Background: People spend a long time in the sitting position may have poor alignment that leads to neck and back pain. A wheelchair represents mobility for people with cerebral palsy, who are unable to walk. They spend long periods of time sitting in their wheelchair. Opining the seat to back support angle of the wheelchair enable realignment body segments and improves posture. Objective: 1) assessed the validity/reliability of Coach’s Eye (CE) smart device application, 2) examined the effect of seat to back support angle adjustments on head, neck, and shoulder posture in the sitting position, and 3) compared changes in cervical rotation at each seat to back support angle. Methods: Thirty-four subjects between the ages of 18 and 45 years abled subjects and subjects with cerebral palsy. All subjects sat in a research wheelchair with seat to back support angle at (90°, 100°, and 110°). Photographs were taken and analyzed by ImageJ and cache’s Eye (CE) software. Three body posture angles were used: sagittal head angle (SHA), cervical angle (CVA), and shoulder angle (SA). Results: There were highly significant differences on abled subjects for CVA and SA (p < 0.001) among the three seat to back support angles. CE had high validity for all angles (r = 0.99, 0.98, 0.99 respectively, p < 0.001). Inter-rater reliability for SHA, CVA, and SA among the three seat to back support angles was high (ICC ranged from 0.95 to 0.99). There were highly significant differences on abled subjects for CVA and SA (p < 0.001). There were highly significant differences on subjects with cerebral palsy for SHA and CVA (p < 0.001) among the three seat to back support angles. Conclusion: Head (CVA) and shoulder (SA) alignment was closest to neutral posture for abled subjects with seat to back support angles set at 110° and 90°, respectively. Head (SHA) and (CVA) alignment was closest to neutral posture for subjects with CP with seat to back support angles set at 110°.
","abstract_html":"<p>Background: People spend a long time in the sitting position may have poor alignment that leads to neck and back pain. A wheelchair represents mobility for people with cerebral palsy, who are unable to walk. They spend long periods of time sitting in their wheelchair. Opining the seat to back support angle of the wheelchair enable realignment body segments and improves posture. Objective: 1) assessed the validity/reliability of Coach’s Eye (CE) smart device application, 2) examined the effect of seat to back support angle adjustments on head, neck, and shoulder posture in the sitting position, and 3) compared changes in cervical rotation at each seat to back support angle. Methods: Thirty-four subjects between the ages of 18 and 45 years abled subjects and subjects with cerebral palsy. All subjects sat in a research wheelchair with seat to back support angle at (90°, 100°, and 110°). Photographs were taken and analyzed by ImageJ and cache’s Eye (CE) software. Three body posture angles were used: sagittal head angle (SHA), cervical angle (CVA), and shoulder angle (SA). Results: There were highly significant differences on abled subjects for CVA and SA (p < 0.001) among the three seat to back support angles. CE had high validity for all angles (r = 0.99, 0.98, 0.99 respectively, p < 0.001). Inter-rater reliability for SHA, CVA, and SA among the three seat to back support angles was high (ICC ranged from 0.95 to 0.99). There were highly significant differences on abled subjects for CVA and SA (p < 0.001). There were highly significant differences on subjects with cerebral palsy for SHA and CVA (p < 0.001) among the three seat to back support angles. Conclusion: Head (CVA) and shoulder (SA) alignment was closest to neutral posture for abled subjects with seat to back support angles set at 110° and 90°, respectively. Head (SHA) and (CVA) alignment was closest to neutral posture for subjects with CP with seat to back support angles set at 110°.</p>","abstract_has_math":false,"creators":["Alkhateeb, Afnan M."],"institution":null,"degree_name":"Doctor of Science (DSc)","degree_level":"Dissertation","degree_discipline":"Physical Therapy","degree_department":null,"school":null,"contributors":["Forrester, Bonnie J.","Daher, Noha S.","Martin, Bradford D."],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2016,"date_issued":"2016-06-01T07:00:00Z","date_published":"2016-06-01T07:00:00Z","updated_at":"2026-07-24T02:52:38Z","subjects":["Medicine and Health Sciences","Physical Therapy","Rehabilitation and Therapy","Wheelchairs; Posture; Cerebral Palsy -- Therapy","Back Support Angle; Body Posture Angles; Sagittal Head Angle; Cervical Angle; Shoulder Angle"],"languages":["English"],"rights":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://scholarsrepository.llu.edu/etd/364","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Forrester, Bonnie J.","Daher, Noha S.","Martin, Bradford D."]},{"key":"dc:creator","label":"Author","values":["Alkhateeb, Afnan M."]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"thesis:degree_discipline","label":"Discipline","values":["Physical Therapy"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Dissertation"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Science (DSc)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Medicine and Health Sciences","Physical Therapy","Rehabilitation and Therapy","Wheelchairs; Posture; Cerebral Palsy -- Therapy","Back Support Angle; Body Posture Angles; Sagittal Head Angle; Cervical Angle; Shoulder Angle"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["English"]},{"key":"dc:rights","label":"Dc Rights","values":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://scholarsrepository.llu.edu/etd/364"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: People spend a long time in the sitting position may have poor alignment that leads to neck and back pain. A wheelchair represents mobility for people with cerebral palsy, who are unable to walk. They spend long periods of time sitting in their wheelchair. Opining the seat to back support angle of the wheelchair enable realignment body segments and improves posture. Objective: 1) assessed the validity/reliability of Coach’s Eye (CE) smart device application, 2) examined the effect of seat to back support angle adjustments on head, neck, and shoulder posture in the sitting position, and 3) compared changes in cervical rotation at each seat to back support angle. Methods: Thirty-four subjects between the ages of 18 and 45 years abled subjects and subjects with cerebral palsy. All subjects sat in a research wheelchair with seat to back support angle at (90°, 100°, and 110°). Photographs were taken and analyzed by ImageJ and cache’s Eye (CE) software. Three body posture angles were used: sagittal head angle (SHA), cervical angle (CVA), and shoulder angle (SA). Results: There were highly significant differences on abled subjects for CVA and SA (p < 0.001) among the three seat to back support angles. CE had high validity for all angles (r = 0.99, 0.98, 0.99 respectively, p < 0.001). Inter-rater reliability for SHA, CVA, and SA among the three seat to back support angles was high (ICC ranged from 0.95 to 0.99). There were highly significant differences on abled subjects for CVA and SA (p < 0.001). There were highly significant differences on subjects with cerebral palsy for SHA and CVA (p < 0.001) among the three seat to back support angles. Conclusion: Head (CVA) and shoulder (SA) alignment was closest to neutral posture for abled subjects with seat to back support angles set at 110° and 90°, respectively. Head (SHA) and (CVA) alignment was closest to neutral posture for subjects with CP with seat to back support angles set at 110°.
"]},{"key":"dc:title","label":"Title","values":["Effects of Adjustments to Wheelchair Seat to Back Support Angle on Head, Neck, and Shoulder Postures"]}]}],"canonical_facts":{"dc:contributor":["Forrester, Bonnie J.","Daher, Noha S.","Martin, Bradford D."],"dc:creator":["Alkhateeb, Afnan M."],"dc:description.abstract":["Background: People spend a long time in the sitting position may have poor alignment that leads to neck and back pain. A wheelchair represents mobility for people with cerebral palsy, who are unable to walk. They spend long periods of time sitting in their wheelchair. Opining the seat to back support angle of the wheelchair enable realignment body segments and improves posture. Objective: 1) assessed the validity/reliability of Coach’s Eye (CE) smart device application, 2) examined the effect of seat to back support angle adjustments on head, neck, and shoulder posture in the sitting position, and 3) compared changes in cervical rotation at each seat to back support angle. Methods: Thirty-four subjects between the ages of 18 and 45 years abled subjects and subjects with cerebral palsy. All subjects sat in a research wheelchair with seat to back support angle at (90°, 100°, and 110°). Photographs were taken and analyzed by ImageJ and cache’s Eye (CE) software. Three body posture angles were used: sagittal head angle (SHA), cervical angle (CVA), and shoulder angle (SA). Results: There were highly significant differences on abled subjects for CVA and SA (p < 0.001) among the three seat to back support angles. CE had high validity for all angles (r = 0.99, 0.98, 0.99 respectively, p < 0.001). Inter-rater reliability for SHA, CVA, and SA among the three seat to back support angles was high (ICC ranged from 0.95 to 0.99). There were highly significant differences on abled subjects for CVA and SA (p < 0.001). There were highly significant differences on subjects with cerebral palsy for SHA and CVA (p < 0.001) among the three seat to back support angles. Conclusion: Head (CVA) and shoulder (SA) alignment was closest to neutral posture for abled subjects with seat to back support angles set at 110° and 90°, respectively. Head (SHA) and (CVA) alignment was closest to neutral posture for subjects with CP with seat to back support angles set at 110°.
"],"dc:identifier":["https://scholarsrepository.llu.edu/etd/364"],"dc:language":["English"],"dc:rights":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."],"dc:subject":["Medicine and Health Sciences","Physical Therapy","Rehabilitation and Therapy","Wheelchairs; Posture; Cerebral Palsy -- Therapy","Back Support Angle; Body Posture Angles; Sagittal Head Angle; Cervical Angle; Shoulder Angle"],"dc:title":["Effects of Adjustments to Wheelchair Seat to Back Support Angle on Head, Neck, and Shoulder Postures"],"thesis:degree_discipline":["Physical Therapy"],"thesis:degree_level":["Dissertation"],"thesis:degree_name":["Doctor of Science (DSc)"]},"updated_at":"2026-07-24T02:52:38Z"}