The Postural Alignment Determinants: What is Known And Further Research

Abstract

The aim of this mini-review was to identify the main determinants for postural misalignments. This paper gathered information about growth, physical activity, physical fitness and postural asymmetries interdependency and implications in sports and quality of life. This paper stated that there is a lack of research about postural misalignments and/or asymmetries and its associations with sedentary behaviours and physical fitness. Joints motion, endurance, agility, speed, balance, rhythm, and the maturation may be studied to assess their relations with postural misalignments or asymmetries.

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Journal of Ergonomics
Research Article
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J Ergonomics, Vol.10 Iss.5 No:266
OPEN ACCESS Freely available online
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ISSN: 2165-7556
The Postural Alignment Determinants: What is Known And Further Research
Pedro Forte1,2,3*, João P Gouveia3,4, Eduarda Coelho3,4
1Department of Sports, Douro Higher Institute of Educational Sciences, Portugal; 2Department of Sports Sciences and Physical Education,
Polytechnic Institute of Braganca, Portugal; 3Research Center in Sports Sciences, Health Sciences and Human Development, Portugal;
4Department of Sports Sciences, Health and Exercise, University of Trás-os-Montes e Alto Douro, Portugal
ABSTRACT
The aim of this mini-review was to identify the main determinants for postural misalignments. This paper
gathered information about growth, physical activity, physical fitness and postural asymmetries interdependency
and implications in sports and quality of life. This paper stated that there is a lack of research about postural
misalignments and/or asymmetries and its associations with sedentary behaviours and physical fitness. Joints
motion, endurance, agility, speed, balance, rhythm, and the maturation may be studied to assess their relations with
postural misalignments or asymmetries.
Keywords: Posture; Growth; Physical activity; Physical fitness
INTRODUCTION
The postural behaviour and postural profile/alignment has been
considered important for health, wellbeing and sports [1,2].
It is speculated that, a perfect body alignment may results in
better functionality, body symmetry and satisfaction and sports
performance. This paper emerged from author’s reflections about
postural analysis in sports and active living. Upon that, the authors
aimed to review the determinants that may affect postural profile
and the relation with physical fitness, sports performance and
quality of life. The authors hypothesised that growth, physical
activity and fitness may affect the postural alignment.
HUMAN GROWTH AND POSTURE
The human growth is not symmetrical or at constant speed and
so it is expected that postural asymmetries may exist during
growth [3]. The growth is dependent of biological characteristics,
physical health (including the physical fitness), the environmental
conditions, socio-demographic profile and daily habits [3,4].
Moreover, the technological development and the computers and
gadgets has increased its dependency. That is due the new and
emerging tasks or web-jobs, these new jobs may minimize sports
and leisure activities. Most of the time is spend seated in front of
a computer, or looking down to smartphones or tablets [5]. Those
habits may cause some postural issues, resulting in misaligned
postural profiles [5,6].
Posture can be defined as the body alignment with minimal
physiological or mechanical stress [7,8]. That sad, the aligned
postural profile may results in less mechanical and physiological
stress. This can also be called a good posture. In sports sciences,
athletes, coaches and sports analysts have been raising the concerns
about postural profile aiming to reduce the injuries probabilities [7-
9]. Upon that, a symmetrical posture and growth will be dependent
of the individual growth, physical health, environmental conditions,
socio-demographics and daily habits. That said, Physical activity
may play an important role in subjects postural profile.
Physical activity and posture
As higher, the physical activity levels, the individuals may spent less
time in seating positions and minimize sedentary behaviours [10].
Therefore, the physical activity levels may predict some postural
behaviours [11,12]. Moreover, as higher the physical activity levels,
better the physical fitness [13]. Upon that, physical fitness may allow
preserving or adopting aligned postures. It is worthy to not that
sometimes, subjects adopt aligned posture, however, that aligned
postures are not the most daily used postural profile. Due the
physical and mental fatigue, the postural profile is characterized by
the shoulders depressed, looking down and adopting hunchback
position [5,6]. That may also be related with social status,
depression and mental health [14]. To date, only few studies have
analysed the effect of physical activity in postural alignment [12].
The vertebral column asymmetries or misalignments is the most
Correspondence to: Pedro Forte, Department of Sports, Douro Higher Institute of Educational Sciences, Portugal, Tel: +351 (255) 318 550; E-mail:
pedromiguelforte@gmail.coml
Received: July 23, 2020, Accepted: Augusr 10, 2020, Published: August 17, 2020
Citation: Forte P, Gouveia JP, Coelho E (2020) The Postural Alignment Determinants: What is Known And Further Research. J Ergonomics 10:266. doi:
10.35248/2165-7556.20.10.266
Copyright: © 2020 Forte P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Forte P, et al.
OPEN ACCESS Freely available online
J Ergonomics, Vol.10 Iss.5 No:266
assessed body part for sports related postural issues [2]. Most of the
vertebral column misalignments results in back pain [9]. That may
raise the need to stop or change the sports practice or adjust the
performance goals. Moreover, assessing physical activity and daily
tasks may predict several postural issues.
Physical fitness and posture
The physical fitness plays an important role in postural profile.
As much symmetric and higher the strength levels the muscles
may have, a more aligned posture the subject may adopt [8,15].
The subjects may have an involuntary aligned posture based on
their habits. So, as much muscular strength, higher the capacity
to maintain an aligned posture without physical or mental fatigue
[5,8]. Some studies have assessed the effect of strength variables
with body posture. However, the strength levels seem to present a
lower association with postural misalignments [8]. That might be
due the evaluations methods. Most of the studies with youths assess
physical fitness and postural profile with physical fitness batteries,
where physical fitness strength are mainly assessed by number or
repetitions tests [16]. Forte et al. assessed the maximal voluntary
strength levels by dynamometry [8]. However, maximal strength may
not predict the ability to stand aligned for a long period. So far, no
study was founded relating postural profile with electromyography.
Electromyography allow to assess the number of muscular fibres in
activity and the influence of fatigue. Upon that, further studies may
assess strength and muscular activity by electromyography trying
to gather new insights about the associations between postural
misalignments, muscular activity and fatigue.
Assessing postural changes and asymmetries associations
To better understand the postural profile, there are many assessing
methods. It is possible to assess by X-ray (Gold standard), the
visual scan and photogrammetry and techniques such as Adam’s
test, vertical line, palpation, symmetograph and scoliometer.
Moreover, different protocols assess different postures [2]. Some
of the protocols indicate that the subjects may be in the typical
comfortable positions [2, 8]; whereas, others specify arms and feet’s
positions.
The postural misalignments are not single factors dependents.
Sometimes, postural alignment or misalignments events are due
involuntary actions. That unpredictability raises the needs to
control every variable that may affect the postural profile. That said,
the postural profile is multifactorial. However, it is well known that
the postural misalignments are interrelated [8]. The misalignments
interdependency is well explained by the grown up and top down
postural misalignments explanation theories [17]. These theories
explain that an upper body misalignment is predicted by lower
body misalignments (grown up); whereas, the top down theory
explains that a lower body misalignments are predicted by upper
body misalignments.
Posture, sports and ageing
In sports context, it is suggested that as higher the asymmetries of
the vertical projection of the center of mass in the support base,
higher the injuries risk [8,9]. Thus, as much postural misalignments
higher the muscle tension in different body structures, higher the
muscles overuse, fatigue and higher the injuries risk [2,18,19]. The
ankle sprains, muscular strains or ruptures seem to be maximized
with postural misalignments [9].
Gait and posture have been assessed in the last decades and the
orthostatic postural alignment is related with balance. These
analyses have been conducted assessing different age’s body
posture [20]. The evaluations have been made by photogrammetry
and it allows to assess the center of mass vertical alignment [21].
The center of mass vertical alignment allows understanding the
elderlies balance. As far as the center of the mass goes out of
the support base, lesser the balance ability [22]. For instance, in
elderlies, balance is mainly affected by the diminishing capacity
of the proprioceptive system reducing the perception of the body
segments positions and motions due ageing [23]. This reduction of
functional capacity also contributes to increase risk and fear of falls
and so, quality of life. Upon that, the postural misalignments that
results from biological human growth may affect elderlies postural
profile. Moreover, as said before, the postural misalignments may
affect the proprioceptive system, reducing balance and increasing
the risk of falls.
CONCLUSION
Altogether, postural misalignments play an important role
in human growth, sports practice and ageing. The postural
misalignments assess during youth may prevent further problems
such as low back pain and reducing the quality of life due ageing. In
sportsmen, postural asymmetries seem to be associated with sports
performance and injuries. Thus, exercise protocols may be designed
to ensure an athlete longer career. Finally, in elderlies, postural
assessment allows to better understand the subjects gait and balance
assessing the center of mass vertical alignment. Moreover, postural
assessment may help to analyse elderlies balance, minimize the
risk of falls and increase the quality of life. The different protocols
and analysis to assess posture still lacks of research. So far, the
authors consider that it is not clear the most accurate method
to associate physical fitness variables with postural profile. Some
studies assessed the strength by physical fitness batteries and others
by dynamometry. Also, some authors assessed postural profile by
visual scan and quantified the number of misalignments; others
assessed the postural profile by photogrammetry, quantifying the
postural asymmetries magnitude.
That said, further studies are needed to better understand the
association between strength levels and posture. Most of postural
concerns have been focused on strength levels. However, variables
such as range of motion, endurance, agility, speed, balance, rhythm,
and the maturation status and growth peak, maximal consumption
of oxygen (VO2 max) might be associated with postural imbalances.
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