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National Posture Institute (NPI) Survey Report
2016 State of the Industry Survey:  Posture, Health, and Fitness Report

2016 State of the Industry Survey: Posture, Health, and Fitness Report


The National Posture Institute (NPI) believes that fitness and allied-health/medical professionals should be concerned with proper posture, exercise performance, injury prevention, and education surrounding proper body alignment and exercise. The NPI created its yearly State of the Industry Survey to determine whether professionals were prepared and currently incorporate posture into their practice. We are proud to present this year’s survey; NPI’s 2016 State of the Industry Survey will also examine the current state of the industry and explore upcoming trends.


NPI surveyed personal trainers, physical therapists, physiotherapists, group exercise instructors, athletic/sports performance specialists, P.E. teachers, chiropractors, and other allied-health, medical, and fitness based professionals for its study. The study found the majority of the respondents work as personal trainers/exercise professionals in settings such as health clubs/fitness facilities, medically-based fitness facilities, personal training studios, at home, senior/older adult facilities, corporate offices/fitness centers, and college/universities recreation centers. The other respondents were comprised of physical therapists, chiropractors, massage therapists, athletic trainers, and other allied health/medical professional who work in similar settings to their counterparts, but also work in hospitals, community based facilities (YMCA/YWCA, JCC), school/university settings, and sports performance facilities.


The respondents indicated that they work with clients from varying age groups and backgrounds, from young children (26%) to (80+) older adults (37%). The survey results show that professionals predominantly work with clients/patients between the ages of 30 to 69 who are office workers, stay at home persons, corporate executives, students, academic/educators, children/adolescents, athletes, manual labor workers (custodial staff, plumbers, mechanics etc.), retirees, musicians, military veterans, and health/medical professionals.


Based on the survey, 60% of professionals generally conduct assessments on their clients; when asked about conducting posture assessments, 65% of respondents said “Yes”. Other forms of assessments include body composition, cardiovascular, sit & reach, balance/agility, muscular strength, and endurance assessments. Only a few professionals indicated that they performed goniometer (flexibility testing), functional movements, Biodex, Ergonomics, orthopedic, biomechanic, and 1 rep maximum assessments.


When asked about corrective exercise programs and corrective exercises for posture related injuries, professionals “sometimes” (48%) administer corrective exercise programs and “sometimes” (46%) perform corrective exercises for posture related injuries and/or deviations. Additionally, clients/patients “sometimes” inquire about posture and body alignment and 74% of professionals actively discussed the subject with them.


According to the survey, 62% of respondents received training on how to conduct and create programs that focus on posture and body alignment while 38% received no training. Respondents indicated that they learned from the National Posture Institute (NPI), personal training organizations, university programs, physical therapy schools, national training associations, yoga schools, and a few other programs. The National Posture Institute was listed as the major source of posture training.


Regarding the most prevalent postural deviations, professionals indicated that “Forward Head Posture” (FHP) was the most prevalent postural deviation they encountered. “Rounded shoulders,” “muscular imbalances,” “anterior pelvic tilt,” “hump back/kyphosis,” “lower back pain,” and “knee pain” were also deviations professionals had encountered. A few respondents indicated that all of the above were ongoing in their clients/patients.


Professionals indicated that the most common training programs were free weight training, commercial strength equipment, body weight training, Pilates, Yoga, HIIT training, running, and suspension training. They preferred exercise tubing, stability balls, body weight exercises, free weight/dumbbells, and foam rollers and indicated the most popular exercises they prescribed when training were squats, lunges, hip abduction/adduction, bicep and triceps curls, rows, chest press on a bench, push-up variations, frontal/lateral raises, trunk rotation, and planks.


When asked about injury sites, the most prevalent were the “knees,” “lower back,” and “rotator cuffs,” and when asked if injuries were more common with particular training programs, 67% said “Yes”. Those respondents indicated that if you performed running, power lifting, HIIT training, heavy lifting, Olympic style lifting, and plyometrics you were more prone to injury.




The results show that fitness, health, and allied-health/medical professionals are aware of posture, body alignment, and exercise selection. They conduct assessments and actively discuss and develop posture programs for their clients/patients. Professionals are working with clients/patients that range from ages 5 (five) to 80+ years old, but are predominantly working with those that range from 30 to 69 years old. Participants also indicated that they worked with a wide range of  clients/patients like office workers and stay at home persons to corporate executives, students, retirees, and health/medical professionals to name a few.


The study revealed that professionals predominantly use free weight training, commercial strength equipment, body weight training, Pilates, Yoga, HIIT training, running, and suspension training when working with clients/patients. It is also important to note that “Forward Head Posture” was the most prevalent postural deviation encountered by professionals, while the most common injury sites were the “knees,” “lower back,” and “rotator cuffs.” Professionals indicated that if you performed running, power lifting, HIIT training, heavy lifting, Olympic style lifting, and plyometrics you were more prone to injury.


Fitness, health and medical professionals must continue to pay attention to the exercise programs and modalities their clients are engaging. They must resist the urge to latch onto fads and popular exercise programs and focus on the overall health and posture of their clients. The results of NPI’s 2016 State of the Industry Survey shows that professionals are engaging their clients/patients with programs and assessments that could be negatively affecting their posture and body alignment. Professionals designing these programs must pay attention to their client’s/patient’s place of work, activities of daily living (ADLs), exercise programs, postural deviations and the possibility of developing injuries when administering assessments and exercise programming.


Professionals must lead the charge toward better health in 2016; good posture and body alignment must continue to play a part in this movement. They must also continue to take an active role in becoming strong role models that can educate the public about proper posture, body alignment, and sound exercise principles.  


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