Does Using a Chair Backrest or Reducing Seated Hip Flexion Influence Trunk Muscle Activity and Discomfort? A Systematic Review

Curran, Máire; O’Sullivan, Leonard; O’Sullivan, Peter; Dankaerts, Wim; O’Sullivan, Kieran

doi:10.1177/0018720815591905

Cited by 36 publications

(18 citation statements)

References 83 publications

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“…Chairs that put an individual in a semi-kneeling position have been shown to increase pedal cutaneous blood flow in subjects over traditional chairs, though participants of that study indicated they preferred to sit in traditional chairs (15). Further, sitting in chairs with backrests have been found to reduce paraspinal muscle activation, not necessarily reduce low back pain (16). More recently, radiographic evidence has supported the idea that using a chair with back support, can minimize changes to lumbar lordosis and pelvic parameters that occur between sitting and standing (17), but this study did not assess the results of using a kneeling chair.…”

Section: Discussionmentioning

confidence: 78%

The effect of standing vs. variants of the seated position on lumbar intersegmental angulation and spacing: a radiographic study of 20 asymptomatic subjects

et al. 2018

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Background: Pain while sitting is the primary complaint of many patients with lumbar spinal ailments, including those with discogenic low back pain and lumbar disc herniations. There has been little basic research on the different mechanical stresses that different sitting positions place on the spine. To demonstrate the effect of different sitting positions on lumbar intersegmental relationships. Methods: Twenty healthy male volunteer subjects were recruited. Lateral X-rays of the lower lumbar spine were taken in four positions: (I) relaxed lateral standing; (II) "standard" sitting position; (III) sitting on a "kneeling" chair; and (IV) unsupported sitting on a stool. Anterior and posterior disc height, disc space angulation, L1-S1 angulation and interspinous distance were measured. Results: The L1-S1 lordotic angle in the standing position (48.8°±14.7°) was found to be statistically significantly greater than the angle measured with any of the sitting positions: the kneeling chair (34.0°±17.7°); hardback chair (28.6°±14.3°); and the stool (16.6°±15.6°). Total average disc height (arithmetic sum of average disc heights L2-S1) in the lumbar spine varied with position: standing (40.5±7.75 mm); hardback chair (38.5±6.9 mm); kneeling chair (38.4±7.9 mm); stool (36.9±7.1 mm). The mean interspinous distance over all the lumbar levels was significantly greater in each of the three seated positions than in the standing position: standing 6.8±4.5 mm; 11.6°±7.5° for the kneeling chair; 12.9±5.8 mm for the hardback chair; 16.9±7.0 mm for the stool. Conclusions: If segmental flexion and segmental loading are the important biomechanical correlates of pain on sitting, such patients should be most comfortable in a kneeling chair, which most closely approximates the standing position. These basic findings will allow better assessment of different seating positions from an ergonomic perspective, and hopefully lead to improvements in chair design.

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Section: Discussionmentioning

confidence: 78%

The effect of standing vs. variants of the seated position on lumbar intersegmental angulation and spacing: a radiographic study of 20 asymptomatic subjects

et al. 2018

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“…However, the trunk and lower limbs are involved in a variety of motor activities such as reaching, sitting without support, and active mobilization exercises [31, 32]. Therefore, a useful task has to be performed by the control group without incorporating the trunk or lower limbs.…”

Section: Methods and Designmentioning

confidence: 99%

Effectiveness of additional trunk exercises on gait performance: study protocol for a randomized controlled trial

Criekinge

Saeys

Hallemans

et al. 2017

Trials

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BackgroundEvidence is lacking concerning the effect of additional trunk rehabilitation on gait performance. Investigating gait performance by both clinical and biomechanical outcome measures might lead to new scientific insights into the importance of the trunk during gait rehabilitation in people suffering from stroke. This protocol was written according to the SPIRIT 2013 Statement.Methods and designAn assessor-blinded randomized controlled trial will be conducted in patients with impaired trunk control after stroke. A total of 60 patients will be randomly allocated to the control or the experimental group by means of sealed opaque envelopes. They will receive either 16 h of additional trunk exercises (experimental group) or cognitive exercises (controls) for 1 h a day, 4 days a week for 4 weeks. Patients will also receive 2 h of standard care consisting of physiotherapy and occupational therapy. Gait performance will be assessed clinically by the Tinetti Test and biomechanically by means of a full body gait analysis. In addition, the effect of the exercise protocol on the trunk itself and trunk activities of daily living will be assessed by the Trunk Impairment Scale and the Barthel Index.DiscussionDespite the evidence demonstrating the importance of trunk control after stroke, studies about the effects of trunk rehabilitation on gait performance are inconsistent. In the current study, a more sophisticated treatment protocol will be used to enlarge therapeutic improvements, the relationship between clinical and biomechanical measures of gait performance can be investigated, and the sustainability of the effects of trunk exercises over time will be examined. Since clinical improvements are of greater importance to patients and physiotherapists, clinical assessment scales will be used as primary outcome measures.Trial registrationClinicalTrials.gov, ID: NCT02708888. Registered on 2 March 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1989-1) contains supplementary material, which is available to authorized users.

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“…The dental stool has an influence on such posture [11][12][13], because it induces the use of certain postural patterns to find a more comfortable and/or functional position [11][12][13]. In addition, the curvature of the spine, as well as the location and correct position of the head and pelvis are crucial for the biomechanics of the sitting position [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Assessment of the ergonomic risk from saddle and conventional seats in dentistry: a systematic review and meta-analysis

2019

Br Dent J

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This study aimed to verify whether the saddle seat provides lower ergonomic risk than conventional seats in dentistry. Methods This review followed the PRISMA statement and a protocol was created and registered in PROSPERO (CRD42017074918). Six electronic databases were searched as primary study sources. The "grey literature" was included to prevent selection and publication biases. The risk of bias among the studies included was assessed with the Joanna Briggs Institute Critical Appraisal Tool for Systematic Reviews. Meta-analysis was performed to estimate the effect of seat type on the ergonomic risk score in dentistry. The heterogeneity among studies was assessed using I 2 statistics. Results The search resulted in 3147 records, from which two were considered eligible for this review. Both studies were conducted with a total of 150 second-year dental students who were starting their laboratory activities using phantom heads. Saddle seats were associated with a significantly lower ergonomic risk than conventional seats [right side (mean difference =-3.18; 95% CI =-4.96,-1.40; p < 0.001) and left side (mean difference =-3.12; 95% CI =-4.56,-1.68; p < 0.001)], indicating posture improvement. Conclusion The two eligible studies for this review provide moderate evidence that saddle seats provided lower ergonomic risk than conventional seats in the examined population of dental students.

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Does Using a Chair Backrest or Reducing Seated Hip Flexion Influence Trunk Muscle Activity and Discomfort? A Systematic Review

Cited by 36 publications

References 83 publications

The effect of standing vs. variants of the seated position on lumbar intersegmental angulation and spacing: a radiographic study of 20 asymptomatic subjects

The effect of standing vs. variants of the seated position on lumbar intersegmental angulation and spacing: a radiographic study of 20 asymptomatic subjects

Effectiveness of additional trunk exercises on gait performance: study protocol for a randomized controlled trial

Assessment of the ergonomic risk from saddle and conventional seats in dentistry: a systematic review and meta-analysis

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