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Postural deficiency syndrome (PDS) is essentially a dysfunction of our postural control system and/or muscle tone. There is a profound alteration in proprioception – considered to be our 6th sense.

An estimated 10 per cent of the population may suffer from this condition in its many and varied aspects.

Symptoms

SDP is generally not diagnosed as such, as it can present itself in the most diverse forms: depression, migraines, dizziness, reading difficulties with no apparent justification in school problems, anxiety and discomfort in open spaces (such as shopping centres and supermarkets), back pain or pain spread throughout the body (similar to fibromyalgia), bruxism ("grinding" of teeth at night), insomnia, etc. Patients with PDS usually have more than one of these associated pathologies. This is why one of the first warning signs is the "coincidence" of a number of these pathologies in the same patient or resistance to treatment for any of them. Given the wide range of complaints, it is normal for patients to be treated in multiple medical specialities with varying results, but always in a form that the patient accepts as a chronic illness.

Origin

PDS stems from the malfunctioning of the so-called Fine Postural System. The functioning of this system depends on the coordination of the following "organs": the eye and eye muscles, the temporomaxillary joint and teeth, the inner ear and the "sensitivity" of the soles of the feet (transmitted by the axis made up of the lower limbs and the spine). Non-coordination of these "organs" can exist even without disease particularly affecting any of them – it is the relationship between them that is disturbed.

Diagnosis

Diagnosis of SDP involves multiple physical and functional examinations, although the one that can currently be considered the most rigorous and quantifiable is Stabilometry.

Stabilometry consists of placing the individual on a plate with sensors, which, connected to a computer, records their oscillations "on line", separating the importance or impairment of the various systems involved: vision and eye muscles, inner ear, temporomaxillary and plantar joints of the feet and spine.

The evolution and increased importance of this test, the driving principles and equipment for which already existed, albeit in a more primitive form, is due to the evolution of electronics technology, but above all to the application of new mathematical and statistical techniques developed in our clinic, using high-capacity computers, which make it possible to draw conclusions regarding the evolution and quantitative assessment of and the interrelationship between the various systems involved.

Therapy

The new therapeutic approaches focus on integrating all the systems that play a relevant role in the fine postural system: the optical system through postural prisms and exercises for visual function and visual perception, balance of the plantar system and auditory-sensory stimulation through programmed and manipulated auditions of musical excerpts (Tomatis method).

Dissemination

Ophthalmology is the medical speciality that is best placed to diagnose and treat SDP, although physiatrists and stomatologists are often relevant.

Publicising PDS, which is an eminently multidisciplinary disease, is slow and difficult. Clínica Oftalmológica Rufino Ribeiro, SA has been dedicated to this area since its beginnings some 20 years ago. The clinics work to increase awareness have included multiple conference presentations to professional groups that should be familiar with this condition.

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