title: Sitting with adjustable ischial and back supports: biomechanical changes.
abstract: METHODS
  The seat and back contact force, pressure distribution, lumbar lordosis, and low back muscle activities associated with a new seat design with adjustable ischial support and backrest were investigated using kinematic, kinetic, electromyographic, and radiographic measurements.
  
  
  OBJECTIVE
  To investigate the biomechanical effects of adjusting ischial and backrest supports during sitting.
  
  
  BACKGROUND
  Sitting may induce posterior rotation of the pelvis, reduction of lumbar lordosis, and increases in muscle tension, disc pressure, and pressure on the ischium and coccyx, which may be associated with low back pain. A device that reduces the ischial load and maintains lumbar lordosis may help increase seating comfort and reduce low back pain.
  
  
  METHODS
  Fifteen office workers with no known low back pain history were tested. Contact pressure distributions, reaction forces between the buttock-thighs and seat and between the back and backrest, load carried by the seat pan and backrest, sacral inclination, lumbar lordosis, intervertebral space of lumbar spine, and muscular activity in stabilizing the trunk were measured for sitting with and without ischial support and with adjustable back support.
  
  
  RESULTS
  When the ischial support was relieved, the center of the force on the seat and on the legs of the chair, and the peak center of pressure on the seat, were significantly (P < 0.002) shifted forward toward the thighs. The total contact area on the seat pan and on the backrest was significantly decreased and increased, respectively (P < 0.001). The sacral inclination, total and segmental lumbar lordosis, and lumbar spine disc height were significantly increased for sitting upright with backrest, with the lumbar curve close to that during standing.
  
  
  CONCLUSIONS
  Sitting with reduced ischial support and fitted backrest to the lower spine altered the contact area, reduced peak pressure under the ischia, reduced muscular activity, maintained total and segmental lumbar lordosis, rotated the sacrum forward, and increased lumbar intervertebral disc heights, which could potentially reduce low back pain.
authors.affiliation: Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois 60611, USA. m-makhsous2@northwestern.edu
authors.forename: Mohsen
authors.initials: M
authors.lastname: Makhsous
authors.forename: Fang
authors.initials: F
authors.lastname: Lin
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Hendrix
authors.forename: Matthew
authors.initials: M
authors.lastname: Hepler
authors.forename: Li-Qun
authors.initials: LQ
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D001698:Biomedical Engineering; D004576:Electromyography; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000502:physiology; D007512:Ischium / Q000502:physiology; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D008161:Lumbosacral Region; D008297:Male; D009119:Muscle Contraction / Q000502:physiology; D011187:Posture / Q000502:physiology*; D011312:Pressure; D012016:Reference Values; D012447:Sacrum / Q000502:physiology; D013131:Spine / Q000502:physiology*; D013848:Thigh / Q000502:physiology