>> Mel wrote:
>>
>> >SOLUTIONS?
>> >
>> >Is it not possible that no posture which deviates moderately from the
>> 'norm'
>> >really will cause any problems provided that it is not held for too long
or
>> >subjected to prolonged or excessive loading in any given direction?
>>
>> >So, if we move around regularly from one posture to another, no matter
>how
>> >poor each may appear to be, are we not then minimising the occurrence of
>> any
>> >dysfunction - as long as we don't load the spine excessively or hold the
>> same
>> >posture for too long in any one state?   Is it only when we forget to
shift
>> >around regularly in seated and other positions that problems begin to
>> emerge?
>> >Is the prevalence of back pain and dysfunction more a consequence of
lack
>> of
>> >adequate postural variation than any single 'correct' posture?
>> >
>> >Though our models of  optimal spinal functioning may well be quite
>> accurate,
>> >is it that essential to implement them so precisely, when regular
shifting
>> >from one position to another may tend to offset most of the alleged
risks
>> of
>> >imprecise spinal usage?  Does this then imply that many of the popular
>> >therapies and methods of spinal use and rehabilitation are unduly
>> prescriptive
>> >and in many cases, redundant?
>>
>>
>> Michael writes:
>>
>> Very thought provoking Mel. One thing we need to be wary of is
>> "the tyranny of the OR" -- ie people often want to know, is it
>> this factor OR is it that factor, when it could possibly be factor A
>> AND factor B (and C and D ...). I think you're very close to the mark
>> with your "postural variation" comments however. We all know how
>> important regular movement is for the spinal structures. The question
>> is then, how can therapists influence this postural variation factor
>> in their patients? Supervision isn't feasible. Reminders and posters
>> etc lose their effect after a short time. Posture education can be in
>> one ear and out the other.
>>
>> This question is what lead to the development of the "Move-It Reminder"
>> function in the posture monitoring device we've been developing over
>> the past few years. The small curvature sensing device can detect
>> when the wearer's posture (eg lumbar curvature in the sagittal plane)
>> has remained relatively unchanged for a certain period of time
>> (eg 20 minutes). When it detects this lack of postural variety, a
vibration
>> is emitted onto the wearer's skin as a Move-It Reminder -- eg if they've
>> been sitting for some time, it's then time to go for a brief walk or
perform
>> some gentle movements or stretches (as prescribed by their therapist).
>>
>> With sedentary lifestyles and occupations becoming more prevalent
>> we believe this simple function could have a positive effect on wearer's
>> back pain levels.
>>
>> To date however, the research trials have focused on the device's other
>> function (which focuses on "postural control" training) so we don't yet
have
>> any data yet on the effect of the Move-It Reminders. That will come.
>>
>> In short, I think two important factors are postural variation AND
postural
>> control (and other factors of course). Certainly, the ideal situation is
>> for people to vary their posture throughout the day, but the reality of
>> many of our occupations and modes of transport means we sit for
>> long periods. Therefore, I agree that (a) people need to take regular
>> "posture breaks", but also that (b) in between these breaks, the
>> "usual posture" should be one that's away from end-range (in that fuzzy
>> "neutral" region).
>>
>> Looking forward to more discussion on this topic.
>>
>> Regards
>> Michael
>> ~~~
>> Michael Carter
>> Spinal Sensor Technologies
>> ~~~
>> Real-time Posture Training Technology:
>> Turning techniques into habits.
>> ~~~
>> E-mail    [log in to unmask]
>> Web site  www.spinalsensor.com
>>
>
Sarah wrote:
>
>Michael,
>
>I am very interested to hear more about your spinal sensor device.  Part of
my
>research is concerned with the psychology of adherence to exercise
>(particularly back exercises) and I wish to set up a project to measure
>adherence (very difficult to do accurately) but would be intriqued to know
if your
>sensor could record frequency of exercising.  This is part of my PhD work
so
>any advice, tips or ideas would be very welcome.
>
>Also very interested in your comments re spinal paradox  - thoroughly agree
>that patient education, reminder posters etc etc has little long term
effect on
>the correct postural behaviour, my psychology background suggests we
>should work on altering patients beliefs about back pain and
exercise/postural
>activity before they will actually adopt the appropriate behaviour.
>
>Looking forward to hearing more about your work,
>Thanks
>
>
>Sarah Dean
>Lecturer in Physiotherapy
>University of Southampton, UK
>
>email [log in to unmask]

Michael replies to Sarah:


Hi Sarah

You've taken on an interesting area. I've suspected that patient
compliance with back exercises was a problem since I was 14
and failed myself to comply with a complex and fiddly exercise
regime presecribed by a physio. Discipline is one factor for
certain, but I think also that a lack of feedback whilst performing
the exercises at home is another -- ie personally, I didn't know
if I was doing the exercises correctly because they involved some
subtle and unusual movements. Without feedback along the way,
doubt creeps in and the motivation disappears quickly.

Anyway, enough of the anecdotal ...

I recall once coming across a UK study that tracked LBP patient
compliance to home exercises and if my memory serves me
correctly, many dropped off in the first week, most of the
remainder dropped off in the second week, and very few were
still doing the exercises into the third week. Not surprising really.
If you'd like me to see if I can source the reference, let me know.

Regardring whether the spinal sensor device could record
frequency of exercising, the short answer is yes. We have included
a data capture function that records various things such as the
percentage of time in and outside of the neutral range and the
number of flexion and extension "transgressions". This is displayed
on the LCD display on the hand-held control unit (which, BTW,
communicates wirelessly with the sensor which is adhered to the
patient's back).

We also have the ability to time and date stamp the data so that
when it is uploaded to a PC, graphs could be plotted showing
what the patient's posture has been up to. These graphs, in your
application, could indicate the times when the exercises were
undertaken.

The challenge will be that we're still in development of the device,
though we're getting closer to the finish line. We plan to produce
the product early next year. This may not be soon enough for your
purposes.

Anyway, perhaps we could go into more detail off-forum -- my
e-mail address is [log in to unmask] .

Look forward to discussing this with you some more.

Michael
E-mail    [log in to unmask]
Web site  www.spinalsensor.com



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