1. Posture Assessment PHT 1261C Tests and Measurements Dr. Kane

2. Posture Assessment  Strength and length of muscles must be balanced  Based on force couple principles  Must be addressed, esp. in head, trunk, shoulders, and pelvis  Alterations in strength &/or length create postural faults  Stretch weakness  Muscles that develop their maximum force in the elongated or stretched position & are weak in normal physiological position  Static and Dynamic Assessment  Reference Line or Gravity Line or Plumb Line

3. Factors that Affect Posture Assessment  Subject minimally clothed with no socks/shoes  Have patient assume relaxed & natural posture  If use orthosis or AD, assess posture with and without the device  Use instruments to make it valid  Note relevant medical history  Note UE limb dominance – usually lower on that side

4. Standing Posture – Plumb Line Position  Lateral - Perform on both sides to pick up rotational abnormalities  Head – through ear lobe to acromion process  Trunk – midline  Hip – through greater trochanter  Knee – anterior to midline, posterior to patella  Ankle – anterior to lateral malleolus  Anterior/Posterior  Divides body into two equal halves

5. Lateral View – Postural Faults  Head and Neck  Forward head  Flattened Lordotic Cervical Curve  Excessive Lordotic Cervical Curve  Shoulder  Forward Shoulders  Lumbar Lordosis  Thoracic Spine  Kyphosis  Pectus Excavatum (Funnel Chest)  Barrel Chest  Pectus Cavinatum (Pigeon Chest)

6. Lateral View – Postural Faults - continued  Lumbar Vertebrae  Increased lordosis  Sway Back  Flat Back  Pelvis and Hip  Anterior Pelvic Tilt  Posterior Pelvic Tilt  Knee  Genu Recurvatum  Flexed Knee  Ankle  Forward Posture/BW on met heads

7. Posterior View – Postural Faults  Head and Neck  Head Tilt  Head Rotated  Shoulder and Scapula  Dropped Shoulder  Shoulder elevated  Shoulder Medial Rotation (IR)  Scapula Adducted  Scapula Abducted  Winging Scapula  Trunk  Scoliosis

8. Posterior View – Postural Faults (cont.)  Pelvis and Hip  Lateral pelvic tilt  Pelvic rotation  Hip abducted/Coxa Valga  Hip Adducted/Coxa Vara  Knee  Genu Varum  Genu Valgum  Ankle/Foot  Pes Planus (pronated)  Pes Cavus (supinated)

9. Anterior View – Postural Faults  Head and Neck  Lateral tilt  Mandibular Asymmetry  Shoulders  Shoulder Dropped  Shoulder Elevated  Clavicle/SC Joint Asymmetry  Elbows  Cubitus Valgus  Cubitus Varus  Hip  Medial Rotation  Lateral Rotation

10. Anterior View – Postural Faults (cont.)  Knee  External Tibial Torsion  Internal Tibial Torsion  Ankle and Foot  Hallux Valgus  Claw Toes  Hammer Toes