Note: Descriptions are shown in the official language in which they were submitted.
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DYNAMIC STANDING DESK
TECHNICAL FIELD
The present invention relates to standing desks designed for use by people
while
standing and to techniques for reducing fatigue caused by standing for
prolonged periods.
B A CK GR OUND
Many people spend most of their day sitting with relatively idle muscles.
Physical
inactivity has many known deleterious effects on the body. Obesity, heart
disease, and
metabolic diseases such as type 2 diabetes are just a few examples of the
consequences of
a sedentary lifestyle. Exercise is generally viewed as important to the
promotion of good
health and slowing the effects of aging, particularly for the cardiovascular
and
musculoskeletal systems. Exercise also is thought to improve brain function,
particularly
cognition (Kramer et al., 2006). Although exercise therapy has the potential
to treat both
cognitive and motor decline in the elderly, long-term compliance with intense
exercise
regimens may be limited.
Advances in diabetes mellitus and obesity research have touted the benefits of
"upright" standing or low-intensity walking activities while performing
routine activities
of daily living. A novel approach in combating metabolic disorders such as
diabetes and
obesity has been developed by the Mayo Clinic endocrinologist James Levine
(Levine et
al., 2005) who noted that non-exercise activity thermogenesis (NEAT), which
reflects
human energy expenditure through changes in posture and movement associated
with
routines of daily life, predicts obesity in office workers. Levine developed
an "office of the
future- by creating a "walk-and-work- desk for office workers (U.S. Patent No.
7,892,148
Stauffer) (Levine and Miller, 2007).
Although Levine's work focused on office workers, there are many activities of
daily living like talking on the phone, watching television, reading the
newspaper, playing
games, or using the home computer that can be done just as enjoyably upright.
Hamilton
et al. found that more standing and less sitting, promoted -optimal
metabolism" (Hamilton
et al., 2007). These authors found that sitting has negative effects on fat
and cholesterol
metabolism because of lack of lipase enzyme activation when muscles are idle.
In contrast,
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standing and other non-exercise activities can double the metabolic rate in
most adults even
if they do no formal exercise at all. These metabolic effects come on top of
physical
conditioning benefits, including training of postural reflexes.
A disadvantage of the more intense walking movements in Levine's "office of
the
future" treadmill desk is that it may limit cognitive or office productivity
performance
when the user must focus on small objects on a computer screen and/or enter
precision data
on a keyboard. For example, a 2009 study investigated the effects of different
workstation
conditions ¨ sitting, static standing, walking, and cycling ¨ on standardized
computerized tasks (Straker et al., 2009). Computer task performances were
lower when
walking and slightly lower when cycling, compared with chair sitting. Standing
performance was not different from sitting performance. Computer mouse
performances
were more affected than typing performance. Performance decrements were equal
for
females and males and for touch typists and no touch typists (Straker et al.,
2009). Another
study of performance on a cognitive and fine motor test battery in young
adults in seated
and walking conditions found that treadmill walking causes a 6% to 11%
decrease in
measures of fine motor skills and math problem solving, but did not affect
selective
attention and processing speed or reading comprehension (John et al. , 2009).
Another
study evaluated the productivity of transcriptionists using a treadmill desk
and found that,
despite no significant change in the accuracy of transcription, the speed of
typing was 16%
slower while walking than while sitting (Thompson and Levine, 2011). Although
dynamic
and able to provide a relatively high amount of physical exercise, the
treadmill workstation
may have a cognitive cost that potentially reduces work performance in users
in spite of
any health benefits. Furthermore, long-term utilization of treadmill desk in
office workers
is limited.
While static standing may overcome some of the cognitive and task performance
disadvantages of the treadmill desktop, actual use of available height-
adjustable standing
tends to decline over the long-term. This may be due to poor human tolerance
of prolonged
static postural conditions. Declining use over time of an available height-
adjustable table
in the standing position reduces or eliminates the metabolic and productivity
benefit of
such a workstation.
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Commercially available height-adjustable tables provide a heavy base of
support
that allow a user to alternate between standing and sitting positions to use
the table. The
table can be lowered to a sitting level or raised to a standing level using an
electronic
controller or hand crank when desired. Occupational studies have demonstrated
short-term
benefits associated with the use of height-adjustable tables when provided to
workers in an
office setting, including increased office productivity, reduced low back
pain, and reduced
absenteeism (Nerhood and Thompson, 1994). When height adjustable tables are
provided
to office workers, a majority of office work participants prefer the height
adjustable table
over a normal desk (Hedge and Ray, 2004). But these studies also show that the
use of
1() stand-up desks tends to rapidly decline after about a month ¨ likely
because people may
not tolerate standing all day. Prolonged use of such stand-up desks can result
in physical
discomfort in the legs, spine, and/or other body regions due to relative lack
of leg or body
movements when standing at a static location. Lack of lower extremity or body
weight
shifting movements may be the most important contributor to the physical
discomfort of
prolonged standing.
Sedentariness is not only a common problem in office workers but also in
persons
with neurological or medical conditions that limit gait and balance functions
because of
poor postural or gait control or limitations in energy expenditure, such as
metabolic
disorders. Consequently, these persons will enter a vicious cycle where
increasing
sedentariness results in physical deconditioning and frailty that in turn will
aggravate gait
and balance disturbances increasing their risk of falls and traumatic
fractures. Current
clinical practice recommends a series of physical therapy to try to break the
vicious cycle.
However, clinical experience and studies have shown that, after completion of
physical
therapy, any early gains in mobility functions in these patient populations
are short-lived,
and afflicted persons quickly return to their sedentary lifestyle and
continuing a downward
clinical course.
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SUMMARY
In accordance with an aspect of the invention, there is provided a dynamic
standing
desk comprising a work surface configured to move with planar motion parallel
with the
ground and with a range of movement that adjusts as a function of the size of
a user of the
desk.
In various embodiments, the standing desk may include one or more of the
following features, either singly or any technically-feasible combination.
- The planar motion is mediolateral motion with respect to the user.
- The planar motion includes mediolateral and anteroposterior motion with
respect
to the user.
- The range of movement is a function of a length of a leg of the user and,
optionally,
wherein the range of movement is between 25% and 35% of said length, the
range of movement is between 55% and 65% of said length, or the range of
movement is not between 40% and 50% of said length.
- The planar motion is at a rate between 2 millimeters per second and 10
millimeters
per second.
- The dynamic standing desk further includes: a base, a tabletop that
includes the
work surface, a frame that movably couples the tabletop to the base, and at
least
one actuator configured to provide the planar motion. Optionally, the tabletop
includes a cut-out at which the user stands and/or optionally the at least one
actuator includes a first actuator configured to move the tabletop with
respect
to the frame along a first direction and a second actuator configured to move
the frame with respect to the base along a different second direction, the
frame
being stationary with respect to the tabletop in the second direction.
- The dynamic standing desk further includes a controller configured to
receive
information pertinent to the size of the user and to set the range of movement
based on the received information.
- The dynamic standing desk further includes a sensor configured to detect
the
presence of the user and, optionally, the sensor is configured to
differentiate the
user from a different user, the desk being further configured to adjust the
range
of movement based on information from the sensor.
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- A height of the work surface is adjustable.
- The dynamic standing desk further includes a tether for attaching the
user to the
desk.
In accordance with another aspect of the invention, there is provided a method
of
reducing lower musculoskeletal discomfort of a user of a standing desk, the
method
comprising the step of oscillating a work surface of the desk with a range of
movement
based on a length of a limb of the user.
In various embodiments, the standing desk may include one or more of the
following features, either singly or any technically-feasible combination.
- The range of movement is between 25% and 35% and/or between 55% and 65% of
the length of a leg of the user.
- A rate of movement of the work surface is between 2 millimeters per
second and
10 millimeters per second.
- The step of oscillating includes mediolateral and anteroposterior motion
of the work
surface with respect to the user.
In accordance with one or more other embodiments, a dynamic standing desk may
be provided with a table base and attached tabletop which is controlled
electronically and
moveable independently both in the X (left-right) and Y (anterior-posterior)
directions. The
table base may be height-adjustable, controlled manually or electronically, so
that it is
moveable in the Z-direction (up-down). Programmable continuous unidirectional
or
multidirectional XY movements or patterns of movements of the tabletop
encourage or
require a user of the desk to continuously take small steps in order to remain
centered in
front of the tabletop. An optional in-cut or cutout in the tabletop allows for
additional
human user step cueing. The tabletop is continuously or intermittently
moveable and can
be programmed with a predetermined rate of movement and range of movement in
the X-
and/or Y-directions or variable combinations of these. These parameters of
tabletop
movement can be input via a tabletop-mounted or remote Human Interface Device
(HID).
Planar XY tabletop movement can be enabled by mounting the tabletop on
independent
support bases movable in the X and Y directions. X and Y support base movement
may be
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established through linear actuators directly moving the X and Y support
bases, via rotary
actuators moving the X and Y tabletop support bases by cogwheel or other
directional
switch transfer of rotary movement to linear movement, or other mechanisms of
displacement.
The desk may include one or more controllers and electronic memory for
collecting
the user's stepping physical activity measurements either wired or wireless
from body-
attached accelerometers and other activity measurement devices. The desk may
be
configured to provide visual feedback of the user's activity levels, such as
via an electronic
display. The standing desk may be used with an anti-fatigue mat on which the
user stands
during use of the desk. Such a mat may be part of the dynamic standing desk
itself or may
be separately provided. An optional desk-attached fall-prevention belt
attachment system
may also be provided.
Another available safety feature is the use of individualized start-up and use
of the
dynamic standing desk based on user-worn sensors, such as radiofrequency
identification
(REID) tagging, and desk-mounted sensors that track the height of the table
and will allow
automatic shut-off once the individual users stops using the desk. The
tabletop of the desk
can be vertically adjusted to the particular human user's individual height
preference or
preference to intermittent alternations between sitting and standing. The
dynamic standing
desk may be an effective solution to combat sedentariness, the quick
development of
musculoskeletal discomfort when standing at a stationary height-adjustable
workstation,
and/or inactivity and prolonged sitting in populations with conditions that
affect mobility
or energy expenditure during physical activity and that generally benefit from
low-intensity
physical activity.
BRIEF DESCRIPTION OF THE DRAWINGS
One or more embodiments will hereinafter be described in conjunction with the
appended drawings, wherein like numerals denote like elements, and wherein:
FIG. 1 is an isometric view of an exemplary dynamic standing desk with the
tabletop in cutaway view;
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FIG. 2 is an exploded view of a dynamic standing desk with a coupling assembly
similar to that of FIG. 1;
FIG. 3 is a rear view of a user standing at the dynamic standing desk at
various
positions relative to the tabletop;
FIG. 4 is a bottom view of the tabletop of an exemplary dynamic standing desk
illustrating another example of the coupling assembly;
FIG. 5 is a side cutaway view of the tabletop of FIG. 4;
FIG. 6 is a perspective view of a portion of the coupling assembly of FIG. 4,
illustrating actuators for moving the tabletop in different directions;
to
FIG. 7 is a chart illustrating musculoskeletal discomfort over time for users
in a
seated position, users in a static standing position, and users of the dynamic
standing desk;
FIG. 8 is a chart illustrating musculoskeletal discomfort over time for users
of a
standing desk with various ranges of work surface movement;
FIG 9 is a chart illustrating frequency of postural adjustments ()fusers as a
function
of range of work surface movement;
FIG. 10 is a chart illustrating musculoskeletal discomfort as a function of
range of
work surface movement;
FIG. 11 is a chart illustrating musculoskeletal discomfort over time for
diabetic
users in same three conditions as the users of FIG. 7;
FIGS. 12A and 12B are charts illustrating results of "Timed get Up and Go"
(TUG)
evaluations for groups of physical therapy patients before starting physical
therapy,
immediately after completing physical therapy, and at 16 weeks after
completing physical
therapy, with results shown for patients who used the dynamic standing desk
after
completing physical therapy and for patients who used no desk after completing
physical
therapy;
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FIGS. 12C and 12D are charts illustrating walking times for the patients of
FIGS.
12A and 12B; and
FIG. 13 is a chart illustrating average daily in-home use of the dynamic
standing
desk by physical therapy patients over time after completion of physical
therapy.
DESCRIPTION OF ILLUSTRATED EMBODIMENTS
Described below is a dynamic standing desk capable of reducing musculoskeletal
fatigue
normally caused by prolonged standing. The desk has a movable work surface
that causes
the user to repeatedly shift their body weight and alter their posture,
thereby providing the
health and productivity benefits of a standing position without the discomfort
that normally
sets in after standing for prolonged periods in a static posture. These
benefits extend beyond
the office environment and into rehabilitation therapy for persons afflicted
with health
conditions, including metabolic or neurological conditions.
FIG. 1 is an isometric view of an exemplary dynamic standing desk 10, which
includes a base 12, a tabletop 14 (shown in cutaway view), and a coupling
assembly 16
that movably couples the tabletop with the base. A work surface 18 at the top
side of the
tabletop 14 is configured to move with planar motion parallel with the ground
or floor
i.e., in an x-y plane of FIG. 1. This movement is with respect to the ground,
the base 12,
and with a user standing at the desk 10. The planar motion has a range of
movement that
adjusts as a function of the size of the user of the desk 10, as discussed in
further detail
below.
The illustrated base 12 is intended to remain static with respect to the
ground and
may be made from a relatively heavy material (e.g., steel or other metal)
and/or with longer
support legs for stability. The base 12 of FIG. 1 has a pair of upright and
laterally spaced
structural members, each with an elongated foot at a bottom end. The upright
members
may be spaced apart as far as is practical, and the feet may extend away from
their
respective upright structural member as far as is practical for stability as
the tabletop 14
and its center of gravity move. The illustrated base 12 also has horizontal
cross-members
¨ one near the vertical center of the upright members, and one near the top of
the upright
members. Although not shown explicitly in the figures, the base 12 may have a
manually
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or electrically adjustable height (e.g., telescopic uprights) so that the work
surface 18 can
be set at different heights for different users.
The work surface 18 of the tabletop 14 may be generally flat and designed to
support items such as a desktop or laptop computer, computer monitor, video
screen, and,
at times, part of the weight of the user. The illustrated tabletop 14 is
generally rectangular
with an optional vertical wall extending downward away from the work surface
18 at its
perimeter. A cavity or recess is can thus be formed beneath the work surface
18, which
houses the coupling assembly 16 and/or other components. Other non-rectangular
work
surfaces are possible, such as more oval or shell-shape configurations. The
tabletop 14 may
additionally include a cut-out 20 along its perimeter as a visual or tactile
cue to the user as
to where to stand when using the desk 10. The cut-out 20 can be made deeper
into the
tabletop 14 so that the user is partly surrounded by the work surface 18. In
some cases, the
effective depth of the cut-out 20 is enhanced by extensions 22 in the y-
direction (see FIG.
3). Deep cut-outs 20 and/or extensions 22 can provide movement cues to the
user to prompt
them to shift their weight away from a part of the tabletop 14 that has moved
closer to the
user during use.
With continued reference to FIG. 1 and additional reference to the exploded
view
of FIG. 2, the coupling assembly 16 includes a frame 24, one or more first
guide sets 26,
and one or more second guide sets 28. Relative movement between the tabletop
14 and the
frame 24, along with independent relative movement between the frame 24 and
the base
12, is provided via one or more actuators 30, 32 with particular degrees of
freedom
provided by and/or limited by the guide sets 26, 28.
The illustrated frame 24 is rectangular with a symmetric cross-shape
connecting its
pairs of opposite sides. One half of each of the guide sets 26, 28 is rigidly
mounted to the
frame 24. Each of the first guide sets 26 includes a guide 34 and a follower
36. The guides
34 in this case are rails with a U-shaped channel and are rigidly mounted to
the frame 24.
The followers 36 are sliders rigidly mounted to the tabletop 14 with downward-
facing
protrusions complimentary in shape with the guide channels. The first guide
sets 26 thus
provide a single linear degree of freedom of movement between the tabletop 14
and the
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frame 24 and restrict movement of the tabletop 14 relative to the frame 24 in
other
directions. In other words, the first guide sets 26 permit movement of the
tabletop 14 with
respect to the frame 24 in a first (x) direction and prevent relative movement
of the tabletop
14 and frame 24 in a different second (y) direction.
Each of the second guide sets 28 also includes a guide 38 and a follower 40.
The
guides 38 in this case are rails with a U-shaped channel and are rigidly
mounted to the
frame 24. The followers 40 are sliders rigidly mounted to the base 12 with
downward-
facing protrusions complimentary in shape with the guide channels. The second
guide sets
28 thus provide a single linear degree of freedom of movement between the
frame 24 and
the base 12 in a first direction (along the y-axis in the figures) and
restrict movement of the
frame 24 relative to the base 12 in a different second direction (along the x-
axis in the
figures).
In this example, one of the actuators 30 is configured to provide movement of
the
tabletop 14 with respect to the base 12 in the first (x) direction. The
illustrated actuator 30
is an electric motor rigidly mounted to the frame 24 with its axis of rotation
oriented parallel
with the y-axis. Rotational motion of the actuator 30 is converted to linear
motion via a
transmission, which in this case includes a pinion or worm gear mounted to the
motor shaft
and engaged with a toothed linear rack rigidly mounted to the tabletop 14. The
other
actuator 32 (FIG. 2) is configured to provide movement of the frame 24
___________ and, thereby,
the tabletop 14 ¨ with respect to the base 12 in the second (y) direction. The
illustrated
actuator 32 is an electric motor rigidly mounted to the base 12 with its axis
of rotation
oriented parallel with the z-axis. Rotational motion of the actuator 32 is
converted to linear
motion via a transmission, which in this case includes a pinion or worm gear
mounted to
the motor shaft and engaged with a toothed linear rack rigidly mounted to the
frame 24.
This configuration provides independently controllable movement of the work
surface 18 in two perpendicular directions parallel with the ground, including
simple
mediolateral (left-to-right) movement, simple anteroposterior movement, and
any
combination of those movements, such as circular, elliptical, or oblique
movement in an x-
y plane. The illustrated configuration also permits the x- and y-guide sets
26, 28 to be
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located within the same layer of the stack-up of the coupling assembly 16. The
weight of
the tabletop 14 is borne by bearings 42 mounted along the base 12. The
illustrated coupling
assembly 16 is merely illustrative and can be embodied in numerous variations,
such as
with the x- and y- directions switched, the guides and followers inverted, the
uses of linear
actuators and/or omission of transmission components, etc. The desk of FIG. 3,
for
example, is a variation of the desk of FIG. 2 in which the guide sets 26, 28
are oriented
with the U-shaped channels opening in the horizontal rather that the vertical
direction.
Both the range of movement and the rate of movement of the work surface 18
relative to the ground are controllable and adjustable. More particularly, the
range of
1() movement of the work surface 18 is adjusted as a function of the size
of the user of the
desk 10. It has been determined that particular amounts and rates of work
surface
movement relative to the user can reduce musculoskeletal discomfort enough to
encourage
the user to remain in the standing position longer than they otherwise would
and to continue
daily use of the standing desk for weeks or months longer than they otherwise
would. As
used herein, the "range of movement" of the work surface 18 or tabletop 14 is
the extent
of movement in an arbitrary direction in the XY plane before the work surface
at least
partially reverses direction. Generally speaking, the optimal ranges of
movement are
relatively greater for relatively tall users and relatively less for
relatively short users. In
particular, the optimal ranges of movement are related to the length of one of
the user's
limbs. For example, the optimal ranges of movement of the work surface
relative to the
user is a function of the length (L) of a leg of the user or the average
length of the legs of
the user. This length (L) can be measured from the center of the hip joint to
the heel of the
user or from the anterior superior iliac spine to the medial malleolus.
In one embodiment, the work surface 18 is configured to move relative to the
user
with a range of movement equal to an amount between 25% and 35% of the length
(L) of
the leg of the user. In another embodiment, the range of movement is equal to
an amount
between 55% and 65% of the length (L) of the leg of the user. In another
embodiment, the
range of movement is exclusive of amounts between 40% and 50% of the length
(L) of the
leg of the user. The range of tabletop movement may be measured in the
mediolateral (x)
direction and/or the anteroposterior (y) direction. The rate of movement of
the work surface
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18 with respect to the user may be in a range from 2 mm/sec to 10 mm/sec in
any planar
direction, or between 2 mm/sec and 7 mm/sec in the mediolateral (x) direction
and/or the
anteroposterior (y) direction. In a specific embodiment, the rate of movement
in the
mediolateral (x) direction and/or the anteroposterior (y) direction is between
6 mm/sec and
7 mm/sec.
The standing desk 10 may further include a controller 44 configured to receive
information pertinent to the size of the user and to set the range of movement
based on the
received information. The controller 44 can receive this information (e.g.,
length of user
leg information) from a variety of sources, such as a human interface device
(HID), a dial
or switch, a sensor, a measurement device, a communication device such as a
wireless
transceiver, or from computer memory. In one embodiment, the standing desk 10
includes
a sensor that determines the resonant frequency of an RFID tag carried by the
user. The
controller 44 receives the information from the sensor, matches it to a known
user stored
in computer memory, and sets the range of movement based on the known leg
length of
that user. In another embodiment, a vision system is used to determine the leg
length of the
user with the controller subsequently receiving that information and using it
to set the range
of movement. In another embodiment, the leg length of the user is entered by
the user or
another person manually, such as via touch screen, keyboard, or dial setting,
or by voice
command, and the controller 44 receives the information and sets the range of
movement
accordingly.
Where a sensor such as a vision system or RFID is employed, the presence or
absence of the user may also be determined by the controller with the
actuators being
deactivated in the absence of the user. Other types of sensors such as motion
or proximity
sensors can be used to provide this safety function. A tether or safety
harness may also be
used to attach the user to the desk or to a nearby structure for further
safety.
FIG. 3 illustrates a user from behind while performing tasks at an exemplary
dynamic standing desk 10. As shown in FIG. 3, the user shifts their weight
from left (a) to
center (b) to right (c) while using the desk. While this may occur naturally
when the user
is at a static standing desk, the frequency of weight shifts and postural
adjustments in that
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case may generally be based on discomfort; that is to say that the user shifts
weight and
changes posture to move from a posture that has already become uncomfortable
to a
different more comfortable posture. In other words, the frequency is too low
or triggered
too late to prevent the initial discomfort from being experienced. If the user
shifts their
weight more frequently ¨ i.e., prior to discomfort setting in ¨ the standing
position is
tolerable for extended periods of time. The dynamic standing desk and the
controlled
movement of the work surface as a function of the size of the user forces the
user to shift
weight and change posture more frequently and from the beginning of desk use.
FIG. 4 illustrates another embodiment of the standing desk 10 and is a bottom
view
of the tabletop 14 and coupling assembly 16. Here, the first and second
actuators 30, 32
are linear. The frame 24 is embodied by x-direction guide rails 34 and y-
direction guide
rails 38, all of which move together. The frame 24 moves in the x-direction
only with
respect to the tabletop 14 under the power of the first actuator.
Independently, the frame
24 moves in the y-direction only with respect to the base 12. Additional views
are
illustrated in FIGS. 5 and 6.
Various other features, benefits, and experimental verification of benefits of
the
dynamic standing desk are provided below.
Use of the dynamic standing desk may be referred to as a "step-and-work" auto-
exercise or "step-and-treat" clinical rehabilitation and is a time- and cost-
effective lifestyle
modification to facilitate lower extremity or body weight shifting movements.
Targeted
users are, but not limited to, office workers, fitness workers, or clinical
rehabilitation
patients, including those with metabolic or neurological disorders that affect
gait and
balance functions. Users stand at the desk with an automatically moving
tabletop that
moves in the transverse plane (X-Y movements). The range of X-Y movements can
be
adjusted such that the tabletop moves away farther than practical physical arm
length use
when using, for example, a keyboard. Tabletop movement necessitates physical
and
bodyweight shifting adjustment steps by the user to stay centered in front of
the work
surface. Built-in or attached cueing systems, such as a centered cut-out in
the tabletop,
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attached flexible and adjustable gooseneck or cutouts at the level of the
torso, or sensory
(e.g., tactile, visual, auditory) sensor-driven cueing signals may produce the
same effects.
The dynamic standing desk will generate variable work surface movement
parameters ¨ i.e., from slow to fast in terms of rate of movement, from
continuous to
discontinuous work surface movement, and from smaller to larger ranges of
displacements.
Relatively slow rates of movement will provide more smooth and slow stepping
movements and will allow non-disrupted visual focus on an object on the desk,
such as a
display screen. Slow rates of movement will also allow non-disrupted use of a
small object
on the desk, such as a computer mouse, and will not interfere with
handwriting, for
example. Faster rates of movement and/or large ranges of movement of the work
surface
will increase the physical activity of the user. Bidirectional or
multidirectional
displacements (left-to-right or anterior-to-posterior or rotational variations
of these) will
induce weight-shifting stepping movements with truncal adjustments for the
user. The
dynamic standing table will increase physical activity and mobility compared
to the sitting
position and prevent or slow down the development of musculoskeletal
discomfort
associated with prolonged static body positions. Unlike the treadmill walk
station
mentioned above, the dynamic standing table can allow the user to maintain a
stable eye-
to-computer screen position and distance, which will allow continued fine
oculomotor
desktop activities. This may prevent cognitive cost and ocular strain effects
while using a
desktop computer or screens.
Advantages and features of the dynamic standing desk disclosed herein may
include
the programmable human use movable tabletop for office, personal,
recreational, or clinical
therapy uses. Built-in physical activity monitoring functions and monitoring
systems can
provide the user's advantageous functions of losing weight, improving energy
and fitness
functions, improving mobility and balance, maintaining cognitive productivity,
and
preventing or reducing musculoskeletal and mental fatigue and stress symptoms.
As described above, a height-adjustable (e.g., electrical, hydraulic, or hand-
cranked) table base (one or multi-legged) may include, among other components,
a
moveable tabletop, a software-controlled programmable controller, a physical
activity
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measurement device (e.g., user-mounted accelerometer), feedback device (e.g.,
electronic
display or auditory information), and an optional tabletop cut-out or attached
or cut-out
physical cueing device. Tabletop XY planar movement can be established by
mounting the
tabletop on independent support bases movable in the X and Y directions. X and
Y support
base movement can established via linear actuators directly moving the X and Y
support
bases or rotary actuators or other motors moving the X and Y support bases by
cogwheel
transfer of the rotary movement to linear movement or other mechanisms of
displacement.
The tabletop is continuously or intermittently moveable and positioned with a
pre-
determined rate and range of X and/or Y movement. These parameters may be
input via a
tabletop-mounted or remote computer and/or controller containing human-user
activated
software selections.
The computer and/or controller may include an input/output assembly that can
be
mounted to the tabletop or controlled remotely via wireless control. The
computer may
include components (e.g., numerical, light, voice, video-type or touch-screen
buttons and
displays) that enable the user to input control command to the actuator and/or
actuator
controller and to receive feedback regarding an exercise or use session (e.g.,
calories
burned, distance traveled, heart rate, time elapsed, time remaining, limb and
truncal
movements, etc.).
The moveable tabletop may include at least one top layer (e.g., the work
surface
layer) with or without a variable number of one to two or more support layers
(e.g., the
coupling assembly). Displacement of one layer relative to the base can include
a sliding,
gliding, wheeled, cogwheeled, or gear-based mechanical translation or rotation
mechanism. Variants of the dynamic standing table include an X-X' oscillating
tabletop
capable of exclusive left-to-right bidirectional movement relative to the
user, or a Y-Y'
oscillating tabletop capable of exclusive anterior-to-posterior bidirectional
movement
relative to the user. The construction of an exclusively X-X' or Y-Y'
oscillating tabletop
will be simplified compared to a multi-directional moving tabletop, as they do
not require
the extra materials (e.g., actuators) and/or translation layer for the
opposite direction.
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The physical activity monitoring and fitness feedback system may include a
portable monitoring device with a feedback system to collect information wired
or
wirelessly from body-attached accelerometers and other activity measurement
devices to
enable feedback of the user's activity levels, such as by displaying the
feedback.
Embodiments of the dynamic standing table can be made to include one or more
of
the following features:
- An oscillating tabletop on a stand-up desk or height-adjustable table with
relatively
faster or slower displacement movements (e.g., 45 seconds per foot) forcing
the
user to make frequent adjustment steps in order to stay connected to the
desktop.
1() -
An oscillating tabletop on a stand-up desk or height-adjustable table where
the
motion of the tabletop is created by a system of motors and gears allowing
multidirectional movement of the working surface. Rotational motors may have
a gear affixed to their rotating shafts to rotate along with the motor shaft.
The
teeth of the gear may interlock with a gear rack in order to move the gear
rack,
and everything it is attached to, in a linear but adjustable direction.
Transfer
bearings, clamps, and/or slider assemblies support the weight of the tabletop
while also allowing the tabletop to move along a safe, confined path. A frame
of the coupling assembly with sliders may be used to spatially separate x-axis
motion from y-axis motion while also connecting them to allow tabletop
movement in diagonal, circular, oblique, rectangular, square, or other
patterns.
- An oscillating tabletop coupled with a desk base via a single layer sliding
system
permitting multidirectional movement of the tabletop driven by one or more
non-linear actuators or other mechanical non-linear movement system (e.g.,
FIGS. 1 and 2).
- An oscillating tabletop on a stand-up desk or height-adjustable table with
smooth
biomechanical means of element displacement that is not based on cogwheel
mechanics or wheels but on minimal to no noise producing mechanics based on
ultra-smooth gliders and engines, such as actuators with minimal to no noise.
The oscillating stand-up desk or height-adjustable desk may be motorized,
including by brushless or other quiet actuators or hydraulic motors, and may
be
located on a system of sound absorbing material covering the motor and
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mechanical part of the oscillating desktop or surrounded by sound-absorbing
cover materials.
- A multi-directional oscillating tabletop on a stand-up desk or height-
adjustable table
with a single lightweight tabletop support frame where motors or actuators are
built-in and attached simultaneously to the tabletop in such way that their
individual perpendicular excursion ranges do not spatially interfere or
overlap
with each other. For example, one approach is shown in FIGS. 4-6, where the
mediolateral and anteroposterior actuators 30, 32 are positioned along an
imaginable 'L' configuration without touching or overlapping each other. This
construction can reduce production costs, material expenditure, and overall
weight of the oscillating tabletop with the additional benefit of reduced
noise
due to a light but robust design. This configuration allows perpendicular
directional movements, such as square stepping movements to enable an
increasing activation of various and different extremity and truncal muscle
groups.
- An oscillating tabletop on a stand-up desk or height-adjustable table
that promotes
not only lower extremity stepping movements but also causes shifts between
upper body forward or side-way leaning posture with a transfer of weight from
the lower trunk and extremities to the desktop which is equipped with a robust
metal or other suitably strong material and a heavy base that prevents table-
tipping movements.
- An oscillating tabletop on a stand-up desk or height-adjustable table
with sufficiently
slow or fast, sufficiently wide, mediolateral, anteroposterior, or
multidirectional
(e.g., patterned, circular, oblique, etc.) movements to provide a therapeutic
means to alleviate debilitating symptoms in afflicted patients.
- An integrated NEAT or limited exercise office, therapy, or home set-up
that includes
standing at an oscillating tabletop on a stand-up desk or height-adjustable
table
with the additional use of applied low weight lower extremity weights to
synergistically combine stepping movements with weight-bearing leg lifting
that may result in improved bodily functions dependent on weight bearing.
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- An oscillating tabletop on a stand-up desk or height-adjustable table or
sitting desk
where user feedback about movements and/or physiological parameters are fed
back to the user to enable incentive use of the set-up.
- An oscillating tabletop on a stand-up desk or height-adjustable table
configured to
disrupt any sedentary activity and promote bipedal stance and stepping.
Individual tolerance of static standing is limited (e.g., 30 minutes or less),
making static standing insufficient to achieve worthy bipedal use exceeding 4-
6 hours or more per day. Stepping movements induced by the dynamic stepping
desk will result in less complaints of lower extremity and truncal discomfort,
thereby providing a means to achieve longer duration bipedal body use and
reciprocally reduced sedentariness.
- The dynamic standing desk may be used with particular flooring features,
such as
anti-fatigue mats or slightly sloped standing surfaces.
- An oscillating tabletop on a stand-up desk or height-adjustable table
with a cueing
system, such as a cutout in the tabletop, which can be semicircular or square
in
nature as demonstrated in FIGS. 1, 3 and 4. Additional cueing may be provided
in the form of L-shaped forms or other extensions 22 (FIGS. 3 and 4) attached
to an adjustable slide system, which will allow for adjustment to
anthropometric
dimensions of the human body. The cutout and form will provide gentle
nudging providing users cues for position changes as the tabletop moves.
- An oscillating tabletop on a stand-up desk, height-adjustable table or
regular desk,
which provides user feedback about accomplished health benefits. An
integrated feedback system can provide information about the number of steps
taken, average heart rate, and calorie use. Integrated force plates or other
form
of force measurement (e.g. Wii balance board)
can provide additional
feedback about symmetry of weight shifting which may allow users to make
postural corrections and improve posture.
- An oscillating tabletop on a stand-up desk or height-adjustable table
configured to
specifically stimulate conditioning of postural reflexes and force weight and
postural adjustment lower extremity stepping movements as a means of non-
exercise thermogenesis (NEAT) or in physically deconditioned persons
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afflicted with medical disease low to intermediate aerobic exercise activities
and physical activity to improve their clinical motor, cognitive, metabolic,
and
other health-related functions in clinical outpatient, hospital,
rehabilitation,
physical therapy, or in-home therapy settings.
Experimental Results
The dynamic standing desk has been found to provide physical activity in users
while at the same time reducing development of musculoskeletal discomfort and
providing
health benefits compared to regular height-adjustable standing desk use and
sitting in
healthy adults.
FIG. 7 is a chart illustrating total musculoskeletal discomfort, as rated by
healthy
adult participants, as a function of time in three different conditions:
sitting, static standing
at a desk, and standing at the dynamic standing desk. In this study, each
participant
completed three 4-hour sessions, including the baseline sitting session first,
followed by
either a static desktop standing session or a dynamic desktop standing
session. The third
session was whichever of the static or dynamic sessions that had not yet been
completed.
Oxygen consumption by the test subjects progressively increased from sitting
to static
standing (+17%; p=0.008) to dynamic standing desk use (+28%; p<0.001), where
an
additional 14% increase in oxygen consumption was observed from static to
dynamic
standing desk use (p=0.047). Overall physical activity and weight-shifting
movements
progressively increased from sitting to static standing (+106%; p=0.006) and
from static
standing to dynamic standing desk use (+75%; p=0.010) use. In FIG. 7, the rate
of total
musculoskeletal discomfort development is indicated by the slope of the dashed
lines for
each condition. The rate of development of musculoskeletal discomfort was
lowest in the
sitting condition (1.01 1.25mm/min) and highest during static standing desk
use (1.76
1.86 mm/min). Use of the dynamic standing desk had a lower rate of development
of
musculoskeletal discomfort (1.35 2.14 mm/min) than static standing. There
was no
significant evidence of cognitive or typing skills worsening between the
dynamic versus
standing desk use and sitting.
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The effects of range of movement of the work surface of the dynamic standing
desk
were also studied. Among three different ranges of work surface movement,
including
30%, 45%, and 60% of the individual user's leg length, the shorter and longer
ranges of
movement resulted in additional attenuation of the levels and rates of
development of
musculoskeletal discomfort in healthy adults. Participants first completed a
baseline sitting
session, then completed a 2-hour static or dynamic standing desk session, then
completed
whichever 2-hour static or dynamic standing desk session had not yet been
completed. The
dynamic standing sessions were completed with the aforementioned different
ranges of
movement. As shown in FIG. 8, the highest levels of musculoskeletal discomfort
at all time
points was in the static standing condition, as was the highest rate of
increase of discomfort.
The rate of increase of musculoskeletal discomfort was similar for the 30% and
60% of leg
length ranges of movement, with the 45% of leg length range of movement
falling between
static and 30/60%. These results show that optimized use of the dynamic
standing desk
favors either a shorter range of tabletop movement (30%) or a longer range of
tabletop
movement (60%), which result in additional attenuation of the level and rate
of
musculoskeletal symptom development compared to a 45% of leg length range of
movement in healthy adults.
As shown in FIG. 9, increasing ranges of tabletop movement of the dynamic
standing desk results in higher but flattening increases in physical activity
from 30%, 45%
to 60% of leg length in healthy adults, as measured by frequency of postural
adjustments.
Increased user physical activity with the dynamic standing workstation was due
to more
frequent postural adjustments, especially in the medio-lateral direction, and
not to larger
postural adjustments. The average magnitude of the postural adjustments was
constant
among all tabletop conditions, in both the medio-lateral and the antero-
posterior directions.
Combining information from musculoskeletal discomfort ratings (FIG. 8) and
total
physical activity (FIG. 9) showed that a 60% of leg length range of movement
of the
tabletop during dynamic standing desk use maximizes physical activity lowering
the
amount of musculoskeletal discomfort and the rate of increase of
musculoskeletal
discomfort in healthy adults. As shown in FIG. 10, at a range of movement of
60% of user
leg length, participants developed less than 20% of the musculoskeletal
discomfort that
was developed when the tabletop was stationary. Stated differently, the
musculoskeletal
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discomfort during static standing was 5.3 times more than when the tabletop
moved with a
range of movement equal to 60% of user leg length. Use of the dynamic standing
desk may
better exploit the motor benefits of standing by increasing physical activity
and by reducing
the development of musculoskeletal discomfort ¨ one of the major negative side
effects
of prolonged standing. The dynamic standing desk may therefore be beneficial
to
populations that perform desktop work in prolonged sitting positions, such as
office
workers, and especially to those individuals who inherently stand rather
statically and/or
require cues to make postural adjustments to maximize physical activity. Other
populations
that may benefit from the dynamic standing desk are those with conditions that
affect
mobility, and as such, tend to be inactive. In such patient populations,
standing can have
positive effects in terms of physical functioning, strength, and balance
compared to the
detrimental effects of sedentariness.
The dynamic standing desk has also been shown to provide metabolic health
improvements in persons with metabolic disorders, such as diabetes mellitus.
FIG. 11 is a
chart illustrating total musculoskeletal discomfort, as rated by older adult
diabetic
participants, as a function of time in three different conditions: sitting,
static standing at a
desk, and standing at the dynamic standing desk. In this study, each
participant completed
three 4-hour sessions, including the baseline sitting session first, followed
by either a static
desktop standing session or a dynamic desktop standing session. The third
session was
whichever of the static or dynamic sessions that had not yet been completed.
Oxygen
consumption and overall movements by the test subjects progressively increased
from
sitting to static standing to dynamic standing desk use (p<0.001). The
duration of breaks
during standing (p=0.024) and rate of total musculoskeletal discomfort
development
(p=0.043) were lower with use of the dynamic standing desk compared to static
standing
sessions. There was no evidence of cognitive worsening during either standing
session
compared to sitting. There was also no significant worsening of leg swelling
during 4-hour
dynamic standing use compared to sitting.
The dynamic standing desk has also been shown to extend clinical effects of
physical therapy in physically deconditioned persons afflicted with age or
disease-related
conditions affecting mobility, such as persons with Parkinson's disease. As
the benefits of
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physical therapy in patients with mobility impairments may be short-lived, a
clinical
rehabilitation dynamic standing desk may augment or extend the early clinical
gain of
physical therapy to serve as a post-physical therapy extension or
supplementation that can
be provided in the home of the person with the mobility condition with long-
term sustained
clinical benefits and without serious adverse effects. For example, data from
a clinical trial
in patients with Parkinson's disease who had gait and balance disturbances
received 12
sessions of physical therapy, after which the patients improved on walking and
balance
control (functional mobility) measures, such as the Timed Up and Go (TUG) test
and
walking time at the time of completion of the therapy. The patients were then
randomized
1()
into one of two groups. One group used a dynamic standing desk at home after
completion
of physical therapy, while the other group use no desk at home (the usual
care) for a 4-
month post-physical therapy extension period. Clinical assessment was repeated
at the end
of the 4-month extension period and compared to assessments prior to and at
the time of
completion of the physical therapy.
Analysis of the group differences showed a clinical effect in favor of
maintaining
the post-physical therapy effects in the dynamic standing desk group compared
to the
control (usual care) group. In FIGS. 12A-12D, lower is better for TUG time and
Walking
Time. As shown in FIGS. 12B and 12D, the control group tended to return to pre-
physical
therapy performance levels at the end of the 4-month extension period. As
shown in FIGS.
12A and 12C, dynamic standing desk users maintained or improved their TUG time
and
walking time results obtained immediately after completion of physical
therapy. In the no-
desk control group, the initial physical therapy benefit of 9.8% improvement
in TUG time
reversed after cessation of the physical therapy (-10%) (FIG. 12B). In
contrast, the dynamic
standing desk group lost only 1.3% of the initial 9.8% physical therapy
improvement
during the post-physical therapy extension period. Interestingly, these
differential trends
occurred despite the relatively slower baseline score times in the dynamic
standing desk
group compared to the usual care control group. This suggests that the use of
the dynamic
standing desk is of benefit in patients with relatively more functional
mobility deficits. It
also suggests that loss of early physical therapy benefits occurs even in
patients with
relatively less severe functional mobility deficits. Similar results were
observed for the 8.5
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m walking task (FIGS. 12C and 12D). The study also confirmed both feasibility
and safety
(no serious adverse effects) of in-home use of the dynamic standing
rehabilitation desk.
Additionally, as shown in FIG. 13, there was very good long-term compliance of
daily use of the dynamic standing desk over the 4-month post-PT period with an
average
of 2.2 + 0.4 hours per day for at least five days per week without a
significant drop-off of
daily use duration with trial progression. 1n-home use of the dynamic standing
rehabilitation desk will allow integration of routine activities of daily
living, such as using
a computer, watching television, mail sorting, cooking, or sewing.
The dynamic standing desk may thus provide one of more of the following
benefits:
- Increases in oxygen consumption and overall physical movement by the user
while
concurrently attenuating musculoskeletal discomfort compared to static
standing desk use in healthy adults.
- Additional attenuation of the level and rate of musculoskeletal symptom
development with ranges of movement of 30% or 60% of user leg length.
- No reduction of cognitive or typing skills compared to sitting in healthy
adults.
- A therapeutic means to alleviate debilitating symptoms in certain patient
populations.
- In-home use as an adjunct to physical therapy.
- As an adjunct to physical therapy, safe at-home use in patients with gait
and balance
disturbances, such as Parkinson's disease.
- As an adjunct to physical therapy, feasible in-home use in patients with
gait and
balance disturbances, such as Parkinson's disease, allowing sustained long-
term
daily use.
- Integration of routine activities of daily living avoiding traditional
barriers to
exercise.
- As an adjunct to physical therapy, in-home use that maintains improvements
in
walking and balance functions in patients with gait and balance disturbances,
such as Parkinson's disease.
- Feasibility of prolonged (e.g., 4-hour) sessions in older adults with
type 2 diabetes
and results in metabolic benefits (increased oxygen consumption and increased
physical activity.
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- No reduction of cognitive or typing skills compared to sitting in elderly
persons with
type 2 diabetes.
- No increased leg swelling compared to sitting in elderly persons with
type 2 diabetes.
It is to be understood that the foregoing description is of one or more
embodiments
of the invention. The invention is not limited to the particular embodiment(s)
disclosed
herein, but rather is defined solely by the claims below. Furthermore, the
statements
contained in the foregoing description relate to the disclosed embodiment(s)
and are not to
be construed as limitations on the scope of the invention or on the definition
of terms used
in the claims, except where a term or phrase is expressly defined above.
Various other
embodiments and various changes and modifications to the disclosed
embodiment(s) will
become apparent to those skilled in the art.
As used in this specification and claims, the terms -e.g.," "for example,"
"for
instance,- "such as,- and "like,- and the verbs "comprising,- "having,-
"including," and
their other verb forms, when used in conjunction with a listing of one or more
components
or other items, are each to be construed as open-ended, meaning that the
listing is not to be
considered as excluding other, additional components or items. Other terms are
to be
construed using their broadest reasonable meaning unless they are used in a
context that
requires a different interpretation. In addition, the term "and/or" is to be
construed as an
inclusive OR. Therefore, for example, the phrase "A, B, and/or C" is to be
interpreted as
covering all of the following: "A"; "B"; "C"; "A and B"; "A and C"; "B and C";
and "A,
B, and C."
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