POSTURE ANALYSIS

:
 posture
• Posture is the position & attitude of the body,
relative arrangement of body parts for specific
activity or characteristic work of bearing one’s
own body weight.

• Good posture is that state of muscular and

skeletal balance which protects die supporting
structures of the body against injury or
progressive deformity, irrespective of the attitude
(erect, lying, squatting, or stooping) in which
these structures are working or resting.
 Static and dynamic posture
• Posture can be either static or dynamic.
• static posture:, the body and its segments are
aligned and maintained in certain positions.
Examples standing, sitting, lying, and kneeling.

• Dynamic posture : in which the body or its

segments are moving—Examples walking,
running, jumping, throwing, and lifting..
Bos and COG
 POSTURE

Static Dynamic
posture a vertical line, directly posture
through the center of
gravity of the body that which is
must fall within the adopted while the
base of support body is in action, or
in the anticipatory
phase just prior to
an action
the net torque about
each articulation of
the body must be zero
• An understanding of static posture forms the
basis for understanding dynamic posture.
• sustained maintenance of erect bipedal stance
is unique to human
 Erect bipedal posture:

• Advantages :
1. allows persons to use their upper extremities for
the performance of large and small motor tasks.

• Distadvantages:
1. increases the work of the heart
2. places increased stress on the vertebral column
pelvis and lower extremities
3. reduces stability.
 Postural Control System
Various system for postural control

Central nervous visual vestibular musculo-

System system system skeletal
proactive system

reactive system
• In addition, postural control depends on
information received from receptors located in
and around the joints (in joint capsules,
tendons, and ligaments), as well as on the
soles of the feet..
Postural control system
Visual
System

Vestibular
System CNS Musculoskeleton
System

Proprioception
System
 Effects of Altered Inputs and Outputs
• A more common example of altered inputs occurs when a person
attempts to attain and maintain an erect standing posture when a foot
has “fallen asleep.” “asleep” foot with the supporting surface, is
missing.

• In addition to altered inputs, a person’s ability to maintain the erect

posture may be affected by altered outputs such as the inability of the
muscles to respond appropriately to signals from the CNS.

• In sedentary elderly persons, muscles that have atrophied through

disuse may not be able to respond with either the appropriate amount
of force to counteract an opposing force or with the necessary speed
to maintain stability. Attempts at standing may result in a fall because
input regarding the position of the foot and ankle, as well as
information from contact of the
Postural control
 Perturbation
• A perturbation: is any sudden change in conditions that displaces the
body posture away from equilibrium.

• sensory perturbation: might be caused by altering of visual input, such as

might occur when a person’s eyes are covered unexpectedly.

mechanical perturbation: are displacements that involve direct changes in

the relationship of CoM to the BoS. These displacements may be caused
by movements of either body segments or the entire body.

• The postural responses to perturbations caused by either platform

movement or by pushes and pulls are reactive or compensatory responses
in that they are involuntary reactions. These postural responses are
referred to as either synergies or strategies.
 Types of synergies

Fixed support change in support head stabilizing

Synergies synergies strategy
hip synergy head stab. on
trunk

ankle synergy head stab. In

space
 Ankle synergy

Forward movement of platform

causes bacward movement of the use of the Ankle strategy is necessary to
body.as a consequence displacement bring the body’s COM back over the BOS
of the body’s COM posterior to BOS. and reestabilish stability.
 Posterior movement of the platform
causes anterior movt. Of the body and
as a consequence displacement of the
body’s COM anterior to the BOS.
Fixed support strategy
 Change in support synergy

Perturbation of erect stance equilibriumcaused by backward platform movement. The

person in this illustration is using a stepping strategy to keep from falling forward in
response to backward movement of the platform. Stepping forward brings the body’s CoM
over a new base of support.
 Head stabilizing strategies
• These two strategies is for maintaining the vertical stability of the
head:

Head stabilization Head stabilization

in space (HSS) on trunk (HST).

• The HSS strategy is a modification of head position in anticipation of

displacements of the body’s CoG. The anticipatory adjustments to
head position are independent of trunk motion.

• The HST strategy is one in which the head and trunk move as a
single unit.
 Kinetics and Kinematics
of Posture
• The muscle strategies in response to perturbations are examples of the active
internal forces employed to counteract the external forces that affect the
equilibrium and stability of the body in the erect standing posture.

• The external forces : inertia, gravity, and ground reaction forces (GRFs).

• The internal forces : produced by muscle activity and passive tension in ligaments,
tendons, joint capsules, and other soft tissue structures.

• For the body to be in equilibrium.

• External forces+internal forces+torques= ZERO
(i.e, acting on the body and its segments)

• Stability is maintained by keeping the body’s CoM over the BoS and the head in a
position that permits gaze to be appropriately oriented.
 Inertial Forces
• In the erect standing posture, little or no
acceleration of the body occurs, except that the
body undergoes a constant swaying motion called
postural sway or sway envelope.
• The extent of sway envelope 12 degrees in the sagittal
for normal individual standing plane
with about 4” between the
feet 16 degrees in the
frontal
plane
• The inertial forces that may result from this
swaying motion usually are not considered in the
analysis of forces for static postures.
• Inertial forces must be considered in postural
analysis of all dynamic postures such as walking,
running, and jogging
• In which the forces needed to produce
acceleration or a change in the direction of
motion are important for understanding the
demands on the body.
 Ground Reaction Forces
• Whenever the body contacts the ground, the ground pushes back on the body.
This force is known as the GRF,and the vector representing it is known as the
ground reaction force vector (GRFV).

• The GRF is a composite (or resultant) force that represents the magnitude and
direction of loading applied to one or both feet.

The GRF is typically described as having three components:

• VERTCAL COMPONENENT HORIZONTAL

COMPONENT(along y-axis)
M-L direction
(along X-axis)

A-P direction
 Ground Reaction Force Vector

•The resultant GRVF is equal in magnitude but opposite in direction to the

gravitational force in the ERECT standing posture.
•GRVF indicates the mag. and direction of LOADING applied to the foot.
 Line of Gravity
• The LoG represents the force of gravity-on-person and is generally
equal in magnitude to and in the same direction as the force of
person-on-ground.
• In equilibrium during static stance, we would expect the force of
gravity-on-person (represented by the LoG) to be equal in
magnitude and opposite in direction to the GRF represented by the
GRFV.
• In many dynamic postures, the intersection of the LoG with the
supporting surface may not coincide with the point of application of
the GRFV.
• The horizontal distance from the point on the supporting surface
where the LoG intersects the ground and the CoP (where the GRFV
acts) indicates the magnitude of the external moment that must be
opposed to maintain a posture and keep the person from falling.
Line of Gravity
 Coincident Action Lines

• The coincident action lines

formed by the GRFV and the
LoG serve as a reference for
the analysis of the effects of
forces on body segments.

• The location of the LoG shifts

continually (as does the CoP)
because of the postural sway.
• As a result of the continuous
motion of the LoG, the
moments acting around the
joints are continually changing.

•Location of the combined action line formed

by the ground reaction force vector (GRFV)
and the (LoG) in the optimal standing posture.
 Optimal posture
• Normal body structure makes
such an ideal posture impossible
to achieve, but it is possible to
attain a posture that is close to
the ideal.

• In an optimal standing posture,

the LoG is close to, but not
through, most joint axes.

• Slight deviations from the optimal

posture are to be expected in a
normal population because of the
many individual variations found
in body structure.
 Coincident Action Lines

• The coincident action lines formed by the

GRFV and the LoG serve as a reference for the
analysis of the effects of forces on body
segments
• The location of the LoG shifts continually (as
does the CoP) because of the postural sway.
As a result of the continuous motion of the
LoG, the moments acting around the joints are
continually changing.
 Point to Remember
• The effect of external forces on body segments in the sagittal
plane is determined by the location of the LoG in relation to
the axis of motion of body segments.
• When the LoG passes directly through a joint axis, no external
gravitational torque is created around that joint.
• If the LoG passes at a distance from the axis, an external
gravitational moment is created. This moment will cause
rotation of the superimposed body segments around that
joint axis unless it is opposed by a counterbalancing internal
moment (an isometric muscle contraction)
• The magnitude of the gravitational moment of force
increases as the distance between the LoG and the joint
axis increases.
• The direction of the external gravitational moment of force
depends on the location of the LoG in relation to a
particular joint axis
• If the LoG is located anterior to a particular joint axis, the
gravitational moment will tend to cause anterior motion of
the proximal segment of the body supported by that joint.
• If the LoG is posterior to the joint axis, the moment will
tend to cause motion of the proximal segment in a
posterior direction .
• In a postural analysis, external gravitational torques
producing sagittal plane motion of the proximal joint
segment are referred to as either flexion or extension
moments.
 Sagittal plane
The anterior location of the LoG in relation to the knee joint axis
The anterior location of the LoG in relation to the ankle joint creates an external extension moment. The arrow indicates the
axis creates an external dorsiflexion moment. The arrow direction of the extension moment. The dotted line indicates the
indicates the direction of the dorsiflexion moment. The direction in which the femur would move if the extension
dotted line indicates the direction in which the tibia would moment were unopposed.
move if the dorsiflexion moment were unopposed
 Postural analysis
• Traditional method:

PLUMBLINE

• When viewing a standing posture, a plumb line is used as a line of reference. Why a plumb line?

• Because it represents a standard. Based on nature's law of gravity, It is a tool in the science of
mechanics.

• The simple device of a plumb line enables one to see the effects of the force of gravity.

• Invisible, imaginary lines and planes in space are the absolutes against which variable and relative
positions as well as movements are measured.

• In the study of body mechanics, plumb lines represent the vertical planes.

• With the anatomical position of the body as the basis, positions and movements are defined in
relation to these planes.
Equipment to asses Posture
• The plumb line is a cord with a plumb bob attached to provide an absolutely
vertical line. The point in line with which a plumb line is suspended must be a
standard fixed point.

• Because the only fixed point in the standing posture is at the base, where the feet
are in contact with the floor, the point of reference must be at the base.
A movable point is not acceptable as a standard.
• The position of the head is not stationary; therefore,using the lobe of the ear as a
point in line with which to suspend a plumb line is not appropriate.

• The plumb line test is used to determine whether the points of reference of the
individual being tested are in the same alignment as the corresponding points in
the standard posture.

• The deviations of the various points of reference from the plumb line reveal the
extent to which the subject's alignment is faulty.
• For the purpose of testing, subjects step up to a suspended plumb line.

• In back view, they stand with the feet equidistant from the line.

• In side view, a point just in front of the lateral malleolus is in line with the plumb
line.

• Deviations from the plumb alignment are described as slight, moderate, or marked
rather than in terms of inches or degrees.

• During routine examinations, it is not practical to try determining exactly how

much each point of reference deviates from the plumb line.

• The standing position may be regarded as a composite alignment of a subject from

four views:
• front,back, right side and left side.
SAGITTAL PLANE ANALYSIS
 STANDARD POSTURE Plumb line
alignment
Line of
Gravity Through
EAM Through ear lobes
Posterior to apex of & dens
coronal suture Through bodies CV

Through shouder jt.

Through Through trunk

VB of LV
Through
sacral
Posterior to the promontory Through GT
center of the hip
jt

Ant. To knee Anterior to midline

joint axis knee

Through
calcaneocuboid jt Anterior to lat
malleolus
 Sagittal Plane Alignment and Analysis

• ■ Ankle move the ankle into dorsiflexion and the

• Neutral position : midway between soleus muscle will undergo an eccentric
dorsiflexion and plantarflexion. contraction while trying to oppose the
• The LoG anterior to the ankle joint axis. forward motion of the tibia.
• creates an external dorsiflexion moment
• It opposed by an internal plantarflexion
moment to prevent forward motion of the
tibia
• There are no ligamentous checks capable of
counterbalancing the external dorsiflexion
moment;
• Therefore, activation of the plantarflexors
creates the internal plantarflexion moment
to prevent forward motion of the tibia.
• The soleus muscle contracts and exerts a
posterior pull on the tibia to oppose the
dorsiflexion moment
• If the force that the muscle can exert is less
than the gravitational moment, the tibia will
• ■ Knee
• Neutral position: full extension,
• The LoG anterior to the knee joint axis
• The anterior location of the LoG
creates an external extension moment.
• The counterbalancing internal flexion
moment created by passive tension in
the posterior joint capsule and
associated ligaments to prevent knee
hyperextension.
• A small amount of activity has been
identified in the hamstrings.
• Activity of the soleus muscle may
augment the gravitational extension
moment at the knee through its
posterior pull on the tibia as it acts at
the ankle joint.
 Hip and Pelvis
The hip is in a neutral position
The pelvis is level with no anterior
or posterior tilt .
In a level pelvis position, lines
connecting the symphysis pubis
and the ASISs are vertical, and the
lines connecting the ASISs PSISs are
horizontal.
The LoG passes slightly posterior to
the axis of the hip joint, through
the greater trochanter.
The posterior location of the LoG in
relation to the hip joint axis creates
an external extension moment at
the hip that tends to rotate the
pelvis (proximal segment)
posteriorly on the femoral heads .
Iliopsoas is acting to create an
internal flexion moment at the hip
to prevent hip hyperextension.
 ■ Lumbosacral Joint
• The average lumbosacral angle measured
between the bottom of the L5 vertebra
and the top of the sacrum (S1) is about 30
but can vary between 6 and 30. Anterior
tilting of the sacrum increases the
lumbosacral angle and results in an
increase in the shearing stress at the
lumbosacral joint and may result in an
increase in lordosis
• In the optimal posture, the LoG passes
through the body of the fifth lumbar
vertebra axis of rotation of the
lumbosacral joint.
• It creates a very slight extension moment
at L5 to S1 that tends to slide L5 and the
entire lumbar spine down and forward on
S1.
• This motion is is opposed primarily by the
ALL and the ILL. Bony resistance is
provided by the locking of the lumbosacral
zygapophyseal joints
 Sacroiliac Joint
• . When the sacrum is in the optimal
position,
• The LoG passes slightly anterior to
the sacroiliac joints.
• The external gravitational moment
is created at the SI joints tends to
cause the anterior superior portion of
the sacrum to rotate anteriorly and
inferiorly, whereas the posterior
inferior portion tends to move
posteriorly and superiorly .
• Passive tension in the sacrospinous
and sacrotuberous ligaments
provides the internal moment that
counterbalances the gravitational
torque by preventing upward tilting
of the lower end of the sacrum.
 Vertebal column
• In Lumbar and cervical
vertebrae LoG passes posterior to
the axis and in thorax vertebra
LoG passes anterior to the axis
• Gravitational moment tend to
increase the nalural curve
• longissimus dorsi, rotatores, and
neck extensor muscles are active
This suggests that ligamentous
structures and passive muscle
tension are unable to provide
enough force to oppose all
external gravitational moments
acting around the joint axes of
the upper vertebral column
• In the lumbar region, where
minimal muscle activity appears
to occur, passive tension in the
ALL and passive tension in the
trunk flexors apparently are
sufficient to balance the external
gravitational extension moment.