Posture Evaluation
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1 Posture Evaluation Martha Macht Sliwinski PT PhD Posture The alignment and positioning of the body in relation to gravity, center of mass and base of support The physical therapist uses posture tests and measures to assess structural abnormalities in addition to the ability to right the body against gravity Correct Posture Maximal physiological and biomechanical efficiency Minimize stress and strains Segments aligned vertically with gravity line through axis of all joints Balanced strength and length of muscles Balance is based on a force couple “Good Posture” A state of musculoskeletal balance that protects the supporting structures of the body against injury or progressive deformity Postural Analysis View from different positions Use dominant eye Identify bony landmarks Assess with and without orthotic devices and shoewear Assess in ideal and real-life postures Note relevant medical history Endomorphs The naturally large person characterized with a round face, wide hips, big bones, slow metabolism and high number of fat cells.
description
posture
Transcript of Posture Evaluation
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Posture Evaluation
Martha Macht Sliwinski PT PhD
Posture
The alignment and positioning of the body in relation to gravity, center of mass and base of supportThe physical therapist uses posture tests and measures to assess structural abnormalities in addition to the ability to right the body against gravity
Correct Posture
Maximal physiological and biomechanical efficiencyMinimize stress and strainsSegments aligned vertically with gravity line through axis of all jointsBalanced strength and length of musclesBalance is based on a force couple
“Good Posture”
A state of musculoskeletal balance that protects the supporting structures of the body against injury or progressive deformity
Postural Analysis
View from different positionsUse dominant eyeIdentify bony landmarksAssess with and without orthotic devices and shoewearAssess in ideal and real-life postures Note relevant medical history
Endomorphs
The naturally large person characterized with a round face, wide hips, big bones, slow metabolism and high number of fat cells.
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Mesomorphs
The naturally muscular person with wide shoulders, small waist, athletic build, low body fat percentage with an increased metabolism
Ectomorphs
The skinny person with a linear appearance, small muscles, ultra fast metabolism, low body fat, narrow shoulders, hips and waist.
Postural Tests & Measures
Analysis of resting (static) posture or preferred in any positionAnalysis of dynamic posturing/functional movementsAnalysis of static and dynamic postures, using computer-assisted imaging, posture grids, plumb lines, still photography, videotape, visual analysis
Clinical Indications for Postural Tests & Measures
Abnormal bony alignmentImpaired aerobic capacityImpaired joint integrity/mobilityImpaired motor functionImpaired muscle performanceImpaired sensory integrityPain
Ideal Posture – lateral view
Ear lobeDensCervical vertebral bodiesTip of the acromionMid trunkLumbar bodies/sacral promontoryGreater trochanterSlightly anterior to kneeSlightly anterior to lateral malleolus
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Ideal Posture
HeadCervical SpineScapulaeThoracic SpineLumbar SpinePelvisHipsKneesAnkle
Muscle Balance
AbdominalsHip FlexorsErector SpinaeHip Extensors
Poor Posture (AAOS 1947)
Increases strain on supporting structures (ie, ligaments, cartilage, bone-tendon interface, etc)
Less efficient balance of body over its base of supportAlteration of the normal arthokinematics/kinetics of affected joints irrespective of position (eg, standing erect, lying, squatting, etc)
Poor Posture
Anatomic impairmentsPhysiologic impairmentsPsychosocial impairmentsBony structure abnormalitiesHabitual Posturing
Development of Posture Lordosis
A marked anterior pelvic tiltA marked lordosisMarked anterior pelvic tilt and lordosis
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Hyperlordotic and Kypholordotic Kypholordotic Posture
Head: forwardC-spine: hyperextendedScapulae: abductedT spine:↑ flexionL spine: hyperextendedPelvis: anterior tiltHips: flexedKnees: slightly hyperextendedAnkles: slight plantar flexion
Military Type
Head: neutralC-spine: normal, slightly anteriorT spine:normal, slightly posteriorL spine: hyperextended lordosisPelvis: anterior tiltKnees: slightly hyperextendedAnkles: slightly plantar flexed
Sway Back
Head: forwardC-spine: slightly extendedT spine:↑ flexionL spine: flexion, flatteningPelvis: posterior tiltHips: hyperextendedKnees: hyperextendedAnkles: neutral
Sway Back and Flat Back Flat Back
Head: forwardC-spine: slightly extendedT spine:↑ flexion upper part, lower part, straightL spine: flexed, straightPelvis: posterior tiltHips: extended Knees: extendedAnkles: slight plantar flexion
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Ideal Alignment: Posterior View
HeadCervical SpineShouldersThoracic SpineLumbar SpinePelvisHipsLower ExtremitiesFeet
Faulty Alignment: Posterior View
HeadC spineShouldersScapulaeT and L spinePelvisHips jointsLower ExtremitiesFeet
Faulty Alignment: Posterior View
HeadC spineShouldersScapulaeT and L spinePelvisHips jointsLower ExtremitiesFeet
Faulty Postures: Side & Back Views
Figure A; posture appears good from the posterior view but is faulty from the sideFigure B faulty posture both front and side views
Anterior View
Lower ExtremityTorsoShoulderHead and Neck
Measuring Leg Length
Structural Leg Length Test (or “true”): measure from ASIS to medial malleolusFunctional Leg Length Test (or apparent): measure from medial malleolus to umbilicus
