International Journal of Industrial Ergonomics, 8 (1991 ) 3-15 3

Elsevier
Some fundamental aspects of posture related to ergonomics
R.S. Bridger
UCT Medical School and Groote Schuur Hospital, Observatory 7925, Cape Town, South Africa
(Received September 10, 1990; accepted in revised form December 21, 1990)
Abs t r a c t
This paper presents a broad review of some fundamental aspects of posture in terms of structure, function and control (including
dysfunction and postural behaviour) and attempts to derive implications for ergonomics. It begins by reviewing research on the
anatomical basis of the upright bipedal posture in man and its evolutionary development, based on recent fossil discoveries.
Relevant aspects of the anatomy of the spine, pelvis and hip are then reviewed together with some developmental aspects of
posture and a consideration of postural faults and muscle balance gleaned from the clinical fiterature. Further clinical aspects are
discussed to introduce the concepts of postural control, feedback and postural behaviour. Finally, some aspects of cross-cultural
postural variation are briefly reviewed.
It is concluded that empirical research on posture and effective workspace design can benefit from a consideration of these
fundamental aspects of posture. Much of modern design practice would appear to be built around a limited set of postural
stereotypes which are probably culturally biased and do not reflect the true limitations and possibilities of human anatomy. Whether
improved designs can be implemented on the basis of these fundamentals is both an empirical question and a challenge to the
ingenuity of designers.
Re l e v a n c e t o i ndus t ry
Postural stress and occupationally-related musculoskeletal disorders have a high incidence in the industrially developed nations of
the world. Much research is currently underway to determine the reasons for this and provide designers with more effective
guidelines. This paper presents a review of fundamental aspects of posture to provide a wider conceptual basis for the investigation of
these problems.
Ke y wo r d s
Posture, hip, pelvis, spine, hominids, bipedalism.
I nt r o duc t i o n
Cu r r e n t r e s e a r c h o n wo r k i n g p o s t u r e a n d i t s
r e l a t i o n t o h e a l t h a n d i n d u s t r i a l e f f i c i e n c y i s r e -
v i e we d i n n u me r o u s r e c e n t p u b l i c a t i o n s ( see, f o r
e x a mp l e , Co r l e t t et al . , 1986; Gr i e c o , 1986;
Ki l b o m, 1988) . A k e y i n t e r e s t i s t h e me a s u r e me n t
o f s t r a i n i n mu s c l e s a n d j o i n t s i n r e s p o n s e t o
p o s t u r a l s t r e s s e s i mp o s e d b y t h e d e s i g n o f a
wo r k s p a c e o r t as k. Th i s e n a b l e s d e s i g n a l t e r n a -
t i ve s t o b e e v a l u a t e d o n t h e b a s i s o f q u a n t i t a t i v e
d a t a c o n c e r n i n g p o s t u r a l s t r e s s o r s t r a i n a n d p r o -
v i d e s a r a t i o n a l , i f s o me t i me s e mp i r i c a l , b a s i s f o r
d e s i g n g u i d e l i n e s .
I t i s n o t t h e p u r p o s e o f t hi s p a p e r t o r e v i e w t hi s
r e s e a r c h , s i n c e t hi s h a s b e e n d o n e e l s e wh e r e ( s ee
Co r l e t t e t al . , 1986; Gr i e c o , 1986; Na c h e ms o n ,
1976; Ag h a z a d e h et al . , 1989, f o r e x a mp l e ) . He r e ,
s o me f u n d a me n t a l a s p e c t s wi l l b e r e v i e we d wi t h
t h e e mp h a s i s o n g r o s s a n a t o my a n d wh o l e b o d y
0169-1936/91/$03.50 1991 - Elsevier Science Publishers B.V.
R.S. Bridger / Some fundamental aspects of posture
post ure, its devel opment , cont r ol and cross-cult-
ural mani fest at i ons. Some i mpl i cat i ons for ergo-
nomi cs will t hen be identified.
T h e upri ght pos t ure: I t s or i gi ns , ant i qui t y and
a n a t o my
The upri ght post ur e and bi pedal mode of
l ocomot i on t hat characterises Homo sapiens has a
long evol ut i onary history. Chart eri s et al. (1982)
at t empt ed to reconst ruct the gait of Aust ral o-
pi t hecus afarensis f r om 3.7 million year old fossil-
ized foot pri nt s f ound at Laetoli, East Africa. Thei r
estimates of stride length, cadence and velocity led
t hem to concl ude t hat Aust ral i pi t hecus was fully
bipedal. Jungers (1982), however, quest i oned
whet her the aust ral opi t heci ne adapt at i on t o bi-
pedal i sm was fully mode m on the basis of an
analysis of limb lengths.
Research on physical ant hr opol ogy in general
and homi ni d evol ut i on in part i cul ar is of interest
since compar at i ve analysis of t he anat omy of earl y
homi ni ds, Homo sapiens and moder n great apes
can help specify the adapt at i ons requi red for the
adopt i on and mai nt enance of t he upri ght post ur e
and, indeed, clarify what is meant by the t er m
post ure as it is used in Ergonomics.
Fi gure 1 depicts t he bi pedal post ure adopt ed by
a human and by a chi mpanzee. In the chi mpanzee,
the cent er of gravi t y (C. O. G. ) of the body lies
ant er i or to the l umbar spine and hip. In the hu-
man, it lies above the hip j oi nt . Thi s reduces the
mechani cal di sadvant age of the gluteal muscles in
keepi ng the t r unk erect. Not e also t hat t he chim-
panzee has limited hi p ext ensi on and cannot ex-
t end the hip to place the femur per pendi cul ar to
the ground. Thi s is due to length and posi t i on of
the ischium. In evol ut i onary terms, the mai n
anat omi cal adapt at i ons t o bi pedal i sm can be sum-
mari sed as follows (see Robi nson, 1972; Zi hl man
and Brunker, 1973; McHenr y and Temeri n, 1979;
Tobi as, 1982; and, for mor e popul ar t reat ment s of
the subject, Napi er, 1967 and Lovej oy, 1988):
- A lowering of the relative C. O. G. of the body
by means of a br oadeni ng and fl at t eni ng of the
ilium and sacrum as well as a short eni ng of the
arms and a l engt heni ng of the legs.
- A change in t he funct i on of t he gluteal muscles
(figure 2). In apes, gluteus medi us and gluteus
. ~ C.O.G.
Fig. 1. The bi pedal pos t ur e i n ma n a n d c hi mpa nz e e - not e t he
l ocat i on of t he cent er of gr avi t y ( C. O. G. ) of t he b o d y i n
rel at i on t o t he hi p j oi nt ( Ada pt e d f r om Zi h l ma n a nd Br unker ,
1979).
mi ni mus are maj or hi p ext ensors used for
l ocomot i on while gluteus maxi mus is of mi nor
i mport ance. These muscles are at t ached to t he
iliac bl ades and t he upper femur. In chi mpan-
zees, the iliac bl ades are flat and lie across the
back of t he t orso in a single pl ane (figure 2b),
whereas in homi ni ds (i ncl udi ng Homo Sapiens),
the ilium is r ot at ed forwards ar ound t he body
(figure 2c). This displaces t he ant er i or gluteals
i nt o a lateral posi t i on on t he body and convert s
t hem to hi p abduct ors. Gl ut eus maxi mus re-
mai ns post eri orl y posi t i oned but exhibits hyper -
t rophy. In homi ni ds, its f unct i on is no l onger
l ocomot i on but t o stabilise t he t r unk and pre-
vent it ' j ackkni fi ng' forwards over the legs when
walking. The sacrum widens to leave r oom f or
the viscera and bi rt h canal.
For par t of t he bi pedal gait cycle, t he pelvis is
onl y suppor t ed on one leg. To stabilise the
upper body, t he r eor i ent at ed ant er i or gluteals
act as hi p abduct ors. Viewed front al l y, it can be
seen t hat the hip j oi nt acts as a ful crum with
t he weight of t he body and t he unsuppor t ed leg
exerting a moment on one side which is coun-
t eract ed by the abduct or s on the ot her (figures
Anterior
Gluteals
R.S. Bridger / Some fundamental aspects of posture
Sacrum
Ilium
( a )
( c )
Ilium
( d )
Fig. 2. The hi p and pel vi s rel at ed t o post ure. (a) Fr ont al view of a huma n pelvis and hi p j oi nt . The j oi nt act s as a f ul cr um dur i ng
wal ki ng. The ant er i or gluteals, act i ng as hi p abduct or s, count er act t he mome nt exer t ed by t he upper t or so and uns uppor t ed leg. (b)
Top view of t he pel vi s of a chi mpanzee. Not e t hat t he iliac bl ades lie al most flat, in a single pl ane. The gl ut eal muscl es act as hi p
ext ensor s in t he chi mpanzee. (c) Top view of a human pelvis. Not e t he curved ilia whi ch pr ovi de l at eral at t achment poi nt s f or t he
ant er i or gluteals, enabl i ng t hem to abduct t he hip. (d) ' Tr endel enbur g' post ur e. Weakness of t he f i ght ant er i or gl ut eal s causes
devi at i on of t he pel vi s t o t he ri ght and lateral t i l t i ng t o t he left. The spi ne exhi bi t s compens at or y scoliosis. Thi s t ype of pos t ur e can
al so be obser ved when peopl e st and on an uneven surface to work. ( Adapt ed f r om Lovej oy, 1988, and Kendal l et al., 1971.)
2a and 2d). In homi ni ds, t he femoral neck is
l engt hened and the ilium is fl ared out ward,
away f r om t he body to increase t he lever arm of
the hip abduct ors. Peopl e wi t h weak or para-
lysed hip abduct or s exhi bi t t he ' Tr endel enbur g'
gait in which the pelvis tilts t owards the unsup-
por t ed leg and the upper body bends t owards
t he suppor t ed leg (figure 2d).
- T h e ilium expands post eri orl y, bri ngi ng the
C. O. G. of t he body closer to the hi p j oi nt in the
sagittal plane.
- In or der to st and erect, the spine must be
reposi t i oned f r om hori zont al in t he quadr upedal
post ur e t o vertical in bi pedal post ure. Thi s can-
not be achieved by simply rot at i ng t he pelvis on
the vertical f emur by 90 degrees until the t r unk
is erect, because the ext ensi on of t he f emor a
requi red for walking (i.e. ext ensi on past t he
vertical by the trailing leg) is t hen i mpeded by
the ischium (figure 3). Thi s is one reason why
t he great apes cannot walk on two legs effi-
ci ent l y (figure 3b). Furt her, t he sacrum cannot
be r ot at ed backwards with respect t o the ilium.
Al t hough this woul d hel p to pl ace t he spi ne in a
vertical posi t i on, while using less t han 90 de-
grees of hi p extension, t he bi rt h canal woul d
t hen be obst r uct ed by t he coccyx. Somewhat
count eri nt ui t i vel y, t he evol ut i onar y sol ut i on
seems to have been t o r ot at e t he sacrum for-
wards on the i schi um and i ncrease t he ext en-
sion of t he l umbar spine. Thi s is t he origin of
t he l umbar lordosis whi ch is of so much con-
cern to researchers in seating. Accor di ng t o
Far f an (1978), t he post er i or l umbar (supra-
spinous) l i gament s and t he zygapophyseal j oi nt s
of the f our t h and fi ft h l umbar ver t ebr ae are
specially adapt ed in man t o resist t he l umbo-
sacral shear force whi ch is br ought about by t he
tilt of the sacrum and whi ch is exacer bat ed
when obj ect s are lifted.
The pelvis can be seen as t he base on whi ch t he
spi ne is support ed. Ma ny muscl e groups which,
in ot her species, pr ovi de l ocomot i ve power take
on new roles in t he bi pedal post ure. As de-
scribed above, t he ant er i or gluteals now stabil-
ise the pelvis. The iliopsoas muscl es i ni t i at e
' swi ng-t hrough' of the trailing leg in wal ki ng
and the hamst ri ngs decel erat e it pr i or t o heel
strike. Onl y t he quadri ceps and t he pl ant arfl ex-
ors (gast rocnemi us and soleus muscles) are left
t o pr ovi de a gr ound r eact i on force f or l ocomo-
t i on in walking.
6 R.S. Bridger / Some fundamental aspects of posture
(a) (b) (c)
Fig. 3. Ori ent at i on of the ischium with respect to the hip joint.
(a) Man standing erect. (b) Chimpanzee standing erect. (c)
Chimpanzee in normal quadrupedal posture. In (b), the ischium
prevents extension of the thigh past the vertical. Comparison
of (a) and (c) reveals the fundamental nat ure of the l umbar
lordosis as an adapt at i on to erect bipedalism. (Adapt ed from
Robinson, 1972.)
- Alterations in foot morphology.
- A decrease in hip and knee j oi nt mobility.
The fossil record provides considerable insights
i nt o the evolution of the upright posture over time
and the anat omi cal adapt at i ons which bipedalism
requires (interestingly, as Kapandj i , 1970, points
out, the true physiological position of the hip in
man corresponds to the position on all fours. In
standing, the head of the femur coincides imper-
fectly with the acetabular cavity. This is used to
argue in favour of man' s evolution from quadruped
ancestors). According to Far f an (1978), the l umbar
lordosis and other adapt at i ons provide an over-
abundance of power for at t ai ni ng the upright pos-
ture. The erection of the t runk has been achieved
onl y part l y by the backward rot at i on of the pelvis,
the rest by the inversion of the normal quadrapedal
l umbar curve (concave anteriorly) i nt o a l umbar
lordosis (concave posteriorly).
T h e hip and pelvis: S o me a n a t o mi c a l a s p e c t s re-
lated t o p o s t u r e
In erect standing, as has been described, onl y
part of the erection of the t runk is accomplished
by extension (posterior pelvic tilting) of the hip
j oi nt from the quadrupedal posture, the rest oc-
curs as extension (lordosis) of the l umbar spine.
This means t hat the pelvis is tilted anteriorly,
relatively speaking, in normal standing.
The antero-posterior tilt of the pelvis has a
major influence on the posture of the body since it
co-varies with the angle of the sacrum from which
the l umbar lordosis arises. An underst andi ng of
factors influencing tilt of the pelvis is therefore
essential for the analysis of post ure and post ural
load.
In figure 4, the pelvis is represented sagittally
with the hip j oi nt regarded as a fulcrum. The tilt
of the pelvis is the equilibrium position of the
moment s and count ermoment s exerted by the
muscular-ligamentous system which fixes the pelvis
on the hip j oi nt . The iliofemoral l i gament lies
anterior to the hip j oi nt and the ischiofemoral
ligament lies posterior to the j oi nt . In standing,
( a )
Erector Spinae
Anterior Superior /
Iliiac Spine ~ . /
k / Posterior Superior
Rectus Femoris t ( - " " ' - - ' - ' J
--%:+
I~liopsoas ~ I JJ
Pubic Body Ischial Tuberosity
(b)
Abdominals
Hip
Flexors
~ ~ 1 ~ Erect r Spinae
sor8
Fig. 4. Conceptual model of t he sagittal pelvis.
R.S. Bridger / Some fundamental aspects of posture 7
these l i gament s are in moder at e tension, dur i ng
ext ensi on of the hi p all of t he l i gament s become
t aut whereas in fl exi on t hey relax. In standing, t he
i l i ofemoral l i gament prevent s t he pelvis f r om tilt-
ing post eri orl y i.e. it prevent s the t r unk f r om
' j ackkni f i ng' backwards over t he legs.
Dur i ng lateral r ot at i on of the hi p (t o st and wi t h
t he toes poi nt i ng out wards, for exampl e) t he ant e-
ri or l i gament s become t aut and the post er i or liga-
ment slackens. The opposi t e occurs duri ng medi al
r ot at i on (Kapandj i , 1970). Thi s may expl ai n why
Cyri ax (1924) hel d t hat walking with the toes
t ur ned out t oo much was a cause of excessive
ant er i or pelvic tilt in chi l dren (and hence excessive
l umbar lordosis). Thi s woul d sl acken t he post er i or
l i gament and tense t he ant er i or l i gament s resul t i ng
in a net increase in t he ant er i or moment act i ng on
t he hi p j oi nt and a mor e ant eri orl y tilted equi-
l i bri um posi t i on of t he pelvis. Thi s illustrates why
an analysis of foot posi t i on is essential to t he
analysis of post ur e and t he i mpr ovement of t he
design of workspaces.
Pelvic tilt is not t he onl y det er mi nant of spinal
curvat ure. Kapandj i (1970) describes how t he
art i cul ar facet of t he sacrum is subject to wide
vari at i on in humans. In t he mor e hori zont al l y
al i gned sacrum, t he spinal curves are pr onounced
- Kapandj i regards this as an over adapt at i on to
t he bi ped state. When t he spinal curves are less
pr onounced, the sacrum t ends t o lie mor e verti-
cal l y on the ilium. Thi s may expl ai n why measure-
ment s of pelvic tilt do not always correl at e with
measur ement s of l umbar cur vat ur e (Wal ker et al.,
1987), whereas measur ement s of sacral tilt do
(Bri dger et al., 1989a; 1990). Al t hough the mor e
vertically aligned sacrum with fl at t er spine does
occur in adults, it is mor e usual l y seen in chi l dren
and closely resembl es t he sacral or i ent at i on f ound
in pri mat es (Kapandj i , 1970).
I n neonat es, t he spi ne exhibits a single, ant eri -
orl y concave curve and vertical sacrum. Thi s
kyphosi s of the l umbar spi ne di sappears at about
13 mont hs of age and is repl aced by a l umbar
lordosis of increasing severity aft er the t hi rd year.
By t en years, the adul t st at e is assumed. When an
adul t stands, the l umbar lordosis suppor t s t he
upper body so as to mi ni mi se the bendi ng moment
on t he spi ne and t he line of gravi t y of t he superin-
cumbent body part s passes t hr ough t he facet j oi nt s
of L4 and L5 ( Kl ausen and Rasmussen, 1968).
Devel opment of t he bi pedal post ur e in chi l dren
suggests a recapi t ul at i on of phyl ogeny in ont og-
eny. The young child is physi cal l y unabl e t o st and
at first, par t l y because of an i nabi l i t y to ful l y
ext end t he knee and hi p and t he absence of a
l umbar lordosis. Crawl i ng is a pr ecur sor t o st and-
i ng in which hi p ext ensi on in t he quadr upedal
posi t i on is used for l ocomot i on. ( Raf t , 1962, re-
garded pr emat ur e st andi ng as a cause of mal devel -
opment of t he feet in children).
The muscles of the hip and t runk and the
mai nt enance of posture
The i mpor t ance of t he ant er i or gluteals in t he
lateral stabilisation of t he pelvis has al ready been
not ed. Fi gure 4 present s a sagittal view of t he hi p
and pelvis. The fl exor and ext ensor muscles of t he
hi p and t r unk pl ay a maj or rol e in t he mai nt e-
nance of the erect post ure. As descri bed above,
t he pelvis is fixed on the hi p by a syst em of
muscles and ligaments. The tilt of t he pelvis de-
pends on the equi l i bri um of t he moment s and
count er moment s exert ed by t he ant agoni st i c
muscles in this system. The one and t wo j oi nt hi p
flexors (iliopsoas and rect us femori s) and t he one
and t wo j oi nt hi p ext ensors (gluteus maxi mus and
t he hamst ri ngs) are of rel evance to ergonomi cs as
are t he abdomi nal and erect ores spi nae muscl es of
t he trunk. Cont r act i on of t he hi p fl exors ( on a
fixed f emur as in st andi ng) and t he erect ores spi nae
t ends to tilt t he pelvis forwards and exaggerat e t he
l umbar lordosis whereas t ensi on in the hi p ex-
t ensors and t he abdomi nal s t ends t o tilt t he pelvis
post eri orl y and r educe t he l umbar lordosis.
The spi ne itself l acks i nt r i nsi c st abi l i t y.
Nachems on (1966, 1968) not es t hat an i sol at ed
l i gament ous spi ne can onl y suppor t a l oad of 2 kg
pl aced on t op of t he first t horaci c vert ebrae. Kl an-
sen (1965) hel d t hat t he short, deep muscles of t he
back suppor t ed t he i ndi vi dual j oi nt s of t he spine.
The l ong back muscles were responsi bl e f or t he
stabilisation of t he spi ne as a whol e when t he line
of gravi t y of t he upper body par t s passed vent ral l y
t o the l umbosacral j oi nt . The ant er i or abdomi nal s
stabilised t he spine when t he line of gravi t y was
dorsal t o t he axis of movement of t he j oi nt .
Nachems on (1966, 1968) i nvest i gat ed t he role
of the vert ebral por t i on of t he iliopsoas muscl e
(psoas maj or) in t he ext ri nsi c st abi l i sat i on of t he
R.S. Bridger /Some fundamental aspects of posture
spine. He concl uded t hat , in addi t i on t o its func-
t i on as a hi p flexor, the psoas muscl e was i nvol ved
in t he st abi l i sat i on of t he l umbar spi ne part i cu-
l arl y in upri ght st andi ng and uns uppor t ed sitting
(i.e. wi t hout a backrest ). Psoas act i vi t y decr eased
when the t r unk was inclined f or war ds while act i v-
ity of the sacro-spi nal i s muscl es si mul t aneousl y
increased. Taken t oget her and recal l i ng the com-
ment s made previ ousl y about t he funct i on of
gl ut eus maxi mus, t he muscl es of the hi p and t r unk
can be seen as a syst em of synergi st s and
ant agoni st s which i nfl uence the shape of t he spi ne
in erect st andi ng and sitting t hr ough t hei r effect s
on the tilt of the pelvis as t hey act to stabilise the
upper body.
The abdomi nal muscl es (rect us abdomi ni s and
obl i que) and the t horaci c (i nt ercost al ) muscl es pl ay
a maj or role in stabilising t he spi ne when a wei ght
is lifted or car ded (in rel axed st andi ng, t hey are
el ect r omyogr aphi cal l y silent) accor di ng to the
cant i l ever anal ysi s of Morri s et al. (1961). The
cont r act i on of these muscl es pressuri ses the con-
t ent s of the t horax and t r unk and convert s t hem
i nt o a ppr oxi ma t e hydr aul i c and pne uma t i c
' s pl i nt s ' or cyl i nders capabl e of resisting some of
the fl exor mome nt on the spi ne and t herefore
reduci ng t ensi on in the ext ensors of the spine.
As pden (1989) pr opos ed a new mat hemat i cal
model of t he spi ne based on arch mechani cs. I n
this model , i nt r a- abdomi nal pressure is essent i al
for lifting heavy wei ght s in conj unct i on wi t h
l umbar lordosis. Empi ri cal l y, Or t engr en et al.
(1981) have demons t r at ed hi gh posi t i ve correl a-
t i ons bet ween measur es of i nt r a- abdomi nal and
i nt ra-di scal pressure and back muscl e activity. Thi s
does not necessari l y i mpl y t hat i nt r a- abdomi nal
pressure exerts an ext ensor mome nt about the
spine, however. As pden pr oposes t hat it appl i es a
compr essi ve stress t o t he convex surface of the
l umba r l ordosi s whi ch act s to stiffen the l umbar
spi ne and t her ef or e i ncreases its abi l i t y to with-
st and loads.
Postural faults and muscle balance
Kendal l et al. (1971) pr esent anal yses of pos-
t ural faul t s which i l l ust rat e the rol e of t he muscl es
of t he hip and t r unk in the mai nt enance of pos-
ture. They make consi der abl e use of t he concept
of ' mus cl e bal ance' in t he anal ysi s of post ure.
( a ) ( b )
! I
( c )
Fig. 5. Alignment of the spine, pelvis and hip in standing. (a)
Normal posture. (b) Excessive anterior pelvic tilt and hyper-
lordosis. The hip flexors and low back muscles are shortened
and the abdominals are lengthened and often weak. (c) 'Flat-
back' posture caused by excessive posterior pelvic tilt (hyperex-
tension of the hips). Sometimes caused by weak hip flexors.
(Adapted from Kendall et al., 1971.)
When a muscl e is weakened and its ant agoni st is
not , a st at e of i mbal ance is said t o occur. The
st ronger muscl e t hen short ens and t he weaker
el ongat es resul t i ng in a def or mi t y of t he post ur e of
t he j oi nt . Fi gur e 5 i l l ust rat es this usi ng exampl es
of i mbal ance in the hi p and t r unk muscul at ur e.
The al i gnment usual l y seen in heal t hy subj ect s is
depi ct ed in figure 5a. The l umba r l ordosi s and
t horaci c kyphosi s are easi l y di scerned. I n fi gure
5b, t he pelvis is tilted ant er i or l y (this ma y be
caused by an i mbal ance bet ween t he hi p fl exors
and l ow back muscl es on t he one hand and the
abdomi nal and hi p ext ensors on the ot her). A
compens at or y i ncrease in t he l umba r l ordosi s oc-
curs to mai nt ai n the t r unk in an erect posi t i on. I n
fi gure 5c the pel vi s is tilted post er i or l y and com-
pens at or y r educt i on of the l umba r l ordosi s occur s
accordi ngl y.
Gener al l y speaki ng, weakness resul t s in a l ack
of suppor t about a j oi nt and per mi t s a st at e of
def or mi t y whereas short ness creat es t he def or mi t y.
Def or mi t i es can also occur if weak muscl es are no
l onger abl e t o adequat el y oppos e gravi t y.
I n a clinical st udy, Fi sk and Bai gent (1981)
f ound t hat young pat i ent s wi t h back pai n fre-
R.S. Bridger / Some fundamental aspects of posture 9
quent l y had stiffness in the lower thoracic spine
and this was related to ' t i ght ' hamst ri ng muscles
(i.e. in these patients, hip flexion with the knee
ext ended was limited to about 30 degrees due to
passive stretching of the hamst ri ngs which pre-
vents furt her flexion). They hypot hesi sed t hat the
tight hamstrings, by limiting hip flexion when the
knees are extended, woul d increase the stress on
the spine when bendi ng (i.e. flexion of the spine
woul d need to be increased to compensat e for the
lack of hip flexion when activities involving bend-
ing were carried out).
A small number of studies have been carried
out to investigate the ant hr opomet r y of the hip
and t runk muscul at ure and the pelvis and spine as
a linkage in heal t hy subjects. Toppenberg and
Bullock (1986) carried out mul t i pl e regression
analyses of thoracic and l umbar angles (of stand-
ing subjects), pelvic tilt and indices of muscle
length (obt ai ned by measuring ranges of passive
flexion and extension of the hip j oi nt and trunk)
of adolescent females. They f ound some signifi-
cant relationships between these variables, in par-
ticular, a negative correlation between the index of
hamst ri ng length (range of hip flexion with the
knee extended) and the l umbar lordosis. This sug-
gested that individuals with short (' t i ght ' ) ham-
strings had more pronounced l umbar lordoses t han
those with long hamst ri ngs - somewhat surprising
since the hamst ri ngs cause posterior pelvic tilting
which flattens, rat her t han accentuates, the l umbar
lordosis. This fi ndi ng was replicated by Bridger et
al. (1989b). They suggested t hat it was a statistical
artifact, the result of a positive correlation be-
tween the measures of hip flexion and extension
(the indices of hamst ri ng and iliopsoas length).
Theoretically, in standing, short (or ' t i ght ' )
iliopsoas muscles would t end to tilt the pelvis
forwards and accent uat e the l umbar lordosis. The
hamst ri ngs are not stretched in st andi ng and would
therefore not be expected to influence the tilt of
the pelvis. Similar findings were report ed by
Bridger et al. (1990). Their dat a furt her stresses
the role pl ayed by iliopsoas in det ermi ni ng stand-
ing post ure and post ural adapt at i on to di fferent
working positions.
This provides a clear theoretical j ust i fi cat i on
for the inclusion of footrests or footrails in the
design of workspaces for st andi ng operators. When
one foot is placed on an elevated footrail, the
correspondi ng hip j oi nt is slightly flexed and its
iliopsoas muscle shortened. Thi s tilts the pelvis
posteriorly and slightly reduces the l umbar lordo-
sis. Essentially, i nt ermi t t ent use of a foot rest by a
st andi ng operat or may help to prevent post ural
fixity of the l umbar spine and therefore reduce
fatigue or backpain. Grieco (1986) suggested t hat
post ural fixity in sitting may be a hazard since it
degrades nut ri t i onal exchange in the intervertebral
discs.
The concept ual model or the hi p/ pe l vi s / s pi ne
linkage present ed in figure 4 is not new.
Forrester-Brown (1930) emphasi sed the clinical
i mport ance of the tilt of the pelvis in det ermi ni ng
the posture of the spine. In ergonomics, Keegan
(1953) used this concept ual approach in his quali-
tative radi ographi c analysis of post ure related to
seating. It is not ewort hy t hat Keegan believed t hat
the application of a knowl edge of physiological
factors to chair design was i mpor t ant and an
i mprovement over the ' t r adi t i onal trial and error
and ant hropomet ri c measurement met hods of de-
signing seats' (Keegan, 1962). Mandal (1981, for
example) ext ended this work in advocat i ng the use
of chairs with forward sloping seats over the con-
ventional flat or rearward tilted seats. Recently,
Bridger et al. applied a similar approach to the
analysis of nine working positions, i ncl udi ng sit-
ting in a variety of ways. They concl uded t hat
postures can be anal ysed not onl y in terms of j oi nt
angles and dept h of spinal curves but also in terms
of the const rai nt i mposed on the pelvis and l umbar
spine by the degree of hip and knee flexion (i.e.
the funct i onal lengths of the one and two j oi nt
muscles of the hip and knee, their resting t one and
the extent to which t hey can be furt her l engt hened
in a part i cul ar working position).
Disturbances of muscle bal ance result in pos-
rural deviation. Initial weakness or tightness of a
muscle may cause faul t y al i gnment of a j oi nt and
vice versa. Cause and effect may be difficult to
distinguish except where some clear precipitating
factor such as paralysis or t r auma is extant. It is
less certain t hat incorrect workplace design and
postural fixity can lead to post ural faults, al-
t hough i mmobi l i sat i on of muscles in a short ened
position has been shown to cause st ruct ural short-
ening and stiffening of muscles over time (Her-
bert, 1988). Al t hough workspace redesign using
ergonomics is an appropri at e approach to the pre-
10 R.S. Bridget / S o me fundamental aspects of posture
vent i on of post ural faults at work, the det ai l ed
knowl edge of funct i onal anat omy possessed by t he
occupat i onal physi ot herapi st is essential at an idi-
opat hi c level for the diagnosis and t r eat ment of
individuals and t he redesign of t hei r workspaces.
Postural reflexes and posturai control
The erect human body is a tall st ruct ure wi t h a
nar r ow base of suppor t - its C. O. G. lies at mor e
t han hal f its t ot al height. In t erms of physics, t he
body is at t he mer cy of envi ronment al per t ur ba-
tions. In t erms of physiology, however, an adul t
wi t h ful l y-devel oped post ural reflexes is very sta-
ble (given t hat movement is not restricted).
Accordi ng to Mar t i n (1967), post ure is an active
process, its cont r ol depends on the existence of a
system of reflexes which are neurol ogi cal l y sep-
arat e f r om t he system which support s the trans-
mission of impulses for vol unt ar y movement and
f r om the ant i -gravi t y reflexes whi ch cause aut o-
mat i c braci ng of a limb when it is l oaded by body
weight.
The ant i -gravi t y reflexes are cent ered in t he
hi nd brai n (pons and medulla, Mart i n, 1967). Al-
t hough t hey are essential for the mai nt enance of
the upri ght post ure, t hey do not assist in the
mai nt enance of equilibrium. A second set of pos-
tural reflexes ( dependent on t he basal ganglia of
the mi d brai n) cont rol t he post ur e of the various
body part s in rel at i on to each ot her (post ural
fi xat i on of limbs, for exampl e) and the post ure of
the whol e body itself. The cerebel l um is also in-
vol ved in post ure in the co- or di nat i on of body
movement s.
The reflex cont rol of post ure (as distinct f r om
bot h low level reflex arcs such as the ' knee j er k'
reflex and vol unt ar y movement ) depends on bot h
intrinsic and extrinsic feedback. The l abyri nt hi ne
reflexes seem to be concer ned with pr ot ect i on
against mechani cal instability. Mar t i n (1967) not es
t hat peopl e devoi d of vest i bul ar funct i on exhi bi t ed
little appar ent disability pr ovi ded they were on a
stable base and obt ai ned visual feedback. Post ural
reflexes dependent on visual feedback are most l y
suppl ement ar y to pr opr i ocept i ve or l abyri nt hi ne
feedback (except t he reflex react i on to an obst acl e
in the pat h of mot i on). However, peopl e with
i mpai red somat i c and or l abyri nt hi ne feedback
exhi bi t part i cul ar disabilities when t hei r vision is
i mpai red (e.g. i nabi l i t y to mai nt ai n t he head erect
when bl i ndfol ded) and in some cases can onl y
funct i on nor mal l y when addi t i onal cues are given
(e.g. t hey can onl y walk when whi t e lines are
pai nt ed on t he fl oor or when gui ded by t he little
finger, Mart i n, 1967).
Ext ri nsi c and i nt ri nsi c f eedback are essential to
the mai nt enance of stable post ure. Some quad-
rupedal ani mal s can ' l ock' t hei r limbs to achi eve
stability at little energy cost (presumabl y, this is
one reason why horses can sleep st andi ng up). In
humans bi pedal stability is achi eved dynami cal l y.
In the sagittal plane, t he ant er i or and post er i or
muscles act as ant agoni st s t o keep t he C. O. G. of
the body wi t hi n t he small base of suppor t def i ned
by the posi t i on of t he feet. Post ural reflexes act
such that, for example, f or war d fl exi on of t he
t r unk ant eri or to t he base is accompani ed by
post eri or proj ect i on of t he but t ocks (the ankl e
j oi nt s pl ant arfl exi ng accordi ngl y). Loss of bal ance
post eri orl y is accompani ed by f or war d t hrust i ng
of the pelvis ( hyper ext ensi on of t he hi p j oi nt s) and
the arms to rest ore t he C. O. G.
Post ural st abi l i t y and post ural s way
In heal t hy subjects under less drast i c cir-
cumst ances, erect post ure is accompani ed by pos-
t ural sway. Thi s can be measur ed usi ng a force
pl at e and used t o eval uat e f unct i on in a vari et y of
medi cal compl ai nt s (e.g. strokes). Passive testing
can be suppl ement ed by active met hods in whi ch
destabilising forces are dehber at el y appl i ed at the
feet or waist ( Duncan et al., 1990). An ' ankl e
strategy' is used t o count er small per t ur bat i ons of
t he C. O. G. and a ' hi p st rat egy' t o count er large
per t ur bat i ons or when the suppor t surface is nar-
row (when worki ng in a conf i ned space or on a
nar r ow pl ank for example). For post er i or displace-
ments, tibialis ant er i or and t hen quadri ceps
femori s cont r act in t he ankl e st rat egy and t he
paraspi nal and hamst ri ng muscles in t he hip
strategy.
Losses of bal ance (i ncl udi ng slips, trips and
falls) are a maj or cause of work-rel at ed i nj ury
(Porri t t , 1985). A summar y of some of t he fact ors
which i nfl uence post ural sway and stability is
t herefore appropri at e.
Several fact ors i nfl uence post ur al st abi l i t y and
R.S. Bridger / Some fundamental aspects of posture 11
sway in heal t hy subj ect s (see Ekdahl et al., 1989).
Age has been f ound to be rel at ed to sway in some
st udi es but not in ot hers. Vi si on is known t o be an
i mpor t ant st abi l i si ng f act or in mai nt ai ni ng the
erect st ance whereas severe heari ng loss has been
shown to cor r el at e wi t h i ncreased sway. Of t he
vari ous bal ance tests i nvest i gat ed by Ekdahl et al.,
st andi ng on one leg while bl i ndf ol ded was the
mos t di ffi cul t ( i mpossi bl e for subj ect s over 55
years) and st andi ng on one leg wi t hout a bl i ndf ol d
was mor e di ffi cul t t han st andi ng wi t h the feet
t oget her wi t h a bl i ndfol d.
These results are not surpri si ng in vi ew of the
r educt i on in t he size of t he base of suppor t , in-
creased muscl e coor di nat i on ( r ecr ui t ment of t he
hi p abduct or s to mai nt ai n the C. O. G. over a single
foot ) and loss of vi sual f eedback br ought about by
this test. Some i nt erest i ng pract i cal i mpl i cat i ons
are, for exampl e, t hat oper at i ng foot pedal s in a
st andi ng posi t i on woul d be cont r ai ndi cat ed, par -
t i cul arl y under poor lighting. Ekdahl et al. al so
obser ved t hat f emal e subj ect s had bet t er bal ance
t han men, possi bl y at t r i but abl e to a l ower C. O. G.
Post ural sway anal ysi s may be of use in ergo-
nomi cs to assist in t he desi gn of l oads f or manual
mat er i al s handl i ng and in wor kspace desi gn gener-
ally, par t i cul ar l y where t here is a l ack of space f or
t he feet and hence i ncreased de ma nd on the pos-
t ural cont r ol syst em.
Fi nal l y, post ur e ma y var y accor di ng to the level
of neur al act i vat i on. Mar ek and Nor owol (1986)
i nvest i gat ed changes in sitting post ur e dependi ng
on t he level of st i mul at i on by t he task. Over st i mu-
l at i on was accompani ed by a decrease in head and
t r unk i ncl i nat i on and under st i mul at i on by an in-
crease in t r unk and head i ncl i nat i ons dur i ng t he
first t wo hour s of work. They at t r i but ed t hese
fi ndi ngs to di fferences in muscl e t one due t o
changes in neural act i vat i on (faci l i t at i on vi a pat h-
ways in the ret i cul ar f or mat i on) .
Behavioural aspects of postural control
Demps t er (1955) vi ewed the body as an open-
chai n syst em of links. Each j oi nt of the body has a
f r eedom for angul ar mot i on in one or mor e di rec-
tions. A compl ex linkage, such as t hat bet ween t he
shoul der, ar m and hand has ma ny degrees of
f r eedom of movement and power t r ansmi ssi on is
i mpossi bl e wi t hout accessory st abi l i sat i on of j oi nt s
by muscl e act i on. For exampl e, supi nat i on of t he
wrist may be requi red to t ur n a door handl e but
this is onl y possi bl e if t he el bow and shoul der
j oi nt s are st abi hsed and can count er t he r eact i on
at t he hand- handl e i nt erface. When anal ysi ng t he
wor kl oad or onset of fat i gue associ at ed wi t h t he
per f or mance of a task, an a t t e mpt t o di st i ngui sh
bet ween t he l oad i mposed by t he wor k i t sel f and
the l oad i mposed by t he r equi r ement s f or post ur al
st abi l i sat i on ma y be appr opr i at e - ma n y in-
dust ri al t asks i nvol ve t he mani pul at i on of obj ect s
whose mass is negligible c ompa r e d t o t he mas s of
the oper at or and his mai n body segment s.
Post ural reflexes exist f or t he compl ex cont r ol
of j oi nt forces whi ch occur dur i ng al mos t all of
our dai l y activities. Na c he ms on (1966) bel i eved
t hat t he psoas muscl e was i nvol ved in post ur e
mai nt enance quot i ng De mps t e r ' s vi ew t hat when
t he body f or ms a cl osed-chai n syst em of l i nks to
exert forces on its envi r onment , t he t r unk and
l i mb muscl es do not di rect l y exert forces, r at her
t hey mai nt ai n j oi nt post ur es such t hat body wei ght
exert s an effect i ve moment . Thi s mechani s m un-
doubt edl y makes possi bl e t hose act i vi t i es in whi ch
the body pr oduces very l arge forces on its envi r on-
ment or in whi ch j oi nt s or ext ernal obj ect s un-
der go r api d accel erat i on t hr ough ' pi vot i ng' ac-
t i ons (as in t hr owi ng a j avel i n, or swi ngi ng a gol f
club).
Br ant on (1969) used t he body- l i nk concept to
eval uat e t he comf or t of t r ai n seat s usi ng obser va-
t i onal dat a on sitting behavi our . An open- chai n
syst em of body links can behave in unpr edi ct abl e
ways when subj ect to i nt er nal and ext ernal forces.
The pr i me f unct i on of a seat is t o s uppor t body
mass agai nst t he forces of gravi t y. A second func-
tion, whi ch was emphasi sed by Br ant on, was t o
st abi l i se the open- chai n syst em. I n t he absence of
ext ernal st abi l i sat i on, t oni c muscl e act i vi t y is re-
qui red whi ch l eads t o di scomf or t . Behavi our s such
as fol di ng t he ar ms and crossi ng t he legs are
post ur al st rat egi es whi ch t ur n open- chai ns i nt o
appr oxi mat e cl osed chains, st abi l i sed by fri ct i on.
The comf or t of a seat, t herefore, depends on t he
ext ent t o whi ch it per mi t s mus cul ar r el axat i on
while st abi l i si ng t he open- chai n of body links.
Br ant on' s anal ysi s r emai ns novel (in t he
aut hor ' s opi ni on) and is of val ue in post ur e anal y-
sis since t he physi cal wor kl oad of ma ny t asks can
be r educed if t he oper at or st abi l i ses a body par t
12 R.S. Bridget / S o me fundamental aspects of posture
by formi ng t empor ar y closed chains wi t h his
workspace (e.g. upper body weight can be used t o
stabilise a forearm, hand and component resting
on t he worksurface while the ot her hand uses a
tool t o work on t he component ). Many post ural
strategies for rel axat i on are cul t ural l y det ermi ned.
A famous exampl e is t he ' st ork-l i ke' stance of the
nilotic herdsmen of East Afri ca (st andi ng on one
leg with the sole of the opposi t e foot resting on
the knee of the weight-bearing leg). A bri ef con-
si derat i on of some cross-cultural aspects of pos-
t ure is t herefore in order.
Cross-cultural variation in postural habits
Man is capabl e of appr oxi mat el y 1000 comfor-
table static post ures (Hewes, 1957). In most cul-
tures, however, onl y a subset of these are pract i ced
due t o tradition, cl i mat e and terrain, cl ot hi ng de-
sign and the met hods of work. The most widely
researched post ure is undoubt edl y st andi ng fol-
lowed by t he west ern ' 90-degree' sitting post ure,
as well as its reclining vari ant s and the furni t ure
used to suppor t it (see Mandal , 1981, for a cri t i que
of 90-degree sitting). The bipedal, upri ght stance
is universal across cultures and can be regarded as
f undament al in an anat omi cal sense. The same
cannot be said for sitting in chairs. This has its
origin in Anci ent Gr eece and Egypt as a high
status post ure. The rest of t he popul at i on appears
to have sat on the fl oor or on low, sloping stools
(Mandal , 1984). A common posture, worldwide, is
t he deep squat (regarded as vulgar by the Anci ent
Greeks, which may explain why it is not pract i sed
in count ri es i nfl uenced by hellenistic culture).
However, millions of peopl e in many part s of
Asia, Africa, Lat i n Ameri ca and Oceani a cust om-
arily work and rest in this posi t i on - t he C. O. G.
of t he body is low and over the feet, the hips and
knees are al most fully flexed, t he hamst ri ngs and
quadri ceps muscles are t owards t he mi ddl e of
t hei r range, t he iliopsoas are short ened and the
gluteals are lengthened. The t r unk is flexed and
inclined ant eri orl y t owards the thighs. This pos-
t ure is similar to t he habi t ual resting posi t i on of
the chi mpanzee and is easy for young chi l dren of
any cul t ure t o adopt . Adul t s not accust omed t o it
find it difficult however - one reason bei ng t hat
t hey lack sufficient dorsiflexion at the ankl e to get
the C. O. G. of the body over t he feet and t her ef or e
t end to fall backwards.
Cross-legged sitting is f ound in Nor t h Africa,
the Mi ddl e East, India, Sout h East Asia and In-
donesi a and also Korea, Japan and Polynesia. It is
depi ct ed in anci ent Mayan sculptures and in t he
pot t er y of many tribes of Nor t h and Sout h
America. Convent i on, cl ot hi ng and cold, damp
floors restrict its use in west ern cul t ure (al t hough
it is a common post ure in school chi l dren), but
most peopl e are able to sit in this way. The hips
are flexed, abduct ed and l at eral l y r ot at ed wi t h t he
knees resting on t he f oot of t he opposi t e leg. The
two-joint muscles of the hi p are rel axed as is
iliopsoas and body weight is bor n by t he ischia
and not the coccyx. (In Indi a t here are many
vari at i ons of this basic position. Sen, 1984, sum-
marises some of the benefits. )
Long sitting (on t he fl oor wi t h a ni net y-degree
t runk-t hi gh angle and knees ext ended) is a com-
mon worki ng and resting post ur e among women
in Africa, Melanesia, Sout h East Asia and I ndi an
Nor t h West America. Bridger et al. (1990) demon-
st rat ed t hat this post ure is ext r emel y stressful for
westerners unaccust omed to it (part i cul arl y males)
because of hamst ri ng tightness, whi ch causes ex-
t reme post eri or pelvic tilting and l umbar flexion.
Sitting on the heels wi t h t he knees resting on
t he fl oor is a formal sitting post ur e f or bot h men
and women in Japan. It is t he posi t i on for pr ayi ng
in the Islamic world. In Africa, Mexi co and part s
of Sout h East Asia it is mai nl y used by women.
Most adults in west ern cul t ure can at t ai n this
post ure even if unpract i sed, except t hose wi t h
overdevel oped or tight quadri ceps muscles or knee
injuries. Of t he ni ne sitting and st andi ng post ures
investigated by Bridger et al. (1990) this was the
post ure of least const r ai nt of t he hi p j oi nt wi t h the
l umbar spine and pelvis in t he mi ddl e of t hei r
ranges. Sitting on t he fl oor is general l y unaccept a-
ble in west ern society and it is i nt erest i ng to
observe t hat kneeling has recent l y been i mpl e-
ment ed in a mor e accept abl e f or m (t he ' Bal ans'
chair) - as a piece of f ur ni t ur e whi ch hft s t he user
of f the fl oor t o desk height (for eval uat i ons of this
concept see Dr ur y and Fr ancher , 1985; Fr ey and
Tecklin, 1986; Bridger, 1988).
Post ures for lifting and st oopi ng also var y across
cultures. In Africa, women t radi t i onal l y st oop to
pi ck up obj ect s and t o car r y out activities such as
R.S. Bridger / Some fundamental aspects of posture 13
gardeni ng. The knees r emai n ext ended and t he
t runk-t hi gh angle of over 90 degrees is achi eved by
flexing the hips. Li t t l e l umbar flexion seems to
t ake place. Most west erners are unabl e t o st oop in
this way pr obabl y due to tight hamstrings. Fl oyd
and Silver (1955) and Ki pper s and Parker (1984)
observed t hat in t r unk fl exi on f r om standing, t he
erect ores spinae muscles exhi bi t electrical silence
at 60% of t he t ot al hi p and 90% of the t ot al
vert ebral flexion requi red t o st oop, body weight
bei ng suppor t ed by t he post er i or ligaments of t he
vert ebral col umn. The st oop met hod of lifting is
general l y regarded as hazar dous since it i mposes a
great er moment at t he l umbosacral j oi nt t han the
pr ef er r ed squat lift ( Gr i eve and Pheasant , 1982). It
is di ffi cul t t o under st and why t he st oop met hod is
habi t ual l y used in Afri ca i f it is hazardous, unless
t he ability t o avoi d l umbar fl exi on when the hips
are flexed confers some prot ect i on. (It may be t hat
with t he head bel ow t he hi p j oi nt s and straight
spine, the component of force al ong t he di rect i on
of t he spi ne exerts t ract i on on t he spine and
reduces disc pressure. )
Several cross-cul t ural investigations of the inci-
dence of spinal pat hol ogy have been carri ed out.
Fahr ni and Tr ueman (1965) compar ed the inci-
dence of disc space narrowi ng and hyper t r ophi c
change in Nor t h Amer i cans and Eur opeans and a
j ungl e-dwel l i ng t ri be in India. In all groups, l umbar
degener at i on i ncreased with age, but the t rends
were st eeper for t he west ern groups t han t he In-
di an tribe. The i nci dence of disc space nar r owi ng
was much less amongst t he Indi ans and was har dl y
age-rel at ed at all. Fahr ni and Tr ueman not ed t hat
t he spines of horses, cows, dogs, camels and
giraffes degenerat e at levels where the mechani cal
st rai n is great est (t he cervi co-t horaci c regi on of
camel s and giraffes, t he l ower t horaci c level in t he
basset hound and dachshund dog and the apex of
t he l umbar spi ne in humans). They observed t hat
the I ndi an t ri be habi t ual l y squat t ed, avoi di ng pos-
t ures in which a l umbar lordosis was ret ai ned, and
suggested t hat t he habi t ual l ordot i c post ures of
west ern cul t ure cont r i but ed to disc degenerat i on.
Fi ndi ngs such as these are di ffi cul t t o i nt er pr et
because of t he number of fact ors involved. Spinal
pat hol ogy is not always f ound t o be l ower in
non-west ern cul t ures ( Tower and Prat t , 1990, ob-
served a hi gher i nci dence of spondyl osi s and
spondyl ol i st hesi s in rural Eski mos t han in ur ban
Eski mos or bl ack or whi t e popul at i ons). Clearly,
t he cross-cultural st udy of post ur e and post ural
habi t s is pot ent i al l y of i mmense val ue in under -
st andi ng t he high i nci dence of occupat i onal
muscul oskel et al di sorders in t he i ndust ri al i sed
world.
S o m e p r a c t i c a l i m p l i c a t i o n s
The l oweri ng of t he C. O. G. of t he body was an
i mpor t ant stage in the evol ut i onar y devel opment
of bipedalism. In ont ogeny, it is accompani ed by
i ncreased post ural stability and devel opment of
adul t gait. Al t hough a great deal of research has
been done on lifting, less at t ent i on has been pai d
to carrying. Gr i eve and Pheasant (1982) argue t hat
hol di ng a weight close to t he body is advi sabl e to
minimise t he moment about t he l umbo-sacral j oi nt .
Ther e woul d appear t o be t heoret i cal suppor t for
t he not i on t hat the C. O. G. of t he body plus l oad
shoul d not be raised when an obj ect is carri ed or
hel d because an increase in t he hei ght of t he
C. O. G. increases the l oad on t he muscles (such as
t he gluteals), whi ch stabilise t he t r unk and may
increase post ural sway and hast en t he onset of
fatigue. It may be hypot hesi sed t hat t he C. O. G. of
t he l oad shoul d be no hi gher t han t he hips, par-
ticularly when walking or st andi ng on uneven
ground. A yoke carri ed over t he shoul ders wi t h the
l oad suspended symmet ri cal l y can satisfy this re-
qui r ement but it increases t he fl exor moment on
t he t r unk as refl ect ed by i ncreased erect ores spi nae
activity (Kl ausen, 1965). Moder n rucksacks trans-
mi t t he l oad t hr ough the iliac crests via a hi p
strap. Thi s met hod of l oad carri age increases t he
ext ensor moment on t he t runk, whi ch is opposed
by t he iliopsoas muscles (Kl ausen, 1965). It is
not ewor t hy t hat in Kl ausen' s original paper, pho-
t ographs of t he above t wo carryi ng met hods show
al most i dent i cal bodi l y post ures, el ect r omyo-
graphi cal analysis bei ng r equi r ed t o disclose the
bi omechani cal di fference bet ween them. In Afri ca,
women t radi t i onal l y car r y young chi l dren l ow on
t hei r backs.
The l umbar lordosis is f undament al t o erect
standing, but it depends on t he angl e of t he sacr um
and t he tilt of t he pelvis. This, in t urn, depends on
t he equi l i bri um of moment s and count er moment s
14 R.S. Bridger / Some fundamental aspects of posture
exerted on the pelvis by the musculo-ligamentous
system which controls movement of the hip and
therefore on the angles of hip and knee flexion
(see Brunswic, 1984). A l umbar angle of 20-30
degrees is normal in European subjects when
st andi ng but is beyond the range of vol unt ary
movement of the hip and pelvis of males in 90-de-
gree sitting and is at the extreme of the vol unt ary
range of bot h males and females in sitting pos-
tures which do not constrain the pelvis (e.g. kneel-
ing and sitting in forward sloping chairs, Bridger
et al., 1990).
Postures other t han st andi ng are not funda-
ment al in an anat omi cal sense. Societal factors
such as t radi t i on and technology can shape the
development of postural reflexes and j oi nt mobili-
ties t hrough their effects on habi t ual activities.
The ' 90-degree' sitting posture, long used as a
model for the ergonomic design of workspaces,
has received much criticism recently (Mandal ,
1981, for example). In view of the above discus-
sion, this posture would appear to be atavistic
(figure 1) and has been replaced by anat omi cal l y
more sophisticated alternatives (Corlett and Ek-
lund, 1984 and Gregg and Corlett, 1988, for exam-
ple). A young child has the ability to at t ai n all of
the resting positions practiced t hroughout the
world, but usually practises onl y a subset. In the
present aut hor' s opinion, the at t ai nment of a wider
post ural repertoire in yout h may be of benefit in
later life. The ergonomics literature cont ai ns infor-
mat i on on ant hr opomet r y and workspace design
much of which is based on a limited set of pos-
tural models - those which are found amongst
people who grew up in a western industrial milieu.
Whet her other postures would be more ap-
propriate, particularly for i mpl ement at i on in de-
veloping countries, is wort hy of further investiga-
tion which should lead to a better underst andi ng
of the true limitations and possibilities of human
anat omy.
Acknowledgements
The aut hor would like to t hank the Medical
Research Council of South Africa, Professor M.
Henneberg, Mrs. D. Orkin, Professor G. G. Jaros
and Dr. H. Gol dberg for their support.
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