Rehabilitation Practitioners' Perceptions of Optimal Sitting and Standing Posture in Men with Normal Weight and Obesity

Abstract

The concepts of "optimal posture (OP)" and "harmful posture (HP)" are commonly used, and specific spinal postures can contribute to back pain. However, quantitative descriptions of optimal and harmful standing (StP) and sitting (SP) postures are currently lacking, particularly for different body mass indices (BMIs). Therefore, this study aimed to identify and quantify the OPs and HPs of StP and SP at different BMIs and investigate the attitudes and beliefs of rehabilitation practitioners toward OPs and HPs. Overall, 552 rehabilitation practitioners were recruited to participate in a questionnaire survey to select the optimal position from seven sitting and five standing postures for each BMI healthy volunteer. The segmental relationships of each posture were qualified using the Vicon software. For normal BMI, the physiotherapists chose two SPs (48.19% and 49.64%) and one StP (80.42%) as the OP. One sitting SP (83.7%) and two standing StPs (43.48% and 48.19%) were selected as optimal for obese BMI. All the most commonly selected OPs had an upright lordotic posture, while the postures with slouched spinal curves or forward head postures were almost all selected as HP. Additionally, 96.74% of participants considered education about optimal SP and StP to be "quite" or "very" important. The OP of the StP and SP postures was mostly based on the vertical alignment of gravity lines and sagittal balance. For obese people, the rehabilitation practitioners' observations may be erroneous, and further physical examination is necessary. Rehabilitation practitioners generally believe that postural education is essential in clinical practice.

Keywords: BMI; back pain; postural health; rehabilitation practitioners; sitting; standing.

Figure 1

Sitting and standing postures of the first healthy volunteer with a BMI of 21 kg/m²: (a) the five determined standing postures; (b) the seven determined sitting postures.

Figure 2

Sitting and standing postures of the second healthy volunteer with a BMI of 32 kg/m²: (a) the five determined standing postures; (b) the seven determined sitting postures.

Figure 3

The eight sagittal angles calculated in the study describe the spinal configuration of each seated and standing posture. Abbreviations: CLMO, center of lateral margins of the orbit; CASIS, center of the anterior superior iliac spine; CPSIS, center of the posterior superior iliac spine; MPFE, main protuberance of the forehead between the eyebrows.