Author Archives: Dr. Henry Sanford

About Dr. Henry Sanford

As a retired consultant in Orthopaedic (Musculo-skeletal) medicine, I was first trained in Orthopaedic Surgery and changed when working with JH Cyriax at St Thomas' Hospital, London, my old teaching hospital. He is regarded as the 'Father' of the subject. I worked as an Associate Consultant in the Rheumatology department, STH, in private practice in Harley St. and the Cromwell Hospital. I have run courses and lectured in in the UK, USA, Belgium, Germany, Scandinavia.

The FUTURE is going the 4M way

From a wierd concept in 1998 to become disruptive in 2017?

The ‘Deskless Chair’ derived from the ergonomic importance of a reclined work position, is morphing into the ‘Workstation’. This should reduce the incidence of LBP and other health issues.

In 1903 Ford’s ‘Horseless Carriage’ had morphed into the Model T, capable of 20 horsepower In 1908.  This, at least, solved the “great horse manure crisis of 1894” when it was suggested that London’s streets would be clogged in 9 feet of horse manure in 50 years. It’s descendants are, in turn, being disrupted by ‘the driverless car’.

Screen Shot 2017-05-23 at 07.28.24Disruptive technologies have to prove themselves first. They do so by working on the same infrastructure as the incumbent leaders. Cars had to run on the same streets as horses. Dial-up internet connections in the late 1990s used the copper in the phone networks.  (Dan Denning
Publisher, Southbank Investment Research ).   So, work-stations have to use existing office spaces before becoming universal.


We are seeing a number of ‘work-station’ type models which include a reclined work mode and so are superior to the present (2016) upright conventional  models.  The models shown here are a step in the right direction but are not 2T compliant and appear to ignore the science and are based on engineering.    They do not invite a great uptake, in spite of extensive PR.  WORK-CHAIRS, a new breed with a reclined mode →

For further reading, see ☛


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This highly innovative chair was introduced to me by it’s designer,Thomas Stroman, the Founder of Stroman Design.   He wrote to me “I am an architect by training, but having experienced back surgery, my focus has been on ergonomic seating design for human-computer interaction.  Over the past three years I have designed, prototyped and patented the Chotto® ( chair + ottoman ) .  It is a uniquely human-centric and recumbent seating / task-seating / standup desk that positions the body
into close proximity to the neutral body posture that is produced in microgravity.”  “I believe  this field of study is increasingly important and needs to be pursued given the scope of benefits it can provide those who must sit by choice or physical condition. I would also like extend an open invitation to you to evaluate my prototypes if you are ever in NYC.    Regards,  “

An excellent objective and a very interesting product.  At first glance I might be excused for thinking that it looked as if it were self mobile with caterpillar tracks.  Perhaps an exciting concept for the future.    I wrote back (May 19, 2017)

Dear Tom    I have had another look at your web page​  At first sight, I admit, I thought the Chatto to be OTT.  But on second thoughts, some might find it attractive, including me, to charge around an open plan office floor in a mini-tank.  But I can see it excites ‘familiarity bias’.  I can see no reason why it cannot be modified to take advantage of the 2T ergonomic optimisation.   This would be a huge selling point.  Even the Chinese put ‘health’ as their top design requirement  Unlike our chair manufacturers who put ‘comfort’.  (See ).Screen Shot 2017-05-20 at 11.11.16
In the early model, above, I was worried about the apparent calf compression that has the potential for DVT.  “An optional footrest elevates the legs and feet while an immediately mobile, nested and freely rotating task tray provides a universal surface for eating, reading, writing, or digital interaction. This same tray can be repositioned within the optional rear support brackets for use with the pivoting display interface / standup desk ( PDI ).  The PDI is based on design research that favors a human-centered interface that literally revolves around the seated, tension-free and fully supported Screen Shot 2017-05-20 at 11.07.26user.  If paired with a laptop, the PDI can also be used as a dual-screen interface in both the seated or standing position.  With the PDI in the default standup desk position, the Chotto simultaneously accommodates both a standing and seated user – all within a small 15 s.f. footprint.”

Also the user is very happy but looks trapped.   How does she get out?   Leg support is unecessary as it is provided by the long bones of the leg but a foot rest is essential, padded support for the heels, for prolonged work but not for the upright mode.

Screen Shot 2017-05-20 at 11.08.23Dear Tom.     Looking at your diagrams, I would make the following points from the bio-medical viewpoint :-
  • You have a good reclined work position.  But the Chair /body shape interface requires  iliac support at 20 cms above the seat pan. This is important for spinal wellbeing.   (See  bottom half).
  • You have correctly spotted that good design encompasses most body shapes and sizes.  Adjustment is only needed at the extremities, neck and legs.   (See ).
  • I like the way your computer screen adjusts to whichever mode.
  • For full 2T compliance I make a point for the intermediate ranges to be unstable for additional health benefits.  Of course, this is not basic (See & ).
  • On further thought, I do not think that a lordotic concave support for the kyphotic/convex thoracic spine, as described in the 2T is strictly required.  The thoracic joints are stable being splinted by the ribs.  Only rotation movement occurs at this spinal level.
    Your configuration depends on the convex shape of the wheel circumference and this can support the fairly solid thorax, providing that it is accompanied by neck/head support in the reclined mode.  You will be glad to hear that I have tested this while having my bath.  In the UK we have prolonged baths and so can think great thoughts.  The iliac support, lower down at the lumbar-sacral junction is very important but can be effected by padding as you have suggested,

Another architects chair

Screen Shot 2017-05-20 at 13.48.22Architects have a tradition for designing good furniture. Aaron Chetwynd did this 2T sketch for me. It is deliberately ‘office chair’ looking to reduce ‘familiarity bias’.   It is not intended to be a work-station.

Screen Shot 2017-05-20 at 13.37.15

The leg/foot-rest design is important and is wrong in the Aaron view above. There is no need for a leg rest as this is effected by the strong long bones of the leg (Lower end of the femur & lower leg tib/fib).  However this brings point pressure onto the heels which I found to be painful over time and needs to be well padded.  I think your design shows this except the pressure seems to be at the ankles.  This may need further consideration. Also it needs adjustment for leg length.  Pressure on the calf muscles should be avoided as it may limit venous return and cause Deep Vein Thrombosis.
New point
Screen Shot 2017-05-22 at 17.22.25



About the Chotto:

Design details


Being the interface btween body shape and chair, it is important that the Reclined mode configuration should be correct.  If not it can engender discomfort (as can be experienced in certain dentists chairs) and more important is potentially dangerous.

  • Since these ‘shell’ components are intended to describe a seat’s supporting interface with the human body, when completed the Shell Chair forms could be employed to assist in creating an actual shell-based seat in various possible ways:
  • Shell1Shows that a slightly flexed thoracic spine + the upper lumbar joints is not adverse.
  • An office version would be narrow with a small telescopic headrest to address height variation and to reduce footprint.
  • Iliac support is included to prevent lumbar spine sagging in the relaxed mode
  • Shoulder width to allow people with broad shoulders to have full movement without laterel constraint.
  • In this assay the headrest is wide to include audio speaker components for home use.


  • Moulded alone in a thin rigid material (as with Aaro Aalto’s ply furniture or the Knoll Saarinen).  Graphene is obviously relevant.
  • Moulded to form a base shell carrying relatively thin textile/foam skin padding (Eero Saarinen Knoll and Eames Vitra collection).
  • As a final form around which a tensile mesh or textile ‘hammock’ design could be generated (Herman Miller Aeron and Knoll Generation chair).
  • As a final form around which various upholstered designs could be generated (Knoll Eames or Herman Miller ranges)
  • As a final form around which other associated furniture or workstation accessories can be generated (modular office systems)
  • Consider Gordon Murray’s system consisting of tubes + composite giving extra strength  (Note by Peter Bessey )


Largely determined  by the the head-rest and foot-rest. Also ? size models.   See .    In spite of all their adjustments, bells and whistles, Hermann Miller still has 3 sizes.   We should follow with something similar.

Pelvic (Iliac) support 

Pelvic support was developed by John Gorman an engineer and chiropractor was in contradistinction to the prevailing ‘lumbar support’.  Precise support, shaped to the curve of the iliac crest is  applied to the posterior iliac spine and iliac crest of the pelvis.   A slight forward nudge at this point is mechanically efficient in extending the two lowest joints and prevents the pelvis rotating backwards.  Pelvic support was designed for upright chairs.   As a component of the cacass ‘shell’ it need only be minimal and not adjustable. Intended to prevent backward pelvic tilting when supine lying.  It cease to be ‘pelvic’ and becomes the adverse ‘lumbar’ support above 20 cm from the seat -pan.  Do not allow adjustment!   See 

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Possible ‘wobble’ arrangement for the Iliac support section

  1. Midline fixing
  2. Main supporting skeleton
  3. Spring/rubber/sponge to allow movement as shown by arrows.

ANGLES & Backrest variability

CAD drawings suggest that the backrest should be hinged to the seat pan to obtain optimal configuration in the 2 modes.    Adds to manufacturing cost.These were explored by Peter Bessey as a theoretical exercise in 3D CAD, based on anthropometric (US) data from the well known Henry Dreyfuss book. It commenced around a simple 50percentile male mannequin which was readily available.  The information from this investigation, should first be used to generate a totally adjustable Rig device, that should be used for trialling and true research purposes, before any final design concepts are prepared.


With the adoption of the 4M deskless, work-station model the constaints imposed by these angles become largely irrelevant   See

The seat

2 holes should be cut near back of wood base to limit slippage with a FTS seat.  Position showed by Okamura research (below).

2T reclnd

“stool height.” The term “sitting height” is reserved for the height to the top of the head when seated. For men, the median popliteal height is 16.3 inches and for American women it is 15.0 inches. The popliteal height, after adjusting for heels, clothing and other issues is used to determine the height of the chair seat. Mass produced chairs are typically 17 inches high.

For someone seated, the buttock popliteal length is the horizontal distance from the back most part of the buttocks to the back of the lower leg. This anthropometric measurement is used to determine the seat depth. Mass Mandal seaproduced chairs are typically 15-17 inches deep.

The Seat height based on Mandal’s ‘Forward tilted seat’ (FTS).  Forward tilt down by 15-20°.

Peripheral details


It is suggested that the head support should be directed to the base of the skull in the simple office form.  Measurements are shown below.
Head-restThe head-rest should be adjustable in both

  • Longitudinal
  • A-P directions

Hd support2

Head suprt





Optional only if the heels do not rest on the floor or desk bar. This can be arranged if the chair is lowered when in the reclined mode (as in the Okamura chair).  I regard this as only acceptable if performed easily without complicated manual adjustments.  ( Is it possible to have a mechanism that does this when the user leans backward into the reclined mode?)   A SPRUNG SOLE MUST BE OPAQUE FOR ISLAMIC SUSCEPTIBILITIES.

Screen Shot 2013-09-19 at 17.01.57A monococque design is probably unsuitable for an office work chair, but may be possible in a deskless design.  Ideally the leg/f00t-rest should retract or fold back when in the upright mode. A simple system is shown in the garden chair. A similar model can be bought cheaply at B&Q.

There is no need for the calf support.  This could result in DVT. The lower leg bones (tibia& fibula) give the only support required between  the thigh at the seat pan and the heel at the foot-rest,   However variability of the leg-support is essential and adjustment can be achieved by a telescopic spring arrangement extended by the user in the reclined mode but  retracts and folds back in the upright mode.

To incorporate a heel-rest to the Aaron design

Screen Shot 2017-05-20 at 13.37.15

foot-rest Close to the Aaron concept

Hospital applications

I was warned by Cambridge to avoid discussion of medical applications of the 2T concept as this might detract from it’s major office use.

There seem to be 3 areas :-

  1. Mass emergency.  With the distressingly increasing frquency of international outrages which involve high volume of casualties which are tended while lying on the floor, a light emergency bed is required.
  2. Hospital special needs.  A 2T bed has a perfect application in a resuscitation unit.
  3. For specific hospital requirments such as neck traction.

A lightweight bed for emergency use.

A design similar to the p/1 prototype monocoque version is suggested.

Screen Shot 2017-04-12 at 17.15.19

The 2T principle Prototype p/1 has to be modified to allow stable positions in the transitional mode, contrary to the 2T principle 8.

Screen Shot 2017-04-12 at 17.21.51

  • Manufacture can be inexpensive.
  • For storage and logistics it can be easily disassembled and stacked.

The patient can be effortlessly put in the Trendelenburg position, can lie comfortably supported when lying  supine and can be in a sitting position.

Screen Shot 2017-04-12 at 17.26.57

Lying on side, prone or in the recovery position is possible.  The slight ‘iliac’ support would be lying above the pelvic brim and limit slippage if the head end is lowered.  The slightly elevated legs aids venous return.    It can be addressed by increasing the seat/back-rest angle or having these components hinged (an added expense).

Screen Shot 2017-04-13 at 16.25.44


.Hospital resus

A similar model to the above but of more robust design.  The ability to attend to the patient at a desired height and tilt is an advantage.  Rapid position change, particularly the Trendelenberg position, needed quickly in acute episodes, is a major advantage.


Hospital special needs

Cervical traction.  At present the patient lies supine and flat with traction from the skull to a weight attached over the end of the bed.  This is  prolonged and the position becomes uncomfortable, the constraint is a disadvantage and reading is difficult.   With a 2T design the patient can be tilted to a more comfortable, less constrained, semi-reclined position without altering the traction.

c tr2

Aetiology of LBP.

LBP. Cause (Aetiology).

The causes of LBP are multifactorial  and ill understood.    It is suggested (Adam et al.2002)  that  there is a need to integrate the evidence from genetics, biomechanics, biochemistry, cell biology and psychology to construct a comprehensive model.

Twin studies suggest that only 70% of the UK population is liable to LBP (Spector 1999). Other twin studies strongly emphasise the genetic factor in the aetiology of LBP  (Battie et al., 2002).   Genetics are not a cause of LBP but a risk factor acting through, possibly, spinal configuration or components of the disc composition.

Psycho-social factors, regarded as an important in the large increase in the last 20 years (Waddell 1996), is  more a response rather than a cause, resulting increases reporting.     Anecdotal evidence from patients with chronic LBP should not be ignored.  Although usually unaware of any causative incident, they are fully aware of what makes their symptoms better or worse.

The prevalence and incidence of LBP in populations that do not use Western style upright chairs but other ‘natural’ styles of sitting. which are culturally determined, is very low or nil, suggesting an adverse effect of the use of Western style upright chairs.    In Japan, this increases as elements of the population adopt Western chairs (Schlemper 1987).

Nutrition, environment and lifestyle may all play a part in the aetiology of LBP, but the only new factors that might account for the present epidemic is lack of exercise and a sedentary Western lifestyle.    Driving, office work, computers and TV,  the modern worker spends an increasing amount of time in a chair.

Epidemiological studies of  backache prevalence.

The literature on epidemiological evidence is extensive but, in relation to aetiology, confusing due to uncertainties and imprecision in describing reliably the condition that is under review.  Low back ‘trouble’ extends from LBP of psycho-genic origin to a midline IVD protrusion causing a corda equina syndrome, which is a surgical emergency.  Meta-analysis of systematic reviews, useful for evidence based therapeutics, have to be viewed with caution in extrapolating to clinical conditions. (Furfan et al 2001).  I have often seen wrong conclusions in my own field.

A study by the US Department of Health and Human Resources (NIOSH 1997) reviewed a number of factors and the general conclusions seem to suggest that the evidence was contradictory and confusing. There was an emphasis on non-physical psycho-social factors and heavy load handling.   Much of the research into the causation of spinal breakdown has concentrated on violent or inappropriate spinal usage afflicting manual workers today and hominins in prehistory (See Origins of lumbar vulnerability→).

In a Swedish review (Linton, van Tulder.2001) of controlled trials of preventive interventions for back pain problems only exercise gave evidence of relatively moderate significance perhaps suggesting that sitting has no influence on LBP.   The divergence of the  clinical and other evidence from that of some epidemiological studies suggests that the methodology of the latter should be reassessed rather than an immediate conclusion that seating plays no part in the symptomatology of LBP.

Invisibility is possibly due to  the universality of the upright sitting posture on chairs becoming  a part of the human condition in Western orientated populations, so that it fails to become apparent to recognition in systematic reviews.  This impacts on research, where musculo-skeletal funding is minuscule, in spite of the economic, which is about £13billion annually in the UK, and personal cost .

Familiarity bias

Familiarity bias is a factor in holding back the development of ergonomic seating.  Efforts at remediation of upright seating seem to have come to the end of the road. To address the epidemic of LBP a paradigm change is required.

The Ptolemaic system of astronomy seemed to make sense of what was observed in the sky above, that the earth is the centre of the universe.  It worked for 1,500 years even becoming a tenet of Christianity, until Galileo made the mistake of inventing a telescope and Copernicus showed, scientifically, that it was wrong.  The Christian was an example of familiarity bias.

There’s now new research coming out on what’s called the double split experiment, which is a major contributor to the understanding we have of quantum mechanics, which is now maybe violating the popular interpretation of that, 70 or 80 years after it was made.  Change can be slow.  Perhaps no bad thing.

People normally think that the experts are correct.  They have the top jobs and the top positions in the professions and universities, and so generally that’s true.  Until the next scientific advance arrives.  A scientist  at CERN explained “you know, so far my theory is safe, but it might – you know, ask me next week, they might have found out that I’ve been wrong my entire career”.   Good scientists are prepared to admit this but most people are overwhelmed by familiarity bias.

I find this bias pervasive among chair designers.  Peter Bessey comments in this work (→COMFORT)  “Introducing medical-based information to designers and their education, at an early stage in their careers, would be a good way to change the status quo. The question is: how do you get that over to them in a lucid and easily digested manner? It needs to be described and presented in an easily accessible manner and not necessarily couched purely in medico-scientific terminology.”  In other words, they are really not up to speed on the scientific evidence.  This bias is extended to manufacturers who are perfectly happy with the status quo.

The bias holdup  Normalcy bias

Failure to understand familiarity and normalcy bias is likely to lead to serious problems for firms, however big.    It is a dangerous trap for manufacturers of ergonomic office chairs to fall into and it can blind recognition to a very real and credible threat.

The general familiarity bias

Screen Shot 2016-03-12 at 16.07.46We are hardwired to believe the world we live in today and to which we are acclimatised so that we become incapable of comprehending and believing that change is coming.  In general most users have been commanded, since nursery days, to ’Sit up straight’ or worse ’Stop tilting your chair forward’, a normal response of a child to adopt an actual correct position.   Later  ‘expert’ advice on ‘correct’ sitting upright is given with authority.  This is inspite of having been demolished by AC Mandal back in 1985 (See→Why? Mandal’s Homo sedens. ).   This mistaken view of correct seating is still accepted and widely promulgated by authorities who advise on such matters.

'Correct sit

It is not surprising that most people have difficulty in over-coming the ‘familiarity bias’ engendered.  The exception are many backache sufferers and the younger, millennial, generation who are capable of thinking ‘sideways’.

My own initial training in Biology has made me mistrust sudden jumps (large mutations) in ‘natural selection’ as these are usually deleterious. It is small incremental advances over time that result in progress.  The same can be applied to political ideology which has made me a conservative.  However when real scientific evidence advances it may be time to change.

 Cognitive dissonance

Cognitive dissonance, described by Leon Festinger in 1957, is the condition described in psychiatry and describes the unease felt by people whose experience or information is inconsistent to other, usually already held, beliefs.  Information and situations are avoided  In an effort to reduce this discomfort and regain psychological consistency and is virtually equivalent to ‘familiarity’ and ‘normalcy’ bias.

The 2T or 4M concept, in terms of chair design is only an incremental change.  Most office chairs need only modifications.  But as a concept it seems to excite cognitive dissonance and be regarded as a ‘paradigm’ shift.


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From Prof. MC Boulter
The comments in your  interesting blog remind me of the theme that d’Arcy Thompson used to preach a century ago. He must have influenced you also.
Best wishes
– Michael

Screen Shot 2017-03-07 at 17.59.30     Reply from Dr HA Sanford 

d’Arcy Thompson, I think, had a mathematical approach to development and did not understand evolution by natural selection, which is my approach.  I see the 2T concept as an incremental change, along the lines of development by natural selection.   In the world of chair design the 2T concept is perceived as a ‘paradigm change’, a reclined instead of an upright posture, and I have to accept that as being so and say so.   These alternate viewpoints may make my explanation sound contradictory and excite cognitive dissonance.

Many thanks
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VR and sitting

Global blue chip companies are throwing their weight into VR development (hardware and software),  Mark Zuckerberg believes “this kind of immersive, augmented reality will become a part of daily life for billions of people”.

Roto VR chair

Andrew Lockley (→   ) discussed this (3/o3/2017) with Eliott Myers from Roto VR, which is a small, innovative firm with designs on the related accessories market.  He claims that “Roto enhances the seated experience with haptic feedback so dramatically you feel like you’re really there, in another world. Once you’ve tried Roto, VR feels empty without it.  With Roto, you can add our Table accessory, so you can drive around 360 degrees with a steering wheel (and pedals). Roto also has “rumble shakers” which can be affixed to the underside and back of the chair for added sensations. It’s like 4D on steroids. Actually we should call it 360D!”

Sounds exciting!

But not if the chair is liable to induce backache (LBP) on prolonged use. Their picture (  ) shows an upright chair with their concomitant disadvantages and with it’s extra, probably excellent, VR additions.

A huge opportunity

VR and sitting, if prolonged, will be relevant to chair design. It would not be difficult to redesign this chair to take advantages of the 2T or 4M concepts and so correct it’s seemingly obvious, from the pictures,  ergonomic deficiencies  This would have the additional advantage that the firm would have the basis for an ergonomic optimised office work chair that would jump ahead of the field.

If you are in the mood have a look at ☛ →


Screen Shot 2017-03-07 at 17.59.30From Gorman JD. MA (Cantab.) (Mechanical Sciences) MI.Mech.E (Member of Institution of Mechanical Engineers). MMCA (Member of the McTimoney Chiropractic Association) on 7/March 2017.

Yes I agree that a typical office chair and the typical office chair slump is wrong. Certainly semi reclined  position is one solution. I have rather given up trying to predict how the sitting world (the world of Homo Sedens) will evolve. It is certainly slow in recognising the problem which would be the first step.   This chair looks to me like a cheap after-market car seat. The computer people probably have no interest in the chair/seat so gave it no thought so long as it looked fairly high tech.     john g.

Screen Shot 2017-03-07 at 17.59.30Reply from Dr HA Sanford MA MB BChir (Cantab) D Phys Med (Lond).

You are probably right.   Then, I am not an expert on car seating like yourself.   Henry

Screen Shot 2017-03-07 at 17.59.30Comment from Dr HA Sanford

Virtual Reality (VR) is taking me back to ‘The Brave New World’ of Aldous Huxley (1932) which I read at school.   He described a dystopic utopian hierarchical society that kept control with consumerism, drugs (Soma) and VR (Feelies).  Work was done by robots and everyone was free to relax and enjoy promiscuous sex. Sounds similar to what may happen now.

This work was superceded by ‘1984′ by George Orwell, who was at my Prep school some 20 years before me, and hated it.  We all did but did not go into print so viciously.  ’1984’ faced the more immediate threat of Marxism which has now intellectually collapsed due to it’s internal contradictions and misunderstanding of the human condition.   So we are now back with ‘Brave New World’.   It does not sound too bad but actually is a form of slavery.  Those who objected, wanting to think, were regarded as barbarians and exiled.    To Iceland (as far as I can remember).  I used to run an annual course there (See the photographs in HOW WE SIT NOW→.)  The people are wonderful and it is very pleasant (in summer).

So, VR, here we come!    HAS

The end of sitting?

Sitting Is Deadly. Could Banning Chairs Help?

Peter Bessey (he did the CADs for me) sent me this link,

My initial reaction was that this was way OTT.  On second thoughts I realised that I had been saying something similar since 1998. As a consultant in Muscle-skeletal (Orthopaedic) medicine my interest was to remediate the factors that could lead to spinal breakdown.  Later, my general medical practice long past, I realised that there were also general medical adverse, potentially terminal,  effects.  It was mentioned under ‘Sitting Disease’ in    Chair DESIGNERS & Low Lumbar Backache

My own view is that sitting at work is not dead but should be transformed into a workstation incorporating the 2T (or 4M) concept.   HAS 18/2/2017.

I append a summary of the work by RAAAF

The End of Sitting 

This is an installation by the interdisciplinary Dutch studio RAAAF (Rietveld Architecture-Art-Affordances) and lies at the crossroads of architecture, visual art and philosophy.   In our society almost the entirety of our surroundings have been designed for sitting.  Evidence from medical research suggests that prolonged sitting results in serious health deficits.   These are so widely studied and well-documented that they’re impossible to ignore and show that sitting increases lower back pain, slows our metabolisms, and shortens our life-spans, amongst other things. Not even daily exercise is enough to offset the damage.

Redesigning the workplace environment and home might manipulate an impact on sedentary behavior.  Their installations are mostly conceptual.  But they bring up an interesting idea: What if chairs were eliminated altogether? Is that even possible? And would that solve work and societal sitting problems or just open up the door to new problems?

The RAAAF installations The End of Sitting, which debuted in 2014, and Breaking Habits, opening at the Mondriaan Fund for Visual Arts in Amsterdam February 16, present chair-free environments that encourage people to get up and move. As Erik Rietveld puts it, “As long as there are chairs present, people will sit in them habitually.”

The End of Sitting – Cut Out marks the beginning of an experimental trial phase, exploring the possibilities for a radical change in the way we work in 2025. This project is a follow-up of theScreen Shot 2017-02-20 at 18.47.09 architectural art instalation made in Looiersgracht 60, Amsterdam by RAAAF. It is cut out of the landscape of standing affordances and includes the most successful positions for supported standing. It allows visitors to stand, lean, hang or lay down while interacting, reading or working. The visitor is both participant and spectator. This travelling exhibition allows everyone to experience the future of the standing office.

Slideshow Credits: 01 / Photo: Jan Kempenaers via RAAAF; 02 / Photo: Jan Kempenaers via RAAAF; 03 / Photo: Jan Kempenaers via RAAAF; 04 / Photo: Ricky Rijkenberg via RAAAF; 05 /Photo: Ricky Rijkenberg via RAAAF;

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The global future?

The future may be much better, or worse,  than most people think. It’s going to “arrive” sooner than they imagine.

Ray Kurzweil – explains  “Now back to the future: it’s widely misunderstood. Our forebears expected the future to be pretty much like their present, which had been pretty much like their past. Although exponential trends did exist a thousand years ago, they were at that very early stage where an exponential trend is so flat that it looks like no trend at all. So their lack of expectations was largely fulfilled. … An analysis of the history of technology shows that technological change is exponential, contrary to the common-sense “intuitive linear” view. So we won’t experience 100 years of progress in the 21st century — it will be more like 20,000 years of progress (at today’s rate). The “returns,” such as chip speed and cost-effectiveness, also increase exponentially. There’s even exponential growth in the rate of exponential growth.”

Michael Bess, professor of history at Vanderbilt University in the United States, opines  “There will be some fantastic benefits from these technologies, and some really potentially cataclysmic dangers. The idea is to go slow, because we need to be careful. We need to give ourselves time to adapt to the power that these changes are going to exert on our life as individuals and in society as a whole. .. Within the wealthy countries, it could exacerbate the rift between the rich and the poor. On a global scale, it’s going to be even worse. I become worried that over time, if there are several generations of enhancements that have gone forward and that rift keeps widening, you will see a fragmentation of the species based on whether they have been able to get access to these things or not.”

The Third Industrial Revolution.

David Brown, entrepreneur, angel investor and the creator of the blockbuster drug Viagra, suggests that  we are living through what he calls the Third Industrial Revolution. His theory is that each revolution is driven by a combination of three things:

  1. a new energy source, 1, coal, 2.oil, 3. ?solar..
  2. a new means of communication. 1. steam-powered printing press 2.the telegraph 3. ?the internet.
  3. and a new source of finance. 1. the stock exchange. 2. the limited company 3. ? peer-to-peer lending and other internet-driven forms of finance.

 … What’s the definition of a bank? It lends money to a broad customer base. These internet companies have massive customer bases – a billion customers with no infrastructure costs – and they’ve got money. Apple’s got $200 billion in cash. Banks are bust! It just takes one step now: for Apple and Google to start lending, and they are then replacing the current banking system.

Genetic editing

We’re talking about memory in the way early computer developers (really early – think 1940s) had to find ways of turning information into a signal that could be read, understood and stored by a machine. In a similar vein, researchers have found a way of getting the DNA in your cells to record certain information that can then be read back later.

Medically, that information is basic: we can record “events”, like whether any inflammation occurred, as well as for how long it lasted and how severe it was. But the ultimate goal of the research is to get our DNA to store more complex information about the progression of an illness or the performance of a drug.

As Timothy Lu, associate professor of electrical engineering and computer science, and of biological engineering, put it: “To enable a deeper understanding of biology, we engineered human cells that are able to report on their own history based on genetically encoded recorders.” 

This breakthrough, like so many others, would not have been possible without CRISPR.

First off, what exactly is CRISPR?   It stands for Clustered Regularly Interspaced Short Palindromic Repeats. It’s sometimes referred to as CRISPR/Cas9. But what we call it isn’t half as interesting as the fact that it enables us to do something no civilisation before us has ever had the ability to do – to edit the genetic makeup of living things and remake ourselves the way we want to be.   It will go down in history as the most significant breakthrough of the century.

In the middle of the last (20th) century, Francis Crick and James Watson , at Cambridge, discovered the structure of DNA. Let’s call that the birth of modern genetic research. It was akin to us finding the instruction manual for the human body.   A half a century later in 2000 and the Human Genome Project decoded a genome for the very first time. That gave us the ability to read the instruction manual (or parts of it).

CRISPR enables us is to rewrite the book altogether – to cross out parts we don’t want, swap whole pages with those of another book, to create an entirely new book if we like. That’s a major shift. It changes our involvement from passive study and understanding of the subject, to active involvement, re-engineering things the way we want them to be.  It is an emerging technology. But its uses are multiplying seemingly by the day.  The doctor behind the experiment called it: “A landmark in the use of new gene engineering technology and the effects on this child have been staggering. “If replicated, it could represent a huge step forward in treating leukaemia and other cancers.”

“CRISPR is a geneticist’s dream come true,” said oncology expert and Novartis researcher Rob McDonald in a 2016 interview. “CRISPR enables us to do experiments that one could only dream of before.” In short, it enables scientists to look into thousands of genes related to cancer. The goal is to find a “kill switch” – the gene or genes that are vital to the survival of the cancer. Find this and you can engineer drugs that hit this target with precision.”  This has helped lead to a major project lead by the Novartis Institutes for BioMedical Research (NIBR) and the Broad Institute of MIT and Harvard, known as the Cancer Cell Line Encyclopaedia. The goal is to turn genomic information of cancer data and tumour biology into more therapeutically useful information.

That tackles a disease that’s already developed in a patient. But what if we could remake our genetic profiles so that we were entirely immune to certain diseases?   In an attempt to create immunity against HIV by “cutting” the offending genetic material away UMass Medical School researchers are using CRISPR/Cas9.  “On the simplest level, we’re employing a very precise pair of scissors to go in and clip out all, or part of, the HIV genome and reattach the severed ends of the human genome,” said principal co-investigator Scot Wolfe, PhD, associate professor of molecular, cell & cancer biology. “If we could do that, the hope is that this would be a step on the road to getting a functional cure for HIV.”

The number of clinical uses of CRISPR – and gene editing more widely – is growing all the time. As well as cancer and HIV, researchers around the world have had preliminary success using CRISPR against cystic fibrosis and sickle cell anaemia.

There are more controversial uses, such as creating mosquitos that are genetically engineered to wipe out the rest of their species (by breeding with them only to have offspring that are incapable of breeding) in an effort to combat malaria and the Zika virus.

Superhumans and the Jetsons fallacy

The author Michael Bess put it that when we imagine the future, we envisage a world in which technology is many times more advanced, but humans are essentially the same as they are today. He calls it the “Jetsons fallacy”: based  on a TV show set in the year 2062. It became a household show. Everyone was watching it. And it depicted a world in the future where cars fly and people can be transported in pneumatic tubes and there are robots everywhere, but the people are exactly the same as the people of 1962.

Consider the other side of the debate? What about using these techniques to enhance healthy people, rather than treat or prevent disease?  Given the potential uses of CRISPR and other genetic editing techniques in the treatment or prevention of illness, it seems near certain that gene editing will become a major industry – and perhaps even a major part of life. It is easier to win the moral argument against altering the building blocks of life if you’ve developed a cure for cancer or heart disease. The benefits to humanity are obvious and immediate.

There’s been a line drawn in the sand between the two uses so far.   Marcy Darnovsky of the Centre for Genetics and Society (an organisation dedicated to looking at human biotechnologies from a social justice, human rights and public interest perspective), who put it like this: ‘When someone has a disease that’s threatening their life or their health, then yes, let’s try to treat them with gene therapy. But when it comes to modifying genes that we’re going to pass onto our children and to every cell in their bodies, and that’s irreversible, and that’s going to be passed on to all their offspring: that’s where we think the line has to be drawn’.

The line has been drawn many countries and by one international treaty – the Council of Europe treaty that the UK has not signed. The UK itself actually does have a national law against human germline modification, which is why Parliament had to vote on that mitochondrial manipulation technique.

Sarah Gray, of the American Association of Tissue Banks, made that same point in a more emotional, but no less relevant, way. Gray gave birth to a son with anencephaly and suffered seizures for six days until he died. As she told a National Academy of Sciences summit on gene editing, “If you have the skills and the knowledge to eliminate these diseases, then freakin’ do it.” 

As these technologies advance, they will make it possible to safely and effectively modify the DNA  of human embryos genetically. This is a choice we are going to have to make. Is this something we want to do or not? Because it’s going to become technologically and medically possible.

We have a technology that allows us to remake the world ourselves as we want – or think we want – it to be. The potential uses are virtually limitless. That creates a massive incentive to explore and push the limits of what we’re able to do.  How to use that power is going to be the most important story of the century.

The Artificial Intelligence Revolution has begun

A time in human history. when we eradicate killer diseases, add decades to the average human lifespan and when we master the art of creating machines capable of superintelligent levels of thought and skill, there’s one revolutionary breakthrough that’s going to be at the heart of almost everything that happens – the development of artificial intelligence (AI).

  • Energy technology: wind, tidal and PV generation, batteries and fuel cells.
  • Consumer technology such as smart appliances, plug-in electric vehicles and social networks.
  • Grid and operational technology – such as automated demand side response, microgrids and condition-based predictive maintenance
  • Information technology (IT) such as the Internet of Things, cloud, and big data.



Assistive technology

Robotics will actually improve our lives in a huge number of different ways.  It isn’t just the branch of technology that will ultimately put millions out of work as every job on the planet gets automated.  There are two categories

  1. Robotics that will assist us: to help us do things our bodies just can’t or won’t do. For instance, helping paraplegic people to walk again.  The Walk Again Project in Brazil announced that they’d helped eight paraplegic people to walk again using a combination of virtual reality, robotic exoskeletons and brain-computer interfaces.
  2. The second category is technology that enhances our abilities, using technology to help us do things we otherwise wouldn’t have been able to do. Robots are already in our factories, increasingly in our homes and providing us with entertainment.


In the 2nd category, while the vast majority of uses are peacefully mundane,  robots can be used as military tools.The USA’s Defense Advanced Research Projects Agency (DARPA) wants to have suits would allow soldiers to walk further, carry more equipment, offer protection from the elements and allow them to arrive less fatigued. It is easy to imagine this projected into, to me, inapproptiate superhuman soldier or killer robots.

Daewoo is experimenting with a powered suit for its shipyard workers that allows them to lift a 30kg piece of iron with ease. In a shipyard where that kind of activity is mundane, there are obvious advantages to pairing the sensitivity of a human with the brawn of a robot.

In the aftermath of the Fukushima nuclear disaster several Japanese robotics firms developed special exoskeleton suits to enable people to reach otherwise inaccessible places.

Sam Volkering – futurist and financial advisor – “

It’s going to effectively change the structure of social groups, in that our definition of work is currently: you get up, you go to work, spend your day at work, come home. In the last 50-odd years robotics has replaced a lot of labour-intensive roles. You see it a lot in manufacturing now: manufacturing plants use a lot of stationary robotics. 

We’re now seeing a trend where robots or automated systems are starting to eat their way into middle-class jobs. You’ve got robo-advisors providing financial recommendations based on a huge amount of data input. So any kind of job that requires a bit of muscle power, or any reasonably repetitive work like bookkeeping – they’re just going to be replaced by automated systems or robotics. Things like self-driving cars – taxis, truck drivers, bus drivers – are not going to be needed, because why get a human to do a job that you can get a robot to do more safely, more reliably, and more consistently over a long period of time and at ultimately lesser cost?

That’s going to create more creative, highly skilled jobs, and jobs that perhaps don’t exist today that no one can predict. It’s going to be a shift of what we know as work. You might end up with three or four jobs on the go. There’s no such thing as a career anymore. You end up with several jobs as your work – micro-work. 

That’s going to mean a shift of where people go physically to work, and how they interact and communicate with each other on a daily basis. It’s not going to be about getting up and going to the office, then going home. You might get up, go to a hub somewhere, interact with a bunch of people on one of your jobs. Then work from home for a couple of hours and then have to go to another community set. That’s going to create issues with transport and things like that. 

Work is such an important part of our social fabric that when there’s a big shift in what it looks like, it’s going to create a lot of ancillary fluctuations in infrastructure: where we go, energy usage in various locations, etc. 

Screen Shot 2018-06-11 at 20.55.56People don’t like change, so that’s going to cause a lot of problems. You’re going to find a lot of people ending up out of work who haven’t had the foresight to reskill or retrain. It’s going to put a strain on economies, because they’re not going to be able to handle these people out of work, and there’s going to be a shortage of people needed for the high-skilled jobs that this change is going to create.”

Ergonomics for DESIGNERS of work chairs

May I be so bold as to suggest that….

  •  Ergonomic chair design seems to have come to the end of the road without huge success in avoiding LBP.
  • A new fix is in order and can be effected by the 2T concept.   A ‘paradigm change’?
  • This can only be achieved by an understanding of the  biomechanics. It is hoped that this work may provide you with this, a resource describing the requirements for safe design.
  • By incorporating the points made in this work,  comfort and ergonomics of both the simplest and most advanced ‘ergonomic’ chairs  should be improved .
  • You must not be  misled by ‘comfort’, that treacherous guide  which only turns up truthfully when the bio-mechanics (ergonomics) are fully correct.  See ☛ Comfort→
  •  Remediating the ergonomics is more important. Comfort is improved the nearer a full remediation  is approached.  Full remediation = maximum comfort.
  • The correct search should be for the Hippocratic “Do no harm”.
  • Bio-mechanic adverse designs can be avoided.  Why? Mandal’s Homo sedensScreen Shot 2016-01-14 at 18.19.39
  • There is now no excuse for poorly designed chairs and the conventional mis-advice that is perpetuated.   ☛ Various chairs→
  • Some selling points to manufacturers and architects are added if required.
  • The comment of Kenichi Ohmae (below) is apposite.