Spinal Posture Research Articles

Development of an Automatic Air-Driven 3D-Printed Spinal Posture Corrector

Billions of people are using smartphones and computers with poor posture. A careless attitude towards spinal posture could be dangerous for long-term spinal health, leading eventually to curvature of the spine. Ignoring this fact and its treatment at the early stage will significantly deteriorate spinal health and force surgical intervention. Instead of developing an automated posture-correcting system, the existing research mostly focused on a posture-monitoring system to inform the users via a human interface, e.g., Bluetooth-based devices. Therefore, this paper proposes a novel posture-correction method to automatically prevent spinal disease by facilitating proper posture habits. Specifically, we develop a fluid-driven wearable posture corrector, whose skeleton can be fabricated simply using a 3D printer, to estimate angular posture deviation using sensors and provide appropriate assistance to correct the posture habit of the user. Mounted sensors provide the degree of postural bending, and a controller regulates the appropriate signals to provide a friendly pulling force as a reminder to the user through a fluid-driven actuator. The skeleton with a fluid-driven tool is designed to mimic the motion of the spinal posture by activating the actuator, which injects (or releases) the fluid into (or from) the skeleton frame and regulates forces to reduce the angular deviation of the skeleton. The 3D-printed skeleton with a flexible rubber tube has been experimentally evaluated to ensure proper actuating mechanism through the adjustment of air pressure. It is found that, by applying air pressure in the range of 0 to 101.4 kPa, the skeleton is pulled back approximately 1 N to 7 N forces, minimizing the angle up to 12.44∘ with respect to the initial steady stage, which leads to a maximum posture correction of 32.55% angle (θ) of poor posture. From the above experiments, we ensure the functionality of the proposed posture corrector in producing backward forces to correct the posture automatically.

The effect of upper limb lymphedema in posture of patients after breast cancer surgery.

Upper limb lymphedema is one of the complications following breast cancer-related surgery. It is a fact that there are alterations in posture of the trunk following surgery, however, there is not much data on whether upper limb lymphedema has any effect on body posture. The main purpose of the study was to investigate the effect of upper limb lymphedema in the trunk posture and spine mobility of patients following breast cancer surgery. Twenty-seven women with lymphedema and 29 women without lymphedema with mastectomy or breast-conserving surgery participated in the study. Posture was evaluated by the New York Posture Rating Chart and spinal stability and thoracic mobility were evaluated by the Spinal Mouse device. Posture and spine posture scores were significantly higher in the without lymphedema group (p= 0.004; 0.041; respectively). There was a significant difference between the groups in terms of lateral (p< 0.001) and posterior (p< 0.001) view of shoulders, spine (p= 0.027), upper (p< 0.001) and lower back (p= 0.009), and trunk postures (p= 0.001). Body posture and spine are more affected due to upper limb lymphedema following breast cancer surgery. Alterations of posture mainly occur on shoulders, spine, upper and lower back, and trunk, but not on head and neck postures.

The impact of lumbosacral alignment on lumbar mobility, functional disability and psychological wellbeing in office workers with chronic low back pain

Background/aims The lumbosacral curvature of the spine has a special role in its mobility during weight-bearing activities. Office work is a sedentary role, which requires sitting for long durations, having a negative effect on spinal posture. Therefore, low back pain risk factors in office workers are different from other populations. The aim of this study was to examine the effect of lumbosacral joint angle on the lumbar mobility, functional disability, pain intensity and overall health in office workers with chronic low back pain. Methods A total of 116 male office workers with chronic low back pain (aged between 30–59 years) participated in this cross-sectional study. The lumbosacral radiography was used to divide the participants into two groups, according to the value of their lumbosacral joint angle: group A (lumbosacral joint angle &lt;20°, n=61) and group B (lumbosacral joint angle group &gt;20°, n=55). The lumbar mobility, functional disability, pain intensity and overall health issues of participants were measured. Results The functional disability and pain intensity of individuals in group A were significantly higher than group B (P&lt;0.05). There was a significant decrease in the lumbar flexion and extension range of motion and activities of daily living of those in group A compared to group B (P&lt;0.05). There was a significant increase in emotional health problems and impaired social activity of individuals in group A compared to group B (P&lt;0.05). There were fair positive correlations between lumbosacral joint angle values and functional disability, pain intensity and social activity in office workers in group B (r=0.292, 0.036, 0.333 respectively). Conclusions A decreased lumbosacral joint angle increases functional disability and pain intensity, decreasing lumbar mobility and level of functionality. Furthermore, it reduces emotional health and social activity in participants with low back pain. Therefore, measuring the lumbosacral joint angle of patients with chronic low back pain during treatment may be useful to decrease their pain intensity and improve their functional disability and quality of life.

ERGONOMICS IN OPHTHALMOLOGY PRACTICE: CROSS-SECTIONAL SURVEY AMONG PAKISTANI OPHTHALMOLOGISTS

OBJECTIVE: To assess the ergonomic practices and prevalence of musculoskeletal symptoms among Pakistani ophthalmologists. METHODS: This cross-sectional questionnaire-based study was conducted at College of Ophthalmology and Allied Vision Sciences/Eye Unit III (King Edward Medical University), Lahore, Pakistan from 01-03-2021 to 31-08-2021. A web-based close ended questionnaire (Google form) was developed consisting of questions related to posture in out-patient and operating room in addition to questions related to musculoskeletal symptoms, their effect on routine practice, management. Questionnaire was circulated via a social media application (WhatsApp) to ophthalmologists across Pakistan. Ophthalmologists at various levels of healthcare were included in study. One hundred and seven ophthalmologists consented to part of study and recorded their responses in questionnaire which were then evaluated. RESULTS: Twenty (18.7%) of the participants were diagnosed as having musculoskeletal disorders. Lower back pain was the main symptom in 39 (36.4%) survey responders while 38 (35.5%) of them reported decreased clinical productivity owing to symptoms. Twenty-five (23.36%) participants had to modify their OPD activity owing to development of musculoskeletal symptoms (p&lt;0.01). Majority of those diagnosed with musculoskeletal symptoms adopted neutral spine postures (ergonomically safe) during work hours as compared to those who were not diagnosed with similar disease (p&gt;0.05). Participants who spent ≥6 hours in operation theatre at a stretch were more prone to develop musculoskeletal symptoms (p=0.013). CONCLUSION: Majority of participants experienced musculoskeletal symptoms related to work necessitating the need for change in work place practices focusing on maintaining a neutral spine posture.

Movement posture and injury pattern of pelvis-lumbar spine of seated human impacted by the vertical high loads: a finite element analysis

The injury conditions of the sitting position occupant inside the military equipment are highly related to the vertical impact environments. In this study, a detailed three-dimensional finite element (FE) model of pelvis-lumbar spine of seated human with nonlinear material property and strain failure criterion was developed and validated. A series of sinusoidal accelerations with a constant peak speed of 8 m/s and frequencies ranging from 10 Hz to 90 Hz were loaded on the FE model to investigate the injury conditions under different high loading rates. The results indicated that the injury patterns mainly include wedge fracture of the junction between lumbar spine and pelvis, and comminuted fracture of ischial tuberosity. The bending moment caused by the large angle deflection of pelvis under 10 Hz case (low rate) and the acting force caused by the excessive curvature of lumbar spine under 30 Hz–70 Hz cases (medium and high rate) cause the junction wedge fractured, while the high impact force under 30 Hz–50 Hz cases (medium rate) leads to comminuted fracture of the ischial tuberosity. The associated mechanism that the shorter the time interval between the peak of seat loading speed and the peak of hip muscle compression, the more serious dynamic responses of pelvis-lumbar spine is revealed for the first time.

Determination of the 3D Human Spine Posture from Wearable Inertial Sensors and a Multibody Model of the Spine.

Determination of spine posture is of great interest for the effective prevention, evaluation, treatment and evolution monitoring of spinal disorders. Limitations of traditional imaging systems, including cost, radiation exposure (for X-ray based systems), projection volume issues and subject positioning requirements, etc., make non-invasive motion assessment tools effective alternatives for clinical and non-clinical use. In this work, a procedure was developed to obtain a subject-specific multibody model of the spine using either inertial or optical sensors and, based on this multibody model, to estimate the locations and orientations of the 17 vertebrae constituting the thoracolumbar spine. The number and calibration of the sensors, angular offsets, scaling difficulties and gender differences were addressed to achieve an accurate 3D-representation of the spine. The approach was validated by comparing the estimated positions of the sensors on 14 healthy subjects with those provided by an optical motion capture system. A mean position error of lower than 12 mm was obtained, thus showing that the proposed method can offer an effective non-invasive tool for the assessment of spine posture.

Functional outcomes of poor ergonomic posture in university workers

&lt;p&gt;&lt;strong&gt;Background and Objectives:&lt;/strong&gt; Work-related musculoskeletal disorders are increasing due to poor posture adaptation. Increasing the use of technologies in the office settings is one of the main reasons behind muscle and soft tissue strains. The objective of the study was to determine the pattern of posture-related musculoskeletal pain in office workers.&lt;br /&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This observational study was conducted from 15th May, to 25th June, 2021. Data were collected by convenient sampling. The Nordic Musculoskeletal questionnaire on body postural habits was filled by 150 office workers from different universities of Lahore. Statistical Package for the Social Sciences software version 25 was used for statistical analysis.&lt;br /&gt;&lt;strong&gt;Results:&lt;/strong&gt; There were 79 (52.7%) male and 71 (43.7%) female participants, with a mean age of 35.7 &amp;plusmn; 5.14 years. Majority (51.3%) of the subjects reported sitting tilted forward, while a few used backrests and footrests for support. Prolonged crossed legs and twisted spine posture were also adopted by many subjects. Neck, lower back, and shoulder were the most affected regions, with increased musculoskeletal pain reported over the last 12 months. Due to recurrent pain in the neck, shoulder, and upper back, difficulty in carrying out routine jobs, housework, and hobbies was reported by 38.7%, 34.7%, and 30% of the subjects, respectively.&lt;br /&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Failure to adopt a good ergonomic approach leads to frequent musculoskeletal pain and difficulty in carrying out routine office and household work.&lt;/p&gt;

인체공학적 좌석이 척추와 골반 자세에 미치는 영향에 대한 생체역학적 비교연구: 원추형 진자 스툴과 반강성 유연 등받이 의자

The most common health problem caused by long-term sitting lifestyle and degenerative changes due to aging was changes in spinal pelvic posture. Sitting posture was a more complex phenomenon because it follows a change in posture. The most common working environment occurs in working with your body tilted back from a chair with a backrest. While sitting down and working, the movement of the seat plate was restricted which result in stiff lumbar spine and pelvic muscles to become stiff that eventually causes fatigue, pain and pathological posture changes. The aim of this study was to analyze the biomechanical changes and effects by evaluating and measuring the changes in spino-pelvic posture including muscle tension in sitting posture according to the type of seat used. Two different type of ergonomic seats, such as conical pendulum stool (CPS) and semirigid flexible backrest chair (SFBC), were used in a total of 17 participants. Among two types of sitting, seat-buttock contact pressure and radiographic changes of coronal trunk imbalance distance (Gravitiy line/Hip axis distance), pelvic and shoulder height differences on the seats were measured and statistically analyzed using partied t-test. The seat-buttock contact pressure reduced from 51.13 ± 32.77 Ω and 59.13 ± 39.62 Ω on initial seated to 38.57 ± 25.61 Ω and 49.37 ± 29.22 Ω on 1hr seated on CPS and SFBC, respectively (p=0.486, p=0.332). Radiographically, changes in pelvic height differed statistically significantly between two sitting types of CPS versus SFBC (average of 2.12 + 2.61 mm versus 4.29 + 4.04 mm, respectively with one hour seating, p=0.008). Improvement in shoulder height difference was statistically significant (average of 8.27 + 6.28 mm to 5.37 + 6.06 mm using CPS from initial to one hour sitting, p=0.038). CPS seating showed better biomechanical effect in reducing the imbalance between pelvic height and shoulder height through the stimulating dynamic control of spinal stability and equilibrium by activation of the upper and lower back core muscles than static ergonomic seat.

Defining the lumbar and trunk-thigh neutral zone from the passive stiffness curve: application to hybrid sit-stand postures and chair design

Minimal data exist on the neutral position for the lumbar spine, trunk, and thighs when adopting a hybrid posture. This study examined sex differences in the neutral zone lumbar stiffness and the lumbar and trunk-thigh angle boundaries of the neutral zone, and determined if the standing lumbar angle fell within the neutral zone. Passive lumbar flexion and extension moment-angle curves were generated for 31 participants (13 M, 18 F), pooled from two datasets, with trunk-thigh angles available for 10 participants. The neutral zone was defined as the low stiffness zone from both the flexion and extension curves. Males demonstrated significantly greater extensor stiffness. Neutral lumbar and trunk-thigh angles ranged on average −22.2 to 0.2° and 124.2 to 159.6° for males and −17.8 to −1.3° and 143.2 to 159.5° for females, respectively. Standing lumbar angles fell outside the neutral zone for 44% of participants. These neutral zone boundaries may inform kinematics for hybrid chair designs. Practitioner summary: Adoption of a neutral spinal posture may be achieved through hybrid chair design, yet minimal data exists on a physiologically defined neutral zone. Using measures of in vivo lumbar stiffness, the lumbar and trunk-thigh angular boundaries of the neutral zone were defined for both males and females. Abbreviations: EMG: electromyography; MVC: maximal voluntary contraction

The immediate effect of simulating leg-length discrepancy on spinal posture and pelvic position: a cross-over designed study

ABSTRACT Leg-length discrepancy (LLD) is a common condition that may cause posture changes and clinical consequences. Rasterstereography is a valid and reliable method that analyzes posture without radiation exposure and invasive procedures. This study aimed to assess the immediate effect of artificial LLD on pelvic position and spinal posture in athletes. Twenty-four elite karate athletes (14 men, 10 women) were included in the study. Sagittal imbalance, coronal imbalance, pelvic obliquity, pelvic torsion angle, thoracic kyphosis angle and lumbar lordosis angle were measured at different artificial LLD heights (5 –10 –15 –20 mm). Statistical analysis was performed with One-Way ANOVA with repeated measures or Friedman test. In cases where there were significant differences, pairwise comparisons were performed with least significant differences (LSD) test or Wilcoxon signed rank test. There were statistically significant differences in pelvic obliquity (p = 0.001), pelvic torsion (p = 0.001) and lumbar lordosis (p = 0.001) with varying LLD. However, there was no significant difference in sagittal imbalance, coronal imbalance and thoracic kyphosis angle. It has been observed that even a 5-mm LLD causes pelvic position and spinal posture changes. Future studies detecting these changes in populations with LLD via rastersterography may prevent possible musculoskeletal disorders.

Detection of cognitive decline by spinal posture assessment in health exams of the general older population

The recent increase in the older adult population has led to a higher prevalence of cognitive impairment, which is often overlooked in routine health examinations. Citizens aged 50–89 years were targeted for this cohort survey by random sampling from the resident registry of a cooperating town in 2014. A total of 411 participants (202 male and 209 female) were enrolled. We analyzed the distribution of cognitive function test scores as determined by Montreal Cognitive Assessment and Mini-Mental State Examination tests in each age (50’s, 60’s, 70’s and 80’s) and sex group to examine whether cognitive decline could be detected by sagittal spinal balance measurement based on a radiological approach. Sagittal spinal balance was quantitatively measured as sagittal vertical axis (SVA). We observed significant associations for higher age and/or SVA anteriorization with lower cognitive function. In males, spinal balance anteriorization was associated with cognitive decline independently of age, with combinations of age and SVA also making valid cognitive decline determinations; male cases of SVA ≥ 100 mm at any age, SVA ≥ 90 mm at ≥ 70 years, and SVA ≥ 70 mm at ≥ 80 years were all more likely to have cognitive decline than cases below those values. For females, cognitive decline was more likely in cases of SVA ≥ 70 mm, regardless of age. Thus, spinal balance anteriorization can be regarded as an easily visible indicator of latent cognitive decline in community-dwelling older people.

Spine Posture, Mobility, and Stability of Top Mobile Esports Athletes: A Case Series.

Simple SummaryProfessional mobile esports athletes may suffer from occupational health risks to their spine because of prolonged sitting with poor posture. The aim of this study is to examine whether esports athletes have poor spine posture, mobility, and stability. Our results showed that professional mobile esports athletes had significantly poorer spine posture, and weaker spine mobility and stability than non-athletes. They may be more susceptible than non-athletes to spine-related musculoskeletal problems, such as back pain or neck pain. Physical-training programs and other ergonomic considerations should be sought to mitigate the risk of musculoskeletal problems and potential injuries for the athletes.Professional esports athletes spend a long time in the same sitting posture during training and competition. Mobile esports may exacerbate potential postural problems because of the closer and unsupported arms and because athletes spend more time in a forward-/flexed-head posture. Prolonged sitting in these postures carries significant health risks and may lead to musculoskeletal problems and injuries. The objective of this retrospective study is to assess the posture, mobility, and stability of the spine for professional mobile esports athletes. We collected spine-assessment data from 48 athletes participating in a top-tier league on a real-time-strategy battle-arena online game. The spinal assessment was conducted using the SpinalMouse® under upright standing and trunk flexion in addition to the Matthiass test. Measurements were converted into Idiag Scores by the SpinalMouse® software. The Idiag Posture, Idiag Mobility, and Idiag Stability scores were 62.50 (IQR: 21), 63.50 (IQR: 19.5), and 54.50 (IQR: 14.5), respectively, and were significantly lower (p < 0.001) than the reference normative value (100). Age was found to have a weak positive correlation with the posture score (ρ = 0.29, p = 0.048). Although career duration appeared to lower the scores, the association was insignificant (p > 0.05). The scores also had no significant association with body height, body mass, body mass index, and esports team (p > 0.05). It was anticipated that mobile-based esports would attenuate the biomechanics of the spine and increase the likelihood of musculoskeletal problems, such as neck and back pain.

Reduction of Work-Related Musculoskeletal Disorders in Plastic Surgeons by Introduction of a Posture Training Device.

Plastic surgeons have an increased risk for the development of musculoskeletal disorders because of frequent poor ergonomics of the operating room. This study characterizes selected plastic surgery procedures, with an attempt to identify high-risk procedures and procedural components as well as the impact of biofeedback on surgical ergonomics. A commercially available posture training device was used to initially record neck and spine positioning and later to send biofeedback to prompt surgeons to correct posture. Device data were correlated with in-person observations to characterize factors associated with more time spent in the slouched/nonneutral cervical and thoracic spine posture. The proportion of time spent in the upright position during surgery was significantly different among male and female participants, level of training, participant height, in the sitting versus nonsitting positioning (P < 0.001), with loupes use, and if there was more than an 8-inch height difference between 2 participants (mean, 0.70 ± 0.285). Using the device intervention, all participants spent a larger proportion of operating time upright. Half of these improvements in posture were statistically significant. While in feedback mode, participants experienced shorter and more frequent periods of slouching/nonneutral posture. When comparing the same participant performing the same procedure with and without device biofeedback, 72.2% of participants spent more time in the upright/neutral posture during the surgery when the device was sending feedback. Biofeedback devices used in the operating room can lead to improved surgical posture, which may translate to reduction of workplace injuries, and overall physician health. This study found that a commercially available posture training device and sitting stools in the operating room could significantly improve physician cervical and thoracic spine posture.

Effects of Occlusal Splints on Spinal Posture in Patients with Temporomandibular Disorders: A Systematic Review.

There is still a gap in the scientific knowledge on the linkage between craniofacial structure and spinal postural control in temporomandibular disorder (TMD) patients. This systematic review aimed to assess the role of occlusal splints on spinal posture of TMD patients. PubMed, Web of Science, and Scopus were systematically searched from inception until 5 January 2022 to identify observational studies with a longitudinal study design presenting: patients with diagnosis of TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD); occlusal splint therapy as intervention; postural assessment as outcome. Out of 133 records identified, 104 were suitable for data screening, and only 7 articles were included satisfying the eligibility criteria. We found that occlusal splints might have a positive effect on posture in TMD patients, albeit there is little evidence of appropriate investigation for postural assessment. This systematic review suggested that the occlusal splint might be considered a non-invasive therapeutic approach for patients with TMD. However, the low number of studies with high-quality methodology in these patients showed an urgent need for further research using combined force platform stabilometry and kinematic evaluation of the spine to investigate the impact of occlusal splints on posture.

Correlation between Postural Impairment and Lymphedema in Breast Cancer Survivors

The major complication of breast cancer is secondary lymphedema seen within few days to months after the surgery. Lymphedema has a debilitating effect on posture. The significance of this study is to show the effect of lymphedema on posture. These all have a huge impact on the quality of life of patients, within her family as well as working places. This study provides a platform to assess the spinal posture which may be at risk due to lymphedema in breast cancer survivors. Hence, the study is to find out correlation between spinal postural impairment and lymphedema in breast cancer survivors and to assess the correlation between demographic variables and lymphedema in breast cancer survivors. The aim of the study was to study and find out the correlation between postural impairment and lymphedema in breast cancer survivors. This was an observational study with the total of 116 breast cancer survivor women’s who had undergone radiotherapy and surgery were selected from Krishna Institute of Medical Sciences, Karad. Their age ranged from 35 to 60 years old. The outcome measures which were included are postural examination chart in the anterior, posterior, lateral views by plumb line, muscle length test, muscle strength test, pain assessment using visual analog scale, and lymphedema measurement using inch tape. The obtained results showed statistically high significant increase in the forward head posture, rounded shoulders, thoracic kyphosis and scoliosis, scapular dyskinesis, and increased volume of affected arm. There were high significant correlation between spinal postural impairments and lymphedema in breast cancer survivors and also correlation between demographic variables and lymphedema in breast cancer survivors.

Effects of a Pilates programme in spinal curvatures and hamstring extensibility in adolescents with thoracic hyperkyphosis: a randomised controlled trial

AimTo evaluate the effects of a 9-month Pilates exercise programme on the sagittal spinal posture and hamstring extensibility of adolescents with thoracic hyperkyphosis.DesignRandomised controlled trial with blinded examiner.PatientsOne-hundred and three...

Effects of a Pilates programme in spinal curvatures and hamstring extensibility in adolescents with thoracic hyperkyphosis: a randomised controlled trial.

To evaluate the effects of a 9-month Pilates exercise programme on the sagittal spinal posture and hamstring extensibility of adolescents with thoracic hyperkyphosis. Randomised controlled trial with blinded examiner. One-hundred and three adolescents with thoracic hyperkyphosis. Participants were randomly placed into an experimental group which participated in a Pilates exercise programme implemented for a total of 38 weeks (two sessions/week, 15 min/session) (Pilates group (PG), sample = 49, or control group (CG), sample = 48). The outcome measures were the thoracic curve in sagittal spinal curvature in relaxed standing, sagittal spinal curvatures and pelvic tilt in relaxed standing and sit-and-reach positions, and hamstring extensibility. There was a significant adjusted mean difference between groups in favour of the PG in the thoracic curve in relaxed standing position (-5.6°, p = 0.003), pelvic tilt (-2.9°, p = 0.03) and all straight leg tests (p<0.001). The PG showed a significant change in thoracic curve (-5.9, p<0.001) and in lumbar angle (4.0, p = 0.001) in relaxed standing position and in all straight leg raise tests (+6.4 to +15°, p<0.0001). The adolescents with thoracic hyperkyphosis from the PG had a decreased thoracic kyphosis in relaxed standing position, and improved hamstring extensibility as compared with the CG. More than 50% of the participants obtained kyphosis values inside normality, showing an adjusted mean difference between groups in the thoracic curve of about 73% of the baseline mean, resulting in a large improvement and high clinical importance. NCT03831867.

Assessment of the head, cervical spine, thoracic spine and shoulder girdle postures in people with and without chronic headache

Background/Aims Cervical dysfunction is one of the common symptoms of chronic headaches. This study was conducted to assess the posture of the head, cervical and thoracic spine and the shoulder girdle in people with and without cervicogenic and migraine headaches. Methods The postural angles of the head, cervical and thoracic spine and the shoulder girdle in frontal and sagittal planes, as well as thoracic spine curvature, were measured on 90 people who were split into three groups: 20 people with cervicogenic headache, 20 people with migraine and 50 people as the control group. Results There were significant differences among the three groups in the craniovertebral angle, coronal head tilt angle and scapular upward rotation angle (P&lt;0.05). There was no relationship between postural angles. Conclusions The results of this study revealed that forward head posture was evident in people with cervicogenic and migraine headache. Decreased scapular upward rotation seen in the migraine headache group highlights the importance of shoulder girdle-related dysfunctions in people with chronic headaches.

Using a Passive Back Exoskeleton During a Simulated Sorting Task: Influence on Muscle Activity, Posture, and Heart Rate.

To evaluate using a back exoskeleton in a simulated sorting task in a static forward bent trunk posture on muscle activity, posture, and heart rate (HR). Potentials of exoskeletons for reducing musculoskeletal demands in work tasks need to be clarified. Thirty-six healthy males performed the sorting task in 40°-forward bent static trunk posture for 90seconds, in three trunk orientations, with and without exoskeleton. Muscle activity of the erector spinae (ES), biceps femoris (BF), trapezius descendens (TD), rectus abdominis (RA), vastus laterals (VL), and gastrocnemius medialis was recorded using surface electromyography normalized to a submaximal or maximal reference electrical activity (%RVE (reference voluntary electrical activity)/%MVE). Spine and lower limb postures were assessed by gravimetric position sensors, and HR by electrocardiography. Using the exoskeleton resulted in decreased BF muscle activity [-8.12%RVE], and minor changes in ES [-1.29%MVE], RA [-0.28%RVE], VL [-0.49%RVE], and TD [+1.13%RVE] muscle activity. Hip and knee flexion increased [+8.1°; +6.7°]. Heart rate decreased by 2.1 bpm. Trunk orientation had an influence on BF muscle activity. Using the back exoskeleton in a short sorting task with static trunk posture mainly reduced hip extensor muscle activity and changed lower limb but not spine posture. Implications of using a back exoskeleton for workers' musculoskeletal health need further clarification. The detected changes by using the Laevo® illustrate the need for further investigation prior to practical recommendations of using exoskeletons in the field. Investigating various work scenarios in different kind of workers and long-term applications would be important elements.

The Role of Neuromuscular Control of Postural and Core Stability in Functional Movement and Athlete Performance.

Balance and core stabilization exercises have often been associated with improved athlete performance and/or decreased incidence of injuries. While these exercises seem to be efficient in the prevention of injuries, there is insufficient evidence regarding their role in sport-specific performance and related functional movements. The aim of this scoping review is (1) to map the literature that investigates whether currently available variables of postural and core stability are functionally related to athlete performance in sports with high demands on body balance and spinal posture and (2) to identify gaps in the literature and suggest further research on this topic. The literature search conducted on MEDLINE, Scopus, Web of Science, PubMed, and Cochrane Library databases was completed by Google Scholar, SpringerLink, and Elsevier. Altogether 21 articles met the inclusion criteria. Findings revealed that postural stability plays an important role in performance in archery, biathlon, gymnastics, shooting, and team sports (e.g., basketball, hockey, soccer, tennis). Also core stability and strength represent an integral part of athlete performance in sports based on lifting tasks and trunk rotations. Variables of these abilities are associated with performance-related skills in cricket, cycling, running, and team sports (e.g., baseball, football, hockey, netball, soccer, tennis). Better neuromuscular control of postural and core stability contribute to more efficient functional movements specific to particular sports. Training programs incorporating general and sport-specific exercises that involve the use of postural and core muscles showed an improvement of body balance, back muscle strength, and endurance. However, there is controversy about whether the improvement in these abilities is translated into athletic performance. There is still a lack of research investigating the relationship of body balance and stability of the core with sport-specific performance. In particular, corresponding variables should be better specified in relation to functional movements in sports with high demands on postural and core stability. Identifying the relationship of passive, active, and neural mechanisms underlying balance control and spinal posture with athlete performance would provide a basis for a multifaced approach in designing training and testing tools addressing postural and core stability in athletes under sport-specific conditions.