Características biomecânicas, ergonômicas e clínicas da postura sentada: uma revisão

The sitting posture is the most adopted in work environment, at school and in leisure activities. However, prolonged maintenance of this position causes the adoption of inadequate postures and overloads skeletal muscle structures, which may lead to spine pain and injuries. The purpose of the present review was to identify biomechanic, ergonomic, and clinical features involved in maintenance of the sitting position. The search in ISI Web of Knowledge, Medline, Pubmed and EBSCOHost data bases led to selecting 72 articles published between 1965 and 2010. Results show that there is not an ideal posture to be kept, but some postures are more recommended than others, like the upright sitting and the lordotic postures. Chairs influence the pattern of sitting, and their design allows for posture diversity. Changes in the chair, exercises to improve endurance and proprioception, as well as postural re-education, are useful interventions to reduce the impact of prolonged sitting position on the skeletal muscle system.

[1]  Julie Hides,et al.  Sitting versus standing: does the intradiscal pressure cause disc degeneration or low back pain? , 2008, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[2]  S. GRACOVETSKY,et al.  Analysis of Spinal and Muscular Activity During Flexion/Extension and Free Lifts , 1990, Spine.

[3]  R. Ferrari,et al.  Sitting biomechanics, Part II: optimal car driver's seat and optimal driver's spinal model. , 2001, Journal of manipulative and physiological therapeutics.

[4]  Jack P. Callaghan,et al.  Stability Ball Versus Office Chair: Comparison of Muscle Activation and Lumbar Spine Posture During Prolonged Sitting , 2006, Hum. Factors.

[5]  S. May,et al.  Sitting posture of subjects with postural backache. , 2006, Journal of manipulative and physiological therapeutics.

[6]  A. Spaepen,et al.  Posture, muscle activity and muscle fatigue in prolonged VDT work at different screen height settings , 2003, Ergonomics.

[7]  M. Polansky,et al.  The Influence of Different Sitting Positions on Cervical and Lumbar Posture , 1996, Spine.

[8]  Salah R. Agha,et al.  School furniture match to students' anthropometry in the Gaza Strip , 2010, Ergonomics.

[9]  Jack P Callaghan,et al.  Examination of the flexion relaxation phenomenon in erector spinae muscles during short duration slumped sitting. , 2002, Clinical biomechanics.

[10]  C. Snijders,et al.  Free shoulder space requirements in the design of high backrests , 2003, Ergonomics.

[11]  Y. Ishige,et al.  Effectiveness of a Lumbar Support Continuous Passive Motion Device in the Prevention of Low Back Pain During Prolonged Sitting , 2007, Spine.

[12]  H. Tsuji,et al.  Water Diffusion Pathway, Swelling Pressure, and Biomechanical Properties of the Intervertebral Disc During Compression Load , 1989, Spine.

[13]  H. Stam,et al.  Why Leg Crossing?: The Influence of Common Postures on Abdominal Muscle Activity , 1995, Spine.

[14]  J. H. van DieËn,et al.  Effects of dynamic office chairs on trunk kinematics, trunk extensor EMG and spinal shrinkage , 2001, Ergonomics.

[15]  M. Panjabi The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. , 1992, Journal of spinal disorders.

[16]  S Lings,et al.  Is sitting-while-at-work associated with low back pain? A systematic, critical literature review. , 2000, Scandinavian journal of public health.

[17]  Paul W Hodges,et al.  Is 'ideal' sitting posture real? Measurement of spinal curves in four sitting postures. , 2009, Manual therapy.

[18]  Mohsen Makhsous,et al.  Sitting with Adjustable Ischial and Back Supports: Biomechanical Changes , 2003, Spine.

[19]  W C Hutton,et al.  The Effect of Posture on the Fluid Content of Lumbar Intervertebral Discs , 1983, Spine.

[20]  Ivica Grbac,et al.  Classroom furniture design--correlation of pupil and chair dimensions. , 2008, Collegium antropologicum.

[21]  Karen V Richards,et al.  The Effect of Different Standing and Sitting Postures on Trunk Muscle Activity in a Pain-Free Population , 2002, Spine.

[22]  A Magora,et al.  Investigation of the relation between low back pain and occupation. 3. Physical requirements: sitting, standing and weight lifting. , 1972, IMS, Industrial medicine and surgery.

[23]  S. McGill,et al.  Low back joint loading and kinematics during standing and unsupported sitting , 2001, Ergonomics.

[24]  C J Snijders,et al.  Mechanical effects of continuous passive motion on the lumbar spine in seating. , 2000, Journal of biomechanics.

[25]  G R Fernie,et al.  Mechanical Response of the Lumbar Spine to Seated Postural Loads , 1997, Spine.

[26]  Joy Higgs,et al.  Seeking the optimal posture of the seated lumbar spine , 2001 .

[27]  Grace P. Y. Szeto,et al.  Work-related Musculoskeletal Disorders in Urban Bus Drivers of Hong Kong , 2007, Journal of Occupational Rehabilitation.

[28]  Peter J Keir,et al.  Effects of backrest design on biomechanics and comfort during seated work. , 2007, Applied ergonomics.

[29]  M. Graf,et al.  An assessment of seated activity and postures at five workplaces , 1995 .

[30]  S M McGill,et al.  Sitting on a chair or an exercise ball: various perspectives to guide decision making. , 2006, Clinical biomechanics.

[31]  M. Panjabi,et al.  Euler stability of the human ligamentous lumbar spine. Part II: Experiment. , 1992, Clinical biomechanics.

[32]  C. Snijders,et al.  The influence of slouching and lumbar support on iliolumbar ligaments, intervertebral discs and sacroiliac joints. , 2004, Clinical biomechanics.

[33]  M. Solomonow,et al.  Biomechanics of increased exposure to lumbar injury caused by cyclic loading. Part 2. Recovery of reflexive muscular stability with rest. , 1999, Spine.

[34]  E N Corlett,et al.  Background to sitting at work: research-based requirements for the design of work seats , 2006, Ergonomics.

[35]  G. Elfström,et al.  The sitting posture: an electromyographic and discometric study. , 1975, The Orthopedic clinics of North America.

[36]  Svend Lings,et al.  Review Article: Is sitting-while-at-work associated with low back pain? A systematic, critical literature review , 2000 .

[37]  L. Maria,et al.  Aspectos a serem considerados na elaboração de programas de prevenção e orientação de problemas posturais , 2000 .

[38]  H. Tsuji,et al.  Effects of Hydrostatic Pressure on Matrix Synthesis and Matrix Metalloproteinase Production in the Human Lumbar Intervertebral Disc , 1997, Spine.

[39]  L. Claes,et al.  New in vivo measurements of pressures in the intervertebral disc in daily life. , 1999, Spine.

[40]  P A Fenety,et al.  In-chair movement: validity, reliability and implications for measuring sitting discomfort. , 2000, Applied ergonomics.

[41]  P. O'Sullivan,et al.  The relationship beween posture and back muscle endurance in industrial workers with flexion-related low back pain. , 2006, Manual therapy.

[42]  M. Adams,et al.  Mechanical testing of the spine. An appraisal of methodology, results, and conclusions. , 1995, Spine.

[43]  Idsart Kingma,et al.  Static and dynamic postural loadings during computer work in females: Sitting on an office chair versus sitting on an exercise ball. , 2009, Applied ergonomics.

[44]  S. Kikuchi,et al.  In vivo intradiscal pressure measurement in healthy individuals and in patients with ongoing back problems. , 1999, Spine.

[45]  P Branton,et al.  An evaluation of train seats by observation of sitting behaviour. , 1967, Ergonomics.

[46]  C M Haslegrave,et al.  Seated work postures for manual, visual and combined tasks. , 1999, Ergonomics.

[47]  L Saarni,et al.  Are the desks and chairs at school appropriate? , 2007, Ergonomics.

[48]  A NACHEMSON,et al.  THE EFFECT OF FORWARD LEANING ON LUMBAR INTRADISCAL PRESSURE. , 1965, Acta orthopaedica Scandinavica.

[49]  D. Harrison,et al.  Sitting biomechanics part I: review of the literature. , 1999, Journal of manipulative and physiological therapeutics.

[50]  P. Dolan,et al.  Recent advances in lumbar spinal mechanics and their clinical significance. , 1995, Clinical biomechanics.

[51]  Thomas W Pelham,et al.  The etiology of low back pain in military helicopter aviators: prevention and treatment. , 2005, Work.

[52]  Wim Dankaerts,et al.  Effect of Different Upright Sitting Postures on Spinal-Pelvic Curvature and Trunk Muscle Activation in a Pain-Free Population , 2006, Spine.

[53]  Margarita Vergara,et al.  Relationship between comfort and back posture and mobility in sitting-posture. , 2002, Applied ergonomics.

[54]  M. Panjabi The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. , 1992, Journal of spinal disorders.