It is known that staying seated for a prolonged period can induce lower back pain (LBP). A growing trend, thought by many to lessen the prevalence of lower back pain, is replacing the regular office chair for the so-called stability ball. For reference, a stability ball, also known as exercise ball, is usually quite large and bouncy. They're typically used in physiotherapy clinics or gyms. However, the use of these stability balls has moved away from the gym and into the workplace. But should you really be recommending them to your clients? In this blog, I'm going to be reviewing 4 scientific articles to maybe shift your perspective about the use of stability balls and to guide you in making your decision.

Stability Ball vs. Office Chair: What is Better to Sit on at Work?

Before I dive into the discussion, I want to tell you first the reason why I want to talk about this. For many of us Ergonomics Consultants, we almost work in a silo. We either do the job by ourselves when working for an organization, or we're self-employed. And if you're anything like me, you desire and love the community to help you improve your techniques and to ask for feedback in your thought processes. One way to do this is to grow your professional network by attending professional conferences. But let’s face it, they don't really exist anymore right now. Or you could take a fancy ergonomics program course that would cost you at least tens of thousands of dollars. Another option is to let me help you through my program called the *NEW* Accelerate: The Business of Ergonomics. One of the things you’ll learn from my program is the professional development aspect that’s so important as an ergonomist. One way I can help you with that is to get those up-to-date literature reviews, like what I'm going to talk about below. So, what’s better for back health: is it a stability ball or an office chair? Let’s find out!

Sitting On A Stability Ball or An Office Chair: The Studies

Although stability balls are quite popular in certain office environments, there’s not enough compelling body of evidence to support their use as an alternative for the office chair. So, what I’ve done is find the 4 best scientific articles about this and then I summarized each of them to assist you in making your decision.

Article 1: Stability ball versus office chair: Comparison of muscle activation and lumbar spine posture during prolonged sitting.

This study evaluated the differences between sitting on a stability ball and an office chair by analyzing the lower back muscle activation of the 14 participants. Stability balls have been marketed by suppliers as a means to eliminate and prevent lower back pain (LBP). Stability balls increase trunk muscle activity as users require a certain baseline of muscle contraction to stay stable when sitting. Theoretically, the increase in muscle activity will increase the user’s core stability and strength over time, which researchers believe to be helpful in preventing the development of LBP. Research supports this claim is useful in exercise programs but prolonged exposure in the office setting has historically been shown to increase reported incidence of pain.

In this study, it was found that participants sat with similar postures no matter if they sat on a regular office chair or on a stability ball. Additionally, there’s no significant differences in postural or muscular activation between the two. It also appears that there were no eminent advantages to utilizing stability balls within the office setting where a job requires prolonged seated-work. Prolonged sitting on a stability ball doesn’t substantially change the way in which the user sits. However, there was an increase of reported discomfort and potential safety issues (sitting on an unstable surface) associated with it. These findings led the researchers to question the implementation of its use in an office environment.

Article 2: Sitting on a chair or an exercise ball: Various perspectives to guide decision making.

Previous research has shown that many find it uncomfortable to sit on a stability ball for a long period of time. This study did not find any benefits for the user to sit on a stability ball for more than 30 minutes. The researchers proposed that this is because sitting on a stability ball increases the soft tissue compression area to the tissues not typically used when sitting. This may be the reason why there are so many comments that stability balls can be uncomfortable for long-term use. 

Article 3: Static and dynamic postural loading during computer work in females: Sitting on an office chair versus sitting on an exercise ball.

Prolonged sitting has always been associated with disc degeneration. Unsupported back postures (sitting with no support from the backrest) have been shown to negatively affect back health, whereas back movement when sitting has been shown to improve back comfort. There’s a predicament with using stability balls: stability balls increase motion in the back (thought to be a good thing), but the absence of armrests and back support could potentially lead to discomfort in the back and upper body over time. Not surprisingly, this study found negative back health outcomes when sitting on a stability ball. The researchers concluded that as far as the low back is concerned, the advantages did not outweigh the disadvantages of using a stability ball in the workplace.

Article 4: The gym ball as a chair for the back pain patient: A two-case report.

The last article is a two-case report of 2 low back pain patients. Improvements in their symptoms were reported when they started consistently using the stability ball. Evidence from the author’s clinic suggests that swapping out the office chair for the stability ball can be beneficial for some patients. However, this case study lacked thorough scientific evidence, and its outcomes should be considered with the appropriate regard.

The Bottom Line

The 4 articles that I found show that using a stability ball for a prolonged period of time can be uncomfortable for the staff and increase their reporting of low back fatigue and discomfort (both are major contributing risk factors for LBP). Stability balls are useful for exercise routines, but they don’t appear to be conducive in the office environment where prolonged seating is required. Isn’t that interesting? How often have you heard the idea of ergonomics and stability balls go hand-in-hand for the fact that it's a fun way to get muscle activation and other things that ergonomics may be marketed as? We all know that even the best-looking ergonomic equipment that can actually help you isn't marketed the best. On the same side, really poor ergonomic equipment can have excellent marketing campaigns. So marketing doesn't change much in terms of how good a product is going to be. However, does this pose change in how you think of stability balls in the office? Were you recommending them in the past? Will you recommend them in the future? 

Your Next Move

I’m so thrilled to announce that I'm going to be opening the enrollment for the Accelerate membership at the end of March 2021. I only open this program 4 times a year, so I can really focus on serving my members. At the same time, I want all of us to grow into the Ergonomics Consultant with a flourishing marketing campaign of our dreams. If you want to learn how other healthcare professionals are building an ergonomics business of their dreams, sign up on this link and join the training at the end of the month.

 

References:

1) https://pubmed.ncbi.nlm.nih.gov/16696264/

2) https://pubmed.ncbi.nlm.nih.gov/16410033/

3) https://pubmed.ncbi.nlm.nih.gov/18508028/

4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924654/