Background: Clinical ergonomic advice for sitting posture has been inferred from anthropometry theory and physiology studies. Qualitative observation of posture has been used to argue that postures are too flexed, too extended, too static, too mobile, require insufficient muscle activity or require too much. In other fields of healthcare, evidence is progressed from basic science to clinical trials before an intervention is prescribed, but postural advice has been prescribed from basic science without quantitative studies of postural behaviour. Spinal neuromuscular control can predict development of low back pain, it is affected by spinal pain, and can be trained, but studies examining these variables rarely measure the spinal position of their test subjects. There is a need for more detail of how spinal positions affect regional muscle activity. Study Objectives: The overall aims of this thesis were to quantify sagittal spinal postures in sitting for comparison within and between subjects and tasks, and to detail paraspinal and abdominal muscle activity associated with sitting postures. The studies quantified regional spinal curves in - Study I: typical posture behaviour during a computer task in comparison with standing, - Study II: postures that are achievable in sitting, - Study III: the regional muscle activity associated with sitting postures that have been clinically advocated as ‘ideal’, - Study IV: cohorts with and without a history of low back pain for comparison of regional muscle activity. Results and Conclusions: For clinical trials quantifying postural behaviour, the postural variation within subjects and task conditions in Study I demonstrated the importance of measurement over a prolonged period and subjects performing relevant tasks (as opposed to brief measures such as radiography that have been the standard for posture assessment). The use of surface tracking to quantify regional spinal curves and sagittal balance establish a foundation to investigate the effect of interventions on posture behaviour (eg. chair geometry, posture training, task variables and subject cohorts). Study I also showed that typical sitting posture for a computer task was more flexed at the thoracolumbar spinal region than when subjects deliberately ‘corrected’ their sitting posture, and both sitting postures were flexed at the lumbar region relative to standing. Study II showed that most subjects were unable to sit with spinal curves like those adopted in standing unless facilitation and feedback were provided, although these curves have been clinically advocated as ‘ideal’ posture. If clinical theories about ‘ideal’ sitting posture are correct, then teaching individuals the awareness of spinal position or skill to adopt these postures could be as important for workplace health and safety as other variables such as design and adjustment of office furniture. Study III showed three upright sitting postures that have been clinically advocated as ‘ideal’ were distinguished by incremental changes in activity of the lumbar multifidus muscles. In Study IV, individuals with a history of low back pain showed more incremental activity at the longissimus thoracis muscle to achieve the same sitting postures. If particular postures are shown to be ‘ideal’ in clinical trials, then training for these postures may need to focus on muscular strategies as well as spinal position. The distinct differences in regional muscle activity observed with spinal curves and subject cohorts (Studies III and IV) imply that studies of spinal neuromuscular control should measure or control spinal curves during testing. If spinal posture were controlled, the flat posture (flat surface from ~T5 to sacrum) would have the advantages of being achievable, commonly used in sitting and easily assessed. The flat posture also demonstrated the lowest muscle activity of the upright sitting postures examined, which may improve accuracy of determining muscle activity onset/offset used as an outcome measure for interventions, distinguishing cohorts or as a predictor for low back pain occurrence.

Thesis (M.Sc.)--University of Alberta, 2009. / Title from pdf file main screen (viewed on August 13, 2009). "A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science, Department of Mechanical Engineering , University of Alberta." Includes bibliographical references.

Background: Research suggests that cervical spine CT examination is over used for potential injury due to blunt trauma. Education of emergency providers regarding evidence-based guidelines can help reduce the over-use of CT examination, and the development of an evidence-based protocol for the management of patients with suspected cervical spine trauma may help promote more appropriate clinical use of radiologic imaging for cervical spine clearance. Purpose: The ultimate goal of this project is to develop a best-practice, evidence-based protocol for the management of patients with suspected cervical spine injury, in order to promote safe and efficient clinical clearance, as well as promote judicious and appropriate use of diagnostic imaging for suspected cervical spine injury. Methods: A retrospective chart review of emergency radiographic imaging studies obtained over a three-month timeframe for suspected cervical spine injury at a 300-bed hospital in Tucson, Arizona was performed to compare ordering practices with the ACR-AC. Descriptive statistics were used for data analysis. A web-based survey was conducted of facility stakeholders including emergency physicians, nurse practitioners and physician assistants regarding their views about clinical guidelines and protocols for radiographic and clinical clearance of cervical spine injury. Descriptive statistics and thematic analysis was used for survey responses. Results: Analysis of 263 imaging studies over a three-month timeframe demonstrated that 24.3% of cervical spine imaging studies obtained in three-month timeframe would be considered not appropriate based on the ACR-AC. The survey of emergency clinicians revealed that none of those who responded have a preference for referring to the ACR appropriateness criteria, and the majority of respondents did not support the implementation of a hospital protocol for the management of patients with suspected cervical spine trauma. Recommendations: An institutional protocol for suspected cervical spine injury developed from the ACR-AC with incorporation of clinical clearance criteria is recommended. To promote clinician acceptance, overcome resistance to implementation, and promote individualized patient care, the protocol should also include provider education and should allow for variance based on individual patient circumstances.

Bibliographical record DVOŘÁK, J. Physiological movements of the spine during locomotion. Prague: Charles University, 2nd Faculty of Medicine, Department of Rehabilitation and Sports Medicine 2021. 75 p. Thesis supervisor PhDr. Marcela Šafářová, Ph.D. Abstract The diploma thesis Physiological movements of the spine during locomotion deals with the relationship between locomotion, spatiotemporal properties of gait and spinal movements. The theoretical part of the work summarizes the knowledge about the phylogenetic and ontogenetic development of the spine. The paper discusses the influences that affect the motility of the spine from intrauterine development to old age. The main part of the theoretical part is devoted to an overview of studies examining the movements of the spine during human locomotion. The experimental part was performed by testing a group of younger (24.6 ± 3.6 years) and older adults (43.5 ± 4.6 years). Both groups consisted of 8 women and 8 men. A total of 32 volunteers were tested. Otto's spine distance, thoracic spine rotation, 95% COP standing, and spatiotemporal gait data were measured using a Zebris Rehawalk FDM-T. Thereafter, therapy was applied to the chest to affect the dynamics of movement. Finally, control measurements of all olunteers were performed. Statistical data...

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Source: Masters Abstracts International, Volume: 46-03, page: 1492. Adviser: Robert E. Roberts. Includes bibliographical references.

Thesis (M.Tech.: - Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 xiii, 75 leaves, Annexures 1-2 / This research study was designed in the form of a quantitative, non-experimental, empirical clinical survey. Objectives: 1) To determine the period prevalence (1 January 1997 – 31 December 2004) of congenital cervical spine anomalies. 2) To determine if there is any association between the presenting clinical features and the congenital cervical spine anomalies in general. 3) To determine if there is any association between the presenting clinical features and individual congenital cervical spine anomalies. 4) To compare subjects presenting clinical features with reported clinical features from literature.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2014. / Correct neck support is required during sleep to align the spine and maintain neutral posture, and to immobilise the joints in the neck which would allow the cervical paraspinal muscles to relax (De Laittre, 1974; Ambrogio et al., 1998; Erfanian et al., 1998). Poor spinal posture during sleep however, has been hypothesized to result in lateral bending and uneven loading on the intervertebral discs and cervical facet joints, and compression of pain-sensitive structures in the neck (Leilnahari et al., 2011). The pillow is a significant contributing factor to sleep quality and the development of symptoms on waking (Gordon et al., 2011). This should theoretically reduce pressure on the pain-sensitive structures and allow the intervertebral discs to be unloaded and rehydrated (Leilnahari et al., 2011). Aim: To determine and compare the effect of the Simmons’ Beautyrest pillow, a polyester foam pillow, a latex pillow, and no pillow, on cervico-thoracic and forward head posture in the supine and recumbent supine positions in asymptomatic individuals. Methods: Forty asymptomatic subjects between the ages of 20 and 30 years were recruited using convenience sampling. The study was a double-blinded comparative investigation where all participants underwent a case history, physical examination and an orthopaedic examination of the cervical spine. Thereafter, digital photographic images of the participants lying without a pillow and on three different pillows (Simmons Beautyrest® pillow, a polyester foam pillow and a latex pillow) in the supine and recumbent positions were captured. These images were then uploaded onto a computer, and using the linear co-ordinates of each anatomical landmark (which was determined by the researcher using CorelDraw Graphics Suite 12), the cervico-thoracic and craniocervical postures were determined. The cervico-thoracic posture was determined by calculating the gradients of the intersegmental slopes, relative to the horizontal plane, using the formula (y2 − y1)/(x2 − x1). The craniocervical posture was determined by calculating the craniocervical angle. This angle was determined by constructing lines between the anatomical landmarks and measuring the angle produced at C7. At the end of the objective data collection, participants were asked verbally which pillow they found most comfortable. All data was collected by the researcher. Statistical analysis was done using IBM SPSS version 21.0. Repeated measures ANOVA test was used to compare the mean slope measurements in the four conditions. Inferential techniques included Wilcoxon Signed-Rank test and t-tests. A p-value of < 0.05 indicated statistical significance. iv Results: The mean (± SD) age of the participants was 24.3 (± 2.57) years. In terms of pillow preference, 15 participants preferred the latex pillow, 8 preferred the polyester pillow and 17 preferred the Simmons Beautyrest® pillow. In the recumbent position for the C2-EOP slope the latex and Simmons Beautyrest® pillows supported the neck in a similar manner (p= 0.480) and closer to neutral than no pillow and the latex pillow. For the C4-C2 and the C7-C4 slopes, the latex pillow produced the least extreme slope. For the T3-C7 slope, the polyester pillow produced the slope closest to neutral. Overall, for the entire cervical spine, the latex pillow produced the least extreme slopes, but at the cervico-thoracic junction, the polyester pillow produced the most neutral slope. In all segments, the condition without a pillow produced the most extreme slopes. When comparing the slopes themselves, it can be seen that the most extreme deviations from neutral occurred at the C2-EOP segment. The midcervical spine deviated least from neutral. In the supine position, there were no significant differences (p> 0.05) in the sagittal angular displacement between the pillows. Conclusion: The results of this study support the view that there is no one particular pillow that is better than the others for providing optimal support to the head and neck. Furthermore, practitioners should be aware that it is the craniocervical and cervico-thoracic slopes, which are determined with the patient in the recumbent position, that provide significant information regarding support provided by the pillow rather than the sagittal angular displacement assessed in the supine position. / Durban University of Technology