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.     

Comfort evaluation as the example of anthropotechnical furniture design

Human health is becoming an increasingly important issue in contemporary hectic lifestyle imposed at work and by struggle to save time and money. Sitting comfort and quality of chairs which we use for the most of our time have, thus, become essential for healthy lifestyle. Sitting discomforts arise from prolonged sitting on the inappropriate chairs, which failing to provide sufficient support to the body cause discomfort and tiring. The studies of the office chair constructions have identified differences in perception of comfort provided by different types of seats. Four seat constructions and the comfort they provide to the sitters were compared by means of subjective indicators. After a two-day sitting on each of the studied chairs the subjects scored their perception of comfort and discomfort, using the questionnaire with 17 statements. Constructional forms and materials which contributed more to the sense of comfort by minimizing fatigue and pains developed by sitting were determined.     

Sitting versus standing: Does the intradiscal pressure cause disc degeneration or low back pain?

Studies of lumbar intradiscal pressure (IDP) in standing and upright sitting have mostly reported higher pressures in sitting. It was assumed clinically that flexion of the lumbar spine in sitting relative to standing, caused higher IDP, disc degeneration or rupture, and low back pain. IDP indicates axial compressive load upon a non-degenerate disc, but provides little or no indication of shear, axial rotation or bending. This review is presented in two main parts. First, in vivo IDP data in standing and upright sitting for non-degenerate discs are comprehensively reviewed. As methodology, results and interpretations varied between IDP studies, in vivo studies measuring spinal shrinkage and spinal internal-fixator loads to infer axial compressive load to the discs are also reviewed. When data are considered together, it is clear that IDP is often similar in standing and sitting. Secondly, clinical assumptions related to IDP in sitting are considered in light of basic and epidemiologic studies. Current studies indicate that IDP in sitting is unlikely to pose a threat to non-degenerate discs, and sitting is no worse than standing for disc degeneration or low back pain incidence. If sitting is a greater threat for development of low back pain than standing, the mechanism is unlikely to be raised IDP.     

Renal sympathetic nerve activity and arterial pressure responses to changes in postural position of conscious dogs

Experiments were conducted in conscious dogs to determine the relationships between postural position, arterial pressure, and renal sympathetic nerve activity. Observations of the changes in arterial pressure and renal nerve activity were made when animals spontaneously changed postural position from lying to sitting, sitting to standing, standing to sitting, and sitting to lying. Rising to sit from lying down increased arterial pressure from 109 +/- 5 to 125 +/- 3 mm Hg and increased renal nerve activity by 96 +/- 58 microV/sec (61% of control). Movement from the sitting to standing position decreased renal nerve activity by 90 +/- 39 microV/sec (48% of control) without changing mean arterial pressure. Sitting down from standing also did not change arterial pressure, whereas renal nerve activity increased by 56 +/- 17 microV/sec (33% of control). Returning to the lying position (from sitting) decreased arterial pressure, and this hypotension was associated with significant reductions in renal nerve activity. These results indicate that nonuniform changes in sympathetic outflow from the central nervous system must occur to various vascular beds during changes in postural position of conscious dogs. Thus, renal sympathetic outflow may or may not reflect changes in nerve traffic which contribute to alterations in arterial pressure.     

Lumbar posture and muscular activity while sitting during office work

PurposeField study, cross-sectional study to measure the posture and sEMG of the lumbar spine during office work for a better understanding of the lumbar spine within such conditions.ScopeThere is high incidence of low back pain in office workers. Currently there is little information about lumbar posture and the activity of lumbar muscles during extended office work.MethodsThirteen volunteers were examined for around 2 h of their normal office work. Typical tasks were documented and synchronised to a portable long term measuring device for sEMG and posture examination. The correlation of lumbar spine posture and sEMG was tested statistically.ResultsThe majority of time spent in office work was sedentary (82%). Only 5% of the measured time was undertaken in erect body position (standing or walking). The sEMG of the lumbar muscles under investigation was task dependent. A strong relation to lumbar spine posture was found within each task. The more the lumbar spine was flexed, the less there was activation of lumbar muscles (P < .01). Periods of very low or no activation of lumbar muscles accounted for about 30% of relaxed sitting postures.ConclusionBecause of very low activation of lumbar muscles while sitting, the load is transmitted by passive structures like ligaments and intervertebral discs. Due to the viscoelasticity of passive structures and low activation of lumbar muscles, the lumbar spine may incline into de-conditioning. This may be a reason for low back pain.     

Differential joint coordination in the tasks of standing up and sitting down

We studied similarities and differences in the use of goal-equivalent patterns of joint coordination to stand up and sit down from different support surfaces, performed without vision. Sagittal plane motion of major body segments was measured and joint angles for the left upper and lower extremities and the trunk were calculated. We used a modeling strategy relating motion in the redundant space of the joints to motion of individual performance variables, such as the center of mass (CM) or head, and determined how the variability of joint combinations across trials was structured; i.e. variations in joint combinations leading to a consistent value of a performance variable (goal-equivalent variability) and variations resulting in variability of the performance variable (non goal-equivalent variability). We found the variability of joint combinations to be selectively channeled into goal-equivalent directions, leading to stable horizontal motion of the CM and of the head, during both standing up and sitting down. In contrast, when evaluating the effect of joint combination variability on the control of vertical CM motion, we found differences in the variability components between standing up and sitting down. In general, more variable vertical CM motion occurred. An important finding was an enhanced use of goal-equivalent joint combinations under challenging task conditions, whether standing up or sitting down.     

Simulating the response of a standing operator to vibration stress by means of a biomechanical model

Under vibration stress the compressive forces transmitted in the joints of a standing operator are composed of nearly static and oscillating force parts. Because these forces can hardly be measured they were assessed by means of a biomechanical model. In the model, 27 rigid bodies with 103 degrees of freedom represent the segments of the human body. 106 force elements imitate the muscles of the trunk and the legs. At first, the model parameter were varied so that for the simulated sitting posture the model fits the seat-to-head transmissibility given in the literature and in ISO/CD 5982. For the standing posture, the transfer functions between the ground acceleration and the oscillating forces in the ankle, the knee, the hip, and the motion segment L3-L4 were computed. According to the moduli of these functions the forces in the ankles are higher than those in the knees or the hips and they nearly come up to the forces in the lumbar spine. Further the results of the simulation indicate that under equal vibration stress in the standing and the sitting posture the differences between the compressive forces in the lumbar spine are small.     

Responsiveness of the H reflex to loading and posture in patients following stroke

The objective of the research was to examine the effects of loading and posture on motoneuronal excitability of the triceps surae (TS) for patients with hemiplegia. Twelve healthy subjects and 12 patient subjects with post-stroke hemiparesis (onset period: 3–60 months) were enrolled in this study. The subjects were instructed to remain in quiet sitting with the test knee straight and three standing conditions of different superincumbent loads by shifting body weight to the test leg (10%, 50%, and 90% of body weight), while the H reflexes and M waves of the TS were measured. The results clearly indicated that H reflex amplitudes were not affected by different loading conditions in standing for both healthy subjects and patients who had a previous stroke. In addition, the H reflex amplitude in quiet standing for healthy subjects was significantly downward modulated relative to that in relaxed sitting with the test knee straight, but this posturally driven modulation was impaired in patients following stroke. Current electrophysiological findings imply that body weight as a means for rehabilitation facilitation had little immediate effect on paretic TS, and absence in postural gating of reflex excitability appeared to be an incentive for postural instability resulting from post-stroke hemiparesis.     

Wear Testing of Moderate Activities of Daily Living Using In Vivo Measured Knee Joint Loading

Resumption of daily living activities is a basic expectation for patients provided with total knee replacements. However, there is a lack of knowledge regarding the impact of different activities on the wear performance. In this study the wear performance under application of different daily activities has been analyzed. In vivo load data for walking, walking downstairs/upstairs, sitting down/standing up, and cycling (50 W & 120 W) has been standardized for wear testing. Wear testing of each activity was carried out on a knee wear simulator. Additionally, ISO walking was tested for reasons of comparison. Wear was assessed gravimetrically and wear particles were analyzed. In vivo walking produced the highest overall wear rates, which were determined to be three times higher than ISO walking. Moderate wear rates were determined for walking upstairs and downstairs. Low wear rates were determined for standing up/sitting down and cycling at power levels of 50 W and 120 W. The largest wear particles were observed for cycling. Walking based on in vivo data has been shown to be the most wear-relevant activity. Highly demanding activities (stair climbing) produced considerably less wear. Taking into account the expected number of loads, low-impact activities like cycling may have a greater impact on articular wear than highly demanding activities.     

The response of the seated human to sinusoidal vibration and impact

Low back pain has been shown to occur more frequently among vehicle drivers than in representative control groups. Thus the response of the human to vibration and impact is of interest. This study investigated the response of the spine to both impact and sinusoidal excitation in either a relaxed or erect seated posture. The sinusoidal testing apparatus used was a resonating system consisting of two parallel wooden beams, simply supported, and the impact testing apparatus a bearing-guided, spring-suspended platform, struck from below. Ten subjects (5 males, 5 females) were evaluated using both methods. Transfer functions were compared at 2-4 Hz, 4-8 Hz and 8-16 Hz intervals using a sign test. Although in 24 comparisons of either test method (vibration or impact) or posture (erect or relaxed) where eleven showed differences significant at the p less than .05 level, only 2 out of 24 comparisons were the differences distinct enough to be significant (at the p less than .01 level). Both of these latter differences were due to test method while the subjects were sitting erect. In those instances where there were no significant differences due to test method, the impact method may be a viable replacement for the vibration test method. Where the levels of significance are higher (p less than .01 or p less than .05), further study of the magnitude of the differences is indicated and may reveal further insight into the seated individual as a system.     

Analysis of standing up and sitting down in humans: definitions and normative data presentation

A formal definition of human standing up and sitting down movements based on sagittal plane goniometric and force plate data from 20 normal subjects is presented. This definition is comparable to the established gait cycle diagram, and consists of defined characteristic events and relative time intervals between them. The characteristic events are selected primarily on changes in ground reaction forces. The terminology proposed may be valuable for introducing more formalized and standardized reporting of both qualitative and quantitative studies in both normals and in patients. This presentation is directed toward the process of defining generally acceptable standards for human standing up and sitting down movements.     

Transient pain developers show increased abdominal muscle activity during prolonged sitting

BackgroundSitting is a commonly adopted posture during work and prolonged exposures may have detrimental effects. Little attention has been paid to the thoracic spine and/or multiple axes of motion during prolonged sitting. Accordingly, this study examined three-dimensional motion and muscle activity of the trunk during two hours of uninterrupted sitting.MethodsTen asymptomatic males sat during a simulated office task. Kinematics were analyzed from six segments (Neck, Upper-, Mid-, and Lower-thoracic, Lumbar, and Pelvis) and electromyography was recorded from eight muscles bilaterally.ResultsFour participants developed transient pain. These participants showed higher average muscle activations in the abdominal muscles. Additionally, the non-pain group showed less lateral bend positional change in the mid-thoracic region compared to the upper- and lower-thoracic regions. Weak-to-moderate positive correlations were also found between rated pain and low back muscle activation.DiscussionThe results provided further evidence of reduced movement in non-pain developers and altered muscle activation patterns in pain developers. Low-level, prolonged static contractions could lead to an increased risk of injury; and though the increased abdominal activity in the pain developers was not directly associated with increased rated pain scores, this could indicate a pre-disposition to, or enhancer of, transient pain development.     

人体坐下站起过程中平衡功能评估及训练系统软件的设计与实现

本研究针对脑卒中偏瘫患者的平衡功能定量评估的需求,设计一种针对坐下站起过程中各阶段平衡功能评估及训练的系统软件,该软件配合坐位站起平衡功能训练仪使用。软件采用面向对象编程技术,应用VS2010(Microsoft Visual Studio2010)开发平台编写,可实时获得人体在坐下站起过程中的各评估参数,包括左右臀前后最大压力、左右足底平均压力、伸展期时间、伸展前期时间、左右侧最大和平均压力及站起时的最大加速度等。结合图形和数字实时显示及虚拟现实技术,对人体坐下站起的各阶段进行平衡功能评估和训练,通过视觉、听觉反馈,使训练更具趣味性。经过测试应用,结果表明,该系统软件运行稳定可靠,具有针对性的评估并结合实时可观测的压力曲线及大量的评估参数,可使评估结果更快速更有效。     

Three-dimensional spine kinematics during multidirectional,target-directed trunk movement in sitting

The current study provides a quantitative assessment of three-dimensional spine motion during target-directed trunk movements in sitting. Subjects sat on an elevated surface, without foot support, and targets were placed in five directions, at three subject-specific distances (based on trunk height). Subjects were asked to lean toward the target, touch it with their head, and return to upright sitting. A retro-reflective motion analysis system was used to measure spine motion, using three kinematic trunk models (1, 3 and 7 segments). Significant differences were noted in the total trunk motion measured between the models, as well as between target distances and directions. In the most segmented model, inter-segmental trunk motion was also found to differ between trunk levels, with complex interaction effects involving target distance and direction. These findings suggest that inter-segmental spine motion is complex, task dependent, and often unevenly distributed between spine levels, with motion patterns differing between subjects, even in the absence of pathology. Use of a multi-segmental model provides the most interpretable findings, allowing for differentiation of individual motion patterns of the spine. Such an approach may be beneficial to the understanding of movement-related spine pathologies.     

Hemodynamic responses during prolonged sitting

Eight young men (group A) underwent 5 h of quiet sitting, preceded by 30 min of recumbency, 20 min of standing, and 20 s of walking, and five other young men (group B) underwent 70 min of sitting, preceded by recumbency only, to determine the effects of prolonged sitting and previous posture on hemodynamic responses (measured by impedance plethysmography). Group A showed more calf blood pooling and a decrease in thigh blood flow during sitting in comparison with the control group, but after 1 h of sitting hemodynamic responses of the two groups were similar. Sitting for 5 h (1st vs. 5th h) resulted in an increase in calf venous pooling (17%) and a decrease in calf BF (13%), a reduction in gravitational pooling in the thigh (corresponding to increased pooling in the calf), increases in diastolic and mean arterial pressures (6 and 7.3 mmHg, respectively), and minor changes in heart rate, stroke volume, and cardiac output. The results show that it is necessary to sit for 1 h before hemodynamic responses can be assessed in this position, regardless of the posture maintained previously. The main effect of prolonged sitting is pooling in the calf, which is compensated for by an increase in peripheral resistance.     

The role of trunk muscles in sitting balance control in people with low back pain

The purpose of this study was to examine the muscular activities and kinetics of the trunk during unstable sitting in healthy and LBP subjects. Thirty-one healthy subjects and twenty-three LBP subjects were recruited. They were sat on a custom-made chair mounted on a force plate. Each subject was asked to regain balance after the chair was tilted backward at 20°, and then released. The motions of the trunk and trunk muscle activity were examined. The internal muscle moment and power at the hip and lumbar spine joints were calculated using the force plate and motion data. No significant differences were found in muscle moment and power between healthy and LBP subjects (p > 0.05). The duration of contraction of various trunk muscles and co-contraction were significantly longer in the LBP subjects (p < 0.05) when compared to healthy subjects, and the reaction times of the muscles were also significantly reduced in LBP subjects (p < 0.05). LBP subjects altered their muscle strategies to maintain balance during unstable sitting, but these active mechanisms appear to be effective as trunk balance was not compromised and the internal moment pattern remained similar. The changes in muscle strategies may be the causes of LBP or the result of LBP with an attempt to protect the spine.     

Influence of high ambient temperatures on the physiological responses and body sway in healthy young adults after quickly standing

This study was aimed to compare the variations in cerebral oxygenation, blood pressure and center-of-foot pressure after standing from sitting and supine positions at normal (22 degrees C) and high (32 degrees C) room temperatures. Thirty young adults stood up from a resting posture (sitting or supine position) and kept the static standing posture for 90 sec. Meanwhile, their center-of-foot pressure (COP), blood pressure, and cerebral oxygenation kinetics were measured in continuity. The change of the frequency domain low-to-high frequency (LF/HF) ratio of the R-R interval before and after standing from a supine position was significantly higher than that from a sitting position under both temperature conditions. Blood pressure as well as total and oxygenated hemoglobin levels decreased immediately after standing up and the ratio of blood pressure change when moving from a supine position to standing at high room temperature was the largest as compared with the other conditions. Total hemoglobin (Hb) volume was found to temporarily decrease after standing and required 22-24 sec to recover when the subject started from the sitting position and 33-36 sec when the subject started from the supine position. Cerebral oxygenation kinetics tended to be larger under high, rather than normal, temperature conditions. All COP parameters after standing were significantly larger in the high temperature condition than in the normal temperature condition. Body sway after standing was larger in the high temperature condition than in the normal temperature condition and after standing from a supine position than from a sitting position. In conclusion, cerebral oxygenation kinetics and blood pressure measured after the subject moved to the standing position changed dramatically under high temperature conditions, and variations in this parameter may influence body sway.     

Mobile Phone Use Behaviors and Postures on Public Transportation Systems

Mobile phones are common in our daily life, but the users’ preferences for postures or screen operating styles have not been studied. This was a cross-sectional and observational study. We randomly sampled passengers who used mobile phones on the Mass Rapid Transit (MRT) system in metropolitan Taipei. A checklist was used to observe their body postures and screen operating styles while sitting or standing. As a result, 1,230 subjects from 400 trips were observed. Overall, of all the passengers who were sitting, 41% of them were using mobile phones. The majority of the tasks involved browsing (84%) with their phones in a portrait orientation (93%). Different-hand holding/operating was the most commonly used operating style while sitting (46%) and same-hand holding/operating was the most common while standing (46%). The distribution of screen operating styles was significantly different for those sitting than for those standing and for different genders and age groups. The most frequently observed postures while sitting were having one’s trunk against a backrest, feet on the floor and with or without an arm supported (58%). As for the users who were standing, the both- and different-hands groups had a high proportion of arms unsupported, feet on the floor and either their trunk supported or not. In contrast, the same-hand group tended to have their trunk unsupported, were holding a pole or handstrap and had both feet on floor. Further studies are warranted to characterize the ergonomic exposure of these commonly used postures and operating styles, and our results will help guide the selection of experimental conditions for laboratory settings.     

Effect of dentures wearing on motor reaction time and balance function in elderly people

OBJECTIVE: To investigate the influence of dentures wearing on the parameters of physical fitness, particularly on agility and balance function in elderly people. DESIGN: A case control study.Setting: Motohachiohjimachi, Hachiohji, Tokyo, Japan. METHODS: Motor reaction time was measured in the presence and absence of dentures in the subjects who were 1) in a sitting position and lifted the lower limbs as fast as possible in response to a stimulus (Sitting Group) and those who were 2) in a standing position and jumped upright as fast as possible in response to a light stimulus (Jumping Group). The effects of dentures wearing on balance function were investigated by comparing the measured values of static and dynamic body sway. RESULTS AND CONCLUSIONS: Light-reaction time was not significantly influenced by dentures wearing in Sitting Group performing a light body movement that required little muscular force.In a relatively heavy body movement that required agility (i.e., jumping from the standing position), the reactivity changed depending on the muscular force; which might result in the difference of the reactivity due to dentures wearing (i.e., t-test showed a significant difference in the light-reaction time under clenching posture between with and without wearing dentures (p < 0.01)).No significant difference was observed in body sway under clenching posture between with and without wearing dentures.Therefore, we assumed that reaction speed varied depending upon dentures wearing.     

Seated whole body vibrations with high-magnitude accelerations--relative roles of inertia and muscle forces

Reliable computation of spinal loads and trunk stability under whole body vibrations with high acceleration contents requires accurate estimation of trunk muscle activities that are often overlooked in existing biodynamic models. A finite element model of the spine that accounts for nonlinear load- and direction-dependent properties of lumbar segments, complex geometry and musculature of the spine, and dynamic characteristics of the trunk was used in our iterative kinematics-driven approach to predict trunk biodynamics in measured vehicle's seat vibrations with shock contents of about 4g (g: gravity acceleration of 9.8m/s(2)) at frequencies of about 4 and 20Hz. Muscle forces, spinal loads and trunk stability were evaluated for two lumbar postures (erect and flexed) with and without coactivity in abdominal muscles. Estimated peak spinal loads were substantially larger under 4Hz excitation frequency as compared to 20Hz with the contribution of muscle forces exceeding that of inertial forces. Flattening of the lumbar lordosis from an erect to a flexed posture and antagonistic coactivity in abdominal muscles, both noticeably increased forces on the spine while substantially improving trunk stability. Our predictions clearly demonstrated the significant role of muscles in trunk biodynamics and associated risk of back injuries. High-magnitude accelerations in seat vibration, especially at near-resonant frequency, expose the vertebral column to large forces and high risk of injury by significantly increasing muscle activities in response to equilibrium and stability demands.