De Carvalho Diana E, Soave David, Ross Kim, Callaghan Jack P
Associate Professor, Faculty of Applied Health Sciences, Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
J Manipulative Physiol Ther. 2010 Jan;33(1):48-55. doi: 10.1016/j.jmpt.2009.11.008.
Sitting has been identified as a cause of mechanical low back pain. The purpose of this study was to use plain film x-rays to measure lumbar spine and pelvic posture differences between standing and sitting.
Eight male subjects were radiographed standing and sitting in an automobile seat. Measures of lumbar lordosis, intervertebral disk angles, lumbosacral angle, lumbosacral lordosis, and sacral tilt were completed. One-way analysis of variance (alpha = .05) was conducted on the variables stated above. A Bland-Altman analysis was conducted to assess agreement and repeatability of the lumbar lordosis angle using 2 raters.
Lumbar lordosis values in standing (average, 63 degrees +/- 15 degrees ) and sacral inclination (average, 43 degrees +/- 10 degrees ) decreased by 43 degrees and 44 degrees , respectively, in sitting. Intervertebral joint angles in sitting underwent substantial flexion (L1/L2-5 degrees [+/-3 degrees ], L2/L3-7 degrees [+/-3 degrees ], L3/L4-8 degrees [+/-3 degrees ], L4/L5-13 degrees [+/-3 degrees ], and L5/S1-4 degrees [+/-10 degrees ]). Measures of lumbar lordosis; intervertebral disk angles between L2/L3, L3/L4, and L4/L5; lumbosacral lordosis; lumbosacral angle; and sacral tilt were significantly decreased between standing and sitting (P < .001). Intervertebral disk angle between L5/S1 was not significantly different. Analysis using the Bland-Altman technique found good agreement and stable repeatability of measures with no statistical significant differences between or within raters (R1, P = .8474; R2, P = .4402; and R-R2, P = .8691).
The significant differences in lumbar and pelvic measures from standing to sitting further emphasize the range of motion experienced at vertebral levels in sitting. Based on the results of this study, interventions to return motion segments to a less flexed posture should be investigated because they may play a role in preventing injury and low back pain.
久坐已被确认为机械性下腰痛的一个原因。本研究的目的是使用普通X线片来测量站立和坐姿时腰椎和骨盆姿势的差异。
对8名男性受试者在站立和坐在汽车座椅上时进行X线摄影。完成对腰椎前凸、椎间盘角度、腰骶角、腰骶前凸和骶骨倾斜度的测量。对上述变量进行单因素方差分析（α = 0.05）。使用两名评估者进行Bland-Altman分析，以评估腰椎前凸角度的一致性和可重复性。
站立时腰椎前凸值（平均，63度±15度）和骶骨倾斜度（平均，43度±10度）在坐姿时分别减少了43度和44度。坐姿时椎间关节角度出现明显屈曲（L1/L2 -5度[±3度]，L2/L3 -7度[±3度]，L3/L4 -8度[±3度]，L4/L5 -13度[±3度]，L5/S1 -4度[±10度]）。站立和坐姿之间，腰椎前凸、L2/L3、L3/L4和L4/L5之间的椎间盘角度、腰骶前凸、腰骶角和骶骨倾斜度的测量值显著降低（P < 0.001）。L5/S1之间的椎间盘角度无显著差异。使用Bland-Altman技术进行的分析发现测量结果具有良好的一致性和稳定的可重复性，评估者之间或评估者内部无统计学显著差异（R1，P = 0.8474；R2，P = 0.4402；R-R2，P = 0.8691）。
从站立到坐姿时腰椎和骨盆测量值的显著差异进一步强调了坐姿时椎体水平所经历的活动范围。基于本研究结果，应研究使运动节段恢复到较少屈曲姿势的干预措施，因为它们可能在预防损伤和下腰痛方面发挥作用。
