Postural Assessment Research Articles

Validação do protocolo de Avaliação Remota da Postura Estática (ARPE)

Abstract Introduction Remote postural assessment, necessary during the pandemic, required strategies to replace its in-person counterpart. Objective Analyze the content validity of a protocol for Remote Static Posture Assessment (ARPE) that includes three items, postural checklist, rater’s manual and ratee’s manual. Methods Six experts in postural assessment were invited to validate the content of the three items of the ARPE protocol and 10 laypersons evaluated the ratee’s Manual. The validity questionnaire encompassed the protocol in general and each individual item, containing an area for suggestions from experts and laypersons. The responses of these raters were used to calculate the Content Validity Indexes (CVI). Results Two rounds of evaluations were carried out with the experts and one with the laypersons. In the first round with the experts, the CVI ranged from 98.6 to 83%. Three aspects (description of head positioning, description of scapula and waist positioning in the frontal plane) required adjustments. In the first round with the laypersons and second round with the experts, the CVI was 100%. Conclusion The 100% agreement between experts and laypersons regarding the content of the ARPE protocol confirms its content validity.

Methods of Postural Assessment used in Hyperkyphotic Elders: A Narrative Review

Background and objective: Aging is a natural process and associated changes in posture, mainly at the spine lead to complications in functional independence and quality of life. The aim of this review is to identify existing measuring tools used to measure hyperkyphotic posture in the elderly population. Methods: Electronic databases were searched from January 2001 to December 2021, with different combinations of keywords, “thoracic kyphosis” or “hyperkyphosis” or “kyphotic posture” or hyperkyphotic posture” or “flexed posture” or “spinal curve” and “assessment”, “measurement” or “instrument” or “equipment” and “elderly” or “older adults” or “elders”. Studies were selected based on inclusion and exclusion criteria. Results: Four thousand one hundred sixty-six studies were obtained from electronic databases. After the removal of 3227 duplicate studies, twenty-six relevant studies were selected from 939 unique studies. Radiographic measurement, Flexicurve ruler, Debrunner kyphometer, Gravity-dependent inclinometer, occiput to wall distance (OTW), tragus to wall distance (TWD), and spinal mouse were used for hyperkyphotic measurement. The radiographic method and Flexicurve showed very high reliability. The block method and flexicurve are widely used methods for assessing hyperkyphotic posture in older adults. Conclusion: Postural assessment methods showed variability in defining criteria for hyperkyphosis in the elderly population. Flexicurve and block methods can be used as non-invasive methods for the early detection of hyperkyphosis. In the future, more measurement tools should be developed for the measurement of kyphosis, that are cost-effective, with excellent reliability and validity.

Assessment of risk of musculoskeletal discomforts in physiotherapists treating neurological patients: A pilot study.

Musculoskeletal disorders (MSDs) are conditions that are caused and/or aggravated by work. The most important reason behind work-related musculoskeletal disorder is abnormal and/or stressful position of joints while working. Physiotherapists are very much prone to develop work-related musculoskeletal disorders, especially while treating neurologically challenged patients. Postural assessment is a key to identify a person at risk of developing work-related musculoskeletal disorders. Proper assessment of some of the areas like neck, spine, upper and lower extremities is the key to get risk factor analysis. REBA (Rapid Entire Body Assessment) is a tool which can be used on field to quantify areas of the body which are more likely to develop work-related musculoskeletal disorders. To find out risk of MSDs among physiotherapists treating neurologically challenged patients. At neuro-paediatric department of SBB College of Physiotherapy, an observational pilot study was conducted. Photographs of the participants were captured with their consent through smart phone camera during treatment of different patients both adult and paediatric. Selected postures were analysed and quantified based on the REBA sheet. Descriptive analysis was done based on areas at higher risk for MSDs according to REBA sheet. More than 50% of participants were at moderate to high risk of developing MSDs. Physiotherapists working with neurological patients were found to be at high to medium risk of work-related musculoskeletal disorders. There is a need to assess MSD risk in detail in all physiotherapists.

Changes in body posture parameters: a four-year follow-up study

Body posture is an alignment of its segments relative to each other in a certain way and the relations between them. Abnormalities in the alignment of body segments or the cooperation of systems may cause postural defects. Scientific evidence showed that children of school age are more exposed to abnormalities in body posture so posture should be monitored because it is a key aspect of their body's physical health. This study aimed to evaluate changes in body posture parameters in the frontal plane in the same children at 5 and then 9 years of age. This four-year follow-up study included 67 children (29 girls and 38 boys) in preschool-age and school-age phases (the first examination at 5 years of age and the second examination at 9 years of age). Measurements of body weight and height were recorded. The computerized assessment of body posture was performed with the photogrammetric method (MORA 4 Generation). The normality of the distribution of variables was assessed with the Shapiro-Wilk test. Analysis of qualitative data was carried out using Pearson’s chi-squared test. The highest percentage of children were characterized by the deterioration in the position of the lower corners of the scapulae, taking into account the division into sex (respectively in girls 51.7 % and boys 50.0 %) and the analysis of the whole group (50.7 %). There were statistically significant differences in the position of the lower corners of scapulae (UL) between the first and second examinations in all examined children (p = 0.005). The difference in the height of the waist and in the position of the shoulders improved and deteriorated in a similar percentage in children (above 30-40 %). Generally, an improvement in body posture was observed, however, the occurred abnormalities of body posture indicate the need to continuously monitor the children's posture and implementation of preventive and corrective measures.

Ergonomics Postural Risk Assessment and Observational Techniques in the 21st Century

Workers in various industries where materials are handled manually are at a higher risk of suffering musculoskeletal disorders (MSDs) and related body pains. These workers experience various occupational diseases due to the awkward working postures they take during tasks. Some of these work postures include sitting (for long period), lifting, body twisting, or bending. This review studied the various body postures and material handling tasks employed during daily work activities by workers. The occupational hazard in human tasks, general survey of postures in human tasks, body parts involved in human tasks, assessment of occupational risk factors and various approaches to modification have also been reviewed. The review concluded with suggestions on possible ergonomic intervention that could alleviate the risk factors caused by these awkward body postures.

Postura corporal e o estado de humor em mulheres

Abstract In the clinical practice of health professionals, it is observed that body posture can reveal the current emotional state. Emotional states can generate habitual gestures and postures that continue even after the emotion has ceased. The objective was to identify postural changes and variables found in the mood state in women. After project submission and approval to the CEP of the Lutheran University of Brazil (ULBRA), 15 women with a mean age of 39.6 years, regardless of color, race, or social class participated in the study. The sample was by convenience, being recruited through invitations on social networks. The research was carried out at the Walk Clinic of Exercise, in Charqueadas/RS. The instruments used were a sociodemographic and clinical questionnaire to characterize the sample, the Brunel Mood Scale (Brums), and the DIPA v13 (Digital Image based Postural Assessment) to assess posture. The results were presented in the form of descriptive statistics. It was found that increased tension and mental confusion for women with head changes in the sagittal plane and who also showed decreased vigor. In this study, it was verified that for women with low vigor, there is head alteration and that they present tension and mental confusion. More studies should be carried out with different methodologies in larger samples to enable the mapping and delineation of most postural changes related to emotional states and mood disorders, with due application in the clinical practice of health professionals.

Evaluation of the relationship of balance and posture with speech functions in stroke patients

Aim: Balance disorders, postural dysfunctions, and speech disorders are common after stroke. This study aims to investigate whether there is a connection between language and speech function and posture and balance in paralyzed patients and to which speech area function the connection is related.Methods: Eighteen stroke patients with speech impairment and no cognitive impairment were included in the study. Balance and postures of stroke patients were evaluated using the Berg Balance Test (BBT) and Postural Assessment Scale for Stroke Patients (PASS-T), while their quality of life was evaluated using the Stroke and Aphasia Quality of Life-39 Test (SAQOL-39). Patients’ speech functions were evaluated using the Gülhane Aphasia Test-2 (GAT-2), voice-related assessments were made with the Voice-Related Quality of Life Scale (V-RQOL), and objective voice analysis.Results: The mean age of the participants was 59.10±14.72 years, the mean score of the Mini-Mental Test was 26.16±2.00. According to statistical analysis, there was a significant relationship between BBT score and GAT-2 (r: 0.552, p=0.017), and BBT score and SAQOL-39 mean score (r: 0.589, p=0.010), there was no significant relationship between BBT and V-RQOL (r: -0.075, p=0.768). While there was a significant relationship between PASS-T (r: 0.499, p=0.035) and SAQOL-39, no significant relationship was found with GAT-2 (r: 0.388, p=0.112). In addition, a significant correlation was found between the SAQOL-39 mean score and the GAT-2 total score (r: 0,606, p=0.008).Conclusion: It was observed that there is a significant relationship between balance functions and speech function and quality of life, and patients with good balance have better functional independence and speech functions. However, it was found that posture did not change speech function. Due to the importance of evaluation in treatment, it is thought that the evaluation of stroke patients who will receive speech and language therapy in terms of balance and postural functions will contribute to the speech functions of patients.

Validity of a protocol for remote static posture assessment (ARPE)

Resumo Introdução A avaliação da postura por atendimento remoto, necessária durante o cenário pandêmico, exigiu estratégias para substituir a avaliação postural presencial. Objetivo Realizar a validação de conteúdo de um protocolo de Avaliação Remota da Postura Estática (ARPE) que contempla três itens: checklist postural, manual do avaliador e manual do avaliado. Métodos Seis especialistas em avaliação postural foram convi-dados para a validação de conteúdo dos três itens do protocolo ARPE e 10 leigos avaliaram o manual do avaliado. O questionário de validação englobava o protocolo em geral e cada item isolado, contendo espaço para sugestões dos especialistas e leigos. As respostas desses avaliadores foram utilizadas no cálculo dos índices de validade de conteúdo (IVCs). Resultados Foram realizadas duas rodadas de avaliações com especialistas e uma com leigos. Na primeira rodada com os especialistas, os IVCs variaram de 98,6 a 83%.Três aspectos (descrição do posicionamento da cabeça, do posicionamento das escápulas e da “cintura” no plano frontal de costas) necessitaram de ajustes. Na primeira rodada com os leigos, os IVCs foram de 100%. Na segunda rodada com os especialistas, os IVCs foram de 100%. Conclusão A concordância de 100% entre os especialistas e leigos sobre o conteúdo do protocolo ARPE confirma sua validade de conteúdo.

The Relationship Between Posture and Dynamic Balance In 10-12 Age Group Wrestlers

Purpose: Posture and balance control is based on a complex set of interrelated mechanisms. Coordination between the musculoskeletal system and the nervous system and receptors that provide this coordination, and the balance organ are needed to ensure postural regularity. This study aimed to determine the relationship between postural problems and dynamic balance. Methods: The study included 31 wrestling athletes aged 10-12 years. The participants were evaluated for posture analysis and dynamic balance in the study. Posture assessments of the participants were performed with the Posture Screen Mobile application and dynamic balance assessments were performed with the Y-Balance Balance test (YBT). Descriptive statistics, the Shapiro-Wilk test, and Pearson correlation analysis were used to analyze the data. The significance level was fixed as P ≤ .05. Results: In the study, a significant negative correlation was found between the forward head angulation of the participants and right and left YBT. Conclusions: In conclusion, forward head posture negatively affects dynamic balance in wrestling athletes aged 10-12 years. In addition to balance exercises for the development of dynamic balance, head posture should be evaluated, and the existing postural problem should be improved. Keywords: Children, dynamic balance, motor control; sports, posture.

Application of D-S Evidence Theory in Marine Environmental Security Posture Assessment

In the past, in geological exploration, marine development and offshore safety management, we have realized that the development and damage to the marine environment are very serious and important. While technology has improved rapidly over the years, the marine environment is changing faster than geological exploration, development and management. We must ensure the safety of hydrographic, meteorological conditions and sea wind weather forecasting. Due to the limitations of geological exploration techniques and methods, many problems are difficult to deal with or unpredictable when analyzing the factors that affect the management of the marine environment. Therefore, we need to solve these problems by some new means.

Validation of non-radiographic APECS software in comparison with standard radiographic measurement of full-length lower limb hip-knee-ankle angle in elderly obese women

IntroductionEvidence suggests that obesity and ageing in women are linked to angular knee abnormalities. The hip-knee-ankle (HKA) angle on a full-limb radiograph is the gold standard measure of lower limb alignment. The AI Posture Evaluation and Correction System (APECS) software is a non-radiographic mobile application designed for whole-body posture assessment. Since exposure to X-ray is associated with harmful effects, there is a need to find a safe and valid alternative for measuring HKA angle. The objective of this research was to determine the validity of the non-radiographic APECS software in comparison with standard radiographic measurement of HKA angle.MethodsThe present cross-sectional diagnostic accuracy study was conducted in a tertiary care hospital of Belagavi, Karnataka, India. Overall, 45 elderly obese females aged 60–80 years with a body mass index of 25 were included. HKA angle was marked bilaterally. Full-limb radiographs were taken and angles were marked with 2.0 version software, DXM model. For the APECS software, full-limb photographs were taken with landmarks indicated with radiant markers and angles were autogenerated by the software.ResultsThe Pearson correlation coefficient between the APECS application and the gold standard (X-ray) was 0.9874 (98.74% of matching). The agreement between standard radiograph and the average of all examiners’ APECS Pro measurements (including right and left sides) equalled 94.64% (kappa = 0.8323; <i>p</i> = 0.001), which suggests very good agreement.ConclusionsThe APECS application demonstrated a high percentage of matching (98.74%) and agreement (94.64%), indicating its excellent validity in measuring HKA angle.

PENILAIAN POSTUR TUBUH PEKERJA HPES PLATING DI PT. ABC MENGGUNAKAN METODE OWAS

PT. ABC is a company engaged in the production and management of metal and plastic electron components, namely Presicion Metal Stamping and Forming, Precision Cold Forged Treatment and Surface Treatment. One of the departments in this company is the HPES Plating department. In production line activities at HPES Plating, there is work that is predominantly done in the work posture, namely standing, sitting, and bending as well as manual lifting handling activities. This study aims to assess the body posture scores of workers in the HPES Plating department of PT. ABC which has the potential for musculoskeletal disorders using the OWAS method. The results of the posture assessment at the time of incoming product inspection activities were 1, receiving system activities were 1, product transfers were 1, product lifting was 3, jigging activities were 1, product preparation was 2, loading activities were 1, VMI inspections were 1, product packing was 3, OQA inspections were 1, and shipment activities were 2. So that immediate improvements are needed for the work posture of product lifting, product preparation, product packing and shipment.

An Investigation of the Association between 3D Spinal Alignment and Fibromyalgia.

Fibromyalgia syndrome (FMS) is a common condition lacking strong diagnostic criteria; these criteria continue to evolve as more and more studies are performed to explore it. This investigation sought to identify whether participants with FMS have more frequent and larger postural/spinal displacements in comparison to a matched control group without the condition of FMS. A total of 67 adults (55 females) out of 380 participants with FMS were recruited. Participants with FMS were sex- and age-matched with 67 asymptomatic participants (controls) without FMS. We used a three-dimensional (3D) postural assessment device (Formetric system) to analyze five posture variables in each participant in both groups: (1) thoracic kyphotic angle, (2) trunk imbalance, (3) trunk inclination, (4) lumbar lordotic angle, and (5) vertebral rotation. In order to determine whether 3D postural measures could predict the likelihood of a participant having FMS, we applied the matched-pairs binary logistic regression analysis. The 3D posture measures identified statistically and clinically significant differences between the FMS and control groups for each of the five posture variables measured (p < 0.001). For three out of five posture measurements assessed, the binary logistic regression identified there was an increased probability of having FMS with an increased: (1) thoracic kyphotic angle proportional odds ratio [Prop OR] = 1.76 (95% CI = 1.03, 3.02); (2) sagittal imbalance Prop OR = 1.54 (95% CI = 0.973, 2.459); and (3) surface rotation Prop OR = 7.9 (95% CI = 1.494, 41.97). We identified no significant probability of having FMS for the following two postural measurements: (1) coronal balance (p = 0.50) and (2) lumbar lordotic angle (p = 0.10). Our study’s findings suggest there is a strong relationship between 3D spinal misalignment and the diagnosis of FMS. In fact, our results support that thoracic kyphotic angle, sagittal imbalance, and surface rotation are predictors of having FMS.

Children’s foot parameters and basic anthropometry — do arch height and midfoot width change?

The aims of this study were as follows: (1) to assess how foot posture and morphology assessments change according to body mass index (BMI) status; (2) to determine which body composition parameter (BMI or waist circumference) correlates better with the foot posture index (FPI), arch height index (AHI), and midfoot width (MFW) in children. Foot morphometry (FPI, AHI, and MFW) and body composition (BMI and waist circumference (WC)) were assessed in a cross-sectional study of 575 children (mean age = 7.42 ± 1.67 years; 53.27% female). When comparing BMI groups, an increase of 8.3% in AHI and 13.6% in MFW (both p < 0.0001) was seen. In linear regression analyses, BMI and WC were positively associated with MFW explaining together 64.8% of its variance. Noteworthy, MFW is the most related to body composition parameters.Conclusion: Foot morphology assessed by FPI, AHI, and MFW differs among BMI categories in children. Noteworthy, WC correlates better with foot measures than does the more commonly used BMI, and more importantly the MFW is the foot measure best explained by children’s body weight. Since foot morphometry is different among different BMI groups, children would benefit from shoes with different patterns (thinner and wider), as well as a good system to adjust midfoot height.What is Known:• Children who are overweight and obese have flatter feet, when assessed using footprints.• Up to 72% of people have incorrectly fitted shoes.What is New:• Children with underweight have thinner and flatter feet than children with normal weight, while children with overweight and obesity have wider and higher arched feet.• Body weight is related to foot shape, which has relevance for footwear manufacturers.

Validity and feasibility of remote measurement systems for functional movement and posture assessments in people with axial spondylarthritis.

This study aimed to estimate the criterion validity of functional movement and posture measurement using remote technology systems in people with and without Axial spondylarthritis (axSpA). Validity and agreement of the remote-technology measurement of functional movement and posture were tested cross-sectionally and compared to a standard clinical measurement by a physiotherapist. The feasibility of remote implementation was tested in a home environment. There were two cohorts of participants: people with axSpA and people without longstanding back pain. In addition, a cost-consequence analysis was performed. Sixty-two participants (31 with axSPA, 53% female, age = 45(SD14), BMI = 26.6(SD4.6) completed the study. In the axSpA group, cervical rotation, lumbar flexion, lumbar side flexion, shoulder flexion, hip abduction, tragus-to-wall and thoracic kyphosis showed a significant moderate to strong correlation; in the non-back pain group, the same measures showed significant correlation ranging from weak to strong. Although not valid for clinical use in its current form, the remote technologies demonstrated moderate to strong correlation and agreement in most functional and postural tests measured in people with AxSA. Testing the CV-aided system in a home environment suggests it is a safe and feasible method. Yet, validity testing in this environment still needs to be performed.

Evaluation of Two Thigh-Worn Accelerometer Brands in Laboratory and Free-Living Settings

Background: Given the popularity of thigh-worn accelerometers, it is important to understand their reliability and validity. Purpose: Our study evaluated laboratory validity and free-living intermonitor reliability of the Fibion monitor and free-living intermonitor reliability of the activPAL monitor. Free-living comparability of the Fibion and activPAL monitors was also assessed. Methods: Nineteen adult participants wore Fibion monitors on both thighs while performing 11 activities in a laboratory setting. Then, participants wore Fibion and activPAL monitors on both thighs for 3 days during waking hours. Accuracy of the Fibion monitor was determined for recognizing lying/sitting, standing, slow walking, fast walking, jogging, and cycling. For the 3-day free-living wear, outputs from the Fibion monitors were compared, with similar analyses conducted for the activPAL monitors. Finally, free-living comparability of the Fibion and activPAL monitors was determined for nonwear, sitting, standing, stepping, and cycling. Results: The Fibion monitor had an overall accuracy of 85%–89%, with high accuracy (94%–100%) for detecting prone and supine lying, sitting, and standing but some misclassification among ambulatory activities and for left-/right-side lying with standing. Intermonitor reliability was similar for the Fibion and activPAL monitors, with best reliability for sitting but poorer reliability for activities performed least often (e.g., cycling). The Fibion and activPAL monitors were not equivalent for most tested metrics. Conclusion: The Fibion monitor appears suitable for assessment of sedentary and nonsedentary waking postures, and the Fibion and activPAL monitors have comparable intermonitor reliability. However, studies using thigh-worn monitors should use the same monitor brand worn on the same leg to optimize reliability.

The effectiveness of Schroth exercises added to the brace on the postural control of adolescents with idiopathic scoliosis: Case series.

One of the disorders that may cause changes in body posture and impair postural control is adolescent idiopathic scoliosis (AIS). Scoliosis-specific exercises, such as the three-dimensional Schroth method added to the brace, may be able to help these patients improve their postural control. The aim of this study was evaluating the effect of Schroth physiotherapy scoliosis-specific exercises added to the brace on AIS patients' postural control. It is a case series study on twenty-three AIS patients. They were treated using the Schroth method and brace for three months, with the first five sessions lasting two weeks and subsequently one session per week. Postural control assessments include center of pressure (COP) range and COP velocity in the anteroposterior (AP) and mediolateral (ML) directions, and the COP sway area in the standing position with opened eyes and closed eyes by the force plate. The angle of trunk rotation (ATR) was assessed by the scoliometer. The methods are consistent with the PROCESS 2020 guidelines. The Schroth method and brace also significantly improved the variables of postural control variables in terms of COP range (p<0.001), COP velocity (p<0.001), and COP sway area in standing positions with opened and closed eyes (p<0.001, p<0.001) as well as ATR (p<0.001) in AIS patients. Schroth method and brace improved the postural control and trunk rotation of AIS patients.

Posture correction in children 11-12 years old by means of swimming with elements of aquafitness

The article is devoted to the justification of the use of a physical therapy program using swimming equipment to improve the physical condition of children aged 11-12 years with postural disorders. The relevance of the study is due to the critical sharp increase in the incidence of disease among children all over the world, in particular, in Ukraine in recent years. The evaluation method was the measurement of Moshkov's rhombus, acromial, digital, iliac crest and lower angles of the scapula of the point. According to the results of the study, it was found that among boys aged 11-12 years under the influence of classes under the rehabilitation program using swimming equipment with elements of aquafitness, the number of people with an index of vertical curvature of the spine of 100.0-90.0% increased by 30.77%, among girls - by 38.46%. At the same time, the number of persons with a spine curvature index of 79.9-70.0% in the main groups of boys and girls decreased significantly compared to the control groups. The feasibility of using the proposed program of complex rehabilitation with the use of swimming equipment with the use of elements of aquafitness was proven due to a significant improvement in the indicators of posture assessment in the studied children 11-12 years old.

A Systematic Review on Spinal Asymmetries in Case Studies of Unilateral Nephroptosis from a Viscerosomatic Point of View.

The assessment of posture and asymmetries is common in musculoskeletal clinical practice, and correction is a frequent goal. In this setting, posture and asymmetries are usually interpreted in terms of musculoskeletal issues. This study aimed to evaluate spinal asymmetries in case studies of unilateral nephroptosis. A systematic review was performed using PubMed, CINAHL, Scopus and Web of Science. We included case reports and case series of nephroptotic patients which showed diagnostic imaging that allowed us to assess the presence of spinal asymmetries in the frontal plane. The methodological quality of the selected studies was assessed by using Case Report (CARE) checklist. Nineteen studies were included, with a total number of 78 reported patients (69 women) ranging 22 to 44 years old (mean: 29). Only one patient presented with medial nephroptosis, while the rest presented with caudal migration. Ninety-one percent of the cases affected to the right kidney. All cases but two showed homolateral flank closure (lower rib descent, iliac crest raise and/or homolateral side-bending). The correction of nephroptosis, either by supine position or surgical treatment, removed asymmetries in some cases while other cases improved only partly. Manual therapists must consider visceral implications while assessing body posture. Further, since the most common symptom of nephroptosis is loin pain, and it has been claimed that loin pain is underdiagnosed, manual therapists should consider its potential presence during clinical practice. Finally, being that nephroptosis shares several features with idiopathic lumbar scoliosis (type of patient, postural adaptation), more research is needed regarding any possible relation between them.

Development and Verification of Postural Control Assessment Using Deep-Learning-Based Pose Estimators: Towards Clinical Applications.

Occupational therapists evaluate various aspects of a client's occupational performance. Among these, postural control is one of the fundamental skills that need assessment. Recently, several methods have been proposed to estimate postural control abilities using deep-learning-based approaches. Such techniques allow for the potential to provide automated, precise, fine-grained quantitative indices simply by evaluating videos of a client engaging in a postural control task. However, the clinical applicability of these assessment tools requires further investigation. In the current study, we compared three deep-learning-based pose estimators to assess their clinical applicability in terms of accuracy of pose estimations and processing speed. In addition, we verified which of the proposed quantitative indices for postural controls best reflected the clinical evaluations of occupational therapists. A framework using deep-learning techniques broadens the possibility of quantifying clients' postural control in a more fine-grained way compared with conventional coarse indices, which can lead to improved occupational therapy practice.