A goal leading to improving motion analysis and therapy

Human posture is commonly understood as the relationship between human body parts in the upright position. Particular body parts, such as the head and neck, the trunk, and the upper and lower limbs, are involved in the final body posture. A good body posture is considered (1) ergonomically advantageous while standing, (2) mechanically effective while moving, and (3) supportive for the normal function of internal organs. Body posture is described and considered in three reference planes: sagittal, coronal, and transversal [1,2]. Kendall et al. proposed a definition of good human posture: “good posture is that state of muscular and skeletal balance which protects the supporting structures of the body against the injury or progressive deformity, irrespective of the attitude (erect, lying, squatting or stooping) in which these structures are working or resting. Under such conditions, the muscles will function most efficiently, and the optimum positions are afforded for the thoracic and abdominal organs” [3]. Such a comprehensive definition of body posture will not be used in this paper since the authors focused on the description of human posture in the upright standing position.

The physiological sagittal spinal curvature represents a typical feature of good body posture in the sagittal plane. The cervical and the lumbar spine are curved anteriorly (lordosis), while the thoracic segment is curved posteriorly (kyphosis). The pelvis is inclined anteriorly, and the lower limbs’ joints remain in a neutral position. However, there are many deviations from the optimal body alignment.

The most common types of non-structural misalignments of body posture in the sagittal plane are as follows: (1) lordotic, (2) kyphotic, (3) flat-back, and (4) sway-back postures [4]. Each one may influence both the skeletal and the muscular system leading to the functional disturbance and an increased strain of the supporting structures. Usually, the disturbances localized within the muscles are analyzed in respect to their shortening or lengthening. However, according to suggestions presented in the literature, when the muscles responsible for maintaining good body posture (the so-called stabilizers) are not being stimulated to resist against gravity for an extended period of time, e.g., during prolonged sitting, their stabilizing function is disturbed by the hypoactivity reaction resulting in muscular weakness. The deficit of the locomotor system stability triggers a compensatory mechanism—the stabilizing function is overtaken by the so-called mobilizing muscles. However, as a side effect, such compensation leads to the increased activity of mobilizers (hyperactivity) and decreased flexibility, which may finally lead to the pathological chain of reaction within the musculoskeletal system

Scoliosis is indeed a complex three-dimensional deformation of the spine, involving curvature in the coronal plane (side-to-side), axial rotation (twisting) in the axial plane, and deformity in the sagittal plane (front-to-back). Each of these components contributes to the overall shape and structure of the spine in individuals with scoliosis. When we consider scoliosis in the sagittal plane, this plane is very important for understanding the overall balance of the spine and its effect on posture and function [5,6].

The causes of postural defects can be divided into physical, environmental, sociocultural, and psychological causes.

• Among the physical causes; age,biological sex, inactive daily lifestyle (especially due to smartphone use and online games), hyper or hypo mobility.
• Environmental reasons may include not providing adequate place and conditions for physical activity to the adolescent.
• Sociocultural causes of spinal disorders may include ignoring adolescents’ prolonged use of screen time with the ever-renewing internet age, failure to fully support the adolescent’s developmental process both physically and mentally by the family or teachers, or lack of knowledge on how to support it.
• Adolescence represents a vulnerable phase of life for psychological health. Adolescents might have disturbed self-esteem, cosmetic problems, negative body image, feeling lonely and depressed cause low psychological resilience and social connectedness. All these agents make adolescents socially lonely and physically inactive, leading them to sedentary lives. The practice of physical activity (PA) appears to have a positive influence on adolescents, increasing self-esteem and producing a more positive body image.

Regardless of the cause of postural defects, it has a negative impact on the adolescent’s physical functioning and often has a negative impact on their mental state as well.

From the moment a specialist becomes aware of a spinal disorder, the adolescent needs the support of the multidisciplinary rehabilitation team, family, teacher and friends.

The main tasks of the medical team include explaining to the adolescent what a spinal disorder is, how treatment and rehabilitation will proceed, and motivating the adolescent to actively participate in therapy. Maintaining a positive relationship with the adolescent is also essential.

In this course, you will acquire the knowledge and skills necessary for the comprehensive assessment of individuals presenting with postural defects in general will gain insights into the muscular components contributing to spinal alignment, treatment options for postural problems and scoliosis and mechanisms of muscular engagement in proper postural maintenance.

Additionally available in the e-manual: Detailed explanations of postural defects in general