Sitting and Your Spine’s Health

Sitting and Your Spine’s Health

Introduction

As the sedentary demands of our society continue to grow, we must evolve in a way that combats the negative effects of increased sitting.  The lumbar spine experiences physiological changes during prolonged flexion which not only has been hypothesized to increase the stiffness of the spine, but has also been linked to a creep phenomena that impairs the sensorimotor control of the low back.  Creep, along with fatigue of the multifidi, leads to decreased stabilization with lifting and weight holding in the lumbar spine.  Therefore, the risk of injury with activity after prolonged sitting is significant.  In order to minimize the tensile stress placed on the spinal structures, one must be educated not only on the most ideal sitting posture and how to maintain it, but also on strategies to counteract the negative effects of sitting on the spine because even the best sitting posture can be harmful to the spine if done long enough.

Brochure

The main objective of my capstone project was to create an educational brochure for those in the workforce who primarily sit while performing their occupation full-time.  Ideally the educational brochure creates self-efficacy through simple illustration and expression of the facts surrounding sitting.  The reader is informed of the physiological impact of prolonged sitting on the spine, the different sitting postures the human spine can assume, which sitting posture places the least amount of stress on the spine, and finally, what can be done to minimize the negative effects of sitting during work and after work because despite our best efforts some occupations will require one to sit.

Here is my brochure:  BrochureFinal

Evaluation Component

I currently work in an outpatient clinic at Duke University.  The brochure was distributed to many of my co-workers who are administrative support staff and sit for >90% of their day.  Along with the brochure itself, a evaluation/feedback form was given to those who read the brochure.

Here is my evaluation form:  CapstoneSurvey

Preliminary results of my evaluation form: SurveyResults

Health Literacy Adventure

One of the challenges to this project was composing a brochure with enough information to create self-efficacy in a language that all readers could understand and enjoy reading.  In order to do this, I spent a great deal of time going through the health literacy chapter in Doak et al.  In this particular chapter I ran my brochure through the 17-item checklist, the Fry Formula, and the Suitability Assessment of Materials (SAM).  I adhered to all items in the 17-item checklist, the Fry Formula produced a second grade reading level and the brochure had a score of 40/44 on the SAM.

Presentation to Physical Therapists

In addition to the brochure, it was evident that more needed to be done beyond reaching out to sedentary co-workers.  Therefore, a power point presentation was constructed with an intended audience of physical therapists.  The objectives of the presentation were the same as the brochure, but with more detailed evidence provided.

Here is my Presentation:  PPTPresentation

Evidence Behind the Products

In EBP II I explored the effects of different lumbar spine postures on the alignment of the cervical spine.  I expanded this evidence table with approximately 10 more studies that examined the physiological effects of lumbar flexion on the spine or how to combat the negative effects of sitting with exercise.  This expanded evidence table was the foundation for both the brochure and the presentation.

Here is my Evidence Table:  CapstoneEvidenceTable

THANK YOUs!

Thank you so much to my advisor Mike Gross, PT, PhD and my committee members Phil Witt, PT, PhD and Lexie Wright, PT, PhD for your guidance and mentorship.

References

1. Shin G, D’Scouza C, Liu Y.  Creep and fatigue development in the low back in static flexion.  Spine.  2009;34(17):1873-1878

2. Beach TA, Parkinson RJ, Stothart RJ, Callaghan JP.  Effects of prolonged sitting on the passive flexion stiffness of the in vivo lumbar spine.  Spine.  2005;5(2):145-154.

3. Sanchez-Zuriaga D, Adams MA, Dolan P.  Is activation of the back muscles impaired by creep or muscle fatigue.  Spine.  2010;35(5):517-25.

4. Shin G, Mirka GA.  An in vivo assessment of the low back response to prolonged flexion:  interplay between active and passive tissues.  Clin Biomech.  2007;22(9):965-71.

5. Caneiro JP, O’Sullivan P, Burnett A, Barach A, O’Neil D. Tveit O, Olafsdottir K.  The influence of different sitting posture on head/neck posture and muscle activity.  Manual Therapy.  2010;15(1):54-60.

6. Black DM, McClure P, Polansky M.  The influence of different sitting positions on cervical and lumbar posture.  Spine.  1996;21(1):65-70

7. Silva AG, Punt TD, Sharples P, Vilas-Boas JP, Johnson MI.  Head posture and neck pain of chronic nontraumatic origin:  comparison between patients and pain free persons.  Arch Phys Med Rehabil.  2009;90(4):669-74.

8. Falla D, Jull G, Russell T, Vicenzino T, Hodges P.  Effect of neck exercise on sitting posture in patients with chronic neck pain.  Phys Ther.  2007;87)4):408-17.

9. O’Sullivan PB, Dankaerts W, Burnett AF, Farrell GT, Jefford E, Naylor CS, O’Sullivan KJ.  Effect of different upright sitting postures on spinal-pelvic curvature and trunk muscle activation in a pain free population.  Spine.  2006;31(19):E707-12.

10. O’Sullivan PB, Grahamslaw KM, Kendell M, Lapenskie SC, Moller NE, Richards KV.  Effect of different standing and sitting postures on trunk muscle activity in a pain-free population.  Spine.  2002;27(11):1238-44.

11. Reeve A, Dilley A.  Effects of posture on the thickness of the transversus abdominis.  Man Ther.  2009;14(6):679-84.

12. Park SY, Too WG.  Effects of a posture sensing air seat device (PSASD) on kinematics and trunk muscle activity during continuous computer work.  J Physiol Anthropol.  2011;30(4):147-51.

13. Gregory DM, Dunk NM, Callaghan JP.  Stability ball versus office chair:  comparison of muscle activation and lumbar spine posture during prolonged sitting.  Hum Factors.  2006;48(1):142-53.

14. Horton SJ, Johnson GM, Skinner MA.  Changes in head and neck posture using an office chair with and with and without lumbar roll support.  Spine.  2010;35(12):E542-8.