Posture Assessment in Occupational Therapy

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Questions and Answers

What does the term 'position' refer to in occupational therapy?

The dynamic adjustment of the body during movement

The use of assistive devices for mobility

The location of an individual in relation to their environment (correct)

The length of time spent in a particular posture

Which of the following best describes 'faulty posture'?

A position that enhances mobility and flexibility

A balanced position with minimal stress on joints

Any position that causes increased stress to the joints (correct)

A perfect alignment of the spine and limbs

What is indicated by 'ideal posture'?

A straight line through specific body landmarks (correct)

An eccentric position that emphasizes muscle engagement

A slouched position to relieve muscle tension

A resting position without any spinal curvature

Which statement about postural alignment is true?

It encompasses how the body functions biomechanically. Signup and view all the answers

What role does the pelvis play in seated ideal posture?

It should remain neutral with no tilt or obliquity. Signup and view all the answers

How is disc compression affected by posture?

It varies based on whether the posture is ideal or faulty. Signup and view all the answers

In ideal seated posture, where should the ears be aligned?

Directly above the shoulders Signup and view all the answers

What does dynamic posture refer to?

An adaptable position that changes with activity demands Signup and view all the answers

What is primarily assessed during posture observation?

Alignment and symmetry Signup and view all the answers

Which system is NOT explicitly listed as part of maintaining posture?

Endocrine system Signup and view all the answers

What observation position is necessary to properly assess posture?

Multiple positions including standing and lying Signup and view all the answers

Which of the following tools is used for marking posture landmarks during assessment?

Goniometer Signup and view all the answers

What is considered a potential outcome of faulty posture?

Pain and dysfunction Signup and view all the answers

During the anterior view observation, which feature should be symmetrical?

Clavicle and shoulder position Signup and view all the answers

What underlying cause of faulty posture can be identified through assessment?

Presence of a medical condition Signup and view all the answers

Which aspect is NOT directly related to the general health of an individual in terms of posture?

Flooring type at home Signup and view all the answers

What distinguishes anterior pelvic tilt in sitting?

There is increased lumbar lordosis. Signup and view all the answers

What is a characteristic of posterior pelvic tilt in sitting?

Backwards rotation of the pelvis occurs. Signup and view all the answers

Which of the following can contribute to thoracic kyphosis?

Compression of intervertebral discs anteriorly. Signup and view all the answers

What is the primary consequence of poor posture?

Pain and fatigue. Signup and view all the answers

Which muscle weaknesses may lead to forward shoulders?

Weakness of thoracic extensor and mid trapezius muscles. Signup and view all the answers

What is likely to occur in the presence of a flat back posture?

Flattening of the lumbar vertebrae. Signup and view all the answers

What is a possible cause of forward head posture?

Tightness of cervical flexor muscles. Signup and view all the answers

What does increased lumbar lordosis indicate?

Forward pelvic tilt. Signup and view all the answers

What is a likely cause of anterior pelvic tilt?

Increased lumbar lordosis and thoracic kyphosis Signup and view all the answers

Which condition is characterized by a lateral curvature of the spine resembling a C or S shape?

Scoliosis Signup and view all the answers

What is a common cause of genu recurvatum at the knee?

Tightness of quadriceps and hamstrings Signup and view all the answers

What contributes to pes planus or flat foot?

Shortened peroneal muscles Signup and view all the answers

What is a likely cause of forward posture in relation to the ankle?

Dorsiflexion of the ankles Signup and view all the answers

Which factor may lead to a dropped shoulder posture?

Hand dominance Signup and view all the answers

What is a primary characteristic of head rotation posture?

Compression of vertebrae Signup and view all the answers

Most cases of scoliosis are attributed to which of the following?

Idiopathic causes Signup and view all the answers

What is the normal angle of valgus range for knees as observed from the anterior view?

13o to 18o Signup and view all the answers

Which of the following indicates tibial torsion when the patella is pointing straight ahead?

Toes pointing outward Signup and view all the answers

What is assessed to determine symmetry in the ribcage during the anterior view observation?

Protrusion or depression of ribs Signup and view all the answers

When observing from the posterior view, which reference line is used to assess spine alignment?

Vertical line from C7 to gluteal cleft Signup and view all the answers

Which observation is important to check for pelvic obliquity?

Height of gluteal folds Signup and view all the answers

What indicates a potential problem in the lateral view observation regarding the head and neck alignment?

Forward or rotated head Signup and view all the answers

What measurement indicates proper alignment of the ankles?

Malleoli are level Signup and view all the answers

Which condition is observed when the scapulae are flat against the thorax in the lateral view?

Excessive protraction Signup and view all the answers

Study Notes

Posture & Postural Faults

Posture is the relative position of the body at any given moment, a composite of the positions of different joints. It can be dynamic or static and changes in response to activity demands.
Postural alignment describes how posture functions biomechanically.
Position in occupational therapy refers to an individual's location in space relative to their environment.
Occupational therapists (OTs) position individuals for functional mobility and to offload pressure points, e.g., on a bed, in a wheelchair, or a splint.

Posture Classification

Ideal posture: a straight line through specific landmarks with a balanced joint position.
Correct posture: minimum stress is applied to each joint.
Faulty posture: any position that causes increased stress on the joints.

Ideal Posture: Upright

The earlobe aligns with the shoulder joint.
The mid-line of the trunk is straight.
The greater trochanter of the femur is in line.
The mid-line of the knee is approximately aligned with the slightly anterior lateral malleolus.
The abdomen should be relatively flat.

Normal Curves of the Spine

The spine has natural curves: cervical (lordosis), thoracic (kyphosis), lumbar (lordosis), sacral (kyphosis), and coccygeal (tailbone).

Ideal Posture: Seated

Neutral pelvis (no tilt or obliquity).
Upright trunk with balanced spinal curvature.
Neutral head and neck position.
Ears aligned with shoulders.

Posture & Intervertebral Discs

Disc compression varies by position, relative to ideal upright posture (standing).
Pressure is often measured at the L3-L4 intervertebral disc.
Hydrostatic pressure is measured in the nucleus pulposus of a non-degenerated disc.
Poor posture and increased disc pressure are associated with disc degeneration.

Effects of Posture on Discs

Illustrations show that disc pressure increases in various body positions depending on the posture (e.g., lying down, sitting, standing).

How Posture Affects Disc Pressure

Illustrations show how different sitting angles can affect disc pressure.

Maintaining Posture - Systems etc.

Musculoskeletal system
Visual system
Vestibular system
Sensory system (tactile, kinesthesia, proprioception)
General health
Psychosocial/emotional factors
Pain

Why is it Important?

Faulty posture usually has an underlying cause.
It can lead to increased pain and dysfunction.
Identifying contributing factors allows for effective intervention.
Consideration of impact on function and an individual's ability to participate in their daily life needs.

Assessing Posture

Client information (self-report, functional limitations, diagnosis, previous medical history).
Observation (begin observing immediately, minimal clothing, relaxed/comfortable positions, with/without aids).
Examination (systematic approach, e.g., top-down).

Posture Assessment: Observation

Begin observation immediately (natural postures).
Minimal clothing is ideal.
Individual stands in a relaxed/comfortable position.
Assess both with and without aids (like orthotics, walkers).

Observation - Tools

Plumb line
Grid
Ruler
Tape measure
Goniometer
Self (eyes, then hands)

Looking for What?

Alignment
Spinal curves (head, neck, trunk, pelvis, extremities).
Symmetry

Positions & Views

Multiple viewpoints (anterior, posterior, lateral).
Various positions (standing, sitting, forward bending, lying supine, lying prone).

Landmarking

Specific anatomical landmarks are identified for postural assessment (e.g., suprasternal notch, temporomandibular joint, mastoid process, acromion process, coracoid process, lateral epicondyle of the humerus & olecranon process of ulna, Xiphoid process, clavicle, vertebral border of scapula, inferior border of scapula, spine of scapula, iliac crest, ASIS, PSIS, Inion, spinous processes, gluteal folds, patella, greater trochanter, head of fibula, lateral & medial malleoli, calcaneus).

Anterior View Observations

Mandible, Head & Neck, Trapezius, Clavicle, & AC and SC joints, Shoulders, Arms(carrying angle), Rib cage, Pelvis, Knees, Feet, & Ankle.

Posterior View Observations

Posterior line of reference, Scapulae, Spine, Ribs, Head & neck, PSIS, Gluteal folds, Popliteal fossae, Ankles, & Feet.

Pelvic Obliquity

Asymmetry of the pelvis in the frontal plane
One side elevated relative to the other

Lateral View Observations

Spine alignment, typical curves, kyphosis, lordosis, scapula placement, thorax, chest, sternum, pectus carinatum & excavatum, head & neck, forward or rotated heads.
Knee flexion, genu recurvatum, pelvic angle (30°), ASIS and pubic symphysis in the same vertical plane, pelvic tilt anterior & posterior, Hip joint flexion, hamstring tightness.

Pelvic Tilt

Neutral pelvis
Anterior pelvic tilt
Posterior pelvic tilt

Anterior Pelvic Tilt in Sitting

Top of pelvis tilts forward
PSIS elevated relative to the ASIS
Increased lumbar lordosis and extension of upper trunk

Posterior Pelvic Tilt in Sitting

Backward rotation of pelvis out of neutral position.
ASIS higher than PSIS
Increased thoracic kyphosis and rounded back

Other Considerations

Muscle atrophy/hypertrophy.
Hair growth patterns
Weight
Components/systems contributing to postural control
Pain

Consequences of Faulty Posture

Loss of function
Restricted range of motion
Pain
Fatigue
Swallowing
Breathing
Social/mood effects

Common Postural Faults

Forward Head
Forward Shoulders
Excessive Lordotic Cervical Curve
Thoracic Kyphosis
Flat Back
Scoliosis
Lateral Pelvic Tilt
Anterior Pelvic Tilt

Genu Recurvatum (knee)

Knee hyperextended, gravitational stress forward of joint axis
Tight quadriceps, gastrocncemius and soleus muscles
Stretched popliteus and hamstring muscles at the knee
Compression forces anteriorly
Shape of tibial plateau

Forward Posture (ankle)

Gravity line posterior to the body, body weight on metatarsal heads
Ankle in dorsiflexion, forward leg inclination
Tightness of dorsal musculature
Posterior muscles of trunk contracted

Head Rotated

Gravity line to the right or left of the midline
Tightness of Sternocleidomastoid, upper traps, scalenes, intrinsic rotator muscles on one side, elongated contralateral rotator muscles
Compression/rotation of vertebrae

Dropped Shoulder

One shoulder lower than the other
Hand dominance
Short lateral trunk muscles, short and high adducted hip joint
Tightness of rhomboid and latissimus dorsi muscles

Pes Planus (flat foot)

Decreased medial longitudinal arch
Achilles' tendon convex medially
Navicular bone below Feiss line (between medial malleoli and first metatarsal)
Shortened peroneal muscle, elongated posterior tibial muscle
Stretched plantar calcaneonavicular (spring) ligament
Structural displacement of talus, calcaneus, and navicular bones

External Tibial Torsion

Distal tibia rotated laterally 25 degrees from proximal tibia; excess of 25 degrees (toeing out).
Tightness of tensor fasciae latae / iliotibial band
Fracture
Cruciate ligament tear
Femoral retroversion

Hallux Valgus

Lateral deviation of the first digit at metatarsophalangeal joint
Excessive medial bone growth of first metatarsal head
Joint dislocation
Tight adductor hallucis muscle
Stretched abductor hallucis muscle

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Description

This quiz covers essential concepts related to posture assessment in occupational therapy. It explores aspects such as ideal posture, faulty posture, and the role of body alignment. Test your understanding of how posture influences health and function in therapy settings.