What do physiotherapists consider to be the best sitting spinal posture?

University of Limerick, HS2-025, Health Sciences Building, Limerick, Ireland.
Manual therapy (Impact Factor: 1.71). 05/2012; 17(5):432-7. DOI: 10.1016/j.math.2012.04.007
Source: PubMed


While sitting is a common aggravating factor in low back pain (LBP), the best sitting posture remains unclear. This study investigated the perceptions of 295 physiotherapists in four different European countries on sitting posture. Physiotherapists selected their perceived best sitting posture from a sample of nine options that ranged from slumped to upright sitting, as well as completing the back beliefs questionnaire (BBQ). 85% of physiotherapists selected one of two postures as best, with one posture being selected significantly more frequently than the remainder (p < 0.05). Interestingly, these two most frequently selected postures were very different from each other. Those who selected the more upright sitting posture had more negative LBP beliefs on the BBQ (p < 0.05). The choice of best sitting posture also varied between countries (p < 0.05). Overall, disagreement remains on what constitutes a neutral spine posture, and what is the best sitting posture. Qualitative comments indicated that sitting postures which matched the natural shape of the spine, and appeared comfortable and/or relaxed without excessive muscle tone were often deemed advantageous. Further research on the perceptions of people with LBP on sitting posture are indicated.

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    • "Some of those groups used multiple camera sensors to build a threedimensional optical motion model of the subject and tried to determine the level of clinical advantage that the so-called 'correct' postures would provide over 'incorrect posture' [24], while other groups used adhesive 3D motion sensors applied on the skin to assess different spinal angles [25] to identify a 'correct' posture. Even recent studies have shown that there still exists a significant disagreement from rehabilitation experts on what is the best sitting posture and what constitutes a neutral spine posture [26]. "
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    ABSTRACT: In a precursory work, an intelligent sensing chair prototype was developed to classify 12 standardized sitting postures using 8 pneumatic bladders (4 in the chair's seat and 4 in the backrest) connected to piezoelectric sensors to measure inner pressure. A Classification of around 80% was obtained using Neural Networks. This work aims to demonstrate how algorithmic optimization can be applied to a newly developed prototype to improve posture classification performance. The aforementioned optimization is based on the split of users by sex and use two different previously trained Neural Networks (one for Male and the other for Female). Results showed that the best neural network parameters had an overall classification 89.0% (from the 92.1% for Female Classification and 85.8% for Male, which translates into an overall optimization of around 8%). Automatic separation of these sets was achieved with Decision Trees with an overall classification optimization of 87.1%.
    Bioengineering (ENBENG), 2015 IEEE 4th Portuguese Meeting on, Porto; 02/2015
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    • "Throughout instrumental playing, such a correct posture needs to also allow supportive muscles to sustain efficient static or dynamic movements and stability of the joints during performance actions. However, achieving optimal posture while performing can challenge basic concepts of “ideal” posture as playing most musical instruments requires maintaining asymmetrical postures in either sitting or standing over prolonged periods of time (Cailliet, 1990; Haslegrave, 1994; Nyman et al., 2007; Claus et al., 2009; Edling and Fjellman-Wiklund, 2009; O’Sullivan et al., 2012). Non-ideal postures requiring higher levels of muscle activation to support the musician and their instrument while compensating for reduced balance and control, may increase static loading and stress of neuromusculoskeletal structures, leading to earlier muscular fatigue and excessive muscular tension, creating a higher risk of developing PRMDs (Magnusson and Pope, 1998; Medoff, 1999; Kapandji, 2000; Tubiana, 2000; Kumar, 2001; Quarrier and Stenback, 2002; Price and Watson, 2011). "
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    ABSTRACT: Playing a musical instrument at an elite level is a highly complex motor skill. The regular daily training loads resulting from practice, rehearsals and performances place great demands on the neuromusculoskeletal systems of the body. As a consequence, performance-related musculoskeletal disorders (PRMDs) are globally recognized as common phenomena amongst professional orchestral musicians. These disorders create a significant financial burden to individuals and orchestras as well as lead to serious consequences to the musicians' performance and ultimately their career. Physical therapists are experts in treating musculoskeletal injuries and are ideally placed to apply their skills to manage PRMDs in this hyper-functioning population, but there is little available evidence to guide specific injury management approaches. An Australia-wide survey of professional orchestral musicians revealed that the musicians attributed excessively high or sudden increase in playing-load as major contributors to their PRMDs. Therefore, facilitating musicians to better manage these loads should be a cornerstone of physical therapy management. The Sound Practice orchestral musicians work health and safety project used formative and process evaluation approaches to develop evidence-informed and clinically applicable physical therapy interventions, ultimately resulting in favorable outcomes. After these methodologies were employed, the intervention studies were conducted with a national cohort of professional musicians including: health education, onsite injury management, cross-training exercise regimes, performance postural analysis, and music performance biomechanics feedback. The outcomes of all these interventions will be discussed alongside a focussed review on the existing literature of these management strategies. Finally, a framework for best-practice physical therapy management of PRMDs in musicians will be provided.
    Frontiers in Psychology 07/2014; 5(706). DOI:10.3389/fpsyg.2014.00706 · 2.80 Impact Factor
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    ABSTRACT: Neutral sitting postures encouraging lumbar lordosis have been recommended in the management of sitting-related low back pain (LBP). However, prolonged lordotic sitting postures can be associated with increased fatigue and discomfort. This pilot study investigated whether changing the type of chair used in sitting can reduce the effort of maintaining a neutral sitting posture. The muscle activation of six trunk muscles was recorded using surface electromyography in 12 painfree participants. Participants were facilitated into a neutral sitting posture for 1min on both a standard backless office chair and a dynamic, forward-inclined chair (Back App). Lumbar multifidus activity was significantly lower on the Back App chair (p=0.013). None of the other five trunk muscles measured demonstrated a significant difference in activity between the chairs. There was no significant difference (p=0.108) in the perceived effort of maintaining the neutral sitting posture on the two chairs. This study suggests that the lumbar multifidus activation required to maintain a neutral sitting posture can be reduced by considering the type of chair used. The mechanism through which the Back App chair reduces lumbar multifidus activation is unclear, but the greatest difference between chairs is the degree of hip flexion. The ability to maintain a neutral lumbar posture with less lumbar multifidus activation is potentially advantageous during prolonged sitting. Further investigations of the effects of chair design on longer duration sitting, and among LBP subjects, are warranted.
    Manual therapy 06/2012; 17(6):566-71. DOI:10.1016/j.math.2012.05.016 · 1.71 Impact Factor
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