Purpose To investigate the effects of four office chairs on the postural angles of the lumbopelvic and cervical regions. Research question Which chair(s) produce an ''ideal'' spinal posture? Methods An experimental same subject design was used involving healthy subjects (n = 14) who conducted a typing task whilst sitting on four different office chairs; two ''dynamic'' chairs (Vari-Kneeler and Swopper), and two static chairs (Saddle and Standard Office with back removed). Data collection was via digital photogrammetry, measuring pelvic and lumbar angles, neck angle and head tilt which were then analysed within MatLab. A repeated measures ANOVA with Bonferroni corrections for multiple comparisons was conducted. Results Statistically significant differences were identified for posterior pelvic tilt and lumbar lordosis between the Vari-Kneeler and Swopper chairs (p = 0.006, p = 0.001) and the Vari-Kneeler and Standard Office chairs (p = 0.000, 0.000); and also for neck angle and head tilt between the Vari-Kneeler and Swopper chairs (p = 0.000, p = 0.000), the Vari-Kneeler and Saddle chairs (p = 0.002, p = 0.001), the Standard Office and Swopper chairs (p = 0.000, p = 0.000), and the Standard Office and Saddle chairs (p = 0.005, p = 0.001). This study confirms a within region association between posterior pelvic tilt and lumbar lordosis, and between neck angle and head tilt. It was noted that an ideal lumbopelvic position does not always result in a corresponding ideal cervical position resulting in a spinal alignment mismatch. Conclusion In this study, the most appropriate posture for the lumbopelvic region was produced by the Saddle chair and for the cervical region by both the Saddle and Swopper chairs. No chair consistently produced an ideal posture across all regions, although the Saddle chair created the best posture of those chairs studied. Chair selection should be based on individual need.
BackgroundClassification of non-specific low back pain (NSLBP) was recommended to better target care and so maximise treatment potential. This study investigated physiotherapy practitioners' (PPs) and managers' (PMs) views, experiences and perceptions of barriers and enablers for using classification systems (CSs) to better target treatment for NSLBP in the NHS primary care setting.DesignQualitative focus group and interviews.MethodsData from semi-structured interviews of three PMs and a focus group with five PPs, considered local opinion leaders in physiotherapy, was thematically analysed.ResultsFive themes emerged (i) CS knowledge: PPs and PMs were aware of CSs and agreed with its usefulness. PPs were mostly aware of CSs informing specific treatments whilst PMs were aware of prognosis based CSs. (ii) Using CSs: PPs classify by experience and clinical reasoning skills, shifting between multiple CSs. PMs were confident that evidence-based practice takes place but believed CSs may not be always used. (iii) Advantages/disadvantages of CSs: Effective targeting of treatments to patients was perceived as advantageous; but the amount of training required was perceived as disadvantageous. (iv) Barriers: Patients' expectations, clinicians' perceptions, insufficiently complex CSs, lack of training resources. (v) Enablers: Development of sufficiently complex CSs, placed within the clinical reasoning process, mentoring, positive engagement with stakeholders and patients.ConclusionsPPs and PMs were aware of CSs and agreed with its usefulness. The current classification process was perceived to be largely influenced by individual practitioner knowledge and clinical reasoning skills rather than being based on one CS alone. Barriers and enablers were identified for future research.
Background/Aim: The Back Book was designed as an evidenced-based booklet to change patients’ beliefs and behaviours regarding back pain. This information focused on encouragement of normal activity, avoiding too much rest and maintaining a positive attitude. Previous studies have shown that The Back Book, when combined with other management strategies, appears to have a positive effect on patients’ beliefs about back pain and clinical outcomes. This study aimed to determine the effect of The Back Book on attitudes towards back pain, function, and pain when given to patients on a waiting list to see a physiotherapist in a spinal pain clinic (SPC). Method: Subjects were recruited from a SPC waiting list and randomized into experimental and control groups. All subjects completed the Back Beliefs, Fear Avoidance Beliefs, and Roland Morris Disability questionnaires, and Visual Analogue Scale for pain before and after reading The Back Book or no intervention. Results: No statistical or clinical differences were seen in any of the outcome measures. Conclusion: This preliminary data suggests that The Back Book may not be suitable to be used in isolation. Further research should establish the most appropriate point and mode of delivery of this information.
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