Posture

Question 1

when is posture assessed?

Answer 1

• any condition affecting the musculoskeletal and neuro-physiological systems
• respiratory system impairments
  cases where organic health/ fitness is not as desired, for instance pt. who has been bedridden for long time
• affective pathology, where gross extension activities are limited
• cases where there is discomfort or pain when participating in activity

Question 2

which questions are asked when observing posture in different situations?

Answer 2

• is what we see normal, abnormal, acceptable, almost normal
• does it need to be treated
• does it need intervention
• do we have sufficient theoretical structure to guide us in what to observe/ assess and to document what we saw

Question 3

what factors are responsible for impaired posture?

Answer 3

• abnormal muscle tone
• diminished automatic postural reactions required to maintain an upright position
• decreased ROM or hypermobility
• coordination problems
• decreased endurance
• inadequate balance
• bone pathology
• adoption of an abnormal posture during activity participation

Question 4

how do we assess posture by observation

Answer 4

1. observe for pain that pt. experiences, signs of anxiety, discomfort, balance and compensations, shoes, type of chair that pt. uses, sitting and working heights, callipers, artificial limbs and splints
2. observe posture that your pt. adopts during rest or without expected action
3. posture that pt. adopts during activity participation
   - name activity pt. participates in while being observed

Question 5

what assessment procedure is followed?

Answer 5

• explain procedure and purpose of test to pt.
• start observing from proximal to distal following key points
• important to know movements of each joint
• assess posture focusing on ant., lat., and post. view
• assess posture in different positions i.e. supine, sitting and standing
• always be aware of effects of pain and fatigue on posture

Question 6

what is the impact of abnormal posture?

Answer 6

• stiffness of joints
• contractures
• pain during activity participation
• postural deformities

Question 7

examples of postural deformities

Answer 7

spine/vertebral column
- kyphosis
- lordosis
- scoliosis
chest/thorax
- pigeon chest
- flat chest
pelvis
- abnormal pelvic tilt
hand
- swan neck
- bouttonniere
- congenital deformities
postural deformities can be structural ( deformities can be corrected by means of external factors) or fixed (deformities cannot be corrected be external factors, only by means of operative procedures. compensation is necessary)

Question 8

explain the assessment of posture using a plumb-line

Answer 8

body alignment:
- standing
+ assessment is done from ant., lat. (left and right), post.
position of pt. during testing
- standing with heels together and forefeet in comfortable extended rotation at 30 or 40 degrees ( ant. view)
- plum-line with weight at end hangs and touches floor
- feet are used as reference point
+ weight hangs between two heels (ant. and post.) or just anterior to lateral malleolus (lat.)

Question 9

how to interpret assessment findings

Answer 9

• comment on
  + symmetry or asymmetry of body parts
  + type of posture the pt. maintains most of the time
  + can pt. correct posture voluntarily or when given verbal cues
• deformities
• what causes the abnormal postural alignment

Question 10

which precautions should be followed during assessment?

Answer 10

• avoid maintenance of static posture for long periods
• avoid fatigue and pain
• avoid falls and injury
• be aware of primary condition causing poor posture
• avoid offering limited or excessive support
• prevention of an incorrect work height