The radiographic assessments of spino-pelvic compensation using IoT-based real-time ischial pressure adjustment: clinical research study

Abstract Background: In malalignment syndrome, the spino-pelvic alignment correction with foot orthotics can be applied only to a standing position in the coronal plane. Considering the fact that the average time Koreans spend sitting in a chair is 7.5 hours per day, studies on spino-pelvic correction in sitting position is needed. The purpose of this study is to investigate the pressure changes and radiographic assessment of spino-pelvic alignment using a chair equipped with a height-adjustable seat-plate.Methods: Experiments were conducted on 30 research participants. The inclusion criteria for the participants were as follows: The volunteers of nonstructural malignment syndrome with shoulder height differences (SHDs) or iliac flea height differences (ICHDs) greater than 5 mm in radiographic images excluding participants with structural deformity. All participants were subjected to measure buttocks interface pressure while seated using a smart chair in three consecutive steps: (1) on initial seated, (2) on balancing seated, and then (3) on 1hr balancing seated. Radiographically, the five spino-pelvic parameters such as SHD, ICHD, LLD, POA, and coronal imbalance were analyzed to investigate the effect of pelvic imbalance compensation on spino-pelvic alignment.Results: Pelvic imbalance was compensated with seat plate height adjustment in average of 3.6 ± 1.8 mm, so that the pressure discrepancy improvement between buttocks from 36.4 ± 32.3 on initial seated to 15.7 ± 20.3 on balancing, 12.7 ± 10.9 on 1hr balancing seated (Ω, p=0.008). The radiographic changes before and after pelvic imbalance compensation demonstrated a statistically significant improvements of spino-pelvic parameters on sitting and standing: at the average value of -0.9 to -0.8 and 9.5 to 2.5, SHD and ICHD, respectively (mm, p=0.005, 0.037) and -3.0 to -1.0, 1.8 to 0.8, and 0.8 to 0.1, SHD, ICHD, and LLD, respectively (mm, p=0.005, 0.016, 0.033).Conclusions: Spino-pelvic malalignment can be improved by individually customized pelvic compensation using balanced seat plate height adjustments under the real-time pressure sensing and monitoring on the buttocks while seated.