199 Questions
What is one of the key pieces of equipment required for carrying out postural assessments?
Body crayons
Why is it recommended to have your own posture assessed?
To experience being the subject of the assessment
What is NOT mentioned as a caution or safety issue to consider before starting postural assessments?
Using sterile gloves
Which of the following is true about preparing for postural assessments?
It includes having a mirror and body crayons
Why should one keep images of standard postural alignments in mind during assessments?
To help guide what to look for in general terms
What role does a full-length mirror play in preparing for postural assessments?
It is used to help visualize posture alignment
It is a good idea to have your own posture ______
assessed
The equipment required for postural assessments includes body ______
crayons
A model ______ is useful when learning to carry out postural assessments
skeleton
One should hold images of standard postural alignments in mind when carrying out ______
assessments
Before starting postural assessments, it is important to consider ______ and safety issues
cautions
Having a warm, private room is recommended when carrying out postural ______
assessments
You might want to start by practising on family and friends. Use the crayons to mark bony landmarks on the client to help you judge the distances of these structures from the midline of the body, the angles of bones and joints, and the relationships they form with one another. Try marking the following points, which are all on the back of the body: Medial border of the scapula, Inferior angle of the scapula, Spinous processes of the spine, Olecranon process of the elbow, Posterior superior iliac spine (PSIS), Knee creases, Midline of the calf, Midline of the Achilles tendon. If you are using a model skeleton that is supported on a base stand (rather than hang- ing), it is likely to be constructed with a central pole running through the bodies of the vertebrae. This means that the spine of your model does not depict the normal lordotic and kyphotic curves we all have; in your model the curves are flattened. Time Required If you are new to postural ______, you may find that you need at least 30 minutes to do a full ______ including anterior, posterior and lateral views. With practice, you can assess the whole body, from all angles, in five minutes or less. A skilled practitioner carries out a general postural ______ quickly, noting only very obvious deviations from the standard posture.
assessment
______ is useful when learning to carry out postural assessments.
model skeleton
Having a warm, private room is recommended when carrying out postural ______.
assessments
What role does a full-length mirror play in preparing for postural assessments?
keeping images of standard postural alignments in mind
Before starting postural assessments, it is important to consider ______ and safety issues.
caution
Why is it recommended to have your own posture assessed?
postural
What is the purpose of using crayons to mark bony landmarks on the client?
To analyze the distances and angles of structures
Why may a model skeleton supported on a base stand not accurately represent normal body curves?
The central pole flattens the normal curves
How long might it take a skilled practitioner to perform a general postural assessment?
5 minutes
What is the importance of considering distances and angles when marking bony landmarks?
To understand body structure relationships
Why does it take longer for someone new to postural assessment to complete a full assessment?
Uncertainty about body landmarks
What effect does the central pole in a model skeleton have on its depiction of body curves?
It flattens them
What is the recommended attire for female clients during a postural assessment?
A normal bra
Why is it suggested that female clients wear a normal bra instead of a sport bra during a postural assessment?
Sport bras obscure the scapulae and spine
Why is it important for the client to adopt their usual standing posture during a postural assessment?
To ensure accurate observation of the everyday stance
What is a critical aspect when conducting a postural assessment at the start of a therapeutic relationship?
The way the assessment is conducted
In terms of overall stance, what are practitioners advised to observe during a postural assessment?
Balance of weight on lower limbs
Why do most people feel vulnerable during a postural assessment?
Due to the need to stand unclothed
The client should stand in her underwear, and have hair tied up if it obscures the face and neck. It is a good idea for female clients to wear a normal bra rather than a sport bra because sport bras can obscure the scapulae and spine at the back, making observation of this part of the body more difficult. Because you want to observe the everyday stance of your client, instruct her to adopt her usual standing posture rather than have her position her feet in any particular way. To begin, hold in mind some general questions regarding your client’s body. Table 2.1 provides some suggestions. The questions here are designed as prompts and are not exhaustive. Most people feel vulnerable when asked to stand unclothed to have their bodies analysed in this way. Yet this is an assessment procedure that usually takes place at the start of the therapeutic relationship. How such a procedure is conducted can be critical. Table 2.1 General Questions Regarding Your Client’s Body Overall stance Is the weight equally distributed through the lower limbs or shifted to one side? Does the client look balanced or unbalanced? Does the client appear to be swaying forwards, backwards or to one side? Alignment of body parts Does each component of the body seem balanced with relation to other parts? Is the head centred over the thorax?
postural assessment
What is the importance of considering distances and angles when marking ______?
bony landmarks
What is the purpose of using ______ to mark bony landmarks on the client?
crayons
What is one of the key pieces of ______ required for carrying out postural assessments?
equipment
Why is it suggested that female clients wear a normal bra instead of a sport bra during a postural assessment?
observation
Why may a model skeleton supported on a base stand not accurately represent normal body ______?
curves
What is one of the key aspects to observe regarding the client's body alignment during a postural assessment?
The distribution of weight through the lower limbs
In terms of muscle observation, what should be checked during a postural assessment?
Presence of hypertrophy or atrophy
Why is observing the alignment of body parts crucial during a postural assessment?
To ensure each body component is balanced with respect to others
What should be examined concerning joints during a postural assessment?
Whether joints appear swollen
Why is it important to check for normal bone shapes during a postural assessment?
To identify any misshapen, bowed, or damaged bones
What aspect should be observed when evaluating the overall stance of the client during a postural assessment?
If there is an equal bulk on both sides of the body
Is the weight equally distributed through the lower limbs or shifted to one ______?
side
Does the client appear to be swaying forwards, backwards or to one ______?
side
Do any bones appear ______, bowed or damaged?
misshapen
Is there equal bulk on the left and right sides of the ______?
body
Are there any areas of inflammation, discolouration or ______?
dryness
Does the client look ______?
comfortable
Why is it crucial for a practitioner to make non-judgemental observations during a postural assessment?
To prevent emotional significance of observations from being overlooked
What is one of the key aspects to consider when aiming for best results during a postural assessment?
Making the client feel curious about the observations
Why are standard alignments referred to as 'standard' rather than 'ideal' in the context of postural assessments?
To align with Kendall, Kendall, and Boynton's terminology
What is a common misconception about observing standard alignments during a postural assessment?
They should be compared to individualized ideal alignments
Why is it important to approach postural assessments supportively and without criticism?
To maintain a positive therapeutic relationship
What role does trust play in achieving an accurate picture of a patient's posture during an assessment?
Without trust and confidence, the practitioner may not get a true picture of posture
Why do deviations from optimal joint alignment increase stress on ligaments and require more muscle effort?
To prevent detrimental structural changes
What role do ligaments play when joints are aligned in an 'ideal' way?
Counter any tendency for joints to flex or extend
What is the purpose of muscles firing intermittently when there are no ligaments to counter joint deviations?
Increase energy expenditure
Why might muscles increase their energy expenditure during a postural assessment?
When the joint positions fall anterior or posterior to the plumb line
In postural assessments, why is it crucial for practitioners to observe if the head is centered over the thorax?
To evaluate overall body balance
Why might recommended attire for female clients during postural assessments include wearing a normal bra instead of a sport bra?
To make observation of the spine and scapulae easier
Deviations from optimal joint ______ increase the stress on ligaments and require that muscles exert more effort not just in the associated joint but usually in the joints above and below the affected part, as part of the body’s corrective mechanism. If mal-______ persists, detrimental structural changes may occur. With joints aligned in this ‘ideal’ way, ligaments counter any tendency for joints to flex or extend. Where there are no ligaments to do this, muscles fire intermittently to counter any joint deviations. The muscles increase their energy expenditure only if the joint falls very anterior or very posterior to the plumb line, or line of gravity, or if they are required to maintain a position of imbalance indefinitely. An excellent and comprehensive text describing the anatomy and function of all joints is Joint Structure and Function (Levangie and Norkin 2001). For information on the static and dynamic control of posture, see chapter 13 of that text. The figures in the sidebar shown on pages 19, 20 and 21 outline where a plumb line (shown as the vertical black line in the illustrations) should fall with respect to various parts of the body, and provide general observations for when postures are said to be good, or ideal. Illustrations within this sidebar show standard ______s for the posterior, lateral and anterior views of the body. If you wish to skip this section, you could turn to the detailed step-by-step instructions explaining what to observe in each of these views in chapters 3, 4 and 5.
alignment
Having a warm, private room is recommended when carrying out postural ______
assessments
Why might muscles increase their energy expenditure during a postural ______?
assessment
Why is it crucial for practitioners to observe if the head is centered over the ______?
thorax
What is the importance of considering distances and angles when marking ______?
bony landmarks
What role do ligaments play when joints are aligned in an 'ideal' way?
counter
To achieve the best results during a postural assessment, it is important to work supportively and without ______
criticism
During a postural assessment, it is crucial for the practitioner to observe if the ______ is centered over the thorax
head
In postural assessments, it is recommended for female clients to wear a normal bra instead of a sport bra to avoid obscuring the ______ and spine
scapulae
Most people feel vulnerable when asked to stand unclothed for a postural assessment, which usually takes place at the start of the ______ relationship
therapeutic
When evaluating the overall stance of the client during a postural assessment, it is important to observe if the weight is equally distributed through the lower limbs or shifted to one ______
side
Before starting postural assessments, it is important to consider ______ and safety issues
caution
What should be observed concerning the scapulae during a postural assessment?
The medial borders should be 3 to 5 cm away from the spine
What is an important consideration regarding the lumbar spine in a postural assessment?
It should appear straight with no right or left curvature
What is a key observation to make about the ankle and feet during a postural assessment?
The calcaneus should not be vertical
Which observation is correct regarding the neck in a postural assessment?
It should have no lateral flexion and appear straight
What is important to note about the arms in a postural assessment?
Arms should hang equidistant from the trunk, and palms should face the sides of the body
Why is it important for the scapulae to lie flat against the rib cage in a postural assessment?
To ensure proper observation without distortion
The neck should appear straight with no lateral ______.
flexion
The scapulae should lie flat against the rib cage with no anterior ______.
tilting
The lumbar spine should be straight with no curvature to the right or ______.
left
The lateral malleoli should be level. The medial malleoli should be ______.
level
Flare in the rib cage should be symmetrical left and ______.
right
The feet should be turned out slightly to maintain proper postural ______.
alignment
What should be observed about the lateral malleoli during a postural assessment?
They should be level
Why might muscles increase their energy expenditure during a postural assessment?
To compensate for joint deviations
What is a critical aspect when evaluating the stance of a client during a postural assessment?
Weight distribution in lower limbs
Why is it important for practitioners to observe if the head is centered over the thorax in a postural assessment?
To assess overall posture
What is crucial to maintain about the scapulae during a postural assessment?
Flatness against the rib cage
The head should be facing forwards with no rotation and no lateral flexion. The shoulders should be approximately level, with the shoulder of the dominant hand possibly being lower than the shoulder of the non-dominant hand. This is an observation for maintaining proper ___________ during a postural assessment.
alignment
The greater trochanters of the femurs should be level, and the buttock creases should be level and equal. These are observations for assessing the proper alignment of the ________ and thigh.
pelvis
The legs should be straight and equidistant from the plumb line with no genu varum or genu valgum. Calf bulk should be equal on the left and right legs. These are key observations for evaluating the alignment of the ________ and legs.
knees
The scapulae should lie flat against the rib cage with no anterior. This is an important observation for maintaining proper ________ alignment during a postural assessment.
shoulder
The medial malleoli should be level. The lateral malleoli should be ________. This is a crucial observation for assessing the alignment of the ankle and feet.
equal
What is a key observation to make about the alignment of the shoulders during a postural assessment?
The shoulder of the dominant hand may be lower than the non-dominant hand.
Why should the legs be straight and equidistant from the plumb line in a postural assessment?
To ensure proper alignment and symmetry.
What is an important observation to make regarding the pelvis and thighs during a postural assessment?
The PSIS should be equidistant from the spine and level.
Why is it important for the head to face forwards with no rotation in a postural assessment?
To ensure proper alignment of the neck.
What is a significant aspect to note about the lateral malleoli during a postural assessment?
They should be level.
What observation should be made regarding the lumbar spine during a postural assessment?
It should be straight with no curvature to the right or left.
What should be noted about the scapulae in relation to the spine during a postural assessment?
The scapulae should lie flat against the rib cage with no anterior tilting.
What is a crucial observation for assessing the thorax and scapulae alignment during a postural assessment?
The scapulae should lie flat against the rib cage with no anterior tilting.
Why is it important for the feet to be slightly turned out during a postural assessment?
To mimic a normal stance and observe natural foot positioning.
What observation should be made regarding the arms during a postural assessment?
The arms should hang close to the trunk.
The head should be facing forwards with no rotation and no medial flexion.
False
The shoulder of the dominant hand should be higher than the shoulder of the non-dominant hand.
False
The greater trochanters of the femurs should be uneven during a postural assessment.
False
Genu varum or genu valgum is acceptable when assessing the knees and legs.
False
The calf bulk should be unequal on the left and right legs.
False
The Achilles tendon should be horizontal.
False
The scapulae should be tilted anteriorly during a postural assessment.
False
The lumbar spine should have curvature to the right or left for optimal alignment.
False
The distance between the elbow and the wrist should be different on each arm during a postural assessment.
True
Flare in the rib cage should only be symmetrical on the right side during a postural assessment.
False
The feet should be turned in slightly during a postural assessment.
False
The cervical spine should have a normal lordotic curve that is neither exaggerated nor ______.
flattened
The chest should be held comfortably upright and not excessively elevated (military posture) nor ______.
depressed
The pelvis should be in a neutral position. That means the anterior superior iliac spine (ASIS) is in the same vertical plane as the ______.
pubis
The distance between the elbow and the wrist should be different on each ______ during a postural assessment.
arm
Flare in the rib cage should be symmetrical left and ______.
right
The legs should be straight and equidistant from the plumb line with no genu varum or genu valgum. Calf bulk should be equal on the left and right legs. These are key observations for evaluating the alignment of the ______ and legs.
ankles
The head should appear positioned over the ______—neither pushed forwards with chin out nor pulled back.
thorax
There should be normal dorsi-flexion at the ______.
ankle
The lumbar spine should have a normal lordotic curve that is neither exaggerated nor ______.
flattened
The shoulders should be neither internally nor (in rare cases) externally ______.
rotated
There should be neither flexion nor hyperextension at the knee joint in standing. Plumb Line Slightly anterior to the ______ joint.
knee
The client should stand in her underwear, and have hair tied up if it obscures the face and neck. It is a good idea for female clients to wear a normal bra rather than a sport bra because sport bras can obscure the scapulae and spine at the back, making observation of this part of the body more difficult. Because you want to observe the everyday stance of your client, instruct her to adopt her usual standing posture rather than have her position her feet in any particular way. To begin, hold in mind some general questions regarding your client’s body. Table 2.1 provides some suggestions. The questions here are designed as prompts and are not exhaustive. Most people feel vulnerable when asked to stand unclothed to have their bodies analysed in this way. Yet this is an assessment procedure that usually takes place at the start of the therapeutic relationship. How such a procedure is conducted can be critical. Table 2.1 General Questions Regarding Your Client’s Body Overall stance Is the weight equally distributed through the lower limbs or shifted to one side? Does the client look balanced or unbalanced? Does the client appear to be swaying forwards, backwards or to one side? Alignment of body parts Does each component of the body seem balanced with relation to other parts? Is the head centred over the ______?
thorax
The cervical spine should have a normal lordotic curve that is either exaggerated or flattened.
False
The lumbar spine should have a kyphotic curve that is exaggerated.
False
The thorax should be held excessively elevated, resembling a military posture.
False
There should be normal hyperextension at the knee joint in standing.
False
The pelvis should be tilted forward in a postural assessment.
False
The head should appear positioned over the thorax with the chin out.
False
The plumb line in the lateral view should run vertically through the cervical vertebrae and the earlobe.
False
The lumbar spine should have curvature to the right or left for optimal alignment.
False
Shoulders should be internally rotated for proper alignment.
False
The Plumb Line for the knees and legs should be posterior to the knee joint.
False
The greater trochanters of the femurs and buttock creases should be level and equal.
True
For proper alignment, there should be normal dorsi-flexion at the ankle.
True
What should be observed about the feet in a postural assessment?
The medial malleoli should be level
How should the lumbar spine be aligned according to the text?
With a normal lordotic curve
Which observation is correct regarding the thighs in a postural assessment?
Thighs should be equidistant between the knees
What should be noted about the shoulders in a postural assessment?
The shoulders should be approximately level
Where should the plumb line go through when assessing the pelvis alignment?
Through the pubic symphysis
What is important to note about the knees and legs in a postural assessment?
Knees should be level
The femurs should be straight and with no internal or external rotation. Thigh bulk should be equal on left and right sides. The thighs plumb line should be equidistant between ______.
thighs
The ASIS should be level. The ASIS should be equidistant from midline. The pelvis plumb line should be bisecting the pelvis through the ______ symphysis.
pubic
Knees should be level. The patellae should face forwards and be level. The tibia should be straight and leg bulk should be equal on the left and right legs. The knees and legs plumb line should be between the medial femoral condyles of the knees equidistant between the ______.
legs
Medial malleoli should be level. Feet should turn out from the midline. The ankle and feet plumb line should be between the ______ malleoli.
medial
The shoulders should be approximately level. The clavicles should be level. The shoulders plumb line should be through the manubrium, sternum, and ______ process.
xyphoid
The head should be facing forwards with no rotation and no lateral flexion. The standard anterior alignment head plumb line should go through the centre of the face: through the forehead, nose, and ______.
chin
Where is the human centre of gravity located?
Second sacral vertebra
Why has the traditional use of a plumb line in postural analysis been criticized?
It does not account for individual variations in stance
How was the plumb line traditionally positioned in relation to the client's feet for postural assessment?
Equidistant between the medial malleoli
In what way do practitioners believe postural assessments should focus more on, according to the text?
Relationship between body parts
What criticism does the text mention about positioning clients' feet on a card with painted foot outlines?
It forces clients into potentially abnormal stances
Why have practitioners been advised to focus more on the relationship between body parts in postural assessments?
To consider individual variations in stance
What is a potential drawback of using a plumb line without forced foot positions in posture research?
It may lead to incorrect alignment of the head relative to the scapula.
Why might identifying a 'standard' seated posture be challenging in postural assessments?
Recommended postures are specific to certain activities.
Why do practitioners aim to have the head positioned over the thorax in postural assessments?
To minimize postural compromises.
What should practitioners observe regarding the feet during a postural assessment?
Even distribution of body weight on both feet.
Why is the alignment of the scapula important in postural assessments?
To support proper alignment of the shoulder joint.
What aspect of posture is less likely to be compromised when the head is positioned directly over the thorax?
Alignment of the lumbar spine.
In practice, the use of a plumb line is essential for accurate posture assessment.
False
The scapula being protracted can cause the head to wrongly appear out of alignment with the plumb line.
True
Identifying a standard seated posture is considered easy due to its existence.
False
It is important for posture to have the head directly above the thorax and supported lumbar spine with knees slightly extended.
False
The thorax should be held in a military posture for optimal alignment.
False
Postural assessment requires the legs to be straight, equidistant from the plumb line and calf bulk to be equal on both legs.
True
The plumb line in postural assessments is mainly used to analyze the relationship between body parts.
False
Placing clients' feet on a card with painted foot outlines has been criticized for potentially forcing them into abnormal foot positions.
True
In postural assessments, the plumb line should fall posterior to the medial malleoli when viewing a client laterally.
False
It is recommended to position clients against a plumb line to ensure their feet adopt a normal stance.
False
The human center of gravity is located just posterior to the second sacral vertebra.
False
One criticism of using a plumb line in postural assessments is that it may not accommodate clients with naturally wider or narrower stances.
True
How can a visually impaired therapist 'observe' a client during a postural assessment?
By palpating the relationships among various body parts
What is identified as one of the disadvantages of assessing posture using photographs?
Photographs lack clarity and aren't life size
What is a common method used to document postural assessment findings?
Writing out findings in longhand
Why is audio-recording information during a postural assessment considered distracting?
It can reveal findings to the client prematurely
In what scenario would a therapist ask a participant to sign a release form during a postural assessment?
To allow for photography of the participant for analysis
What is highlighted as an advantage of assessing posture through photographs?
Photographs enable detailed examination at a slower pace
One of the advantages of assessing posture using photographs is that it allows you to take your time to identify deviations in posture that would best support the information in the text. One of the disadvantages is that a photograph retains only a certain amount of clarity and is not life size. How you record information depends on which method is most appropriate for you. A visually impaired therapist, for example, may 'observe' a client by palpation. The therapist may assess the relationships among various body parts using her hands while audio-recording her findings to transcribe later.
Photographs
When documenting postural assessment ______, one common method mentioned is to simply write out your ______ in longhand. Another method suggested is to speak your ______ into a recorder. If carrying out postural assessment as part of research, one approach is to ask your participant to sign a release form granting you permission to take photographs that you later analyze. Audio-recording information is quick and easy, but it is likely to be distracting for the client to whom you may not wish to reveal your ______ just yet. Photographs enable you to take your time over the assessment, but they are no substitute for having the client in front of you.
findings
How you record information from a postural assessment depends on which ______ is most appropriate for you. A visually impaired therapist, for example, may 'observe' a client by palpation. The therapist may assess the relationships among various body parts using her hands while audio-recording her findings to transcribe later.
method
Documenting your findings during postural ______ can be done in various ways. One common method mentioned is to simply write out your findings in longhand. Another approach is to speak your findings into a recorder. If carrying out postural ______ as part of research, one option is to ask your participant to sign a release form granting you permission to take photographs that you later analyze. Audio-recording information is quick and easy, but it is likely to be distracting for the client to whom you may not wish to reveal your findings just yet.
assessment
One of the disadvantages of assessing posture using photographs is that a photograph retains only a certain amount of ______ and is not life size. How you record information depends on which method is most appropriate for you. A visually impaired therapist, for example, may 'observe' a client by palpation. The therapist may assess the relationships among various body parts using her hands while audio-recording her findings to transcribe later.
clarity
In postural assessment, documenting your ______ is crucial. There are various methods to do this. One common approach is to write out your ______ in longhand. Alternatively, you could speak your ______ into a recorder. If conducting postural assessment as part of research, you may ask your participant to sign a release form granting you permission to take photographs that you later analyze. Audio-recording information is quick and easy, but it may be distracting for the client. Photographs allow for a detailed assessment but may lack certain clarity and size. How you document your ______ depends on the most suitable method for you.
findings
What precaution should be taken during a postural assessment for clients with low blood pressure?
Have a chair at hand in case they get dizzy
Why was the elderly man on page 4 allowed to keep his vest top on during the assessment?
To obscure the bruising he had from a fall
In what scenario should face crayons marking the body be removed during a postural assessment?
When there is increased blood flow to the marked area
Why is it important for clients to be disrobed appropriately before a postural assessment?
To allow for accurate assessment of body alignment
What should be done if a client has pain on prolonged standing during a postural assessment?
Ask them to sit instead of stand for the assessment
Why is it important for practitioners to watch for clients feeling unbalanced during a postural assessment?
To account for recent injury or surgery recovery
The lateral malleoli should be uneven during a postural assessment.
False
In postural assessments, the plumb line should fall posterior to the medial malleoli when viewing a client laterally.
False
The human center of gravity is located just posterior to the second sacral vertebra.
False
Placing clients' feet on a card with painted foot outlines has been criticized for potentially forcing them into abnormal foot positions.
True
The lumbar spine should be straight with no curvature to the right or left.
False
There should be normal hyperextension at the knee joint in standing.
False
Study Notes
Preparing for Postural Assessment
- Practice postural assessment on family and friends to gain experience
- Use crayons to mark bony landmarks on the client's body to help judge distances and angles of bones and joints
- Mark the following points on the back of the body: medial border of the scapula, inferior angle of the scapula, spinous processes of the spine, olecranon process of the elbow, posterior superior iliac spine (PSIS), knee creases, midline of the calf, and midline of the Achilles tendon
Conducting the Assessment
- The client should stand in their underwear and have hair tied up if it obscures the face and neck
- Instruct the client to adopt their usual standing posture, rather than positioning their feet in a particular way
- Observe the client's overall stance, looking for equal weight distribution, balance, and swaying
- Examine the alignment of body parts, including the head, thorax, and limbs, checking for balance and centring
Postural Assessment Steps
- Observe the overall stance, looking for equal weight distribution, balance, and swaying
- Examine the alignment of body parts, including:
- Head: centred over the thorax
- Thorax: centred over the pelvis
- Limbs: equidistant from the trunk
- Observe bones, joints, muscles, and skin, looking for:
- Normal shape and alignment of bones
- Swelling or mal-alignment of joints
- Equal bulk and tone of muscles
- Areas of inflammation, discolouration, or dryness on the skin
- Evaluate the client's physical attitude, looking for comfort, balance, and tension
Standard Alignments
- Standard posterior alignment:
- Neck: plumb line through midline of all cervical vertebrae
- Upper limbs: arms hang equidistant from the trunk, palms facing the sides of the body
- Thorax and scapulae: scapulae equidistant from the spine, medial borders approximately 1.5 to 2 inches from the spine
- Lumbar spine: straight with no curvature to the right or left
- Ankle and feet: lateral malleoli level, medial malleoli level, Achilles tendon vertical, calcaneus vertical, feet turned out slightly### Standard Alignments
- Standard Posterior Alignment:
- Head: facing forward, no rotation or lateral flexion
- Shoulders: approximately level, with dominant hand shoulder possibly lower
- Pelvis and Thigh: posterior superior iliac spines (PSIS) equidistant from spine, level, and equal buttock creases
- Knees and Legs: straight, equidistant from plumb line, no genu varum or genu valgum, equal calf bulk
- Standard Posterior Alignment (continued):
- Neck: straight, no lateral flexion
- Upper Limbs: arms hang equidistant from trunk, palms facing body sides, level elbows and wrists
- Thorax and Scapulae: scapulae equidistant from spine, lie flat against rib cage, level inferior angles
- Lumbar Spine: straight, no curvature
- Ankle and Feet: lateral malleoli level, medial malleoli level, Achilles tendon and calcaneus vertical, feet turned out slightly
Standard Lateral Posture
- Neck:
- Cervical spine: normal lordotic curve, no deformity at cervicothoracic junction
- Thorax and Scapulae:
- Normal kyphotic curve, no exaggeration or flattening
- Chest: comfortably upright, not excessively elevated or depressed
- Pelvis and Thigh:
- Neutral position, anterior superior iliac spine (ASIS) in same plane as pubis
- Equal gluteal and thigh muscle bulk on both sides
- Ankle and Feet:
- Plumb line slightly anterior to lateral malleolus
- Normal dorsi-flexion at ankle
Standard Anterior Alignment
-
Head:
- Facing forward, no rotation or lateral flexion
-
Lumbar Spine:
- Umbilicus central, not deviated
-
Thighs:
- Femurs straight, no internal or external rotation
- Equal thigh bulk on both sides
-
Ankle and Feet:
- Medial malleoli level, feet turned out from midline
-
Shoulders:
- Approximately level, clavicles level
-
Pelvis:
- ASIS level, equidistant from midline
-
Knees and Legs:
- Level, patellae facing forward, level tibia, equal leg bulk on both sides### Documenting Findings
-
Documenting findings is essential during a postural assessment
-
Methods of documentation include writing in longhand, speaking into a recorder, or taking photographs
-
Photographs allow for thorough analysis, but may lack clarity and are not life-size
-
Audio-recording is quick and easy, but may be distracting for the client
-
Visually impaired therapists may use palpation and audio-recording to document findings
Cautions and Safety Issues
- Postural assessment is contraindicated for clients with pain on prolonged standing or sitting
- Clients with low blood pressure may get dizzy if asked to stand for too long, so a chair should be available
- Care should be taken when examining clients who feel unbalanced, especially elderly people or those recovering from an injury
- Clients should be appropriately disrobed before the assessment, taking into account any physical limitations or injuries
- Face crayons used for marking should be checked for allergic reactions, and removed if an allergic reaction occurs
Learn about how to prepare for carrying out a postural assessment, including information on assessment procedure, required equipment, duration, and general guidelines for what to observe. Familiarize yourself with standard postural alignments and concepts to apply during subsequent assessments.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
