REMEDIATION

Screen Shot 2018-09-23 at 12.12.55The main adverse effects of upright sitting have already been covered.  Once  recognised then it becomes possible to consider the options available for remediation.   This is a resource for the design of chairs to avoid the associated LBP.   It should be an essential tool for any chair designer

The adverse effects of upright sitting.

This has already been covered in ☛Biomechanics→.  .  AVOID :-

  • The intradiscal pressure from spinal axial loading in the upright state. The conventional upright sitting posture increases disc compression.Reduction of axial loading→
  • Retroversion (backward tilt or to an an anatomist a ‘forward tilt’)  of the pelvis results in lumbar spinal flexion which reduces or reverses the protective disc wedge angle.avoid backward tilting of the pelvis→
  •  Preserve the lumbar lordosis→
  • Stretching of the posterior elements (ligaments joint capsules) allowing instability of the motion segment and can lead to CTD.  Ligaments→
  • AugmentedA reduced hip angle.  With a seat parallel to the floor the hip angle at only 90° the hip extensor muscles (hamstrings & glutei) also rotate the pelvis so as to flatten the lumbar lordosis.
  • The lower lumbar intervertebral joints (L5/S1, L4/5 & less, L3/4), on the mobile side of the lumbo-sacral junction, being the most at risk
  • Localised pressure in the area of the ischial tuberosities (IT)
  • Immobility.  Ensure disc nutrition by pressure changes with movement→

 Requirements for  REMEDIATION & optimisation.

Partial solutions in use at present  include :-

These partial solutions are for mid-upright sitting in chairs that have been well designed and engineered.

Screen Shot 2018-07-04 at 14.21.47

Partial solutionsThe ‘Supine reclined mode’, if correctly configured, is the only position that addresses all the requirements for remediation shown above.  It provides the default working position for the 2T (3M) concept.   For the 2T full remediation further requirements are necessary. See ☛ 2T CONCEPT a full solution →

Back support of some sort.         ☛ Lumbar v Iliac support→  

Forward Tilted seat (FTS)     ☛ The FTS→   ☛ Mandal

‘Ischial off-load   A third system, combines these two. by use of a convex seat.   This combines both a FTS and allows, at the back half, pelvic support.☛ (ischial offload),

ALTERNATIVE SYSTEMS

  1. Sit/Stand.  The  importance of keeping staff exercised is increasingly recognised.   For more detail See ☛Sit/Stand→     The negative consequences of constrained sitting has been described by a number of authorities (Adams and Hutton, 1983Duncan and Ferguson, 1974Edlund  There are advantages in keeping staff moving around and inter-reacting in certain types of office.
    Note that a sit/stand system can always incorporated into a 3M work chair station→ 
  2. Office in a pool.  Hardly suitable for the UK!

 

Screen Shot 2018-09-22 at 14.05.14An advantage

Dynamic seating.     Spinal movement aids muscle proprioception and IV Disc nutrition which has a physiological advantages over constrained seating and also may have a comforting effect if under the control of the user.      ☛   EXERCISE & movement  Also ☛ Disc Nutrition & Spinal Movement.

 

Screen Shot 2018-09-23 at 12.06.57However they are not a solution to fully reduce  the incidence of backache (LBP).   This would require a new technical fix that addresses all identified adverse bio-mechanics effects of prolonged upright sitting.   An optimal system that effectively fully remediates all the adverse effects that have been enumerated.  Any chair can be compared to it for establishing it’s ergonomic efficiency.   An essential tool for chair design.      ☛2T CONCEPT a full solution