BACKGROUND: Sit-to-stand and treadmill desks may help sedentary office workers meet the physical activity guideline to "move more and sit less," but little is known about their long-term impact on altering the accumulation patterns of physical behaviors. OBJECTIVE: This study explores the impact of sit-to-stand and treadmill desks on physical behavior accumulation patterns during a 12-month multicomponent intervention with an intent-to-treat design in overweight and obese seated office workers. METHODS: In total, 66 office workers were cluster randomized into a seated desk control (n = 21, 32%; 8 clusters), sit-to-stand desk (n = 23, 35%; 9 clusters), or treadmill desk (n = 22, 33%; 7 clusters) group. Participants wore an activPAL (PAL Technologies Ltd) accelerometer for 7 days at baseline, 3 month follow-up (M3), 6 month follow-up (M6), and 12 month follow-up (M12) and received periodic feedback on their physical behaviors. Analyses of physical behavior patterns included total day and workday number of sedentary, standing, and stepping bouts categorized into durations ranging from 1 to 60 and > 60 minutes and usual sedentary, standing, and stepping bout durations. Intervention trends were analyzed using random-intercept mixed linear models accounting for repeated measures and clustering effects. RESULTS: The treadmill desk group favored prolonged sedentary bouts (> 60 min), whereas the sit-to-stand desk group accrued more short-duration sedentary bouts (< 20 min). Therefore, compared with controls, sit-to-stand desk users had shorter usual sedentary bout durations short-term (total day delta M3 -10.1 min/bout, 95% CI -17.9 to -2.2; p = 0.01, workday delta M3 -20.3 min/bout, 95% CI -37.7 to -2.9; p = 0.02), whereas treadmill desk users had longer usual sedentary bout durations long-term (total day delta M12: 9.0 min/bout, 95% CI 1.6 to 16.4, p = 0.02). The treadmill desk group favored prolonged standing bouts (30 to 60 min and > 60 min), whereas the sit-to-stand desk group accrued more short-duration standing bouts (< 20 min). As such, relative to controls, treadmill desk users had longer usual standing bout durations short-term (total day delta M3 6.9 min/bout, 95% CI 2.5 to 11.4, p = 0.002; workday delta M3 8.9 min/bout, 95% CI 2.1 to 15.7, p = 0.01) and sustained this long-term (total day delta M12 4.5 min/bout, 95% CI 0.7 to 8.4, p = 0.02; workday delta M12: 5.8 min/bout, 95% CI 0.9 to 10.6; p = 0.02), whereas sit-to-stand desk users showed this trend only in the long-term (total day delta M12 4.2 min/bout, 95% CI 0.1 to 8.3, p = 0.046). The treadmill desk group accumulated more stepping bouts across various bins of duration (5 to 50 min), primarily at M3. Thus, treadmill desk users had longer usual stepping bout durations in the short-term compared with controls (workday delta M3 4.8 min/bout, 95% CI 1.3 to 8.3, p = 0.007) and in the short- and long-term compared with sit-to-stand desk users (workday delta M3 4.7 min/bout, 95% CI 1.6 to 7.8, p = 0.003; workday delta M12 3.0 min/bout, 95% CI 0.1 to 5.9, p = 0.04). CONCLUSIONS: Sit-to-stand desks exerted potentially more favorable physical behavior accumulation patterns than treadmill desks. Future active workstation trials should consider strategies to promote more frequent long-term movement bouts and dissuade prolonged static postural fixity. TRIAL REGISTRATION: ClinicalTrials.gov NCT02376504, https://clinicaltrials.gov/ct2/show/NCT02376504.

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