The Effect of Wallet Thickness on Spine Posture, Seat Interface Pressure, and Perceived Discomfort During Sitting

OCCUPATIONAL APPLICATIONS Occupational sitting has been associated with an increased risk for developing low back pain. The present investigation examined the effects of asymmetrical sitting surfaces induced by a wallet on acute changes in spine/pelvis posture, interface pressure, and discomfort. Compared to level sitting, sitting on a wallet resulted in greater sagittal and lateral spine flexion, a smaller total contact area with the seat pan, and greater gluteal discomfort. At wallet thicknesses of 22 mm and thicker, seat pan contact pressure area decreased and thoracic spine and pelvic angles deviated laterally compared to the no-wallet condition. At a 32-mm wallet thickness, gluteal discomfort increased. These results indicate that sitting for brief periods (15 minutes) on an uneven seating surface greater than 32 mm in thickness causes postural deviations from neutral spine positions and increases gluteal discomfort. This study supports the removal of rear pocket items, especially larger ones, during sitting. TECHNICAL ABSTRACT Background: Occupations in mobile or office settings can involve prolonged seated exposures, increasing the likelihood of low back pain development. The seat-occupant interface can be impeded by wallets or other objects (cell phones, paper documents, etc.) placed in the rear pocket, potentially increasing the risk of developing low back pain directly (nerve compression) or indirectly (altered kinematics). However, there are no published studies that have examined the effect of an uneven seating surface. Purpose: This study aimed to quantify the outcomes of a non-level sitting surface on trunk kinematics, seat pan pressure distribution, and discomfort. Gender differences in responses were also examined. Methods: Twelve males and 12 females sat for 15 minutes each on 4 wallet thicknesses (0, 12, 22, and 32 mm). Sagittal and frontal plane angles of the thoracic, lumbar spine and the pelvis were measured. Seat pressure distribution (total pressure area) and discomfort using a 100-mm visual analogue scale were also collected for each thickness. Results: In the 22- and 32-mm conditions, there was greater pelvic posterior rotation, pelvic left lateral bending, thoracic flexion, and thoracic right lateral bending compared to the 0-mm condition. Males and females showed differences in the magnitude of lateral bend angles at all spine levels; however, both genders demonstrated the same directions of postural compensation. Total pressure area decreased and gluteal discomfort increased with thicker wallets, reaching significance in the 22- and 32-mm conditions, respectively. Conclusions: Sitting on wallets greater than 32 mm in thickness increased gluteal discomfort reporting after short duration exposures. Asymmetrical sitting promotes non-neutral spine postures and reduces seat pan contact area. Asymmetrical sitting is therefore not recommended, even for short duration exposures.