Background:After a stroke, the control of the trunk muscle may be severely impaired. Due to the importance of trunk control in complex daily postures, the ability to adopt a correct sitting posture is considered a determinant of the recovery of independent function after a stroke.Objects:The purposes of this study were to compare differences in buttock pressure between the left and right sides of hemiplegic patients and differences in their pelvic tilting angles (sagittal and coronal planes) after sitting training with visual biofeedback (VBF) in real time.Methods:Twenty-two individuals with unilateral strokes (11 left-side and 11 right-side hemiplegic stroke patients) participated in this study. Buttock pressure was measured using a pressure mat, and pelvic angles were measured using a palpation meter.Results:The asymmetry of pressure between the right and left (first and third chamber) sides was significantly decreased after the VBF training. The measurements obtained using the palpation meter revealed a significant decrease in the pelvic angles pre- versus post-intervention.Conclusion:VBF training may be distribute a patient’s buttock pressure equally while in a sitting posture and increase the length of time a stroke patient can maintain a symmetrical sitting posture. It can also improve pelvic control while sitting in a neutral position.

Asymmetric sitting posture may cause asymmetric buttock pressure and unilateral low back pain (LBP). The purpose of this study was to compare the differences of buttock pressure between both sides, and pelvic angle (sagittal and coronal planes) during typing in a sitting position on a pressure mat (Baltube) in individuals with and without unilateral LBP. Ten subjects with unilateral LBP and ten subjects without unilateral LBP were recruited for this study. Buttock pressure was measured using a pressure mat and pelvic angles were measured using a palpation meter. The subjects performed typing in a sitting posture for 30 minutes. Pressure data were collected and averaged at initial term (from start to first minutes) and final term (last minutes of 30 minutes). Angles of pelvic tilting were measured after 30 minutes typing. Pressure asymmetry values (difference in pressure between both sides) were calculated at the initial and final terms. A two-way analysis of variance was used to compare the differences between the initial and final pressure asymmetry values in subjects with and without unilateral LBP. An independent t-test was applied to compare the pelvic tilt angles between the two groups. To compare the change of pressure from the initial term to the final term between the symptomatic and asymptomatic sides in the unilateral LBP group, a paired t-test was applied. In the unilateral LBP group, the pressure asymmetric value at the final term was significantly greater than that of the initial term (p<.05). The angle of pelvic tilting in coronal plane was significantly greater in the unilateral back pain group compared to the without unilateral LBP group (p<.05), however, there was no significant difference in the angle of pelvic tilting in the sagittal plane between the two groups (p>.05). In the unilateral LBP group, the change of pressure from the initial term to the final term was significantly less in the symptomatic side (-6.90 ㎜Hg) than the asymptomatic side (5.10 ㎜Hg). This asymmetric sitting posture may contribute to unilateral LBP in the sitting position. Further studies are needed to determine if asymmetric weight bearing in sitting causes unilateral LBP or if unilateral back pain causes asymmetric weight bearing, and if the correction of asymmetric weight bearing in sitting can reduce unilateral LBP.

The purpose of this study was to investigate the kinematic and kinetic changes that may occur in the pelvic and spine regions during cross-legged sitting postures. Experiments were performed on sixteen healthy subjects. Data were collected while the subject sat in 4 different sitting postures for 5 seconds: uncrossed sitting with both feet on the floor (Posture A), sitting while placing his right knee on the left knee (Posture B), sitting by placing right ankle on left knee (Posture C), and sitting by placing right ankle over the left ankle (Posture D). The order of the sitting posture was random. The sagittal plane angles (pelvic tilt, lumbar A-P curve, thoracic A-P curve) and the frontal plane angles (pelvic obliquity, lumber lateral curves, thoracic lateral curves) were obtained using VICON system with 6 cameras and analyzed with Nexus software. The pressure on each buttock was measured using Tekscan. Repeated one-way analysis of variance (ANOVA) was used to compare the angle and pressure across the four postures. The Bonferroni's post hoc test was used to determine the differences between upright trunk sitting and cross-legged postures. In sagittal plane, cross-legged sitting postures showed significantly greater kyphotic curves in lumbar and thoracic spine when compared uncrossed sitting posture. Also, pelvic posterior tilting was greater in cross-legged postures. In frontal plane, only height of the right pelvic was significantly higher in Posture B than in Posture A. Finally, in Posture B, the pressure on the right buttock area was greater than Posture A and, in Posture C, the pressure on the left buttock area was greater than Posture A. However, all dependent variables in both planes did not demonstrate any significant difference among the three cross-legged postures (p>.05). The findings suggest that asymmetric changes in the pelvic and spine region secondary to the prolonged cross-legged sitting postures may cause lower back pain and deformities in the spine structures.

Pressure ulcers are serious complications of tissue damage that can develop in patients with diminished pain sensation and diminished mobility. Pressure ulcers can result in irreversible tissue damage caused by ischemia resulting from external loading. There are many intrinsic and extrinsic contributors to the problem, including interface tissue pressure, shear, temperature, moisture, hygiene, nutrition, tissue tolerance, sensory and motor dysfunction, disease and infection, posture, and body support systems. The purposes of this study were to investigate the relationship between buttock interface pressure and seating position, wheelchair propulsion speed. Seated-interface pressure was measured using the Force Sensing Array pressure mapping system. Twenty subjects propelled wheelchair handrim on a motor-driven treadmill at different velocities (40, 60, 80 m/min) and seating position used recline (, , ) with a wheelchair simulator. Interface pressure consists of average (mean of the pressure sensor values) and maximum pressure (highest individual sensor value). The results of this study were as follows; No significant correlation in maximum/average pressure was found between a static position and a 40 m/min wheelchair propulsion (p>.05). However, a significant increase in maximum/average pressure were identified between conditions of a static position and 60 m/min, and 80 m/min wheelchair propulsion (p<.05). No significant correlation in maximum pressure were found between a recline (neutral position) and a , , or recline of the wheelchair back (p>.05). No significant difference in average pressure was found between conditions of a recline and both a and recline of wheelchair back. However, a significant reduction in average pressure was identified between conditions of a and recline of wheelchair back (p<.05). This study has shown some interesting results that reclining the seat by reduced average interface pressure, including the reduction or prevention in edema. And interface pressure was greater during dynamic wheelchair propulsion compared with static seating. Therefore, the optimal seating position and seating system ought to provide postural control and pressure relief. We need an education on optimal seating position and a suitable propulsion speeds for wheelchair users.