The effect of a lumbar support pillow on lumbar posture and comfort during a prolonged seated task

Diane E Grondin, John J Triano, Steve Tran, David Soave, Diane E Grondin, John J Triano, Steve Tran, David Soave

Abstract

Background: Several risk factors exist for the development of low back pain, including prolonged sitting and flexed spinal curvature. Several investigators have studied lumbar support devices and spinal curvatures in sitting, however few have investigated a pain population and reported a quantitative measure of comfort. The purpose of the current project was to determine whether a lumbar support pillow, outfitted with a cut-out to accommodate the bulk of posterior pelvic soft tissue volume, is more effective than a standard chair in promoting a neutral spinal posture and improving subjective and objective measures of comfort in healthy individuals and patients with low back pain.

Methods: Twenty eight male participants with and without a history of low back pain sat in a standard office chair and in a chair with the lumbar support pillow for 30 minutes. Lumbar and thoracolumbar postures were measured through electromagnetic markers. Comfort was determined based on the least squares radius of centre of pressure shifting, measured at the buttock-chair interface as well as reported discomfort through visual analog scales. Chair support effects were assessed through ANOVA methods. The study was approved by the Canadian Memorial Chiropractic College research ethics board.

Results: There was a main effect of condition on lumbar posture (p = 0.006) and thoracolumbar posture (p = 0.014). In the lumbar region, the support and standard chair differed by 2.88° (95% CI; 1.01-4.75), with the lumbar support being closer to neutral than the standard chair. In the thoracolumbar region, the support and standard chair differed by -2.42° (95% CI; -4.22 to -0.62), with the standard chair being closer to neutral than the support device. The centre of pressure measure was significantly improved with the pillow (p = 0.017), however there were no subjective changes in comfort.

Conclusions: A lumbar support pillow with a cut-out for the posterior pelvic tissues improved an objective measure of comfort in healthy individuals and patients with low back pain. Lumbar flattening was decreased and thoracolumbar curvature was increased. However, angular changes were small and future work is required to determine clinical relevance over the long term.

Trial registration: ClinicalTrials.gov, NCT00754585.

Figures

Figure 1
Figure 1
Photograph of the lumbar support pillow placed on the standard, split back office chair.
Figure 2
Figure 2
Sample view and placement of the kinematic electromagnetic sensors.
Figure 3
Figure 3
Sample demonstration of the thoracolumbar and lumbar angles (lateral view). The thoracolumbar and lumbar angles were calculated about T12 and L3, respectively.
Figure 4
Figure 4
Sample MatLab output of the seated CoP tracing and best fit circle over time.
Figure 5
Figure 5
Mean lumbar angle across the standing, lumbar support and regular chair conditions. Error bars represent 95% confidence intervals. Each comparison between all three conditions was significant (p < 0.05).
Figure 6
Figure 6
Mean thoracolumbar angle across the standing, lumbar support and regular chair conditions. Error bars represent 95% confidence intervals. Each comparison between all three conditions was significant (p < 0.05).

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