{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T04:01:39Z","timestamp":1793419299436,"version":"4.5.0"},"reference-count":39,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Health and Medical Research Council of Australia","award":["#1091302"],"award-info":[{"award-number":["#1091302"]}]},{"name":"National Health and Medical Research Council of Australia","award":["#1194937"],"award-info":[{"award-number":["#1194937"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Sitting is linked to health problems, including back pain. Sitting posture is commonly measured in the laboratory, but it remains unclear how this relates to real-world spine posture. Methods: A cross-sectional study of pain-free adults conducted measurements in \u201claboratory\u201d and \u201creal-world\u201d settings. Wearable motion sensors recorded lumbar spine angular orientation to compare lumbar spine flexion angle during sitting postures in between settings. Gaussian mixture models defined participant-specific modes and overall probability distributions of real-world sitting posture. Measures included periods of real-world sedentary\/activity behaviours and trunk postural control (laboratory). Results: Laboratory measures of lumbar angle were more flexed during questionnaire (30.0\u00b0) than upright (19.8\u00b0) sitting. The angle in unstable sitting was intermediate (27.1\u00b0). Spine posture in unstable sitting correlated with real-world overall mean posture (r = 0.49\u20130.54) and most frequent mode (r = 0.47). Upright laboratory sitting posture correlated with real-world second most frequent mode (r = 0.54). Sitting less (r = 0.45) and walking more (r = 0.41) in the real world related to better balance performance and lumbar spine coordination. Conclusions: Spine posture in an unstable sitting laboratory task had the closest association with real-world sitting but does not replicate the diversity of spine postures adopted in real-world sitting. Wearable sensors are viable to study real-world postures.<\/jats:p>","DOI":"10.3390\/jcm14217518","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T02:34:45Z","timestamp":1761273285000},"page":"7518","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Exploring Lumbar Spine Posture and Movement in Sitting: A Comparison Between Laboratory and Real-World Measures"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0294-9856","authenticated-orcid":false,"given":"Mansour Abdullah","family":"Alshehri","sequence":"first","affiliation":[{"name":"School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia"},{"name":"Department of Medical Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca 24382, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Riddick","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Besomi","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia"},{"name":"Physical Therapy Department, Universidad del Desarrollo, Av. Plaza 680, Las Condes 7610615, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9658-2388","authenticated-orcid":false,"given":"Wolbert","family":"van den Hoorn","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia"},{"name":"School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4993-5101","authenticated-orcid":false,"given":"David M.","family":"Klyne","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1206-9107","authenticated-orcid":false,"given":"Paul W.","family":"Hodges","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/JES.0b013e3181e373a2","article-title":"Too much sitting: The population health science of sedentary behavior","volume":"38","author":"Owen","year":"2010","journal-title":"Exerc. Sport Sci. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.jelekin.2012.10.002","article-title":"Lumbar posture and muscular activity while sitting during office work","volume":"23","author":"Bradl","year":"2013","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e20230059","DOI":"10.47626\/1679-4435-2023-770","article-title":"Ergonomic interventions for work in a sitting position: An integrative review","volume":"21","author":"Soares","year":"2023","journal-title":"Rev. Bras. Med. Trab."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1177\/00187208211027020","article-title":"Significance of lower body postures in chair design","volume":"65","author":"Kim","year":"2023","journal-title":"Hum. Factors"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Alshehri, M.A., Alzahrani, H., van den Hoorn, W., Klyne, D.M., Vette, A.H., Hendershot, B.D., Roberts, B.W., Larivi\u00e8re, C., Barbado, D., and Vera-Garcia, F.J. (2024). Trunk postural control during unstable sitting among individuals with and without low back pain: A systematic review with an individual participant data meta-analysis. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0296968"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.jbmt.2015.10.002","article-title":"Sagittal evaluation of usual standing and sitting spinal posture","volume":"20","author":"Claeys","year":"2016","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"409","DOI":"10.3233\/THC-174717","article-title":"The effect of sitting posture on the loads at cervico-thoracic and lumbosacral joints","volume":"26","author":"Kwon","year":"2018","journal-title":"Technol. Health Care"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"In, T.S., Jung, J.H., Jung, K.S., and Cho, H.Y. (2021). Spinal and pelvic alignment of sitting posture associated with smartphone use in adolescents with low back pain. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18168369"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1097\/01.brs.0000202532.76925.d2","article-title":"Differences in sitting postures are associated with nonspecific chronic low back pain disorders when patients are subclassified","volume":"31","author":"Dankaerts","year":"2006","journal-title":"Spine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1007\/s00586-018-5846-z","article-title":"Lumbar spine posture and spinopelvic parameters change in various standing and sitting postures","volume":"28","author":"Misir","year":"2019","journal-title":"Eur. Spine J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.spinee.2023.12.001","article-title":"Coordination of hip and spine in individuals with acute low back pain during unstable sitting","volume":"24","author":"Alshehri","year":"2024","journal-title":"Spine J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1007\/s00586-024-08205-w","article-title":"Poor lumbar spine coordination in acute low back pain predicts persistent long-term pain and disability","volume":"33","author":"Alshehri","year":"2024","journal-title":"Eur. Spine J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"464","DOI":"10.2519\/jospt.2019.8827","article-title":"Changes in structure and function of the back muscles in low back pain: Different time points, observations, and mechanisms","volume":"49","author":"Hodges","year":"2019","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2614","DOI":"10.1097\/01.brs.0000188273.27463.bc","article-title":"Delayed trunk muscle reflex responses increase the risk of low back injuries","volume":"30","author":"Cholewicki","year":"2005","journal-title":"Spine"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s10926-012-9375-z","article-title":"Cumulative low back load at work as a risk factor of low back pain: A prospective cohort study","volume":"23","author":"Coenen","year":"2013","journal-title":"J. Occup. Rehabil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"103","DOI":"10.21037\/jss-21-112","article-title":"A vision for the future of wearable sensors in spine care and its challenges: Narrative review","volume":"8","author":"Hodges","year":"2022","journal-title":"J. Spine Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.apergo.2015.09.006","article-title":"Thoracic and lumbar posture behaviour in sitting tasks and standing: Progressing the biomechanics from observations to measurements","volume":"53","author":"Claus","year":"2016","journal-title":"Appl. Ergon."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kuo, Y.L., Huang, K.Y., Kao, C.Y., and Tsai, Y.J. (2021). Sitting posture during prolonged computer typing with and without a wearable biofeedback sensor. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18105430"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1016\/S0021-9290(00)00126-3","article-title":"Postural control of trunk during unstable sitting","volume":"33","author":"Cholewicki","year":"2000","journal-title":"J. Biomech."},{"key":"ref_20","first-page":"1458","article-title":"Coordination of hip and spine to maintain equilibrium in unstable sitting revealed by spectral analysis","volume":"126","author":"Alshehri","year":"2021","journal-title":"J. Neurophysiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"102418","DOI":"10.1016\/j.jelekin.2020.102418","article-title":"Spatial and temporal relation of kinematics and muscle activity during unstable sitting","volume":"52","author":"Roberts","year":"2020","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Simpson, L., Maharaj, M.M., and Mobbs, R.J. (2019). The role of wearables in spinal posture analysis: A systematic review. BMC Musculoskelet. Disord., 20.","DOI":"10.1186\/s12891-019-2430-6"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.jbiomech.2017.09.037","article-title":"Wearable technology for spine movement assessment: A systematic review","volume":"64","author":"Papi","year":"2017","journal-title":"J. Biomech."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/j.jelekin.2013.03.002","article-title":"Criterion validity and between-day reliability of an inertial-sensor-based trunk postural stability test during unstable sitting","volume":"23","author":"Mecheri","year":"2013","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Mj\u00f8sund, H.L., Boyle, E., Kjaer, P., Mieritz, R.M., Skallg\u00e5rd, T., and Kent, P. (2017). Clinically acceptable agreement between the ViMove wireless motion sensor system and the Vicon motion capture system when measuring lumbar region inclination motion in the sagittal and coronal planes. BMC Musculoskelet. Disord., 18.","DOI":"10.1186\/s12891-017-1489-1"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.gaitpost.2015.04.007","article-title":"Consistent accuracy in whole-body joint kinetics during gait using wearable inertial motion sensors and in-shoe pressure sensors","volume":"42","author":"Khurelbaatar","year":"2015","journal-title":"Gait Posture"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Kos, A., Toma\u017ei\u010d, S., and Umek, A. (2016). Evaluation of smartphone inertial sensor performance for cross-platform mobile applications. Sensors, 16.","DOI":"10.3390\/s16040477"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Riddick, R., Smits, E., Faber, G., Shearwin, C., Hodges, P., and van den Hoorn, W. (2023). Estimation of human spine orientation with inertial measurement units (IMU) at low sampling rate: How low can we go?. J. Biomech., 157.","DOI":"10.1016\/j.jbiomech.2023.111726"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2371","DOI":"10.1016\/j.jbiomech.2014.04.023","article-title":"Should a standing or seated reference posture be used when normalizing seated spine kinematics?","volume":"47","author":"Cotter","year":"2014","journal-title":"J. Biomech."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s00221-005-2346-2","article-title":"Can stooped posture explain multidirectional postural instability in patients with Parkinson\u2019s disease?","volume":"166","author":"Jacobs","year":"2005","journal-title":"Exp. Brain Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/1743-0003-6-32","article-title":"Walking speed-related changes in stride time variability: Effects of decreased speed","volume":"6","author":"Beauchet","year":"2009","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Zhu, W., Li, Y., Wang, B., Zhao, C., Wu, T., Liu, T., and Sun, F. (2021). Objectively measured physical activity is associated with static balance in young adults. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182010787"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e18892","DOI":"10.1097\/MD.0000000000018544","article-title":"Non-specific chronic low back pain and physical activity: A comparison of postural control and hip muscle isometric strength: A cross-sectional study","volume":"99","author":"Alsufiany","year":"2020","journal-title":"Medicine"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Maitre, J., and Paillard, T. (2016). Postural effects of vestibular manipulation depend on the physical activity status. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0162966"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Onofrei, R.R., and Amaricai, E. (2022). Postural balance in relation with vision and physical activity in healthy young adults. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19095021"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2371","DOI":"10.1111\/sms.13793","article-title":"Associations of sitting and physical activity with grip strength and balance in mid-life: 1970 British Cohort Study","volume":"30","author":"Cooper","year":"2020","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.humov.2017.01.009","article-title":"Athletic background is related to superior trunk proprioceptive ability, postural control, and neuromuscular responses to sudden perturbations","volume":"52","author":"Glofcheskie","year":"2017","journal-title":"Hum. Mov. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"154","DOI":"10.12674\/ptk.2021.28.2.154","article-title":"Effect on the center of pressure of vision, floor condition, and the height of center of mass during quiet standing","volume":"28","author":"Kim","year":"2021","journal-title":"Phys. Ther. Korea"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Ligorio, G., and Sabatini, A.M. (2016). Dealing with magnetic disturbances in human motion capture: A survey of techniques. Micromachines, 7.","DOI":"10.3390\/mi7030043"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/21\/7518\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T02:46:27Z","timestamp":1761273987000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/21\/7518"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":39,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["jcm14217518"],"URL":"https:\/\/doi.org\/10.3390\/jcm14217518","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,23]]}}}