Abstract :
[en] Introduction : The relationship between sedentary life and poor health has become a central concern in occupational medicine. Sedentary behaviour is defined as an energy expenditure of less than 1.6 metabolic equivalent in a sitting or lying position while awake. Sedentary lifestyle is a risk factor for many diseases such as breast, colon and endometrial cancer, osteoporosis, osteoarthritis but especially cardiovascular diseases, leading cause of death in the world. Indeed, a daily sedentary period of more than seven hours increases the risk of cardiovascular diseases by 85%. As first-line practitioners, osteopaths have preventive roles in public health, using counselling and educational activities. This study aim to explore how osteopaths can help patients to reduce their sedentary lifestyle.
Method : We conducted a scoping review using the Medline and Pedro databases with the combination of following Mesh : sedentary lifestyle, health promotion, workplace, sitting time. Inclusion criteria were : articles published within the last ten years, in French or English, fulltext available, concerning patients with no pathologies, no age limit, with or without employment, using sedentary lifestyle as a primary or secondary measure.
Results : We selected 16 articles out of 1465. The strategies found mainly targeted the professional environment - the primary factor for daily sedentary lifestyle. The strategies combined several methods : motivational counseling, increasing physical activity, coaching, vertical offices, reminders to break up sedentary periods and tips to be implemented in the professional environment. Electronic evaluation appeared to be the simplest and most effective method in order to asses the effect of strategies. Results suggested that it could be possible to increase significantly sedentary lifestyle in the short term, but there is a lack of long-term research.
Conclusion : The strategies identified (active transportation, standing work, counseling, organizational support) in the literature to face sedentary lifestyle were not specifically designed for osteopaths, but it is possible to integrate them in liberal practice. This strategies should be multidisciplinary and patient centered.
The evaluation of sedentary lifestyle can be done through the anamnesis with specific questions. In such perspective, organizational support methods emphasize self-assessment of sedentary behaviours, and the identification of barriers to achieve anti-sedentary goals, and also social norms that influence the achievement of these goals, and patient knowledge about sedentary behaviour.
Several anti-sedentary goals should be negociated with patients, such as : reduce television time, replace the sitting position with the standing position, break up periods of sitting time or stay seated for a maximum of 30 minutes.
Therefore, it requires specifics skills regarding communication and patient education. Furthermore, there is a need for developing information and educational materials adapted to patient's literacy.
Further studies are needed to evaluate the feasibility and implementation of sedentary lifestyle strategies during osteopathic treatment.
