The usefulness of movement analysis and postural biomechanics in the legal medical field

Abstract

The fulcrum of the medical-legal evaluation on living beings is the study of the functional repercussions of the injuries sustained by the subject. The evaluation of impairments is carried out, in general, on the basis of the findings of medico-legal objectivity and documentary evidence, which often leave ample room for interpretation regarding the actual limitations of the subject.

For example, the finding of a reduction in the passive mobility of a joint, of a dysmetria, or of a reported tenderness, will only be able to approximately estimate the functional reflex that should guide the evaluation. It is precisely in this situation, and specifically in the impairments study concerning (directly or indirectly) the locomotor system, that postural biomechanics can find concrete and valuable application. In fact, thanks to the biomechanical analysis of posture and movement, it is possible to research and document the impairment aspects, and produce evidence of important evidential support.

For this reason, a human movement analysis laboratory, managed by a biomedical engineer, expert in postural biomechanics, can be fundamental in order to obtain fair compensation.

Through the use of latest generation instruments and so performing appropriate biomechanical tests and analyzing the human movement motion, it is possible integrate the medical-legal assessment with quantifiable biomedical data with the resutl to have more scientifically accurate picture of the entire complex of damages suffered.

Furthermore, it is sometimes also possible to reconstruct the dynamics of accidents at work or on the road, creating ad hoc models with the use of high-level software, in order to determine the existence of a causal relationship, in the most accurate possible way.

In economic terms, the postural biomechanical tests, if necessary correlated with a digital modelling/ simulation of the accident, will help the legal doctor assessment, allowing the recognition of adequate compensation for the damage.

To have a better conception, postural biomechanical expertise means a biomechanical analysis of posture and movement, through the performance of various instrumental tests with data processing, correlation and evaluation.

The use of certain instruments, the analysis of biomedical data, and their interpretation require specific skills and knowledge in various fields, including engineering and medicine.

Posture is a multidisciplinary subject, which affects many professionals such as the orthopaedist, the physiatrist, the dentist, the physiotherapist, the osteopath, the podiatrist, the ophthalmologist, the orthoptist, the speech therapist, the kinesiologist, the trainer athletic etc…

Postural adaptations can be caused by interference of the postural tonic system, but can also be secondary to “structural” problems due to injuries, accidents and surgical interventions.

A postural biomechanical assessment can constitute, in addition to classic diagnostic imaging, a fundamental integration to the medical-legal examination from a functional point of view which was not previously possible, in order to guarantee the acquisition of important evidence for evidentiary purposes, as well as a precious tool in clinical and rehabilitation practice.

Therefore, a laboratory for the analysis of human movement and postural biomechanics, equipped with high-tech instruments and managed by a specialized biomedical engineer, objectively, on the basis of scientific evidence, the real functional deficits, and allows the forensic doctor to formulate with greater accuracy, the correct causal link with the event suffered by the patient.

To conclude, in this chapter some cases have been proposed where some types of investigations are shown in the evaluation of functional damage with the support of scientific literature which helps to understand the causal link.