The Effect of a Pelvic Support Chair on Sagittal Lumbosacral Alignment in Sitting Position in Patients with Lower Back Pain

Kyue-Nam Park; Si-Hyun Kim

doi:10.18502/ijph.v51i9.10562

The Effect of a Pelvic Support Chair on Sagittal Lumbosacral Alignment in Sitting Position in Patients with Lower Back Pain

Kyue-Nam Park

Si-Hyun Kim

Abstract

Background: A slouched lumbar posture during sitting is risk factor for the low back pain (LBP). Various chairs have been used to maintain sagittal lumbar lordosis and sacral alignment during sitting. We aimed to demonstrate the effect of a pelvic-support chair on the lumbar lordosis and sacral tilt in patients with LBP.

Methods: We recruited 29 patients with non-specific LBP and 11 healthy subjects in South Korea from Apr 2017 to Mar 2018. The sagittal lumbosacral alignment was examined radiographically in three sitting postures: usual, erect, and sitting in a pelvic-support chair. Five angles [the lumbar lordosis, upper lumbar (ULA), lower lumbar (LLA), lumbosacral (LSA), and sacral slope (SS) angles] were compared between the subjects with LBP and healthy subjects in the three sitting conditions.

Results: There were significant differences in the lumbar lordosis, ULA, LLA, LSA, and SS according to sitting condition (P<.05). All five angles were significantly greater when participants sat erect or in a pelvic-support chair than in their usual sitting position (P<.05). ULA and SS were significantly greater when sitting erect than in a pelvic-support chair (P<.05). LLA was significantly greater in controls than in patients with LBP (P=.042).

Conclusion: The sagittal alignment of the lumbosacral region differed significantly among usual, erect, and pelvic-support chair sitting in patients with LBP and controls. Decreased lordotic curve of the lumbar spine in the usual sitting position can be changed in both patients with LBP and healthy subjects by sitting with pelvic support chair.

1. Gupta N, CS Christiansen, DM Hallman, et al (2015). Is objectively measured sitting time associated with low back pain? A cross-sectional investigation in the NOMAD study. PLoS One, 10(3):e0121159.
2. Lis AM, KM Black, H Korn, et al (2007). Association between sitting and occupational LBP. Eur Spine J, 16(2):283-8.
3. Murphy S, P Buckle, D Stubbs (2004). Classroom posture and self-reported back and neck pain in schoolchildren. Appl Ergon, 35(2):113-20.
4. Sjolie AN (2004). Associations between activities and low back pain in adolescents. Scand J Med Sci Sports, 14(6):352-9.
5. Sato K, S Kikuchi, T Yonezawa (1999). In vivo intradiscal pressure measurement in healthy individuals and in patients with ongoing back problems. Spine (Phila Pa 1976), 24(23):2468-74.
6. Wilke HJ, P Neef, M Caimi, et al (1999). New in vivo measurements of pressures in the intervertebral disc in daily life. Spine (Phila Pa 1976), 24(8):755-62.
7. Adams MA, WC Hutton (1983). The effect of posture on the fluid content of lumbar intervertebral discs. Spine (Phila Pa 1976), 8(6):665-71.
8. Dankaerts W, P O'Sullivan, A Burnett, et al (2006). Differences in sitting postures are associated with nonspecific chronic low back pain disorders when patients are subclassified. Spine, 31(6):698-704.
9. Shirazi-Adl A, G Drouin (1987). Load-bearing role of facets in a lumbar segment under sagittal plane loadings. J Biomech, 20(6):601-13.
10. O'Sullivan K, P O'Dea, W Dankaerts, et al (2010). Neutral lumbar spine sitting posture in pain-free subjects. Man Ther, 15(6):557-61.
11. Cho IY, SY Park, JH Park, et al (2015). The Effect of Standing and Different Sitting Positions on Lumbar Lordosis: Radiographic Study of 30 Healthy Volunteers. Asian Spine J, 9(5):762-9.
12. De Carvalho DE, D Soave, K Ross, et al (2010). Lumbar spine and pelvic posture between standing and sitting: a radiologic investigation including reliability and repeatability of the lumbar lordosis measure. J Manipulative Physiol Ther, 33(1):48-55.
13. Horton SJ, GM Johnson, MA Skinner (2010). Changes in head and neck posture using an office chair with and without lumbar roll support. Spine (Phila Pa 1976), 35(12):E542-8.
14. Alamin TF, V Agarwal, A Zagel, et al (2018). The effect of standing vs. variants of the seated position on lumbar intersegmental angulation and spacing: a radiographic study of 20 asymptomatic subjects. J Spine Surg, 4(3):509-15.
15. O’Sullivan K, R McCarthy, A White, et al (2012). Lumbar posture and trunk muscle activation during a typing task when sitting on a novel dynamic ergonomic chair. Ergonomics, 55(12):1586-95.
16. Annetts S, P Coales, R Colville, et al (2012). A pilot investigation into the effects of different office chairs on spinal angles. Eur Spine J, 21(2):165-70.
17. Viggiani D, KM Gallagher, M Sehl, et al (2017). The distribution of lumbar intervertebral angles in upright standing and extension is related to low back pain developed during standing. Clin Biomech (Bristol, Avon), 49:85-90.
18. De Carvalho D, D Grondin, J Callaghan (2017). The impact of office chair features on lumbar lordosis, intervertebral joint and sacral tilt angles: a radiographic assessment. Ergonomics, 60(10):1393-404.
19. Lengsfeld M, A Frank, DL van Deursen, et al (2000). Lumbar spine curvature during office chair sitting. Med Eng Phys, 22(9):665-9.
20. O'Keeffe M, W Dankaerts, P O'Sullivan, et al (2013). Specific flexion-related low back pain and sitting: comparison of seated discomfort on two different chairs. Ergonomics, 56(4):650-8.
21. Dunk NM, AE Kedgley, TR Jenkyn, et al (2009). Evidence of a pelvis-driven flexion pattern: are the joints of the lower lumbar spine fully flexed in seated postures? Clin Biomech (Bristol, Avon), 24(2):164-8.
22. Suzuki H, K Endo, J Mizuochi, et al (2016). Sagittal lumbo-pelvic alignment in the sitting position of elderly persons. J Orthop Sci, 21(6):713-7.
23. Castanharo R, M Duarte, S McGill (2014). Corrective sitting strategies: An examination of muscle activity and spine loading. J Electromyogr Kinesiol, 24(1):114-9.
24. Hey HWD, CG Wong, ET-C Lau, et al (2017). Differences in erect sitting and natural sitting spinal alignment—insights into a new paradigm and implications in deformity correction. Spine J, 17(2):183-9.
25. O’Sullivan PB, W Dankaerts, AF Burnett, et al (2006). Effect of different upright sitting postures on spinal-pelvic curvature and trunk muscle activation in a pain-free population. Spine, 31(19):E707-12.
26. Roffey DM, EK Wai, P Bishop, et al (2010). Causal assessment of occupational sitting and low back pain: results of a systematic review. Spine J, 10(3):252-61.
27. Womersley L, S May (2006). Sitting posture of subjects with postural backache. J Manipulative Physiol Ther, 29(3):213-8.
28. O’Sullivan PB, KM Grahamslaw, M Kendell, et al (2002). The effect of different standing and sitting postures on trunk muscle activity in a pain-free population. Spine, 27(11):1238-44.
29. Williams MM, JA Hawley, RA McKenzie, et al (1991). A comparison of the effects of two sitting postures on back and referred pain. Spine (Phila Pa 1976), 16(10):1185-91.
30. Grondin DE, JJ Triano, S Tran, et al (2013). The effect of a lumbar support pillow on lumbar posture and comfort during a prolonged seated task. Chiropr Man Therap, 21(1):21.
31. Black KM, P McClure, M Polansky (1996). The influence of different sitting positions on cervical and lumbar posture. Spine (Phila Pa 1976), 21(1):65-70.

Files	XML PDF (1MB)
Issue	Vol 51 No 9 (2022)
Section	Original Article(s)
DOI	https://doi.org/10.18502/ijph.v51i9.10562
Keywords
Chair Mechanical low back pain Posture Radiography Spine

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Park K-N, Kim S-H. The Effect of a Pelvic Support Chair on Sagittal Lumbosacral Alignment in Sitting Position in Patients with Lower Back Pain. Iran J Public Health. 2022;51(9):2069-2077.

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