SpinaliS Office Chairs – Neuroseminars

Active Sitting for an Active Life

https://upright-balanced.co.uk

What is active sitting?

Sitting is considered ‘active’ or ‘dynamic’ when constant muscular activity is required to maintain the sitting posture.

Static or passive sitting, on the other hand, requires very little muscular activation. Sitting posture is maintained by loading the passive holding elements of the spine, such as joint capsules, ligaments and intervertebral disks, and by leaning on the backrest, armrest or desk.

The adverse health effects of prolonged static sitting

Prolonged static sitting is a modern-day occupational health hazard, especially when combined with a sedentary lifestyle. According to the European Agency for Safety and Health at Work (EU-OSHA)¹, adverse health effects that have been linked to prolonged sitting include:

Low back pain
Neck and shoulder complaints
Type 2 diabetes and cardiovascular disease
Obesity
Certain types of cancers, in particular breast cancer and colon cancer
Mental health issues
Premature death

¹ European Agency for Safety and Health at Work (2021). Prolonged static sitting at work: health effects and good practice advice. Available from:

https://osha.europa.eu/en/publications/summary-prolonged-static-sitting-work-health-effects-and-good-practice-advice

Core muscle activation through active sitting

Active sitting has been shown to increase activity in the lumbar multifidus muscle², a deep spinal stabilising (core) muscle in the low back. In many chronic low back pain sufferers, especially those who have had a previous spinal disc injury, structural changes to the muscle and its nerve receptors cause not only muscle weakness, but also deficits in the nerve signals that are transmitted from the muscle to the brain (proprioception).³ The better news is that exercise has been shown to attenuate those structural muscle changes⁴, and it is probable that sitting actively rather than statically (when work-related sitting is required) will aid this process.

² Scott, I. R., Vaughan, A. R., & Hall, J. (2015). Swiss ball enhances lumbar multifidus activity in chronic low back pain. Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine, 16(1), 40–44. https://doi.org/10.1016/j.ptsp.2014.02.007

³ James, G., Stecco, C., Blomster, L., Hall, L., Schmid, A. B., Shu, C. C., Little, C. B., Melrose, J., & Hodges, P. W. (2022). Muscle spindles of the multifidus muscle undergo structural change after intervertebral disc degeneration. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 31(7), 1879–1888. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7613463/

⁴ James, G., Klyne, D. M., Millecamps, M., Stone, L. S., & Hodges, P. W. (2019). ISSLS Prize in Basic science 2019: Physical activity attenuates fibrotic alterations to the multifidus muscle associated with intervertebral disc degeneration. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 28(5), 893–904. https://doi.org/10.1007/s00586-019-05902-9

Stimulate the brain to relieve pain

The benefits of active sitting are likely to go far beyond the activation and strengthening of core muscles. And it is likely that the reduction in chronic low back, neck and shoulder pain often experienced by office workers when they exchange their conventional office chair for a SpinaliS active sitting chair cannot simply be attributed to having greater core muscle activation and/or strength.

Chronic or long-term pain involves brain changes, not simply muscle weakness. The brain areas that process pain become more sensitive, and in many people with long-term pain have been shown to activate spontaneously; without any or with only minimal stimulation of pain nerves signalling injury or excessive biomechanical loading of muscles, tendons, joints or ligaments.⁵ In addition to this, brain areas that are meant to dampen pain perception and processing work less efficiently; this is known as poor endogenous pain modulation. Unfortunately, a major risk factor for developing such brain changes that can lead to chronic pain is having a sedentary lifestyle.^6,7,8 Several recent studies^9,10,11,12 have shown exercise programmes involving core muscle strengthening, motor control and/or balance training to be effective in reducing chronic low back pain. Such exercises will not only strengthen muscles, but they will also activate brain areas associated with balance and coordination of movement (cerebellum, vestibular system, frontal lobe motor areas). This, in turn, can directly or indirectly stimulate brain areas involved in endogenous pain modulation, e.g. raphe nuclei, nucleus tractus solitarius, periaqueductal gray and hypothalamus.^{13,14,15,16,17}

Training the spinal muscles through active sitting will also improve what is known as pain-gating. A well-known example of pain-gating is when you accidently knock your elbow and instinctively rub it to make it hurt less. The basic principle is to activate nerve fibres that transmit a non-painful signal (rubbing) as this partially blocks the transmission and processing of pain nerve signals. Nerve signals from muscles, that signal muscle length and speed of stretch (proprioception), also powerfully activate the pain gates, and therefore help to reduce the transmission and processing of pain¹⁸. Muscles that have better muscle tone and are activated regularly produce better pain-gating. So training the spinal muscles through active sitting is likely to produce better pain-gating for people with back pain.

⁵ Nijs, J., Lahousse, A., Kapreli, E., Bilika, P., Saraçoğlu, İ., Malfliet, A., Coppieters, I., De Baets, L., Leysen, L., Roose, E., Clark, J., Voogt, L., & Huysmans, E. (2021). Nociplastic Pain Criteria or Recognition of Central Sensitization? Pain Phenotyping in the Past, Present and Future. Journal of clinical medicine, 10(15), 3203. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347369/

⁶ Årnes, A. P., Nielsen, C. S., Stubhaug, A., Fjeld, M. K., Johansen, A., Morseth, B., Strand, B. H., Wilsgaard, T., & Steingrímsdóttir, Ó. A. (2023). Longitudinal relationships between habitual physical activity and pain tolerance in the general population. PloS one, 18(5), e0285041. https://doi.org/10.1371/journal.pone.0285041

⁷ Naugle, K. M., Ohlman, T., Naugle, K. E., Riley, Z. A., & Keith, N. R. (2017). Physical activity behavior predicts endogenous pain modulation in older adults. Pain, 158(3), 383–390. https://doi.org/10.1097/j.pain.0000000000000769

⁸ Law, L. F., & Sluka, K. A. (2017). How does physical activity modulate pain?. Pain, 158(3), 369–370. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5303119/

⁹ Mirshahi, M., Najafi, R., Golbakhsh, M., Mirshahi, A., & Pishkuhi, M. A. (2023). Effectiveness of a Core Stability Exercise Program on Pain and Function in Musicians with Chronic Low Back Pain: A Randomized Controlled Trial. Medical problems of performing artists, 38(4), 207–213. https://doi.org/10.21091/mppa.2023.4025

¹⁰ Alqhtani, R. S., Ahmed, H., Alshahrani, A., Alyami, A. M., Khan, A. R., & Khan, A. (2023). Synergistic Benefits of Motor Control Exercises and Balance Training in Sacroiliac Joint Dysfunction: A Randomized Controlled Trial. Life (Basel, Switzerland), 13(12), 2258. https://doi.org/10.3390/life13122258

¹¹ Muthukrishnan, R., Mohammed Badr Ul Islam, F., Shanmugam, S., Arulsingh, W., Gopal, K., Kandakurti, P. K., Rajasekar, S., Shahzadi Malik, G., & Sg, G. (2023). Perturbation-based Balance Training in Adults Aged above 55 years with Chronic Low Back Pain: A Comparison of Effects of Water versus Land Medium – A Preliminary Randomized Trial. Current aging science, 10.2174/0118746098254991231125143735. Advance online publication. https://doi.org/10.2174/0118746098254991231125143735

¹² Babiloni-Lopez, C., Fritz, N., Ramirez-Campillo, R., & Colado, J. C. (2024). Water-Based Exercise in Patients With Nonspecific Chronic Low-Back Pain: A Systematic Review With Meta-Analysis. Journal of strength and conditioning research, 38(1), 206–219. https://doi.org/10.1519/JSC.0000000000004635

¹³ Cuccurazzu, B., & Halberstadt, A. L. (2008). Projections from the vestibular nuclei and nucleus prepositus hypoglossi to dorsal raphe nucleus in rats. Neuroscience letters, 439(1), 70–74. https://pubmed.ncbi.nlm.nih.gov/18511198/

¹⁴ Espinosa-Sanchez, J. M., & Lopez-Escamez, J. A. (2015). New insights into pathophysiology of vestibular migraine. Frontiers in neurology, 6, 12. https://doi.org/10.3389/fneur.2015.00012

¹⁵ Balaban, C. D., Jacob, R. G., & Furman, J. M. (2011). Neurologic bases for comorbidity of balance disorders, anxiety disorders and migraine: neurotherapeutic implications. Expert review of neurotherapeutics, 11(3), 379–394. https://doi.org/10.1586/ern.11.19

¹⁶ Stacheneder, R., Alt, L., Straube, A., & Ruscheweyh, R. (2023). Effects of Transcranial Direct Current Stimulation (t-DCS) of the Cerebellum on Pain Perception and Endogenous Pain Modulation: a Randomized, Monocentric, Double-Blind, Sham-Controlled Crossover Study. Cerebellum (London, England), 22(6), 1234–1242. https://doi.org/10.1007/s12311-022-01498-x

¹⁷ Giannoni-Luza, S., Pacheco-Barrios, K., Cardenas-Rojas, A., Mejia-Pando, P. F., Luna-Cuadros, M. A., Barouh, J. L., Gnoatto-Medeiros, M., Candido-Santos, L., Barra, A., Caumo, W., & Fregni, F. (2020). Noninvasive motor cortex stimulation effects on quantitative sensory testing in healthy and chronic pain subjects: a systematic review and meta-analysis. Pain, 161(9), 1955–1975. https://doi.org/10.1097/j.pain.0000000000001893

¹⁸ Fuller, A. M., Luiz, A., Tian, N., Arcangeletti, M., Iseppon, F., Sexton, J. E., Millet, Q., Caxaria, S., Ketabi, N., Celik, P., Wood, J. N., & Sikandar, S. (2023). Gate control of sensory neurotransmission in peripheral ganglia by proprioceptive sensory neurons. Brain : a journal of neurology, 146(10), 4033–4039. https://doi.org/10.1093/brain/awad182

Musculoskeletal injury prevention

Increased muscle tone in the spinal muscles makes the proprioceptive nerve signals from muscles more sensitive, which, in turn, leads to better motor responsiveness for injury prevention. In other words, people who have good muscle tone and good motor responsiveness are less likely to pull their back during day-to-day activities.

Proper activation of stabilising muscles and motor responsiveness relies largely on subconscious motor programmes, which are mediated by a subcortical brain network involving the cerebellum, basal ganglia, thalamus and cingulate cortex.¹⁹ Active sitting while doing a brain-based task (e.g. office work) will train subconscious motor programmes for postural control, as you are not consciously thinking about controlling your posture; you are focusing on working. Conscious core stability exercises, on the other hand, mostly activate a cortical brain network for movement,¹⁹ which will provide less efficient spinal stabilisation and injury prevention.

¹⁹ Kim, D. H., Lee, J. J., & You, S. J. H. (2018). Best core stabilization exercise to facilitate subcortical neuroplasticity: A functional MRI neuroimaging study. Technology and health care : official journal of the European Society for Engineering and Medicine, 26(3), 401–407. https://doi.org/10.3233/THC-171051

Other benefits of active sitting

It has been shown²⁰ that active sitting on a balance ball or air-filled cushion burns significantly more calories than sitting on a firm flat surface. Although active sitting is not a substitute for regular exercise, it might help reduce the epidemic of obese sedentary office workers.

Long-term regular exercise causes certain immune system cells (e.g. macrophages, peripheral blood mononuclear cells and microglial cells) to release more anti-inflammatory than inflammatory chemicals.²¹This helps to reduce the likelihood of suffering chronic pain, but it also helps you heal up more quickly if you do get injured. Reduced inflammatory levels in the body also help to prevent some chronic disease, such as heart disease, certain cancers, diabetes, chronic liver or kidney disease, inflammatory bowel disease, depression, as well as cognitive decline / dementia.²² Active sitting is likely to have beneficial effects on inflammation levels in the body, but studies are needed to verify this.

²⁰ Dickin, D. C., Surowiec, R. K., & Wang, H. (2017). Energy expenditure and muscular activation patterns through active sitting on compliant surfaces. Journal of sport and health science, 6(2), 207–212. https://doi.org/10.1016/j.jshs.2015.10.004

²¹ Sluka, K. A., Frey-Law, L., & Hoeger Bement, M. (2018). Exercise-induced pain and analgesia? Underlying mechanisms and clinical translation. Pain, 159 Suppl 1(Suppl 1), S91–S97. https://doi.org/10.1097/j.pain.0000000000001235

²² Pahwa, R., Goyal, A., Jialal, I. (2023). Chronic Inflammation. In: StatPearls. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493173

Please see below for the different models of SpinaliS active sitting chairs. You can find further information about each model by clicking on the image of the chair (link opens in new window). This will take you to the website of our sister company – Upright & Balanced. Upright & Balanced Ltd is an authorised UK retailer of SpinaliS office chairs.

All SpinaliS office chair models have patented spring technology that facilitates active sitting. They all have the same benificial effects on your health and wellbeing. Your choice depends on which seat and backrest suits you the most.

People come in different shapes and sizes, which is why SpinaliS have developed a chair for every body type. Higher backrests on some models suit taller people and padded chairs are for those looking for superior comfort. The height range of the chair’s seat base can be customised to your body height, and the type of wheels can also be modified according to your needs.

Specialist workplaces are also catered for. Chairs designed for the sterile clinical environment, for higher workstations, for small spaces, and for workplaces that demand frequent and rapid transitions between sitting and standing are available.

Please see upright-balanced.co.uk for further details.