Postural Allignment
Does The Patient Sit Symetrically ?
Good posture can be defined as the position of maximal function. Most of us perform best when we are positioned symetrically. When symetric joints are not in extreme positions, nor are muscles working unduly to keep us upright. In symetry one is able to perform functions equally well on either side of the body.
When seated symetrically :-
- Nose is vertical
- Eyes are horizontal
- Shoulders level
- Iliac crests level (see pelvis )
Is The Patient Positioned To The Rear Of The Seat ?
Ask or assist the patient to sit towards the rear of the seat, sot that their posterior pelvisd areais contacting the back of the chair.
Ask The Patient To Assume A Symetric Sitting Posture
Once the patient's pelvis is to the rear of the seat ensure that they can voluntarily maintain a symetrical sitting position, without support
Where Fixed Deformaties Are Present, Ensure Optimal Position To Accommodate
If fixed deformaties are present such as scoiliosis, dislocated hips determine which body part should be oriented toward the patient environment.
Patient head,shoulders,pelvis or knees face front?
Often it will be necessary to balance the head and trunk over the pelvis. Head and shoulders should be facing front if possible so that the eyes are horizontal and the nose vertical. ( see above)
Remaining parts are then supported in whatever posture they are fixed , being careful to avoid excessive pressure on one ishium or greater trochanter, when attempting to balance the patients head and shoulders over an inflexible pelvis. as this may give rise to pressure sores. ( see wound management below)
Where the patient suffers scoliosis it may be necessary to adopt a windswept position with the knees, in order to get the head facing forward.
Fixed Assymetric Deformity
In fixed assymetric deformity the head is balanced over the the support base with eyes horizontal and nose vertical