Hindawi Publishing Corporation BioMed Research International Volume 2013, Article ID 153165, 4 pages http://dx.doi.org/10.1155/2013/153165 Clinical Study Effect of Therapy Ball Seating on Learning and Sitting Discomforts among Saudi Female Students Einas Al-Eisa, 1 Syamala Buragadda, 2 and Ganeswara Rao Melam 2 1 Female Centre for Science and Medical Studies, King Saud University, Riyadh, Saudi Arabia 2 Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia Correspondence should be addressed to Syamala Buragadda; syamala3110@yahoo.co.in Received 15 April 2013; Accepted 26 May 2013 Academic Editor: Panagiotis Korovessis Copyright © 2013 Einas Al-Eisa et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. he aim of the study was to evaluate the efect of therapy ball seating as an alternative for typical chair seating in a classroom. We evaluated the efect of ball seating on the student’s sitting discomfort and academic performance using Cornell Musculoskeletal Discomfort Questionnaire and problem-based learning scales, respectively. A sample of convenience was taken. Data was collected and analyzed using t-test. Subjects experienced a major discomfort at neck and a minor discomfort at knee joint. Results showed that there was a signiicant improvement ( ≤ 0.05) in sitting discomfort and student’s performance when seated on therapy balls compared to typical classroom chairs. his study provides evidence for the efectiveness of therapy balls as a classroom seating for students who exhibit sitting discomfort and problem-based learning. 1. Introduction Factors like student’s gender, personality diferences, and class room environment afects the student’s learning and par- ticipation in the classroom. Most of the college and university professors follow a lecture method of teaching which involves delivering a lecture where the instructor speaks and the student sits for a prolonged period of time in the classroom. Human brain maintains an optimal state of arousal and attention only with the help of sensory stimuli, and arousal can be either low associated with lethargy and drowsiness or high leading to hyperactivity and distractibility. Sensory modulation is required for optimal attention and learning [1, 2]. It was assumed that the student’s capacity to pay attention depends on the ability to access learning opportunities at school/university [3]. Instructors/teachers usually adopt various behavioral programs to improve the student’s in- seat behavior [4] Behavioral diferences were observed when students were seated in front row compared to middle- and back-row seating. hey found that students were more attentive when seated in the front rows [5, 6]. A study conducted on autistic children of age three to four, resulted in the improvement of classroom behavior when they were asked to sit on therapy balls instead of a typical classroom chair [7]. Another study on fourth grade classroom seating showed that the students had better in-seat behavior and legible word productivity when they sat on therapy balls. Survey completed by the teacher and the students indicated the preference for therapy ball seating [8]. Researchers found that the design of the class should be lexible, creative, and problem solving. Cornell deined furniture as both a tool and an environment. To create a suitable learning environment for students it is mandatory to think of the furniture and seating arrangements of a class- room [8]. Some researchers also reviewed diferent seating arrangements in terms of rows and columns in relation to student’s interaction and speciic interaction patterns [9–12]. Experimentally controlled research on the use of therapy balls as an alternative seating arrangement for children with attention and hyperactivity concerns was done. However, limited literature is available on the use of therapy balls as alternative class room seating in normal students. Since 1991, the ball had replaced chairs in schools for thousands of children of Europe due to increased information on the postural beneits of “active sitting” and back injury