Postural Alignment

Question 1

What is postural control?

Answer 1

Controlling the body’s position in space for the dual purposes of stability and orientation (neurologic basis of control= sensory, motor, and biomechanics)

Question 3

What is postural alignment?

Answer 3

Biomechanical alignment (body’s alignment)

Question 4

What is postural orientation?

Answer 4

Ability to maintain an appropriate relationship between the body segments and between the body and environment for a task (RELATIONSHIP POSTURE AND TASK)

Question 5

What are some components of postural control?

Answer 5

• Ability to control the center of mass in relationship to the base of support
• COM: point that is the center of the body mass
• BOS: area of body in contact with support surface
• COG: vertical projection of COM

Question 6

What is ideal postural alignment?

Answer 6

• COM anterior to S2
• Line of gravity
• BOS

Question 7

Ideal postural alignment comes from…

Answer 7

• Controlling the COM relative to BOS
• Stable posture is the COM falling within BOS
• Requiring minimal muscular effort

Question 8

What are some key points about the center of mass?

Answer 8

1. COM is a virtual point in space dependent on position of all body segments
2. If the NS controls COM, it must be able to estimate the position of the COM using information from the various sensory receptors (adaptation to protect head)
3. Sensory feedback from muscle spindles, joint receptors, somatosensory, and vestibular provide an estimation of the COM

Question 9

What are some key landmarks for postural assessments (posteriorly)?

Answer 9

• C7
  -T3 (superior angle of scapula)
• T7 (inferior angle of scapula)
• Acromion process

Question 9

What do you look for in a frontal plane postural analyzes?

Answer 9

• ear height
• upper shoulder height
• acromion height
• lower thoracic
• humeral folds
• pelvis height
• PSIS
• genu varum/valgus
• calcaneus with midfoot

Question 10

What is Adams’ test?

Answer 10

• a scoliosis screening where you have the patient bend forward looking for any spinal deviations

Question 11

Sagittal landmarks in postural analyses

Answer 11

• ear lobe/tragus
• greater trochanter of femur
• anterior to center of knee joint
• anterior to lateral malleolus

Question 12

What muscles are active in quiet (static standing)?

Answer 12

• Active muscles: erector spinae, iliopsoas, glute med, TFL, gastroc, solues
• Active muscles w/ pertubation: abdominals, TA
• Inactive muscles: bicep femoris,

Question 13

What are the key muscles for lower limbs during standing?

Answer 13

• Gastroc-soleus , erector spinae, abdominals, and paraspinals

Question 14

What does forward head posture promote?

Answer 14

• Reduced efficiency of muscle groups
• Changes in scapula musculature
• Impaired rhomboids and middle traps
• Anterior thoracic musculature becomes shortened
• Increased kyphosis

Question 15

What is upper crossed syndrome?

Answer 15

• tight: upper traps, levator, and pectorals
• weak: deep neck flexors, lower traps and serratus anterior

Question 16

What causes an anterior pelvic tilt

Answer 16

• tight illiopsoas and rectus femoris
• tight erector spinae
• weak gluteal max

Question 17

What causes a posterior pelvic tilt?

Answer 17

• tight hamstrings
• tight glute max
• tight rectus abdominus

Question 18

An anterior pelvic tilt creates what type of back deformity?

Answer 18

• lordotic back

Question 19

A posterior pelvis tilt creates what type of spinal deformity?

Answer 19

• flat back

Question 20

What does a forward shifted pelvis lead to?

Answer 20

• swayback position with hyperextension at the knees and hip along with posterior pelvic tilt

Question 21

What does moving out of the line of gravity create?

Answer 21

more musculature work

Question 22

What are the major factors in dynamic postural control?

Answer 22

1. Biomechnaical alignment
2. Muscle groups (work together to maintain position)
3. Task (adapts to COM, BOS, and COG)

Question 23

The sensory system plays a major role in which of the two, dynamic posture or static posture?

Answer 23

• Dynamic posture: task related performances

Question 24

What does dynamic postural control require?

Answer 24

• COM: changes with GRF and movement
• BOS: dynamic COM has linear movement
• Line of Gravity: dynamic: linear movement

Question 25

What does a BOS outside the COM increase risk of?

Answer 25

• Greater risk for falls or loss of balance

Question 26

How would you learn to control unique dynamic situations?

Answer 26

• repetition
• specificity
• transference

Question 26

What are postural strageties?

Answer 26

• “set” neuromuscular patterns
• provide fast unconscious motor pattern to provide adaptation to changes in COM
• humans have unique strategies in quiet standing to a perturbation or force that moves their COM

Question 27

Postural strageties are somewhat similar to reflexes via…

Answer 27

1. Respond via sensory input
2. Activate sensory response
3. Muscular system responds w/ set muscular response