KIN 191A A ss e ss m e n t   o f  P o s t u r e
INTRODUCTION <ul><li>WHAT IS POSTURE </li></ul><ul><li>CLINICAL ANATOMY </li></ul><ul><li>CLINICAL EVALUATION OF POSTURE <...
WHAT IS POSTURE <ul><li>The position of the body at a given point in time </li></ul><ul><li>Ideal posture </li></ul><ul><u...
CLINICAL ANATOMY <ul><li>Kinetic chain </li></ul><ul><li>Muscular function </li></ul><ul><li>Muscular length-tension relat...
Kinetic Chain <ul><li>Open kinetic chain (OKC) </li></ul><ul><ul><li>Non-weight-bearing </li></ul></ul><ul><ul><li>Movemen...
 
Muscular Function <ul><li>Produce joint motion </li></ul><ul><li>Provide dynamic joint stability </li></ul>
Muscular Length-Tension Relationships <ul><li>Describes how a muscle is capable of producing different amounts of tension ...
 
Agonist and Antagonist Relationships <ul><li>Agonist </li></ul><ul><ul><li>A muscle that contracts to perform the primary ...
Muscular Imbalances <ul><li>An impaired relationship between a muscle that is overactivated, subsequently shortened and ti...
Soft Tissue Imbalances <ul><li>A joint capsule and surrounding ligaments adaptation due to abnormal compressive or shear f...
CLINICAL EVALUATION OF POSTURE <ul><li>Views of Postural Inspection </li></ul><ul><ul><li>Lateral view </li></ul></ul><ul>...
Views of Postural Inspection
Assessment of Ideal Posture
Lateral View <ul><li>Determinations of the anterior and posterior alignment of the body relative to the frontal plane </li...
Anterior View <ul><li>Bisects the midline of the body in sagittal plane </li></ul><ul><li>Alignment relative to plumb line...
Posterior View <ul><li>Plumb line should be equal distance from both feet, bisecting spinal column or trunk and head </li>...
Classification of Body Types
Palpation
Lateral Aspect <ul><li>Pelvic position </li></ul><ul><ul><li>Palpate ASIS and PSIS on the same side </li></ul></ul><ul><ul...
 
Anterior Aspect <ul><li>Patellar position </li></ul><ul><li>Iliac crest heights </li></ul><ul><li>ASIS heights </li></ul><...
Posterior Aspect <ul><li>PSIS positions </li></ul><ul><li>Spinal alignments </li></ul><ul><li>Scapular positions </li></ul>
COMMON POSTURAL DEVIATIONS <ul><li>FOOT AND ANKLE </li></ul><ul><ul><li>Hyperpronation </li></ul></ul><ul><ul><li>Hypersup...
<ul><li>SPINAL COLUMN </li></ul><ul><ul><li>Hyperlordotic posture </li></ul></ul><ul><ul><li>Kypholordotic posture </li></...
<ul><li>SHOULDER AND SCAPULAR </li></ul><ul><ul><li>Forward shoulder posture </li></ul></ul><ul><ul><li>Scapular winging <...
Lordosis / Good / Sway Back
Hyperlordo tic  Posture <ul><li>Increase in the anterior curve of the lumbar spine </li></ul><ul><li>Tighten or shortened ...
Lordosis
During Extension
Kypholordotic Posture <ul><li>Increase in total lumbar lordosis </li></ul><ul><li>Com p ensatory increase in thoracic kyp ...
Swayback Posture <ul><li>Tightens or shortens  hip extensors </li></ul><ul><li>Posterior pelvic tilt </li></ul><ul><li>Gen...
Flat Back Posture <ul><li>Tightens or shortens  hip extensors </li></ul><ul><li>Posterior pelvic tilt </li></ul><ul><li>Fl...
Scoliosis <ul><li>Lateral curve of the vertebral column </li></ul><ul><ul><li>Curve is named according to the convexity </...
Scoliosis Curve Patterns
Adams’ Position
C o bb’s Angle
Forward Shoulder Posture <ul><li>Tightened, shortened, overdeveloped anterior shoulder girdle muscles </li></ul><ul><li>La...
Scapular Winging <ul><li>Weakness of ser r atus anterior muscle </li></ul><ul><li>Weakness of middle and lower trapezius m...
Forward Head Posture <ul><li>Extension of upper  cervical spine </li></ul><ul><li>Flexion of lower  cervical spine </li></...
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Kin191 A. Ch.3. Assessment Of Posture. Fall 2007

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  • I though t you started plumbline slightly anterior to laterla malleolus, then the line should go through knne, greater trochanter bodies of lumbar vertebrae, middle acromion, cervical vertebrae and ear hole
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Kin191 A. Ch.3. Assessment Of Posture. Fall 2007

  1. 1. KIN 191A A ss e ss m e n t o f P o s t u r e
  2. 2. INTRODUCTION <ul><li>WHAT IS POSTURE </li></ul><ul><li>CLINICAL ANATOMY </li></ul><ul><li>CLINICAL EVALUATION OF POSTURE </li></ul><ul><li>COMMON POSTURAL DEVIATIONS </li></ul>
  3. 3. WHAT IS POSTURE <ul><li>The position of the body at a given point in time </li></ul><ul><li>Ideal posture </li></ul><ul><ul><li>Characterized by specific landmarks being aligned with the force of gravity, keeping the body as close to physiological equilibrium as possible </li></ul></ul>
  4. 4. CLINICAL ANATOMY <ul><li>Kinetic chain </li></ul><ul><li>Muscular function </li></ul><ul><li>Muscular length-tension relationships </li></ul><ul><li>Agonist and antagonist relationships </li></ul><ul><li>Muscular imbalances </li></ul><ul><li>Soft tissue imbalances </li></ul>
  5. 5. Kinetic Chain <ul><li>Open kinetic chain (OKC) </li></ul><ul><ul><li>Non-weight-bearing </li></ul></ul><ul><ul><li>Movement occurs at predominantly at one joint (movement at one joint does not affect at other joints) </li></ul></ul><ul><li>Closed kinetic chain (CKC) </li></ul><ul><ul><li>Weight-bearing </li></ul></ul><ul><ul><li>Movement at one joint affects movement at other joints in a consistent and predictable fashion </li></ul></ul>
  6. 7. Muscular Function <ul><li>Produce joint motion </li></ul><ul><li>Provide dynamic joint stability </li></ul>
  7. 8. Muscular Length-Tension Relationships <ul><li>Describes how a muscle is capable of producing different amounts of tension (force) depending on its length </li></ul><ul><li>Active insufficiency </li></ul><ul><ul><li>Occurs when muscle is shortens and the actin and myosin myofilaments are overlapped to the point where maximum tension cannot be produced </li></ul></ul><ul><li>Passive insufficiency </li></ul><ul><ul><li>Occurs when the muscle is lengthened and the actin and myosin myofilaments lack sufficient overlap to stretch enough to complete full ROM </li></ul></ul>
  8. 10. Agonist and Antagonist Relationships <ul><li>Agonist </li></ul><ul><ul><li>A muscle that contracts to perform the primary movements of the joint </li></ul></ul><ul><li>Antagonist </li></ul><ul><ul><li>Performs the opposite movement of the agonist muscle </li></ul></ul><ul><ul><li>Must reflexively relax to allow the agonist’s motion to occur </li></ul></ul><ul><li>Co-contraction </li></ul><ul><ul><li>Concurrent contraction of the agonist and antagonist muscles </li></ul></ul>
  9. 11. Muscular Imbalances <ul><li>An impaired relationship between a muscle that is overactivated, subsequently shortened and tightened and another that is inhibited and weakened </li></ul><ul><li>Nerve injury/Pain/Joint effusion/ Poor posture/Repetitive activity of one muscle group </li></ul>
  10. 12. Soft Tissue Imbalances <ul><li>A joint capsule and surrounding ligaments adaptation due to abnormal compressive or shear forces being produced within the joint(s) crossed by those muscles </li></ul>
  11. 13. CLINICAL EVALUATION OF POSTURE <ul><li>Views of Postural Inspection </li></ul><ul><ul><li>Lateral view </li></ul></ul><ul><ul><li>Anterior view </li></ul></ul><ul><ul><li>Posterior view </li></ul></ul><ul><li>Inspection of Leg length Discrepancy </li></ul><ul><li>Palpation </li></ul><ul><ul><li>Lateral aspect </li></ul></ul><ul><ul><li>Anterior aspect </li></ul></ul><ul><ul><li>Posterior aspect </li></ul></ul>
  12. 14. Views of Postural Inspection
  13. 15. Assessment of Ideal Posture
  14. 16. Lateral View <ul><li>Determinations of the anterior and posterior alignment of the body relative to the frontal plane </li></ul><ul><li>Alignment relative to plumb line (bisects) </li></ul><ul><ul><li>Auditory meatus </li></ul></ul><ul><ul><li>Acromion process </li></ul></ul><ul><ul><li>Mid thoracic region </li></ul></ul><ul><ul><li>Greater trochanter </li></ul></ul><ul><ul><li>Lateral femoral condyle (slightly anterior) </li></ul></ul><ul><ul><li>Lateral malleolus (slight posterior) </li></ul></ul>
  15. 17. Anterior View <ul><li>Bisects the midline of the body in sagittal plane </li></ul><ul><li>Alignment relative to plumb line (bisects) </li></ul><ul><ul><li>Head </li></ul></ul><ul><ul><li>Chest </li></ul></ul><ul><ul><li>Umbilicus </li></ul></ul>
  16. 18. Posterior View <ul><li>Plumb line should be equal distance from both feet, bisecting spinal column or trunk and head </li></ul><ul><li>Alignment relative to plumb line (bisects) </li></ul><ul><ul><li>Occipital protuberance </li></ul></ul><ul><ul><li>Cervical spinous processes </li></ul></ul><ul><ul><li>Scapular borders </li></ul></ul><ul><ul><li>Thoracic spinous processes </li></ul></ul><ul><ul><li>Lumbar spinous processes </li></ul></ul><ul><ul><li>Median sacral crests </li></ul></ul>
  17. 19. Classification of Body Types
  18. 20. Palpation
  19. 21. Lateral Aspect <ul><li>Pelvic position </li></ul><ul><ul><li>Palpate ASIS and PSIS on the same side </li></ul></ul><ul><ul><li>Relationship between ASIS and PSIS, normally 8 -10 ° </li></ul></ul>
  20. 23. Anterior Aspect <ul><li>Patellar position </li></ul><ul><li>Iliac crest heights </li></ul><ul><li>ASIS heights </li></ul><ul><li>Lateral malleol u s and fibular head heights </li></ul><ul><li>Shoulder heights </li></ul>
  21. 24. Posterior Aspect <ul><li>PSIS positions </li></ul><ul><li>Spinal alignments </li></ul><ul><li>Scapular positions </li></ul>
  22. 25. COMMON POSTURAL DEVIATIONS <ul><li>FOOT AND ANKLE </li></ul><ul><ul><li>Hyperpronation </li></ul></ul><ul><ul><li>Hypersupination </li></ul></ul><ul><li>KNEE </li></ul><ul><ul><li>Genu recurvatum </li></ul></ul><ul><ul><li>Genu varum </li></ul></ul><ul><ul><li>Genu valgum </li></ul></ul>
  23. 26. <ul><li>SPINAL COLUMN </li></ul><ul><ul><li>Hyperlordotic posture </li></ul></ul><ul><ul><li>Kypholordotic posture </li></ul></ul><ul><ul><li>Swayback posture </li></ul></ul><ul><ul><li>Flat back posture </li></ul></ul><ul><ul><li>Scoliosis </li></ul></ul>
  24. 27. <ul><li>SHOULDER AND SCAPULAR </li></ul><ul><ul><li>Forward shoulder posture </li></ul></ul><ul><ul><li>Scapular winging </li></ul></ul><ul><li>HEAD AND CERVICAL SPINE </li></ul><ul><ul><li>Forward head posture </li></ul></ul>
  25. 28. Lordosis / Good / Sway Back
  26. 29. Hyperlordo tic Posture <ul><li>Increase in the anterior curve of the lumbar spine </li></ul><ul><li>Tighten or shortened hip flexor muscles </li></ul><ul><li>Anterior pelvic tilt </li></ul><ul><li>General concavity viewed from behind </li></ul>
  27. 30. Lordosis
  28. 31. During Extension
  29. 32. Kypholordotic Posture <ul><li>Increase in total lumbar lordosis </li></ul><ul><li>Com p ensatory increase in thoracic kyp h osis </li></ul><ul><li>Tighten or shortened hip flexor muscles or back extensors </li></ul><ul><li>Anterior pelvic tilt </li></ul>
  30. 33. Swayback Posture <ul><li>Tightens or shortens hip extensors </li></ul><ul><li>Posterior pelvic tilt </li></ul><ul><li>Genu recurvatum </li></ul>
  31. 34. Flat Back Posture <ul><li>Tightens or shortens hip extensors </li></ul><ul><li>Posterior pelvic tilt </li></ul><ul><li>Flexed lumbar spine ( ↓ lumbar lordosis) </li></ul><ul><li>Extended thoracic spine ( ↓ thoracic kyphosis) </li></ul>
  32. 35. Scoliosis <ul><li>Lateral curve of the vertebral column </li></ul><ul><ul><li>Curve is named according to the convexity </li></ul></ul><ul><ul><li>If the curve is convex to the left: left scoliotic curve </li></ul></ul><ul><ul><li>“ C” curves or compound “S” curves </li></ul></ul>
  33. 36. Scoliosis Curve Patterns
  34. 37. Adams’ Position
  35. 38. C o bb’s Angle
  36. 39. Forward Shoulder Posture <ul><li>Tightened, shortened, overdeveloped anterior shoulder girdle muscles </li></ul><ul><li>Large breast development </li></ul><ul><li>Humeral head displaced anteriorly </li></ul>
  37. 40. Scapular Winging <ul><li>Weakness of ser r atus anterior muscle </li></ul><ul><li>Weakness of middle and lower trapezius muscles </li></ul><ul><li>Trauma to the long thoracic nerve </li></ul>
  38. 41. Forward Head Posture <ul><li>Extension of upper cervical spine </li></ul><ul><li>Flexion of lower cervical spine </li></ul><ul><li>Forward shoulder </li></ul>

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