What is postural control?
Controlling the body’s position in space for the dual purposes of stability and orientation (neurologic basis of control= sensory, motor, and biomechanics)
What is postural alignment?
Biomechanical alignment (body’s alignment)
What is postural orientation?
Ability to maintain an appropriate relationship between the body segments and between the body and environment for a task (RELATIONSHIP POSTURE AND TASK)
What are some components of postural control?
- Ability to control the center of mass in relationship to the base of support
- COM: point that is the center of the body mass
- BOS: area of body in contact with support surface
- COG: vertical projection of COM
What is ideal postural alignment?
- COM anterior to S2
- Line of gravity
- BOS
Ideal postural alignment comes from…
- Controlling the COM relative to BOS
- Stable posture is the COM falling within BOS
- Requiring minimal muscular effort
What are some key points about the center of mass?
- COM is a virtual point in space dependent on position of all body segments
- If the NS controls COM, it must be able to estimate the position of the COM using information from the various sensory receptors (adaptation to protect head)
- Sensory feedback from muscle spindles, joint receptors, somatosensory, and vestibular provide an estimation of the COM
What are some key landmarks for postural assessments (posteriorly)?
- C7
-T3 (superior angle of scapula) - T7 (inferior angle of scapula)
- Acromion process
What do you look for in a frontal plane postural analyzes?
- ear height
- upper shoulder height
- acromion height
- lower thoracic
- humeral folds
- pelvis height
- PSIS
- genu varum/valgus
- calcaneus with midfoot
What is Adams’ test?
- a scoliosis screening where you have the patient bend forward looking for any spinal deviations
Sagittal landmarks in postural analyses
- ear lobe/tragus
- greater trochanter of femur
- anterior to center of knee joint
- anterior to lateral malleolus
What muscles are active in quiet (static standing)?
- Active muscles: erector spinae, iliopsoas, glute med, TFL, gastroc, solues
- Active muscles w/ pertubation: abdominals, TA
- Inactive muscles: bicep femoris,
What are the key muscles for lower limbs during standing?
- Gastroc-soleus , erector spinae, abdominals, and paraspinals
What does forward head posture promote?
- Reduced efficiency of muscle groups
- Changes in scapula musculature
- Impaired rhomboids and middle traps
- Anterior thoracic musculature becomes shortened
- Increased kyphosis
What is upper crossed syndrome?
- tight: upper traps, levator, and pectorals
- weak: deep neck flexors, lower traps and serratus anterior
What causes an anterior pelvic tilt
- tight illiopsoas and rectus femoris
- tight erector spinae
- weak gluteal max
What causes a posterior pelvic tilt?
- tight hamstrings
- tight glute max
- tight rectus abdominus
An anterior pelvic tilt creates what type of back deformity?
- lordotic back
A posterior pelvis tilt creates what type of spinal deformity?
- flat back
What does a forward shifted pelvis lead to?
- swayback position with hyperextension at the knees and hip along with posterior pelvic tilt
What does moving out of the line of gravity create?
more musculature work
What are the major factors in dynamic postural control?
- Biomechnaical alignment
- Muscle groups (work together to maintain position)
- Task (adapts to COM, BOS, and COG)
The sensory system plays a major role in which of the two, dynamic posture or static posture?
- Dynamic posture: task related performances
