Lumbar Roll Usage While Sitting Reduces the Forward Head Posture in Healthy Individuals: A Systematic Review with Meta-Analysis

Yusuke Handa, Kenya Okada, Hiroshi Takasaki, Yusuke Handa, Kenya Okada, Hiroshi Takasaki

Abstract

This systematic review and meta-analysis investigated whether the use of a lumbar roll reduced forward head posture (FHP) while sitting among individuals with or without musculoskeletal disorders. EMBASE, MEDLINE, and the Cochrane Library were systematically searched from their inception to August 2020. The quality of evidence for variables used in the meta-analysis was determined using the GRADE system. Five studies satisfied the criteria for data analysis. All studies included individuals without any spinal symptoms. Data from five studies on neck angle showed a statistically significant (p = 0.02) overall effect (standardized mean difference (SMD) = 0.77), indicating a lesser neck flexion angle while sitting with a lumbar roll than without it. Data from two studies on head angle showed a statistically significant (p = 0.04) overall effect (SMD = 0.47), indicating a lesser head extension angle while sitting with a lumbar roll than without it. In each meta-analysis, the quality of evidence was very low in the GRADE system. The use of a lumbar roll while sitting reduced FHP among individuals without spinal symptoms.

Keywords: alignment; lumbar roll; posture; sitting.

Conflict of interest statement

All authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow of study selection.
Figure 2
Figure 2
Forest plot of the effect of a lumbar roll in sitting on a neck angle. Abbreviations: SMD, standardized mean difference; CIs, confidence intervals.
Figure 3
Figure 3
Post-hoc forest plot of the effect of a lumbar roll in sitting on a neck angle, excluding individuals with a cranio-vertebral angle

Figure 4

Forest plot of the effect…

Figure 4

Forest plot of the effect of a lumbar roll in sitting on a…

Figure 4
Forest plot of the effect of a lumbar roll in sitting on a head angle. Abbreviations: SMD, standardized mean difference; CIs, confidence intervals.
Figure 4
Figure 4
Forest plot of the effect of a lumbar roll in sitting on a head angle. Abbreviations: SMD, standardized mean difference; CIs, confidence intervals.

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