Week 13 PP Posture, Alignment, Gait, Devices(1) (2) (1)
Stability and Mobility
Importance of positioning, postural alignment, and functional mobility in occupational performance.
Description of bed mobility, wheelchair propulsion, transfers, and gait.
Learning Objectives
Connect concepts of positioning, postural alignment, and functional mobility.
Understand the human gait pattern as part of functional mobility.
Analyze atypical posture and gait patterns impacting occupational performance.
Recognize the role of mobility devices in occupational therapy.
Interconnected Body Segments
Body segments are interrelated; the function and position of one impact others.
Movements can be analyzed through open-link and closed-link chains.
Stability Defined
Stability: Control over body position/movement.
Base of Support (BOS): Area created by body parts in contact with surfaces.
Larger distance between points of contact increases stability.
Application in activities of daily living (ADLs).
Dynamic stability changes during walking or running as base of support shifts.
Use of Gait Devices
Gait Devices: Increase points of contact, enhance stability.
Types: walkers, canes, crutches.
Consider how devices affect posture.
Cane Usage
Cane Selection: Factors include minor weakness or balance impairment.
Proper cane height for optimal use.
Cane Sequencing While Walking: Start with the cane opposite the affected side, step with affected leg, then advance the stronger leg.
Special Features of Canes
Ergonomic handles, seats, collapsible shafts, and LED lights can enhance usability.
Consider aesthetics for compliance.
Safety Precautions for Cane Use
Ensure cane tip is in good condition (replace if worn).
Keep walking paths clear of hazards.
Use proper footwear.
Mobility Devices Overview
Mobility Devices can extend base of support and stability.
Walker: Offers multiple points of contact; suitable for weight bearing.
Crutches: Provides alternative support through additional points.
Center of Gravity (COG)
COG: Balance point, stability increases as the COG lowers.
Movement alters COG, affecting balance and support.
Line of Gravity (LOG)
LOG is a vertical line from COG to the ground; if in BOS, increases stability.
Functional Stability
Essential for performing tasks in various contexts.
Methods to enhance stability include increasing the BOS and weight distribution.
Posture and Postural Alignment
Posture: Relative position of body segments during activity.
Postural Control: Ability to maintain balance; involves both voluntary and involuntary adjustments.
Functional Mobility
Involves moving from one place to another, including bed mobility, wheelchair mobility, transfers, ambulation.
Good posture enhances functional mobility.
High Pressure Areas in Positioning
Positioning needs to address pressure sores associated with bony prominences.
Wheelchair Mobility
Proper positioning is crucial; consider neutral pelvic tilt, degree of elbow flexion.
Understanding Gait
Gait Cycle: Alternate phases of stance and swing allow forward movement.
Each leg alternates between weight acceptance, single leg support, and double leg support.
Abnormal Gait Patterns
Antalgic Gait: Avoids pain; shortened stance phase.
Ataxic Gait: Lack of coordination, not due to strength compromise.
Trendelenburg Gait: Pelvic drop during swing leg advancement; weak gluteus medius.
Circumduction Gait: Leg moves outward due to difficulties with hip/knee/ankle movement.
Foot Drop: Toes drag due to loss of ankle dorsiflexion.
Hemiplegic Gait: Weakness/paralysis on one side from neurological conditions.
Scissor Gait: Legs cross during ambulation; tight hip adductors.
Parkinsonian Gait: Shuffling with trunk flexion and weight on toes.
Transfers Review
Key steps for sit-to-stand and stand-to-sit transfers, ensuring proper body mechanics.
References
Short, N., Vilensky, J., Suarez-Quian, C.A. (2021). Functional anatomy for occupational therapy. Bools of Discovery.