Posture PPT Flashcards
What is the definition of posture?
relative arrangement of the parts of the body
postural faults occur due to what?
misuse of the capacities of the body
poor posture leads to what?
muscle weakness, shortened muscles
ideal alignment of the human body results in minimal _______ and maximal _________ of the body
minimal amount of stress/strain
maximum efficiency
what are some ways of assessing posture?
visual observation (most common, least reliable)
plumbline
photographic/digital
goniometry
radiographic
in an ideally aligned posture, the center of gravity is located slightly _________ to spinal segments ____ and ____.
anterior, S1-S2
what is the gravity line?
a vertical line that falls through the center of gravity, places the body in equilibrium
where is the gravity line found?
intersection of the midsagittal and coronal planes of the body
what two things does the gravity line imply?
balanced distribution of weight and stable position of each joint
where does the gravity line fall in relation to the hip joint?
posterior (natural hip extension moment)
where does the gravity line fall in relation to the knee joint?
anterior (natural knee extension moment)
where does the gravity line fall in relation to the ankle joint?
anterior (natural dorsiflexion moment)
what is a systematic approach to analyzing posture/the body?
a global screen into a more focused, local approach
how should you sequence a systematic approach of posture?
either the head to the feet or the feet to the head
when looking at a lateral view of the body, where key landmarks does the gravity line go through?
external auditory meatus
shoulder joint (acromion)
bodies of lumbar vertebrae
slightly posterior to the greater trochanter
slightly anterior to the lateral epicondyle
slightly anterior to the lateral malleolus
what are some of the static position of posture?
sitting
standing
supine
side-lying
when performing an assessment, what position should the patient be in (at minimum)?
the position that brings on the patient’s symptoms
what are some example of functional positions of posture?
squatting, bending, walking, lunging
what are some factors that may cause postural variations?
age
structural/anatomical
physiological
pathological
nutritional
occupational
recreational
environmental
social and cultural
emotional
what are some common postural deviations of the upper quarter of the spine?
forward head
anterior translation of cervical spine
increased upper thoracic kyphosis
protracted, winging, elevated scapula
what are some common postural deviations of the lower quarter of the spine?
increased anterior/posterior pelvic tilt
increased/decreased lumbar lordosis
increased flexion of the hips or excessive hip extended posture
are postural deviations able to limit movement patterns?
yes
ex: lifting arms in a slumped position
what are some typical observations that you make within the upper extremity?
winging of scapula
position of the scapula
position of the shoulder
carrying angle
what is the typical positioning of the scapula?
~2 inches lateral from the spine (frontal plane - medial/lateral positioning)
T2-T7 (frontal plane - superior/inferior position)
what is the most common postural defect in the upper extremity that requires correction?
forward (rounded) shoulders (acromion anterior to the line of gravity)
what is the normal carrying angle formed by humeral and forearm axes for males and females?
males: 5-10 degrees
females: 10-15 degrees
what are some examples of lower extremity observations you may see?
femoral internal rotation
knee varus/valgus
knee hyperextension
arch height
calcaneal position
toe out/in angle
toes sign
what is the definition of valgus?
distal segment away from midline
what is the definition of varus?
distal segment towards midline
what are the technical names of the differentiating foot arch types and what do they mean?
pes planus - flat foot
pes cavus - high arch
what is the too-many-toes sign a signal of?
excessive pronation
what toes should you be able to see with a normal hindfoot approach?
5th and 1/2 of the 4th
what are some common spinal observations?
cranial extension/tilt
cervical lordosis
thoracic kyphosis
lumbar lordosis
PSIS/iliac crest height
what is normal cervical lordosis and what is its most common postural defect requiring correction?
30-35 degrees
forward head posture
what is normal thoracic kyphosis?
40 degrees
what is normal lumbar lordosis and what is its most common postural defect requiring correction?
45 degrees
increased anterior pelvic tilt
what level should the iliac crest fall at?
LV4
what level should the PSIS fall at?
S2
what is a neutral position of the pelvis?
ASISs are in the same horizontal plane, and the ASIS and symphysis pubis are in the same vertical plane
what does an increased anterior pelvic tilt cause?
increased lordosis of the lumbar spine
what does an increased posterior pelvic tilt cause?
flattening of the back/lower lumbar spine
what is the idea of crossed patterns and how does it relate to the cervical spine and neck muscles?
tight upper traps/levator scapulae and SCM/pectoralis results in a weak middle trap/lower trap/serratus anterior and deep neck flexors (and vice versa)
what is the definition of scoliosis and how is it named in relation to side affected?
lateral curvature of the spine
C-curve: curvature named to the convex side of the curve
is right or left thoracic curve most common?
right
is scoliosis more common in boys or girls?
girls
what is the most common age of onset for scoliosis?
10-14 years old
what are some clinical manifestations of a scoliosis posture?
rib cage asymmetry and/or rib hump when bending forward
uneven shoulder and/or pelvic height
prominence of scapula/hip
difference in space between arms and trunk when standing
apparent leg-length discrepancy
the body develops a compensatory curve to maintain what three things wthin the body? (typically found with scoliosis)
posture
balance
equilibrium
can functional scoliosis be corrected, and if so, how?
yes, corrected through active shift in posture
but it can become structural over time
what is the difference in structural and functional scoliosis?
structural cannot be corrected actively - it is a composition of the body structure
what is the name of the test used to assess scoliosis and how is it performed?
adam’s forward bend test
knees fully extended, hands to side
bend forward to a horizontal position and document asymmetry with a scoliometer
7 degrees on a scoliometer = 20 degrees on a x-ray
what are some components of clinical reasoning for postural assessments?
examine postural orientation in standing, sitting, and dynamically from more than one plane to identify areas for investigation
assess for flexibility and muscle length
assess impacts of muscle strength
is there evidence that prolonged standing, walking, and sitting at work is associated with LBP?
no
is there evidence that there is a relationship between posture and neck pain in adolescents?
no
should all deviations of posture be considered pathological?
no
in order to determine the effect on the patient’s symptoms, traisl should be performed between ______ active correction and ________ passive correction
patient active, clinician/therapist passive
what is proper sitting posture?
feet comfortably flat on floor
hips and knees flexed to roughly 90 degrees
back of the chair inclined roughly 10 degrees
armrests allows elbow flexion at about 90 degrees
what kinds of movements can help to alleviate the stress and strain associated with prolonged sitting?
simple extension movements and/or occasionally standing up
