Physiotherapy And Posture

What Is Posture?

Posture is the attitude assumed by the body either with support during muscular inactivity, or by means of coordinated action of many muscles working to maintain stability.

WHAT IS  INACTIVE POSTURE?

These are attitudes adopted for resting or sleeping, and they are most suitable for this purpose when all the essential muscular activity required to maintain life is reduced to a minimum.

The posture used for training and general relaxation fulfills these conditions.

ACTIVE POSTURE 

the integrated action of many muscles is required to maintain active postures, which may be static or dynamic. 

1. STATIC POSTURE 

2. DYNAMIC POSTURE

STATIC POSTURE 

 a constant pattern of posture is maintained by the interaction of groups of muscles which work more or less statically to stabilize the joints, and in opposition to gravity or other forces. 

DYNAMIC POSTURE  

For the movement, the pattern of the posture is constantly modified and adjusted to meet the changing circumstances which arise as a result of movement.

THE POSTURAL MECHANISM

The Postural Mechanism

• The muscles: The groups of muscles most frequently employed are those which are used to maintain the erect position of the body, by working to counteract the effect of gravity.( anti-gravity muscles = extensors) The muscle form is multi pennate and fans-shaped which signifies the wide range of movement at high speed. They are made up of ‘RED’ fibers, indicating their capability of continues contraction without fatigue.

• Nervous control: posture is maintained by neuromuscular co-ordination, with the help of a very complex reflex mechanism.
• The postural Reflexes: an efferent response to an afferent stimulus. Afferent stimuli arise from a variety of sources all over the body. 
• The muscles: Neuromuscular and neurotendinous spindles within muscles record the changing tension. increase tension results in the reflex contraction of muscle, like a stretch reflex. 
• The eyes: visual sensation records any alteration in the body position concerning surrounding and helps the restored body in erect position by activating ‘righting reflexes’. All the sensation and information are conveyed and coordinate into CNS
• The ears: stimulation of the receptor of the vestibular nerve results from the movement of fluid of semicircular canals of the internal ear. each canal lies in a different plane and any movement of head disturb fluid they contain. it gives knowledge of movement and the direction.
• Joint structures: In the weight-bearing position approximation of bones stimulates receptors in joint structure and elicits a reflex reaction to maintain the position.
• Tactile stimulation

THE PATTERN OF POSTURE

Patterns of posture both static and dynamic, are gradually built up by integration of many reflexes which together make up the Postural Reflex. Some of them are inborn and some are conditioned. 

1.GOOD POSTURE 

2.POOR POSTURE

*GOOD POSTURE 

posture is said to be good when it fulfills the purpose for which it is used with maximum efficiency and minimum effort. 

DEVELOPMENT OF GOOD POSTURE 

1. A stable psychological background, 

2. Good hygienic conditions, 

3. Opportunity for plenty of natural free movement.

*POOR POSTURE 

posture is poor when it is inefficient, that is, when it fails to serve the purpose for which it was designed, or if an unnecessary amount of muscular effort is used to maintain it.

Factors which predispose to poor posture: 

1. General causes: mental attitude, poor hygienic conditions, prolonged fatigue, etc. 
2. Local factors: localized pain, muscular weakness, occupational stresses

Principles of re-education 

1. The cause must be treated first! 2. The success of any physical treatment invariably depends upon the ability to gain the co-operation of the patient by the physiotherapist. 3. Remedied permanently by an alteration in mental attitude by improving the hygienic condition. 4. Relaxation & Mobility exercise for improving and the repeated presentation of the satisfactory postural pattern 5. Patient education on the merits of good posture 6. Alleviation of pain 7. Analysis of the work environment

TECHNIQUES OF RE-EDUCATION RELAXATION 

Voluntary relaxation of a specific group of muscles can be taught and practiced so that the patient learns to recognize tension and can relax at will. 

MOBILITY Normally maintain by general free exercises.

MUSCLE POWER General muscular weakness is there due to poor posture, with the help of free movement and harmonious muscular development it can be prevented

PRESENTATION OF GOOD POSTURE The physiotherapist must ‘sell’ the patterns of good posture ESTABLISHMENT OF GOOD POSTURE By using audiovisual instruments and giving seminar or presentation on good posture

ESTABLISHMENT OF GOOD POSTURE

• Presentation of a good posture 

1. The Head: An upward thrust of the vertex in the erect position may be sufficient to achieve satisfactory alignment of the whole body
2.  The pelvic tilt: give training of voluntary control of pelvic tilt and trains him to be able to adjust and correct it at will. 
3.  The feet: Painless, mobile and strong feet from a stable base on which the weight of the body is balanced and supported. The arches are braced and the weight of the body transferred progressively from one part of the weight-bearing area to the next during WALKING.

Patient education 

• Repetition and precision 
• Facilitation of neuromuscular pathways by coordinated impulses.

Topics covered 

•  Definition 

•  Types 

• The postural mechanism 

•  The pattern of posture 

•  Principle and Technique of Re-education 

•  Presentation of good posture 

•  Patient education