week 9: posture to balance Flashcards
Plumb line view from side:
________ to mastoid process
through ________ acromion process
________ to hip joint
_________ to knee
________ to lateral malleolus
anterior to mastoid
through anterior acromion process
posterior to hip jt
anterior to knee
anterior to lateral malleolus
what is this?
swayback
what is this?
right side lean
upper quarter cross syndrome:
what is tight?
what is weak?
tight upper traps and levator, tight pectoralis
weak rhomboids, low and mid traps, serratus anterior, deep neck flexors
T or F: spine should have some thoracic kyphosis and some lumbar lordosis
T!
What is this?
flat back posture
what is this?
sway back
what is this?
kyphotic-lordotic posture
increased cervical forward head leads to what?
increased compressive forces on anterior, lower cervical, and posterior facets
levator scapulae shortening
shoulder protraction
sway back is _______ kyphosis and _________ lordosis
increased kyphosis and decreased lordosis
swayback causes:
_____ hip extensors
_____ hip flexors or lower abdominals
generalized _______ strength
genu ________
________ pelvic tilt
tight hip extensors
weak hip flexors
generalized decreased strength
genu recurvatum
posterior pelvic tilt
lordosis:
______ hip flexors and/or back extensors
_______ pelvic tilt
increased _____ forces on lumbar vertebrae
increased ______ forces on lumbar facets
________ of anterior spinal ligaments
tight hip flexors/ back extensors
anterior pelvic tilt
increased shear forces lumbar vertebrae
increased compression forces on lumbar facets
elongation of anterior spinal ligaments
flatback:
_______ kyphosis and _______ lordosis
______ head, _______ pelvic tilt, knee _____
______ hip extensors
______ hip flexors and back extensors
decreases kyphosis and decreased lordosis
forward head, posterior pelvic tilt, knee flexion
tight hip extensors
weak hip flexors and back extensors
postural sway, AP sway is ___ mm in quiet stance
5-7 mm
postural sway, ML sway is ___ mm in quiet stance
3-4 mm
what causes postural sway?
high COM and small BOS in standing
in sway, what is the body pivoting about?
ankle joint
in sitting, proper posture looks like
lordosis _______
hips _____ than knees
feet on the ground
lordosis preserved
hips higher than the knees
what causes a posterior pelvic tilt in sitting?
short hamstrings
in sitting, if the chair is too high it leads to
pressure on posterior thighs
in sitting, if the chair is too low it leads to
increases posterior tilt
percentage pressure on discs when laying supine
25
percentage pressure on discs when laying side lying
75
percentage pressure on discs when standing
100
percentage pressure on discs when standing leaning over
150
percentage pressure on discs when standing leaning over holding weight
220
percentage pressure on discs when sitting upright
140
percentage pressure on discs when sitting and leaning back
105
percentage pressure on discs when sitting leaning forward
185
percentage pressure on discs when sitting, leaning forward with weight
275
for the computer:
head should be tilted __ degrees into flexion or less
elbows should be ____
wrists in _____
keyboard slope no greater than __
head should be tilted 15 degrees into flexion or less
elbows should be close
wrists in neutral
keyboard slope no greater than 15
a hip flexion contracture will present how?
shortened, adducted, internally rotated
strengths of HHD
document force in a number
more reliability
able to demonstrate a more subtle improvement of strength
HHD limitation
forces may not be linear across the entire spectrum
difficulty with specific instructions
cost
inadequate resistive force
HHD: the force must be
Isometric
clinical pearls for HHD
consistent test position
same joint
max stabilization
same therapist
flat learning curve
HHD: resistance must be
prependicular
HHD: to compare across subjects, you must use
torque
what may make a pt a high fall risk? review
of all hip fracture over 65, __% are related to a fall
90
falls account for __% of hospital admissions and __% of nursing home admissiond
25%
40%
multifactors of balance and fall prevention
physical activity
education
environment modifications
fall risk assessment
review of other systems
3 subsystems for balance
visual, somatosensory, vestibular
if there is a conflict in sensorimotor integration, what happens?
loss of balance/ fall/ faulty motor response
for ankle corrective forces, if the COM is shifted anterior what activates?
gastroc and HS
for ankle corrective forces, is the COM is shifted posterior what activates?
tib anterior and quads
outcome measures for balance/ confidence
ABC Scale- activities-specific balance confidence (score of less than 67% predict fall 84% of the time
Falls Efficacy Scale
static balance: 2 types
quiet stance or active standing
reactive versus proactive standing
reactive to perturbations
proactive- ex: sit to stand/functional reach
2 types of dynamic balance
step initiation and ambulation
T or F: good dynamic balance means good static balance
False
5 categories of balance tests
clinical
laboratory
functional
specific population- concussion
combination
