Abstract
BackgroundSeveral risk factors exist for the development of low back pain, including prolonged sitting and flexed spinal curvature. Several investigators have studied lumbar support devices and spinal curvatures in sitting, however few have investigated a pain population and reported a quantitative measure of comfort. The purpose of the current project was to determine whether a lumbar support pillow, outfitted with a cut-out to accommodate the bulk of posterior pelvic soft tissue volume, is more effective than a standard chair in promoting a neutral spinal posture and improving subjective and objective measures of comfort in healthy individuals and patients with low back pain.MethodsTwenty eight male participants with and without a history of low back pain sat in a standard office chair and in a chair with the lumbar support pillow for 30 minutes. Lumbar and thoracolumbar postures were measured through electromagnetic markers. Comfort was determined based on the least squares radius of centre of pressure shifting, measured at the buttock-chair interface as well as reported discomfort through visual analog scales. Chair support effects were assessed through ANOVA methods. The study was approved by the Canadian Memorial Chiropractic College research ethics board.ResultsThere was a main effect of condition on lumbar posture (p = 0.006) and thoracolumbar posture (p = 0.014). In the lumbar region, the support and standard chair differed by 2.88° (95% CI; 1.01-4.75), with the lumbar support being closer to neutral than the standard chair. In the thoracolumbar region, the support and standard chair differed by -2.42° (95% CI; -4.22 to -0.62), with the standard chair being closer to neutral than the support device. The centre of pressure measure was significantly improved with the pillow (p = 0.017), however there were no subjective changes in comfort.ConclusionsA lumbar support pillow with a cut-out for the posterior pelvic tissues improved an objective measure of comfort in healthy individuals and patients with low back pain. Lumbar flattening was decreased and thoracolumbar curvature was increased. However, angular changes were small and future work is required to determine clinical relevance over the long term.Trial registrationClinicalTrials.gov, NCT00754585
Highlights
Several risk factors exist for the development of low back pain, including prolonged sitting and flexed spinal curvature
Several risk factors have been identified for the development of low back pain (LBP) in individuals who are required to sit throughout the majority of their work day
Healthy individuals consisted of those who were free of LBP for the six months previous to the study, whereas patients with LBP had a history of LBP for at least three consecutive days over the last three consecutive weeks prior to testing
Summary
Several risk factors exist for the development of low back pain, including prolonged sitting and flexed spinal curvature. The purpose of the current project was to determine whether a lumbar support pillow, outfitted with a cut-out to accommodate the bulk of posterior pelvic soft tissue volume, is more effective than a standard chair in promoting a neutral spinal posture and improving subjective and objective measures of comfort in healthy individuals and patients with low back pain. Several risk factors have been identified for the development of LBP in individuals who are required to sit throughout the majority of their work day. These include prolonged muscle contractions [3,4], vibration [5], and sustained body postures. The seated lumbar pressures may be minimized by maintaining the natural lordotic curvature [8,14]
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