Exploring real-world lumbar posture behaviour. A whole day comparison of individuals with low back pain and healthy controls

Background Previous research of lumbar posture on individuals with low back pain (LBP) has produced conflicting findings compared to control groups. This research has been limited by environmental or task constraints. Real-world postural behaviour across an entire day remains poorly understood. This study examined whole-day lumbar posture characteristics in people with and without LBP using wearable sensors. Methods 13 people with LBP and 11 healthy controls volunteered for this study. A three-accelerometer setup was used to measure real-world lumbar posture classifying sitting and standing. Data were normalised to individual maximum ranges. Differences in measures of mean posture, variability, fidgeting, and posture-use frequency distributions, were derived. Findings An average of 350 min of data per person was available for analysis. Overall, between group differences were small. LBP demonstrated more flexed posture use in standing and a more flexed sitting frequency distribution. Interpretation Real-world posture behaviour was similar between individuals with and without LBP. Where differences were determined they related to temporal components such as frequencies which are masked with traditional postural estimates. These findings suggest that posture-pain relationships may vary substantially between individuals, emphasising the need for person-specific analysis in future research.