POSTURE AND WELL-BEING - POSTURAL EXAMINATION AND RE-EDUCATION - SPORT-AND-HEALTH

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Posture and well-being

an ergonomic approach

Edited by Dr. Giovanni Chetta

Postural examination and re-education

Starting from the first chapter onwards, we have highlighted how the alterations of posture, of our tonic postural system, are common in almost all of us due, first of all, to the flat ground. The first reaction of our organism is the lumbar hyperlordosis from which, over time and according to the characteristics of each subject, anomalies and dysfunctions, both at a musculoskeletal and organic level, depart from throughout the body. this gives rise to the importance of professional exams and postural re-education for the general well-being of the organism.
It is evident that the real solution to postural disorders cannot be represented by the continuous intake of drugs or surgery. They must represent, respectively, temporary synergistic phases and rare and indispensable exceptions. As stated by Prof. C. Villani (director of the Department of Sciences of the "Locomotor System of the" La Sapienza "University of Rome), on the occasion of the" V International Congress of Posture and Movement "(Rome 27-28 / 01/07 ): "The importance of the treatment of the Biomechanical-Postural Syndrome is very evident since these dysfunctional events, through a series of different clinical pictures, afflict a" high percentage of the adult population, whose foundations often lie in adolescence. These disorders they could be avoided through small postural measures, which concern both the standing and sitting position and which should be respected from "adolescence".

A correct therapeutic-rehabilitative approach must aim first of all at postural realignment, or rather at normalizing the general center of gravity of the body through inputs capable of creating new and more functional postural strategies (engrams) in our cybernetic equilibrium system.

Technology today allows us to perform precise instrumental postural examinations capable of carrying out and, subsequently, processing, storing and recalling precise, instantaneous, repeatable and non-invasive measurements. This first of all allows us to overcome the limits of "subjective interference" of the "human eye. Even if true objectivity will probably remain an unattainable goal, the instrumental techniques allow us to get very close to it, providing us with a method that takes us from personal secondary realities. in which each of us lives (as the American psychiatrist MH Erickson, father of modern hypnosis, taught us) towards a reality very close to the primary one, ie totally shared.
Second, the determination of appropriate indicators anthropometric and behavioral, will facilitate the definition of the diagnosis and the postural re-education project. In particular, the digitized biometrics (D.B.I.S. system, Digital Biometry Images Scanning) consists of various surveys carried out with specific procedures and protocols:

"morphological investigation", by means of detecting, with camera or infrared, anatomical landmarks marked with adhesive markers, to perform anthropometric measurements and calculations on the various anatomical planes;
"baropodometric survey", performed on a high sensitivity baropodometric platform, for the detection of reactions on the ground in standing (static examination) and in walking (dynamic examination);
"stabilometric survey", carried out on a baropodometric platform as a stabilometer, for the detection of postural oscillations in a static position (eyes open, closed, head retroflexed, with glasses, in monopodalic support, etc.)
"computerized podoscopy survey" for the detection of the podalic morphology (image and measurements);

"kinematic investigation of the movement", contemporary to the baropodometric investigations, to detect angular and tilt variations during the various phases of the step;
"digitized processing", via software, capable of analyzing the main indicators selected in the individual surveys and relating them to physiological values.

All this allows an "accurate initial analysis of the static and dynamic posture, then the drafting of a precise postural re-education program, the progress of which will be verified through periodic checks. The examination detects possible alterations of the vestibular, visual and stomatognathic functions ( which will be verified through specialist visits and possibly treated through specific treatments).

From the point of view ergonomic digitized biometrics allows to design and / or test, for each specific case, the possible ideal human-environment interface (insole and / or ergonomic footwear), which acts as a foundation, and the "ideal" roof "(bite). In particular, the podalic ergonomic system can act, depending on the case, as an ideal "guide", ie as a brace, for the physiological functioning of the foot accompanied by postural normalization, or as a "simulator" of the natural terrain, so as to stimulate one's own balance system towards postural self-correction. In case of simultaneous use of the "ergonomic occlusal system", bite, it will be necessary to verify the synergy with the ergonomic breech braces.

Of course, the postural re-education will be supported by a personalized physiotherapy program which may include, depending on the case: massage therapy, stretching and muscle strengthening, joint mobilization, instrumental physiotherapy, motor re-education, respiratory re-education, etc. The physiotherapy intervention will greatly facilitate the work carried out by the eventual ergonomic plantar and stomatognathic brace, therefore postural normalization.
In addition to inconvenient attitudes physical, the alimentary ones will also have to be corrected, for the reasons described in the previous chapter, and, last but not least, food.

Nutrition provides our body with the energy and "building blocks" necessary for life and beyond. In fact, today we know that there is a close connection between the brain and the belly, guaranteed both by the autonomic nervous system connection - metasympathetic or enteric nervous system (vagus, pelvic and splanchnic nerve), and by the simultaneous presence, in the brain and in the gastrointestinal tract, of the same group of hormones (somatostatin, neurotensin, opioids, etc.). The enteric brain is, in turn, in close connection with the endocrine system, very widespread within the gastrointestinal mucosa (APUD cells), and with the immune system, which here presents a "large lymphatic network. Our abdomen therefore presents itself as an important integrated neuroendocrineimmune complex that performs functions with a large margin of autonomy but which, at the same time, is heavily influenced both from the outside (food, visual inputs, etc.) and from the inside (emotions, beliefs, habits, etc.).
Eating therefore not only serves to replenish energy and structural reserves but also serves to influence the general regulation systems of the organism (nervous, immune, endocrine systems), including DNA.
The expression F = G x A (F = phenotype, G = genome, A = environment) thus becomes more and more a three-variable relationship and this, if on the one hand it can make the diagnostic processing appear more complex, on the other enormously expands the possible curative and preventive strategies.

It is clear that the complexity of our organism requires a multidisciplinary approach to posturology. A postural reorganization in fact concerns the body in its entirety and the postural re-education protocol therefore normally requires a "team of specialists in various sectors but experts in posturology (physiatrist, orthopedist, physiotherapist, orthopedic technician, gnathologist, vestibologist, ophthalmologist, psychologist, dietician etc.) who collaborate synergistically.
Only in this way can the postural re-education program have a significant impact on improving the general well-being of the person, in a functional and lasting way. In fact, the restoration of correct posture will not take place in a forced and mostly transitory way, as happened in the past (through for example gymnastics and corrective braces), but in a natural, synergistic, gradual and stable way; in other words ergonomic. The postural system, feeling on a more functional ground and free from upper blocks, will immediately begin postural adjustment which will be facilitated by appropriate physical exercises, correct vestibular and ocular function as well as improved life habits (including mental and dietary habits).