Posture & Gait

Question 1

When examining the anterior static posture screen landmarks you should check the alignment of facial structures including

Answer 1

Eyes, ears, nose/nostrils and angles of the jaw

Question 2

When examining the anterior static posture screen landmarks you should check the alignment of the trunk and upper extremities including

Answer 2

Large neck muscles, shoulder bone (acromion), collar bone, carriage of arms and finger tip length

Question 3

When checking the alignment of the lower trunk in an anterior static posture you should examine the

Answer 3

Angle of the rib cage, belly button (umbilicus), pelvic bones, hip bone (greater trochanter), knee and ankle

Question 4

What are three common anterior postural findings?

Answer 4

Facial droop, flexed arm held against the body and knees facing inward “knocking”

Question 5

Facial droop can be due to

Answer 5

Nerve paralysis/stroke

Question 6

Flexed arm held against the body can be a result fo

Answer 6

Nerve damage or splinting due to injury

Question 7

Knees facing inward “knocking” can be due to

Answer 7

Bone pathology or leg pain

Question 8

Which landmarks should be examined when checking the alignment of the head, neck and shoulders in a posterior static posture screen?

Answer 8

Ears, c spine (paravertebral muscle mass), slope of the shoulders, tips of the shoulders and bottom angle of the shoulder blades

Question 9

Which landmarks should be examined when checking the alignment of the trunk and lower extremities in a posterior static posture screen?

Answer 9

Spinal alignment, paraspinal muscles, pelvis, hip bones, knee (popliteal space) and ankles

Question 10

What are three common posterior postural findings?

Answer 10

Scoliosis (alternating unevenness)
Short leg (anatomical vs postural) 
Shoulder winging (due to muscle/nerve weakness or postural)

Question 11

Normal spinal curvatures are important for maintaining what?

Answer 11

Musculature balance and posture

Question 12

Lordosis

Answer 12

Anterior curvature of the spine

Cervical and lumbar

Question 13

Kyphosis

Answer 13

Posterior curvature of the spine

Thoracic and sacrum

Question 14

What landmarks should be examined when performing a lateral static postural screen?

Answer 14

Assess alignment by using the gravitational/plump line, head carriage (ears), shoulder carriage, spinal curves, knee alignment and pelvis alignment

Question 15

What is considered as the ideal posture?

Answer 15

All land marks including ear, shoulder, middle of lower spine, anterior 1/3 of tail bone, hip bone, knee and ankle are on or slightly anterior/posterior to gravitational line

Question 16

What is a common lateral postural finding?

Answer 16

Poor/hunched posture
Leads to loss or exaggeration of spinal curves
Also large anterior carriage of the head and neck is seen due to chronic MSK pain or muscle/neuro pathology

Question 17

What are the goals of gait?

Answer 17

Move body weight forward with as little energy as possible and without hurting yourself

Question 18

What are some challenges to gait?

Answer 18

Must be able to absorb body weight/forces from ground
Transfer body weight in an efficient manner
Convert absorbed forces into forward movement

Question 19

Summarize the stance phase

Answer 19

Heel strike: establish stable contact
Loading response: absorb ground reaction to weight
Mid stance to pre-swing: body weight carried forward

Question 20

Summarize the swing phase

Answer 20

Toe off, mid swing and terminal swing

Question 21

What is the goal of the swing phase?

Answer 21

Clear foot, advance lower extremity and prepare the lower extremity for loading

Question 22

What are the two common etiologies for gait pathologies?

Answer 22

Neurologic in which muscles become spastic or flaccid

Musculoskeletal associated with pain or weakness

Question 23

What are the common gait pathologies that have a neurologic etiology?

Answer 23

Ataxic, hemiparesis, scissor, stoppage/foot drop and Parkinsonian gaits

Question 24

Ataxic gait

Answer 24

Effects BOTH legs (bilateral)
Wide base with irregular steps
Lack of balance/proprioception
Due to alcohol intoxication or damage to balance centers of brain/spinal cord
(Walking like a drunk person all over the place)

Question 25

Hemiparesis gait

Answer 25

Loss of function
Effects ONE leg (unilateral)
Will drag/pull limbs stuck in spasm
Arm is flexed and the leg is extended (circumduction)
Due to damage to motor control of brain (ex. Strokes)

Question 26

Scissor gait

Answer 26

BOTH legs (bilateral)
Leg muscles stiff due to spasm with knees inward
Legs and foot commonly cross midline
Due to damage at motor part of spinal cord

Question 27

Stoppage gait/foot drop

Answer 27

Effects ONE leg (unilateral)
“Hiking” = bending at hip/knee to raise leg higher
Clear weak foot during swing phase
Due to weakness in specific nerve causing inability to raise the foot

Question 28

Parkinsonian gait

Answer 28

Bilateral
Stiff and stooped over with tremors
Short shuffling gait that speeds up involuntarily (Fenstrating)
Due to damage muscle tone/movement initiation center of brain

Question 29

What are common gait pathologies with musculoskeletal etiology?

Answer 29

Waddling gait/trendelenburg gait and antalgic gait

Question 30

Waddling/Trendelenburg gait

Answer 30

Bilateral
Duck like waddle
Trunk shifts toward stance leg and hip drops on swing leg
Due to trunk and leg muscular weakness/pathology

Question 31

Antalgic gait

Answer 31

Unilateral
Shorten gait to prevent placing weight on the leg
Decrease stance phase on effected limb
Due to pain in LE
Concern for trauma, joint damage or joint inflammation
(Basic limp walk)

Question 32

Inspecting posture and gait

Answer 32

Can be easily done with general inspection
Gather a wealth of info when walking into the room
Further examination if pathology is suspected which can indicate MSK or neuro pathology