Effects of Pelvic Asymmetry and Low Back Pain on Trunk Kinematics During Sitting: A Comparison With Standing Identification of Modifiable Personal Factors That Predict New-onset Low Back Pain: A Prospective Study of Female Nursing Students Energy transfer across the lumbosacral and lower-extremity joints in patients with low back pain during sit-to-stand. Persistence and Change in Nonspecific Low Back Pain Among Adolescents: A 3-Year Prospective Study Exploring Factors Influencing Low Back Pain in People With Nondysvascular Lower Limb Amputation: A National Survey. Reducing sedentary behaviour to decrease chronic low back pain: the stand back randomised trial Impact of a Sit-Stand Workstation on Chronic Low Back Pain: Results of a Randomized Trial Reliability and Validity of a New Objective Tool for Low Back Pain Functional Assessment Sitting and low back pain: the positive effect of rotatory dynamic stimuli during prolonged sitting Immediate changes in feedforward postural adjustments following voluntary motor training Efficacy of two multimodal treatments on physical strength of occupationally subgrouped male with low back pain.
Study Design . A prospect i ve study was conducted on a group of patients with unilateral nonspecific low back pain ( LBP ) and healthy controls . Objectives . To answer 3 questions : ( 1 ) Does pelvic asymmetry measured in st and ing affect the dynamics of motion performed in sitting ? ( 2 ) Do patients with LBP perform trunk motions differently from non-LBP participants in sitting position ? and ( 3 ) Do the kinematics of lateral flexion and axial rotation differ between sitting and st and ing positions ? Summary of Background Data . The effect of pelvic asymmetry on trunk motion while sitting remains unclear . LBP has been associated with altered trunk kinematics in st and ing ; however , there is limited information available describing trunk kinematics in sitting position in comparison to st and ing . Methods . Pelvic asymmetry was measured in 54 patients with unilateral nonspecific LBP and 59 control subjects .  A motion- analysis system was used to test the  range and symmetry of lateral flexion and axial rotation  in sitting and st and ing positions . Bivariate correlations , regression , multivariate analysis of variance , and paired sample t tests were used to test for associations between variables and differences between groups . Results . We found significant : ( 1 ) correlations between pelvic asymmetry and asymmetric trunk motion performed in sitting , ( 2 ) differences between the LBP and control groups in patterns of trunk motion performed in a sitting posture , and ( 3 ) differences between kinematics of motions performed in sitting versus st and ing postures . Conclusions . This study shows a link between pelvic asymmetry and altered trunk motion in sitting position . We suggest that people with LBP may have a distinct compensatory mechanism , secondary to pelvic asymmetry , which puts the lumbar spine under higher stress . Movement asymmetry , rather than range of motion , may be a better indicator of disturbed function for people with LBP . Structural and functional asymmetries are factors that may be considered in the seating design and work environment Objectives Prevention of occupational low back pain ( LBP ) in nurses is a research priority . Recent research suggests intervening before commencing nursing employment is ideal ; however , identification of modifiable risk factors is required . The objective of this study was to investigate modifiable personal characteristics that predicted new-onset LBP in nursing students . Methods This prospect i ve study was conducted on female nursing students ( n=117 ) without LBP at baseline to predict new-onset LBP ( an episode of significant LBP during the follow-up period ) . At the 12-month follow-up , participants with ( n=31 ) and without new-onset LBP ( n=76 ) were compared across baseline social or lifestyle , psychologic ( distress , back pain beliefs , coping strategies , and catastrophising ) , and physical ( spinal postures and spinal kinematics in functional tasks , leg and back muscle endurance , spinal repositioning error , and cardiovascular fitness ) characteristics . Results Participants response rate at follow-up was excellent ( 91 % ) . After controlling for earlier LBP , age , and BMI , regression analysis showed that modifiable social or lifestyle , psychologic and physical characteristics ( namely , smoking , increased physical activity , higher stress , reduced back muscle endurance , greater posterior pelvic rotation in slump sitting , and more accurate spinal repositioning in sitting ) were significant and independent predictors of new-onset LBP at follow-up . Inclusion of these factors in multivariate logistic regression analysis , with significant new-onset LBP as the outcome , result ed in a substantial model R2 of 0.45 . Discussion Modifiable personal characteristics across multiple domains are associated with new-onset LBP in female nursing students . These findings may have implication s for the development of prevention and management interventions for LBP in nurses OBJECTIVE To examine the transfer of energy through the pelvis and the lower limb during sit-to-st and ( STS ) in low back pain ( LBP ) subjects with or without a straight-leg raise sign . DESIGN Cross-sectional . SETTING Biomechanics laboratory . PARTICIPANTS Three groups , each of 20 subjects , participated . The first group consisted of asymptomatic subjects , and the other 2 groups of consisted of LBP subjects ( duration between 7 days and 12 weeks ) with and without a straight-leg raise sign .  INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES The work done and the power of the pelvis , thigh , and leg segments during STS  were determined . RESULTS Energy was transferred from the pelvis to the thigh segment and then to the leg segment , and this was achieved mainly by passive mechanisms . The power flow of the pelvis segment was significantly decreased in subjects with LBP . Although the power of the lower-limb segments was decreased , the total work done of these segments was increased . CONCLUSIONS STS is a more energy-dem and ing and less efficient task for subjects with LBP , either with or without a positive straight-leg raise sign . Such increases in energy dem and may further exacerbate back pain , and treatment should be developed to restore a more efficient energy transfer pattern Study Design . This is a 3-year prospect i ve study of juvenile low back pain ( LBP ) . Objectives . To investigate persistence and change in LBP . Summary of Background Data . Earlier episodes of LBP are a strong risk factor for LBP in adults , while the persistence of LBP through adolescence is not known . Methods . The material comprised all pupils in eighth and ninth grade s ( N = 105 , mean age 14.7 years ) , living within two geographic areas in Eastern Norway in January 1997 . The analyses included 88 adolescents at baseline , and 85 at follow-up . The question naire , which identified LBP as pain or ache in the low back during the preceding year , was answered at baseline in the classroom and at follow-up by post . Results . LBP was reported by 58 % at baseline and by 39 % at follow-up , and LBP provoked by manual work by 40 % at baseline and 26 % at follow-up . Thirty-one percent reported LBP at both occasions . LBP more than 7 days was reported by 32 % at baseline , by 26 % at follow-up , and by 18 % at both occasions . Twenty-two percent of those reporting LBP at baseline rejected ever LBP at follow-up . Baseline reports of LBP predicted corresponding reports of LBP at follow-up : Odds ratio was 4.7 ( 95 % confidence interval 1.7–12.7 ) for LBP generally , 9.1 ( 3.0–27.2 ) for LBP more than 7 days , 9.2 ( 2.9–28.8 ) for LBP provoked by manual work , and 3.8 ( 1.3–11.3 ) for LBP provoked by sitting at school . Conclusion . The findings indicate a persistent , but changeable , trend in LBP from midadolescence until late adolescence . The consistency and the high rates of reports of LBP provoked by manual work and sitting imply needs for more research on the persistence of LBP , and on relevant interventions during school age BACKGROUND Chronic low back pain ( LBP ) is a common musculoskeletal impairment in people with lower limb amputation . Given the multifactorial nature of LBP , exploring the factors influencing the presence and intensity of LBP is warranted . OBJECTIVE To investigate which physical , personal , and amputee-specific factors predicted the presence and intensity of LBP in persons with nondysvascular transfemoral amputation ( TFA ) and transtibial amputation ( TTA ) . DESIGN A retrospective cross-sectional survey . SETTING A national r and om sample of people with nondysvascular TFA and TTA . PARTICIPANTS Participants ( N = 526 ) with unilateral TFA and TTA due to nondysvascular etiology ( ie , trauma , tumors , and congenital causes ) and a minimum prosthesis use of 1 year since amputation were invited to participate in the survey . The data from 208 participants ( 43.4 % response rate ) were used for multivariate regression analysis . METHODS ( INDEPENDENT VARIABLES ) Personal ( ie , age , body mass , gender , work status , and presence of comorbid conditions ) , amputee-specific ( ie , level of amputation , years of prosthesis use , presence of phantom-limb pain , residual-limb problems , and nonamputated limb pain ) , and physical factors ( ie , pain-provoking postures including st and ing , bending , lifting , walking , sitting , sit-to-st and , and climbing stairs ) . MAIN OUTCOME MEASURES ( DEPENDENT VARIABLES ) LBP presence and intensity . RESULTS A multivariate logistic regression model showed that the presence of 2 or more comorbid conditions ( prevalence odds ratio [ POR ] = 4.34 , P = .01 ) , residual-limb problems ( POR = 3.76 , P < .01 ) , and phantom-limb pain ( POR = 2.46 , P = .01 ) influenced the presence of LBP . Given the high LBP prevalence ( 63 % ) in the study , there is a tendency for overestimation of POR , and the results must be interpreted with caution . In those with LBP , the presence of residual-limb problems ( β = 0.21 , P = .01 ) and experiencing LBP symptoms during sit-to-st and task ( β = 0.22 , P = .03 ) were positively associated with LBP intensity , whereas being employed demonstrated a negative association ( β = -0.18 , P = .03 ) in the multivariate linear regression model . CONCLUSIONS Rehabilitation professionals should be cognizant of the influence that comorbid conditions , residual-limb problems , and phantom pain have on the presence of LBP in people with nondysvascular lower limb amputation .  Further prospect i ve studies could investigate the underlying causal mechanisms of LBP . LEVEL OF EVIDENCE II Objective The St and Back study evaluated the feasibility and effects of a multicomponent intervention targeting reduced prolonged sitting and pain self-management in desk workers with chronic low back pain ( LBP ) . Methods This r and omised controlled trial recruited 27 individuals with chronic LBP , Oswestry Disability Index ( ODI ) > 10 % and desk jobs ( sitting ≥20 hours/week ) . Participants were r and omised within strata of ODI ( > 10%–<20 % , ≥20 % ) to receive bimonthly behavioural counselling ( in-person and telephone ) , a sit-st and desk attachment , a wrist-worn activity-prompting device and cognitive behavioural therapy for LBP self-management or control . Self-reported work sitting time , visual analogue scales ( VAS ) for LBP and the ODI were assessed by monthly , online question naires and compared across intervention groups using linear mixed models . Results Baseline mean ( SD ) age was 52 ( 11 ) years , 78 % were women , and ODI was 24.1 (10.5)% . Across the 6-month follow-up in models adjusted for baseline value , work sitting time was 1.5 hour/day ( P<0.001 ) lower comparing intervention to controls . Also across follow-up , ODI was on average 8 points lower in intervention versus control ( P=0.001 ) . At 6 months , the relative decrease in ODI from baseline was 50 % in intervention and 14 % in control ( P=0.042 ) . LBP from VAS was not significantly reduced in intervention versus control , though small-to-moderate effect sizes favouring the intervention were observed ( Cohen ’s d ranged from 0.22 to 0.42 ) . Conclusion An intervention coupling behavioural counselling targeting reduced sedentary behaviour and pain self-management is a translatable treatment strategy that shows promise for treating chronic LBP in desk-bound employees . Trial registration number NCT0224687 ; Pre- results Objective : The aim of the study was to determine whether  chronic low back pain ( LBP ) might be attenuated through the introduction of a sit-st and workstation ( SSW ) in office employees . Methods : Participants were r and omized to receive a SSW at the beginning or at the end of a 3-month study period . Participants responded to a short survey at the end of each workday and a comprehensive survey at weeks 1 , 6 , and 12 . Surveys consisted of a modified brief pain inventory and the Rol and Morris Disability Question naire . Results : Forty-six university employees with self-reported chronic LBP were enrolled . Participants who were given access to a SSW reported a significant reduction in current ( P = 0.02 ) and worst ( P = 0.04 ) LBP over time . Conclusions : Our findings support the hypothesis that chronic LBP might be improved by the introduction of a SSW in an office environment Study Design . Classification and functional assessment model for nonspecific low back pain ( LBP ) patients and controls on the basis of kinematic analysis parameters . Objective . Develop a logistic regression model using kinematic analysis variables to ( 1 ) discriminate between LBP patients and controls and ( 2 ) obtain objective parameters for LBP functional assessment . Summary of Background Data . Functional assessment of spinal disorders has been carried out traditionally by means of subjective scales . Objective functional techniques have been developed , which usually involve the application of external loads or the analysis of highly st and ardized trunk flexion-extension maneuvers . Few studies have used everyday activities such as sit-to-st and or lifting an object from the ground . They have shown that the motion patterns of LBP patients differ from those of healthy subjects . Nevertheless , very few studies have tried to correlate objective findings to the results of subjective scales , and no previous study has developed a LBP classification and functional assessment model on the basis of kinematic analysis of everyday activities . Methods . Sixteen controls and 39 LBP patients performed a sit-to-st and task , and lifted three different weights from a st and ing position . The vertical forces exerted and the relative positions of the lower limb and the cervical , thoracic , lumbar , and sacroiliac regions were recorded . Reliability was determined from repetitions of the tests performed by the control group . Binary logistic regression analyses were computed . The results of the selected regression equation were correlated to the Oswestry Disability Index scale results , to check the validity of the procedure for the measurement of functional disability . Results . Reliability of the parameters was good . The selected regression model used two variables , and correctly classified 97.3 % of the patients . High correlations were found between the results of this regression equation and the Oswestry Disability Index scale . Conclusion . It is possible to distinguish LBP patients from healthy subjects by means of the biomechanical analysis of everyday tasks . This kind of analysis can produce objective and reliable indexes about the patients ' degree of functional impairment Abstract In this study the effect of dynamic stimuli on  low back pain during prolonged sitting was investigated . The pain experience of two groups of 60 subjects with aspecific low back pain was recorded . All subjects were investigated on pain behaviour by the Multidimensional Pain Inventory ( MPI ) and pain was measured on an open visual analogue scale ( VAS ) . During sitting , one group received dynamic stimuli that were generated by alternating rotations in the horizontal plane of the seat of the chair , with back and arm rests in fixed position . Two different frequencies of rotation were applied in subgroups . The authors concluded that such stimuli , especially of the lower frequency , reduced pain in prolonged sitting There is limited evidence that preprogrammed feedforward adjustments , which are modified in people with neurological and musculoskeletal conditions , can be trained and whether this depends on the type of training . As previous findings demonstrate consistent delays in feedforward activation of the deep abdominal muscle , transversus abdominis ( TrA ) , in people with recurrent low back pain ( LBP ) , we investigated whether training involving voluntary muscle activation can change feedforward mechanisms , and whether this depends on the manner in which the muscle is trained . Twenty-two volunteers with recurrent LBP were r and omly assigned to undertake either training of isolated voluntary activation of TrA or sit-up training to activate TrA in a non-isolated manner to identical amplitude . Subjects performed a trunk perturbation task involving arm movement prior to and after training , and surface and fine-wire electromyography ( EMG ) recordings were made from trunk and arm muscles . Following a single session of training of isolated voluntary activation of TrA , onset of TrA EMG was earlier during rapid arm flexion and extension , to more closely resemble the responses in pain-free individuals . The magnitude of change in TrA EMG onset was correlated with the quality of isolated training . In contrast , all of the abdominal muscles were recruited earlier during arm flexion after sit-up training , while onset of TrA EMG was further delayed during arm extension . The results provide evidence that training of isolated muscle activation leads to changes in feedforward postural strategies , and the magnitude of the effect is dependent on the type and quality of motor training OBJECTIVES Some occupations are more prone to low back pain ( LBP ) due to their static work postures and work place design . Multidisciplinary pain programs have shown their effectiveness in the management of LBP in general population but which treatment and which segment of the population will be benefited more was not investigated yet . This study determines the effect of two treatment protocol s on five occupationally subgrouped male LBP patients . METHODS A total of 102 occupational male , 20 - 40 yrs of age , with sub-acute or chronic nonspecific LBP were r and omized and treated either with conventional treatment a combination of two electrotherapy ( ultrasound and short wave diathermy ) and one exercise therapy ( lumbar strengthening exercises ) or dynamic muscular stabilization techniques ( DMST ) an active approach of stabilizing training . At the end of the treatment , subjects of both the groups were further stratified in five subgroups on the basis of their occupation . The pain was the primary outcome measure while physical strength [ back pressure changes ( BPC ) and abdominal pressure changes ( APC ) ] the secondary . RESULTS The Pain , BPC and APC of all subgroups improved significantly ( P < 0.01 ) in the both treatments but more in DMST . For each variable , improvement in subgroups differed within and between the treatments . Overall improvement in all assessed variables were evident on Desk workers followed by Shop keepers the most while BPC of Movement job , APC of Others and Pain of Sedentary and Shop keepers improved the least . CONCLUSIONS Study concluded that for the management of occupational LBP , DMST is more effective than conventional treatment . The Pain of Sedentary and Shopkeepers and physical strength of Movement job and Others may need more clinical attention . Findings of this study may be helpful in the management of occupational LBP
The results suggest there is currently no evidence to support the use of dynamic sitting as a st and -alone approach in the management of LBP .
Overall , the evidence suggests that dynamic sitting approaches are not effective as a st and -alone management approach for LBP
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 .
Practitioner Summary : This systematic review investigated the effect of dynamic sitting on LBP or LBD .