can enhance workplace health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of an intervention for reducing sitting time and improving health in office workers: three arm cluster randomised controlled trial. Edwardson, CL., Biddle, SJH., Clemes, SA., et al.[2022]

In a study involving 49 individuals with COPD, the 1-minute sit-to-stand test using an individually adapted seat height (1MSTSIND) resulted in slightly lower performance compared to a standard chair height (1MSTSSTD), with an average difference of -0.78 repetitions.

Despite the statistical significance of this difference, the actual impact on performance is considered negligible, suggesting that the standard chair height may be sufficient for assessing sit-to-stand ability in most COPD patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of seat height on 1-min sit-to-stand test performance in COPD: a randomised crossover trial. Zumbrunnen, V., Riegler, TF., Haile, SR., et al.[2022]

The BeUpstanding™ Champion Toolkit, designed to reduce prolonged sitting in workplaces, was well-received by both champions and staff, with positive feedback on its 'train-the-champion' approach and resources.

Participants reported increased awareness about sitting, improved team culture, and benefits to staff wellbeing, although sustained change was influenced by organizational support and workload challenges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perceptions of an online 'train-the-champion' approach to increase workplace movement. Goode, AD., Hadgraft, NT., Neuhaus, M., et al.[2020]

Sedentary behavior, especially prolonged sitting, is linked to increased risks of cardiovascular disease, highlighting the need for effective public health guidelines to reduce sitting time.

The review emphasizes the necessity for well-designed randomized controlled trials to test specific strategies for reducing sitting behavior, as current guidelines lack specificity due to insufficient evidence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Primer on Repeated Sitting Exposure and the Cardiovascular System: Considerations for Study Design, Analysis, Interpretation, and Translation. Stoner, L., Barone Gibbs, B., Meyer, ML., et al.[2023]

In a study where participants used an interactive airplane seat for 3.5 hours, they engaged in significantly more in-seat movements compared to a standard economy class seat, which may help reduce discomfort during long flights.

The interactive seat led to better overall comfort experiences, and passengers expressed a preference for it over traditional seats, although it did not significantly reduce localized musculoskeletal discomfort.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of in-seat exercising on comfort perception of airplane passengers. Bouwens, JMA., Fasulo, L., Hiemstra-van Mastrigt, S., et al.[2018]

Sitting on a stability ball during arm ergometry resulted in a significantly higher peak VO2 (8% to 12% increase) compared to sitting on a chair, indicating a greater metabolic response during exercise.

While heart rate was also higher when using the stability ball at peak exercise levels, the overall impact on heart rate was minimal, suggesting that exercise intensity prescriptions should focus on absolute metabolic levels rather than percentages of maximum.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Stability Ball Sitting Elevates Peak Arm Ergometry Oxygen Consumption and Heart Rate. Marks, CR., Dupuie, L., Patros, J.[2019]

The dynamic seat pan design significantly reduced perceived pain and calf circumference after 2 hours of sitting, indicating improved comfort and reduced negative effects of prolonged sitting among 30 male participants.

Participants using the dynamic seat experienced lower average seat pressure and greater seat contact area, suggesting that this design may enhance sitting biomechanics without altering spine angles or muscle activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of a dynamic seat pan design on spine biomechanics, calf circumference and perceived pain during prolonged sitting. Frey, M., Barrett, M., De Carvalho, D.[2021]

A new instrument was developed to measure floor activities, tested on 733 participants from rural, urban, and metropolitan communities, showing significant differences in activity levels among these groups.

Rural participants scored the highest in floor activities, while those from metropolitan areas scored the lowest, indicating varying levels of physical engagement based on community type.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Floor activity score. Laohacharoensombat, W., Aekplakorn, W., Wanvarie, S., et al.[2019]

In a longitudinal study of 3735 adults, total daily sitting time decreased by an average of 26 minutes over 7 years, with notable increases in computer-related sitting, particularly among younger middle-aged individuals.

Changes in sitting behavior were influenced by occupational status and self-rated health, with different patterns observed across age groups, highlighting the importance of these factors in understanding sitting habits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Change and determinants of total and context specific sitting in adults: A 7-year longitudinal study. Wennman, H., Härkänen, T., Hagströmer, M., et al.[2020]

The study analyzed floor-sitting patterns in 30 young adults (average age 23) and 30 older adults (average age 70), finding that older adults took longer and used more complex movements compared to younger adults, indicating age-related changes in movement strategies.

Cross-legged sitting was the most common position for both age groups, and engaging in an activity like simulated feeding helped both young and older adults use better movement strategies, although it also increased the time taken to rise from the floor.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using the Newly Developed Floor-Sitting Movement Analysis Proforma to Study the Effect of Age and Activity on Floor-Sitting in Indian Adults. Nagrajan, A., D'Souza, SA.[2018]

A study involving 98 community-dwelling adults showed that using a tally counter is a feasible method for tracking daily sit-to-stands (STSs), with participants accurately recording their activity over 7 days.

On average, participants performed between 42.8 to 49.3 STSs daily, with significantly more STSs recorded on weekdays compared to weekends, indicating variability in activity levels based on the day of the week.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Documentation of daily sit-to-stands performed by community-dwelling adults. Bohannon, RW., Barreca, SR., Shove, ME., et al.[2009]

The pilot study tested a multicomponent intervention aimed at reducing sitting time among contact center call agents over 10 months, showing that using height-adjustable workstations (SLAMM+) may effectively decrease worktime sitting.

Challenges such as high staff turnover affected participant retention, but the overall recruitment and intervention processes were deemed acceptable, indicating readiness for a larger randomized controlled trial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sit Less and Move More-A Multicomponent Intervention With and Without Height-Adjustable Workstations in Contact Center Call Agents: A Pilot Randomized Controlled Trial. Morris, AS., Murphy, RC., Hopkins, ND., et al.[2021]

References

1. England pubmed.ncbi.nlm.nih.gov

Validation of the relation between the type and amount of seating support provided and Level of Sitting Scale (LSS) scores for children with neuromotor disorders. [2012]

2. England pubmed.ncbi.nlm.nih.gov

Measurement of sitting balance using the Manchester Active Position Seat (MAPS): a feasibility study. [2017]

3. United States pubmed.ncbi.nlm.nih.gov

The Instrumented Sit-to-Stand Test (iSTS) Has Greater Clinical Relevance than the Manually Recorded Sit-to-Stand Test in Older Adults. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Effectiveness of an intervention for reducing sitting time and improving health in office workers: three arm cluster randomised controlled trial. [2022]

5. England pubmed.ncbi.nlm.nih.gov

The impact of seat height on 1-min sit-to-stand test performance in COPD: a randomised crossover trial. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Perceptions of an online 'train-the-champion' approach to increase workplace movement. [2020]

7. Switzerland pubmed.ncbi.nlm.nih.gov

A Primer on Repeated Sitting Exposure and the Cardiovascular System: Considerations for Study Design, Analysis, Interpretation, and Translation. [2023]

8. England pubmed.ncbi.nlm.nih.gov

Effect of in-seat exercising on comfort perception of airplane passengers. [2018]

9. United States pubmed.ncbi.nlm.nih.gov

Stability Ball Sitting Elevates Peak Arm Ergometry Oxygen Consumption and Heart Rate. [2019]

10. England pubmed.ncbi.nlm.nih.gov

Effect of a dynamic seat pan design on spine biomechanics, calf circumference and perceived pain during prolonged sitting. [2021]

11. Thailand pubmed.ncbi.nlm.nih.gov

Floor activity score. [2019]

12. Australia pubmed.ncbi.nlm.nih.gov

Change and determinants of total and context specific sitting in adults: A 7-year longitudinal study. [2020]

13. Netherlands pubmed.ncbi.nlm.nih.gov

Using the Newly Developed Floor-Sitting Movement Analysis Proforma to Study the Effect of Age and Activity on Floor-Sitting in Indian Adults. [2018]

14. England pubmed.ncbi.nlm.nih.gov

Documentation of daily sit-to-stands performed by community-dwelling adults. [2009]

15. United States pubmed.ncbi.nlm.nih.gov

Sit Less and Move More-A Multicomponent Intervention With and Without Height-Adjustable Workstations in Contact Center Call Agents: A Pilot Randomized Controlled Trial. [2021]