The effect of dynamic sitting on the prevention and management of low back pain and low back discomfort: a systematic review

Dynamic sitting has been proposed to reduce low back pain (LBP) and/or low back discomfort (LBD) while sitting. This is supported by studies suggesting that subjects with LBP assume more static, sustained postures while sitting. This systematic review investigated the effect of dynamic sitting on LBP among subjects with LBP and the development of LBD among pain-free subjects. Electronic databases were searched by two independent assessors. All prospective studies which compared the effect of a dynamic sitting condition on LBP or LBD to another sitting condition were eligible, with no minimum follow-up period applied. The quality of the included studies was assessed using the PEDro scale. Seven high-quality studies were eligible, including five crossover studies and two randomised controlled trials. The results suggest there is currently no evidence to support the use of dynamic sitting as a stand-alone approach in the management of LBP. Practitioner Summary: This systematic review investigated the effect of dynamic sitting on LBP or LBD. Seven high-quality studies met the inclusion and exclusion criteria. Overall, the evidence suggests that dynamic sitting approaches are not effective as a stand-alone management approach for LBP.

[1]  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.

[2]  S. McGill,et al.  Using a pneumatic support to correct sitting posture for prolonged periods: A study using airline seats , 2009, Ergonomics.

[3]  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.

[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]  A. Woolf,et al.  Burden of major musculoskeletal conditions. , 2003, Bulletin of the World Health Organization.

[6]  R A Deyo,et al.  The Longitudinal Assessment of Imaging and Disability of the Back (LAIDBack) Study: Baseline Data , 2001, Spine.

[7]  M Pope,et al.  The effect of posture and seat suspension design on discomfort and back muscle fatigue during simulated truck driving. , 1994, Applied ergonomics.

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

[9]  J. Patijn,et al.  Sitting and low back pain: the positive effect of rotatory dynamic stimuli during prolonged sitting , 1999, European Spine Journal.

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

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

[12]  Allard J van der Beek,et al.  The effectiveness of physical and organisational ergonomic interventions on low back pain and neck pain: a systematic review , 2010, Occupational and Environmental Medicine.

[13]  M. Jorgensen,et al.  Field evaluation of a continuous passive lumbar motion system among operators of earthmoving equipment , 2006 .

[14]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement , 2009, BMJ.

[15]  R. Hazard,et al.  Continuous passive motion in seating: a new strategy against low back pain. , 1994, Journal of spinal disorders.

[16]  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.

[17]  Scott Telfer,et al.  The Potential for Actigraphy to Be Used as an Indicator of Sitting Discomfort , 2009, Hum. Factors.

[18]  M. Nordin,et al.  Association between sitting and occupational LBP , 2007, European Spine Journal.

[19]  N. Roberts,et al.  The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males , 2005, European Spine Journal.

[20]  D. Moher,et al.  Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement , 2009, BMJ : British Medical Journal.

[21]  Simon Dagenais,et al.  Causal assessment of occupational lifting and low back pain: results of a systematic review. , 2010, The spine journal : official journal of the North American Spine Society.

[22]  B. Kwon,et al.  Causal assessment of awkward occupational postures and low back pain: results of a systematic review. , 2010, The spine journal : official journal of the North American Spine Society.

[23]  A Page,et al.  System to measure the use of the backrest in sitting-posture office tasks. , 2000, Applied ergonomics.

[24]  B. Koes,et al.  Spinal Mechanical Load as a Risk Factor for Low Back Pain: A Systematic Review of Prospective Cohort Studies , 2009, Spine.

[25]  Catherine Sherrington,et al.  Reliability of the PEDro scale for rating quality of randomized controlled trials. , 2003, Physical therapy.

[26]  N. D. de Morton.  The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. , 2009, The Australian journal of physiotherapy.

[27]  Simon Dagenais,et al.  Causal assessment of workplace manual handling or assisting patients and low back pain: results of a systematic review. , 2010, The spine journal : official journal of the North American Spine Society.

[28]  Leon Straker,et al.  Differences in Sitting Postures are Associated With Nonspecific Chronic Low Back Pain Disorders When Patients Are Subclassified , 2006, Spine.

[29]  R. Ortengren,et al.  Myoelectric activity in individual lumbar erector spinae muscles in sitting. A study with surface and wire electrodes. , 1974, Scandinavian journal of rehabilitation medicine. Supplement.

[30]  O. Hänninen,et al.  Sitting and standing postures are corrected by adjustable furniture with lowered muscle tension in high-school students , 2007, Ergonomics.

[31]  Jack P Callaghan,et al.  The effects of a continuous passive motion device on myoelectric activity of the erector spinae during prolonged sitting at a computer workstation. , 2003, Work.

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

[33]  P. O'Sullivan.  It's time for change with the management of non-specific chronic low back pain , 2011, British Journal of Sports Medicine.

[34]  Julie A. Hides,et al.  Different Ways to Balance the Spine: Subtle Changes in Sagittal Spinal Curves Affect Regional Muscle Activity , 2009, Spine.

[35]  L. Straker,et al.  Altered Patterns of Superficial Trunk Muscle Activation During Sitting in Nonspecific Chronic Low Back Pain Patients: Importance of Subclassification , 2006, Spine.

[36]  Leon Straker,et al.  Lumbopelvic kinematics and trunk muscle activity during sitting on stable and unstable surfaces. , 2006, The Journal of orthopaedic and sports physical therapy.

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

[38]  Simon Dagenais,et al.  Causal assessment of occupational sitting and low back pain: results of a systematic review. , 2010, The spine journal : official journal of the North American Spine Society.

[39]  K. Bennell,et al.  Effects of rehabilitative interventions on pain, function and physical impairments in people with hand osteoarthritis: a systematic review , 2011, Arthritis Research & Therapy.

[40]  I. König,et al.  Passive rotary dynamic sitting at the workplace by office-workers with lumbar pain: a randomized multicenter study. , 2007, The spine journal.

[41]  H. Vet,et al.  The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. , 1998, Journal of clinical epidemiology.

[42]  C. Soutar,et al.  Epidemiologic Study of Back Pain in Miners and Office Workers , 1986, Spine.

[43]  J A Hawley,et al.  A Comparison of the Effects of Two Sitting Postures on Back and Referred Pain , 1991, Spine.

[44]  Ev Innes,et al.  An investigation into the immediate effects on comfort, productivity and posture of the Bambach saddle seat and a standard office chair. , 2007, Work.