Clinical posturology

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What is clinical posturology?

Clinical posturology is the study of the mechanisms that regulate posture and muscle tone in the human body. Postural imbalance can disrupt motor patterns and cause various symptoms.

It is a discipline that studies the posture of the human body and its impact on stability, pain, and overall health.

It focuses on analyzing the interactions between the sensory, motor, and cognitive systems involved in maintaining balance.

Using a comprehensive approach, including a series of precise tests during the postural assessment, clinical posturology aims to identify postural imbalances, prioritize them, and correct them in order to improve quality of life and prevent musculoskeletal disorders.

It is a discipline that offers solutions tailored to each patient in order to restore harmony between the body and its environment.

Several sensory inputs stabilize posture:

The feet (foot sensors)
The eyes (visual sensors)
The jaw (mandibular sensors)
The inner ear (vestibular sensors)
The skin, muscles, and joints (somesthetic proprioceptive sensors)

The coordination of all the information from these inputs to the brain allows for the regulation of overall balance. However, if one or more of these inputs malfunction, postural tone is disrupted.

Posturology is therefore a study of the body as a whole, from anatomical variations to musculature and personal statics, to the compensations put in place to move around on a daily basis. And, where applicable, the pain or discomfort that this may cause.

It allows us to assess the patient’s physical condition in order to best meet their expectations: reduction or even elimination of chronic or acute pain, alleviation of daily discomfort (muscle fatigue, instability, migraines, tinnitus, etc.) or optimization of athletic performance through improved postural balance.

The podiatrist will perform a comprehensive assessment of the patient through a series of clinical tests, then draw connections between the various elements of the patient’s medical history (patient interview) and the results of the clinical tests, and thus propose an “action plan to meet the patient’s expectations, through exercises, strengthening, orthopedic insoles if necessary, multidisciplinary advice, or referral to practitioners specializing in a specific field that would be relevant for the patient to consult.

Clinical posturology is intended for patients with various functional and chronic symptoms, i.e., pain, discomfort, and instability that persist on a recurring basis.

It is just as relevant for consultations for foot pain (commonly known as plantalgia) as it is for back pain (cervicalgia, dorsalgia, lumbalgia, coxalgia, and sacralgia).

It can also be used in children and adolescents to improve and stabilize dysfunctional posture in order to prevent the worsening of scoliosis or growing pains such as Sever’s syndrome and Osgood Schlatter syndrome.

Finally, after physical changes related to life changes (after an operation or illness with or without rehabilitation that has changed lifestyle, after pregnancy, after stopping or resuming a sport), posturology can help patients regain “control” of their bodies in the most optimal and least painful way possible.

The postural assessment allows a protocol to be established and helps with the initial phase of treatment, providing a set of specialized recommendations and therapeutic education for the patient on the actions necessary for recovery and the sustainability of treatment.

As various sensors may be malfunctioning, the podiatrist is not the only person involved in rehabilitation but may require the expertise of other practitioners (ophthalmologist, orthoptist, dentist, occlusodontist, physical therapist, osteopath, etc.).

Successful treatment requires teamwork involving the patient and several practitioners.

How is a postural assessment carried out?

A comprehensive postural and podiatric assessment is an in-depth evaluation of the postural system, starting with its foundation: the feet. Here is how it works:

1. Medical history: gathering information about the patient’s medical history, symptoms, lifestyle, and specific complaints.

2. Observation: The practitioner carefully observes the patient’s overall posture, noting any imbalances, asymmetries, or postural compensations.

3. Static analysis: The patient is placed in different standing, sitting, or lying positions in order to analyze alignment, spinal curvature, lower limb position, etc. A series of specific tests are then performed to assess the patient’s abilities, stability, and range of motion.

4. Dynamic analysis: The patient is asked to perform specific movements, such as walking and running, in order to observe any abnormalities in postural dynamics.

5. Podiatric assessment: Specific examination of the patient’s feet, checking the alignment of the joints, skin trophicity, the presence of palpable pain or deformities, and joint range of motion.

6. Additional measurements: Depending on the needs, additional measurements may be taken, such as analysis of plantar pressure distribution (Stabilometry), foot impressions (3D Scanner), or additional examinations with the RunTime baporodometric mat.

7. Summary and treatment plan: Based on the information gathered, the practitioner compiles the information, makes connections, and proposes a personalized treatment plan.

This may include rehabilitation exercises, foot orthotics (orthopedic insoles), posture advice, shoe adjustments, or other therapies tailored to the patient’s needs.

Optoelectronic analysis Spine 3D™

Spine 3D™ offers various clinical parameters, such as posture analysis, scoliosis analysis, and analysis of all possible spinal deformities (lateral, frontal, and sagittal), vertebral rotations, and pelvic position. This is made possible by LiDar (Light Detection and Ranging) technology.

Spine 3D is a non-invasive, radiation-free scanner that uses a markerless scanning method to capture a 3D image of the patient’s body.

This innovative optoelectronic system for three-dimensional body detection enables accurate assessment and visualization of spinal pathologies and postural alterations.

It performs sections, cutting planes, frontal, sagittal, and transverse axes, onto which a radiological examination can be imported and superimposed on the 3D acquisition.

It is also an interesting device for monitoring all phases of patient treatment without the need for constant X-ray imaging, especially in cases where the attending physician does not recommend it.

The Spine3D system is an acquisition device with RGB and infrared cameras (ToF cameras) offering enhanced visualizations, advanced intelligence, streamlined workflow, and patient-centered care support. All this makes Spine 3D an additional resource for podiatrists in the rehabilitation and treatment of spinal problems.

If you are interested in this topic, here are some publications about this tool: https://www.youtube.com/watch?v=V2-sN90rQsc