The standard posture is a myth: a scoping review.
Martin E Barra-López
PMID 39404455WHAT IT FOUND
The "ideal" upright posture taught in clinical manuals is a myth.
It was designed based on incorrect 19th-century anatomy and assumes standing is effortless. Healthy adults do not naturally stand this way. Using it as a standard labels normal people as abnormal and ignores individual variation.
Key findings
01The standard posture used for assessment is based on the false assumption that the body can balance statically without muscle work, and on incorrect anatomical ideas about the neck ligaments.
02Healthy adults do not naturally stand in this "ideal" position; their actual gravity line and spinal alignment differ significantly from the standard.
03Using this rigid standard to assess posture results in many false-positive diagnoses of abnormalities, especially in older adults who have developed natural compensations.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review was limited to articles in English, French, German, or Spanish. A single author performed the screening and data extraction, which increases the risk of bias. The methodological quality of the included studies was not critically appraised. The review focused on healthy adults, so findings may not apply to populations with specific pathologies.
Declared interests
The author declared no conflicts of interest.
The easy way to misread this
Do not conclude that all postural deviations are harmless. While the "ideal" standard is flawed, this does not mean every asymmetry is normal. The paper argues against a single rigid benchmark, not against assessing posture. Use individualized functional assessment rather than dismissing all deviations.