Today, Americans spend an average of 13 hours per day sitting. Sitting for as little as two continuous hours increases the risk of heart disease, diabetes, metabolic syndrome, cancer, back and neck pain, and other orthopedic problems. This project contains 8 YouTube videos presented in an engaging, educational and detailed manner to show individuals what they can do to combat prolonged sitting. The videos focus on moving the body’s joints through their normal ranges of motion & improving an individual’s NEAT (non exercise activity thermogenesis)https://scholarworks.uvm.edu/fmclerk/1455/thumbnail.jp

Syed, Harris

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UVM ScholarWorks

University of VermontScholarWorks @ UVMFamily Medicine Clerkship Student Projects Larner College of Medicine2018Fight Sitting with MovementHarris SyedUniversity of VermontFollow this and additional works at: https://scholarworks.uvm.edu/fmclerkPart of the Medical Education Commons, and the Primary Care CommonsThis Book is brought to you for free and open access by the Larner College of Medicine at ScholarWorks @ UVM. It has been accepted for inclusion inFamily Medicine Clerkship Student Projects by an authorized administrator of ScholarWorks @ UVM. For more information, please contactdonna.omalley@uvm.edu.Recommended CitationSyed, Harris, "Fight Sitting with Movement" (2018). Family Medicine Clerkship Student Projects. 406.https://scholarworks.uvm.edu/fmclerk/406Fight Sitting with Movement!By: Harris Syed, MS3Brookfield Family MedicineSeptember 2018Project Mentors:Dr. Cornelius Ferreira MD&Kathy McCoy-Goldstein APRN 2A) PROBLEM IDENTIFICATION  & DESCRIPTION OF NEED• Today, Americans spend an average of 13 hours per day sitting. (1)• Sitting for as little as two continuous hours increases the risk of heart disease, diabetes, metabolic syndrome, cancer, back and neck pain, and other orthopedic problems. (2)• The typical seated office worker has more musculoskeletal injuries than any other industry sector worker, including construction, metal industry, and transportation workers. One researcher’s conclusion: sitting is as much an occupational risk as lifting heavy weights on the job. (4)2B) PROBLEM IDENTIFICATION  & DESCRIPTION OF NEED• The proposed solution: Increase our NEAT! NEAT = Non-Exercise Activity Thermogenesis.• A standing body uses energy quite differently than a sitting body. Depending on our level of activity, we burn calories at different rates, and we also store calories differently. “Non-exercise activity” is what you do when you’re not exercising at high intensity – things like standing, walking, gardening, cooking, and fidgeting. (12)• Dr. James Levine calls it Non-Exercise Activity Thermogenesis or NEAT. (14). People with LOW levels of non-exercise activity are predisposed to obesity. Obesity and sedentary behavior (sitting) go hand in hand. 3) PUBLIC HEALTH COST CONSIDERATIONS• The Centers for Disease Control reports that we are spending 75 cents of every health-care dollar on chronic conditions linked to sedentary behavior, like obesity, diabetes, and heart disease. (6)• According to the National Institutes of Health, back pain affects 8 of 10 people in their lifetime, and it is the leading cause of disability worldwide. (7)• Risk Factors for Low Back Pain include: Prolonged sitting (with truck driving having the highest rate of low back pain, followed by desk jobs) & Obesity.• In the United States alone, we spend almost $1 billion treating back pain. (8) 4) COMMUNITY PERSPECTIVE & SUPPORT FOR PROJECT“Sedentary lifestyle is associated with diabetes, hypertension, dyslipidemia & obesity. We see patients with those problems EVERY single day. Anything that can get them to be more physically active would be a step in the right direction for better health outcomes.” Kathy McCoy APRNDr. Cornelius Ferreira MD“During all of our annual physicals, patients are counseled to be physically active for at least 150 minutes per week. It can be difficult for many to get started - a free, engaging online resource showing them some movement they can do on their own would be very helpful!”5) INTERVENTION & METHODOLOGY My Family Medicine Clerkship Community Health Improvement Project• Health with Harris → FSWM Campaign• FSWM = Fight Sitting with Movement!• #4for60 = Take 4 minutes of movement for every 60 minutes of sitting • 8 YouTube videos presented in an engaging, educational and detailed manner to show individuals WHAT they can do and HOW to do it• The 8 videos focus on moving the body’s joints through their normal ranges of motion & improving an individual’s NEAT (non exercise activity thermogenesis)• The joints focused on: Neck, Scapula, Shoulder, Spine, Hips, Knee, Ankle, Foot https://www.youtube.com/playlist?list=PLeybsH7G8Y8BGxuiC_arQt-_9UAP_Oto-6A) RESULTS/RESPONSE• “The videos are informative, upbeat and fun!”• “I actually stood up IMMEDIATELY when I started watching it! EEK!”• “It’s awesome! Very engaging and informative”• “Love it! Love your enthusiasm and the content! Simple and easy-to-apply!”• “These are great!”• “Would love for you to come in an instruct us on these a few times so we can feel comfortable doing them on our own” 6B) RESULTS/RESPONSE• “Short and to the point”• “light and upbeat, high energy”• “seems very doable in any office setting”• “Potential for broad use, potential for broad impact—applies to everyone!”7) EVALUATION OF EFFECTIVENESS & LIMITATIONS• Schedule meetings with local primary care offices!• Schedule me coming in one day for one hour to demonstrate all 8 exercise videos to staff • Answer all questions and concerns• Follow up by sending links to videos for reference • Follow up every month with a survey asking what they have been able to do and if they feel like it has made them feel better, or helped/hurt them in anyway• Make appropriate changes based off of the feedback!RECOMMENDATIONS FOR FUTURE INTERVENTIONS/PROJECTS • More targeted video series focusing on exercises a patient can do for the most common musculoskeletal injury related primary care visits• Low back pain• Shoulder pain• Knee Pain REFERENCES 1. James A. Levine, Get Up! Why Your Chair Is Killing You and What You Can Do About it (New York: St. Martin’s Press, 2014): 103.2. Levine, Get Up!, 70-713. Aviroop Biswas, Paul I. Oh, Guy E. Faulkner, Ravi R. Bajaj, Michael A. Silver, Marc S. Mitchell, and David A. Alter, “Sedentary Time and Its Association with Risk for Disease Incidence, Mortality, and Hospitalizations in Adults: A Systematic Review and Meta-Analysis,” Annals of Internal Medicine 162, no. 2 (2015): 123-1324. Eric Jensen, “Moving with the Brain in Mind,” Educational Leadership 58, no. 3 (2000): 34-37. 5. “Health Topics: Physical Activity,” World Health Organization, www.who.int/topics/physical_activity/en/6. U.S. Department of Health and Human Services, The Power of Prevention: Chronic Disease…The Public Health Challenge of the 21st Century (Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2009). www.cdc.gov/chronicdisease/pdf/2009-Power-of-Prevention.pdf7. “Back Pain,” MedLine Plus, National Institutes of Health, www.nlm.nih.gov/medlineplus/backpain.html; Pat Anson, “Lower Back Pain is #1 Cause of Disability,” National Pain Foundation, www.thenationalpainfoundation.org/Lower-Back-Pain-is-the-number-1-cause-of-disability.8. M. Mehra, K. Hill, D. Nicholl, and J. Schadrack, “The Burden of Chronic Low Back Pain with and without a Neuropathic Component: A Healthcare Resource Use and Cost Analysis,” Journal of Medical Economics 15, no. 12 (2012): 245-252. 9. Alpa V. Patel, Leslie Bernstein, Anusila Deka, Heather Spencer Feigelson, Peter T. Cambell, Susan M. Gapstur, Graham A. Colditz, and Michael J Thun, “Leisure Time Spent Sitting in Relation to Total Mortality in a Prospective Cohort of US Adults,” American Journal of Epidemiology, 172, no. 4 (2010): 419-429. 10. Levine, Get Up!, 70-71; Daniela Schmid and Graham Colditz, “Sedentary Behavior Increases the Risk of Certain Cancers,” Journal of the National Cancer Institute 106, no. 7 (2014)11. J.A. Bell, M. Hamer, G.D. Batty, A. Singh-Manoux, S. Sabia, M. Kivimaki, “Combined Effect of Physical Activity and Leisure Time Sitting on Long-Term Risk of Incident Obesity and Metabolic Risk Factor Clustering,” Diabetologia 57, no. 10 (2014): 2048-2056. 12. Kelly Starrett, Deskbound: Standing Up to a Sitting World (Las Vegas: Victory Belt Publishing Inc., 2016): pg. 1813. Levine, Get Up!, 29-3214. Levine, Get Up!, 24-27. 15. Kelly Starrett, Deskbound: Standing Up to a Sitting World (Las Vegas: Victory Belt Publishing Inc., 2016): pg. 218

Fight Sitting with Movement

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