Influence of COVID-19 Building Restrictions on Physical Activity Promotion Through Increased Stair Use and Limited Elevator Access: A Quasi-Experimental Study—Sport and Physical Activity Group Active Campus Project

Background: The aim of this study was to determine the effectiveness of UK government COVID-19 safe offices policy to increase stair use in a higher education setting during the COVID-19 pandemic. Methods: Automated counts at 3 ground floor staircases and the elevator entrances were used to estimate stair to elevator use ratio for ascent and descent from/to the ground floor of a university building at baseline (January to March 2020), first and second intervention months (October 2020, November 2020, respectively). Stair promoting signage and a 1-way system was implemented, in line with government policy. Results: At baseline, stair to elevator use ratio for ascent from and descent to the ground floor was 1.36 (0.02) and 1.88 (0.02) people, respectively. The ratio significantly increased in the first intervention month to 2.64 (0.09) and 3.96 (0.22) people for ascent and descent, respectively. However, the ratio decreased between the first and second intervention months to 1.63 (0.06) and 3.05 (0.52) people for ascent and descent, respectively. Conclusion: The UK government COVID-19 policy was effective at increasing stair use in a higher education setting.

Comparison of postoperative effectiveness of less invasive short external rotator sparing approach versus standard posterior approach for total hip arthroplasty

Background Studies assessing corrective posterior total hip arthroplasty (THA) mostly focused on the mini-incision approach, with few exploring the short external rotator sparing approach. This study aimed to compare the effectiveness of standard posterior approach versus short external rotator sparing approach. Methods This prospective observational study included patients treated in the Orthopedics Department of Jinhua Central Hospital in 06/2017-06/2018. Patient grouping was based on the surgical methods. Surgical data were recorded postoperatively. Postoperative hip joint recovery was assessed by the times to ambulation and independent stair use, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and Harris score and Oxford hip score (OHS) at 2 and 8 postoperative weeks. The visual analog scale (VAS) was used for postoperative pain assessment. Results Postoperative changes of creatine kinase (CK), myoglobin, CRP, and prosthesis position were similar in both groups. However, intraoperative blood loss and postoperative 6-h drainage volume, hospital stay, and blood transfusion rate were significantly reduced in the corrective (short external rotator sparing) group, as well as times to ambulation and independent stair use. Oxford and WOMAC scores in both groups decreased significantly postoperatively. The VAS score was more overtly decreased postoperatively in the corrective group compared with the standard group. Conclusions The corrective THA causes less damage and reduces perioperative blood loss, shortening functional recovery time, maintaining prosthesis stability and improving pain postoperatively.

Stair Width, Pitch and Alignment in Stair Climbing and Descending Rates

Innovative interventions in the planning and design of stair and escalator facilities call for understanding their effects on stair use. This study considers five planning variables for the twinned stair and escalator facilities–stair pitch and width, angle of deviation, height and separating distance. Public sites were identified in 8 commercial districts in Beijing. Facilities (n=21) presenting heterogeneously across variables were sampled for simultaneous up and down pedestrian counts in 18 5-minute video segments middays, for a total of 1464 counts. Stair width accounts for 20% of the variance in ascending rate and 10% in descending. Plan angle accounts for 2% in ascending and 5% in descending, while pitch accounts for 1% in ascending and 5% in descending. The study confirms the effects of layout and design of stairway and escalator facilities on facility choice. The results point directly to interventions in support of higher stair-climbing rates.

Healthy Behaviors through Behavioral Design–Obesity Prevention

Evidence for behavior modification for improved health outcomes was evaluated for nutrition, physical activity (PA), and indoor environmental quality (IEQ). The databases searched included LISTA, PubMed, and Web of Science, with articles rated using an a priori baseline score of 70/100 to establish inclusion. The initial search produced 52,847 articles, 63 of which were included in the qualitative synthesis. Thirteen articles met inclusion for nutrition: cafeteria interventions, single interventions, and vending interventions. Seventeen articles on physical activity were included: stair use, walking, and adjustable desks. For IEQ, 33 articles met inclusion: circadian disruption, view and natural light, and artificial light. A narrative synthesis was used to find meaningful connections across interventions with evidence contributing to health improvements. Commonalities throughout the nutrition studies included choice architecture, increasing the availability of healthy food items, and point-of-purchase food labeling. Interventions that promoted PA included stair use, sit/stand furniture, workplace exercise facilities and walking. Exposure to natural light and views of natural elements were found to increase PA and improve sleep quality. Overexposure to artificial light may cause circadian disruption, suppressing melatonin and increasing risks of cancers. Overall, design that encourages healthy behaviors may lower risks associated with chronic disease.

Nudging physical activity in offices

Purpose This paper aims to investigate whether and why nudging interventions in an office environment are effective to stimulate stair use of employees. Design/methodology/approach This paper is based on a pre-test/post-test case study design at the headquarters of a Dutch online retailer. Observations were conducted to test the impact of two nudge interventions, being footprints and posters, on employees’ stair use in two consecutive pre-test/post-test weeks. An online survey questionnaire was used to assess employees’ overall experience with the nudging interventions after the fifth and again neutral week. Findings A total of 14,357 observations were recorded during five weeks. This research shows that footprints as nudging intervention significantly increase stair use of employees, and after removal, significantly decrease stair use again. Moreover, footprints were more effective than posters, of which the latter did not impact stair use significantly. Results from the survey questionnaire, completed by 46.2 per cent of the employees, showed that, in terms of degree of perception, footprints (91.4 per cent) were more noticeable than posters (46.3 per cent). Originality/value This paper contributes to the non-conclusive research regarding the effectiveness of nudging interventions on stair use in office environments. It clearly shows that perceptibility in combination with a positive attitude towards the nudge leads to a higher degree of initial behavioural change, yet not to a change of mind.