(Postural examination and re-education)


Posturology deals with the relationships between the posture of a living being and the living being itself. Posture studies, thanks to technological innovations, have made great strides in recent years. Research shows that more and more posture is implicated in many musculoskeletal, organic and psychological problems and pathologies. A correct posture is therefore one of the essential prerequisites for the proper functioning of the whole organism.


The fields of application of posturology are therefore vast and it represents an interdisciplinary science.



What are the indications?


Prevention, treatment and improvement of postural anomalies / alterations with potential physical, organic and psychological development in children, young people and adults, able to determine or aggravate:

  • Scoliosis, paramorphism, lumbar hyperlordosis, flat back, curved back (dorsal hypercifosis), flat/hollow feet, valgus/varus knee, coxa vara/valga, hallux valgus, heterometry (difference in length) of the lower limbs, disc herniation and joint dysfunction (arthrosis, meniscopathies, tendinitis, fascitis, capsulitis, etc.).
  • Algie of various types such as low back pain, specific migraines and headaches, neck pain, joint pains (metatarsalgia, gonalgia, coxalgia, scapulo-humeral periarthritis etc.), tendency to repeat trauma in the same district etc.
  • Nervous system disorders such as balance disorders (dizziness, vertigo, nausea, specific tinnitus), paresthesia (tingling, sensations of heat/cold or swelling etc.), neuritis (inflammation of the nerves) and coordination disorders (oculomotor, swallowing and phonation muscles included), adjuvant action in neurodegenerative diseases such as Parkinson’s disease, multiple sclerosis, ALS.
  • Stomatognathic diseases (malocclusion and temporomandibular joint – TMJ – disorders, dysfunction of lingual and chewing muscles, nocturnal bruxism and dental serration).
  • Circulatory problems (especially in the lower limbs) and cardiac dysfunctions (due to the presence of a flat back).
  • Respiratory disorders caused by structural and functional changes in the thorax (respiratory failure, bronchitis, tracheitis, asthma and chronic or recurrent colds).
  • Urinary tract disorders such as recurrent urethritis and incontinence problems.
  • Disorders of the digestive system (e.g. constipation, lazy bowel, irritable bowel).
  • Disorders of the endocrine system (thyroid dysfunction due to mechanical actions of the surrounding environment).
  • Autoimmune disorders, an adjuvant action in problems such as rheumatoid arthritis, fibromyalgia, systemic lupus erythematosus (SLE).
  • Disorders of the psychic sphere, adjuvant action in cases of panic attacks, anxiety, depression, anorexia, bulimia, attention, concentration and memory deficits.
  • Prosthetics and surgeries, in cases of prosthesis posturology helps extend the life of the prosthesis and optimize their functionality, in post-surgery situations especially concerning intervertebral discs, meniscus, ligaments, tendons, osteotomies (e.g. hallux valgus and knee valgus) optimizes results and prevents recurrences.
  • Reduced sports performance (improvement of sports performance for professionals and amateurs).


Postural examination is the fulcrum of posturology both in research and in therapeutic, preventive and performance applications.



What is the Postural Exam performed at the Ortho-Bio-Med center?


Given its importance, postural analysis must be as complete, precise and reliable as possible.

The posturological evaluation therefore consists of three basic phases:

2) Case history and objective examination

1) Instrumental examination

3) Postural rehabilitation program


1) During the anamnesis and the objective examination of the posture analysis, all the previous useful information of the subject is collected, clinical reports are examined and an accurate muscular-fascial-skeletal-neurological (state of the myofascial system, joint mobility, proprioception and motor skills) examination is performed through specific tests.


2) The instrumental postural evaluation allows obtaining numerous significant, accurate and precise parameters that are comparable over time; the latter is a decisive aspect to evaluate the progress of the following postural rehabilitation path. Another important prerogative of these devices is that they do not present any side effects.


3) The many extremely accurate results provided by the instrumental examinations, integrated with the specific objective tests and the anamnestic information, allow a complete, in-depth and reliable postural check-up that is crucial for the planning, execution and monitoring of the personalized and interdisciplinary postural rehabilitation program.



What is the instrumentation for the postural examination used in the Ortho-Bio-Med center?


German technology is used which is today the most advanced on the market:

Formetric 4D + ® (Diers), baropodometry and stabilometry (Zebris®).


The Diers Formetric 4D ® allows a radiation-free and markerless surface topography scanning method  that performs a detailed static and dynamic three-dimensional (non-structural) morphological detection of the entire spine and pelvis, providing precise quantitative data (error less than 0.2 mm) and various graphical representations. Unlike the postural analysis systems that use the detection markers thus identifying only a few points on the skin surface and with more possible positioning errors of the markers themselves, the 4D formetric ® performs a volumetric acquisition through 10,000 measurement points (based physically on the principle of the triangulation applied to the video-raster-stereography). This makes it possible to detect, in addition to the postural alterations and the functional blocks, also small morphological variations occurred e.g. after for a therapeutic and/or ergonomic treatment (applications of foot orthotics, occlusal splints etc.).

The image acquisition process is quick and is performed in total comfort and safety: X-rays are not used but a special halogen light projection that has no side effect. A light projector throws a line grid on the back of the patient, which is recorded by a camera unit. A computer software analyzes the curvature lines and uses the method of photogrammetry to generate a three-dimensional image of the surface, as if it were a virtual plaster cast.

The scan is performed only on the back surface of the body; the subject should not reposition himself for analysis on the other sides. The system detects 12 images in 6 seconds (about the time of a complete breath) calculating and representing the average value; this allows overcoming the poor repeatability of the results of the exams that perform only 1 shot such as radiographic or optical (BAK). All this greatly increases the reliability of the data obtained.


The realization of the Formetric Diers® system is carried out in collaboration with the most important European university within a project promoted by the European Union which has allowed a drastic reduction in the use of radiographs in conditions such as scoliosis, flat back, lumbar hyperlordosis, dorsal hypercifosis, pelvis malposition and heterometry (difference in length) of the lower limbs.


The Zebris® baropodometry captures the static and dynamic pressure distribution during standing and walking in a simple, safe and fast way. This platform is a device with baroreceptors (capacitive sensor technology) connected to a computer system that performs precise, repeatable and non-invasive acquisitions of ground reactions in stand position and walking, providing various numerical and graphical parameters including the distribution of the body load in the various points of the feet and the projections on the ground of the human centers of gravity. The correct interpretation of them allows to evaluate the general behavior of the postural tonic system of the subject compared to the normality indices.

The same baropodometric device can also perform the stabilometry measuring, in a precise and non-invasive way, the body oscillations in a static upright position (posturography). Appropriate standardized tests show quantitatively and differentially, through data and graphic representations, problems of balance of the subject due to vestibular, oculomotor and proprioceptive interferences.


At the end a complete and totally safe postural check-up is obtained, that allows the identification of postural alterations and abnormalities as well as the planning/monitoring of specific integrated preventive, therapeutic and performance actions within an interdisciplinary postural rehabilitation program.



What is the postural re-education program?


Based on the several data deriving from case history, objective and instrumental examinations, indications are given on the improvement / resolution / prevention of the specific postural problems and needs of the subject. The complexity of our organism “imposes” as a rule a multidisciplinary approach developed therefore by a team composed of various specialists. Depending on the case, the postural rehabilitation program may require the application of manual therapies, instrumental therapies, postural gymnastics, foot orthotics and/or ergonomic shoes, splints, orthomolecular and functional medicine etc.


Periodic checks, through postural examinations, are essential to monitor the progress of the rehabilitation program so as to appropriately provide any changes and optimizations that may be necessary. It should be considered the fact that even if the benefits can be found already after a few days, it takes at least 12 months to stabilize a new and more functional postural adaptation. 3-5 is the average number of checks to be performed during the first year of postural rehabilitation; subsequently it will normally be sufficient to fulfill one control per year.



Does the postural exam have any contraindication?


No if non-invasive instruments and technologies with no side effects (such as those present in the Ortho-Bio-Med center) are used for the postural evaluation and the postural rehabilitation protocol is correctly performed and followed.





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