An approach for hip joint center calculation for use in seated postures

In seated postures, such as those in office or automotive seats, locating the hip joint center (HJC) using three markers on the pelvis has been difficult if not impossible. A two-target approach by Bell et al. (J. Biomech. 23 (1990) 617) has been used, however, this method was shown to have inaccuracies when compared to the three-target method developed by Seidel et al. (J. Biomech. 28 (1995) 995). A new two-target method that is specific to the seated environment, has better accuracy than the Bell et al. approach, and is based on the Seidel et al. approach was developed and tested on 13 seated subjects. This new method used three targets and an initial reference file to estimate the HJC location. Once the HJC was located, assumptions were made that the magnitudes between the HJC and the respective anterior superior iliac spine, and the HJC and the respective lateral epicondyle remained constant. The primary concern when evaluating this new method was the affect of seated posture movement, in particular leg splay and spinal flexion on the assumptions. The results obtained with the new approach were compared to Seidel et al. and provided HJC locations with average differences of 3.8, 1.2 and 2.8mm for spinal flexion in the anterior/posterior, medial/lateral and superior/inferior directions, respectively, and 2.3, 1.0 and 1.4mm for knee splay. The proposed method provided better HJC estimation than the Bell et al. approach particularly in the superior/inferior dimensions.     

The relationship between lumbopelvic flexibility and sitting posture in adult women

Clinical observations have suggested that limited hamstring flexibility may be associated with sagittal spinal curvatures in spine flexed postures. Thus, limited hamstring flexibility may be related to large amounts of spine flexion in “slumped” sitting postures which could contribute to low back pain and injury. The aim of this study was to determine if hamstring and pelvic flexibility are associated with flexed sitting postures using a backless office chair. Forty-one healthy female adults aged 18–69 years were recruited. Subjects performed the Sit-and-Reach test to determine maximum flexibility values and lumbar and pelvic angles were measured with accelerometers. Participants then completed a standardized typing task for a 10-minute sitting trial at an ergonomically adjusted workstation. The results showed no association between hamstring flexibility and seated lumbar spine and pelvic angles (p = 0.999, η² = 0.000; p = 0.901, η² = 0.006). Greater pelvic flexibility was associated with a more upright lumbar sitting posture (p = 0.023; η² = 0.132) but with no specific pelvic sitting posture (p = 0.660; η² = 0.005). Different movement strategies during the Sit-and-Reach test were detected: all participants moved through their lumbar spine; but only those with ‘excellent’ flexibility also used their pelvis. Individuals in the ‘excellent’ flexibility group were significantly shorter than those with ‘poor’ and ‘good’ flexibility (p = 0.020; η² = 0.190). In conclusion, hamstring flexibility does not influence sitting posture but pelvic flexibility does. Other factors such as acetabulofemoral joint limitations, consciousness of posture, or the seat itself may also influence sitting posture. Different movement strategies as well as height appear to contribute to the Sit-and-Reach test which should be researched further.     

Support force measures of midsized men in seated positions

Two areas not well researched in the field of seating mechanics are the distribution of normal and shear forces, and how those forces change with seat position. The availability of these data would be beneficial for the design and development of office, automotive and medical seats. To increase our knowledge in the area of seating mechanics, this study sought to measure the normal and shear loads applied to segmental supports in 12 seated positions, utilizing three inclination angles and four levels of seat back articulation that were associated with automotive driving positions. Force data from six regions, including the thorax, sacral region, buttocks, thighs, feet, and hand support were gathered using multi-axis load cells. The sample contained 23 midsized subjects with an average weight of 76.7 kg and a standard deviation of 4.2 kg, and an average height of 1745 mm with a standard deviation of 19 mm. Results were examined in terms of seat back inclination and in terms of torso articulation for relationships between seat positions and support forces. Using a repeated measures analysis, significant differences (p<0.05) were identified for normal forces relative to all inclination angles except for forces occurring at the hand support. Other significant differences were observed between normal forces behind the buttocks, pelvis, and feet for torso articulations. Significant differences in the shear forces occurred under the buttocks and posterior pelvis during changes in seat back inclination. Significant differences in shear forces were also identified for torso articulations. These data suggest that as seat back inclination or torso articulation change, significant shifts in force distribution occur.     

The Effects of Backward Adjustable Thoracic Support in Wheelchair on Spinal Curvature and Back Muscle Activation for Elderly People

Objectives

To investigate the effects of backward adjustable thoracic support on spinal curvature and back muscle activation during wheelchair sitting.

Methods

Twenty elderly people were recruited for this study. The backward adjustable thoracic support sitting posture was compared with the slumped, normal, and lumbar support sitting postures. Spinal curvatures (pelvic, lumbar, and thoracic angles) and muscle activations of 4 back muscles on both sides (maximal voluntary isometric contraction of the lumbar multifidus, lumbar erector spinae, iliocostalis lumborum pars thoracis, and thoracic erector spinae at T9) were measured and compared between the different sitting postures using one-way analysis of variance with repeated measures.

Results

The backward adjustable thoracic support sitting posture showed a relatively neutral pelvic tilt (−0.32±4.80°) when compared with the slumped (22.84±5.27°) and lumbar support (−8.97±3.31°) sitting postures (P<0.001), and showed relatively higher lumbar lordosis (−23.38±6.50°) when compared with the slumped (14.77±7.83°), normal (0.44±7.47°), and lumbar support (−16.76±4.77°) sitting postures (P<0.05). It also showed relatively lower back muscle activity when compared with the normal and lumbar support sitting postures (P<0.05).

Conclusions

The backward adjustable thoracic support sitting concept was suggested because it maintains a more neutral pelvic tilt, higher lumbar lordosis, and lower back muscle activation, which may help maintain a better sitting posture and reduce the risk of back pain.     

Should a standing or seated reference posture be used when normalizing seated spine kinematics?

Currently in the literature there is no consensus on which procedure for normalizing seated spine kinematics is most effective. The objective of this study was to examine the changes in the range of motion (ROM) of seated posture trials when expressed as a percent of maximum standing and seated ROM. A secondary purpose was to determine whether the typical maximum planar calibration movements (flexion, lateral-bend, and axial twist) elicited the respective maximum ROM values for each spine region versus postures with specific movement instruction. Thirteen male participants completed seven different movement trials. These consisted of the maximum planar movement trials, with the remaining four postures being combinations of specific lumbar and thoracic movements. Global and relative angles for the upper-thoracic, mid-thoracic, lower-thoracic, and lumbar regions were calculated and normalized to both a seated and standing reference posture. When normalizing both global and relative angles the standing reference appears optimal for flexion, twisting and lateral bend angles in all spine regions, with the exception of relative flexion angle in the mid-thoracic region. The maximum planar movement trials captured the greatest ROM for each global angle, relative lower-thoracic angle and relative lumbar flexion angle, but did not for all other relative angles in the upper-thoracic, mid-thoracic, and lumbar regions. If future researchers can only collect one reference posture these results recommend that a standing reference posture be collected for normalizing seated spine kinematics, although a seated reference posture should be collected if examining relative flexion angles at the mid-thoracic region.     

The variability and complexity of sitting postural control are associated with discomfort

The present investigation examined the variability of sitting postural movement in relation to the development of perceived discomfort by means of linear and nonlinear analysis. Nine male subjects participated in this study. Discomfort ratings, kinetic and kinematics data were recorded during prolonged sitting. Body part discomfort index, displacement of the center of pressure (COP) in anterior–posterior and medial–lateral directions as well as lumbar curvature were calculated. Mean, standard deviation and sample entropy values were extracted from COP and lumbar curvature signals. Standard deviation and sample entropy were used to assess the degree of variability and complexity of sitting. A correlation analysis was performed to determine the correlation of each parameter with discomfort. There were no correlations between discomfort and any of the mean values. On the contrary, the standard deviations of the COP displacement in both directions and lumbar curvature were positively correlated to discomfort, whereas sample entropies were negatively correlated. The present study suggests that the increase in degree of variability and the decrease in complexity of sitting postural control are interrelated with the increase in perceived discomfort. Finally, the present study underlined the importance of quantifying motor variability for understanding the biomechanics of seated posture.     

Effects of abnormal posture on capsular ligament elongations in a computational model subjected to whiplash loading

Although considerable biomechanical investigations have been conducted to understand the response of the cervical spine under whiplash (rear impact-induced postero-anterior loading to the thorax), studies delineating the effects of initial spinal curvature are limited. This study advanced the hypothesis that abnormal curvatures (straight or kyphotic) of the cervical column affect spinal kinematics during whiplash loading. Specifically, compared to the normal lordotic curvature, abnormal curvatures altered facet joint ligament elongations. The quantifications of these elongations were accomplished using a validated mathematical model of the human head-neck complex that simulated three curvatures. The model was validated using companion experiments conducted in our laboratory that provided facet joint kinematics as a function of cervical spinal level. Regional facet joint ligament elongations were investigated as a function of whiplash loading in the four local anatomic regions of each joint. Under the normal posture, greatest elongations occurred in the dorsal anatomic region at the C2-C3 level and in the lateral anatomic region from C3-C4 to C6-C7 levels. Abnormal postures increased elongation magnitudes in these regions by up to 70%. Excessive ligament elongations induce laxity to the facet joint, particularly at the local regions of the anatomy in the abnormal kyphotic posture. Increased laxity may predispose the cervical spine to accelerated degenerative changes over time and lead to instability. Results from the present study, while providing quantified level- and region-specific kinematic data, concur with clinical findings that abnormal spinal curvatures enhance the likelihood of whiplash injury and may have long-term clinical and biomechanical implications.     

Automatic localization of anatomical landmarks on the back surface and construction of a body-fixed coordinate system

A method for automatic measurement of anatomical landmarks on the back surface is presented. The landmarks correspond to the verteba prominens, the dimples of the posterior superior iliac spines and the sacrum point (beginning of rima ani), which are characterized by distinct surface curvature. The surface curvatures are calculated from rasterstereographic surface measurements. The procedure of isolating a region of interest for each landmark (surface segmentation) and the calculation of the landmark coordinates are described in detail. The accuracy of landmark localization was tested with serial rasterstereographs of 28 patients (with moderate idiopathic scoliosis). From the results the intrinsic accuracy of the method is estimated to be little more than 1 mm (depending on the sampling density of the surface measurement). Therefore, the landmarks may well be used for the objective definition of a body-fixed reference coordinate system. The accuracy is, however, dependent on the specific landmark and a minor influence of posture variations is observed.     

一期经后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核临床效果观察

目的：探究一期经后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核临床效果。方法：回顾性分析我院2007年1月-2010年12月收治下腰椎结核老年患者共84例,分别设立实验组和对照组。实验组42例采用后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核,对照组42例采用前路病灶清除。分别对两组一期治疗后临床效果进行观察,对患者术后腰椎局部前凸角、Oswestry障碍指数（ODI）及脊髓损伤神经功能分级标准（ASIA）分级进行客观评定。结果：实验组一期经后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核,术后腰椎局部前凸角为（8．22±1．67）°,明显优于对照组患者术后腰椎局部前凸角为（5．02±1．93）°,（P〉0．05）;实验组患者术后ODI为（21．25±3．75）％,对照组ODI为（35．72±4．15）％,实验组疗效优于对照组（P〈0．05）;实验组患者术后ASIA分级全部转化为E级。而对照组仍有7人为D级。结论：一期经后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核具有显著的临床效果,应进一步临床推广。     

Spinal load bearing during sitting in an office chair with a tilting back]

Long periods of quiet sitting is considered a cause of low back pain. It is often assumed that spinal loads are high, especially when sitting erect. Modern office chairs with a tiltable back permit changes in the seated posture. In the most reclined position, some new chairs even match a kyphotic form of the lumbar spine. It is assumed that sitting on such a chair reduces low back pain. With the aim of determining spinal loading in different sitting positions, the loads acting on implanted fixation devices were measured telemetrically in two patients. Loads were measured in patients sitting on six different chairs with tiltable backs. In modern chairs, implant loading was always lower than while walking. In the end-tilt position of the chairback, loads were always lower than when the chairback was upright. Even when the lordotic curvature of the lumbar spine was "corrected", loads on the fixator were lower than when the subject was seated in the upright position. In a modern chair, spinal loading is no higher than with non-adjustable office chairs.     

Validation of single-segment and three-segment spinal models used to represent lumbar flexion

Changes in spinal posture between the erect and flexed positions were calculated using angular measurements from lateral photographs and radiographs of ten adult male subjects. For photographic measurements, the thoracolumbar vertebral column was modelled as either a single segment or as three segments. In the three-segment model, there was a non-significant correlation between the decrease in lumbar concavity and intervertebral motion. In addition, there was a non-significant negative correlation between the increase in thoracic convexity and lumbar motion determined radiographically. In the single-segment model, the decrease in angulation between the thoracolumbar spine and pelvis was a good representation of lumbar spine flexion as determined by the mean lumbar intervertebral angular change. Therefore, modelling the thoracolumbar vertebral column as a single segment allowed better estimation of lumbar intervertebral angular change during flexion than a three-segment model. The results indicate that large range dynamic motion of the lumbar vertebral column can be represented using photographic analysis of the positions of three easily identified anatomical landmarks: the anterior superior iliac spine, posterior superior iliac spine and the spinous process of the first thoracic vertebra.     

Lumbar–pelvic range and coordination during lifting tasks

Spine motion has been described to have two regions, a neutral zone where lumbar rotation can occur with little resistance and an elastic zone where structures such as ligaments, facet joints and intervertebral disks resist rotation. In vivo, the passive musculature can contribute to further limiting the functional neutral range of lumbar motion. Movement out of this functional neutral range could potentially put greater loads on these structures. In this study, the range of lumbar curvature rotation was examined in twelve healthy, untrained volunteers at four torso inclination angles. The lumbar curvature during straight-leg lifting tasks was then defined as a percentage of this range of possible lumbar curvatures. Subjects were found to remain neutrally oriented during the flexion phase of a lifting task. During the extension phase of the lifting task, however, subjects were found to assume a more kyphotic posture, approaching the edge of the functional range of motion. This was found to be most pronounced for heavy lifting tasks. By allowing the lumbar curvature to go into a highly kyphotic posture, subjects may be taking advantage of stretch-shortening behavior in extensor musculature and associated tendons to reduce the energy required to raise the torso. Such a kyphotic posture during extension, however, may put excessive loading on the elastic structures of the spine and torso musculature increasing the risk of injury.     

Lumbar lordosis of extinct hominins

The lordotic curvature of the lumbar spine (lumbar lordosis) in humans is a critical component in the ability to achieve upright posture and bipedal gait. Only general estimates of the lordotic angle (LA) of extinct hominins are currently available, most of which are based on the wedging of the vertebral bodies. Recently, a new method for calculating the LA in skeletal material has become available. This method is based on the relationship between the lordotic curvature and the orientation of the inferior articular processes relative to vertebral bodies in the lumbar spines of living primates. Using this relationship, we developed new regression models in order to calculate the LAs in hominins. The new models are based on primate group-means and were used to calculate the LAs in the spines of eight extinct hominins. The results were also compared with the LAs of modern humans and modern nonhuman apes. The lordotic angles of australopithecines (41° ± 4), H. erectus (45°) and fossil H. sapiens (54° ± 14) are similar to those of modern humans (51° ± 11). This analysis confirms the assumption that human-like lordotic curvature was a morphological change that took place during the acquisition of erect posture and bipedalism as the habitual form of locomotion. Neandertals have smaller lordotic angles (LA = 29° ± 4) than modern humans, but higher angles than nonhuman apes (22° ± 3). This suggests possible subtle differences in Neandertal posture and locomotion from that of modern humans.     

Effects of posture on shear rates in human brachial and superficial femoral arteries

Shear rate is significantly lower in the superficial femoral compared with the brachial artery in the supine posture. The relative shear rates in these arteries of subjects in the upright posture (seated and/or standing) are unknown. The purpose of this investigation was to test the hypothesis that upright posture (seated and/or standing) would produce greater shear rates in the superficial femoral compared with the brachial artery. To test this hypothesis, Doppler ultrasound was used to measure mean blood velocity (MBV) and diameter in the brachial and superficial femoral arteries of 21 healthy subjects after being in the supine, seated, and standing postures for 10 min. MBV was significantly higher in the brachial compared with the superficial femoral artery during upright postures. Superficial femoral artery diameter was significantly larger than brachial artery diameter. However, posture had no significant effect on either brachial or superficial femoral artery diameter. The calculated shear rate was significantly greater in the brachial (73 +/- 5, 91 +/- 11, and 97 +/- 13 s(-1)) compared with the superficial femoral (53 +/- 4, 39 +/- 77, and 44 +/- 5 s(-1)) artery in the supine, seated, and standing postures, respectively. Contrary to our hypothesis, our current findings indicate that mean shear rate is lower in the superficial femoral compared with the brachial artery in the supine, seated, and standing postures. These findings of lower shear rates in the superficial femoral artery may be one mechanism for the higher propensity for atherosclerosis in the arteries of the leg than of the arm.     

Experimental optimization of pivot point height for swing-arm type rear suspensions in off-road bicycles

Towards the ultimate goal of designing dual suspension off-road bicycles which decouple the suspension motion from the pedaling action, this study focused on determining experimentally the optimum pivot point height for a swing-arm type rear suspension such that the suspension motion was minimized. Specific objectives were (1) to determine the effect of interaction between the front and rear suspensions on the optimal pivot point height, (2) to investigate the sensitivity of the optimal height to the pedaling mechanics of the rider in both the seated and standing postures, (3) to determine the dependence of the optimal height on the rider posture. Eleven experienced subjects rode a custom-built adjustable dual suspension off-road bicycle, [Needle, S., and Hull, M. L., 1997, "An Off-Road Bicycle With Adjustable Suspension Kinematics," Journal of Mechanical Design 119, pp. 370-375], on an inclined treadmill. The treadmill was set to a constant 6 percent grade at a constant velocity of 24.8 km/hr. With the bicycle in a fixed gear combination of 38 x 14, the corresponding cadence was 84 rpm. For each subject, the pivot point height was varied randomly while the motions across both the front and rear suspension elements were measured. Subjects rode in both the seated and standing postures and with the front suspension active and inactive. It was found that the power loss from the rear suspension at the optimal pivot point height was not significantly dependent on the interaction between the front and rear suspensions. In the seated posture, the optimal pivot point height was 9.8 cm on average and had a range of 8.0-12.3 cm. The average optimal pivot point height for the seated posture corresponded to an average power loss for the rear suspension that was within 10 percent of the minimum power loss for each subject for 8 of the 11 subjects. In the standing posture, the average height was 5.9 cm and ranged from 5.1-7.2 cm. The average heightfor the standing posture was within 10 percent of the minimum power loss for each subject for 9 of the 11 subjects. While the optimum height was relatively insensitive to pedaling mechanics in both the seated and standing postures, the choice of the optimal pivot point height in production bicycles necessitates some compromise in performance given the disparity in the averages between the seated and standing postures.     

Soft tissue displacement over pelvic anatomical landmarks during 3-D hip movements

The position, in a pelvis-embedded anatomical coordinate system, of skin points located over the following anatomical landmarks (AL) was determined while the hip assumed different spatial postures: right and left anterior superior and posterior superior iliac spines, and the sacrum. Postures were selected as occurring during walking and during a flexion–extension and circumduction movement, as used to determine the hip joint centre position (star-arc movement). Five volunteers, characterised by a wide range of body mass indices (22–37), were investigated. Subject-specific MRI pelvis digital bone models were obtained. For each posture, the pose of the pelvis-embedded anatomical coordinate system was determined by registering this bone model with points digitised over bony prominences of the pelvis, using a wand carrying a marker-cluster and stereophotogrammetry. The knowledge of how the position of the skin points varies as a function of the hip posture provided information regarding the soft tissue artefact (STA) that would affect skin markers located over those points during stereophotogrammetric movement analysis. The STA was described in terms of amplitude (relative to the position of the AL during an orthostatic posture), diameter (distance between the positions of the AL which were farthest away from each other), and pelvis orientation. The STA amplitude, exhibited, over all postures, a median [inter-quartile] value of 9[6] and 16[11] mm, for normal and overweight volunteers, respectively. STA diameters were larger for the star-arc than for the walking postures, and the direction was predominantly upwards. Consequent errors in pelvic orientation were in the range 1–9 and 4–11 degrees, for the two groups respectively.     

The effect of postural correction on muscle activation amplitudes recorded from the cervicobrachial region

In clinical practice, postural correction is a common treatment approach for individuals with neck and shoulder pain. As chronic static muscle use is thought to be associated with the onset of some neck and shoulder pain syndromes, it is important to understand the impact a postural correction program might have on muscle activation amplitudes in the neck and shoulder regions. Normalized surface electromyographic data were recorded from the levator scapulae, upper trapezius, supraspinatus, posterior deltoid, masseter, rhomboid major, cervical erector spinae, and sternocleidomastoid muscles of the dominant side of each of eighteen healthy subjects. Subjects performed five repetitions of each of four seated typing postures (habitual, corrected, head-forward and slouched) and four standing postures (habitual, corrected, and head-forward and slouched). Repeated-measures analysis of variance models (α = 0.05) revealed that in sitting postural correction tended to decreased the level of muscle activation required in all muscles studied during seated computer work, however this finding was not statistically significant. Corrected posture in sitting did, however produce a statistically significant reduction in muscle activity compared to forward head posture. Corrected posture in standing required more muscle activity than habitual or forward head posture in the majority of cervicobrachial and jaw muscles, suggesting that a graduated approach to postural correction exercises might be required in order to train the muscles to appropriately withstand the requirements of the task. A surprising finding was that muscle activity levels and postural changes had the largest impact on the masseter muscle, which demonstrated activation levels in the order of 20% maximum voluntary electrical activation.     

Effect of the intra-abdominal pressure and the center of segmental body mass on the lumbar spine mechanics - a computational parametric study

Determination of physiological loads in human lumbar spine is critical for understanding the mechanisms of lumbar diseases and for designing surgical treatments. Computational models have been used widely to estimate the physiological loads of the spine during simulated functional activities. However, various assumptions on physiological factors such as the intra-abdominal pressure (IAP), centers of mass (COMs) of the upper body and lumbar segments, and vertebral centers of rotation (CORs) have been made in modeling techniques. Systematic knowledge of how these assumptions will affect the predicted spinal biomechanics is important for improving the simulation accuracy. In this paper, we developed a 3D subject-specific numerical model of the lumbosacral spine including T12 and 90 muscles. The effects of the IAP magnitude and COMs locations on the COR of each motion segment and on the joint/muscle forces were investigated using a global convergence optimization procedure when the subject was in a weight bearing standing position. The data indicated that the line connecting the CORs showed a smaller curvature than the lordosis of the lumbar spine in standing posture when the IAP was 0?kPa and the COMs were 10?mm anterior to the geometric center of the T12 vertebra. Increasing the IAP from 0 kPa to 10 kPa shifted the location of CORs toward the posterior direction (from 1.4?±?8.9 mm anterior to intervertebral disc (IVD) centers to 40.5?±?3.1 mm posterior to the IVD centers) and reduced the average joint force (from 0.78?±?0.11 Body weight (BW) to 0.31?±?0.07 BW) and overall muscle force (from 349.3?±?57.7 N to 221.5?±?84.2 N). Anterior movement of the COMs from -30 mm to 70 mm relative to the geometric center of T12 vertebra caused an anterior shift of the CORs (from 25.1?±?8.3 mm posterior to IVD centers to 7.8?±?6.2 mm anterior to IVD centers) and increases of average joint forces (from 0.78?±?0.1 BW to 0.93?±?0.1 BW) and muscle force (from 348.9?±?47.7 N to 452.9?±?58.6 N). Therefore, it is important to consider the IAP and correct COMs in order to accurately simulate human spine biomechanics. The method and results of this study could be useful for designing prevention strategies of spinal injuries and recurrences, and for enhancing rehabilitation efficiency.     

Approximate surface development of the left side half-trunk by a free-formed model

The approximate surface development, skin length, and surface area of the left side of the trunk of 51 female students were compared with regard to static and stretched postures. The data for each subject were obtained from geometrical models generated by moiré topography with a computer. When the chest was stretched, the anterior surface, the shoulder line, and the arm-base line were transformed from concave to convex, and a gap oriented toward the nipple widened out. The skin elongated vertically and transversely, except at the side of the waistline, where the skin contracted. The area at the top of the trunk decreased about 25%, while the other parts of the trunk increased 8-15%. The total anterior area was 1.20 m2 for the static posture and 1.29 m2 for the stretched posture. When the posterior surface was stretched, the shoulder line changed from convex to concave, the side line from quasi-straight to concave, and gaps oriented toward the chest line disappeared. The skin elongated most at the infrascapular region (20-35%), while the neck base line contracted (-11%). The center of the back and the lower arm base areas enlarged the most (25%) and the lumbar area enlarged the least (12%). The total posterior area was 1.26 m2 in the static posture and 1.37 m2 in the back-stretched posture. In conclusion, the back skin elongated and enlarged more when stretched than the frontal skin.     

Position sense in the lumbar spine with torso flexion and loading

Proprioception plays an important role in appropriate sensation of spine position, movement, and stability. Previous research has demonstrated that position sense error in the lumbar spine is increased in flexed postures. This study investigated the change in position sense as a function of altered trunk flexion and moment loading independently. Reposition sense of lumbar angle in 17 subjects was assessed. Subjects were trained to assume specified lumbar angles using visual feedback. The ability of the subjects to reproduce this curvature without feedback was then assessed. This procedure was repeated for different torso flexion and moment loading conditions. These measurements demonstrated that position sense error increased significantly with the trunk flexion (40%, p < .05) but did not increase with moment load (p = .13). This increased error with flexion suggests a loss in the ability to appropriately sense and therefore control lumbar posture in flexed tasks. This loss in proprioceptive sense could lead to more variable lifting coordination and a loss in dynamic stability that could increase low back injury risk. This research suggests that it is advisable to avoid work in flexed postures.