Association of accelerometer measured sedentary behavior patterns with cognitive functions in sedentary office workers: Insights from SMART-STEP study.

BACKGROUND: High levels of sedentary behavior in workplaces are currently recognized as an independent risk factor for cognitive dysfunction and poor mental health. However, sedentary patterns vary between workdays and non-workdays, which may influence cognitive functions. OBJECTIVE: The present study aimed to quantify and compare work and nonwork device-measured sedentary time (ST) and its association with cognitive function in Indian office workers. METHODS: In an ongoing randomized controlled trial (SMART-STEP), the baseline data of 136 full-time office workers, including accelerometer-measured sedentary patterns and cognitive functions, were analyzed. The ST was measured using a hip-worn accelerometer (Actigraph wGT3X-BT) for seven days, and executive functions were measured using computer-based tests. Linear regression models were employed to analyze the relationships between ST and executive function measures. RESULTS: The median daily ST of Indian office workers was 11.41 hours. The ST was greater on both workdays (11.43 hrs.) and non-workdays (11.14 hrs.) though different (F = 6.76, p = 0.001, ηp2 = 0.032). Office workers accumulate more prolonged sitting bouts (+21.36 min) during work days than non-workdays. No associations between device-measured ST and executive functions were observed. CONCLUSION: Indian office workers exhibited high ST patterns, especially on workdays. Although lower than workdays, Indian office workers exhibited more ST patterns during non-workdays than did their Western counterparts. Culturally adaptable workplace and leisure time physical activity interventions are needed to address the high ST of Indian office workers.

Influence of short bouts of stair climbing on young adults during prolonged sitting on posture, discomfort, and musculoskeletal performance outcomes: a counterbalanced pilot randomised crossover trial.

Prolonged sitting is postulated to influence musculoskeletal performance (cervical flexor endurance, balance, and agility), discomfort and alter cervical spine angles during work-based computer use. Stair climbing breaks may be a great addition at typical and home offices however remain unexplored for its impact on musculoskeletal performance. In our counterbalanced pilot crossover trial, 24 adults were randomised to three interventions: (1) prolonged sitting, (2) interrupted by 2 min of self-paced, and (3) externally paced stair climbing for 2 h. Cervical spine angles were measured every 30 min while balance, agility, endurance, and discomfort were assessed before and after 120 min. Stair climbing interruptions have favourable effects on agility (F = 8.12, p = 0.009, ηp2 = 0.26) and musculoskeletal discomfort, but failed to improve other musculoskeletal outcomes associated with prolonged sitting. Brief stair climbing interruptions are effective in improving discomfort and agility while pragmatic trials are warranted for translated effects.

Stair climbing interventions are known for their cardiovascular benefits, however their impact on musculoskeletal performance remains unclear. In our randomised crossover pilot study, we explored the effects of stair climbing interruptions on cervical posture, endurance, agility, and balance during 120 min of prolonged sitting. Stair climbing interruptions were favourable in reducing time to complete agility tasks and neck/shoulder discomfort score compared to prolonged sitting. However other performance measures remained unaltered.

Influence of smartphone-based physical activity intervention on executive functions and cardiometabolic disease risk in obese young adults: a pilot randomised controlled trial.

Purpose: Smartphone is an impending solution to influence long-term behavior change, including physical activity; however, the evidence regarding personalized prescription remains mixed in obese. We aimed to explore the influence of smartphone-based physical activity promotion on weight loss and cognitive functions in obese young adults. Methods: In our pilot randomised controlled trial, 24 obese adults were randomized to two conditions: (1) EXI group receiving a smartphone-application based personalized physical activity prescription; (2) CONT group continuing their routine work for eight weeks. Executive functions and cardiometabolic risk variables [body and fat mass, waist circumference (WC), blood pressure (BP)] and executive functions were measured before and after eight weeks. Results: Our study findings revealed a significant improvement in reaction times with overall (H = 7.71, p = 0.005), congruent stimuli (H = 4.43, p = 0.03) and incongruent stimuli (H = 5.35, p = 0.02) between groups. Though EXI participants reduced their fat mass by 5.07 kg more than CONT group users after eight weeks, the findings were statistically insignificant. Similarly, our study did not find significant differences in body mass, WC, BP or accuracy between EXI and CONT groups. There was a decreased user engagement (H = 5.80, p = 0.564) after the 3rd week of the study period. Conclusion: Short-term smartphone-based physical activity programs may offer favourable cognitive benefits to young adults; however, the weight loss benefits remain unconvincing. Trial Registration: The study was registered prospectively with the Clinical Trials Registry of India (CTRI/2022/02/040202). Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01182-9.

Dose-response effects of periodic physical activity breaks on the chronic inflammatory risk associated with sedentary behavior in high- and upper-middle income countries: A systematic review and meta-analysis.

BACKGROUND AND AIMS: Though moderate-vigorous physical activity (MVPA) is speculated to mitigate the inflammatory risk associated with sedentary behavior, only a fraction of the global population meets the recommended weekly dose of MVPA. More individuals indulge in bouted and sporadic light-intensity physical activity (LIPA) that occurs throughout the typical day. However, the anti-inflammatory effects of LIPA or MVPA breaks during prolonged sitting remains unclear. METHODS: A systematic search was done on six peer-reviewed databases through January 27th, 2023. Two authors independently screened the citations for eligibility, and risk of bias and performed a meta-analysis. RESULTS: The included studies originated from high and upper - middle income countries. Observational studies of SB interruptions with LIPA showed favourable effects on inflammatory mediators such as higher levels of adiponectin (odds ratio, OR = +0.14; p = 0.02). However, these findings are not supported by the experimental studies. Experimental studies reported non-significant increase in cytokines including IL-1ß (standardised mean difference, SMD = 0.11 pg/ml; p = 0.29) and IL-6 (SMD = 0.19 pg/ml; p = 0.46) after interrupting sitting with LIPA breaks. But these LIPA breaks were found to reduce C-reactive protein (SMD = - 0.50 mg/dl; p = 0.85) and IL-8 levels (SMD = -0.08 pg/ml; p = 0.34) but did not reach statistical significance. CONCLUSION: Interrupting prolonged sitting time with LIPA breaks shows promise for preventing the inflammatory effects associated with prolonged bouts of daily sitting, though the evidence remains in infancy and limited to high- and upper-middle income countries.

Effects of physical activity breaks during prolonged sitting on vascular and executive function-A randomised cross-over trial.

Objectives: High sedentary behaviour is associated with adverse effects on central vascular function and cognitive function. Although interventions to mitigate the adverse effects of workplace sitting are intriguing, evidence of the efficacy of such interventions remains lacking. This randomised cross-over trial was aimed at exploring the effectiveness of prolonged sitting, with or without physical activity breaks, on central, peripheral vascular and cognitive function in adults. Methods: Twenty one healthy adults completed 4 h of simulated work conditions in three experimental visits: (1) uninterrupted sitting (SIT); (2) sitting interrupted by 3 min of walking every hour (LIT); and (3) sitting interrupted by 3 min of stair climbing every hour (MIT). Carotid (CA) and superficial femoral artery (SFA) diameter, velocity, shear rate and blood flow were measured with Duplex ultrasound at 50 MHz at three time points (hours 0, 2 and 4), and executive function was assessed with the computer based Eriksen Flanker task every hour. Results: The decreases in reaction time (-30.59%) and accuracy (-10.56%) during SIT conditions were statistically significant, and less of a decrease was observed under LIT and MIT conditions. No significant differences in CA and SFA function were observed with LIT and MIT interventions. Conclusion: Physical activity breaks of varying intensity during prolonged sitting improve reaction time. However, the vascular benefits of physical activity breaks should be confirmed in the future through long term studies in natural environment.

Do energy expenditure differences across work postures influence cognitive processing speed? A counter-balanced randomised cross-over trial.

BACKGROUND: Anecdotal evidence links occupational sedentary behaviour, low energy expenditure (EE) and cognitive dysfunction. Nevertheless, EE across different work postures including active workstations remains unclear and its influence on cognitive processing speed is yet to be established. OBJECTIVE: We aimed to investigate differences in EE across various work postures and its influence on cognitive processing speed. METHODS: Sixteen desk-based employees performed simulated work tasks (typing, reading and cognitive tasks) in three different work positions (sitting, standing, and walking) in three different days. EE was measured for three days consecutively for 30-minutes in three simulated working postures using indirect calorimetry. Cognitive processing speed was assessed through computer-based choice reaction times during each work posture. The outcome variables of interest (EE, reaction times and accuracy) were compared between three work postures using repeated measures ANOVA and Pearson correlation. RESULTS: EE in walking posture was higher (5.57±0.45 Kcal) than sitting (1.07±0.12 Kcal) and standing (1.88±0.42 Kcal). Total EE was significantly higher in walking than standing (35.17±6.86 Kcal) and sitting postures (41.37±8.46 Kcal). We did not find any significant differences in cognitive processing speed between different work postures except within standing work condition (60.22±13.97 ms). Accuracy was found to be reduced in walking compared to sitting (0.76±0.83%) and standing (0.43±0.09%) but not reached significance. CONCLUSION: Although significant differences in EE were observed between work postures, walking or standing at work did not affect the cognitive processing speed.

Physical activity interventions for glycaemic control in African adults - A systematic review and meta-analysis.

BACKGROUND AND AIM: Growing evidence indicates that increasing physical activity may aid in regulating altered glycaemic control, thereby mitigating the risk of diabetes. However, the evidence summarising the efficacy of physical activity on glycaemic control among African adults remains unconsolidated. Our objective was to provide an amalgamated summary of the empirical evidence that explored the effectiveness of physical activity interventions on glycaemic control among African adults. METHODS: A systematic search of six journal databases for the studies exploring the efficacy of physical activity on glycaemic control among African adults until March 21, 2022, was administered. Two independent reviewers screened the citations based on a priori set eligibility criteria. Data were analysed using inverse variance method and a summary of findings was synthesised using the Grading of Recommendations, Assessment, Development and Evaluations approach. RESULTS: Of the 14,624 citations retrieved, 26 articles with 1474 participants were included for final analysis. Most of the included trials had a high risk of bias (N = 20; 76.92%). Our review found a significant reduction in fasting blood glucose (FBG, -2.18 [ 95% CI -3.18, -1.18] mmol/L), insulin (-0.99 [-2.71, 0.74] µU/L), Glycosylated haemoglobin (HbA1C) (-0.53% [-0.88, -0.19]), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (-0.74% [-1.10, -0.38]) and insulin sensitivity (-0.90 µU/l/min [-1.75, -0.06]) following physical activity interventions. The review reports low certainty of evidence across all outcome measures. DISCUSSION AND CONCLUSION: Physical activity interventions were found to improve glycaemic control among African adults. However, the optimal physical activity dose for demonstrating meaningful benefits on glucose tolerance still remains unclear due to the limited number of primary studies available.

Association between Physical Activity Levels and Brain Volumes in Adults Visiting Radio-Imaging Center of Tertiary Care Hospital.

BACKGROUND AND AIM: There is evidence to support the favorable impact of physical activity (PA) on brain volume. However, the empirical evidence exploring the relationship between physical and sedentary behavior remains mixed. We aimed to explore the relationship between PA and sedentary behavior and brain volume. METHODS: The study sample (n = 150, mean age = 39.7 years) included patients interviewed with the International Physical Activity Questionnaire (IPAQ) who underwent an MRI brain scan. From the images obtained, we measured total intracranial, gray matter, and white matter volume along with the hippocampus, amygdala, parahippocampal gyrus, and posterior cingulate cortex (PCC). Multivariable linear regression analysis was done. RESULTS AND DISCUSSION: Left hippocampus and overall PA were positively and significantly associated (ß = 0.71, p = 0.021) whereas time spent on vigorous physical activity showed a negative association (ß = -0.328, p = 0.049) with left hippocampal volume. CONCLUSION: We found a positive association between total PA and the left hippocampus, whereas vigorous PA showed a negative association with the left hippocampus.

Influence of Sedentary Behaviour Interventions on Vascular Functions and Cognitive Functions in Hypertensive Adults-A Scoping Review on Potential Mechanisms and Recommendations.

Since the workplace has become desk-based and leisure time has become dominated by digital relaxation modes, the world is moving at a pace where physical activity has become a time-bound routine. The negative effects of extended sitting are a global concern since the workforce is becoming more desk based. There is a dearth of reviews that may link the knowledge on the effects of sedentary behaviour on hypertension and its accompanying damage to the brain and blood vessels and provide a future scope for the investigations connected to the relationship between sedentary behaviour and hypertension. Methods: Based on the database search and extensive research we did, we found studies that concentrated on the adverse effects of sedentary behaviour in association with blood pressure, cognitive decline and brain damage on adults. Results: We extracted 12 articles out of 20,625. We identified the potential adverse effects of sedentary behaviour, methods to reduce sedentary behaviour and the positive changes on health due to the interventions introduced. Sedentary lifestyle has shown a decline in human health. However, the visible symptoms presented later in life makes it very important to know the areas of decline and look for ways to curb the decline or procrastinate it.

Association of Physical Activity and Quality of Life with Work-Related Musculoskeletal Disorders in the UAE Young Adults.

BACKGROUND: Work-related musculoskeletal disorders (WRMSDs) pose threat to the global economy and work productivity. Though growing evidence shows physical activity and quality of life are major determinants for WRMSDs, the association between physical activity and the quality of life among the young adults of the United Arab Emirates (UAE) remains unclear. METHODS: In a cross-sectional study, a total of 507 young adults who were between the ages 18-35 years were administered an interviewer-based survey on musculoskeletal disorders, physical activity, and quality of life. The association between the potential determinants and the WRMSDs was analyzed using linear and logistic regression models. RESULTS: High prevalence (75%) of WRMSDs was found among the UAE young adults. Participants with low leisure-time physical activity had few WRMSDs. There was no significant association between physical activity or quality-of-life scores with the incidence of WRMSDs although physical activity time was highly associated with the quality of life, especially the social domain. CONCLUSION: Though a high prevalence of WRMSDs among UAE men and women was found, neither physical activity nor the quality-of-life scores determined the incidence of WRMSDs.

"Wearables on vogue": a scoping review on wearables on physical activity and sedentary behavior during COVID-19 pandemic.

Background: Wearables are intriguing way to promote physical activity and reduce sedentary behavior in populations with and without chronic diseases. However, the contemporary evidence demonstrating the effectiveness of wearables on physical health during the COVID-19 pandemic has yet to be explored. Aim: The present review aims to provide the readers with a broader knowledge of the impact of wearables on physical health during the pandemic. Methods: Five electronic databases (Web of Science, Scopus, Ovid Medline, Cumulative Index to Nursing and Allied Health Literature and Embase) were searched. The eligibility criteria of the studies to be included were based on PICOT criteria: population (adults, children and elderly), intervention (wearable, smartphones), comparison (any behavioral intervention), outcome (physical activity or sedentary behavior levels) and time frame (between December 1st, 2019 and November 19th, 2021). The present scoping review was framed as per the guidelines of the Arksey and O'Malley framework. Results: Of 469 citations initially screened, 17 articles were deemed eligible for inclusion and potential scoping was done. Smartphone-based applications with inbuilt accelerometers were commonly used, while a few studies employed smart bands, smartwatches for physical health monitoring. Most of the studies observed the increased use of wearables in healthy adults followed by elderly, children and pregnant women. Considerable reduction (almost-50%) in physical activity during the pandemic: daily step count (- 2812 steps/min), standing (- 32.7%) and walking (- 52.2%) time was found. Conclusion: Wearables appears to be impending means of improving physical activity and reducing sedentary behavior remotely during the COVID-19 pandemic. Supplementary Information: The online version contains supplementary material available at 10.1007/s11332-021-00885-x.

"Occupational sitting kills; but who cares?": Quantitative analysis of barriers and facilitators of sedentary behavior in Indian white-collar workers.

The knowledge, attitude and practices of employees and employers toward reducing sedentary behavior (SB) and improving physical activity (PA) at Indian workplaces remain unclear. A bespoke questionnaire assessing barriers and facilitators of occupational SB and PA practices as informed by the theoretical framework and behavioral change wheel model was adapted. Two hundred and three white-collar workers (both employees and managers) from eight corporate sectors were inquired about the SB, and PA practices at workplaces. The dichotomous variables of barriers and facilitators were analyzed by nonparametric tests. Excessive sitters had good knowledge (>75%), good attitude (>85%) but poor workplace SB and PA practice (>90%). Workplace SB, or PA practices differed between employers and employees. Low practice of workplace PA or SB interventions may be due to lack of workplace policies for SB interventions.

Effect of an education-based workplace intervention (move in office with education) on sedentary behaviour and well-being in desk-based workers: a cluster randomized controlled trial.

This study aimed to assess the effectiveness of short-term workplace-based physical activity education on altering sitting outcomes, maximal oxygen consumption (VO2max) and occupational well-being. Four office clusters (46 participants) of desk-based workers were randomized to either the move in office with education (MOWE) group or the control (CONT) group for 4 weeks. The outcomes were occupational sedentary time, VO2max and workplace well-being. Data were analysed using non-parametric tests. Our study results did not show any significant change in sitting time or VO2max. Nevertheless, workplace well-being of the MOWE group significantly improved when compared to the CONT group, especially in the domains of work satisfaction (odds ratio 11.67; p = 0.001) and employer care (odds ratio 0.167; p = 0.001). Workplace education (MOWE) improves well-being but may not alter sitting outcomes or VO2max in office workers. Workplace education without policy change may not yield positive health outcomes.

Association between physical and mental health variables among software professionals working at home: a secondary analysis.

The association of physical activity (PA) or sedentary behaviour (SB) with mental health in remotely working software professionals remains unclear. We administered a secondary analysis of physical health variables (PA and SB time during work and non-work days) and mental health variables (stress, anxiety, depression) from a primary study. Ninety-five per cent of the participants (n = 76) did not meet the global PA recommendations. Our study found daily PA time to be negatively associated with stress (ß = -1.57; p = 0.02), anxiety (ß = -1.01; p = 0.04) and depression (ß = -0.68; p = 0.47). Furthermore, the average daily sitting time during the work day was found to be positively associated with stress (ß = 0.28; p = 0.00), anxiety (ß = 0.01; p = 0.04) and depression (ß = -0.68; p = 0.03). Organizational policies should advocate the implementation of PA or SB strategies for improving mental health in remote workers.Trial registrationClinical Trials Registry India identifier CTRI/2021/03/032146.

Short-term effects of a social media-based intervention on the physical and mental health of remotely working young software professionals: A randomised controlled trial.

The present study aimed to explore the short term effects of a social media-based intervention on the physical and mental health of the software professionals working remotely during the pandemic. Sixty software professionals with poor physical and mental health were randomised to Facebook-based intervention (FIIT) and a control (CONT) group for 2 months. Forty-six remote workers (26.25 ± 3.49 years) completed the study (FIIT = 22; CONT = 26). All the respondents had the median sitting time (7.07 ± 2.30 h/day) during office hours on workdays. We found a significant difference in the sitting time during office hours in workday within the subjects (F1,46 = 4.66; p < .004; ηp2  = .048) and between the subjects (F1,46 = 3.81; p < .004; ηp2  = .040). Post hoc analysis revealed participants in the FIIT group reduced their sitting time by 58 min during office hours during a typical workday compared with the control group. Nevertheless, we found a significant difference in the scores of stress, anxiety and depression within and between the groups. Short-term social media-based physical and mental health intervention may improve physical and mental health scores in the desk-based office workers working remotely.

Maximal Respiratory Pressures and Maximum Voluntary Ventilation in Young Arabs: Association with Anthropometrics and Physical Activity.

BACKGROUND: Maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and maximum voluntary ventilation (MVV) measurements assist in determining the respiratory muscle strength and endurance. These determinants of respiratory muscles vary significantly by age, gender, height, and ethnic origin. Normative values for maximum respiratory pressures (MRPs) and MVV would aid in evaluating respiratory muscle function in athletes, estimating performance, and assisting in rehabilitation. In addition, the reference values may aid in determining the efficacy of therapeutic interventions in young people with chronic respiratory diseases. The purpose of this study was to see how respiratory muscle strength indices correlated with anthropometric and physical activity characteristics in young Arabs. METHODOLOGY: The study included 80 male volunteers and 85 female volunteers ranging in age from 18 to 30 years. MicroRPM was used to measure MIP and MEP, and pulmonary function test data, including MVV values, were recorded. All subjects completed the Global Physical Activity Questionnaire (GPAQ) and anthropometric measurements. Unpaired t-tests or Mann-Whitney U-tests were used to determine male-female differences. Using the Pearson correlation coefficient and Spearman Rho correlation coefficient tests, MIP and MEP values were correlated with body composition and physical activity. Using stepwise multiple linear regression analysis, the relationships between respiratory function (MVV, MIP, and MEP) and PFT values (FVC, FEV1, and FEV1/FVC), physical activity, and sedentary behavior were investigated. RESULTS: MIP, MEP, and MVV values were significantly lower in females than in males. MIP, MEP, and MVV values had a moderate correlation with forced vital capacity, forced expiratory volume in 1 second, and height, but not with weight, BMI, or GPAQ. Age, gender, and body mass index were found to be significant predictors of maximal respiratory pressures in a young Arab population. CONCLUSION: Maximum respiratory pressures and maximal voluntary ventilation were significantly lower in young Arabs than in other ethnic groups; these values were influenced by gender and height but not by levels of physical activity.

"We are so close; yet too far": perceived barriers to smartphone-based telerehabilitation among healthcare providers and patients with Chronic Obstructive Pulmonary Disease in India.

BACKGROUND: Telerehabilitation is imperative and impending in the management of chronic obstructive pulmonary disease patients. However, its feasibility in low- and middle-income nations such as India remained unclear. OBJECTIVE: To assess the feasibility of administering a smartphone-based telerehabilitation program for chronic obstructive pulmonary disease patients in India. MATERIAL AND METHOD: An online cross-sectional survey was administered to stakeholders of the telerehabilitation program: chronic obstructive pulmonary disease patients, health care professionals including pulmonary care physicians, rehabilitation nurses and physiotherapists. The survey sought to ascertain the causes, barriers, and facilitators associated with the implementation of smartphone-based telerehabilitation, as well as strategies for practice improvement. RESULTS: While 71% (n = 37/52) of the 52 healthcare professionals surveyed were aware of smartphone-based telerehabilitation, implementation was found to be extremely low (n = 4/37; 10%). The majority of patients with chronic obstructive pulmonary disease (n = 21/30; 70%) agreed to accept smartphone-based telerehabilitation as one of their treatment options. In India, challenges to efficient telerehabilitation implementation included a lack of infrastructure, perceived time consumption, a lack of expertise and training, organizational support, and perceived inefficacy. CONCLUSION: While knowledge of smartphone-based telerehabilitation is high among healthcare professionals and chronic obstructive pulmonary disease patients, implementation of this novel intervention measure has been limited due to perceived constraints associated with smartphone-based telerehabilitation. Adapting national and organizational policies to support smartphone-based telerehabilitation services is critical during this decade of social isolation.

Estimating the Impact of the Pandemic on Children's Physical Health: A Scoping Review.

BACKGROUND: Children are expected to adhere to the recommended physical activity (PA) dose of 60 minutes per day and minimize sedentary behaviors (SB) to stray away from the cardio-metabolic disease risk. However, there is a lack of review of current evidence pointing to the negative physical health effects of the Covid-19 lockdown, with its barriers and facilitators for effective PA implementation in children aged 3 to 13. METHODS: Two independent authors conducted an extensive search on five peer-reviewed journal databases for the studies examining changes in PA or SB in children and the potential barriers during Covid-19 lockdown. RESULTS: Of 1039 studies initially screened, only 14 studies were included. Ninety-three percent of the studies were cross-sectional surveys. A 34% reduction in PA was noted while SB, including screen time, increased by 82%. Our review identified potential barriers to the effective implementation of PA behaviors in children at four levels: individual, family, school, and government policies. CONCLUSIONS: A moderate reduction in PA and high SB in children during lockdown was linked with obstacles at the individual, family, school, and political levels. Stakeholders should consider the above barriers when designing and implementing interventions to address low PA and SB practices.

SMART STEP - SMARTphone-driven exercise and pedometer-based STEP intervention to promote physical activity among desk-based employees: Study protocol for a three-arm cluster randomized controlled trial.

BACKGROUND: Prolonged sitting in desk-based office workers is found to be associated with increased cardiometabolic risk and poor cognitive performance. Technology-based physical activity (PA) interventions using smartphone applications (SmPh app) to promote PA levels might be effective in reducing cardiometabolic risk among sedentary population but the evidence remains inconclusive. OBJECTIVE: The objective is to investigate the effects of a technology-based PA intervention compared to PA education with a worksite manual or no intervention on PA levels, cardiometabolic risk, cognitive performance, and work productivity among desk-based employees. METHOD: A three-arm clustered randomized trial will be conducted. The study will be conducted among various administrative offices of a multifaceted university in India. Desk-based employees aged between 30 and 50 years (n = 159; 53 in each arm) will be recruited. Employees from various constituent institutions (clusters) of the university will be randomized into one of the three following groups - SMART: SmPh app-driven break reminders (visual exercise prompts) plus pedometer-based step intervention, TRADE: worksite PA education with a manual plus American College of Sports Medicine guided PA prescription, or CONTROL: usual work group. At baseline and after the 1st, 3rd and 6th month of the trial period, accelerometer-measured sitting time and PA levels, cardiometabolic risk (fasting blood glucose, triglycerides, insulin, blood pressure, heart rate variability, functional capacity, and subcutaneous fat), cognitive performance (executive function), sickness absenteeism and work limitations will be assessed by a blinded assessor. Therapist delivering interventions will not be blinded. CONCLUSION: This trial will determine whether a combined SmPh-app and pedometer-based intervention is more effective than education or no intervention in altering PA levels, cardiometabolic risk and cognitive performance among desk-based employees in India. This study has the potential to foster institutional recommendations for using SmPh-based technology and pedometers to promote PA and reduce sedentary behavior at work.