AllSteel Tall Chair Ergonomics Review by RaniLueder

Humanics ErgoSystems, Inc.
Specialists in Ergonomics
ERGONOMICS REVIEW
Ergonomics of seated movement

A review of the scientific literature
Considerations relevant to the Sum™ chair
written for Allsteel
by Rani Lueder, CPE

June 1, 2004
Certificant, Board of Certification of Professional Ergonomists

Mail: P.O. Box 17388 Encino, CA 91416-7388
Ph: (818) 345-ERGO Fax: (818) 705-3903 [email protected] www.humanics-es.com
Ergonomics Review of the research
From Corlett and Eklund (1984) How does a backrest work?

Graphic used with permission

Ergonomics Review of the research
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Table of Contents
ERGONOMICS AND THE SUM.............................................................. 1

Summary ................................................................................................................ 1
Overview ................................................................................................................ 1
We need to move ................................................................................................... 2

Not moving is harmful .................................................................................................... 2
… and contributes to backpain and injury ...................................................................... 4
… as well as leg swelling (edema) ................................................................................. 5
Yet all movements are not the same ....................................................................... 6

Unsupported sitting ........................................................................................................ 7
Forward-oriented movements ........................................................................................ 8
Twisting / rotation / bending movements ........................................................................ 9
Sitting and seating .............................................................................................. 12

What happens when we sit? ........................................................................................ 12
Relaxed sitting flattens (flexes) our lumbar spine ......................................................... 12
”Dynamic” backrests promote continuous support........................................................ 15
Unsupported sitting (upright) ........................................................................................ 16
Support forward and back movements from centered positions................................... 17
Reclined sitting (relaxed).............................................................................................. 17
Conclusions......................................................................................................... 19
Acknowledgement............................................................................................... 19
References ........................................................................................................... 20
About Rani Lueder, CPE ...................................................................................... 30

Ergonomics Review of Sitting and Movements™ Page 1
Rani Lueder, CPE
Ergonomics and the Sum
Summary
Over the last two decades, our focus has gradually shifted from
identifying the best single sitting posture towards a more Movement is
dynamic view of sitting and movement. essential, but
While this emphasis on movement has helped avoid ergonomic movements are not
risk factors, it also confused the issues. Movement is critical, alike. Some should
but it is not the only consideration. Taken to extremes, a strict even be avoided.
emphasis on movement may even introduce new risk factors.
Movements are not the same; we ought to avoid some movements. This paper
describes research relevant to movement and its implications for sitting and seating.
These research dimensions include:
1. Why movement is so important.
2. Why different movements are not equal.
3. Selected seat design considerations.
Overview
As in all fields of science, our assumptions about sitting reflect changing paradigms in
the research that shape the questions we ask and how we interpret its findings.
For most of the last century, ergonomists widely assumed that we should sit upright
(Staffel, 1884; Hooton, 1945; Akerblom, 1954). This emphasis on what Dainoff (1994)
described as the “cubist posture” (with 90° knee, torso and elbow positions) aimed to
prevent ergonomic risk factors that lead to discomfort and health disorders.
The late 1980’s saw a recognition that office work is more hazardous than had been
believed – and that constrained sitting postures can cause health disorders,
particularly when other risk factors are present (e.g., NIOSH, 1997).
While movement is critical, this emphasis on movement for its own sake sometimes
takes extremes. The drumbeat that “we need to move” has heralded new products
that may contribute to awkward, unstable and unsupported postures. At times, health
professionals also worsen the situation by maintaining that awkward and unstable
postures are fine if users change positions from anything, to anything.
This is not to downplay the importance of movement. Movement is essential.
Rather, the aim of this paper is to revisit these assumptions.

Rani Lueder, CPE
We need to move
We have long known that constrained sitting is bad for our health (s.f., Adams and
Hutton, 1983; Duncan and Ferguson, 1974; Eklund, 1967; Graf et. al, 1995; Hunting, et. al,
1980 and 1981; Hult, 1954; Langdon, 1965; NIOSH, 1997).
In 1777, Ramazzini described hazards of constrained sitting among writers:
“Now 'tis certain that constant sitting produces Obstructions of the Viscera,
especially of the Liver and Spleen, Crudities of the Stomach, a Torper of the
Leggs, a languid Motion of the refluent Blood and Cacbexies. In a word, Writers
are depriv'd of all the Advantages arising from moderate and salutary Exercise.”
More recently, a report by the National Institute of Occupational Safety and Health
(NIOSH, 1997) summarized research demonstrating a relationship between awkward
and constrained postures and musculoskeletal disorders.
Constrained postures increase discomfort and health risks (s.f. the review by Aaras et al,
1997). Videman et al. (I990) found that both sedentary work and heavy physical work
were associated with abnormalities of the spine1, but the relationship was particularly
strong for sedentary work such as in the office.
Static seating postures cause discomfort. Graf et al. (1993, 1995) reported more
discomfort and chronic disorders among workers who sit in fixed postures. Movement
reduces these risks (Aaras et al, 1997; Kilbom, 1987).
It is difficult for us to tolerate unsupported and static seated postures for more than a
short while (Reinecke et. al., 1985). When allowed to move freely, people are usually in
constant motion (Branton, 1967, 1969; Jurgens 1980). Sitters tend to cycle through postures
over the day (Bhatnager et al, 1985; Branton and Grayson, 1967; Fleischer et al, 1987).
People tend to develop unique patterns of seated movements (Fleischer et al, 1987;
Jurgens, 1980; Ortiz et al, 1997) - which Fleischer (1987) compared to individual
handwriting styles2.
Unfortunately, intensive computer work diminishes opportunities to change postures

and move (Grieco, 1986; Waersted and Westgaard, 1997).
Not moving is harmful
1
These researchers studied disc degeneration in 86 cadavers. They described abnormalities such
as disc degeneration, end-plate defects and osteoarthrosis of the facet joints of the vertebra.
2
That is, “as a sequence of actions thought to be produced by an internalized specification of
commands that indicates which muscles shall act at what time and what intensity”.

Rani Lueder, CPE
We have long known that constrained sitting is uncomfortable. Static postures

contribute to a broad range of chronic disorders (e.g., Hunting et al., 1981) that include
joint impairments such as arthritis, inflamed tendons and tendon sheaths, chronic joint
degeneration (arthroses), muscle pain (Grandjean, 1987), impaired circulation and
tissue damage (Kilbom, 1986).
Static and constrained postures interrupt blood flow in The effect of static postures
direct proportion to the muscle loads (Grandjean, 1987). magnify over time.
Muscle oxygenation reduces with fairly low loads3 (McGill Kumar wrote, “an
and Hughson, 2000). At sixty percent of maximum force accumulation of residual
(e.g., working with elevated arms), blood flow is virtually strain over years may set
occluded (Grandjean, 1987). the stage for injury even if
Static postures reduce our effectiveness4, causing us to stress does not rise
move more often5, (Bhatnager et al6, 1985; Fenety et al, extraordinarily. The latter is
2000; Jurgens, 1980) and to move into postures due to a progressive
(Bhatnager et al, 1985) that we know to be harmful reduction in stress
(Andersson, 1980; Andersson et al, 1974a, 1975, 1986; tolerance capacity”.
Bhatnager et al, 1985).
Some researchers maintain that such damaging effects
are more related to a "lack of physical variation" than inactivity (Bendix 1994; Winkel and
Oxenburgh, 1990). That is, the actual lack of variety of postures is more hazardous
than the sedentary nature of the work.
3
These researchers found a reduction in tissue oxygenation of the lumbar extensor muscles with
as little as 2% of Maximum Voluntary Contraction (MVC).
4
Bhatnager et al (1985) reported that the percentage of errors increased from less than 2% to
more than 8% over the three hours’ of sitting, which they attributed to less effective scanning
patterns. Between the best and worst workplace conditions, performance increased from about
4% to about 6% errors. They wrote, “subjects appeared to realize that their performance was
getting worse and increased their stopping times in an (unsuccessful) effort to compensate.”
5
Such as by fidgeting.
6
Bhatnager et al (1985) wrote, “The frequency and severity of body part discomfort increased with
time on task, as did frequency of postural changes... Frequency of postural changed increased by
more than 50% over the three hours and such appear to be a sensitive indicator of postural
stress.”

Rani Lueder, CPE
… and contributes to backpain and injury
More than seventy percent of

people older than 40 experience
intermittent back pain. Our sitting
habits affect our risk of back pain
(e.g., Bendix 1994; Kelsey 1975b).
Kelsey (1975b) found that sitting

more than half the time at work was
associated with herniated discs in
those older than 35.
People often assume that back pain

is caused by short-term (acute)
events such as accidents. Yet
though slips and falls certainly
injure, research suggests long-term
The herniated lumbar spine, from two directions
(low-level) chronic stressors are at
(Slavin and Raja, 2001)
least as important.
That is, fixed postures are as likely to

lead to disabling back pain as heavy
manual work such as construction.
Constrained postures can cause

chronic degenerative alterations of
the cervical, thoracic, and lumbo-
sacral areas of the spine (Graf et. al.
1995; Hunting et. al., 1980; Occipinti et.
al., 1987; Polus et. al., 1985). Progression of disc herniation (Bendix, 1994)
Insurance and bank employees, who

commonly sit in static positions for long periods, are likely
Fixed postures are as to develop very high levels of intervertebral disk immobility
likely to lead to (Wood and McLeich, 1974).
disabling back pain as
heavy manual work One reason that it is so important to move is that after the
such as construction. age of ten, our spine loses its ability to actively feed itself
(or, rather, feed the inter-vertebral discs of the spine) and

Rani Lueder, CPE
eliminate waste products (Adams and Hutton, 1983; Grandjean, 1987; Maroudas, et al,
1975; Schoberth, 1978). After this age, the spine receives nutrients and eliminates
wastes through passive changes in osmosis resulting from movement.
Faiks and Reinecke wrote “there is scientific evidence that prolonged static sitting may
compromise spinal structures by reducing disk nutrition, restricting capillary blood flow,
and increasing muscle fatigue.”
Adams (1996) reported that people with severely degenerated discs had more
extensive disc innervation than “normal” people.
… as well as leg swelling (edema)
Leg swelling (edema) is caused by “an increase in net transcapillary filtration, which
exceeds the removal of fluids by the lymphatics” (Van
Deursen et al, 2000).
Leg swelling causes more
Leg swelling (edema) is common. Widmer (1986) than cold feet.
interviewed 4,529 workers, finding that 70% of It increases blood pressure,
women and 44% of men reported this discomfort. heart rate and venous
The American Public Health Association (APHA, pressures to the heart. It
2003) indicates that between 200,000 and 600,000 predisposes users to
Americans will suffer from deep-vein thrombosis varicose veins. It can also be
(DVT) and pulmonary embolism each year. fatal.
They note:
Deep-vein thrombosis occurs when a thrombus forms … in one of the large

veins, usually in the lower limbs, leading to either partially or completely
blocked circulation. The condition may result in health complications…
Pulmonary embolism can occur when a fragment of a blood clot breaks loose
from the wall of the vein and migrates to the lungs, where it blocks a pulmonary
artery or one of its branches. When that clot is large enough to completely
block one or more vessels that supply the lungs with blood, it can result in
sudden death.
Leg swelling causes more than cold feet. Local pooling of blood increases venous
pressures to the heart, blood pressure and heart rate. It predisposes users to venous
disorders such as varicose veins (Kilbom 1986; van Deursen 2000c).

Rani Lueder, CPE
Lack of movement is strongly associated with leg swelling

(Van Deursen et al, 2000)7; Winkel 1981; Winkel and Jorgensen,
Ergonomists have
1986). During movement, muscles expand and contract,
traditionally emphasized
thereby promoting circulation.
the how seating affects
It can also be fatal (APHA, 2003; Beasley et al, 2003). The intradiscal pressures.
latter described a case in which a 32 year-old male Yet this measure is only
developed life-threatening venous thromboembolism from part of the equation.
sedentary work.
High loads increase risk
When users move about in their seat, their foot swelling of injury – yet injury can
improves (Sherman and Hedge, 2003; van Deursen et al, 2000c; be sustained despite
Winkel and Jorgenson, 1986) relatively moderate
Van Deursen (2000c) reported that incorporating small but intradiscal pressures.
continuous movements into the day increased the time of
onset of leg swelling. Not surprisingly, intermittent exercise
is also effective (Winkel, 1981).
Yet all movements are not the same
The overall forces acting on the spine are less important than the concentration of
forces acting on the discs, ligaments and related spinal structures (Dolan and Adams,
2001) and the susceptibility of these structures to damage.
The associated risk also varies considerably between people. Compressive loads and
displacement of force are affected by our age and the degeneration of the spine (e.g.,
Pollintine et al, 2004).
Dolan and Adams (2001) add, “tissue stress probably plays a major role in determining
if a given tissue is painful, it is tissue stress rather than overall loading which
influences the metabolism of connective tissue cells”.
We know that repetitive movements can be hazardous (NIOSH, 1997). Repeated
cycles of movements resemble the effects of static postures (e.g., Kumar, 2004).

Rani Lueder, CPE
Unsupported sitting
It is difficult to sit upright and unsupported for very Most office employees
long. Most people would rather slump than perform spend most of their
the muscle work needed to sit upright. day working with their
Leaning against a backrest reduces both intradiscal backs unsupported.
pressures in the spine and loads at the back portion of
the spine8 (Rohlmann et al, 2001).
Several things happen when we maintain

unsupported postures – even when there is
movement. Of particular importance, we tend to
slump forward, reversing the lumbar curve (lumbar
kyphosis) (Bridger and Eisenhart-Rothe, 1989)
If users are fit, their abdominal muscles may help

stabilize postures (Corlett and Eklund, 1984) although
this is not fully agreed on (Kumar, 2004). Even so, fit
or not, postural support shifts from the muscles to the
ligaments that support the spine. Ligaments deform,
increasing risk of spine and joint injury.
This is particularly important in today’s offices

because most office employees work most of their
day with their back unsupported by their backrest
(e.g., Dowell et al, 2001).
8
That is, at the fixator loads involving the facet joints, articular surfaces close to individual vertebral
bodies (bones).

Rani Lueder, CPE
Forward-oriented movements
Sitting in static positions leads to small

movements in our chair that we often refer to as
“fidgeting” (Bhatnager et al, 1985; Fenety et al, Forward-leaning postures
2000). That is, as we become uncomfortable we increase risk of back injury.
tend to move, perhaps to compensate for
reduced effectiveness at work. This is in part because the
posterior ligaments and fibrous
Further, this tendency to fidget with time is tissues surrounding the discs are
associated with a tendency towards forward thinner and less able to withstand
oriented (anterior) movements and postures that force and may rupture.
increase loads on the spine and soft tissues9
(Andersson, 1980; Andersson et al, 1974a, 1975,
1986; Bhatnager et al, 1985; Rohlmann et al, 2001;
Wilke et al, 1999).
In fact, loads on the spine (intra-discal pressures) are almost twice as high when
flexing forward relative to unsupported sitting – and almost three times higher than
relaxed sitting (Wilke et al, 1999). Others reported that leaning forwards (flexion)
dramatically increases intradiscal pressures as well (Andersson et al, 1974a, 1975;
Rohlmann et al., 2001).
Forward-leaning postures also increase risk of disc

rupture because the posterior segment of the disc lacks
Research suggests the strength to withstand these loads – even when
that as the day intradiscal pressures are low10 (Adams et al, 1994).
progresses in static
postures, we begin to The posterior longitudinal ligaments are considerably
assume more forward- thinner than the anterior (front) ligaments. Further, the
oriented postures.
9
This tendency to shift towards forward-leaning (anterior) postures during long-term static sitting
should not surprise us. Long-term static sitting work is very demanding… muscle work and other
physical loads become difficult to sustain, particularly given that static postures impair circulation.
It becomes increasingly difficult to perform the muscle work needed to “sit properly”.
Forward leaning postures introduce risk factors, but users do not mind because they do not have
to work their muscles as hard while their ligaments hold their spine in position.
Of course, other factors may also contribute to this tendency to lean forwards with time. For
example, the visual demands of the task and the reach distances can also play a role.
10
These researchers noted that serious disc failure is closely associated with what is called the
“moment arm” of forces associated with forward bending – even when the compressive loads on
the spine are not particularly high. They add, “Conversely, if the bending moment is small or
absent, no amount of compression can damage the soft tissues before the vertebrae”.

Rani Lueder, CPE
fibrous tissues that surrounds the intervertebral discs11 are not equivalent – forward
(anterior) postures are much more likely to cause tearing.
Fleischer (1987) emphasized the importance of designing chairs that promote

movements that we recognize as beneficial - particularly between shifts between
upright and reclined sitting (as opposed to shits toward forward-leaning postures).
Twisting / rotation / bending movements
Twisting is unique to human beings. We are

fortunate to be able to do so; it would otherwise Hazards from twisting may increase
be difficult for us to function (Kumar, 2004). because “If a single segment is
Kumar (2001) described spinal rotation as “a restricted, the adjacent segments
destabilizating motion for an inherently unstable may assume part of its normal tasks
structure”. in executing movement.
Much of this unpredictability relates to the fact Thus, hypomobility and forced
that twisting typically involves a combination of hypermobility may both exist in a
rotation, forward / back and sideways (lateral) relatively short section of the spine.”
movements that are difficult for us to predict and
control for any particular situation.
Further, combined movements along these three planes interact with each other when
we twist. Combined movements are problematic in a variety of ways. Movement
along one plane typically diminishes the available range of movement along other
dimensions (Evjenth and Hamberg, 1984).
Twisting movements along the forward (anterior) plane is particularly compromising.

Combined movements that lock the facet joints12 at the back end of the spine
introduce a different sort of risk.
Risk also increases when natural movements of individual segments are constrained.
Evjenth and Hamberg (1984) wrote the following:
First, because the vertebral column consists of many articulating segments,

movements are complex and usually involve several segments. This also means
that restrictions may be complex. For instance, if a single segment is restricted,
the adjacent segments may assume part of its normal tasks in executing
movement. Thus, hypomobility and forced hypermobility may both exist in a
relatively short section of the spine.
11
This fibro-cartilaginous tissue of the intervertebral discs is called the annulus fibrosus.
12
Each facet joint represents two opposing bony surfaces separated by cartilage and surrounded
by a capsule.

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Second, because the spinal cord runs along the

channel formed by the vertebral column, damage to Extremely small twisting
or excessive movement of the column is potentially movements (about 2°
hazardous to the nervous system. movement of individual
vertebral segments) are
Twisting is also complicated by the direction of twisting beneficial and actually
of its different components that sometimes work reduce the potential for
together and at other times are at odds with each other injury.
(Evjenth and Hamberg, 1984)
These represent the
Twisting (axial rotation of the spine) increases risk of natural range of
injury (Au et al, 2001; Kumar et al., 1998; Kumar, 2001), in movement of the
part from the increased compressive loads on the spine individual segments of the
(Au et al, 2001).
spine.
Yet compression is only part of the equation.
That is not what we are
Kumar described how prolonged and extreme twisting referring to here.
damage joints. First, heightened loads increase the
forces acting on the joints, deform connective tissues
and ultimately destabilize the joints.
With time, as muscles fatigue and joints weaken, the resulting imbalance can lead to
unnatural and uncoordinated movements at the joints that cause injury.
Research suggests that extremely small rotations (less than 2° per vertebral segment)
are not harmful and may even benefit users13 (Van Deursen et al, 2001).
Such micro-movements correspond to the natural / free range of motion of the

individual motion segments that make up the spine14.
Minute rotary movements15 in one’s chair may lessen back plain and reduce forces
acting on the lumbar spine from improved disc nutrition (Lengsfeld et al, 2000b).
Yet our spine enables us to twist considerably farther than the 2° to 3° in natural range
of motion lumbar segments– actually (when including motion of each of the
segments). Kumar (1996, 2004) reported as much as 70° of twisting (axial rotation) for
the entire spine.
Kumar (2004) described the massive body of research demonstrating a very strong
relationship between twisting and back injury16. Some suggest that as little as 20° of
13
This laboratory study by Van Deursen et al (2001) used pig cadavers. These findings appear to
be confounded because they removed the facet joints (segments towards the back of vertebra)
and related spinal components. Even so, these researchers maintained that this did not affect
results as the range of rotation was within the joint’s free inter-space range of movement.
14
Punjabi and White (2001) suggest the natural range may be closer to 3°.
15
These researchers used one patient diagnosed with degenerative instability of the lumbar spine.
The rotational movements of the chair were 1.2° to the right and left, at a frequency of .22 Hz.

Rani Lueder, CPE
twist involving across the mid-back may greatly increase the risk of disc herniation.
Kumar described a number of possible mechanisms for this increased risk of injuries,
including compression of spine.
Yet biomechanical forces on the spine (the “moment arm”) alone cannot explain the
increase in risk with twisting. Au et al (2001) found that even when biomechanical
loads are equivalent in different postures, twisting resulted in considerably greater
compression of the spine than when leaning forwards or in controlled sideways
bending. The authors note, “it is interesting to consider that the torso is very limited in
the production of dynamic twisting torque”, even when relatively small levels of force
are involved.
Kumar (2004) describes the effect of twisting as jamming the facet joints (bony
protrusions of the vertebra), twisting intervertebral discs and tightening some
ligaments while slackening others.
Even so, the associated risks vary across the spine and are greater at the lumbar
spine. The different vertebrae that make up the spine are very flexible and rotate
differently at each level of the spine. In part, these differences in flexibility relate to the
facet joints at the back of the spine, which prevent rotation and lateral bending
(flexion) displacement.
Seated twisting also reduces muscle strength. In his previous research, Kumar (2004)
found that sitting forward in a neutral posture requires the least amount of strength,
but the loads increase as the user moves to 20° of combined vertebral rotation17. He
concluded, “thus, when it comes to forceful exertions involving axial rotations, human
capability is considerably limited”. He continues that “with increasing reach distances,
the strengths significantly declined…”
Such studies point to twisting – even rotation while seated at the low (lumbar) and
mid-back (thoracolumbar junction) may sometimes increase risk substantially.
We need more research to understand the full impact of these issues. Even so,
caution is warranted; we expect people to rotate sideways to some extent during
seated work, but then it should not be encouraged either.
Chairs that flex should limit specific combinations of movements that increase risk.
16
Risk increased even when lifting was not involved. For example, Kumar (2004) describes
research by Marras (1993) that found “twisting without lifting is associated with disc prolapse with
an odds ratio of 3.0. A combination of twisting and lifting increased the odds ratio to 6.1.
17
It is not surprising that twisting can lessen the amount of muscle work since twisting involves
locking up the spine along the different dimensions (s.f. Evjenth and Hamberg, 1984). At the
same time, these postures increase risk of injury to the spine in various ways, discussed earlier.

Rani Lueder, CPE
Sitting and seating
What happens when we sit?
Most of us would rather sit than stand. Sitting has been found to require less muscle
work than standing (Andersson et al, 1974b). It is easier to work while sitting and it also
stabilizes postures. Sitting may increase intradiscal pressure relative to standing
(Andersson, 1980), but research is not consistent18 (Althoff et al, 1992; Rohlmann et al,
2001; Wilke et al, 1999).
Many of us spend most of our day (at work, at home, driving, and out) sitting.
However, continuous sitting has disadvantages and potential long-term
consequences.
Relaxed sitting flattens (flexes) our lumbar spine
Sitting flattens the lumbar spine.

As we sit, our hamstring muscles
stretch, rotating our pelvis back.
About 2/3 of this shift towards
sitting is by flattening the lumbar
spine – with the rest from tilting of
the pelvis (e.g., Bendix and Biering-
19
Sorensen, 1983). This flattens the
lumbar curve20 excessively.
Research indicates that lumbar supports can reduce load on the spine (Andersson et al,
1974b; 1975). It also tilts the angle of the individual vertebra so that pressures at the
front of the discs increase (Adams et al, 1996; Bendix et al, 1996; Corlett, 1999).
18
Rohlmann et al (2001) suggests that research may sometimes seem contradictory because we
still have so much to learn about the very complicated geometry of the spine. For example, high
intradiscal pressures reflect greater loads on the forward portion of the spinal column, but tell us
little about loads transferred to the rear portion of the spinal segments (facet joints)
Each facet joint represents two opposing bony surfaces separated by cartilage and surrounded by
a capsule.
19
On the other hand, standing causes the pelvis to rotate forward, thereby excessively
increasing the lumbar curve depth.
20
However, Leivseth and Drerup (1997) found less spinal shrinkage when sitting (particularly
relaxed sitting) than with standing work. They attributed this to several factors, but particularly to
the greater bending and twisting while standing.

Rani Lueder, CPE
Although Andersson’s research demonstrates that lumbar supports can reduce

intradiscal loads on the lumbar spine, the benefits of backrest lumbar supports are not
consistent (Corlett, 1999).
Bendix et al (1996) reported that lumbar supports on backrests helped to reinstate

lumbar curves compared to straight backrests while performing tasks, but not during
passive sitting and reading21.
Characteristics of the lumbar support vary between users22 and may vary over time for
the same individual. Reinecke et al (1992, 1994) developed a pneumatic device that
induces continuous passive motion in the lumbar spine in order to reverse the
detrimental impact of constrained sitting.
Additionally, lumbar supports only benefit users if they are properly designed, correctly
adjusted for the user, and the user sits in the chair in a manner that takes advantage
of the feature.
That is not to say that lumbar supports cannot benefit users. They reduce
intradiscal pressure, often stabilize postures, reduce muscle loads and help promote
comfort.
Yet lumbar supports only benefit users if they are properly designed, adjusted for the
user and the user sits in the chair in a way that enables them to benefit.
21
Using pig cadavers, Brodeur and Reynolds (1990) concluded that lumbar supports have little
effect on the contours of the lumbar spine. Rather, they reported that the pelvic angle had the
greatest effect on the lumbar curvature. It’s not clear, however whether this finding is relevant to
humans.
22
Pregnant women and heavy users, for example, have more forward center of gravities. Tichauer
(1978) notes that while men have centers of gravity above their hip socket, for women these are
forward. Perhaps this is why various researchers (s.f. Bridger and Eisenhart-Rothe, 1989) have
reported that women have deeper lumbar contours than men.

Rani Lueder, CPE
Some suggest that excessive lumbar curvature also

substantially increases risk. Bendix (1987) notes
that excessive lumbar curvature can adversely
affect posterior portions of the lumbar vertebrae.
prolonged compression can contribute to pain.
Poor postures aggravate those problems. Most

injuries involve combinations of flexion, side
bending and rotation (Evjenth and Hamberg, 1984).
Neutral postures help reduce the impact of individual Facet joints forces are a
risk factors from combined movements23. significant source of injury
(Bendix, 1994)
Seat angles also affect the curve of the lumbar spine. Nachemson (1981) concluded
that that we need a minimum of 110° thigh-torso angles to reinstate the natural curve
of the lumbar spine24. The hip/pelvic angle affects the lumbar spine as well (Makhsous
et al, 2003; Wu et al., 1998).
Although lumbar supports can clearly benefit users, they may also introduce new
problems when the lumbar back support does not adjust high enough for the user.
Sitters may also position their lumbar support improperly (sometimes to lock in their
hips to reduce the amount of muscle work) but in the process, they may reverse the
natural curve of their lumbar spine.
Consequently, lumbar supports are important but they are affected by the specific
conditions. The spine – and the lumbar spine functions best in a dynamic
environment.
23
As mentioned earlier, combined movements are problematic in that movement along one plane
typically diminishes the available range of movement along other dimensions (Evjenth and
Hamberg, 1984). Twisting movements along the forward (anterior) plane is particularly
compromising. Combined movements that lock the facet joints at the back end of the spine
introduce a different sort of risk.
24
He found that sitting caused the lumbar curvature (lordosis) to decrease by about 38°. About
two-thirds of this flattening is from pelvic rotation (28°) and one-third from flattening the lumbar
curve (10°).

Rani Lueder, CPE
”Dynamic” backrests promote continuous support
In recent years, there has been considerable interest in how chair designs can
promote movements without user intervention. That is, how such features affect users’
sitting behaviors and their sense of well-being.
Research indicates that back support reduces both loads on the spine and muscle
work (e.g. Andersson et al, 1975). For this reason, many chair backrests enable users to
set their backrest in “free-float” mode, and to adjust their backrest tension so that they
can sit and move while maintaining continuous backrest support.
When used properly, these features provide important benefits… there is reason to
believe that when set for the user, this free-float capability is the most important chair
feature.
Research indicates that in the right circumstances, advanced “ergonomic seating”, in

conjunction with high-quality training can lead to pronounced benefits in comfort and
health, which exceeds benefits from training alone (Amick and Robertson, 2003). Yet
training alone does not suffice.
Hedge and Ruder (2003) compared subjects typing intensively for 30-minute trials
while sitting with their backrest either “locked” or “unlocked” in free-float. Short term
sitting in these chairs in “free-float” mode did not cause them to move more often, but
their back support improved.
Thus, the value of a dynamic chair back may not be in encouraging a greater
frequency of movement [during the brief experimental periods], but in providing
better support for such back recline movements.
Van Dieen et al (2001) compared changes in stature between two types of dynamic
seats and a traditional office chair25. They concluded:
“Results showed a potential advantage of the dynamic chairs. Spinal shrinkage

measurements showed an increase in stature when working in dynamic chairs.
This increase in stature is explained by recovery of disc height, which can be
accounted for by compression being lower during the experimental trial than
during preceding activities… In addition, movement [in normal postures] can
contribute to recovery of disc height.
25
These researchers compared a traditional office seat with a synchro-tilt (which adjusted in a
fixed ratio of seat and back recline) and a chair with freely movable seat and backrest.
Spinal shrinkage was measured with a Stadiometer ( www.humanics-es.com/stadiometer.htm)

Rani Lueder, CPE
The stronger increase in stature observed after working on the dynamic chairs as
compared with the fixed could be due to better trunk support or small effects on
trunk kinematics. The increase in stature is to be interpreted as a positive effect,
in view of the fact that it reflects an influx of fluids and consequently nutrients into
the avascular disc.”
Yet movement does not always benefit the user. These beneficial changes in stature
are greater during relaxed sitting than when performing task-related activities while
sitting upright. Leivseth and Drerup (1997) attributed such increases in height while
sitting relaxed to the unloading of the lumbar spine rather than the upper back
(thoracic spine). Movement while in neutral postures also provides a greater potential
for recovery of disc height.
Unsupported sitting (upright)
Unsupported upright sitting involves the

worst of all worlds (except forward leaning /
anterior postures).
Sitting in this way does not allow for thigh-

torso angles that are large enough to reinstate
the natural curve of user’s lumbar spine (s.f.
Nachemson, 1981).
Additionally, the forces (called the “moment

arm”) exerted on the spine shifts forward (e.g.,
Corlett and Eklund, 1984; Reinecke and Hazard,
1994). This destabilizes postures, stresses
and potentially deforms ligaments, weakens
joint structures and increases loads on the
spine.
It is obvious to anyone that sits in a position
that loads on the back muscles increase
(Andersson et al, 1974, 1980 and 1986; Corlett
and Eklund, 1984).
Unsupported upright posture

(Corlett and Eklund, 1984)

Rani Lueder, CPE
Support forward and back movements from centered positions
Hedge and Ruder (2003) found that sitting with backrests in the “free-float” mode
improved users’ back support as they worked on the computer.
Users benefit when the chair’s center of

gravity is close to that of the user,
encouraging free movements of the user.
Centered positions facilitate changes of
posture (Andersson, 1986; Fleischer et al,
1987).
Andersson (1986) concluded that the

relationship between the pivot point of
the chair and its user is more important
than the height of the backrest (which
does not need to be exact26).
A close fit between users and their

chairs’ center of rotations also help
prevent the “shirttail effect”, where the
backrest displaces upward, pulling up users’ shirttails.
Finally, such chairs helps avoid the potential for ergonomic problems with some users
in knee pivoting chairs27. Namely, knee-pivoting chairs take the user down and away
from their worksurface. These chairs may increase risk by contributing to awkward
postures from elevated arms and craned necks as they attempt to read.
Such issues suggest that a chair should enable the user to remain supported while
moving through a range of postures characterized by a shifting center of gravity,
where the chair and its user correspond.
Reclined sitting (relaxed)
Reclined postures have advantages.
26
Boudrifa and Davies (1984) also found that the exact position of the lumbar curve does not need
to be exact, as long as it is in the general lumbar area. Corlett (2002), Rebiffe (1980) and others
suggested that the optimum lumbar height reflects the users’ dynamic movements. For example,
the driver of a car would benefit from a higher lumbar than the passenger where the driver’s arms
are higher (on the steering wheel), and they need to reach the controls.
27
Knee pivoting chairs enable the user to recline by tilting their seat away from their work surface
while it pivots from the knees.

Rani Lueder, CPE
They simultaneously reduce loads on the

spine (intra-discal pressure) and muscle work
(Andersson et al, 1974).
Backrests stabilize posture by relieving the

amount of effort required to fight gravity.
Leaning back should theoretically reinstate the
lumbar curve 1) as the weight of the torso
shifts back against the backrest and 2) as the
angle between torso and the legs increases.
Umezawa (1970) showed that leaning back
could promote neutral postures. This
research also showed that both the seat angle
and the backrest contributed to this effect.
Yet leaning back also has disadvantages.
Many (perhaps even most) intensive computer
users slump against their backrest, locking in
their pelvis and causing them to lose (or
reverse) the natural curves of their low back
and neck (Dolan and Adams, 2001).
There also appears to be a relationship
between flattening of the neck and the lower back28 (Fitzsimmons, 2004).
Corlett and Eklund (1984) note, “this will lead to increased pressure on and within the
discs, both from forces arising from the stretched muscles and ligaments and the
increased wedging at the anterior [forward] edges of the disks”.
Bendix (1996) concluded, “the traditional conception that a backrest facilitates lordosis
is apparently not true. It seems rather that backrests actually facilitate the opportunity
for the user to stabilize their lumbar spines by providing their lower back with support,
resulting in relative kyphotic increases”.
There are also functional limitations associated with reclining. It is difficult to lean
back when our visual target is a document and our hands need to reach the mouse.
Reclined postures also increase loads on the neck as the reclined employees attempt
to re-establish the task-related visual field (Grandjean et al, 1983; Corlett, 1999).
28
Fitzsimmons (2004) reported that preloaded and flexed/flatter necks contribute to flattening of
lumbar spines.

Rani Lueder, CPE
Loads on the shoulders and arms may increase if reclining causes the users to move
back against their work items.
However, the problem is not reclining itself as much as reclining in a static posture.
Intermittent reclining is important and beneficial if it is part of a range of postures users
sit in over their workday.
Conclusion
Static sitting postures introduce ergonomic risk factors by constraining postures and
promoting unnatural postures that deviate from the natural position of the spine. Each
of these can negatively affect our health, comfort and effectiveness at work.
Both larger “macro-movements” and very small “micro-movements” are essential for
our wellbeing. Yet while this emphasis on movement can avoid ergonomic risk
factors, it has also confused the issues. Movement is critical, but it is not the only
consideration. Taken to extremes, a strict emphasis on movement may even
introduce new risk factors. Movements are not the same; we ought to avoid some
movements
The only truly effective way to maintain a seated posture for extended durations is to
continuously cycle through a range of natural, centered and healthful positions. This
requires a chair that allows users to dynamically shift between a range of stable
postures.
Acknowledgement
My thanks to John Fitzsimmons of John Fitzsimmons and Associates for his insightful
comments.

Rani Lueder, CPE
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Rani Lueder, CPE
About Rani Lueder
Rani Lueder, CPE is President of Humanics ErgoSystems, Inc., an occupational

ergonomics-consulting firm in Encino, California established in 1982.
She has consulted for corporations, governments, and universities in five countries.
Rani is a member of the ANSI committee revising the American National Standards
for seating and computer workstation design and continues to serve on extended
retainer to the Japan Institute of Human Posture (Tokyo) over the last decade.
Recent projects include establishing a nation-wide health and safety data base for the
Social Security Administration as part of an five year involvement with them;
consulting for NIOSH in the development of recommended guidelines for alternative
keyboards; performing physiological and biomechanics research for evaluating
products, working with a team to develop ErgoSaver expert system software for
evaluating ergonomic risk factors and performing frequent worker's comp evaluations.
She is currently co-editing and co-writing a book on Ergonomics for Children for Taylor
and Francis (London).
Her second edited book, "Hard Facts about Soft Machines: The ergonomics of
seating" is available in seven countries from Taylor and Francis (December 1995).
Previously, she edited and was a joint author of the book “The Ergonomics Payoff;
Designing the electronic office” (Holt Rinehart and Winston of Canada).
Rani has an MSIE in Ergonomics/Industrial Engineering from Virginia Tech, and is a

member of the Human Factors and Ergonomics Society (U.S.) and The Ergonomics
Society (Europe).
The Board of Certification certifies her in Professional Ergonomics (#258).

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Humanics ErgoSystems, Inc.

Ergonomics of seated movement

by Rani Lueder, CPE

Certificant, Board of Certification of Professional Ergonomists

From Corlett and Eklund (1984) How does a backrest work?

Humanics ErgoSystems, Inc.

ERGONOMICS AND THE SUM.............................................................. 1

We need to move ................................................................................................... 2

Yet all movements are not the same ....................................................................... 6

Sitting and seating .............................................................................................. 12

About Rani Lueder, CPE ...................................................................................... 30

Humanics ErgoSystems, Inc.

Ergonomics and the Sum

Humanics ErgoSystems, Inc.

In 1777, Ramazzini described hazards of constrained sitting among writers:

Unfortunately, intensive computer work diminishes opportunities to change postures

Not moving is harmful

Humanics ErgoSystems, Inc.

We have long known that constrained sitting is uncomfortable. Static postures

Humanics ErgoSystems, Inc.

… and contributes to backpain and injury

More than seventy percent of

Kelsey (1975b) found that sitting

People often assume that back pain

That is, fixed postures are as likely to

Constrained postures can cause

Insurance and bank employees, who

Humanics ErgoSystems, Inc.

… as well as leg swelling (edema)

Deep-vein thrombosis occurs when a thrombus forms … in one of the large

Humanics ErgoSystems, Inc.

Lack of movement is strongly associated with leg swelling

Yet all movements are not the same

Humanics ErgoSystems, Inc.

Several things happen when we maintain

If users are fit, their abdominal muscles may help

This is particularly important in today’s offices

Humanics ErgoSystems, Inc.

Sitting in static positions leads to small

Forward-leaning postures also increase risk of disc

Humanics ErgoSystems, Inc.

Fleischer (1987) emphasized the importance of designing chairs that promote

Twisting / rotation / bending movements

Twisting is unique to human beings. We are

Twisting movements along the forward (anterior) plane is particularly compromising.

First, because the vertebral column consists of many articulating segments,

Humanics ErgoSystems, Inc.

Second, because the spinal cord runs along the

Such micro-movements correspond to the natural / free range of motion of the

Humanics ErgoSystems, Inc.

Humanics ErgoSystems, Inc.

Sitting and seating

What happens when we sit?

Relaxed sitting flattens (flexes) our lumbar spine

Sitting flattens the lumbar spine.

Humanics ErgoSystems, Inc.

Although Andersson’s research demonstrates that lumbar supports can reduce

Bendix et al (1996) reported that lumbar supports on backrests helped to reinstate

Humanics ErgoSystems, Inc.