Integrating biofeedback technologies into postural education: improving back posture, health literacy, and sustainable health habits

Low back pain (LBP) is a prevalent condition across all ages, and inadequate back posture is a key contributing factor. Educational settings offer an opportunity to promote postural awareness as a preventive measure. Biofeedback tools, such as the EduBack system, which uses Inertial Measurement Units (IMUs) to monitor lumbar curvature, have shown potential for enhancing body awareness and supporting posture correction. However, their impact within school-based postural education remains underexplored. This study evaluated the immediate effects of the EduBack biofeedback system on postural awareness and back posture habits among secondary school students. An experimental pre-post design was implemented with 47 students in their fourth year of secondary education, randomly assigned to an experimental group using the biofeedback tool or a control group. Across eight sessions, several postural parameters were assessed during sitting, standing, and functional lifting tasks. The experimental group showed significant improvements in most measured postural variables. Lumbar lordosis in sitting increased from –5.9° to –10.1° ( \\({\\eta }_{p}^{2}\\) = 0.18), maximum active pelvic tilt range of motion in standing improved from 20.4° to 30.7° ( \\({\\eta }_{p}^{2}\\) = 0.63), and excessive lumbar flexion-extension during the rising-from-a-chair task decreased from 82.7% to 41.1% ( \\({\\eta }_{p}^{2}\\) = 0.27). Significant Group × Time interactions ( p < 0.05) confirmed that the biofeedback tool produced greater improvements than the control group. These findings indicate that the EduBack biofeedback system enhances immediate postural awareness and supports healthier back posture behaviours in adolescents. The results highlight the potential of integrating biofeedback technologies into school-based postural education programmes and underscore the need for further research examining long-term effects and broader implementation.