Proper trunk positioning is an essential component of optimal aerobic capacity training. Poor positioning of the head, neck, shoulders, trunk, and pelvis during aerobic exercise may compromise an individual’s ability to reach optimal functional outcomes.
Postural malalignment during exercise can exacerbate multiple problems, including:
• Compromised breathing due to reduced diaphragm movement and inability to fully expand the lungs
o The slouched sitting position had a lower sniff nasal inspiratory pressure (SNIP) score compared to upright sitting position, suggesting a reduced diaphragm tension and movement as a result of altered body position.¹
• Decreased strength in the upper extremities and core due to poor muscle length-tension
o Shoulder external rotation strength declined by 8% following five minutes in forward head, rounded shoulder
• Increased risk of pressure ulcers on the buttocks due to increased shear force in the ischial region
o Sacral sitting in a wheelchair increases the maximum contract pressure on the back, contact areas of the buttocks and back, and the shear force generated by sliding the ischial region forward.³
As part of a skilled intervention, therapists can facilitate postural correction during therapeutic cycling by providing verbal and tactile cueing, thus maximizing the ability to achieve therapy goals. Electrical stimulation in conjunction with exercise can improve strength of key postural muscles.
Upper Extremity Cycling with Patterned Electrical Neuromuscular
PENS upper extremity biphasic neck and/or upper extremity triphasic thoracic protocols applied during or preceding backward and forward upper extremity therapeutic cycling exercise may aid in the improvement of postural alignment.
Lower Extremity Cycling with Electrical Stimulation to Improve Posture:
PENS lower extremity triphasic trunk flexion/extension protocol applied during or preceding lower extremity therapeutic cycling exercise may aid in the improvement of postural alignment.
1. Albarrati A, Zafar H, Alghadir A, Anwer S: Effect of Upright and Slouched Sitting Postures on the Respiratory Muscle Strength in Health Young Males. Biomed Res Int. 2018:3058970; Feb 2018.
2. Pheasant S, Haydt R, Gottstein T, Grasso A, Lombard N, Stone B: Shoulder External Rotator Strength in Response to Various Sitting Postures: A Controlled Laboratory Study. Int J Sports Phys Ther. 13(1):50-57; Feb 2018.
3. Kamegaya T: Influence of sacral sitting in a wheelchair on the distribution of contact pressure on the buttocks and back and shear force on the ischial region. J Phys
Ther Sci. 28(10):2830-2833; Oct 2016.
4. OmniStim® FX² Pro and OmniVersa® PENS Lab