Posture & Gate

Question 1

Anterior Static Posture Screen: Facial Structures

Answer 1

Check alignment of:
- Eyes
- Ears
- Nose
- Angles of the jaw (angle of the mandible landmark)

Question 2

Anterior Static Posture Screen: Trunk and UE Structures

Answer 2

Check alignment of:
- Larger neck muscles
- Acromion
- Clavicle
- Carriage of the arms
- Fingertip length

Question 3

Anterior Static Posture Screen: Lower Trunk, Pelvis, & LE Structures

Answer 3

Check alignment of:
- Angle of rib cage
- Umbilicus
- Iliac crests
- Greater trochanter
- Knee
- Ankle

Question 4

Common Anterior Postural Findings: Facial Droop

Answer 4

indicates nerve paralysis/stroke

Question 5

Common Anterior Postural Findings: Flexed arm held against body

Answer 5

possible nerve damage or splinting due to an injury

Question 6

Common Anterior Postural Findings: Knees facing inwards

Answer 6

possible bone pathology or due to leg pain

Question 7

Posterior Static Posture Screen: Head, Neck, & Shoulder Structures

Answer 7

Check alignment of:
- Ears
- Cervical Spine (paravertebral muscle mass)
- Slope of shoulders
- Acromion
- Inferior angle of Scapula

Question 8

Posterior Static Posture Screen: Trunk & LE Structures

Answer 8

Check alignment of:
- Spinal alignment
- Paraspinal muscles
- Iliac crests
- Greater trochanter
- Popliteal space
- Ankles

Question 9

Common Posterior Postural Findings

Answer 9

• Scoliosis: alternating unevenness
• Short leg: anatomic vs postural
• Shoulder winging: muscle/nerve weakness, postural

Question 10

Lordosis

Answer 10

• Anterior apex of curve
• Present in Cervical and Lumbar region of spine

Question 11

Kyphosis

Answer 11

• Posterior apex of curve
• Present in Thoracic and Sacrum region of spine

Question 12

Ideal Posture

Answer 12

• structures on or slightly anterior/posterior to gravitational line

Question 13

Components of Lateral Static Postural Screen

Answer 13

Check alignment (in regards to Gravitational/Plumb Line) of:
- Head carriage
- Shoulder carriage
- Spinal curves
- Knees
- Pelvis

Question 14

Poor/Hunched Posture

Answer 14

• Lateral Static Posture finding
• Loss or exaggeration of spinal curves
• Large anterior carriage of head and shoulders – chronic MSK pain, muscle or neurologic pathology

Question 15

Goals of Gait

Answer 15

Move body weight forward with as little energy as possible and without hurting oneself

Question 16

Challenges to Gait

Answer 16

• Must be able to absorb body weight/forces from ground
• Transfer body weight in an efficient manner
• Convert absorbed forces into forward movement

Question 17

Stance Phase

Answer 17

(1) Heel Strike: establish stable contact
(2) Loading Response: absorb ground reaction to weight
(3) Mid-stance to Pre-swing: body weight carried forward

Question 18

Swing Phase

Answer 18

(4) Toe-off
(5) Mid-swing
(6) Terminal swing

Question 19

Goals of Swing Phase

Answer 19

• clear foot
• advance LE
• prepares LE for loading

Question 20

Ataxic Gait

Answer 20

• neurologic etiology
• effects both legs (bilateral)
• wide base, irregular steps
• lack of balances/proprioception
• due to: alcohol intoxication, damage to balance centers of brain/spinal cord

Question 21

Hemiparesis (loss of function) Gait

Answer 21

• neurologic etiology
• effects one leg (unilateral)
• will drag/pull limbs that are stuck in spasm – arm is flexed, leg extended (circumduction)
• due to damage to motor control of brain; common with strokes

Question 22

Scissor Gait

Answer 22

• neurologic etiology
• bilateral
• leg muscles stiff due to spasm with knees pointing inward
• legs and foot commonly crosses midline
• due to damage at motor part of brain; abnormal brain development or damage at birth (cerebral palsy)

Question 23

Steppage Gait/Foot Drop

Answer 23

• neurologic etiology
• unilateral
• “hiking” = bending at hip/knee to raise weak leg higher; clears weak foot during swing phase
• due to weakness in a specific nerve causing inability to raise the foot

Question 24

Parkinsonian Gait

Answer 24

• neurologic etiology
• bilateral
• stiff and stooped over with tremors
• short shuffling gait that speeds up involuntarily (Festinating)
• due to damage in muscle tone/movement initiation center of brain (Parkinsons)

Question 25

Waddling Gait/Trendelenburg Gait

Answer 25

- musculoskeletal etiology - bilateral - duck-like waddle -- trunk shifts toward stance leg, hip drops on swing leg - due to trunk and leg muscular weakness/pathology

Question 26

Antalgic Gait

Answer 26

- musculoskeletal etiology - unilateral - shorten gait to prevent placing weight on injury -- decrease stance phase on effected limb - due to pain in LE - concern for trauma, joint damage, or joint inflammation