Artificial intelligence and epistemology in clinical posturology: challenges and interdisciplinary perspectives
Abstract
Introduction: Clinical posturology, a discipline dedicated to the study of human postural control, has significantly evolved through the integration of interdisciplinary approaches, including neuroscience, biomechanics, and artificial intelligence (AI). This evolution raises epistemological questions regarding objectivity, the reproducibility of measurements, and the management of variability in nonlinear dynamic systems. Objective: To examine the epistemological foundations of clinical posturology, with an emphasis on the use of AI to enhance the evaluation and management of postural control. Methodology: A critical literature review was conducted, drawing on major contemporary epistemological frameworks (Popper, Kuhn, Lakatos, among others) and their application to clinical posturology. This was complemented by recent studies on the use of AI in the interpretation of stabilometric data. Results: Findings indicate that objectivity in posturology does not lie in eliminating variability but in its critical and contextual management. AI emerges as a key tool in identifying center of pressure (COP) oscillation patterns, improving reproducibility, and personalizing clinical interventions. The need for an interdisciplinary approach to address the complexity of postural control was emphasized. Conclusion: The integration of AI into clinical posturology addresses core epistemological challenges such as variability and the falsifiability of hypotheses. This approach helps consolidate posturology as an autonomous scientific discipline and promotes more accurate and adaptive clinical practices.
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References
Asai, M. (2016). International Standardization in Clinical Stabilometry and Problems in Japan. Equilibrium Research, 75(3), 135-141. https://doi.org/10.3757/jser.75.135
Bertalanffy, L. (1968). Fundamentos de la teoría general de sistemas, desarrollo. George Braziller.
Bizzo, G., Guillet, N., Patat, A., & Gagey, P. M. (1985). Specifications for building a vertical force platform designed for clinical stabilomtery. Medical & Biological Engineering & Computing, 474-476.
Błaszczyk, J., & Beck, M. (2023). Posturographic Standards for Optimal Control of Human Standing Posture. Journal of Human Kinetics, 86(1), 7-15. https://doi.org/10.5114/jhk/159452
Bois, É. (2010). La Dynamique Posturale Non-Linéaire. Partie I: Bases et fondements. L’Anthropologie, 114(3), 370-387. https://doi.org/10.1016/j.anthro.2010.05.002
Bricot, B. (2014). Reprogramacion Postural (1era edicion). CIES Argentina.
Bucci, M. P., & Villeneuve, P. (2022). Interaction between Feet and Gaze in Postural Control. Brain Sciences, 12(11), 1459. https://doi.org/10.3390/brainsci12111459
Bunge, M. (2012). Filosofía para médicos. Gedisa.
Conde-Vázquez, O., Calvo-Moreno, S. O., & Villeneuve, P. (2024). Pierre-Marie Gagey and the Evolution of Posturology: Unraveling the Complexity of the Fine Postural Control System. Cureus. https://doi.org/10.7759/cureus.69052
De Blasiis, P., Caravaggi, P., Fullin, A., Leardini, A., Lucariello, A., Perna, A., Guerra, G., & De Luca, A. (2023). Postural stability and plantar pressure parameters in healthy subjects: Variability, correlation analysis and differences under open and closed eye conditions. Frontiers in Bioengineering and Biotechnology, 11, 1198120. https://doi.org/10.3389/fbioe.2023.1198120
Foisy, A., & Kapoula, Z. (2016). How Plantar Exteroceptive Efficiency Modulates Postural and Oculomotor Control: Inter-Individual Variability. Frontiers in Human Neuroscience, 10. https://doi.org/10.3389/fnhum.2016.00228
Gagey, P. (1988). [The postural system]. Agressologie: Revue Internationale De Physio-Biologie Et De Pharmacologie Appliquees Aux Effets De L’agression, 29(9), 621-625. https://pubmed.ncbi.nlm.nih.gov/3073667/
Gagey, P. M. (2020a). International standardization of clinical stabilometry (Minutes of the meeting of posturologists, Paris 07.10.2015). Manual Therapy, Posturology & Rehabilitation Journal, 1-3. https://doi.org/10.17784/mtprehabjournal.2016.14.315
Gagey, P. M. (Director). (2011, marzo 8). Histoire de la posturologie [Youtube]. https://www.youtube.com/watch?v=XZnNPLDbdf4&t=41s
Gagey, P. M., & Weber, B. (2001). Posturologia. Regulacion y alteraciones de la bipedestacion. (2da Edicion). Masson.
Gagey, P. M., & Weber, B. (2010). Study of intra-subject random variations of stabilometric parameters. Medical & Biological Engineering & Computing, 48(8), 833-835. https://doi.org/10.1007/s11517-010-0656-4
Gagey, P. M., Martinerie, J., Pezard, L., & Benaim, C. (1998). [Static balance is controlled by a non-linear dynamic system]. Annales D’oto-Laryngologie Et De Chirurgie Cervico Faciale: Bulletin De La Societe D’oto-Laryngologie Des Hopitaux De Paris, 115(3), 161-168.
Gagey, P.M. (2020b). Specifications of the clinical stabilometry platform ‘ADAP_NORMES13’. Manual Therapy, Posturology & Rehabilitation Journal, 1-3. https://doi.org/10.17784/mtprehabjournal.2016.14.332
García Jiménez, L. (2008). Aproximación epistemológica al concepto de ciencia: Una propuesta básica a partir de Kuhn, Popper, Lakatos y Feyerabend. Andamios, 4(8), 185-212. https://doi.org/10.1016/j.ijporl.2009.01.016
Hsu, Y.-S., Kuan, C.-C., & Young, Y.-H. (2009). Assessing the development of balance function in children using stabilometry. International Journal of Pediatric Otorhinolaryngology, 73(5), 737-740. https://doi.org/10.1016/j.ijporl.2009.01.016
Hume, D. (1988). La investigación sobre el conocimiento humano. Alianza Editorial
Ivanenko, Y., & Gurfinkel, V. S. (2018). Human Postural Control. Frontiers in Neuroscience, 12, 171. https://doi.org/10.3389/fnins.2018.00171
Kapteyn, T. S., Bles, W., Njiokiktjien, C. J., Kodde, L., Massen, C. H., & Mol, J. M. (1983). Standardization in platform stabilometry being a part of posturography. Agressologie: Revue Internationale De Physio-Biologie Et De Pharmacologie Appliquees Aux Effets De L’agression, 24(7), 321-326.
Kataoka, M., Yosida, T., Shimizu, A., Iyama, K., Yamamoto, M., & Suzuki, M. (2018). Comparison of stabilometric findings in the closed parallel feet position and with each foot placed at 30° with heels in contact with each other. Equilibrium Res, 7, 58-63.
Koltermann, J. J., Floessel, P., Hammerschmidt, F., & Disch, A. C. (2024). A Statistical and AI Analysis of the Frequency Spectrum in the Measurement of the Center of Pressure Track in the Seated Position in Healthy Subjects and Subjects with Low Back Pain. Sensors, 24(10), 3011. https://doi.org/10.3390/s24103011
Martins Da Cunha, H. (1987). Le syndrome de déficience posturale (SDP). Agressologie, 28, 941_943.
Nashner, L. M., & McCollum, G. (1985). The organization of human postural movements: A formal basis and experimental synthesis. Behavioral and Brain Sciences, 8(1), 135-150. https://doi.org/10.1017/S0140525X00020008
Ohlendorf, D., Pflaum, J., Wischnewski, C., Schamberger, S., Erbe, C., Wanke, E. M., Holzgreve, F., & Groneberg, D. A. (2020). Standard reference values of the postural control in healthy female adults aged between 31 and 40 years in Germany: An observational study. Journal of Physiological Anthropology, 39(1), 27. https://doi.org/10.1186/s40101-020-00229-7
Patti, A., Bianco, A., Şahin, N., Sekulic, D., Paoli, A., Iovane, A., Messina, G., Gagey, P. M., & Palma, A. (2018). Postural control and balance in a cohort of healthy people living in Europe: An observational study. Medicine, 97(52), e13835. https://doi.org/10.1097/MD.0000000000013835
Peterka, R. J. (2018). Sensory integration for human balance control. En Handbook of Clinical Neurology (Vol. 159, pp. 27-42). Elsevier. https://doi.org/10.1016/B978-0-444-63916-5.00002-1
Reiss, J., & Ankeny, R. A. (2022). Philosophy of Medicine [The Stanford Encyclopedia of Philosophy]. https://plato.stanford.edu/archives/spr2022/entries/medicine/
Saborido, C. (2020). Filosofia de la Medicina. Tecnos. https://gredos.usal.es/bitstream/10366/146226/1/Saborido_C_Filosofia_de_la_Medicina_Madr.pdf
Schwesig, R., Fischer, D., & Kluttig, A. (2013). Are there changes in postural regulation across the lifespan? Somatosensory & Motor Research, 30(4), 167-174. https://doi.org/10.3109/08990220.2013.779245
Scoppa, F., Capra, R., Gallamini, M., & Shiffer, R. (2013). Clinical stabilometry standardization. Gait & Posture, 37(2), 290-292. https://doi.org/10.1016/j.gaitpost.2012.07.009
Shumway-Cook, A., & Woollacott, M. H. (2017). Control Motor. De la investigacion a la practica clínica. (5ta Edicion). Wolters Kluwer.
Wiener, N. (1948). Cibernética: control y comunicación en animales y máquinas. Wiley.
Winter, D. A., Patla, A. E., Prince, F., Ishac, M., & Gielo-Perczak, K. (1998). Stiffness Control of Balance in Quiet Standing. Journal of Neurophysiology, 80(3), 1211-1221. https://doi.org/10.1152/jn.1998.80.3.1211
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