Abstract: Current international practice for sit/stand office furniture is to provide height adjustable tables and chairs that may be used sitting or standing. As an alternative to this, the author designed a tall fixed height workstation (90 cm high) with a tall chair that can be used sitting in a tall chair and standing when collaborating with other people. People of 152-172 cm height could use the furniture standing up also. To validate this idea, 18 ‘Pyramid Workstations’ were installed in the author’s architectural office of Space Design Consultants, New Delhi (SDC) in 2008. Since then 100 more similar workstations have been installed in different kinds of offices.  The ‘Pyramid Workstation’ design included a 90 cm high table and a perch without back support. The design focused on an ‘active’ work culture. The arrangement became useful for collaborative design work where stand up meetings could be held around any of the workstations.  Tables with variable height require additional mechanism to change the table height and are complicated and too expensive for common use in India. The Pyramid Workstation was designed as an affordable arrangement for general offices.
To validate the usefulness of these workstations, the author conducted a longitudinal survey of the users experience to address issues of wellbeing and change of behaviour. This paper discusses the results of the survey.

I. Introduction
The typical Architect’s worktable in India always had a high table (90 cm or more) with an adjustable sloping top and a high stool for a seat. Architects would work both sitting down on a stool and standing up. They had to bend over the table to reach the further parts of the drawing. The drawing table was replaced eventually by a computer workstation and the architect’s worktable became identical to what people use in common offices even though the work of the architect is not quite the same as that of say, an insurance company employee. Architects still refer paper drawings while working but with the new arrangement they became prone to the same musculoskeletal problems that affect other types of sedentary office workers.

Two well-known ergonomists, J.J. Keegan an American surgeon [3] and A.C. Mandal a Danish doctor, have both recommended the use of high tables and chairs with forward sloping seats [4]. Keeping their recommendations in mind, the author designed the Pyramid Workstation and Pyramid Chair and installed 18 of them in the architectural office of Space Design Consultants in 2008 (Fig. 6). The workstation was designed to let people sit in Keegan’s posture, 135o angle between the torso and the thighs, and be able to use the video monitor at (still higher) eye level (Fig. 4). The objective of this design was to create an office environment where people could work in a better posture than the standard office table allows. It was also to cause a change in behavior from sitting and working to a situation where people could use either posture and be active throughout the day. Finally it was to study the behavioural changes that this might cause. Since furniture is only one of the factors that control human behaviour at work, the design also looked at lighting, specially day lighting and views outside and put in place policies that encouraged people to move from their seats in the normal course of work [7]. Printers were put in a relatively distant place and staff was encouraged to not use the phone to talk to each other but to walk across. Brief discussions between 2 to 4 team members could be held standing around the high level video monitor. In order to meet the requirements of Indian women workers who sometimes lost their long dupattas in the wheels of an office chair, the Pyramid seats (Fig. 7) were without castors.

In 2009, 40 Pyramid workstations with stools without a backrest were installed for a ‘start-up’ company with young staff. While the Owner was happy with the set up as the employees stayed alert, the employees themselves were not happy using seats that did not meet their expectations of a chair. The chair as a symbol of status is hard to get away from and eventually the owner replaced the stools with normal tall chairs with a backrest.

In 2015, 40 Pyramid Stations were installed for a web design company along with 40 workstations of normal height (Fig. 9). Within the numbers available, the employees had the option of choosing one or the other. Keeping in mind the experience of the earlier office, this time saddle chairs with small backrests (Fig.11) were used for the tall workstations and normal chairs for others. In early 2015, 8 tall workstations with saddle chairs with small back rests were also installed for the creative section of a graphic design company (Fig. 10). In both offices the saddle chairs have been accepted easily both with Pyramid Stations as well as with normal height tables. Conforming Opsvik’s recommendations about the need for chairs that allow different postures, some users have liked the fact that the saddle chair can be used with the backrest in front [2].

II. Evaluation Method
Soon after installation of the Pyramid workstations in 2008 at SDC, knowledgeable people (designers, office trainer, physiotherapist, employers) were invited to test and evaluate the new workstations. These evaluations were of limited value as reviewers did not have time to get acclimatised to the furniture. After a few months of use, workers at SDC were asked for their subjective response to the furniture. These undocumented responses were generally positive about the sitting posture but the users found it difficult to take it easy at some point of time and missed a comfortable footrest. Some of them had problems with the small forward tilting seat of the Pyramid chair. Using the observations and responses of the above two sets of persons, some changes were made to the workstation design and the Pyramid chairs were replaced with saddle chairs on wheels with a flat seat and no backrest. The same saddle seats with a small backrest were used subsequently in other locations also. While the positive user response at SDC was used to modify the Pyramid workstations, the feedback from the ‘start–up’ company was not encouraging. It was felt by the author that a definitive study was required to establish the validity or otherwise of Pyramid Workstations.
Short duration user evaluations provide a snapshot of people’s responses to a given situation, similar to the informal surveys carried out at SDC. These address anthropometric questions as well as issues like perceived comfort. Since the Pyramid workstation was not about comfort but about user ‘wellbeing’, a snapshot survey was considered to be of little value. Longer term surveys follow users for a period of time, not exceeding a few months, but even this kind of survey is unable to deal with long term behavioural changes.
With the focus on wellbeing and not comfort, a longitudinal study of the users of this furniture at the first site (SDC) was conducted in 2016, using an anonymous online response form. A small incentive was offered to those who completed the survey. The survey addressed persons who had worked at SDC from 2008 to 2016 and who could be contacted – 35 in all. It included people who had used the Pyramid workstations for at least four months and had become acclimatized to it. For studying long term effects, the respondents were asked to compare office working arrangement at SDC with their experience at other places. Most were not in service with SDC at the time of the survey. Apart from the subjective questions, the users were also asked about musculoskeletal disorders that they experienced at different times and also the type of workstation they use currently.

III. Statistical Analysis
Only 23 of the 35 persons (66%) contacted, responded to the questionnaire. They included architects and engineers but no administrative staff. The responses indicated that

1)74% of the respondents had used the furniture for more than 4 months.
2)74% respondents had initial difficulty with the Pyramid furniture and 4% reported continued difficulty.
3)22% of respondents did not experience any difficulty at any time.
4)Most architects (93% of respondents) who used the furniture did not have any difficulty with it after the initial period of acclimitisation.
5)27% of the respondents suffered from back ache or neck ache before they joined SDC. Only 13.5 % suffered from these problems while using the Pyramid workstations.
6)A few respondents continued using tall furniture similar to Pyramid at home after leaving SDC. This was change of behaviour.
7)Some respondents reported improvements in their sitting posture and others reported freedom from back ache.
8) 87% respondents would recommend the furniture to others without any reservation.

The sample size was statistically insignificant. The response rate was 66% and it is possible that those who did not respond (administrative staff for instance) did not share the views of the respondents.

IV. DISCUSSION
The common office work station has known problems, not the least of which is that users suffer from repetitive stress injuries and musculoskeletal disorders. Changes in the workstation arrangement have been recommended by different ergonomic authorities. Usually they require one to use an ‘ergonomically designed’ chair with the standard table [6]. Others have recommended that the seated posture itself is a problem and that people ought to stand up and work at least for part of time [2]. To create this possibility, new type of sit/stand workstations are now available in the international market (Fig. 1). A more extreme variant is a ‘treadmill workstation’ where one can walk instead of standing or sitting. A recent study (N. Shrestha) by Dr. Jos Verbeek’s team has indicated that the evidence in favour of standing desks is insufficient to make a proper evaluation [5]. But the study does show that the mere installation of a sit stand workstation has not resulted in people standing and working for longer periods.
As an architect, the author has worked standing up for decades and is aware that there are advantages and disadvantages with both sitting and standing at work. A flexible arrangement that allows either posture is better. Electrically controlled workstations that allow this possibility are available internationally. Furniture that allows these changes requires additional mechanism to change the table height and is complicated and too expensive for common use in India.

The high cost of such adjustable work tables precludes their use by most office workers in India. There is thus need for a cost effective, robust system that will actually encourage workers to stand and work.
Ergonomic design of Indian offices is driven by two notions, the first of an ergonomically designed chair that can be used with any standard office table and the second notion of a good worktable at which one can sit still and work for long hours. All chair manufacturers subscribe to the first and most office owners subscribe to the second. Both notions are questionable. JJ Keegan’s work indicated that the standard sitting posture with the thighs at 90 degrees to the torso results in kyphosis of the spine and it is better to have a more open posture with 135 degrees between the torso and the thighs [3]. With Keegan work in mind, AC Mandal designed table and chair as a combined system [4]. Mandal made changes to the standard work tables and chairs used in educational institutions. His ergonomic work tables have a sloping top and the chairs have a forward slope.
Most chairs come with a back support and many with additional lumbar support. There is some evidence that a back support is not needed and that the human body is quite capable of supporting itself [1]. Because they are used to treating people in pain, physicians and physiotherapists usually recommend chairs with a back support. Yoga instructors, who train people to live in good health without pain, never recommend a back support. There are many professionals like dentists, surgeons, nurses, painters and architects who work long hours without back support and suffer no back pain. There are other chairs available that challenge the appropriateness of a standard ergonomic chair. All of them come without a back support and require the user to engage with them(Fig. 2 and 3).

For sit/stand workstations, current recommended international practice is to have a table top that can move from 750mm level to 1050 mm so that a person could use it while seated in a chair or while standing (Fig. 1). An alternative is to fix the table for working while standing (Fig.4) and let the user sit in a tall chair (Fig.5). Being an architect, the author has experience of using such furniture for a long time.

One reason why it is possible for us to sit and work at tables of standard height is because the sitting posture reduces the difference in people’s height to about half. It is not possible to have a stand up table with fixed height that will suit a large range of users’ heights. Sitting also provides a more stable arrangement for accurate work. Because of these considerations the Pyramid workstation was designed to be used primarily in the sit down mode and the Pyramid chair was one that allowed effortless getting up. After several years of use, the Pyramid Chair (Fig.7) was replaced by a saddle chair on wheels but still without a backrest (Fig.8).
The Pyramid Workstation and seat were designed as part of a larger experiment in creating an ‘interactive office’ where people move about as part of their normal routine. People at SDC did not have the choice of any other kind of seat or table.
V. Conclusion
The Pyramid table and chair was designed for an active and collaborative style of work [7]. They resulted in a more active and healthy work day for designers of different kinds in the non-hierarchical setup at SDC. Once people got used to it, the chair without a backrest created no problems for the users back. However, without the backrest, a seat is considered a stool and not a chair. General office users did not like a seat without a back. A saddle chair with a minimal backrest designed by the author, (Fig. 11) has been found to meet both the ergonomic and social requirements.
The fixed height sit/stand workstation is robust and inexpensive enough for use by most people. It is a departure from the generally recommended ergonomic practice but enables a more active use of the office space.
References:
[1]  Galen Crantz, “The Chair – Rethinking Culture Body and Design,” New York: W.W. Norton & Co.1998 p.96
[2]  Peter Opsvik, ”Rethinking Sitting,” New York: W.W. Norton & Co., 2008
[3]  J. J. Keegan, “Alterations of the lumbar curve related to posture and seating”. Journal of Bone and Joint Surgery. 35A, 3, 589-603, 1953
[4]  A.C. Mandal, “Balanced Sitting Posture on Forward Sloping Seat” , Copenhagen, http://www.acmandal.com/
[5]  N. Shrestha, K.T. Kukkonen-Harjula, J.H. Verbeek, S. Ijaz, V. Hermans ,S. Bhaumik , “Workplace Interventions for Reducing Sitting Time at Work,” In Cochrane Review. 17 March 2016 http://www.cochrane.org/CD010912/OCCHEALTH_workplace-interventions-reducing-sitting-time-work
[6]  Rani Lueder, “Ergonomics of the seated movement: A Review of Scientific Literature,” June 2004
[7] Vinod Gupta,”The Interactive Work Place; A fresh approach to office design ” in Architecture + Design, Vol.XXV No.7, New Delhi, July 2008 pp 74-78