INFOBULLETIN
Edition no.3
June 2014
ADVANCE
Posturology represents the knowledge of the human posture, its related regulation systems and, based
on feedback, the integral implementation of it.
This bulletin has been edited for the third time, on a monthly base, in the Dutch language. The aim is to
make posturology better known as an interdisciplinary vision, in order to ensure consistency between
the different therapies.
Recently I have been asked to edit also a version in the English language. I am not sure if this meets your
interest abroad, so please let me know.
So let’s start with our factual basis: the feet. Two issues are essential:
 Sensomotoric information about and from the skin of the barefoot sole and
 the function of the intrinsic foot muscles
The information about publications will exist of an 'abstract' which refers to the available literature. The
choice of these publications remains by definition subjective.
A limiting factor may further be that this text is not always cost-free available for every reader. These
abstracts will be marked A*. The reader can then decide whether he / she want to download the full
text.
Sensomotoric information of the barefoot sole represents the neurological information about the
sensors located in the hairless skin. These include, among others Krause, Ruffini, Meissner, Pacini and
free nerve endings. In addition to specific tasks, most of these are sensitive to mechanical pressure.
These are called mechanoreceptors.
Podopostural therapy
In the late seventies, in a number of European countries, including the Netherlands, a therapy has been
introduced based on stimulation of the above mentioned sensors; originally called podo-orthesiologie. In
1998, this profession was merged with another group, and called from then: podopostural therapy.
Podopostural therapy is literally the foundation of posturology.
Founder of this therapy was René Jacques Bourdiol, a French doctor who discovered that minimal small
elements (1 to 2 mm thick) placed under a loaded foot, lead to an altered base load and consequently to
an adjustment of the human posture. This method of prescribing patients thin inlays in their shoes has
proved to be effective over 35 years (practice based).
Surprising?
"Shoes protect against sharp objects and elements, but if it were up to the foot, he ran well in the nude"
... This statement is from Ralph Sakkers, orthopedic surgeon, Wilhelmina Children's Hospital (UMC) in an
interview with a national newspaper, April 6, 2013. He advocates for adults as well as children walking
barefoot as much as possible: http://posturology.nl/fileadmin/user_upload/Orthopd_AD.pdf.
What about sitting?
Long before doctors, biomechanical engineers, ergonomists and other experts were engaged themselves
with sitting, man had already invented 'how to sit’: in the squat position.
And still this is used in a large part of world: to sit on the toilet and to give birth. Even now, in the 21st
century, there are still toilets France where you have to defecate this way.
This natural approach does not lend itself to sit behind a desk, in school or in the office. Want to read
more? http://posturology.nl/en/posturology/what-about-posturology/
Daily posturology
Walk upright, shoulders back and more of these well-meant advices, often passed on for generations.
Parents and educators are trying to teach so to their children in order to prevent them from later
problems.
Our youngsters have, compared to a few decades ago, grown considerably. Which we do not always find
back in our school furniture and at other places? For example the bed length? Do you have experience or
an opinion about this, mail regulatietherapie@gmail.com?
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Eyes and posture also posturology!
In my practice Integral Postural Therapy I regularly saw young children. Main reason: parents thought
their child walked and moved poorly. Often the children hated their shoes. Further investigation showed
also other problems:
• Tilt head
• Body slightly rotated
• Concentration problems
• Does not like to read
• Hyperactive
Seeing:
with both eyes is called binocular sight. When we sleep, the eyes turn outward. Once we open them the
brains give a signal to look more or less straight forward. This is effectuated by the nasal motor eye
muscles. A particularly complex mechanism (the accommodation-convergence-miosis synergism) now
ensures that we can see.
When this mechanism becomes disturbed, seeing becomes difficult (asthenopia). One is not always
immediately aware; we continue to see sharp, it just takes more effort. Only when focusing nearby and
at distance becomes too difficult, when the eyes are itching, burning, tearing and or red, one realizes to
have a problem. The eyes are restless; some are even giving a double image.
The temporal motor eye muscles can shorten, the pupil becomes larger. The eyes become 'stressed'.
Seeing at distance has become difficult and there is an 'apparent' myopia (pseudo myopia).
Dominant eye:
What is that? Look with both eyes at a fixed point at about arm length distance. Cover one eye with your
hand and then pull it back. If that what you are looking at does not change you have covered the nondominant eye. If the picture changes instead, you covered the dominant eye.
Though we see with two eyes, one 'dominates'. This causes a minimal rotation of the head around the
body length axis. I have already observed this phenomenon in very young children.
The dominant eye is set to the distance; the non-dominant eye is now focused on nearby. Sometimes so
extreme that this leads to strabismus. Taping the ‘good’ eye must then ensure that the nearby eye is
looking forward again. Sometimes it succeeds, sometimes surgery is necessary (shortening the temporal
motor eye muscle). Sometimes the taped eye turns inward.
With the convergence test, bring a pencil as close as possible to the patients nose, asking him to follow it
with both eyes, you can observe that the muscles of one eye are more tense than of the other eye. Just
by covering eye by eye with your hand. Often crossing per eye becomes then easier.
Dyslexia: I would not go so far as to say that this is the cause of dyslexia, but there is a relation.
(To be continued)
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Hallux valgus, a postural problem?
This often painful lump you see more in women than in men. Experts attribute the cause to, for example:
• too small shoes;
• (high) heels;
• fashion.
There is indeed a basis of truth in it. But why it occurs more frequently or more on one foot? Why it also
occurs in people who do not wear shoes too small? Or do not walk on high heels? Wherefore also in
men?
We do a little test. Stand relaxed on bare feet, slightly spread, hands along the body. Tilt slowly forward
and feel what is happening on your front foot, the toes grabbing as it were to the ground. Just relax, and
do so again. Now notice the big toe: the proximal phalanx 'wants' out. . .
Make a grasping movement with your hand: with a little imagination, these movements alike. The thumb
proximally pointing outward and the fingers 'claw'.
Question: Can a hallux valgus (also) be the result of a 'wrong' posture? Because the body center of
gravity is too much forward?
Agree? Disagree? Like discussion? regulatietherapie@gmail.com
Effect of vision, proprioception and the position of the vestibular organ on postural sway
Eva Ekvall Hansson RPT, PhD, Anders Beckman MD, PhD, Anders Håkansson Professor all
Lund University, Department of Clinical Sciences in Malmö/Family Medicine/ General Practice.
(A*) Abstract
Conclusion: When measured together, it seems that vision and proprioception as well as position of the
vestibular organ affect postural sway, vision the most. Mediolateral sway does not seem to be influenced
by the position of the vestibular organ.
Objective: To investigate how postural sway was affected by provocation of vision, by the position of the
vestibular organ and by provocation of proprioception, when measured together.
Method: Postural sway was measured by using a force plate. Tests were performed with eyes open and
eyes closed, with head in neutral position and rotated to the right and to the left and with head
maximally extended, both standing on firm surface and on foam. Measures of mediolateral (ML) speed
(mm/sec), anteriorposterior (AP) speed (mm/sec) and sway area (SA) (mm2/sec) were analysed using
multilevel approach.
Results: The multilevel analysis revealed how postural sway was significantly affected by closed eyes,
standing on foam and by the position of the vestibular organ. Closed eyes and standing on foam both
significantly prolong the dependent measurement, irrespective of whether it is ML, AP or SA. However,
only AP and SA were significantly affected by vestibular position, i.e. maximal head movement to the
right and extension of the head.
Keywords: Postural control, balance, vestibular system.
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Distribution and behaviour of glabrous cutaneous receptors in the human foot sole Paul M Kennedy
and J Timothy Inglis, School of Human Kinetics, University of British ColumbiaVancouver, Canada
Corresponding author
J. T. Inglis: School of Human Kinetics, The University of British Columbia, 210-6081 University
Boulevard, Vancouver, British Columbia, Canada, V6T 1Z1. Email: tinglis@interchange.ubc.ca
Abstract
To document the activity of cutaneous mechanoreceptors in the glabrous skin of the foot sole, tungsten
microelectrodes were inserted through the popliteal fossa and into the tibial nerve of thirteen healthy
human subjects. A total of 104 cutaneous mechanoreceptors were identified in the glabrous skin of the
foot. This sample consisted of 15 slow adapting type I (14 %), 16 slow adapting type II (15 %), 59 fast
adapting type I (57 %), and 14 fast adapting type II units (14 %). The location of the receptors and the
outline of the receptive fields were determined by using nylon monofilaments perpendicularly applied
against the surface of the skin. This revealed that the receptors were widely distributed without an
accumulation of receptors in the toes. There were also larger receptive fields predominantly isolated on
the plantar surface of the metatarsal-tarsal region of the foot sole. Furthermore, with the foot in an
unloaded position, there was no background discharge activity in any of the cutaneous receptors in the
absence of intentionally applied stimulation. These findings suggest that skin receptors in the foot sole
behave differently from those receptors found on the glabrous skin of the hand. This may reflect the role
of foot sole skin receptors in standing balance and movement control.
Full pdf: http://posturology.nl/fileadmin/user_upload/glabrous_cutaneus.pdf
Next time:
 intrinsic foot muscles
 more sensomotoric information
COLOFON
Edited 10 times a year.
CONTACT: regulatietherapie@gmail.com
Editorial: Peter Oomens
APP bulletin
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e-mail: regulatietherapie@gmail.com
http://www.posturologie.nl/en/
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