PRESENT BY-
Dr.Debanjan
INTRODUCTION
Posture is a position or attitude of the body a relative arrangement of body part
for a specific activity or a characteristic manner of bearing the body.
S:-Stable joints;
T:-Tight abdominals;
U:-upright ribs;
A. Inactive Posture
B. Active
A) Static Posture
B) Dynamic posture
POSTURAL
MECHANISM
Postural Reflex
1. Muscle
2. Eyes
3. Ears
4. Joint Structure
Skin sensation also plays a part, eg.soles of the feet, when the body in
standing position.
Impulses from all these receptors are conveyed and coordinated in the
central nervous system.
Good / Correct Posture-
Good posture is the state of muscular and skeletal balance that protect
the supporting structures of the body against injury or progressive
deformity irrespective of the attitude.
Faulty posture
Postural/Positional Structural
Postural Development
Correct posture
Position in which
minimum stress is placed
on each joint. (Magee)
Faulty posture
Any position that
increases stress on joints
Postural Development
Birth
Entire spine concave
forward (flexed)
Primary curves
Thoracic spine
Sacrum
Developmental (usually
around 3 mos.)
Secondary curves
Cervical spine
Lumbar spine
Postural Development
Factors affecting posture
Bony contours
Laxity of ligamentous structures
Fascial & musculotendinous tightness
Muscle tonus
Pelvic angle
Joint position & mobility
Neurogenic outflow & inflow
Postural Development
Causes of poor posture
Positional factors
Appearance of increased
height (social stigma)
Muscle imbalances/ contractures
Pain
Respiratory conditions
Postural Development
Structural factors
Congenital anomalies
Developmental problems
Trauma
Disease
Postural Control
Standard Posture-
POSTURAL EXAMINATION
The assessment of posture is in standing position. The whole posture is
asessed from head to toes in different views,
(a) Lateral views
(b) Posterior views
(c) Anterior views
The examiner should first determine the patient body type. There are three body
types:
(i) Ecotomorph is a person who has a thin body builds characterized by a
relative prominence of structure developed from the embryonic ectoderm.
Ectomorph
Mesomorph
Endomorph
ANTERIOR &
LATERAL VIEW
Anterior View Lateral View
Correct Posture
Anterior view
Kyphotic Lordotic
Common Cause
Structural scoliosis Neuromuscular disease,osteopathic
disorder, and idiopathic disorder
Non structural Leg length discrepancy,either structural
or functional, muscle guarding or spasm a painful stimuli
in the back or neck, and habitual or asymmetric posture.
Treatment of scoliosis
3)Bony anomaly
Treatment of Sway Back
Plumb Alignment
Lateral view:
Left
Right
Back view:
Deviated Left
Deviated Right
EVIDENCES
1)Relationships Between Lumbar Lordosis, Pelvic Tilt,
and Abdominal Muscle Performance
MARTHA L. WALKER, et al
METHODS
Subjects-The subjects were 31 healthy physical therapy students, 23
women and 8 men, between the ages of 20 and 33 years, with a mean
age of 23.9 years (s = 3.8 years).
Inclusion criteria- ages between 20 and 33years
Exclusion criteria- acute or chronic back pain
scoliosis of greater than 15 degrees
Instrumentation- inclinometer
Procedure
Measurements of pelvic tilt and lumbar lordosis were taken before
testing the abdominal muscle function
RESULTS
Lumbar Lordosis
Pelvic Tilt
Abdominal Muscle Function
Relationship of Abdominal Muscle Function,
Lordosis, and Pelvic Tilt
CONCLUSION
Lumbar lordosis, pelvic tilt, and abdominal muscle
function during normal standing are not related.
This study demonstrates the need for a reexamination of
clinical practices based on assumed relationships of
abdominal muscle performance,pelvic tilt, and lordosis.
2)Effects of Approximation on Postural Sway in
Healthy Subjects
KATHERINE T. RATLIFFE
METHOD
Subjects- studied 20 subjects, 6men and 14 women, between the
ages of 23 and 30 years.
Data Analysis-
A one-sample t test was used to determine the
significance(p < .02) of the mean weight effect (d) at
each bony landmark.
DISCUSSION
PURPOSE-
To use an objective noninvasive method to determine the
effect of the pelvic tilt on the spinal curves in the sagittal plane.
METHOD
Subjects
Exclusion criteria-
Spinal fusions, herniated intervertebral disks
Lateral curvatures of spine
Muscle atrophic diseases.
Anatomical Position System
A noninvasive computerized method, Iowa Anatomical
Position System(IAPS)
Both the Healthy Group and Patient Group were able to rotate
their pelvis a sufficient amount to change the thoracolumbar
curve Pelvic rotation or pelvic tilt did not alter the configuration of
the thoracic spinal curve.
Subjects
Forty-four subjects (mean age [SD]=62.37.1 years) were
dichotomized into high kyphosis and low kyphosis groups.
Methods
Lateral standing radiographs and photographs were captured and
then digitized.These data were input into biomechanical models to
estimate net segmental loading from T2L5 as well as trunk muscle
forces
Participants with (A) high kyphosis and (B) low kyphosis in a standing
posture with their respective lateral thoracic radiograph.
Sequential steps in
estimating net segmental
loads and muscle forces
for each
participant.
Results
The high kyphosis group demonstrated significantly greater
normalized flexion moments and net compression and shear forces.
Trunk muscle forces also were significantly greater in the high
kyphosis group.
A strong relationship existed between thoracic curvature and net
segmental loads (r.85.93) and between thoracic curvature
and muscle forces (r.70 .82).
Results
The subjects with vestibular hypofunction demonstrated less
stability than the subjects without impairment, but there were no
postural differences.
Subjects with vestibular hypofunction had more weight on the left
lower extremity during standing with feet apart.
In all subjects during standing with feet apart, the COG was
anterior
to the ankle, knee, back, and shoulder and posterior to the hip and
neck.
Subjects had an anterior pelvic tilt, extended trunk and head, right
laterally flexed trunk and pelvis, and flexed.
Conclusion and Discussion