Posture & Gait Flashcards
When examining the anterior static posture screen landmarks you should check the alignment of facial structures including
Eyes, ears, nose/nostrils and angles of the jaw
When examining the anterior static posture screen landmarks you should check the alignment of the trunk and upper extremities including
Large neck muscles, shoulder bone (acromion), collar bone, carriage of arms and finger tip length
When checking the alignment of the lower trunk in an anterior static posture you should examine the
Angle of the rib cage, belly button (umbilicus), pelvic bones, hip bone (greater trochanter), knee and ankle
What are three common anterior postural findings?
Facial droop, flexed arm held against the body and knees facing inward “knocking”
Facial droop can be due to
Nerve paralysis/stroke
Flexed arm held against the body can be a result fo
Nerve damage or splinting due to injury
Knees facing inward “knocking” can be due to
Bone pathology or leg pain
Which landmarks should be examined when checking the alignment of the head, neck and shoulders in a posterior static posture screen?
Ears, c spine (paravertebral muscle mass), slope of the shoulders, tips of the shoulders and bottom angle of the shoulder blades
Which landmarks should be examined when checking the alignment of the trunk and lower extremities in a posterior static posture screen?
Spinal alignment, paraspinal muscles, pelvis, hip bones, knee (popliteal space) and ankles
What are three common posterior postural findings?
Scoliosis (alternating unevenness) Short leg (anatomical vs postural) Shoulder winging (due to muscle/nerve weakness or postural)
Normal spinal curvatures are important for maintaining what?
Musculature balance and posture
Lordosis
Anterior curvature of the spine
Cervical and lumbar
Kyphosis
Posterior curvature of the spine
Thoracic and sacrum
What landmarks should be examined when performing a lateral static postural screen?
Assess alignment by using the gravitational/plump line, head carriage (ears), shoulder carriage, spinal curves, knee alignment and pelvis alignment
What is considered as the ideal posture?
All land marks including ear, shoulder, middle of lower spine, anterior 1/3 of tail bone, hip bone, knee and ankle are on or slightly anterior/posterior to gravitational line
What is a common lateral postural finding?
Poor/hunched posture
Leads to loss or exaggeration of spinal curves
Also large anterior carriage of the head and neck is seen due to chronic MSK pain or muscle/neuro pathology
What are the goals of gait?
Move body weight forward with as little energy as possible and without hurting yourself
What are some challenges to gait?
Must be able to absorb body weight/forces from ground
Transfer body weight in an efficient manner
Convert absorbed forces into forward movement
Summarize the stance phase
Heel strike: establish stable contact
Loading response: absorb ground reaction to weight
Mid stance to pre-swing: body weight carried forward
Summarize the swing phase
Toe off, mid swing and terminal swing
What is the goal of the swing phase?
Clear foot, advance lower extremity and prepare the lower extremity for loading
What are the two common etiologies for gait pathologies?
Neurologic in which muscles become spastic or flaccid
Musculoskeletal associated with pain or weakness
What are the common gait pathologies that have a neurologic etiology?
Ataxic, hemiparesis, scissor, stoppage/foot drop and Parkinsonian gaits
Ataxic gait
Effects BOTH legs (bilateral)
Wide base with irregular steps
Lack of balance/proprioception
Due to alcohol intoxication or damage to balance centers of brain/spinal cord
(Walking like a drunk person all over the place)
Hemiparesis gait
Loss of function
Effects ONE leg (unilateral)
Will drag/pull limbs stuck in spasm
Arm is flexed and the leg is extended (circumduction)
Due to damage to motor control of brain (ex. Strokes)
Scissor gait
BOTH legs (bilateral)
Leg muscles stiff due to spasm with knees inward
Legs and foot commonly cross midline
Due to damage at motor part of spinal cord
Stoppage gait/foot drop
Effects ONE leg (unilateral)
“Hiking” = bending at hip/knee to raise leg higher
Clear weak foot during swing phase
Due to weakness in specific nerve causing inability to raise the foot
Parkinsonian gait
Bilateral
Stiff and stooped over with tremors
Short shuffling gait that speeds up involuntarily (Fenstrating)
Due to damage muscle tone/movement initiation center of brain
What are common gait pathologies with musculoskeletal etiology?
Waddling gait/trendelenburg gait and antalgic gait
Waddling/Trendelenburg gait
Bilateral
Duck like waddle
Trunk shifts toward stance leg and hip drops on swing leg
Due to trunk and leg muscular weakness/pathology
Antalgic gait
Unilateral
Shorten gait to prevent placing weight on the leg
Decrease stance phase on effected limb
Due to pain in LE
Concern for trauma, joint damage or joint inflammation
(Basic limp walk)
Inspecting posture and gait
Can be easily done with general inspection
Gather a wealth of info when walking into the room
Further examination if pathology is suspected which can indicate MSK or neuro pathology
