Kinesiology 1 Credit H. 3

KinesiologyM Farrukh ShahzadBSPT, PPDPT

Lesson 11

PostureReview PostureInactive postureActive postureStatic posture Dynamic posturePostural MechanismMuscles Nervous controlPostural reflexPattern of PostureGood posture Development of good posturePoor postureFactors predisposing to poor posturePrincipals of Re-EducationTechniques of Re-EducationAbnormal postures Physiological application to postural tone

PostureThe attitude that the body assumes is known as postureIt is also known as an indication of the soundness of the musculoskeletal system

To the Kinesiologist, it is a measure of mechanical efficiency of muscles, balance and of neuromuscular coordination.

PostureIt is considered as the relative arrangement of parts of the body. It changes with the positions and movements of the body throughout life and throughout the day.

It is the attitude which is assumed by body parts to maintain stability and balance with minimum effort and least strain during supportive and non supportive positions.

Posture

Inactive postureAttitudes adopted for rest or sleep

Muscular activity which is required to maintain the life reduced to minimum

Active postureThere will be integrated action of many muscles to maintain the posture it could be Static postureDynamic posture

Static PostureA constant pattern of posture is maintained by the interaction of groups of muscles which work more or less statically to stabilize the joints and in opposition to the gravity or other forces. In erect posture they preserve a state of equilibriumDynamic posture Attitudes assumption while performing different activities is known as dynamic posture. Dynamic posture makes the efficient base for the movement to occur. Pattern of posture constantly modified and adjusted to meet the changing circumstances which arise from the result of movement.

The Postural MechanismMuscles Intensity and distribution of the muscle work required in both static and dynamic postures varies considerably with the pattern of the movement, and physical characteristics of the individuals who assumes itThe group of muscles mostly employed/work are those which are used to maintain the erect position of the body by working to counteract the effects of gravity

MusclesThese muscles are known as anti gravity muscles and their action with regard to the joint is mostly extensionThe antigravity muscles present certain structural characteristics that enable them to perform their function with efficiency and minimum of effort

MusclesAnti gravity muscle fibres are red this indicated their capability to produce sustained contraction without fatigue

They are slow in action. This is because they have low metabolic rate of action

Other muscle fibres are white they are fast is action and got fatigue early because of their higher metabolic rate of action.

MusclesThese muscles are multi-pinnate or fan shaped. This signifies their strength of action.They work at low speed as compare to other muscles which work at high speed and got fatigued earlier. e.g gastronemius is an anti gravity muscle it can produce sustained contraction for longer period without fatigue in comparison with it soleous is the muscle whose function is to push the foot off the ground is a fast acing muscle and got fatigued early

Nervous control of posturePosture are maintained or adopted as a result of neuromuscular co-ordination

The appropriate muscles being innervated by means of a very complex reflex mechanism

13Nervous controlPostural reflexesSimply reflex is an efferent response to an afferent stimulus

Regarding posture efferent response is a motor response means the anti gravity muscles are the effecter organs

Afferent stimuli arise from the variety of the sources all over the body.

Afferent Sources For StimulusThe MusclesNeuromuscular and neurotendinuous spindle within the muscles record changing tension .Increased tension or stretch act as a stimulus to initiate a reflex contraction of the muscles.

Afferent Sources For StimulusThe eyes: Visual sensation records any alteration or deviation in the position of the body with regard to its surroundings.Eyes are one of the receptors for the rightening reflexes.Rightening reflex enable the head and body to restore themselves to erect position.

Afferent Sources For StimulusThe Ears:There are semicircular canals present in the internal ears which contains the fluid in them .Stimulation of the vestibular nerve results from the movement of the fluid within the semicircular canals.Each canal lies at different plane which is at right angle to each other.Any movement of the head disturbs the fluid in the canal.Thus knowledge of the movement and direction in which it takes place got recorded.

Afferent Sources For StimulusJoints structure: In weight bearing the approximation of the bone/joint surfaces takes place and joints. This approximation stimulates the structures in the joints and elicit the reflex reaction to maintain the position.

Pattern of posturePattern of posture (static, dynamic) gradually build up by the integration of many reflexes which together make up the postural reflex.Some reflexes are inborn.Some are conditioned (developed as the result of constant repetition of postures maintained by voluntary control.

Good PosturePosture is good when it fulfils the purpose for which it is used with the maximum efficiency and minimum effort.A good posture is the state of muscular and skeletal balance which protects the supporting structures of the body against injury and progressive deformities, irrespective of the attitude in which these structures are working or resting.

Good PostureUnder these conditions, the muscles will function most efficiently and the optimum positions are afforded for the thoracic and abdominal organs.There is no single best posture for all individuals. Each person must take the body he / she has and make the best of it. The good Posture is the one that suits ones own condition and the condition of the environment.e.g. during attention. The normal posture will be erect, while in extreme fatigue, the normal posture will be that conserves energy.

Development of good posture Essential mechanisms for the maintenance and adjustments of good posture are intact (working properly) and healthy These factors are following A stable psychological backgroundGood hygienic conditions Opportunity for plenty of natural free movements

Poor posturePoor posture is the posture that results from certain muscles tightening up or shortening while others lengthen and become weak. This often occurs as a result of ones daily activities.

Poor posture There are different factors which can impact on posture and they include occupational activities biomechanical factors such as force and repetition. psychosocial factors such as job stress and strain. Workers who have higher job stress are more likely to develop neck and shoulder symptoms.

Factors predisposing to poor postureGeneral factorsMental attitude of the patient Poor hygienic conditions General debility after constitutional illness Prolonged fatigue

Principles of Re-educationMeasures taken by the physiotherapist to combat poor posture and train better posture depends onThe root causeCo-operation of the patient

Principles of Re-educationBad posture can be caused by:Mental attitudePoor hygienic conditions

Principles of Re-educationPostural defects rarely lead to marked structural changes in the bodyHowever if they are sustained for a long time it may lead to changes in the joints, muscles and ligaments as they adapt to the habitual positionsMuscles can lead to:Adaptive shorteningLengtheningWeakness

Principles of Re-educationThese changes make it very difficult for patient to assume good posture in the futureRelaxation and mobility exercises help to train good postureA mental awareness of holding good posture and that good posture will have benefits will enable the patient to change

Principles of Re-educationLocal conditions which result in an alteration in posture can be removed

Patient can assume a new habit of posture which is better and maintain it through voluntary effort

Techniques of Re-educationAtmosphere give to patient is of great importance during postural re-educationPhysiotherapist must gain co-operation by his/her manner and approach

Patient must feel that the acquisition of good posture is worth whileEfforts made will be noticed and appreciated while difficulties can be overcome

Techniques of Re-educationIndividual instruction is essential as no two patients are identical

Later on a group instruction in a re-education program is enjoyable and helps the patient feel stimulated by working with others

RelaxationThe ability to relax is essential to improve postureSome degree of useless tension is nearly always associated with poor posture

Voluntary relaxation of specific muscle groups can be taught and practised

Patient needs to learn the difference between tension and relaxation

RelaxationExcessive use of arms are demanded in many occupation and house hold activitiesWashing clothes, cooking, cleaningUsing the computerDrivingThis may develop tension in the shoulder and neck area

Examples of relaxation

Crook lyingProne lyingProne lying, head raising and loweringSitting: Shoulder shrugging and retraction followed by relaxationPhysiological relaxation can be used in the treatment of occupational induced tensions

MobilityMaintenance of normal mobility is essential to a wide variety of postures assumedAbnormally high levels of mobility is a liability rather advantageIt requires higher muscular effort for control and can lead to the development of poor posture

MobilityNormal mobility is maintained by free exercise which are rhythmical and induce full range of motion movementsEmphasis is laid on full extension movements which is liable to limitation in most joints except for the lumbar spineIf joints have become limited in motion than exercises targeting increased mobility should be done

MobilityExercises that increase respiratory effort are also very essentialHanging position give good body alignment and are enjoyed by children

Muscle power General muscle weakness is rarely the root cause of poor postureMuscular development helps maintain efficiency and the ability to withstand stresses and strains imposed on the bodyWhen muscles are short or accompanied by joint stiffness than exercises to ensure relaxation and restoration of muscular balance are essential

Muscle power

Example:Work for back extensors and scapula retractors is required during re education

Presentation of good posturePhysiotherapist must be an the example for the patient to followVideos can be shown on good posture to motivate patientMirror can be used to show patient difference between good and bad posture

The headAn upward thrust of the vertex in an upright position may be sufficient to achieve satisfactory alignmentProvided unnecessary tension does not develop elsewhereIn beginning stages, thrust can be developed in lying and inclined positions

Pelvic tiltVoluntary control of the pelvis teaches the patient to be aware in any deviation of the normal positionCan be trained in crook lying and later in sitting and standing

FeetPainless, mobile, strong feet form a good base for which body is supported and balancedFoot arches should be balanced so that weight of the body is distributed evenly to all areas of the feetBracing of the aches can be practised with or without weight bearing

Abnormal Postures