Optimizing Backrest Geometry to Minimize Interfacial Pressure Concentrations in the Mid-to-Lumbar Region During Leg Press Resistance Training.

The leg press is a resistance training (RT) exercise common to both weight- and powerlifting, where spine-related injuries remain prevalent. Here, the elevated loading has the potential to result in increased pressure on vertebral bodies and introduce the risk of spinal injury. This study, therefore, investigates back interfacial pressure under leg press loading conditions and offers design recommendations to minimize spatial pressure concentrations. A pressure mat was used to assess the back-backrest interfacial pressure distribution of 15 subjects executing RT leg-presses at 50% body weight, over 16 different back-support geometries. Real-time forces, knee angles, and pressures were captured. The resulting data show that more prominent (≥2.1 cm) back-supports, positioned 19 cm above the seat pan typically produced greater peak pressures (41.8 ± 7.2 kPa). Conversely, less prominent supports (∼0.7 cm) generally achieved lower peak pressures (with greater distribution). Our data suggest that the most prudent choice for fixed-shape backrests to best distribute interfacial pressure on leg-press devices is to incorporate shallow convex supports (∼0.7 cm) and locate them away from P = 19 cm. The result is surprising as this prominence location is a common ergonomic feature. If an adjustable backrest is considered, peak pressures may be reduced by up to 26 ± 8% (9.7 ± 3.1 kPa) compared to flat geometries.