For those who sit for long hours at a time, the correct way to sit or choosing the right chair has been advocated for lower back pain relief. But is this advice based on sound scientific evidence?

Gary Schwitzer, publisher of HealthNewsReview.org writes a repudiation of the notion that a “talking chair” can provide lower back pain relief or prevent low back pain.

A talking chair called the “Intelli Chair” has fast-talked its way into dozens of media outlets around the world, with the glib message that it can prevent low back pain. And this means that dozens of editors and/or journalists dropped the ball on this news item, making unwarranted leaps of faith about this chair–while ¬¨completely ignoring the scientific evidence in this area. The resulting articles are really “info-entertainment” not professional journalism.

The editors who allowed these news blurbs to pass across their desks would do well to review the ABCs of health journalism: “accuracy”, “balance”, and “completeness”. (See http://healthnewsreview.org/who-we-are.php). They missed on all three.

Here is an interpretation of the potential of the “Intelli-chair” by Reuters: “Getting back pain from sitting still for too long or in a bad position could be a thing of the past thanks to a chair developed by a German scientist which makes noises to tell users when they need to move.” (See Martin, 2010)

There were similar comments in a brief blurb on National Public Radio: “Back pain, bad posture – I’m sitting up straight just thinking about it. Now a German scientist has designed a desk chair to keep you sitting right all the time.” (See Montagne, 2010).

These two poorly researched stories have morphed into more than 50 news reports around the world– from the UK to Iran to Vietnam. This may have given tens of thousands people misleading messages about sitting and back pain.

In the Reuters story Risto Kolva, who invented the “Intelli Chair”, explained that the new chair contains eight pressure-sensitive sensors, which can monitor the way a person uses the chair. The sensors send information to a computer via a Bluetooth module. If the sitter adopts an “inappropriate” position or sits “too long”, the chair will prompt an accompanying computer to make an irritating warning noise.

A second person involved with the development of the chair said it could be used at home, in schoolrooms, and large offices. He suggested it would be useful in determining when employees need to take a break.

So what is wrong with the interpretation at Reuters and NPR? Almost everything. There was no discussion of the scientific evidence on sitting and back pain. There was no mention of any studies showing that the Intelli Chair can prevent back pain. And there were no comments by independent experts who might have provided an overview of the scientific evidence in this area.

Journalists covering this story should have asked three fundamental questions: (1) Is there persuasive evidence that sitting causes low back pain?; (2) Is there conclusive evidence that any particular chair can prevent low back pain? and; (3) Is there a single “proper” sitting posture? The answer to all three questions is “no.”

So the journalists and editors at Reuters and NPR were making assertions about sitting and back pain that don’t find support in the scientific evidence.

How might a journalist have found this information? The first two questions could have been answered with expert commentary or with a brief visit to Pubmed.com–the medical search site sponsored by the National Institutes of Health. There, journalists could have found two recent systematic reviews that failed to show any strong causal relationship between sitting and low back pain. (See Roffey et al., 2010; Chen et al., 2009).

If they dug deeper at Pubmed.com they could also have found two large evidence-based reviews on the prevention of back pain. Neither of these found any evidence that a particular chair, or sitting posture, can prevent low back pain. (See Bigos et al., 2010; Burton et al., 2006).

Consulting an independent expert or a textbook could have answered the third question. There is no agreement in the medical literature on what constitutes ideal sitting posture. And there may not be a perfect posture.

“There is no ideal sitting or standing posture…because no single posture can be comfortably maintained for a long period of time,” noted Michael Adams, PhD, and colleagues in The Biomechanics of Back Pain (See Adams et al., 2002). “Therefore any recommendations on ‘good’ sitting…must incorporate the need for intermittent postural adjustments.”

The latter point does support the contention of the creators of the Intelli Chair that seated workers need to get up from time to time. But scientific studies haven’t identified any single appropriate duration for sitting–and this may vary from person to person. So prescribing an appropriate duration of sitting is somewhat arbitrary.

And if employees, students, and home workers are just going to use arbitrary time points to determine when to get up and walk around, they wouldn’t need an expensive computerized chair. A $3 kitchen alarm clock would suffice.

References:

Adams M et al., The Biomechanics of Back Pain, Churchill Livingstone, Edinburgh, 2002, p. 174.

Bigos SJ et al., High quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults, Spine Journal, 2009; 9(2): 147-168.

Burton AK et al., European guidelines for prevention in low back pain, European Spine Journal, 2006; Supplement 2: S136-168.

Chen SM et al., Sedentary lifestyle as a risk factor for low back pain, Sedentary lifestyle as a risk factor for low back pain: a systematic review, International Archives of Occupational and Environmental Health, 2009; 82(7): 797-806.

Roffey DM et al., Causal assessment of occupational sitting and low back pain: results of a systematic review, Spine Journal, 2010; 10(3): 251-261.

Martin M, Are you sitting comfortably? Ask the chair, Reuters, 2010; see
http://www.reuters.com/article/idUSTRE6954PI20101006

Montagne R, “Intelli Chair” could cut down on back pain, NPR, 2010; see
http://www.npr.org/templates/story/story.php?storyId=130396419&ft=1&f=3

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