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Background The Critical Shoulder Angle was introduced as a combined radiographic surrogate parameter reflecting the influence of the morphological characteristics of the scapula on the development of degenerative shoulder disease such as rotator cuff tears and osteoarthritis. Although, glenoid inclination and lateral extension of the acromion were studied in biomechanical models separately, no investigation included all three individual parameters that determine the Critical Shoulder Angle: glenoid inclination, acromial coverage and acromial height in one cadaveric study protocol. Methods Three proximal humerus cadavers were attached to a robotic shoulder simulator which allowed for independent change of either lateral acromial coverage, glenoid inclination or acromial height. Combined dynamic scapula-thoracic and glenohumeral abduction up to 60° with different Critical Shoulder Angle configurations was performed and muscle forces as well as joint reaction forces were recorded. Findings All three components had an effect on either muscle forces and or joint reaction forces. While glenoid inclination showed the highest impact on joint stability with increasing upward-tilting causing cranial subluxation, changing of the lateral acromial coverage or acromial height had less influence on stability but showed significant alteration of joint reaction forces. Interpretation All three components of the Critical Shoulder Angle, glenoid inclination, lateral acromial extension and acromial height showed independent biomechanical effects when changed isolated. However, glenoid inclination seems to have the largest impact regarding joint stability.

The mobility of the upper extremity is essential for everyday activities and for independent living. Shoulder disorders affect the range of motion, therefore a patient assistive system (PAS) for the shoulder joint can be used to compensate the restrictions. The developed PAS supports up to 120° of flexion and abduction. The portable dynamic orthotic consists of two levers and is attached to a hip belt. The upper arm of the patient is connected to the device using a brace. The prototype is driven by one motor and controlled by surface electromyography (EMG). The functionality of the system was successfully verified by tests with healthy subjects. For further development, a study with shoulder patients will be performed and health professionals will evaluate the PAS.

Motion analysis systems deliver quantitative information, e.g. on the progress of rehabilitation programs aimed at improving range of motion. Markerless systems are of interest for clinical application because they are low-cost and easy to use. The first generation of the Kinect™ sensor showed promising results in validity assessment compared to an established marker-based system. However, no literature is available on the validity of the new 'Kinect™ for Xbox one' (KinectOne) in tracking upper body motion. Consequently, this study was conducted to analyze the accuracy and reliability of the KinectOne in tracking upper body motion. Twenty subjects performed shoulder abduction in frontal and scapula plane, flexion, external rotation and horizontal flexion in two conditions (sitting and standing). Arm and trunk motion were analyzed using the KinectOne and compared to a marker-based system. Comparisons were made using Bland Altman statistics and Coefficient of Multiple Correlation. On average, differences between systems of 3.9±4.0° and 0.1±3.8° were found for arm and trunk motion, respectively. Correlation was higher for the arm than for the trunk motion. Based on the observed bias, the accuracy of the KinectOne was found to be adequate to measure arm motion in a clinical setting. Although trunk motion showed a very low absolute bias between the two systems, the KinectOne was not able to track small changes over time. Before the KinectOne can find clinical application, further research is required analyzing whether validity can be improved using a customized tracking algorithm or other sensor placement, and to analyze test-retest reliability.

Ergonomics science recommends office chairs that promote active sitting to reduce sitting related complaints. Since current office chairs do not fulfill this recommendation, a new chair was developed by inverting an existing dynamic chair principle. This study compares active sitting on the inverted chair during a simulated computer-based office task to two existing dynamic office chairs (n = 8). Upper body stability was analysed using Friedman ANOVA (p = .01). In addition, participants completed a questionnaire to rate their comfort and activity after half a working day. The inverted chair allowed the participants to perform a substantial range of lateral spine flexion (11.5°) with the most stable upper body posture (≤11 mm, ≤2°, p ≤ .01). The results of this study suggest that the inverted chair supports active sitting with backrest support during computer-based office work. However, according to comfort and activity ratings, results should be verified in a future field study with 24 participants. Practitioner Summary: This experimental laboratory study analyses the feasibility of active sitting with a backrest support during common office work on a new type of dynamic office chair. The results demonstrate that active sitting with a backrest support is feasible on the new but limited on existing chairs.

Objective The aim of this study was to determine and verify the optimal location of the motion axis (MA) for the seat of a dynamic office chair. Background A dynamic seat that supports pelvic motion may improve physical well-being and decrease the risk of sitting-associated disorders. However, office work requires an undisturbed view on the work task, which means a stable position of the upper trunk and head. Current dynamic office chairs do not fulfill this need. Consequently, a dynamic seat was adapted to the physiological kinematics of the human spine. Method Three-dimensional motion tracking in free sitting helped determine the physiological MA of the spine in the frontal plane. Three dynamic seats with physiological, lower, and higher MA were compared in stable upper body posture (thorax inclination) and seat support of pelvic motion (dynamic fitting accuracy). Spinal kinematics during sitting and walking were compared. Results The physiological MA was at the level of the 11th thoracic vertebra, causing minimal thorax inclination and high dynamic fitting accuracy. Spinal motion in active sitting and walking was similar. Conclusion The physiological MA of the seat allows considerable lateral flexion of the spine similar to walking with a stable upper body posture and a high seat support of pelvic motion. Application The physiological MA enables lateral flexion of the spine, similar to walking, without affecting stable upper body posture, thus allowing active sitting while focusing on work.