Biofeedback Modalities Targeting Kyphosis and Lordosis: A Critical Appraisal Topic

Area of Science:

• Biomedical Engineering
• Rehabilitation Science
• Human-Computer Interaction

Background:

• Sedentary behavior leads to postural deviations like thoracic kyphosis and lumbar lordosis, causing pain and disability.
• Biofeedback offers an active, user-engaged approach to correct these postural issues, unlike passive methods.

Purpose of the Study:

• To systematically review evidence on biofeedback modalities for correcting kyphosis and lordosis.
• To assess the effectiveness of biofeedback in improving spinal alignment, reducing pain, and enhancing user engagement.

Main Methods:

• Systematic literature search of major scientific databases (PubMed, Web of Science, Scopus, IEEE Xplore) up to September 2025.
• Inclusion of studies on adult populations, focusing on spinal alignment, muscle activity, pain, usability, and satisfaction.
• Qualitative narrative synthesis of results from 14 included studies.

Main Results:

• Fourteen studies with 288 participants showed short-term improvements in spinal alignment (reduced kyphosis/lordosis), pain, and trunk posture.
• Vibration feedback was most common, followed by auditory and visual systems; multimodal systems also used.
• Biofeedback enhanced awareness and muscle relaxation, with actuator-based systems showing significant active correction, though long-term data is lacking.

Conclusions:

• Biofeedback modalities, particularly vibration and auditory, show promise for improving spinal alignment and user engagement.
• Current evidence is limited by study rigor, sample size, and short-term focus.
• Future research should focus on long-term, real-world trials with integrated multimodal feedback for sustained postural correction.