Lecture #13 (Posture, Body Mechanics, Ambulation)

Question 1

What is posture?

Answer 1

The relative alignment of various segments of the body

Question 2

True or false:

You need several views of the posture in order to determine if alignment is correct.

Answer 2

True…you should look at anterior, posterior, and lateral, preferably with a plumb line

Question 3

What are the three main spinal positions and a fourth possible position you might observe when looking at posture?

Answer 3

Cervical lordosis, thoracic kyphosis, lumbar lordosis, and scoliosis (abnormal)

Question 4

What is the most common cause of a postural problem?

Answer 4

Muscle imbalances…these may stem from overuse, loss of motion/flexibility, postural deviations, and injuries

Question 5

True or false:

A pt with a postural problem may not be strong enough to maintain good posture for very long.

Answer 5

True…aka why we rehab bad posture

Question 6

True or false:
As with any rehabilitation program, in dealing with a postural problem, if there is inflammation and spasm present, it is important to be sure to include rest in the program before implementing strength exercise.

Answer 6

True

Question 7

After the targeted areas are calmed down and less inflammed, how should you progress with the rehab?

Answer 7

Begin with slow movements and less exercise. Progress from there like any other injury. Later stages of rehab should focus on endurance exercises because they are postural muscles.

Question 8

True or false:

RTP or return to work may need to be done in gradual steps to avoid re-injury and/or additional irritation or spasm.

Answer 8

True

Question 9

How could an ergonomic assessment be beneficial in a patient dealing with postural injury or problems?

Answer 9

This could help determine if there is a functional activity being done wrong, or if there is a way to control the amount of work being done by the postural muscles.

Question 10

What is the key to proper posture?

Answer 10

Proper body mechanics.

Question 11

What are the 9 principle keys to body mechanics to help maintain proper posture?

Answer 11

• keep spine straight when possible
• lower the COG when performing work
• keep a broad BOS
• use a stance in the direction of force application
• keep the pelvis neutral during force application
• maintain a strong core and hip musculature
• use legs (not arms) for heavy/hard work
• don’t tense or strain the whole body during activities
• breathe normally

Question 12

What are some programs available for body awareness? What do they promote?

Answer 12

Pilates, yoga, Alexander technique, and the Feldenkrais method; they promote self improvement through increased body awareness, a strong body-mind interaction to determine movement patterns, and whole body treatment (not just one area)

Question 13

What is the gait sequence and components?

Answer 13

1) stance phase 1) heel strike
2) initial contact 2) foot flat
3) loading response 3) midstance
4) midstance 4) heel-off
5) terminal stance 5) toe-off
6) preswing 6) acceleration
7) swing phase 7) swing through
8) initial swing 8) deceleration
9) mid swing
10) terminal swing

Question 14

What is a pathological gait a reflection of?

Answer 14

Injury, weakness, loss of flexibility, pain, or bad habits

Question 15

What types of ambulation with assistive devices are there?

Answer 15

3 point gait (2 crutches, 1 leg), 4 point gait (2 crutches, 2 legs), and single support (1 cane or crutch)

Question 16

What type of assistive ambulation tends to serve as a transition between 4 point gait and no devices?

Answer 16

Single support

Question 17

Which is more functional, 3 point or 4 point gait?

Answer 17

4 point

Question 18

If patient has normal strength, endurance, flexibility, and ROM, but their gait is still having deviations, when what may be the issue?

Answer 18

Neuromuscular control, balance, or proprioception is probably not back to normal

Question 19

If you have a patient with normal strength, endurance, flexibility, ROM, neuromuscular control, balance, and proprioception, but is still having gait deviations, what should you potentially consider?

Answer 19

• joint laxity, or a pivot shift?
• disease or disorder involved
• is the pt compensating for arthritis or pain
• is the pt having radicular problem or nerve compression

Question 20

How should you instruct a pt using crutches on how to go up or down stairs?

Answer 20

• no hopping!
• “up with the good, down with the bad”
• the injured leg goes where the crutches go

Question 21

How should you instruct a pt using crutches to go from sitting to standing?

Answer 21

• slide forward as much as possible
• uninjured leg close to the chair/bed
• use arms or chair and push the weight through the good leg simultaneously to stand