Escolar Documentos
Profissional Documentos
Cultura Documentos
Lumbar posture and muscular activity while sitting during ofce work
Falk Mrl a,, Ingo Bradl b,c
a
Forschungsgesellschaft fr angewandte Systemsicherheit und Arbeitsmedizin mbH, Dubliner Strae 12, 99091 Erfurt, Germany
German Social Accident Insurance Institution for the Foodstuffs and Catering Industry, Department of Prevention, Biomechanics, Dubliner Strae 12, 99091 Erfurt, Germany
c
University Hospital Jena, Clinic for Trauma-, Hand- and Reconstructive Surgery, Division for Motor Research, Pathophysiology and Biomechanics, 07740 Jena, Germany
b
a r t i c l e
i n f o
Article history:
Received 20 June 2012
Received in revised form 11 September 2012
Accepted 2 October 2012
Keywords:
Lumbar spine
Long term EMG
Sitting
Ofce work
Lordosis
Lumbar posture
a b s t r a c t
Purpose: Field study, cross-sectional study to measure the posture and sEMG of the lumbar spine during
ofce work for a better understanding of the lumbar spine within such conditions.
Scope: There is high incidence of low back pain in ofce workers. Currently there is little information
about lumbar posture and the activity of lumbar muscles during extended ofce work.
Methods: Thirteen volunteers were examined for around 2 h of their normal ofce work. Typical tasks
were documented and synchronised to a portable long term measuring device for sEMG and posture
examination. The correlation of lumbar spine posture and sEMG was tested statistically.
Results: The majority of time spent in ofce work was sedentary (82%). Only 5% of the measured time was
undertaken in erect body position (standing or walking). The sEMG of the lumbar muscles under investigation was task dependent. A strong relation to lumbar spine posture was found within each task. The
more the lumbar spine was exed, the less there was activation of lumbar muscles (P < .01). Periods of
very low or no activation of lumbar muscles accounted for about 30% of relaxed sitting postures.
Conclusion: Because of very low activation of lumbar muscles while sitting, the load is transmitted by
passive structures like ligaments and intervertebral discs. Due to the viscoelasticity of passive structures
and low activation of lumbar muscles, the lumbar spine may incline into de-conditioning. This may be a
reason for low back pain.
2012 Elsevier Ltd. All rights reserved.
1. Introduction
Ofce work and sitting at a desk for longer periods is common
for people in western civilisation. Orthopaedists and physical therapists assume de-conditioning of the trunk and lumbar spine
structures due to long-term sitting without longer active periods
of standing, walking or running. This de-conditioning may be a reason for low back pain and accelerated degeneration of lumbar
spine structures. Looking at the incidence of low back pain and
the inability to work because of low back pain in ofce workers
conrms this assumption (Burdorf et al., 1993; Hemingway et al.,
1997; Janwantanakul et al., 2008; Juul-Kristensen and Jensen,
2005; Juul-Kristensen et al., 2004; Riihimki et al., 1989, 1994;
Spyropoulos et al., 2007; Trner et al., 1991; Videman and Battie,
1999). In summary, there is high prevalence of low back pain in ofce workers with the risk of getting low back pain comparable to
more demanding work. However, there is currently little information available about the behaviour of the lumbar spine over long
periods because of a lack of adequate measurement devices. In laboratory settings, no coherence of lumbar exion angle and lumbar
Corresponding author.
E-mail address: falk.moerl@apz-erfurt.de (F. Mrl).
1050-6411/$ - see front matter 2012 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.jelekin.2012.10.002
Table 1
Age, body height, and body weight as mean (standard deviation) for all investigated
subjects.
Gender (n)
Age (years)
Female (8)
Male (5)
36.0 (7.0)
41.2 (11.7)
168 (3.2)
182 (4.2)
61.8 (6.1)
81.2 (8.4)
363
364
Table 2
Summary of distribution [%, relating to individual measuring time] of different tasks during ofce work for all subjects.
Subject
Standing
Walking
Uns. sitting
Sup. sitting
Keyboard
Phoning
Misc
S1
S2
S3
S4
S5
S6
S7
S8
S9
S10
S11
S12
S13
1.3
4.1
5.0
3.6
0.1
7.0
2.1
11.2
6.7
2.7
2.6
0.1
1.4
2.4
2.7
2.9
1.5
1.1
1.6
5.2
2.6
1.7
1.3
0.1
2.7
1.4
23.7
3.6
60.2
65.5
75.2
59.6
60.0
38.9
21.4
55.2
19.0
44.0
0.1
41.3
0.1
3.4
23.7
2.8
5.3
0.4
28.5
22.3
25.8
54.9
16.1
54.2
0.1
49.0
22.2
0.1
0.1
14.2
6.7
9.6
37.4
15.0
12.9
20.7
4.1
6.5
3.0
0.1
8.3
20.6
5.8
8.5
14.7
6.8
18.9
23.5
32.5
3.7
6.8
4.6
0.8
10.0
12.6
4.7
0.1
6.9
15.9
procedure. For this, the body position of the subjects was as follows: standing position, slightly bent knees and hips about 45,
the trunk tilted about 45. The researcher advised the subjects to
maintain lordosis of the lumbar spine. Within this posture the torque of the tilted trunk has to be compensated for mostly by the
lumbar muscles under investigation. Activation was moderately
comparable to an exercise in gymnastics. Subjects had to hold this
position (isometric contraction) for about 3060 s. Repeated measurements carried out previously in the laboratory showed adequate reliability and validity. All given sEMG data was
normalised to this activation (i.e. fractions of this activation).
2.3. Data processing and analysis
The PS11-UD measures and stores the raw sEMG data (4
650 Hz) at a sampling frequency of 4096 Hz. Amplication of the
signal was selected to get a resolution of 688 nV per bit. The raw
signals were high pass ltered (16 Hz), low pass ltered (1 kHz)
and band pass ltered (moving average at multiplies of 50 Hz) to
repress crosstalk from power supply lines.
During measurement, the device processes and stores the rectied and averaged activity (RMS, root mean square) at 8 Hz by
with the gain k, frequency limits fl/u, amplitude A and frequency f for
amplitude information. It also calculates and stores the median frequency (not discussed in this paper). The angular data of the motion
sensors on the spine were also stored synchronously at 8 Hz. The
lumbar exion angle was calculated by
3. Results
3.1. Occurrence of ofce tasks
The majority (over 82%) of ofce work was sedentary. Only
standing and walking occurred in an erect body position and these
accounted for just 5% of the total ofce time. In the sitting posture,
unsupported sitting (41%) made up the main part, with supported
sitting only accounting for 17%. Other tasks like keyboard use (16%)
and phoning (8%) were not that frequent. In summary, ofce work
was very passive, with 5% undertaken in an erect body position and
only 2% walking (Table 2).
3.2. Different tasks and lumbar muscle activation
This passivity was accentuated by the differences in lumbar
muscle activation within different seating postures. Neither type
of sitting activated the lumbar muscles a quarter as much as normalisation posture (Fig. 1). In unsupported sitting, the longissimus
muscle showed up to 20% of the normalisation posture whereas
with inclination angle from vertical axis aSn of each single motion
sensor (S1 at lumbar level L1 . . .S3 at level L5) in sagittal plane.
All the data presented here is based on the calculated RMS and
angular position data.
The measurements taken were summarised for each task observed and presented as percentages for all subjects. For the tasks
unsupported sitting and supported sitting the lumbar curvature angle in the sagittal plane was plotted by a dened histogram.
Bins of a range of 5 within the total range from 40 (maximum
lordosis) to 20 (maximum kyphotic posture of lumbar spine) were
used. Sporadic outliers below 40 or over 20 lumbar exion angle were allocated to the rst or last bin respectively. The coincidental RMS measurements of the investigated muscles were
presented as medians and quartiles over the occurrence of lumbar
posture. The tasks standing, walking, keyboard use and telephoning were excluded from this analysis because of high variation in muscle activation due to movements of the arms.
Mu L4 ri
Mu L4 le
Lo L1 ri
Lo L1 le
0.9
0.8
0.7
rel RMS
s
Z fu
1
RMS k
A2 f df
fu fl fl
0.6
0.5
0.4
0.3
0.2
0.1
0
unsupported sitting
supported sitting
1.5
rel RMS
15
0.5
occurence [%]
occurence
LoL1 le
LoL1 ri
MuL4 le
MuL4 ri
22.5
7.5
0
40
30
20
10
10
Lordosis
20
Kyphosis
the multidus muscle had lower activity at the level of 10% of normalisation. Supported sitting was effectively passive. The longissimus muscle showed up to 12% of normalised activation. The
activity of the multidus muscle was near the limit of the resolution of the measurement device at only 5%. This low activation of
multidus muscle was below 5 lV (non-normalised value) for
most cases. The differences between the described tasks are highly
signicant (P < .01).
30
occurence
LoL1 le
LoL1 ri
MuL4 le
MuL4 ri
rel RMS
15
0.5
occurence [%]
22.5
7.5
40
Lordosis
30
20
10
10
20
Kyphosis
365
366
setting, while doing their own work at their own workplace, the
subjects focused on the task in hand and their lumbar muscles
relaxed.
Because the load on the lumbar spine in the sitting posture is
not small, and there is no adequate muscular support, passive
structures like ligaments and intervertebral discs or passive muscle
properties have to carry the load (Nachemson, 1966; Wilke et al.,
2001; Schultz et al., 1985; Sihvonen et al., 1988). When sitting supported by the backrest of the chair, stress on the disc is reduced,
whereas intradiscal stress is about three times greater in unsupported exed sitting (Wilke et al., 1999). There is no knowledge
about stress on the ligaments during sedentary work in vivo currently. Biomechanical models may give hints, but depending on
the optimisation parameter used and components included (e.g.
ligaments, muscles) different results were predicted (McGill,
1986; Cholewicki et al., 1995; McGill et al., 1994; Arjmand and
Shirazi-Adl, 2005, 2006; McGill et al., 2006; Brown and McGill,
2008).
Due to their viscoelasticity and the long-lasting loading
caused by sitting, creep of passive structures can be predicted
(Adams and Dolan, 1996; Solomonow et al., 1998, 1999). Step
by step, this may lead to changes in mechanical properties and
dysfunction of these structures and also to muscular dysfunction
(Solomonow et al., 2003). The load on the human lumbar spine
during sitting is probably not directly comparable to the cited
experiments, but consideration of the daily reiterative longlasting periods of sitting during ofce work (around 8 h) and
the long times for recovery of passive structures may support
this assumption (Gedalia et al., 1999). First studies also give
evidence of this hypothetical behaviour in humans (Olson
et al., 2009; Shin et al., 2009). In reality, low back pain does
not develop after some hours of ofce work, but the fact that life
in western societies is more and more physically passive (sitting
at desks, sitting to drive cars, resting in an elevator, sitting on
the couch and watching TV, etc.) may contribute to the longterm hypothesis described.
Distinct passivity due to bedrest and low back pain are associated with atrophy or fatty replacement of paravertebral muscles (Hadar et al., 1983; McConnell and Daneman, 1984;
Mattila et al., 1986; Cooper et al., 1992; Hides et al., 1994,
2007; Bloomeld, 1997; Ng et al., 1998; Danneels et al., 2000;
Kader et al., 2000; Yoshihara et al., 2001, 2003; Barker et al.,
2004; Hyun et al., 2007; Belavy et al., 2008; Lee et al., 2008).
In an animal study, the main reason for atrophy of lumbar muscles was nonexistent neural activation (Hodges et al., 2006). Only
one study documents the coherence of physical inactivity, low
back pain and atrophy of paravertebral muscles in children
(Salminen et al., 1993). It is currently speculative to assume that
years of ofce work without active leisure lead to atrophy of
paravertebral muscles. However, the increase in the cross sectional area of back muscles due to training in patients suffering
from low back pain would support this assumption (Rissanen
et al., 1995). If there is atrophy because of years of ofce work,
the muscle function to stabilise the spine is reduced and may be
a reason for the high prevalence of low back pain. Longitudinal
studies on the cross sectional area, function or force of lumbar
muscles are necessary to investigate this further.
Paravertebral muscles and passive structures of the spine are
not independent from each other. Changes in the mechanical properties of both structures and the disappearance of reexes due to
long-lasting (also low) loading, can cause the whole spine to be
out of tune (Solomonow et al., 2003; Panjabi, 1992a,b). In this condition of dysfunction, increased degeneration and low back pain
can be assumed.
The sample of 13 subjects is small and limits the explanatory
power of this study. More subjects may lead to more variation in
lumbar posture and lumbar muscle activation within the investigated tasks. In general, signicant deviations from the results presented here should not be assumed: Firstly, low or no activation of
the lumbar muscles in exed postures of the trunk also seem to be
mechanically linked in lifting (Schultz et al., 1985; Toussaint et al.,
1995). Secondly, the medians of lumbar muscle activation presented here are (near) zero within kyphotic lumbar posture during
sedentary work. Thus, 50% of time within such postures there is
low or no activation of the lumbar muscles.
5. Conclusions
In conclusion, to reduce the high prevalence of low back
pain in sedentary work, reasonable prevention is necessary.
Considering the low activation of lumbar muscles in the sitting
posture, the use of instable seats or special ofce chairs to protect the spine or to train the paravertebral muscles will fail.
This is because lumbar muscle activation depends more on
the task than on the ofce chair used (van Dien et al.,
2001). Further, lumbar muscle activation does not differ when
seated on an exercise ball, different dynamic ofce chairs or
on a reference chair (McGill et al., 2006; Ellegast et al., 2012).
Again the spine has to be seen as a complex of muscles, passive
structures and neural control: In the sitting posture, the passive
structures are stretched/loaded, the muscles only have low activation within the stretched condition, and the lumbar spine is
in at or kyphotic curvature. A natural way to activate the paravertebral muscles within the normal length conditions within
the lordotic curvature of the lumbar spine may be breaks for
walking, working in standing position and active leisure in erect
body position.
Conict of interest
The authors have no conict of interest, no funding.
Acknowledgments
Thanks to Carol Keelan for language assistance. Thanks to
Sabine Franke for data collection.
References
Adams M, Dolan P. Time-dependent changes in the lumbar spines resistance to
bending. Clin Biomech (Bristol, Avon) 1996;11(4):194200.
Ahern DK, Follick MJ, Council JR, Laser-Wolston N, Litchman H. Comparison of
lumbar paravertebral EMG patterns in chronic low back pain patients and nonpatient controls. Pain 1988;34(2):15360.
Aminian K, Naja B. Capturing human motion using body-xed sensors: outdoor
measurement and clinical applications. Comput Anim Virtual Worlds
2004;15(2):7994.
Arjmand N, Shirazi-Adl A. Biomechanics of changes in lumbar posture in static
lifting. Spine 2005;30(23):263748.
Arjmand N, Shirazi-Adl A. Role of intra-abdominal pressure in the unloading and
stabilization of the human spine during static lifting tasks. Eur Spine J
2006;15(8):126575.
Barker KL, Shamley DR, Jackson D. Changes in the cross-sectional area of multidus
and psoas in patients with unilateral back pain: the relationship to pain and
disability. Spine 2004;29(22):E5159.
Belavy DL, Hides JA, Wilson SJ, Stanton W, Dimeo FC, et al. Resistive simulated
weightbearing exercise with whole body vibration reduces lumbar spine
deconditioning in bed-rest. Spine 2008;33(5):E12131.
Bloomeld SA. Changes in musculoskeletal structure and function with prolonged
bed rest. Med Sci Sports Exerc 1997;29(2):197206.
Brown SHM, McGill SM. How the inherent stiffness of the in vivo human trunk
varies with changing magnitudes of muscular activation. Clin Biomech (Bristol,
Avon) 2008;23(1):1522.
Burdorf A, Naaktgeboren B, de Groot HC. Occupational risk factors for low back pain
among sedentary workers. J Occup Med 1993;35(12):121320.
Callaghan JP, Dunk NM. Examination of the exion relaxation phenomenon in
erector spinae muscles during short duration slumped sitting. Clin Biomech
(Bristol, Avon) 2002;17(5):35360.
367
Mork PJ, Westgaard RH. Back posture and low back muscle activity in female
computer workers: a eld study. Clin Biomech (Bristol, Avon)
2009;24(2):16975.
Mrl F, Anders C, Grame R. An easy and robust method for ecg artifact elimination
of SEMG signals. In: ISEK. 2010.
Mrl F, Blickhan R. Three-dimensional relation of skin markers to lumbar vertebrae
of healthy subjects in different postures measured by open MRI. Eur Spine J
2006;15(6):74251.
Nachemson A. The load on lumbar discs in different positions of the body. Clin
Orthop 1966;45:107.
Newman NM, Gracovetsky SA. Flexionrelaxation phenomenon (transfer of loads
between lumbar tissues during the exionrelaxation phenomenon). Spine
(Phila Pa 1976) 1995;20(15):173940.
Ng JK, Richardson CA, Kippers V, Parnianpour M. Relationship between muscle
ber composition and functional capacity of back muscles in healthy
subjects and patients with back pain. J Orthop Sports Phys Ther
1998;27(6):389402.
Olson MW, Li L, Solomonow M. Interaction of viscoelastic tissue compliance with
lumbar muscles during passive cyclic exionextension. J Electromyogr
Kinesiol 2009;19(1):308.
OSullivan P, Dankaerts W, Burnett A, Chen D, Booth R, Carlsen C, et al. Evaluation of
the exion relaxation phenomenon of the trunk muscles in sitting. Spine (Phila
Pa 1976) 2006;31(17):200916.
Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction,
adaptation, and enhancement. J Spinal Disord 1992a;5(4):3839 [discussion
397].
Panjabi MM. The stabilizing system of the spine. Part II. Neutral zone and instability
hypothesis. J Spinal Disord 1992b;5(4):3906 [discussion 397].
de-las Peas CF, Albert-Sanchs JC, Buil M, Benitez JC, Alburquerque-Sendn F.
Cross-sectional area of cervical multidus muscle in females with chronic
bilateral neck pain compared to controls. J Orthop Sports Phys Ther
2008;38(4):17580.
Riihimki H, Tola S, Videman T, Hnninen K. Low-back pain and occupation: a crosssectional questionnaire study of men in machine operating, dynamic physical
work, and sedentary work. Spine 1989;14(2):2049.
Riihimki H, Viikari-Juntura E, Moneta G, Kuha J, Videman T, Tola S.
Incidence of sciatic pain among men in machine operating, dynamic
physical work, and sedentary work: a three-year follow-up. Spine
1994;19(2):13842.
Rissanen A, Kalimo H, Alaranta H. Effect of intensive training on the isokinetic
strength and structure of lumbar muscles in patients with chronic low back
pain. Spine 1995;20(3):33340.
Salminen JJ, Erkintalo-Tertti MO, Paajanen HE. Magnetic resonance imaging ndings
of lumbar spine in the young: correlation with leisure time physical activity,
spinal mobility, and trunk muscle strength in 15-year-old pupils with or
without low-back pain. J Spinal Disord 1993;6(5):38691.
Schultz AB, Haderspeck-Grib K, Sinkora G, Warwick DN. Quantitative studies of
the exionrelaxation phenomenon in back muscles. J Orthop Res
1985:189.
Shin G, DSouza C, Liu YH. Creep and fatigue development in the low back in static
exion. Spine (Phila Pa 1976) 2009;34(17):18738.
Sihvonen T, Partanen J, Hnninen O. Averaged (rms) surface EMG in testing back
function. Electromyogr Clin Neurophysiol 1988;28(6):3359.
Solomonow M, Baratta R, Zhou BH, Shoji H, Bose W, Beck C, et al. The synergistic
action of the anterior cruciate ligament and thigh muscles in maintaining joint
stability. Am J Sports Med 1987;15(3):20713.
Solomonow M, Baratta RV, Zhou BH, Burger E, Zieske A, Gedalia A. Muscular
dysfunction elicited by creep of lumbar viscoelastic tissue. J Electromyogr
Kinesiol 2003;13(4):38196.
Solomonow M, Zhou BH, Baratta RV, Lu Y, Harris M. Biomechanics of increased
exposure to lumbar injury caused by cyclic loading: Part 1. loss of reexive
muscular stabilization. Spine 1999;24(23):242634.
Solomonow M, Zhou BH, Harris M, Lu Y, Baratta RV. The ligamento-muscular
stabilizing system of the spine. Spine 1998;23(23):255262.
Spyropoulos P, Papathanasiou G, Georgoudis G, Chronopoulos E, Koutis H,
Koumoutsou F. Prevalence of low back pain in greek public ofce workers.
Pain Phys 2007;10(5):6519.
Toussaint HM, de Winter AF, de Haas Y, de Looze MP, van Dieen JH, Kingma I.
Flexion relaxation during lifting: implications for torque production by muscle
activity and tissue strain at the lumbo-sacral joint. J Biomech
1995;28(2):199210.
Trner M, Zetterberg C, Andn U, Hansson T, Lindell V. Workload and
musculoskeletal problems: a comparison between welders and ofce clerks
(with reference also to shermen). Ergonomics 1991;34(9):117996.
Videman T, Battie M. The inuence of occupation on lumbar degeneration. Spine
1999;24(11):11648.
Wilke H, Neef P, Hinz B, Seidel H, Claes L. Intradiscal pressure together with
anthropometric data a data set for the validation of models. Clin Biomech
(Bristol, Avon) 2001;16(1):11126.
Wilke HJ, Neef P, Caimi M, Hoogland T, Claes LE. New in vivo measurements of
pressures in the intervertebral disc in daily life. Spine (Phila Pa 1976)
1999;24(8):75562.
Yoshihara K, Nakayama Y, Fujii N, Aoki T, Ito H. Atrophy of the multidus muscle in
patients with lumbar disk herniation: histochemical and electromyographic
study. Orthopedics 2003;26(5):4935.
368