23107 - NEW TRENDS IN POSTURE EVALUATION AND TREATMENT

Subject type: Optional

Coordinator: Esther Wall Gimeno

Trimester: Third term

Credits: 4

Balanced body posture consists of aligning the body with physiological, biomechanical efficiency, which reduces the stress and overloads exerted on the lifting system, by the effects of gravity. The integrity of this body alignment plays a relevant role in the physical and emotional well-being of people. A significant mismatch in posture is considered a risk factor in musculoskeletal dysfunctions.

As outlined in the guidelines set by the American Medical Association, postural assessment should be part of the usual procedure in the analysis of our patients. It is common in the clinical setting to perform visual assessments of posture (visual inspection) knowing that both intra- and inter-observer reliability is usually low. Thanks to the development of new technologies in the field of health, physical activity and sport, we have economical and easy-to-apply systems for assessing body position in an objective and reliable way, both in 2D and 3D.

The physiotherapist must have knowledge of assessing posture clinically and also using available technology in order to detect clinically significant imbalances and propose a treatment plan based on clinical reasoning. In this sense, postural reeducation based on the rebalancing of the myofascial and articular chains is indicated by the treatments of the pathologies associated with the postural imbalance, whether of the spine or the limbs.

The main objective of this theoretical and practical subject will be to integrate a systematic assessment of orthostatic posture, both clinical and using 3D technology, which allows to offer a diagnosis based on clinical reasoning. Learn the therapeutic exercises, in the field of a global myofascial physiotherapy, to improve the most common musculoskeletal disorders in the spine.

The subject does not require any prerequisite for passing subjects by the student.

“This subject has methodological and digital resources to make possible its continuity in non-contact mode in the case of being necessary for reasons related to the Covid-19. This will facilitate the achievement of the knowledge and skills specified in this teaching plan. However, in relation to those practical contents of the subject in which the acquisition of procedural and attitudinal skills by students is essential, it can be considered, if the health situation requires it, the partial and temporary suspension of this with the consequent postponement in its continuity until the health situation allows it.

LO13. Incorporate new technologies for obtaining records and processing information and images into physiotherapy: formulate projects that integrate the various operations.

LO21. It analyzes the patient's expectations regarding their evolution, demand and needs.

LO22. Establishes the intervention protocol based on the joint negotiation between therapist and patient.

LO23. Perform the physiotherapeutic diagnosis to determine the dysfunctions and disabilities that will require a specific physiotherapy intervention.

LO29. Analyze the effects produced by the interventions. Evaluate benefits and risks and establish an intervention criterion based on the priorities and effects pursued.

LO58. Apply the scientific method to the various fields of physiotherapy: methodological design, records, databases and statistical analysis.

LO59. Understand substantial problems in physiotherapy and propose hypotheses to design the methodological strategy for their scientific demonstration, which would lead to the best resolution of the identified problems.

MD1.Exhibitory method or master class: transmitting knowledge and activating the student's cognitive processes through unidirectional learning
MD2.Case study: acquire learning through the analysis of real or simulated cases
MD3.Resolution of exercises and problems: exercise, rehearse and put into practice the previous knowledge
MD4.Problem-based learning (PBL): developing active knowledge through problem solving
MD5.Project-oriented learning: carrying out a project to solve a problem, applying skills and knowledge acquired
MD6.Cooperative learning: foster active and meaningful knowledge in a cooperative way

1. Assessment of posture and myofascial chains
   1. The morphostatic posture. Fundamental concepts
   2. Body types. Clinical analysis
   3. Clinical evaluation of joint and myofascial chains
   4. Current technologies related to postural assessment
   5. Body types. Analysis with 2D and 3D technology
   6. Evaluation of joint and muscle chains with 2D and 3D technology
2. Postural reeducation
   1. Fundamentals of postural reeducation; 2.2. Limits and indications
   2. Most common spinal pathologies in sagittal statics.
   3. Strategies for joint and muscle compensations
   4. Postural reeducation. Basic posture and breathing.
   5. Postural reeducation. Treatment of imbalances in the cephalocervical region: hyperlordosis and cervical rectification
   6. Postural reeducation. Treatment of imbalances in the thoracic region. Hyperkyphosis
   7. Postural reeducation. Treatment of imbalances of the lumbo-pelvic region. Hyperlordosis.
   8. Postural reeducation. Global treatment of sagittal imbalances of the spine
   9. Analysis and treatment of a clinical case
3. Continuous assessment activities
   1. Clinical analysis of posture
   2. Clinical analysis of myofascial chains
   3. Posture analysis with technology
   4. Analysis of myofascial chains with technology

In this subject the following evaluation process will be followed:

SE1. During the course of the course will be assessed the performance of four individual activities related to the analysis of posture. The weighting of these activities will be 40% on the final grade (see schedule of the subject).

SE2. On the last day of class there will be an individual practical oral presentation. This evaluation will correspond to 30% of the final mark of the subject.

SE3: The theoretical evaluation will also take place on the last day of class of the seminar. This will consist of a written test with 10 test-type questions. This exam will have a weighting of 30%.

To pass the course it is necessary to obtain a grade of 5/10 in the final average of the assessment.

It will be considered that the total or partial copy in any of the learning activities will mean a "Not Presented" in the subject, without option to present in the proof of recovery and without prejudice of the opening of a record for this reason.

According to current regulations, only those students who have obtained a failing grade during the assessment of the regular period may take the resit exam.

The evaluation of recovery, will consist of a final written test on conceptual aspects of theory and practice developed in class.

In accordance with current regulations, you can only opt for recovery, if the subject has been suspended. If the grade is Not Presented, you will not be eligible for recovery.

Health

Attendance Considering the current health situation, attendance at the theoretical-practical classes will be highly recommended and absenteeism for health reasons will not prevent the possibility of passing the subject.

Rules of conduct

Class attendance without respecting the basic rules of hygiene and uniformity in dress may be sanctioned. Given the situation caused by the pandemic, the indications related to security and protection in the practical spaces, included in a document of the School and which will be available to students in the virtual classroom, must be considered and respected. All teachers will be aware of this information and will ensure compliance.

During the class practices and especially during the assessment tests, students will not be able to wear objects that may interfere with the execution of the techniques, such as rings, watches, bracelets, long earrings, etc. Also, hand hygiene will be paramount, with short, clean, unpainted cut nails. Given the practical nature of the classes and to facilitate and perform in a correct way the practical procedures and postural observation, it will be necessary to wear appropriate clothing such as shorts and top, as well as a towel.

Specific criteria of the grade Not Presented

This situation will be considered when the student has not taken the theoretical test and / or the practical oral presentation.

The total or partial copy in any of the learning activities will mean a "Not Presented" in the subject, without option to present in the proof of recovery and without prejudice of the opening of a file for this reason

Mézières F. Originality of the Mézières Method. Paris: Ed. Maloine; 1984.

Patté J. The Mézières method, a global approach to the body. Paris: Ed. Chiron; 2009.

 Patté J. Le grand livre de la méthode Mézières. Paris: Ed. Eyrolles; 2018.

Sider F. The Mézières Method, protocol, treatment examination. Tome 1 et 2. Paris: Éd.Format; 2013.

Revilla JR, Ramírez-Moreno J. Global treatment of sagittal spinal imbalances by the Mézières Method. Rev. Cient. Iberoam. Fisioglobal 2009; 2: 15-23.

Reyes M, Clapés A, Ramírez J, Revilla J. Automatic digital biometry analysis based on depth maps. Comput Ind. 2013; 64 (9): 1316–25.

Reyes M, Clapés A, Escalera S, Ramírez J, Revilla JR. Posture Analysis and Range of Movement Estimation Using Depth Maps. In: Advances in Depth Image Analysis and Applications. Springer. Berlin; 2013. p. 97–105.

Ségui, Y., Ramírez-Moreno J. Global physiotherapy approach to thoracolumbar junction syndrome. A case report. Journal of Bodywork and Movement Therapies 2021; 25: 6-15.

Ramírez-Moreno J., Revilla-Gutiérrez JR. New academic definition of the Mézières Method. Kinesésér Scient 2018; 598: 35-45.   

Ramírez-Moreno J, Revilla JR. Sagittal balance of the spine. Analysis and treatment by the Mézières Method. Hands Free, May 2009; 3: 5-13.

Ramírez-Moreno J, Revilla JR. The pathogenesis of idiopathic scoliosis and the Mézières method. Kinesésér Scient 2013,0546: 21-32.

Struyf Denys G. The Handbook of the Mezerist (Volumes 1 and 2). Paris: Ed Frison Roche ;. 1995.

  Roussouly P, Gollogly S, Berthonnaud E, Dimnet J. Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine (Phila Pa 1976). 2005 Feb 1; 30 (3): 346-353.

Legaye J, Duval-Beaupere G. Gravitational forces and sagittal shape of the spine. Clinical estimation of their relationships. Int Orthop. 2008 Dec; 32 (6): 809-816.

Mac-Thiong JM, Roussouly P, Berthonnaud E, Guigui P. Sagittal parameters of global spinal balance: normative values ​​from a prospective cohort of seven hundred nine Caucasian asymptomatic adults. Spine (Phila Pa 1976). 2010 Oct 15; 35 (22): E1193-8.

Ferreira EA, Duarte M, Maldonado EP, Bersanetti AA, Marques AP. Quantitative assessment of postural alignment in young adults based on photographs of anterior, posterior, and lateral views. J Manipulative Physiol Ther. 2011 Jul-Aug; 34 (6): 371-380

ADIBAS software   http://physicaltech.com

Mézières AMIK Method (International Physiotherapy Association) http://www.methode-mezieres.fr

IFGM (Mézières Global Physiotherapy Institute) http://www.ifgm.es  et http://www.metodo-mezieres.com

  Dutta, T. Evaluation of the Kinect sensor for 3-D kinematic measurement in the workplace. Appl.Ergon. 2012 Jul; 43 (4): 645-9.

Ramírez-Moreno J, Revilla JR. Analysis, morphostatic evaluation and muscle extensibility by digital photometry. Updates in Physiotherapy 2008; 3: 11-18.

Struyf Denys G. Muscle and joint chains. Brussels: Ictgds; 1979.

Campignon Ph. Breathing actions. Brussels: Ed. Philippe Campignion; 1996.

Busquet L. The Muscle Chains. Ed. Busquet, 1992.

Keleman S. Emotional Anatomy. Ed. Guilbot; 1996.

Alexander, G. The body found by eutonia. Ed. Tchou; 1981.

Rolf Ida P. Rolfing: The Integration of Human structures. Harper Collins Editions; 1987

Calais-Germain B. Anatomy for movement. Ed. Desiris; 1989.

Dunk NM, Lalonde J, Callaghan JP. Implications for the use of postural analysis as a clinical diagnostic tool: reliability of quantifying upright standing spinal postures from photographic images. J Manipulative Physiol Ther. 2005 Jul-Aug; 28 (6): 386-392.