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Sitting Postures and Trunk Muscle Activity in Adolescents With and Without Nonspecific Chronic Low Back Pain: An Analysis Based on Subclassification

Astfalck, Roslyn G. PT*; O'Sullivan, Peter B. PhD*†; Straker, Leon M. PhD*†; Smith, Anne J. PhD*†; Burnett, Angus PhD; Paulo Caneiro, Joao PT*; Dankaerts, Wim PhD§¶

doi: 10.1097/BRS.0b013e3181bd3ea6
Occupational Health/Ergonomics

Study Design. A preliminary cross-sectional comparative study of adolescents with nonspecific chronic low back pain (NSCLBP) and healthy controls.

Objective. To investigate whether differences in spinal kinematic and trunk muscle activity exist in both usual and slump sitting in adolescents with NSCLBP.

Summary of Background. Evidence suggests that low back pain commonly develops in adolescence and increases the risk for low back pain in adulthood. Sitting is an important consideration in adolescents with NSCLBP: currently there are no reports investigating their motor control strategies in sitting.

Methods. Twenty-eight adolescents (14 female) with NSCLBP and 28 matched pain-free controls were recruited from a large cohort study. Pain subjects were subclassified based on O'Sullivan's classification system. Three-dimensional lumbo-pelvic kinematic data and the activation of 3 back and 2 abdominal muscles were recorded during usual and slump sitting. The flexion-relaxation phenomenon in sitting was also investigated.

Results. Spinal posture in usual and slump sitting were similar for adolescents with and without NSCLBP. However, differences were identified in both sitting conditions when those with NSCLPB were subclassified and compared with controls. Muscle activation differences were not consistently identified, with only lower levels of internal oblique activation in usual sitting in NSCLBP compared with pain-free controls showing significance. Flexion relaxation was observed in both iliocostalis and thoracic erector spinae in the NSCLBP group but not controls.

Conclusion. This study provides preliminary results. Differences with sitting posture are only seen when adolescents with NSCLBP are classified. Trunk muscle activation is not a sensitive marker for discriminating subgroups of NSCLBP during adolescence.

Preliminary results suggest spinal posture in usual and slump sitting were similar for adolescents with and without nonspecific chronic low back pain (NSCLBP). However, differences were identified in both sitting conditions when those with NSCLPB were subclassified and compared with controls. Trunk muscle activation is not a sensitive marker for discriminating subgroups of NSCLBP during adolescence.

From the *Curtin University of Technology, Perth, Western Australia; †Telethon Institute of Child Health Research, Perth Western Australia; ‡Edith Cowan University, Perth, Western Australia; §Musculoskeletal Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences K. U. Leuven, Leuven, Belgium; ¶Department of Health Care, University College Limburg, AUHL-PHL, REVAL–Rehabilitation and Health Care Research Center, Hasselt, Belgium.

Acknowledgment date: May 17, 2009. Revision date: July 28, 2009. Acceptance date: August 20, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Supported by a National Health and Medical Research Council of Australia Project grant (#323200) (to L. M. S. and A. J. S.), the Telethon Institute for Child Health Research, the Raine Medical Foundation at the University of Western Australia, the Arthritis Foundation of Australia and the Arthritis Foundation of Western Australia.

The authors A. B. and W. D. were previously associated with the Curtin University of Technology, Perth, Western Australia.

This research was approved by the Human Research Ethics Committees of Curtin University of Technology and Princess Margaret Hospital, Perth, Western Australia.

Address correspondence and reprint requests to Peter O'Sullivan, PhD, School of Physiotherapy, Curtin University of Technology, GPO Box U1987, PERTH WA 6845, Australia; E-mail: P.OSullivan@curtin.edu.au.

© 2010 Lippincott Williams & Wilkins, Inc.