The effectiveness of a dynamic seat cushion in preventing neck and low-back pain among high-risk office workers: a 6-month cluster-randomized controlled trial.

OBJECTIVE: This study evaluated the effectiveness of the promotion of postural shift intervention using a dynamic seat cushion on the 6-month incidence of neck and low-back pain among high-risk office workers. METHODS: In a cluster-randomized controlled trial (RCT), 133 office workers were randomly assigned, at cluster level, to intervention (N=67) and control (N=66) groups. The intervention group received a dynamic seat cushion to encourage postural shifts during sitting, while the control group received a placebo seat pad. Primary outcomes were 6-month incidence of neck and low-back pain. Secondary outcomes included sitting discomfort, pain intensity, disability, and trunk muscle performance. Analyses utilized Cox proportional hazard models. RESULTS: During the 6-month period, 15% of participants in the intervention group developed neck pain and 10% developed low-back pain. For the control group, this was 65% and 59%, respectively. Hazard rate (HR) ratios, after adjusting for biopsychosocial factors, indicated a protective effect of the intervention for neck pain [HRadj 0.19, 95% confidence interval (CI) 0.09-0.39, P<0.001] and low-back pain (HRadj 0.16, 95% CI 0.07-0.35, P<0.001). The intervention group demonstrated a significant reduction in sitting discomfort and improvement in trunk muscle performance compared to the control group (P<0.05). However, the intervention did not reduce pain and disability in individuals experiencing pain compared to the control group. CONCLUSIONS: The dynamic seat cushion effectively reduced the incidence of neck and low-back pain by promoting postural shifts. These findings suggest that the key factor in reducing the risk of developing neck and low-back pain is the facilitation of postural shifts during sitting, which can potentially be achieved with other dynamic interventions designed to reduce prolonged and static sitting among office workers.

Effect of two dynamic seat cushions on postural shift, trunk muscle activation and spinal discomfort in office workers.

We investigated the effect of two dynamic seat cushions on postural shift, trunk muscle activation and spinal discomfort. In this repeated-measures study, 30 healthy office workers were randomly assigned to a sequence of three conditions: sitting on a dynamic seat cushion-A, cushion-B and control (no seat cushion). The two dynamic seat cushions had different inflation levels. Participants typed a standard text for an hour and were monitored for postural shift by using a seat pressure mat, transversus abdominis/internal oblique and lumbar multifidus muscles activity by using surface EMG, spinal discomfort by using Borg's CR-10 scale. Two-way repeated ANOVAs showed no statistically significant interaction effects between condition and time on postural shift and muscle activation. Post hoc Bonferroni tests showed that postural shifts and lumbar multifidus activation during sitting on cushion-A were significantly higher (p < 0.01) than in the control and cushion-B conditions. Both cushions reduced spinal discomfort, compared to the control condition (p < 0.05).

Postural shifts and body perceived discomfort during 1-hour sitting when leaning and sitting on an air-filled seat cushion among healthy office workers.

This study compared the number of postural shifts and perceived discomfort while leaning and sitting on an air-filled seat cushion for 1 hour. Sixty office workers typed a standard text while leaning on a cushion placed behind the low back, sitting on a cushion placed under the buttocks, and sitting without a cushion (a control condition). The number of postural shifts was collected using a seat pressure mat device. Low back discomfort was assessed using the Borg CR-10 scale. Leaning on a seat cushion (22 shifts/h) led to a significantly higher number of postural shifts than sitting on a seat cushion (18 shifts/h) and the control condition (20 shifts/h). Leaning or sitting on a seat cushion significantly decreased low back discomfort compared to the control condition (p < 0.05). Leaning on a seat cushion placed behind the low back may be an effective means of preventing low back pain among office workers.

During prolonged sitting, using a seat cushion, whether leaning or sitting on it, may be more efficient in preventing low back pain compared to not using one. Particularly, leaning on a seat cushion led to more postural shifts during sitting compared to sitting on one or not using any.

The effects of chair intervention on lower back pain, discomfort and trunk muscle activation in office workers: a systematic review.

Objectives. The chair is a standard piece of workstation equipment in an office. Previous studies showed that a suitable chair may reduce musculoskeletal symptoms. This review investigated the effect of chair intervention on lower back pain (LBP), discomfort and trunk muscle activation among office workers. Methods. Five electronic databases from 1980 to May 2020 were searched for relevant randomized and non-randomized controlled trials. The methodological quality of the included studies was assessed using the 13-item Cochrane risk of bias tool. Quality of evidence was assessed and rated according to Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines. Results. Two randomized controlled trials, 10 repeated-measures studies and two prospective cohort studies were included in this review. Nine studies were rated as high quality. The results indicated very low-quality to low-quality evidence for the conflicting effect of chair intervention on pain and discomfort reduction as well as trunk muscle activation among office workers. When stratified by chair type, the level of evidence for health benefits derived from any type of chair was still of very low to low quality. Conclusion. Unless supplementary high-quality studies provide different evidence, chair interventions are not recommended to reduce LBP or discomfort and activate trunk muscles.

The effect of an acupressure backrest on pain and disability in office workers with chronic low back pain: A randomized, controlled study and patients' preferences.

OBJECTIVE: This study investigated the effects of an acupoint-stimulating lumbar backrest on pain and disability in office workers who suffering from low back pain (LBP) as well as the preference influence on pain and disability. METHODS: Sixty-four participants were randomly assigned to two groups: one with no intervention (n=32) and another with 1 month of backrest use (n=32). An additional group (n=37) who wished to try 1 month of acupressure backrest were recruited to indicate the preference effect. Pain and disability were two key outcomes. RESULTS: Significant differences between control and randomized acupressure backrest groups were found at 2 week period for disability and at 4 weeks for pain after the backrest use. Also, significant differences were found in both groups for 3 month period with an increase of the treatment effect on pain and disability. Both control and randomized acupressure backrest groups showed greater improvement in pain and disability scores which were more than the minimal clinically important change (30% improvement for both outcomes). No significant difference was found for pain and disability between the randomized and preferred backrest groups. CONCLUSION: These findings suggested 1-month of acupressure backrest use could improve LBP conditions. Preference was not a powerful moderator to the significant treatment effect.