Quantify the Invisible : Notes Toward a Future of Posture

‘ Quantify the Invisible’: Notes Toward a Future of Posture

ABSTRACT

This paper contributes to the literature on the phenomenon termed mHealth through a critical examination of wearable posture tracking technologies. The paper specifically reports on a qualitative document analysis of promotional materials for three devices of this kind, carried out with the aim of assessing their mode of operation, the logic underpinning their development, and their purported benefits for users. Findings initially highlight how Lumo Lift and Lumo Back, made by the company Lumo Bodytech Inc., and Prana, made by Prana Tech LLC, are designed to enable haptic surveillance and discipline whereby the body is monitored and ‘reprimanded’ through the touch. These forms of interactive posture training are underpinned by scientific insight from fields such as biomechanics and by data science on consumer posture habits. In turn, the benefits for those engaging with commercial posture tracking devices are said to include, unsurprisingly, better posture, but also a less tangible form of ‘optimised’ living. With these findings in mind, it is argued that the arrival of interactive posture technologies has two main implications. In one sense, whereas good posture has historically been imagined as a dividing line between ‘civilized’ humans and

‘uncivilized’ others, devices such as Lumo Lift make posture into a matter of posthuman optimisation: humans and non-humans are enfolded in the pursuit self-betterment. In another sense, posture technologies are important in emboldening the wider mHealth phenomenon, privileging as they do the idea that commercial technologies are now allies and not foes when it comes to improving health. INTRODUCTION

If ‘stand up straight’ echoes for many as a memory of household and classroom discipline, this paper is about the possibility that such language may in the future be irrelevant – or at least redundant. Wearable, sensor-based posture technologies have emerged in recent years to fulfill the role of parents and schoolteachers in promoting good bodily comportment. In doing so, they have effectively de-institutionalised posture monitoring and training by uprooting such activity from its confined settings of old. In this regard, posture technologies contribute to the recent arrival of

‘mHealth’, the phenomenon whereby mobile technologies are used for unearthing and assessing a vast array of (generally quantified) insights into personal health and fitness. The paper thus contributes to the critical literature on the mHealth phenomenon, and specifically takes up Rock,

Degeling, and Blue’s (2014) call for scholarship that interrogates the growing role of non-humans in public health initiatives.

The analysis presented herein involves an examination of three posture technologies: Lumo

Lift and Lumo Back, from the company Lumo Bodytech Inc., and Prana, from Prana Tech LLC.

Each of these devices uses sensor technology as means for monitoring the body through the touch, in turn delivering actionable insight into bodily comportment in the form of numerical data. The findings of this analysis are used in support of a two-fold argument: first, that posture technologies render posture a matter of posthuman optimisation, as opposed to an indicator of humanness and civilization, as posture has historically been; and second, that interactive posture devices reinforce the merits of the wider mHealth movement, positioning consumer technologies as allies and not foes in the quest for better health.

The name of this paper originates from Gilman’s (2014) historical excursus, entitled “‘Stand

Up Straight’: Notes Toward a History of Posture.” Before outlining the methods guiding this work and the key findings that arose from it, the following section situates posture technologies in their historical and contemporary contexts.

2 LITERATURE REVIEW

Historicising Posture

Posture is far from a fixed concept, both in that posture is marked by fluidity (e.g., in moving between static and active positions – see Gilman, 2014, p. 58) and in that our understanding of posture has existed in and through multiple entangled discourses over time. In retrospect, posture has been culturally significant most of all as a boundary line dividing humans from their primitive ancestors – and at times from one another.

For Gilman (2014), the idealised, rigid position called forth in countless exhortations to ‘stand up straight’ originated in the late sixteenth century with military drill formations. Both in practice and in its representation – drill books were originally called posture books – proper military posture centered on a straight and rigid ‘plumb line’, drawn from head to toe through the body. This was not a ‘natural’ position, but one that needed to be learned and rehearsed until soldiers were standing ‘at attention’ uniformly. Moreover, as Gilman notes, the plumb line itself evolved over time. Across these changes, the important point is that ‘proper’ posture took on meaning that transcended the body. Posture became a sign of normal and healthy personhood, the implication being that poor posture signaled the opposite.

The equation of good health and good posture helped transport the plumb line beyond the military context. As Gilman (2014) writes, “the person who trains the body moves in the course of the 18th century from the military into civilian life” (p. 60). On the one hand, posture became a matter of etiquette, with conduct books emerging in the early nineteenth century with the aim of defining the middle class – and implicitly defining what the middle was not – “through the semiotics of body discipline” (Yosifon and Stearns, 1998, p. 1059). On the other hand, it was not long before posture became a medical issue, and thus an object of concern for an array of medical and quasi-medical authorities. Outside medicine, in both science and philosophy, upright posture had long been deemed central to humanness. Darwin saw bipedalism as key to survival; Engels supposed that standing upright was the decisive step in becoming human (see Gilman, 2014, p. 61-

66). What medicine did was reinforce the merits of good posture whilst at the same time pathologising its antithesis. At its worst, the medicalising of posture spiraled together with the eugenics movement and/or with notions of primitiveness based on class and race. In 1922, for example, it was said in The Lancet that ‘primitive races’ had a carriage and gait not far superior to that of apes, and that, as a general rule, the better the carriage the more civilised the subject (Knox

Thompson, 1922; also see Gilman, 2014, p. 68).

A ‘Vigorous Counterattack’: Posture in the Age of Consumerism

Eugenicists’ concerns notwithstanding, as the 1900s arrived, the will to power that laid in urging others to stand up straight was situated in a context that increasingly allowed people to do the opposite. Focusing on America, Yosifon and Stearns (1998) see the intensified focus on consumerism in the twentieth century as an important development in this regard. Clothing at this time became looser and more permissive; furniture was made softer and more conducive to slouching. Such changes furthermore came replete with advertising imagery showing men and women in leisurely positions. Posture as a result was under threat. Hence the arrival at the turn of the twentieth century of a “vigorous counterattack” (Yosifon & Stearns, 1998, p. 1062) against slackening posture standards.

From a Foucauldian perspective, the emergent ‘posture movement’ was disciplinary in its inclination, first in its exertion of authority over and through the body, but also in its institutionalisation. School-based physical education (PE) was particularly important in creating and enforcing posture standards. PE in one sense was a site for observing faulty posture. In the early- to mid-1900s, for example, physical educator William Sheldon engaged in an ambitious somatotyping project – one aimed at both devising a bodily typology and correlating particular bodies with specific intellectual aptitudes. Sheldon, among others, was aided at this time by technical means for visualising posture (most notably photography) and was motivated to convert good or bad posture

4 into statistical terms (Vertinsky, 2002, p. 110). PE was also a site for teaching good posture at this time (Yosifon & Stearns, 1998, p. 1073), meaning bodily surveillance was partnered with instructional techniques on disciplining oneself.

Even so, the posture movement failed. If the first half of the 1900s brought a current of relaxation, consumer culture’s new iteration in the second half of the century was tantamount to a tidal wave: clothing was made looser still, furniture was designed explicitly for lounging, and the

TV-centric living room became a site for relaxation par excellence. In medicine, absolute posture standards were abandoned. “Tests were silly, because no two individuals had the same posture.

There was no proof anyway that bad posture harmed health” (Yosifon & Stearns, 1998, p. 1089).

For its part, physical education became more about exercise and athletics. Even parents’ manuals in the 1960s scaled back their rhetoric on the need for posture discipline (Yosifon & Stearns, 1998, p.

1086-1087).

mHealth and the Politics of Optimisation

From an historical perspective, posture has thus been regarded as an indicator of humanness. When practiced ‘properly’, it has been deemed a signifier of health and civilisation too. This section turns from the historical to the contemporary conditions in which posture technologies have emerged.

A first important trend in this regard is the de-institutionalising of health through consumer products. In theoretical terms, whilst disciplinary societies, in Foucault’s (1977) conception, to a great extent counted on physical enclosure in sites like schools and medical clinics in the enactment of surveillance and discipline, Foucault also recognised a tendency towards de-institutionalisation:

While, on the one hand, the disciplinary establishments increase, their mechanisms have a certain tendency to become ‘de-institutionalised’, to emerge from the closed fortress in which they once functioned and to circulate in a 'free' state; the massive, compact disciplines are broken down into flexible methods of control, which may be transferred and adapted (p. 211).

This is a theme picked up by Deleuze (1995) in his influential observations on ‘societies of control’.

For Deleuze, there is not just a trend towards de-institutionalisation, as Foucault avers. Enclosed environments such as prisons, hospitals, and schools are ‘in crisis’. The logics and practices once held within these sites now easily transcend their institutional walls – something owing in part to digital technologies. The point is not that discipline disappears as confinement becomes less relevant. Rather, the Deleuzian subject is still exhorted towards self-care, but is “embedded in a set of relationships that are increasingly fluid and in flux” (Elmer, 2012, p. 27).

Turning to health specifically, Nettleton (2004) contends that medicine, in a time of online communication, has indeed ‘e-scaped’ in a dual sense. On the hand, the medical body has escaped formal medical sites when it comes to learning about and treating the self; on the other, “it is also e- scaped in the sense that it is ‘viewable’ through the electronic infoscape that is the internet” (p. 670, emphasis added). Mobile technologies have in more recent years helped exacerbate this trend, giving rise to mHealth initiatives that leverage the sensing capacities of new technologies to deliver intimate and purportedly objective insights into consumer health. The body in such initiatives becomes knowable in new ways, with a vast range of personalised measures – blood glucose, body temperature, breathing rate, and cardiac output, among myriad others – accessible any time and from virtually anywhere (see French & Smith, 2013; Lupton, 2012, 2013, 2014; Millington, 2014;

Rich & Miah, 2014). Health surveillance technologies in this sense contribute to a general trend whereby sensors, whether worn on the body or located in the wider environment, automatically (or passively) register data with little effort required from people themselves. This is the rise of the

‘sensor society’ (Andrejevic & Burdon, 2015).

A second, related matter pertains to mHealth’s ideological underpinnings. As Nettleton (2004) notes, the implications of medicine’s e-scaping are political as much as they are spatial: consumer- patients are potentially empowered in their ability to access, assess, and reappropriate the knowledge that was once consolidated in the hands of medical authorities. Mobile health in this regard is about optimisation as much if not more so than treatment. That is to say, whilst curative efforts persist, contemporary health practices are also directed towards ‘susceptibility’ and

‘enhancement’: the former involving treatment of the asymptomatic but vulnerable; the latter

6 comprising attempts to improve virtually all human capacities – “strength, endurance, longevity, attention, intelligence” (Rose, 2007, p. 82) – through medical/marketplace interventions. The irony here is that the logic of optimisation, in ostensibly making humans ‘better’, at the same time unsettles historical conceptions of humanness. The ‘end of the human’ looms large (Herbrechter,

2013), though not in the sense that the body disappears. Rather, the dividing line between people and ‘things’ – for some, a fictional divide to begin with (e.g., see Latour, 1999) – recedes through increasingly obvious forms of human/non-human integration (also see Miah, 2007; Rock, Degeling

& Blue, 2014).

All told, new posture technologies have arrived into historical and contemporary contexts marked by complexity. Even so, mHealth remains an underexplored trend, with Lupton (2014) noting the need for investigation into the social, political, and cultural dimensions of new health technologies in particular. It is with such calls for further research in mind that the current analysis was taken up.

SAMPLE AND METHOD

The posture device Lumo Lift was chosen first for this analysis as it has to date earned considerable media attention and consumer support. The verdict rendered by The Guardian upon reviewing this device, for example, was that “Lumo Lift delivers” (Parkinson, 2014). This same product was released after a highly successful crowdfunding campaign (see Lumo Bodytech Inc., 2014l). Lumo

Lift is focused on the upper back region. It comes in two parts: the Lift sensor, measuring 1.75 inches across and worn under the clothes near the collarbone, and an externally-facing magnetic clasp that holds the sensor in place. Lumo Back and Prana were added to the study sample to allow further insight into and comparison of how posture technologies are made to operate – though it is worth noting that these devices have earned media attention of their own (e.g., see Prana Tech LLC,

2014a). Lumo Back focuses on the lower back region and comes as a sensor measuring 3.9 inches wide, to be worn near the waist with an accompanying belt. For its part, the recently-launched Prana device is a disc-shaped sensor measuring 1.25 inches in diameter, to be hooked onto one’s waistband so as to allow tracking of both posture and breathing. None of these technologies appear to have a clear target audience. Marketing references to poor posture at the office and ‘Silicon

Valley Syndrome’ (see below) suggest an adult-aged target demographic, though Lumo Bodytech also offers a Lumo Lift Family 4-Pack, implying that young people might benefit from this product as well.

A qualitative document analysis of online promotional materials was used to assess the functionalities and purposes of these products, as presented to potential consumers. The online marketing documents made public by Lumo Bodytech and Prana Tech are both highly stylized and highly informative in describing their respective products. In promoting Lumo Lift, for example,

Lumo Bodytech offers videos of this product in use, written descriptions of its key features, a summary of ‘technical specs’, and a list of frequently asked questions with accompanying responses. Lumo Back and Prana are marketed in similar fashion. Lumo Bodytech also offers a

‘Blog’ section pertaining to its two posture technologies, replete with nearly 100 entries as of March

2015. Prana forgoes a blog for webpages labeled ‘Science’, ‘Press’, and ‘Company’ – all aimed at further explaining Prana’s mode of operation and its merits as a health promotion tool.

As a research method, qualitative document analysis has been deemed appropriate for

‘discovery and description’ (Altheide et al., 2008, p. 128) – necessary in this case given the shortage of research to date on mHealth and, even more so, posture technologies. The promotional sites in question were treated as texts and examined across multiple steps. A first reading was aimed at developing familiarity with the three technologies under study. Subsequent readings involved assessing and coding promotional materials with three questions in mind: How are Lumo Lift,

Lumo Back, and Prana designed to operate? What logics underpin the development of these technologies? And what benefits purportedly arise from their use?

8 FINDINGS

1) ‘Your Personal Coach’: Posture and Interactivity

What stands out first with Lumo Lift, Lumo Back, and Prana is their emphasis on interactivity – something that first involves the process of generating data. Posture surveillance has long been ocularcentric: photographs, shadowgraphs, and, of course, the naked eye, have served as means for visualising the body and its sound or faulty construction. New posture technologies trade optic for haptic surveillance. Sensors replace the eye with the touch en route to amassing extensive data on where posture goes ‘right’ and ‘wrong’.

Take Lumo Lift. When clasped near the collarbone, a process of constant data collection begins, and not just with respect to posture. Steps, distance travelled, and calorie expenditure can be tracked as well. Progress in each of these measures is then made visible:

The main screen of the Lumo Lift app offers a quick view of how you’ve been doing for the past hour including your posture hours, steps taken, distance traveled and calories burned. Tapping the orb [displayed on the screen] will give you hourly judgements such as ‘At Rest’, ‘Active,’ or ‘Super Active’. (Lumo Bodytech Inc., 2014a).

Surveillance here is effectively ‘passivised’, as users do not so much participate as they do generate: data is registered automatically as people move about their day (Andrejevic & Burdon,

2015). The upshot is that health surveillance is made constant and mobile, transcending institutional confines. A similar incitement towards mobile, haptic surveillance appears in marketing for Lift’s predecessor device, Lumo Back: “Track your entire day – wherever you go” (Lumo Bodytech Inc.,

2014b).1

Yet passive tracking is not the sole manifestation of interactivity, as users of posture technologies can be ‘called to attention’ as well. In one sense, Lumo Lift, Lumo Back, and Prana are all depicted as anthropomorphic posture experts, armed with the ability to rectify poor habits in real time. Lumo Lift’s ‘Posture Alert’ mode, for example, delivers vibrations when poor posture has set in for a pre-planned period of time. This same device’s tellingly named ‘Coaching’ mode is even more meddlesome, ‘buzzing’ the user as soon as slouching manifests. Prana is similarly inclined: Prana is your personal coach to breathe and sit better … In our active training, you select a pattern which best fits your health goals, and Prana actively guides your breath in a fun new way. In our passive tracking, Prana can send occasional push alert reminders to breathe or sit better. Prana monitors the effects of posture on breath, and distinguishes between chest and belly breathing for a more complete picture of how we breathe (Prana Tech LLC, 2014a).

Haptic surveillance thus yields haptic discipline: the user is not only observed through the touch, but can be ‘reprimanded’ in much the same way.

In another sense, and even with the ‘passivisation’ of data generation, posture technology users are still made active in that posture data is imagined as actionable. Representation is a key step in this regard: Lumo Lift, Lumo Back, and Prana all have accompanying apps that allow the visualization of sensor-generated data on mobile devices. As above, Lumo Lift turns its measures of the body into metrics such as posture hours, steps taken, and distanced travelled, and into

‘judgements’ such as ‘At Rest’, ‘Active,’ and ‘Super Active’. Prana’s ‘Clinical Mode’ “offers full data analytics for each breath, tracking 10 distinct stats plus posture across all phases of respiration”

(Prana Tech LLC, 2014b). In this sense, haptic surveillance is partnered with self-surveillance, with users encouraged to monitor ‘datafied’ versions of themselves on their tablet or smartphone. Indeed, the very slogan greeting visitors to Lumo Back’s marketing page – ‘Quantify the Invisible’ (Lumo

Bodytech Inc., 2014b) – suggests as much. The ideal outcome in this regard is presumably that posture ‘trainees’ will pay greater attention to maintaining proper posture in the flesh. Monitoring data, in other words, is an avenue towards improved behaviour.

2) Posture Science, Data Scientists

With Lumo Lift, Lumo Back, and Prana, posture interventionism is therefore made both interactive and portable. “Via m-health technologies,” writes Lupton (2012), “the health promoter is able to insert her- or himself even more insistently into the private world of others, accessing them in any location in which their mobile device accompanies them” (p. 241). Of course, automated posture coaching is not fully disconnected from human expertise. Apart from training their users, Lumo

Bodytech and Prana Tech aim to assert the medical importance of standing up straight.

10 Prana, for example, is in one sense inspired by breathing techniques from the practice of yoga;

“The basic idea is that good posture facilitates good breathing” (Prana Tech LLC, 2014b). Yet marketing for Prana’s disc-shaped sensor device also makes clear that these longstanding traditions are now supported by science as well. With reference to research from the Journal of Physiology and Pathophysiology, for example, slumped sitting, compared to an upright alternative, is said to be detrimental to “spirometric measurements of forced vital capacity, forced expiratory volume, and peak expiratory flow” (Prana Tech LLC, 2014b). More to the point, traditional and scientific insights were brought together with technological ingenuity in the process of devising Prana’s commercial tracking tool. This much is said in a press release from the company’s co-founder and

We wanted to offer a truer more holistic picture of breathing quality, which necessitated factoring in posture, but also providing the capability to distinguish between chest and belly breathing, as most traditions of good breathing (and recent science) emphasize the value of breathing from the abdomen. Our team has worked over two years in developing a unique set of algorithms, with key breakthroughs for disentangling breath from posture signals, as well as chest from belly breathing, all within one small wearable worn near the waist (Prana Tech LLC, 2014c).

Lumo products likewise come replete with scientific backing. In devising Lumo Back, for example, the Lumo Bodytech company, “worked with spine physicians and physical therapists to develop a biomechanical model of posture for the lower back” (Lumo Bodytech Inc., 2014c).

Moreover, what Lumo’s online blog also reveals is the company’s interest in amassing, in the style of the Big Data movement writ large, consumer data in the name of product improvement. In June

2013, for example, a blog entry from Lumo’s Data Scientist noted that 15,000,000 pieces of data had been collected from ‘LUMObackers’ since the year began (Lumo Bodytech Inc., 2014d). In another post from the next month, more detail was given on how such data can be put to use:

One of the ideas that we’ve been working on is an algorithm that trains LUMOback to be more vigilant about monitoring your posture during certain points of the day, while cutting you a bit more slack at other points. As a starting point for this project, I’ve been analyzing how people’s posture varies throughout the course of the day and identifying interesting patterns (Lumo Bodytech Inc., 2014e).

In keeping with the wider arrival of the Big Data movement, data procurement of this kind can potentially go towards other ends – for example, Lumo’s Privacy Policy notes that non-personal aggregated information can be shared with advertisers, among others (see Lumo Bodytech Inc.,

2014f). The point for these purposes pertains to the integration of multiple disciplines – medical, data, and computer sciences, for example – with the aim of both devising and improving consumer health technologies. In Lumo’s case, data generation goes not only towards self-surveillance on a personal level, but also the assessment of Lumo consumers on a wider scale. Confined to observation, William Sheldon could at best assess thousands of posture photographs. With posture fully ‘datafied’, Lumo Bodytech has millions of data points at their disposal.

3) ‘Be Your Best Self’: Posture as Optimisation

The question remains as to the (imagined) outcomes of these diligent forms of posture monitoring.

Underpinned by scientific expertise, it is unsurprising that posture technologies are in turn linked to concrete health benefits. Prana lists both ‘consumer uses’ and ‘medical uses’ on its ‘Science’ webpage (Prana Tech LLC, 2014b). The former include benefits such as ‘learning how to breathe better’, ‘maintaining good posture’, and ‘relaxation and stress reduction’. The latter include references to chronic pain, depression, and hypertension, among other conditions, along with links to studies corroborating the merits of particular breathing patterns and techniques. Lumo’s blog brings posture into a post-industrial context through entries on ‘Silicon Valley Syndrome’ – the manifestation of problems such as eye strain and back pain from prolonged technology use and desk sitting (see Lumo Bodytech Inc., 2014g). The implication of course is that posture training has remedial benefits in the face of this nascent ‘syndrome’.

Yet beyond these specific health benefits, marketing for the technologies in question is also marked by the language of optimisation. Important first in this regard is the tone of promotional materials in espousing the merits of posture training. For Rose (2007), while experts – or, in his terms, ‘pastors of the soma’ – once wielded uncompromising authority, “new pastors of the soma espouse the ethical principles of informed consent, autonomy, voluntary action, and choice and non-

12 directiveness” (p. 74). Good posture is now sold as opposed to enforced. As one example, readers of

Lumo’s blog are told that, “On occasion, it’s perfectly acceptable to kick back and relax, or be in a less than ideal position for your spine – there is no need to spend all day as if you’ve swallowed a ruler” (Lumo Bodytech Inc., 2014h). This is a far from a ‘vigorous counterattack’ against consumer culture. It effectively stands as an acknowledgement that posture is a fluid and context-dependent construct.

With good posture framed as a matter of choice, optimisation subsequently emerges through the customisability of the technologies under study. We have seen a principle of customisation at work already in the way Lumo Lift, Lumo Back, and Prana are designed to deliver idiosyncratic measures of the self. Says Lumo Bodytech: “Everybody is different and we get that – realistic and attainable daily goals are super important for success in the long-term” (Lumo Bodytech Inc.,

2014i). Moreover, and again in the case of Lumo Bodytech, even proper posture itself is seen as customisable in nature. After affixing the Lift device near the collarbone, users are asked to stand up straight and push on the Lift clasp to calibrate their sensor to their own good posture. The spirit of the plumb line lives on in that Lumo still advocates upright positioning in general. Yet whereas

Yosifon and Stearns (1998) note that posture tests were deemed ‘silly’ in the postwar years

“because no two individuals had the same posture” (p. 1089), Lumo Lift uses this very same fact as the basis for its customised posture surveillance and training.2

Posture as a result is highly personalised, making way for a final step: the ‘use’ of posture in achieving personal empowerment. Posture technologies, in guarding against problems such as back pain, in one sense trade in the realm of ‘susceptibility’ – a notion that is key to Rose’s description of the logic and practice of optimisation. But the notion of ‘enhancement’ – the unceasing pursuit of self-betterment – is prominent in promotional documents too. What would you do if you were not afraid? This is the question posed in a promotional video for the Lift product. The small changes in life, the video goes on to say, are what empower people towards bigger and better things (Lumo Bodytech Inc., 2014j). Indeed, even Lumo Bodytech’s company description bespeaks a mantra of this kind: “We strive to optimize human potential and empower you to be your best self” (Lumo

Bodytech Inc., 2014k). For its part, Prana is inclined to stress the tangible health benefits attainable through sound breathing and postural habits. Even still, the tagline “Breathe better, sit better, live better” (Prana Tech LLC, 2014a) extrapolates from particular behaviours to an optimised, less tangible, state of living.

Human bodies, say Clarke et al. (2010) in their discussion of biomedicalisation, “are no longer expected to adhere to a single universal norm” (p. 79). Rather, bodies are customised with the aim of optimisation in mind. Posture was once a universalising concept, perceived as transposable across any given population. With posture technologies, you can be at your best self, irrespective of the comportment of others.

DISCUSSION

A Posthumanist Future?

Underpinned by scientific expertise, posture technologies allow for an interactive form of health provision, one that pairs haptic surveillance and discipline with the representation of user data – all towards the achievement of health benefits and, more broadly, an ‘optimised’ way of living. Posture is effectively ‘e-scaped’, both in the translation of posture science and training mechanisms into sensor technologies and in the transcendence of posture’s disciplinary confines of old.

The significance of this analysis first pertains to posture’s standing as a contemporary health issue. Of course, there is no guarantee of success for Lumo Lift, Lumo Back, or Prana – though

Lumo Bodytech’s successful crowdfunding campaign for its Lift device, earning over $1 million, is perhaps a harbinger of posture tracking’s economic viability (Lumo Bodytech Inc., 2014l). Whether they thrive or not, at the very least these technologies are contributing to a sustained posture discourse in postindustrial times. Posture certainly waned as an object of concern with the failure of the posture movement in the mid-1900s. It did not disappear, however, and remains alive today in

14 ergonomic chairs, desks, and similar devices, in scientific attention to posture and gait, and now in the provision of personalised, interactive, commercial posture technologies as well.

More to the point, posture technologies suggest that our understanding of posture itself is changing. Posture was in the past deemed central to humanness – a point that was ripe for cooptation by eugenicists. The claim forwarded here is that posture technologies bring posture from the realm of humanism to that of posthumanism. The latter term is not meant to imply transcendence: the body remains present in the flesh, and (neo)liberal values such as self- improvement are certainly still important. Rather, the term posthumanism suggests integration. On the one hand, bodies literally come together with technologies, and in turn take on technical descriptions whence broken down into quantified measures such as ‘posture hours’. On the other hand, posture technologies themselves are given human qualities. Indeed, Lumo Lift, Lumo Back, and Prana are all imagined as active agents – as coaches and trainers – apt to respond dynamically to human movement. Posture thus becomes a site for the collapsing together of people and ‘things’ in a more obvious and intense way than in the past. This is less a matter of civilised humanness and more one of posthuman optimisation.

Yet the implications here also go beyond the matter of posture itself. They pertain too to posture’s role in wider conceptions of healthy living. This is a time of mHealth, with mobile health provision positioned in general as an avenue towards personal empowerment and improved health outcomes. The claim forwarded in this regard is that posture technologies lend credence to this general supposition. One particular entry in the Lumo blog is telling in this regard. Under the headline ‘Is Your Tablet Hurting Your Health?’, the post goes on to outline the detrimental effects of tablet and phone use on posture, citing research along the way (Lumo Bodytech Inc., 2014m).

The irony of course is that posture technologies are themselves made to work with tablets and smartphones, thus directing consumer attention towards these otherwise ‘unhealthy’ devices.

Communication technologies in this sense become solutions to the problems they are allegedly causing or contributing to in the first place.

Elsewhere, Prana notes that “valuable health data hides within our breath pattern” (Prana

Tech LLC, 2014b), the implication being that a device such Prana makes this ‘dark data’ accessible.

In these ways – in ‘bending’ technologies towards positive health outcomes, and in delivering quantitative insights otherwise hidden to consumers – posture technologies reinforce the purported benefits of mHealth writ large. The ‘current’ of consumer culture is not to be swam against; if harnessed properly it flows towards a healthier state of being.

CONCLUSION

This inquiry into posture technologies was motivated by Rock, Degeling, and Blue’s (2014) call for greater consideration of how non-humans are incorporated into public health initiatives. In the end, the analysis presented herein itself raises further questions on both posture tracking in particular and the mHealth movement in general. The ‘end of the human’ may indeed have arrived – though not in the sense that humanness disappears. Even so, and even though posture training is now institutionally unbound, such activity is still likely to be taken up in idiosyncratic and context- dependent ways. How do people engage with these technologies? How does posture tracking sit alongside other forms of self-quantification? More broadly, one might ask, what other ‘ends’, if any, are spelled out alongside the ‘end of the human’? Are we ‘post’ expertise, or at least moving in that direction? Again, the question is not meant to imply that human experts disappear, but rather that their expertise is increasingly delegated to sophisticated non-human devices. Do mHealth technologies signal the ‘end’ of healthism as conceived to date? Healthism, after all, trades on personal responsibility on the part of the rational and entrepreneurial subject (Crawford, 2006). In one sense, mHealth devices can be perceived as simply the latest ‘tools’ for learning about and improving the self; technologies are not new to the healthism imperative (see Lupton, 2013). But with posture technologies, responsibility is also delegated to the non-human ‘trainer’, at least in part. Personal responsibility is unlikely to disappear from the realm of public health. But haptic

16 surveillance and discipline also enable shared responsibility in the tasks of standing up straight and, in general, self-optimisation.

For Rock, Degeling, and Blue (2014), “the development of public health since the nineteenth century can be interpreted as a humanist achievement” (p. 339). The arrival of posture technologies at the mHealth marketplace lends credence to the idea that, henceforth, public health achievements and challenges alike will be posthumanist in nature.

ACKNOWLEDGEMENTS

The author wishes to thank the anonymous reviewers of this article and the editors of Critical

Public Health for their very helpful comments during the review process.

REFERENCES

Altheide, D.L., Coyle, M., DeVriese, K., & Schneider, C. (2008). Emergent qualitative document

analysis. In S.N. Hesse-Biber & P. Leavy, Handbook of emergent methods (pp. 127-154).

New York: Guilford.

Andrejevic M. & Burdon, M. (2015). Defining the sensor society. Television & New Media, 16(1),

19-36.

Childress, J. (2015). Surveillance and public health data: The foundation and eyes of public health.

In R. Gaare Bernheim, J.F. Childress, A. Melnick & R.J. Bonnie (Eds.), Essentials of public

health ethics (pp. 97-118). Burlington, MA: Jones & Bartlett Learning.

Clarke, A.E., Shim, J.K., Mamo, L., Fosket, J.R. & Fishman, J.R. (2010). Biomedicalization.

Technoscientific transformations of health, illness, and U.S. biomedicine. In A.E. Clarke, L.

Mamo, J.R. Fosket, J.R. Fishman & J.K. Shim (Eds.), Biomedicalization: Technoscience,

health, and illness in the U.S. (pp. 47-87). Durham: Duke University Press.

Crawford, R. (2006). Health as a meaningful social practice. Health, 10(4), 401-420. Deleuze, G. (1995). Postscript on control societies. In G. Deleuze (Author), Negotiations, 1972-

1990 (pp. 177-182). New York: Columbia Press.

Elmer, G. (2012). Panopticon-discipline-control. In K. Ball, K. Haggerty & D. Lyon (Eds.),

Routledge handbook of surveillance studies (pp. 21-29). New York: Routledge.

Foucault, M. (1977). Discipline and punish: The birth of the prison. New York: Pantheon Books.

French, M. & Smith, G. (2013). ‘Health’ surveillance: New modes of monitoring bodies,

populations, and polities. Critical Public Health, 23(4), 383-392.

Gilman, S.L. (2014). ‘Stand up straight’: Notes toward a history of posture. Journal of Medical

Humanities, 35(1), 57-83.

Herbrechter, S. (2013). Posthumanism: A critical analysis. London: Bloomsbury Academic.

Knox Thompson, J. (1922). The erect posture. The Lancet, 199(5136), 251.

Latour, B. (1999). Pandora’s hope: Essays on the reality of science studies. Cambridge: Harvard

Press.

Lumo Bodytech Inc. (2014a). How To View Your Data in the Lumo Lift App. Retrieved 24 March

2015 from http://www.lumobodytech.com/2014/09/how-to-view-your-data-in-the-lumo-lift-

Lumo Bodytech Inc. (2014b). Lumo Back. Retrieved 25 March 2015 from

http://www.lumobodytech.com/lumoback/.

Lumo Bodytech Inc. (2014c). The Science of Lumo Back. Retrieved 24 March 2015 from

http://www.lumobodytech.com/2013/12/the-science-of-lumo-back/.

Lumo Bodytech Inc. (2014d). Enter Stage Left: The Data Scientist. Retrieved 24 March 2015 from

http://www.lumobodytech.com/2013/06/enter-stage-left-the-data-scientist/.

Lumo Bodytech Inc. (2014e). The Data Scientist: The Afternoon Slump, Part 1. Retrieved 24 March

2015 from http://www.lumobodytech.com/2013/07/the-afternoon-slump-part-1/.

Lumo Bodytech Inc. (2014f). Privacy Policy. Retrieved 24 March 2015 from

http://www.lumobodytech.com/privacy-policy/.

18 Lumo Bodytech Inc. (2014g). ‘Silicon Valley Syndrome’: Tech’s Toll On Our Bodies – Data

Report & Guide. Retrieved 24 March 2015 from

http://www.lumobodytech.com/2013/10/silicon-valley-syndrome/.

Lumo Bodytech Inc. (2014h). Welcome to Lumo Lift – 14 Tips to Get You Started. Retrieved 24

March 2015 from http://www.lumobodytech.com/2015/03/welcome-to-lumo-lift-14-tips-to-

get-you-started/.

Lumo Bodytech Inc. (2014i). Introducing Custom Goals. Retrieved 24 March 2015 from

www.lumobodytech.com/2015/01/introducing-custom-goals/.

Lumo Bodytech Inc. (2014j). Posture Coaching. Retrieved 24 March 2015 from

http://www.lumobodytech.com.

Lumo Bodytech Inc. (2014k). About Lumo. Retrieved 24 March 2015 from

http://www.lumobodytech.com/about-us/.

Lumo Bodytech Inc. (2014l). Lumo Lift Update: New Prototypes Have Arrived! Retrieved 24

March 2015 from www.lumobodytech.com/2014/03/lumo-lift-update-new-prototypes-have-

arrived/.

Lumo Bodytech Inc. (2014m). Is Your Tablet Hurting Your Health? Retrieved 24 March 2015 from

http://www.lumobodytech.com/2013/07/is-your-tablet-hurting-your-health/.

Lumo Bodytech Inc. (2014n). Lumo 2015 Posture Challenge: Week 1. Retrieved 24 March 2015

from www.lumobodytech.com/2015/01/workplace-posture-challenge-week-1.

Lupton, D. (2012). M-health and health promotion: The digital cyborg and surveillance society.

Social Theory & Health, 10(3), 229–244.

Lupton, D. (2013). Quantifying the body: Monitoring and measuring health in the age of mhealth

technologies. Critical Public Health, 23(4), 393–403

Lupton, D. (2014). Apps as artefacts: Towards a critical perspective on mobile health and medical

apps. Societies, 4(4), 606-622. Miah, A. (2007). Posthumanism: A critical history. In B. Gordijn & R. Chadwick. Medical

enhancements & posthumanity (pp. 71-94). New York: Routledge.

Millington, B. (2014). Smartphone apps and the mobile privatization of health and fitness. Critical

Studies in Media Communication, 31(5), 479-493.

Nettleton, S. (2004). The emergence of E-scaped medicine. Sociology, 38(4), 661–79.

Parkinson, H.J. (2014). Lumo Lift review: Posture-tracking gadget is a straight shooter. Retrieved

11 August 2015 from http://www.theguardian.com/technology/2014/nov/14/lumo-lift-review-

posture-tracking-gadget.

Prana Tech LLC. (2014a). What is Prana? Retrieved 26 March 2015 from http://prana.co.

Prana Tech LLC. (2014b). Science. Retrieved 26 March 2015 from http://prana.co/science/.

Prana Tech LLC. (2014c). Press. Retrieved 26 March 2015 from http://prana.co/press/.

Rich, E. & Miah, A. (2014). Understanding digital health as public pedagogy: A critical framework.

Societies, 4(2), 296-315.

Rock, M.J., Degeling, C. & Blue, G. (2014). Toward stronger theory in critical public health:

Insights from debates surrounding posthumanism. Critical Public Health, 24(3), 337-348.

Rose, N. (2007). The politics of life itself. Biomedicine, power, and subjectivity in the twenty-first

century. Princeton: Princeton University Press.

Vertinsky, P. (2002). Embodying normalcy: Anthropometry and the long arm of William H.

Sheldon's somatotyping project. Journal of Sport History, 29(1), 95-133.

Yosifon, D. & Stearns, P.N. (1998). The rise and fall of American posture. The American Historical

Review, 103(4), pp. 1057-1095.

20 1 A reviewer makes an interesting point in regards to the epidemiological distinction between active surveillance (whereby health officials seek out health data) and passive surveillance (whereby data is supplied without deliberate outreach). Using the example of vaccinations, Childress (2015) illustrates how these forms of surveillance can implicate individuals/patients: “In active surveillance, healthcare providers actively follow those who are vaccinated by asking, at set intervals, direct, specific questions about any reactions … By contrast, in passive surveillance individuals may self-report at any time they believe they have a negative reaction to report, and then healthcare providers can follow up” (p. 99). Surveillance with posture technologies is ‘passivised’ in the style described by Andrejevic and Burdon (2015): it is sensor-based and automatic, and so data collection requires little effort from users themselves. At the same time, however, it is interesting how this passivised form of surveillance parallels active surveillance in the epidemiological sense. Technologies like Lumo Lift act in much the same way as the active (human) healthcare providers in Childress’ (2015) vaccination example. 2 To urge upright positioning whilst at the same time imagining posture as customisable indeed seems contradictory in nature. These two positions make sense together, however, if one considers that Lumo Bodytech is interested in informing consumers about the distinction between good and bad posture before giving them leeway to decide what their baseline good posture will be each day. For example, one entry to the Lumo blog lists steps in achieving good posture, beginning with the step of imagining one’s head being pulled upward by a string (see Lumo Bodytech Inc., 2014n). In this sense, whilst there is sure to be variance in how Lumo users calibrate their devices, and whilst Lumo is evidently open to this variance, the company still sets parameters on proper body positioning.