Lab 2 - Posture activity document - W2021-converted PDF

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Posture Activity Document – W2021

Lab 2: Postural Assessment Activity Document Client:

Date:

You have completed the initial consultation with your client and decided that it is important to perform a postural assessment of your client. Refer to your Lab 2 Postural Assessment Manual for instructions on how to perform a postural assessment. You are encouraged to perform these activities on someone who is in your immediate household (roommate, family member, etc.) If you do not have a person in your immediate circle with whom you feel comfortable working in close physical contact, you will perform the required landmarking and palpation on yourself and then analyze and submit the images of yourself. Explain to your client what a postural assessment involves, and ask for permission to touch, palpate and mark each of the landmarks. Explain to your client the necessity to take pictures of them in the anterior, lateral and posterior view in order to complete the postural analysis. Inform your client that these images will be embedded in your assignment submission and uploaded to the dropbox for grading. Your dropbox submission is only visible by the instructor(s). Photos will not be shared and will be deleted one year after the course is completed. The following grid will be used for overlaying with the photos of your client when you are ready to perform postural analysis. You can find the .PNG file containing this grid on learn as “Grid.png”.

Activity to Complete Landmarking and Palpation 

On your client (or yourself), identify and palpate the body segments and anatomical landmarks that are observed during a postural assessment (see pages 1 - 3 of lab manual). Use washable markers and/or stickers to mark these on the body. These will provide a visual aid when performing your assessment.

Postural Examination – Standing Follow the steps listed in the lab manual for administering a postural assessment.  Instruct your partner to stand comfortably in a neutral position– not in the anatomical position. Take your time to observe your client from the anterior, lateral and posterior point of view. Focus on visual and palpation skills for bilateral differences in muscle tone and location of bony landmarks.  Perform an informal visual assessment to look for asymmetries. Note any observations and document any asymmetries or deviations on your activity document. Perform an informal palpation assessment for asymmetries in terms of muscle tone/tightness and note any observations. Record your observations in the charts below – using correct anatomical terminology.  For each view (anterior, lateral and posterior), take a full-length picture of your client with a camera or phone. Ensure the quality of your image and lighting in your space allows you to clearly see the markers you have placed on your client. The camera should be level and square with the segment(s) that are being recorded, not at an angle. The distance of the camera from the subject should be adjusted to obtain the appropriate clarity of the joint/segment required and a full-length image of your client.  Upload the pictures to a word document. Overlay your photos with the grid paper file “Grid.png” below.  Use the Insert > line feature in your word document to create a vertical (0°) plumb line. Use the landmarks outlined on page 4 of the lab manual to align your client behind the plumb line. You should attempt to match as many of the landmarks listed for the lateral view and to divide the body into two equal halves in the midsagittal plane for the anterior and posterior view. The plumb line should be in a contrasting colour and should be at least 1.5 pt thickness.  Continue your postural assessment using the grid line and plumb line. Note any additional observations seen from using the vertical plumb line and/or grid paper. Did the plumb line and grid paper indicate any other deviations not observed during your initial observation? If so, note these additional observations in the charts below.

Activity Document Submission to Dropbox The following must be submitted to the designated dropbox on Learn on or before the due date indicated in course syllabus as a single pdf formatted document. 1.

What strategies can you use to improve the reliability and validity of your postural assessment (consider both the setup of your client and instructions you will provide them). (≈ 2 mark)

2.

With reference to the Lippert article (posted on Learn), list markers of good posture in the lateral view and anterior & posterior views, when standing and with reference to the plumb line. Please be sure to use anatomical terminology. (≈ 8 marks) Lateral View

3.

Anterior/Posterior Views

Include the full-sized images of your client in the anterior, posterior and lateral view (three images total). Your images should be of good quality and should be large enough to clearly see the client’s posture and the markers you have placed. Overlay each image with the provided square grid paper (file Grid.png). Ensure that the aspect ratio is locked when resizing the grid. Insert a vertical “plumb line” in the appropriate location. (≈ 6 marks)

4. Observation in Anterior View (≈ 2 marks) Use the image of the individual behind the plumb line that you created using the anteriorline-of-reference. Observe the position of key landmarks in reference to the “anterior-lineof-reference”. Make note of any/all asymmetries or deviations in the chart below. Enter any observations in the comments section.  Observe head and neck position. Note any asymmetries or deviations of head/neck position.  Observe shoulder levels. Look for any shoulder elevation/depression and compare clavicles for level/symmetry.  Observe the pelvis. Compare the levels of the iliac crests and the levels of the ASIS.  Observe the hip and knee joints. Compare the levels of the patella. In addition, look at the direction the patella are facing.  Observe the ankles and feet. Compare the levels of the medial malleoli and lateral malleoli. Observe the amount of supination/pronation. Segment

Alignment Lateral tilt

Head

Rotated Elevated

Shoulders

Depressed Lateral tilt

Pelvis

Rotated Medially rotated

Hip

Laterally rotated External tibial torsion

Knee

Internal tibial torsion (toe in) Genu Valgum Genu Varum Hallux valgus

Ankle/foot

Supination Pronation

Comments (asymmetry, muscle tone etc)

5. Observation in Lateral View (≈ 2 marks) Use the image of the individual behind the plumb line that you created using the “lateralline-of-reference”. Observe the position of key landmarks in reference to the “lateral-line-ofreference”. Make note of any/all asymmetries or deviations in the chart below. Enter any observations in the comments section.     

Observe head and neck position. Note any ‘forward-head’ posture. Observe the position of the cervical, thoracic and lumbar spine. Do you observe any increase/decrease in kyphosis or lordosis? Observe the pelvis and low back. In reference to the planes of reference, compare the levels of the ASIS and PSIS. Observe the hip and knee joints. Compare the observed alignment of the hip and knee landmarks to normal alignment with respect to the line of reference. Observe the ankles and feet. Compare the observed alignment of the ankle landmarks to normal alignment with respect to the line of reference.

Segment

Alignment

Head

Forward (Protracted)

Cervical spine

Exaggerated lordosis

Shoulders

Flattened curve Internally Rotated

Thoracic spine

Exaggerated kyphosis

Lumbar spine

Exaggerated lordosis

Flattened curve

Flattened curve Anterior pelvic tilt

Pelvis

Posterior pelvic tilt Hyperextension

Hip & knee

Flexed knee Flattened longitudinal arch

Ankle/foot

Exaggerated longitudinal arch Forward posture

Comments (Asymmetry, muscle tone etc.)

6.

Observation in Posterior View (≈ 2 marks)

Use the image of the individual behind the plumb line that you created using the “posteriorline-of-reference”. Observe the position of key landmarks in reference to the “posterior-lineof-reference”’. Make note of any/all asymmetries or deviations in the chart below. Enter any observations in the comments section.    

Observe the scapula. What is proper positioning? Do you notice any deviations? Observe the position of the spine – do you notice any curvature (i.e. “S” or “C”)? Observe the pelvis. Compare the levels of the iliac crests. Compare the PSIS and Iliac Crests (notice any tilt of the pelvis). Observe the position of the ankles/feet – do you notice any supination or pronation?

Segment

Alignment

Lateral tilt Head Rotated Elevated Shoulders Depressed Protracted Scapulae Retracted Thoracic Spine

Lateral deviation

Lumbar Spine

Lateral deviation Lateral tilt

Pelvis Rotated Genu valgum Knee Genu varum Pronation (pes planus) Ankle/foot Supination (pes cavus)

Comments (Asymmetry, muscle tone etc.)

7.

Provide a brief summary of the client or (SOAP note): a. Identify one of the more prominent postural deviations/asymmetries noted from your assessment. b. Indicate how you have identified the deviation. c. Hypothesize what might be contributing to this (i.e., Muscle weakness (long/weak), tightness (short/strong)) d. Identify specific muscles that are involved, and how this postural deviation may be corrected (≈ 4 marks)

References (≈ 1 mark)...