DIERS measuring systems – 4D analysis for back & gait (DE/EN)

What does 4D analysis mean?

4D stands for 3D over time: The body surface is recorded spatially and evaluated as a temporal sequence. In this way, posture, movement sequences and their stability can be assessed - both when standing and when walking on the treadmill.

• 3D: spatial coordinates of the back surface, pelvic position and foot load
• Time: Dynamic changes during breathing, step cycle or posture change
• Radiation-free: Optical measurement, no X-rays

DIERS measuring systems at a glance

Depending on the question and complaint, we combine different DIERS modules. The aim is a comprehensive but practical analysis – as much measurement as necessary, as little as possible.

• Back/posture analysis (raster stereography): Non-contact 4D recording of the back surface to derive spinal shape, pelvic tilt and symmetry.
• Gait analysis on the treadmill: 4D assessment of step frequency, step length, joint angles and movement patterns.
• Foot pressure measurement: distribution of load, rolling behavior, center of gravity; helpful for foot, knee and back problems.
• Leg axis and pelvis analysis: assessment of leg length differences, pelvic rotation and tilt under load.

Not every module makes sense in every case. We discuss in advance which measurement modules correspond to your question.

When does a DIERS 4D analysis make sense?

• Unspecific back pain, postural asymmetries, recurring tension
• Scoliosis screening and follow-up (especially in young people, radiation-free)
• Hip, knee and foot problems with suspected axis or strain problems
• Running and sports pain (e.g. medial knee pain, Achilles tendon problems, shin splints)
• Clarification after surgery or during the course of rehabilitation (e.g. to objectively document therapy effects)
• Prevention: Ergonomic issues, return-to-activity decisions

Note: If there are warning signs such as paralysis, sensory disturbances, severe pain at rest, fever or unexplained weight loss, medical examination and, if necessary, imaging has priority.

Which metrics are recorded?

• Spinal parameters: kyphosis and lordosis angles, sagittal profile, rotation cues from the surface
• Symmetry: shoulder tilt, scapular prominence, trunk tilt, vertical deviation
• Pelvis and leg axes: pelvic tilt/rotation, functional leg length difference (estimate), knee axis
• Gait parameters: step length, width, cadence, stance/swing phase, joint angle progression
• Foot pressure: pressure peaks, center of gravity, pronation/supination, points of loading

Important: The spine values ​​derived from the back surface are indirect parameters. X-ray diagnostics remain the standard for the initial diagnosis of structural changes (e.g. precise Cobb angle determination).

Process in our practice in Hamburg

1. Preliminary discussion: Clarification of your complaints, goals of the measurement and selection of modules.
2. Preparation: Barefoot, light sports clothing; Remove jewelry/scarves. No special preparation required.
3. Stand analysis: 4D back measurement in a relaxed stand and with slight changes in posture.
4. Gait analysis: treadmill measurement at a comfortable speed; optionally with foot pressure measurement.
5. Evaluation: Immediate visual representation; Explanation of the findings in language that the patient can understand.
6. Documentation: You will receive a summary of the results; with consent storage for history.

Duration: Typically 20-40 minutes depending on the question. The measurement is painless and contactless.

How does 4D analysis support conservative therapy?

• Targeted physiotherapy: deriving individual exercise and stabilization programs based on objective deficits.
• Posture training and ergonomics: Concrete information on everyday and workplace adjustments.
• Insoles and shoe care: Foot pressure data promotes accurate, conservative care.
• Training control: build-up of load in sport, return criteria after injuries.
• Follow-up: Measurable documentation of therapy effects without radiation exposure.

Regenerative procedures (e.g. shock wave, neuromodulative approaches) are only considered - if at all - after conservative measures have been exhausted and there is a clear indication.

Limitations and when additional imaging makes sense

• Structural diagnoses: Herniated discs, spinal canal stenosis or recent fractures are not detected by 4D surface measurement; Clinical examination and, if necessary, MRI/CT or X-ray are necessary here.
• Initial diagnosis of scoliosis: Raster stereography is suitable for screening and follow-up, but does not replace the initial radiological angle determination.
• Measurement conditions: Very loose skin/soft tissue situation, heavy sweating, dark/reflective clothing or hair covering can reduce the quality.
• Treadmill vs. free running: Walking on the treadmill is not the same as free walking; Findings are classified accordingly.

Evidence in brief

In studies, raster stereographic methods show good reproducibility and a relevant correlation to X-ray-based parameters of the shape of the spine, especially for follow-up checks. When planning therapy for non-specific back problems, objective documentation supports targeted conservative treatment. Instrumented gait analyzes provide valid temporo-spatial parameters and pressure distributions; The direct evidence of better long-term outcomes through the measurement itself is proven to varying degrees depending on the indication. We discuss benefits and limitations transparently.

Safety, freedom from radiation and suitability

• Radiation-free and non-contact: optical measurement of the surface.
• Suitable for children and pregnant women: Usually problem-free as there is no ionizing radiation.
• No pain: The measurement is non-invasive; If there is acute pain, we adjust the load.
• Contraindications: No classic ones; If there is a strong tendency to dizziness or an acute attack, the gait analysis may not be necessary.

Data protection and documentation

Your measurement data will be stored in accordance with applicable data protection regulations and used exclusively for medical treatment. It will not be passed on without your express consent. If you wish, we can provide you with the results digitally.

Who is 4D analysis particularly helpful for?

• Adolescents with suspected scoliosis or poor posture
• Office and skilled trades with significant stress
• Runners with recurring complaints
• Patients with knee/hip arthrosis to optimize their load
• Rehabilitation after operations or injuries for objective follow-up

English summary: DIERS 4D posture and gait analysis

DIERS 4D systems provide radiation-free, contactless measurements of posture, spine alignment and gait over time. We use this tool to analyze back, hip, knee and foot problems and to plan conservative treatments. Typical indications include non-specific back pain, scoliosis screening and follow-up, and running-related injuries.

• What is measured: spinal curvature estimates, pelvic tilt, symmetry, step length and cadence, plantar pressure.
• What to expect: 20–40 minutes, barefoot and in sportswear; stand and treadmill assessments; instant feedback.
• Limits: does not replace X-ray/MRI when structural pathology is suspected. It is a diagnostic aid, not a therapy.

Location: Dorotheenstraße 48, 22301 Hamburg. Appointments via Doctolib or email. We provide transparent information about benefits and limitations—no promises of cure.

Location Hamburg-Winterhude and date

Our practice is located at Dorotheenstraße 48, 22301 Hamburg (Winterhude). The 4D analysis is an integrated part of evidence-based, primarily conservative orthopedics. We decide together whether and which measurements make sense - always without promises of cure and with realistic expectations.

Further topics and videos

You can find more in-depth content on conservative and complementary procedures in our guide articles and videos. They help to translate findings from 4D analysis into everyday measures - from posture training to shock wave therapy options to neuromodulative approaches when conservative strategies have been exhausted.

The 5 tips at a glance

1. 3D: spatial coordinates of the back surface, pelvic position and foot load
2. Time: Dynamic changes during breathing, step cycle or posture change
3. Radiation-free: Optical measurement, no X-rays
4. Back/posture analysis (raster stereography): Non-contact 4D recording of the back surface to derive spinal shape, pelvic tilt and symmetry.
5. Gait analysis on the treadmill: 4D assessment of step frequency, step length, joint angles and movement patterns.

Information does not replace an individual examination. If there are any warning signs, please seek medical advice.