Which biomechanical models are currently used in standing posture analysis?

Abstract

In 1995, David Winter concluded that postural analysis of upright stance was often restricted to studying the trajectory of the center of pressure (CoP). However, postural control means regulation of the center of mass (CoM) with respect to CoP. As CoM is only accessible by using a biomechanical model of the human body, the present article proposes to determine which models are actually used in postural analysis, twenty years after Winter's observation. To do so, a selection of 252 representative articles dealing with upright posture and published during the four last years has been checked. It appears that the CoP model largely remains the most common one (accounting for nearly two thirds of the selection). Other models, CoP/CoM and segmental models (with one, two or more segments) are much less used. The choice of the model does not appear to be guided by the population studied. Conversely, while some confusion remains between postural control and the associated concepts of stability or strategy, this choice is better justified for real methodological concerns when dealing with such high-level parameters. Finally, the computation of the CoM continues to be a limitation in achieving a more complete postural analysis. This unfortunately implies that the model is chosen for technological reasons in many cases (choice being a euphemism here). Some effort still has to be made so that bioengineering developments allow us to go beyond this limit.