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  1. 1. KKU_Biomech_M4_L1 Posture Dr / Shimaa Essa Lecturer of physical therapy , faculty of community, King Khalid university Lesson (1)
  2. 2. Upon successful completion of this lesson you would be able to: 1. 2. 3. 4. 5. 6. 7. Define normal posture. Realize the development of posture. Identify advantages of normal posture. Distinguish between different types of posture. Realize types of poor posture. Analysis posture. Evaluate deviations of normal posture.
  3. 3. The postural alignment starts its development from early period of life with development of the spine and its curvature. You we learn what is meant by posture, the development and characteristics of normal posture, advantages of correct posture, types of postures, what is meant by poor or faulty posture, the disadvantages of poor posture. And practically diagnose posture deviations of normal.
  4. 4. DEVELOPMENT OF POSTURE The postural alignment starts its development from early period of life with development of the spine and its curvature. At first, at birth the spine has one "C"-shaped curve with one convexity and one concavity. Then, as the child is trying to raise his head 'from prone lying position cervical curve starts to develop and in the early phase of education of walking, another curve will be developed which is the lumbar curve. These two curves are considered as "secondary curves" to the first one which is called "primary curve".
  5. 5. CURVATURES OF THE SPINE 1- FROM FRONTAL VIEW: If the spine is viewed from the front or the back view it seems to be straight and symmetrical. Posterior (Back) Spinal Column
  6. 6. CURVATURES OF THE SPINE 2- FROM SAGITTAL VIEW: If the spine is viewed from the lateral side, four normal curves will appear which are: a- Two primary curves: dorsal and sacral which are convex posteriorly. b- Two secondary curves: cervical and lumbar which are convex anteriorly.
  7. 7. DEFINITION: Good posture is the attitude which, is assumed by Body parts to maintain stability and balance with minimum effort and least strain during supportive and non supportive positions.
  8. 8. CHARACTERISTICS OF GOOD POSTURE (Prerequisites of good posture): For good posture to be maintained the following must be obtained: The ability to maintain 'the body upright in good and erect position with less energy. The ability to maintain balance in upright position via keeping the line of gravity near the center of the base of support.
  9. 9. Effects of good posture: Maintaining good posture has its values in different body functions and systems. The effects of good posture include: 1- Helps the muscles in the body to be unloaded and relaxed. 2- Improves respiratory and circulatory efficiency. 3- Prevents unnecessary strain and fatigue. 4- Decreases the incidence of diseases resulting from bad posture. 5- Improves the subject’s state; mentally or psychologically.
  10. 10. TYPES OF POSTURE 1) Fatigue posture 2) Easy posture 3) Rigid posture
  11. 11. 1- Easy Posture It Is good, symmetrical and balanced position This position can not be maintained for a long time. So, the subject will shift his weight in a swaying movement in order to prevent fatigue and to maintain a good circulation in the postural muscles of the legs when standing. By alternating the main support from one leg to the other; the muscles become periodically unloaded and relaxed.
  12. 12. 2- Fatigue Posture It is asymmetrical or sagging posture This position is relaxed and can be maintained for. a long time as most of body's joints are in semi-flexion. The load on the muscles will decrease and the energy expenditure is 10% less than easy posture.
  13. 13. 3- Rigid Posture It is called posture of attention. It doesn't mean normal posture This position can not be assumed for a long time as most of body's joints are. In extension; so, the load will increase on joints and muscles and energy expenditure is 20% more than easy posture. So, with referring to 3 types of posture the energy in: Rigid > Easy > Fatigue
  14. 14. DEFINITION: Poor posture is a position resulting from any deviation from ideally aligned erect posture (good posture).
  15. 15. CAUSES OF POOR POSTURE: Poor posture may occur due to:1- Defects in: •Joints: such as stiffness or immobilization. •Bones: such as shortening or deformity. •Muscles: such as weakness, paralysis or contracture. •Vision or hearing. 2- Bad habits: either from early childhood or from occupational positions. Example for that is the workers that perform jobs which require continuous flexed position of the trunk. 3- Pain, fatigue or bad psychological state.
  16. 16. EFFECTS OF POOR POSTURE: Poor posture causes deviations from the normally aligned posture. As a result the body functions are altered and this may lead to dysfunction and diseases. Poor posture may cause one or more of the following dysfunction: 1. Secondary deformities and compensatory postural defects. 2. Easy fatigability and high energy expenditure. 3. Decrease both respiratory and circulatory efficiency. 4. Pain, bad cosmetic appearance and psychological disturbances.
  17. 17. Analysis of Posture
  18. 18. To assess posture ideally, the subject stands upright, and attention should be given to the following: No movement in the atlantoaxial or atlanto-occipital joint which results in protrusion of the jaw. Stands as straight as possible. Knees should be straight as much as possible. Head faces forward and arms beside the body. Almost all joints of the body must be in the neutral position.
  19. 19. Assessment should be From 3 Views: 1- Anterior view. 2- Posterior view. 3- Lateral view. The Parts Which are Important to be Observe: 1- Head alignment. 2- Curvature of the spine; cervical, thoracic and lumbar. 3- Shoulders and arms. 4- Pelvic inclination. 5- Hip, knee and ankle joints.
  20. 20. Correct Posture (Lateral) Line is… • Through external auditory meatus (Ear) • Midway through shoulder • Through lumbar bodies • Slightly anterior to midline of knee • Slightly anterior to lateral malleolus
  21. 21. Correct Posture (Posterior) Line is… • In the center of head, neck, back and pelvis • Falls exactly in the mid point between the two Knees and ankles Good Posture
  22. 22. Types of Poor Posture (from the lateral view) Kyphotic-lordotic Posture Flat-back Posture Sway-back Posture
  23. 23. Kyphotic-Lordotic Posture Head- Forward Cervical Spine- Hyper-lordosis (hyper-extended) Thoracic Vertebrate- increased flexion Lumbar Vertebrate- Hyperlordosis; (hyperextended). Pelvis- Anterior tilt (forward and down) Knees- hyperextended Ankle joints- plantar flexed, legs are behind midline IDEAL
  24. 24. Flat-Back Posture Head- Forward Cervical Spine- extended Thoracic Vertebrate- reduced curvature (extension) Lumbar Vertebrate – straight (flexion) Pelvis- posterior tilt (backward) and down) Hips- extended Knees- extended Ankle joints- slightly plantar flexed IDEAL
  25. 25. Sway-Back Posture Head: Forward Cervical Spine -Hyper extended Thoracic Vertebrate- slight flexion Lumbar Vertebrate –slight extension Pelvis-posterior tilt and anterior to midline Hips- Hyper extended Knees- Hyper extended Ankle- slightly planter-flexed IDEAL
  26. 26. Evaluation Lateral Evaluation • Plumb Alignment: aligned anterior to lateral malleolus Things to Examine • Position of knees – Check for hyperextension or flexion • Pelvic position and spine curvature • Head, chest and abdominal position
  27. 27. Lateral: Knee Position Good Alignment Flexion of Knees Hyperextension of knees
  28. 28. Evaluation Anterior Evaluation • Position of feet – Check for pronation or supination – Check arch of the foot • Position of legs – Check for bowlegs • Position of knees – Check for knock-knees • Appearance of ribs • Position of head
  29. 29. Anterior: Good Alignment Knee caps face straight ahead Legs are straight up and down Toes are straight Arches have normal halfdome shape
  30. 30. Anterior: Foot Supination & Pronation Slight knee knocking Contracted anterior tibalis Feet are supinated Weight is on outside of feet Feet are pronated
  31. 31. Evaluation Posterior Evaluation • Plumb Alignment- align midway between heels Things to Examine • • • • • Note alignment of Achilles Tendon Hip adduction/abduction Check for level posterior iliac spine Check for lateral pelvic tilt Check for spine and shoulder problems
  32. 32. Posterior Evaluation Scoliosis •Lateral curve in the spine Types of Scoliosis •Congenital •Neuromuscular •Paralytic •Idiopathic 85% of cases Unknown Cause Adolescent Idiopathic Scoliosis (AIS)
  33. 33. Posterior Evaluation Scoliosis: Perform Posture Analysis Check if shoulders are level Check distance between arms and side of body Check if hips are level Check if head is centered over the pelvis.
  34. 34. Posterior Evaluation Scoliosis • Shoulders not level, prominent or uneven scapulas • Uneven gap between arm and body • Elevated or uneven hip • Head not centered over pelvis • Bending test reveals uneven portions of back
  35. 35. Summary of Posture
  36. 36. o The spinal column has 2 primary curves (Thoracic & Sacral) and 2 secondary curves (Cervical & Lumber). o Good posture is the attitude which, is assumed by Body parts to maintain stability and balance with minimum effort and least strain during supportive and non supportive positions. o Poor posture is a position resulting from any deviation from ideally aligned erect posture (good posture). o There are 3 types of normal posture, Easy, fatigue and rigid postures. o Evaluation of posture is conducted from 3 views. Lateral, Anterior and posterior views.