Cone of Economy with the Chain of Balance―Historical Perspective and Proof of Concept

A bipedal erect posture with a horizontal gaze is a distinctly human characteristic. The standing mechanism was described by Jean Felix Dubousset in the early 1970s as the “cone of economy,” in which the axial skeleton is aligned in balance with the feet, lower limbs, and pelvis (pelvic vertebra) to the spinal segments, ending with the cranium (cephalic vertebra). All the components act in concert, allowing for adaptive motion in all directions on the horizontal plane. In a normal subject, the body maintains balance within a small “cone” using minimal muscle activity, and in a subject with pathologic lesions of the locomotor system, maintaining a standing posture requires a larger “cone” and greater muscle activity. Evidence from recent studies using the EOS imaging system, force plate measurements, surface electromyography, and full-body reflective markers with surface electromyography have gradually consolidated the “cone of economy” concept, a fundamental hypothetical theory of human locomotion.