Comparing the effects of different dynamic sitting strategies in wheelchair seating on lumbar-pelvic angle

Chun-Ting Li; Yao-Te Peng; Yen-Ting Tseng; Yen-Nien Chen; Kuen-Horng Tsai

doi:10.1186/s12891-016-1358-3

Comparing the effects of different dynamic sitting strategies in wheelchair seating on lumbar-pelvic angle

BMC Musculoskelet Disord. 2016 Dec 9;17(1):496. doi: 10.1186/s12891-016-1358-3.

Authors

Chun-Ting Li¹, Yao-Te Peng², Yen-Ting Tseng^{1

3}, Yen-Nien Chen⁴, Kuen-Horng Tsai⁵

Affiliations

¹ Graduate Institute of Mechatronic System Engineering, National University of Tainan, No. 33, Sec. 2, Shu-Lin St., West Central Dist., Tainan City, 70005, Taiwan.
² Department of BioMedical Engineering, National Cheng Kung University, No.1, University Rd., East Dist., Tainan City, 70101, Taiwan.
³ Center of Excellence for Diagnostic Products, Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, No. 195, Sec. 4, Chung-Hsing Rd., Chutung Township, Hsinchu County, 31040, Taiwan.
⁴ Department of BioMedical Engineering, National Cheng Kung University, No.1, University Rd., East Dist., Tainan City, 70101, Taiwan. yennien.chen@gmail.com.
⁵ Graduate Institute of Mechatronic System Engineering, National University of Tainan, No. 33, Sec. 2, Shu-Lin St., West Central Dist., Tainan City, 70005, Taiwan. khnutn@gmail.com.

Abstract

Background: Prolonged static sitting in a wheelchair is associated with an increased risk of lower back pain. The wheelchair seating system is a key factor of this risk because it affects spinal loading in the sitting position. In this study, 7 dynamic sitting strategies (DSSs) are examined: lumbar prominent dynamic sitting (LPDS), back reclined dynamic sitting (BRDS), femur upward dynamic sitting (FUDS), lumbar prominent with back reclined dynamic sitting (LBDS), lumbar prominent with femur upward dynamic sitting (LFDS), back reclined with femur upward dynamic sitting (BFDS), and lumbar prominent with back reclined with femur upward dynamic sitting (LBFDS). The objective of this study was to analyze the biomechanical effects of these sitting strategies on lumbar-pelvic angles.

Methods: Twenty able-bodied participants were recruited for the study. All participants performed LPDS, BRDS, FUDS, LBDS, LFDS, BFDS, and LBFDS in a random order. All lumbar-pelvic angle parameters, including the static lumbar angle, static pelvic angle, lumbar range of motion, and pelvic range of motion were measured and compared.

Results: Results show that LBDS and LBFDS enabled the most beneficial lumbar movements, although the difference between the 2 strategies was nonsignificant. BRDS and BFDS enabled the most beneficial pelvic movements, although the difference between the 2 strategies was nonsignificant. Among all the upright DSSs, LPDS and LFDS enabled the most beneficial lumbar and pelvic movements, although no significant difference was observed between these 2 strategies.

Conclusions: We identified the effects and differences among 7 DSSs on lumbar-pelvic angles. Wheelchair users can choose the most suitable DSS that meets their needs. These findings may serve as a reference for practicing physicians or wheelchair users to choose an appropriate dynamic wheelchair seating system.

Trial registration: ISRCTN12389808 , 18th November 2016, retrospectively registered.

Keywords: Dynamic sitting; Lower back pain; Lumbar spine; Wheelchair.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Biomechanical Phenomena
Female
Humans
Low Back Pain / etiology
Low Back Pain / prevention & control*
Lumbosacral Region / anatomy & histology*
Male
Pelvic Bones / anatomy & histology*
Posture*
Range of Motion, Articular
Wheelchairs / adverse effects*
Young Adult

Associated data

ISRCTN/ISRCTN12389808