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POSTURE &
PHYSIOTHERAPY




    SUBHASH KHATRI
      physiokhatri@gmail.com
Somatization of psyche is posture !
If one's body is straight, one's mind is
easily straightened too.
OBJECTIVES

Identify normal & abnormal posture
Postural screening
Evaluation
Postural training
WHY TO ANALYSE THE
        POSTURE?


Endurance of antigravity muscles
Homeostasis of Musculoskeletal system
Treatment planning
Insight to structural & functional relationship
Idea about emotional, spiritual &
psychological element
POSTURE CLASSIFICATION
Military posture
 TK normal, LL ↑, PT ant
Flat back posture
 LL ↓ TK ↓, PT post
Kypholordotic posture
  LL ↑ TK ↑ PT ant
Sway back
Ideal
Unable to classify
CHANGE IN POSTURE

Poor sit / stand habits
Inactivation
Aging
Strenuous posture at work
Defective shoe wear
Worn heels
Muscle weakness due to aging
CHANGE IN POSTURE

Pain
High heels
Congenital / developmental disorder
Pregnancy
Trauma ( sprain/strain)
Handedness
Environmental factors
GEM

Student’s paper: God only knows answer
to these questions. Merry Christmas!
Professor marked the papers and
returned them to students. One had
message on it: God gets an A, you get F.
            Happy New Year!
EVALUATION
    LEVELS OF HORIZONTAL PLANE
   Occipital level
   Shoulder level / Acromion process
   Inferior scapular plane
   Iliac crest level
   PSIS level
   Greater trochanter level
   Malleolar level
EVALUATION
NYPRS
Plumb Line
Pelvic inclinometer
Photographs
Extremity length
T/C/D
Video
Observation
Electrogoniometer
EVALUATION
Posture board
Foot prints
Spirit level
Wooden blocks (LLD/ Pelvic lift)
Marking pencil
Tape measure
Flexicurve ruler
Kyphometer
EVALUATION
CARPENTER’S TRIASQUARE
MEASURE
FH
CT ear
CT shoulder
CT hip
CT knee
CT ankle
EVALUATION
CTM calculations for relative positions
HST= CT ear- CT shoulder
HAT =CT ear- CT ankle
SAT =CT shoulder - CT ankle
HPAT =CT hip- CT ankle
KAT =CT knee- CT ankle
GEM
Jack :what day is today, Harry?
Harry: You have got me, I don’t know
what day it is! …. Contd.
Well! Jacky why don’t you look at that
news paper in your pocket, that should tell us.
Jack: Oh, no , that won’t do us any good,
it is yesterday’s news paper!!
EVALUATION
FLEXICURVE & INDEX OF KYPHOSIS


   A
    C           B
IK =Thoracic height (A)
    Spinal length ©
MANAGEMENT


EDUCATION
EXERCISES
SHORT TERM BRACES
BIOFEEDBACK
Thanks for Listening!

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Posture & Physiotherapy

Notes de l'éditeur

  1. Dogen Zenji our Buddhist saint ancestor
  2. Analysis of posture provides information about 1 endurance of antigravity muscles or postural muscles, 2capability of musculoskeletal system to adjust homeostatically to physical stresses, 3. Offers an insight to structural and functional relationship on physical level, 4 to get get emotional, psychological and spiritual elements of patint’s halth and 5. For treatment planning.
  3. KENDALL, McCREARY & PROVANCE CLASSIFICATION.Analysis of posture provides information about 1 endurance of antigravity muscles or postural muscles, 2capability of musculoskeletal system to adjust homeostatically to physical stresses, 3. Offers an insight to structural and functional relationship on physical level, 4 to get get emotional, psychological and spiritual elements of patint’s halth and 5. For treatment planning.
  4. Environmental factors such as habits, tight clothes
  5. Some college students were taking an examination just prior to the Christmas vacation. This was an exam they hadn’t looked forward to, since they knew it would be tough one, it was!One student handed his paper with above remark.
  6. Electrogoniometer to find out the position of the lower extremity joints in standing. NYPRS: Therapist observes the posture and puts the score for 13 criterias on score points 1, 3, 5.
  7. These measurements can be taken with the help of carpenter’s trisquare in relation to a bak board where individual can stand facing his back towards the board.
  8. CTM calculations can be done so as to find out the relative positions of the body parts. HST= head translation in relation to the shoulder, Hat = head translation in relation to the ankle, SAT= shoulder translation in relation to ankle, HPAT= hip translation in relation to the ankle, KAT= knee translation in relation to the ankle
  9. C7 to PSIS total length. For IK spinal length is C7 to the junction of thoraco lumbar curve.
  10. Long term use of braces increases weakness.