Osteopathic Neurorehabilitation
About Tony Tranfield
I am an osteopath with a special interest in neurological rehabilitation. This site provides technical information for health care professionals about my clinical expertise as well as a blog about my passion – the control of balance, posture and the use of posturography in musculoskeletal clinical practice.
Who This Site is For

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Philosophy & Interests
As clinicians we tend to view the nervous system in terms of ‘hard lesions’; we look for pathology. I think that for a musculoskeletal clinician it is also important to look for function, quantify ‘dysfunction’ and look for ways of establishing a greater capacity for the nervous system to adapt, learn and repair itself.

My interests are in:

Changing resting centres of gravity.

Improving the ability of a patient to shift their weight more efficiently.

Improving timing, coordination, and motor learning.

Restoring aberrant patterns of movement, motor planning, rehearsal and execution.

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Computerized dynamic posturography (CDP), also called test of balance (TOB), is a non-invasive specialized clinical assessment technique used to quantify the central nervous system adaptive mechanisms (sensory, motor and central) involved in the control of posture and balance, both in normal (such as in physical education and sports training) and abnormal conditions (particularly in the diagnosis of balance disorders and in physical therapy and postural re-education). Due to the complex interactions among sensory, motor, and central processes involved in posture and balance, CDP requires different protocols in order to differentiate among the many defects and impairments which may affect the patient's posture control system. Thus, CDP challenges it by using several combinations of visual and support surface stimuli and parameters.
Posturography for the Clinician

The value of posturography to the musculoskeletal clinician is that it enables us to measure movement in a vertical plane, or indeed any movement that can be translated into a vertical plane. This means that we can use standardised objective testing to quantify and document what we do. In addition we can test and measure function in ways that we couldn’t do previously, and we can do all this quickly, and see the results in real time.

I have laid out in Specific Movement and Balance Testing the testing that I do. For further information and how to apply posturography clinically for evaluation and rehabilitation, please subscribe to my blog.

I am currently writing a Posturography training program for Physical Therapists. If you would like to learn how to incorporate Posturographic testing and rehabilitation in your practice register your interest by contacting me.

Inner Ear Pathology

Posturography is a non specific test of balance. It can quantify stability and document the characteristics of instability, however it is not a diagnostic tool for specific pathology. Patients with suspected vestibular pathology should be considered for MRI, VEMP’s (Vestibular Evoked Myogenic Potentials) and Caloric testing, which test the saccule and lateral canals respectively.


Specific movement and balance tests include:

  • Modified Clinical Test of Sensory Integration in Balance (mCTSIB);
  • Limit of Stability Test (LoS);
  • Sit to Stand Test (StS);
  • Weight – Shift Targeting; and
  • Power, Velocity and acceleration.

Our in-house developed Falls Risk Assessment protocol includes a focussed balance history and specialised posturographic assessment to measure static stability and quantify fall risk, limit of stability, efficiency and speed and a lower extremity strength test.


A 6 week exercise and physical therapy program suitable for patients with musculoskeletal conditions with a weight bearing component as well as patients with deteriorating stability aimed at improving the patient’s centre of pressure (CoP) in static stance and limit of stability (LoS).


Once stability has been established and limit of stability increased we work on stability during the gait cycle. Rehabilitation includes step timing, coordination, stimulation of central pattern generators and dual tasking.


I am currently writing a Posturography training program for Physical Therapists. If you would like to learn how to incorporate Posturographic testing and rehabilitation in your practice register your interest by contacting me.

Physical Therapy

A comprehensive list of treatment modalities  and management of specific conditions is available in the expertise section.

Click below to learn more about the services that I offer.

  • Physical Therapy
  • Rehabilitation
  • General Musculoskeletal Care
  • Temperomandibular Dysorders (TMD)
  • Paediatric Musculoskeletal Care
  • Testing
  • Rehabilitation
  • Training
  • Neurological Rehabilitation
  • Paediatric Neurological Development
  • Posture and Balance evaluation for surfers, gymnasts and dancers.

My expertise covers a wide range of modalities across the spectrum of physical therapy and rehabilitation, musculoskeletal care, neurological rehabilitation, paediatrics, performance enhancement and posturography.

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Memberships & Fellowships
Dr Tony Tranfield is a leading Osteopath providing general musculoskeletal services, neurological and vestibular rehabilitation.

I graduated from the European School of Osteopathy in Maidstone UK in 1994 and moved to Sydney in 1996 before setting up the Beaches Osteopathic Centre in Narrabeen on Sydney’s northern beaches in 1999. After ten years in practice I started to realise that while biomechanical spinal conditions responded well to general spinal manipulative therapy often the underlying postural conditions that caused the problem were deep rooted and the condition remained to resurface again at a later date.

Thus I became interested in how to change posture, how our posture develops in our early years, and how we develop our ‘postural character’. In 2004 I started training in Functional Neurology through the Carrick Institute in Florida. I completed the 250 hour course and in 2009 took the exams for the American Chiropractic Neurology Board.

Always looking for ways to improve diagnosis and quantify change, in 2009 I purchased a Comprehensive Assessment of Postural Systems (CAPS) posturography system and developed specific protocols for the rehabilitation of postural conditions.

In 2013 I travelled to Cheyenne Wyoming USA and spend a week with Vestibular Technologies doing advanced training on their posturographic system.

Today in my practice, I start with assessing and improving static stability as a precursor to improving biomechanical efficiency.

Once the patient has better static stability and an understanding of their postural position this gives them a ‘vocabulary’ from which I can install more efficient patterns of movement.

This is not a ‘one size fits all’ approach, because each patient has individual postural characteristics which need to be addressed in an individual and unique way.

Today in my practice, after acute management I will assess and improve stability for a functional baseline measurement and biomechanical efficiency.

As this is a fundamental to efficient movement I use this approach for a diverse range of presentations such as the following.

  • chronic lower back pain;
  • deteriorating balance;
  • Parkinson’s Disease;
  • childhood developmental problems;
  • gait, coordination, balance and postural development;
  • attention and motor learning; and
  • improvement of athletic performance.
  • DO (Osteopath)
    European School of Osteopathy

    The European School of Osteopathy (ESO) is recognised globally as a leading osteopathic institution for forward thinking osteopaths from the UK and internationally.

  • Member of Osteopathy Australia
    Osteopathy Australia

    Osteopathy Australia  (formerly the Australian Osteopathic Association) is the peak representative body for all Australian osteopaths.

  • Member of the Sutherland Cranial Teaching Foundation
    Sutherland Cranial Teaching Foundation

    Sutherland Cranial Teaching Foundation disseminates knowledge and increases the proficiency of practitioners using osteopathy in the cranial field through the provision of high quality, best practice post graduate training.

  • Fellow of the AAFN (FAAFN)
    Australasian Academy of Functional Neurology

    The Australasian Academy of Functional Neurology (AAFN) is a multi-disciplinary professional organisation that represents and promotes the field of functional neurology / neuroscience in the Australasia region and assists the clinical advancement of evidence-based functional neuroscience within health care practices.

  • Fellow of the ACFN (FACFN)
    American College of Functional Neurology

    The American College of Functional Neurology (ACFN) conducts certification activities to uphold standards of practice in the field of Functional Neurology through certification of qualified physicians at the Fellowship Level.

  • Diplomate of the ACNB (DACNB)
    American Chiropractic Neurology Board (ACNB)

    The American Chiropractic Neurology Board is the sole specialty board in neurology recognized by the American Chiropractic Association (ACA). The ACNB’s Diplomate program has achieved accreditation by the National Commission for Certifying Agencies (NCCA). Dr Tranfield is presently the only osteopath in Australia with this qualification.

Brochures & Forms

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My blog focusses on the latest issues on the topics of the control of balance, posture and the use of posturography in musculoskeletal clinical practice. View the most recent posts below or visit the blog for all posts.

Latest Blog Posts

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Phone: 02 9913 7900

Address: 21/20 Wellington St Narrabeen NSW 2101

Fax: 02 9913 7886

E-mail: contact@drtonytranfield.com.au

Medical Disclaimer

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