The amount of postural change experienced by adolescent computer users developing seated –related upper quadrant musculoskeletal pain

Background: Improved techniques of measuring sitting posture have not led to a more comprehensive understanding of poor posture, nor its association with pain. There is also an evidence gap regarding critical thresholds of sitting postural change over time related to pain production. This paper describes postural angle changes over a 12-month period, and describes the process of placing defensible cut-points in the angle change data, to better understand associations between posture change over time, and onset of upper quadrant musculoskeletal pain (UQMP). Methods: This paper reports on data captured at baseline and 12-month follow-up, in adolescents in school using computers. Four sitting postural angles, head flexion (HF), neck flexion (NF), craniocervical angle (CCA) and trunk flexion (TF), and self-reported seated UQMP in the previous month were captured at each time-point. Research questions were: 1) What is the magnitude and direction of change in each postural angle over 12 months? 2) What are best cut-points in the continuous posture change distribution to most sensitively test the association between posture change and UQMP? 3) Is gender-specific cut-points required? The 12-month posture angle change data was divided into quintiles (0-20th%; 21-40 th %, 41-60 th %, 61-80 th %, > 80 th %), and the odds of UQMP occurring in each posture change quintile were calculated using logistic regression models. Results: Two hundred and eleven students participated at baseline, of which 153 were followed-up at one year. Both males and females with postural change into extension (which represents lesser flexion range) were more at risk for the development of UQMP, than any other group. The best cut-point for HF was 40 th % (≤-3.9°), NF was 20th% (≤-2.9°) and TF was 40 th % (≤-1.1°). For CCA however, change at or beyond 40 th % for extension or beyond 60% for flexion was associated with UQMP. Conclusions: Identification of critical postural angle change cut-points assists in considering the pain-producing mechanisms for adolescents using desk top computers. Refereed/Peer-reviewed