References

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The Reliability Of A Wireless Monitor For Measurement Of Lumbar Spine Range Of Motion And Posture

Abstract accepted KCMACP conference 2009, Edinburgh, UK)

Kieran O’Sullivan1, Luciana Galeotti1,2, Wim Dankaerts2,3, Leonard O’Sullivan1, Peter O’Sullivan4

  • 1 University of Limerick, Ireland
  • 2 Catholic University, Leuven,Belgium
  • 3 Association University, Hasselt, Belgium
  • 4 Curtin University of Technology, Perth, Australia

Introduction: Low back pain (LBP) is a common and costly musculoskeletal disorder (Hansson, Ihlebæk et al. 2006), requiring consideration of multiple factors including lumbar posture and movement patterns (Dankaerts, O'Sullivan et al. 2006). Most LBP research has been done using complex and time-consuming laboratory-based motion analysis systems (Dankaerts, O'Sullivan et al.
2006), which do not allow analysis outside the laboratory e.g. in occupational settings. The Sels Posture Monitoring Device (SPMD) monitor is capable of monitoring spinal posture in real-time via wireless technology. This study examined the reliability (intra-rater and inter-rater) of this novel monitor for measuring spinal posture during two commonly provocative tasks in subjects with LBP.

Methods: 20 healthy subjects participated in the study. The reliability of two tasks (usual sitting posture, and forward bending) was examined using intra-class correlation coefficients (ICC) and Bland and Altman methods.

Results: Intra-rater reliability was excellent for both tasks (ICC =0.837 - 0.874, with low mean differences). Similarly inter-rater reliability was excellent for both tasks (ICC =0.914 - 0.940, with low mean differences).

Discussion: This novel wireless posture monitor appears to be a reliable method for measuring lumbar posture and movement patterns. This non-invasive device may have significant clinical utility for assessing and providing feedback on spinal postures and movement patterns in occupational environments. Further research is required to investigate the validity of this new monitor, and it's application in clinical trials.

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The intra-rater and inter-rater reliability of a novel wireless system to analyse lumbar spine posture Submitted to Ergonomics

O'Sullivan, Kieran; University of Limerick, Physiotherapy; Galeotti, Luciana; University of Limerick, Dankaerts, Wim; Catholic University, Leuven, Belgium, Department of Rehabilitation Sciences, O'Sullivan, Lenonard; University of Limerick, O'Sullivan, Peter; Curtin University of Technology, School of Physiotherapy

Lumbar posture is commonly assessed in non-specific chronic low back pain (NSCLBP), although quantitative measures have mostly been limited to laboratory environments. The Sels spinal position monitoring device (SPMD) can monitor posture in real-time, both inside and outside the laboratory. The reliability of this wireless device was examined in 18 healthy participants during usual sitting and forward bending, two tasks which are commonly provocative in NSCLBP. Reliability was determined using intra-class correlation coefficients (ICC), the standard error of measurement (SEM), and Bland and Altman methods. Intra-rater ICC values ranged from 0.837 – 0.874, with small SEM and mean difference values. Inter-rater ICC values ranged from 0.914 – 0.940, with small SEM and mean difference values. Intra-rater and inter-rater reliability is an essential requirement for clinical utility, and was excellent in this study. Further studies into the validity of this device, and its application in clinical trials in occupational settings are required.

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Towards the validation of a remote monitoring and training device for chronic low back pain in an occupational setting

Research Training Fellowships for Healthcare Professionals 2009 (HPF/2009/ )
Funding: 250.000€

Investigators: Kieran O’Sullivan1, Wim Dankaerts2,3, Leonard O’Sullivan1, Peter O’Sullivan4

  • 1 University of Limerick, Ireland
  • 2 Catholic University, Leuven,Belgium
  • 3 Association University, Hasselt, Belgium
  • 4 Curtin University of Technology, Perth, Australia

Non-specific chronic low back pain (NSCLBP) is the most common and costly work-related musculoskeletal disorder, but rehabilitation approaches vary. The NSCLBP population may consist of distinct subgroups, with management ideally tailored to each subgroup. One specific subgroup adopts provocative end-range lumbar flexion postures during functional activities. Most previous postural research has been conducted in laboratories.
Technological advances mean that postural monitoring and feedback in occupational settings is now possible. This could have significant implications for NSCLBP management and rehabilitation. Preliminary data suggests that one postural monitor - the Sels Posture Monitoring Device (SPMD) - is reliable. It is unclear however whether:

  • The SPMD is a valid measure of lumbar posture.
  • The laboratory-based differences (between controls and NSCLBP) in lumbar posture can be identified (using the SPMD) in occupational settings.
  • Providing postural feedback in occupational settings improves clinical outcomes.

This project aims to investigate the capacity of the SPMD to identify and train a subgroup with NSCLBP in occupational settings. This involves three studies:

  1. A laboratory-based, comparative evaluation of the concurrent validity of the SPMD.
    Mean lumbar posture values during simulated occupational tasks (laboratory-based) using the SPC will be correlated (ICC, limits of agreement) with a recognised motion analysis system.
  2. A cross-sectional study evaluating the discriminative validity of the SPMD. This will examine whether the SPMD can detect differences (Anova) in mean lumbar posture between NSCLBP subjects and healthy controls, while performing real occupational tasks.
  3. A randomised prospective study to evaluate whether the SPMD improves clinical outcomes in occupational settings. This will be compared (Anova) to a conventional control treatment. Primary (e.g. pain, disability) and secondary (e.g. postural control) outcomes will be analysed between groups at completion of the intervention (6 weeks), and after 3 months.
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Evaluation of postural control in cyclist with and without low back pain - field study using a novel posture monitoring and feedback system.

Master Thesis
Promotor: Wim Dankaerts
Co-promotor: Sabine Verschueren
Students: Wannes Van Hoof and Koen Volkaerts

Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven.

Aims of study was to investigate:
(1) differences in lumbar sagittal postural characteristics, using a novel postural monitoring device, in cyclists with and without LBP and
(2) the possibility of influencing maladaptive motor control at the lumbar spine using postural biofeedback.

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Longitudinal evaluation of lumbar postural control in sitting: specific chronic low back pain patients (Flexion Pattern) versus healthy controls.

Master Thesis
Promotor: Wim Dankaerts
Co-promotor: Sabine Verschueren
Students: Jonathan De Keyser and Roel Boesmans

Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven.

The purpose of study:
(1) to evaluate the 'quality of sitting' using a novel monitoring device (Sels Posture Monitoring Device (SPMD)), designed to measure directly lumbar postural characteristics during sitting in a non-lab environment.
(2) to determine whether a difference exist between postural control of healthy no-LBP and CLBP subjects during one hour of usual unsupported sitting.

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Validation of a new device to measure lumbar curvature during static postures and trunk movements in the sagittal plane.

Master Thesis
Promotor: Wim Dankaerts
Co-promotor: Sabine Verschueren
Students: Karel Dekelver, David Smets
Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven

Aim of study:
to validate a novel posture monitoring system (Sels Posture Monitoring Device (SPMD)) in estimating the spinal curvature changes during static postures and trunk movements in the sagittal plane. The accuracy of system will be tested in vivo on healthy subjects and compared with a gold standard motion analysis system (digital video-fluoroscopy)