Development and preliminary testing of a practical tool for visual assessment of seated posture

Abstract

Introduction to thesis Exposure to sitting during work and leisure is common in today’s society and has been linked to metabolic diseases such as type 2 diabetes, cardiovascular disease and premature mortality (Allman-Farinelli, Chey, Merom, & Bauman, 2010; Dunstan, Howard, Healy, & Owen,2012; Gilson, Burton, Uffelen, & Brown, 2011; Pronk, Katz, Lowry, & Payfer, 2012). In addition to metabolic issues, there are musculoskeletal (MSK) consequences resulting from poor posture. This includes discomfort, commonly discussed as affecting the neck, shoulders and low back (Hartvigsen, Leboeuf-Yde, Lings, & Corder, 2000; Page, 2005; Szeto, Straker, & Raine, 2002). As exposure to sitting is increasing, more so than to standing, it is becoming more relevant to assess for manual therapists (Gilson et al., 2011; Hakala, Rimpelä, Saarni, & Salminen, 2006). Physical examination is used by manual therapists to assess requirements for intervention as well as to assess the result or effectiveness of intervention (Lederman, 2011).\

Currently within the literature there are studies investigating aspects of sitting posture, however, none use both a field-setting and field-based methods such as those used in clinical scenarios to find a rating tool with high ecological validity. Ecological validity is the part of external validity of which the experimental study investigates the postural assessment tool in conditions similar or of exact likeness to a similar setting which the sitting posture assessment tool will be used (Schmuckler, 2001). This implies that the studied tool uses the same type of equipment and the same setting as it would be used outside of the study. The results yielded should then be as close as to what they would be outside of the study. This type of validity is important to explore with clinical tools, to investigate how well the tool will work in the setting it will ultimately be used in. Due to the absence of investigations for sitting posture using field-expedient methods, this study aims to complete the development of a Sitting Posture Rating Tool (SPRT) and to do preliminary testing of the reliability of scores using the SPRT by raters.

This thesis is arranged into three sections.

Section 1 is a literature review discussing sitting posture, the relevance in society and its relation to MSK discomfort. It also investigates other studies that have investigated sitting posture using both laboratory-type methods and fieldbased methods. These two methods are differentiated by either using specialised equipment or not using specialised equipment, respectively. This review will identify some components of posture that are commonly assessed in sitting posture and it will investigate the applicability of these postures in the development of the SPRT.

Section 2 consists of a manuscript, styled according to the guidelines for Musculoskeletal Science and Practice: an international journal of musculoskeletal physiotherapy [Appendix A]. The Manuscript reports a study of the SPRT outlining the process and results of the preliminary reliability testing of raters using the SPRT on subjects’ video. See Appendix D for the development of the SPRT.

Section 3 comprises the appendices which contain materials supplementary to the thesis, including ethics documentation.