Intro to Posture and Posture Assessment Flashcards
What is the definition of posture?
The relative position of different joints at any given moment
Any posture that does not satisfy the attributes of “good or correct/ balanced” posture = _____ _____
Faulty Posture
Why do we look at posture?
- Notice structural variations
- Notice altered mechanics
- Notice muscle imbalances
- Notice residual effects of a previous pathology
When looking at a base of support and center or gravity chart, what does the “X” represent?
Vertical projection of COG within the BOS … basically the X will be in the middle of your feet when standing and walking
What is the COG?
- Point at which mass is evenly distributed
- “Balance” point
With a patient who has had a R unilateral AKA, how will the COG affect the patients perception of balance? (where does the COG move?)
COG will shift towards the stance leg to level out the balance
With a narrowed BOS will a person generally become more or less balanced?
Less
Where does the COG need to move relative to the BOS before walking?
Anterior
What is the definition of “correct/ balanced posture”?
- “The optimal alignment of the patients body that allows the neuromuscular system to preform actions requiring the least amount of energy to achieve the desired effect”
- Position at which minimum stress is applied to each joint
The position of each joint has an effect on other joints. What are two examples of this?
- Anterior tilt of the pelvis –> increased hip flexion and lumbar spine extension
- Thoracic kyphosis –> increased cervical spine extension as compensation
What is the definition of faulty posture?
Any static position that increases the stress to the joints
What is a “pathology” in reference to posture?
If joints are hyper or hypomobile or if muscles are shortened, lengthened or weak
What kind of effect does a kyphotic- lordotic posture cause?
- Anterior pelvic tilt
- Excessive lordotic extension
- Lengthened hip extensors (ex: biceps femoris)
- Lengthened abdominals (ex: external obliques)
- Shortened hip flexors (leads to increased hip flexion)
- Thoracic extensions lengthened
- Thoracic (chest) muscles shortened
- Shortened neck extension
What kind of effect does a sway back posture posture cause?
- Posterior tilted pelvis
- Shortened hip extensors (greater hip extension in this position)
- Lengthened hip flexors
- Flatter lordosis of the lumbar spine
- Upper trunk shifts backwards
- Lengthened upper back muscles
- Shortened chest muscles
- Shortened neck muscles
- Knees are hyper extended
What kind of effect does a flat back posture posture cause?
- Posterior pelvic tilt
- Shortened hip extensors
- Lengthened hip flexors
- Lengthened upper back muscles
- Shortened chest muscles
- Shortened neck muscles
- Flat thoracic to lumbar spine
- Entire body has a slight forward tilt
When the abdominals contract which way do they pull the pelvis? anterior or posterior?
Posterior
When the hip extensors contract which way do they pull the pelvis? anterior or posterior?
Posterior
What muscles might lock someone in a posterior tilt?
- Strong abdominals and hip extensors
- Weak hip flexors and low back extensors
What muscles will cases the pelvis to tilt anterior?
- Strong hip flexors and low back extensors
- Weak abdominals and hip extensors
What might cause deviations from optimal alignment?
Changes in position or malalignment of one body segment will cause changes in adjacent and other body segments as body seeks to adjust or compensate for the malalignment
If stress is maintained over a long period of time and muscles shorten what might this prevent?
Full ROM
If stress is maintained over a long period of time and muscles lengthen what might this alter?
Lengthen- tension relationship
If stress is maintained over a long period of time and ligaments shorten what might this limit?
ROM
If stress is maintained over a long period of time and ligaments lengthen what might this decrease?
Ability to provide stability
What are some structural factors that affect posture?
- Developmental factors like scoliosis or congenital abnormalities (ex: hemivertebrae)
- Neurological factors like muscle tone or laxity of ligamentous structures
What are some positional factors that affect posture?
- Poor postural endurance such as sitting or standing for long periods of time that lead to slouching due to weakness or prolonged faulty positioning
- Psychological factors such as not wanting to appear taller than peers
- Muscle imbalance or contractures
- Pain
- Respiratory conditions
When preforming a postural assessment how should you best prepare your patient?
- Patient should be adequately undressed
- Posture should be examined in usual, relaxed standing posture
- Look for asymmetries (some abnormalities between sides is normal)
- Frontal (anterior/posterior) and sagittal (lateral) views
What are the body landmarks you are looking at for a postural assessment?
- Behind the coronal suture
- Through the external auditory meatus
- Through the dens of the axis
- Through cervical vertebral bodies
- Through lumbar vertebral bodies
- Through sacral promontory
- Slightly behind the hip joint
- Slightly anterior to the knee joint
- Slightly anterior to the ankle joint
- Through the calcaneocuboid joint
What are the surface landmarks you are looking at for a postural assessment?
- Through the ear lobe
- Through the shoulder joint
- Midway of the trunk
- Through the greater trochanter
- Slightly anterior to the knee joint
- Slightly anterior to the ankle joint
When preforming a sagittal analysis where should your line of gravity fall?
- ANterior to the ankle (lateral malleolus)
- Through or anterior to the knee (posterior to patella)
- Through or posterior to the hip (common hip axis)
- Posterior to or through the thoracic spine
- Through the acromion
- Through or anterior to the atlanto- occipital joint (earlobe)
What are your looking for at the ankle with a sagittal posture assessment?
Is the ankle excessive plantar-flexed or dorsiflexed
What are your looking for at the knee with a sagittal posture assessment?
Genu recrvatum (excessive knee hyperextension)
What is Genu recrvatum typically caused by?
Usually caused by limited ankle dorsiflexion or fixed plantarflexion position of the ankle (ankle equinus)
What are your looking for at the pelvis with a sagittal posture assessment?
Anterior or posterior tilting
What are your looking for at the spine with a sagittal posture assessment?
- Lumbar spine: excessive lordosis or flattened curve
- Thoracic spine: excessive kyphosis or thoracic spine flexion
- Shoulders: rounded/ forward
- Cervical spine: excessive lordosis or forward head posture
When preforming a frontal analysis where should your line of gravity fall?
- Symmetrically between two feet
- Through the umbilicus
- Through the xiphoid process
- Through the chin and nose
- Between the eyes
What should you be looking for in a frontal plane analysis?
- Angle of the head in the frontal plane
- Shoulder height asymmetry (dominant is usually a little more depressed)
- Spinal curve deviations
- Level of iliac crests and PSIS
- Knee position in frontal plane (varum/ valgum)
- Ankle (calcaneal/ rearfoot) position (varum/ valgum)
Is it normal when looking at the feet in the frontal plane from the posterior side to be able to see the last two toes?
Yes
What should you be looking for in the knees in a frontal plane position analysis?
Genu varum (bowed legs) and genu valgum (knock knees) … remember GUM sticks together so valgum is knock knees
What should you be looking for in the foot/ ankle in a frontal plane position analysis?
Rearfoot varus/ valgus … should be examined in NWB as well as in standing
What should you be looking for in the pelvis in a frontal plane position analysis?
- Lateral pelvic tilt
- Which way is her pelvis tilting
- What is this doing to the hips
- Which leg might be longer
What should you be looking for in the scapula in a frontal plane position analysis?
- Distance from thoracic spine
- Protraction
- Up/down rotation
- Winging: Serratus Anterior –> Long thoracic (C5-C7)
- Normal for scapula to be lower on dominant side
What should you be looking for in the shoulders in a frontal plane position analysis?
Asymmetries between acromion processes
What should you be looking for in the head in a frontal plane position analysis?
Lateral flexion to either side … you can look at the ears
Why is seated posture important?
It effects the load and pressure on intervertebral discs
What kind of pressure is applied as we decrease our hip angle in sitting?
Increased pressure: 100% in standing, 105% at 110 degrees of hip flexion to 190 degrees plus at 80 degrees of hip flexion
What are tips for good sitting posture? (this is longgg)
- Keep the feet flat or resting them on the floor or a footrest
- Avoid crossing the knees or ankles
- Maintain a small gap between the back of the knees and the
chair - Position the knees at the same height or slightly lower than the
hips - Place the ankles in front of the knees
- Relax the shoulders
- Keep the forearms and knees parallel to the floor where
possible - Hold the elbows at the sides, creating an L-shape in the arms
- Sit up straight and looking forward without straining the neck
- Keep the back against the chair or using a backrest or cushion if
there are places where the back does not comfortably meet the
chair, especially in the lower back region - Avoid sitting for extended periods, ideally taking at least a 10-
minute break for every hour of sitting - Switch positions regularly
