Effect of a kneeling chair on lumbar curvature in patients with low back pain and healthy controls: A pilot study

Ann Phys Rehabil Med. 2015 Jun;58(3):151-6. doi: 10.1016/j.rehab.2015.01.003. Epub 2015 May 5.


Background: The concept of an ideal sitting posture is often used in practice but lacks a basis in evidence.

Objective: We designed a cross-sectional, comparative, matched study to determine the effects of chair and posture on lumbar curvature in 10 patients with chronic non-specific low back pain (CLBP; mean pain duration 24 ± 18 months) and 10 healthy matched controls.

Methods: Pelvic incidence, sacral slope and lumbar curvature were measured on computed radiographs by 2 blinded clinicians for subjects in 2 postures (upright vs slumped sitting) and on 2 chairs (usual flat chair vs kneeling chair).

Results: The reliability of measures was excellent (intraclass correlation coefficient>0.9). As hypothesized, the expected sacral slope and lumbar lordosis changed between standing and sitting on a kneeling chair as compared with a usual chair (P<0.0001) and less in patients than controls (P=0.046) for lordosis only. In addition, as expected, changes were more pronounced with slumped than upright sitting (P<0.0001). An interaction between chairs and postures for lumbar lordosis (P=0.02) indicated more pronounced effects of the chair in slumped sitting. Therefore, lumbar lordosis was reduced less when sitting on a kneeling chair as compared with a usual chair.

Conclusions: Although healthy subjects showed more reduction in lordosis between standing and sitting, the chair effect was found in both CLBP patients and healthy subjects.

Trial registration: ClinicalTrials.gov NCT01323127.

Keywords: Chair; Low back pain; Lumbar lordosis; Sitting.

MeSH terms

  • Adult
  • Case-Control Studies
  • Cross-Sectional Studies
  • Equipment Design
  • Female
  • Humans
  • Interior Design and Furnishings / instrumentation*
  • Lordosis / complications
  • Lordosis / physiopathology*
  • Low Back Pain / etiology
  • Low Back Pain / physiopathology*
  • Lumbar Vertebrae / physiopathology
  • Male
  • Middle Aged
  • Pelvis
  • Pilot Projects
  • Posture / physiology*
  • Sacrum

Associated data

  • ClinicalTrials.gov/NCT01323127