Identifying a neutral lumbar spine sitting posture
O’Sullivan, K O’Dea, P Dankaerts, Wim O’Sullivan, P Clifford, A O’Sullivan, L #
Balanced solutions: effective implementation of evidence based research pages:274
World congress LBP&PP date:9-12 November 2010
• Purpose: Sitting is a common aggravating factor in low back pain (LBP), and re-education of sitting posture is a common aspect of LBP management. However, there is considerable debate regarding what is an optimal sitting posture. This study had 2 aims; to investigate whether pain-free subjects can be reliably positioned in a neutral sitting posture (involving slight lumbar lordosis and relaxed thorax); and secondly to compare perceptions of neutral sitting posture to habitual sitting posture (HSP).
• Relevance: It is important that the ability to consistently position subjects in a neutral sitting posture is evaluated, if assuming such a posture is to be a realistic treatment goal for subjects with LBP. Furthermore, a comparison of neutral sitting posture with habitual sitting posture and subjective perceptions of good sitting posture has never been performed.
• Methods: The lower lumbar spine HSP of seventeen pain-free subjects was initially recorded. Subjects then assumed their own subject perceived ideal posture (SPIP). Finally, 2 blinded testers independently positioned the subjects into a tester perceived neutral posture (TPNP).
• Results: The inter-tester reliability of positioning in TPNP was very good (ICC=0.91, mean difference = 3% of range of motion). A repeated measures ANOVA revealed that HSP was significantly more flexed than both SPIP and TPNP (p<0.05). There was no significant difference between SPIP and TPNP (p>0.05).
• Conclusions: HSP was more kyphotic than all other postures. The results suggest that pain-free subjects can be reliably positioned in a neutral lumbar sitting posture.
• Implications: The results indicate pain-free subjects can assume a neutral lumbar spine sitting posture reliably with minimal instruction. Further investigation into the role of neutral sitting posture in LBP subjects is planned. HSP is more kyphotic than neutral lumbar spine sitting.