Biomechanical effects of a lumbar support in a mattress

For many patients with chronic low back pain, the lack of sleep and sufficient rest period that allows some relaxation is a major obstacle to a good quality of life. During sleep periods, neuromuscular activity is at a minimal level. The major factor influencing the forces on the body, and particularly the spine, is gravity. The force of gravity is sufficient to deform soft tissues when the body is resting on a mattress. Thus, the goal of this study is to measure the contact pressure forces acting on the spine with and without an inflatable support in various experimental conditions. Our hypothesis is that a lumbar support will distribute the force of gravity more uniformly over the pelvic, lumbar and thoracic areas, maintaining the lumbar lordosis, in a supine posture. In this study, 10 participants were tested when lying supine in six separate experimental conditions. These conditions varied according to the surface (no mattress, foam, mattress) and the fact that the support was inflated or not. The dependent variable measured was the contact pressure. It was measured using a pressure sensor mat (Tekscan). When the cushion was inflated the distribution of contact pressure in the different areas (pelvic, lumbar and thoracic) was modified. The comparison of the mean forces revealed that when the cushion was not inflated, the pressure distribution was mainly localized in the pelvic area. After the cushion was inflated, a significant decrease of contact pressure in the pelvic region and a significant increase in the lumbar area were observed. Our results confirm the hypothesis that a lumbar support inserted in a mattress allows a more homogenous distribution of contact pressure over the pelvic, lumbar and thoracic areas during supine posture. The use of an inflatable cushion favouring a transition of the contact pressure from the pelvic to the lumbar region could potentially limit unfavourable compressive and shearing forces acting on the lumbar spine.