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1. POSTURE By; Dr. Sadia Saleem

2. VERTEBRAL COLUMN 33 vertebral bony segments divided into five regions. Cervical Thoracic Lumbar Sacral Coccygeal

3. Review Postural curve development Posture Good posture types Good and Bad posture Postural assessment views Correct and Faulty posture type Importance of posture

4. Posture Development Primary curves are retained from the original fetal curvature, “C” curve Flexion of the spine. Concave anteriorly. Secondary curve is achieved by hyper extension of the spine. Develop post-birth. Secondary curve concave posteriorly.

5. What is Posture? Posture refers to the position in which someone holds their body when standing or sitting. It's the alignment and positioning of the body in relation to its limbs and surroundings. Good posture ensures that the body’s muscles and ligaments are used properly and efficiently, whereas bad posture can lead to various physical complications.

6. Active Posture Static Dynamic A static posture occurs when we maintain one alignment for a prolonged period of time. Standing, sitting, or kneeling. Dynamic postures refer to body alignments that occur when the body and/or limbs are moving such as walking, jumping, or running.

7. POSTURE Correct Posture “Position in which minimum stress is each joint.” (Magee) Maintains the natural curves. Faulty posture Any position that increases stress on joints Create muscle imbalances, ligamentous tension, circulatory occlusion

8. What is the postural muscle? Core stability muscles or postural muscles, are the deep muscles in abdomen, pelvis and back. Helps to maintain a good posture. Good posture can help prevent pain, pressure sores or reduced mobility.

9. Muscles in this category include the abdominals Gluteals Deep neck flexors and the rhomboids These muscles seldom act alone but typically act in relation to postural muscles.

10. BASE OF SUPPORT The area beneath a person that includes every point of contact that person makes with the supporting surface. This means that when you are standing, your base of support is the area between your two feet. The wider feet are positioned, the easier it is to balance

11. CENTER OF GRAVITY In the vertebral column, the line of gravity typically falls just to the concave side of the apex of each region’s curvature. Ideal posture allows gravity to produce a torque that helps maintain the optimal shape of the spinal curvatures. The external torque attributed to gravity is the greatest at the apex of each region: C4 and C5, T6, and L3.

12. Postural Reflex Definition. Postural reflexes are complex motor responses that provide automatic control of posture, balance, and coordination. They are characterized by a certain stereotyped posture of the trunk, head, and extremities . Muscle Eyes Ears Joint Structure  Skin sensation also plays a part, eg.soles of the feet, when the body in standing position.  Impulses from all these receptors are conveyed and coordinated in the central nervous system.

13. Postural Control Postural control refers to the ability to maintain the stability of the body as a whole and body segments “against gravity” or “movement of different body segments” or “changes in the supporting surface”. Control depends on the integrity of nervous system, muculoskeletal system and special senses.

14. CAUSES OF POOR POSTURE Positional factors/Habitual

15. Bad Posture in Sitting Characteristics Slouching: The spine is curved forward, leading the head to lean forward too. Crossed Legs: This can lead to an imbalance in the pelvic region. Leaning to One Side: Puts uneven pressure on the pelvis and lower back. Forward Neck: Protruding the head forward, straining the cervical vertebrae. Hunched Shoulders: Raises the tension in the neck and shoulders.

16. Good posture the term good posture that puts the least strain on bones, joints and their supporting structures. In practice, good posture should equate with standing, sitting, lying or moving comfortably.

17. Ideal sitting posture Static postural observation from the side In correct sitting posture the body weight is adjusted to balance over the ischial tuberosities so that, together with the thighs, they provide a stable base of support The knees are flexed approximately 90 degrees and the lower legs are perpendicular, with the heels aligned with the backs of the knees.

18. POSTURAL EXAMINATION The assessment of posture is in standing position. The whole posture is asessed from head to toes in different views, (a) Anterior views (b) Lateral views (c) Posterior views

19. Faulty Posture Disorders associated with the curvature of the spine include kyphosis — excessive anterior concavity of the thoracic region; lordosis — excessive posterior concavity of the lumbar region scoliosis — an abnormal lateral curvature accompanied by twisting of the spine.

20. Static postural observation from the side In this position the imaginary plumb line represents the postural line of gravity and facilitates the observation of relative symmetry in the sagittal plane. Beginning with the spine, observe in relation to the plumb line the positions of the head, tips of the shoulders, hip and knee joints, and note unnecessary tension in associated muscles and soft tissue  ASSESSMENT

21. 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

22. 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

23. 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

24. 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