PTY 312 (PATHOKINESIOLOGY)

C.M. ISHAKU BMR,PT, MSC, PGDM

HUMAN POSTURE, MOVEMENT AND GAIT

• Posture, movement, and gait are essential aspects of human function, influencing both
physical and mental well-being. Understanding the analysis of human posture, movement
and gait is crucial for medical professionals, particularly physiotherapists, to diagnose and
treat various disorders and injuries.
• This analysis encompasses a broad spectrum of potential assessment strategies used to
evaluate normal and abnormal gait, both walking and running. Such assessments range
from simple observation to a sophisticated computer analysis of biomechanics.
• Posture plays a significant role in daily life, affecting not only physical health but also
mental well-being. Poor posture can lead to musculoskeletal pain, fatigue, and decreased
quality of life. Research highlights the prevalence of posture-related issues, particularly
among college-aged populations, where sedentary behavior and prolonged mobile phone
usage contribute to poor postural habits.
• Movement/gait analysis is made possible by the acquisition of objective data that
describes a subject’s movement.
 ANALYSIS OF POSTURE, MOVEMENT AND GAIT

• Visual Observation: Clinicians should visually • sEMG

assess the patient's posture, noting any
deviations from normal alignment, such as
kyphosis, lordosis, or scoliosis.
• Goniometry: Goniometers are used to measure
joint angles and range of motion (ROM) to
assess postural alignment and mobility.
• Surface Electromyography (sEMG): sEMG
measures muscle activity to assess posture and
movement patterns.
• Photogrammetric Systems: These systems use • Photogrammetric system
cameras to capture images of the patient from
various angles, allowing for the calculation of
postural angles and quantifiable data.
• Dynamic Movement Assessment: Clinicians
assess dynamic movements, such as forward
bending and sit-to-stand tests, to evaluate the
quality of posture and movement patterns
ABNORMAL HUMAN POSTURES

Kyphosis:
• Description: An excessive outward
curvature of the thoracic spine posteriorly,
leading to a hunched back.
• Causes: Poor posture, osteoporosis, spinal
fractures, congenital malformations.
• Effects: Back pain, stiffness, breathing
difficulties, and decreased range of motion.
Lordosis:
• Description: An excessive inward/anterior
curvature of the lumbar spine, creating a
pronounced lower back arch.
• Causes: Obesity, pregnancy, weak core
muscles, poor posture.
• Effects: Lower back pain, discomfort, and
potential nerve compression.
Scoliosis:
• Description: A lateral curvature of the
spine, often forming an "S" or "C" shape
when viewed posteriorly.
• Causes: Idiopathic (unknown cause),
congenital spine deformities,
neuromuscular conditions.
• Effects: Uneven shoulders or hips, back
pain, and in severe cases, respiratory
challenges.
Forward Head Posture:
• Description: The head juts forward, out
of alignment with the spine.
• Causes: Prolonged use of electronic
devices, poor sitting or standing posture.
• Effects: Neck pain, headaches, shoulder
tension, and decreased mobility.
Flat Back Posture:
• Description: A condition where the
natural curve of the lower spine is lost,
leading to a flat appearance.
• Causes: Degenerative disc disease, spinal
surgery, ankylosing spondylitis.
• Effects: Back pain, difficulty standing up
straight, and muscle fatigue.
Sway Back Posture:
• Description: The pelvis goes forward, and
the upper body leans backward.
• Causes: Weak core muscles, prolonged
sitting, and poor postural habits.
• Effects: Lower back pain, muscle strain,
and altered gait.
Anterior Pelvic Tilt:
• Description: The front of the pelvis
drops, and the back of the pelvis rises,
creating an exaggerated lumbar curve.
• Causes: Sedentary lifestyle, tight hip
flexors, weak gluteal muscles.
• Effects: Lower back pain, hamstring strain,
and postural imbalance.
ABNORMAL HUMAN MOVEMENT

Tremors:
• Description: Involuntary, rhythmic muscle contractions causing shaking movements.
• Types: Essential tremor (common, often hereditary), Parkinsonian tremor (associated
with Parkinson's disease), and intention tremor (occurs during purposeful movements).
• Causes: Neurological disorders, metabolic issues, medications, or substance withdrawal.
• Effects: Difficulty with fine motor tasks, social embarrassment, and functional
impairments.
Dystonia:
• Description: Sustained or repetitive muscle contractions causing twisting and abnormal
postures.
• Types: Focal dystonia (affects one part of the body), segmental dystonia (two or more
connected parts), and generalized dystonia (whole body).
• Causes: Genetic mutations, brain injuries.
• Effects: Pain, disability, and difficulty performing daily activities.
Chorea:
• Description: Irregular, rapid, and involuntary movements that flow from one part of the
body to another.
• Causes: Huntington's disease, rheumatic fever (Sydenham's chorea).
• Effects: Unpredictable movements, difficulty with coordination, and impaired speech or
swallowing.
Athetosis:

• Description: Slow, writhing, continuous movements, primarily affecting the hands and feet.
• Causes: Cerebral palsy, basal ganglia damage, or as a side effect of certain medications.
• Effects: Difficulty with precise movements, maintaining posture, and performing everyday
tasks.
Ballismus:

• Description:Violent, flinging movements, usually affecting one side of the body

(hemiballismus).
• Causes: Lesions in the subthalamic nucleus, typically due to stroke.
• Effects: Severe motor disability, risk of injury, and significant impairment in daily life.
Akathisia:
• Description: An inner feeling of restlessness leading to constant movement, such as
pacing or leg shaking.
• Causes: Side effects of antipsychotic medications, antidepressants, or other drugs.
• Effects: Extreme discomfort, anxiety, and interference with sleep and daily activities.
Bradykinesia:

• Description: Slowness of movement, often with reduced amplitude and speed.

• Causes: Parkinson's disease, other parkinsonian syndromes, or severe depression.
• Effects: Difficulty initiating movements, performing tasks, and significant impact on quality
of life.
Dyskinesia:
• Description: Involuntary, erratic, and often dance-like movements.
• Types: Levodopa-induced dyskinesia (in Parkinson's disease patients) and tardive
dyskinesia (resulting from long-term use of certain medications).
• Causes: Long-term use of dopaminergic medications or antipsychotics.
• Effects: Social embarrassment, discomfort, and functional impairment.
ABNORMAL HUMAN GAIT PATTERN

Antalgic Gait:
• Description: A protective gait pattern where the individual spends less time on the
affected leg to avoid pain.
• Causes: Painful conditions such as arthritis, fractures, or soft tissue injuries.
• Characteristics: Shortened stance phase on the affected side, often with a limp.
Ataxic Gait:
• Description: An unsteady, staggering walk often associated with a lack of coordination.
• Causes: Cerebellar dysfunction, multiple sclerosis, or intoxication.
• Characteristics: Wide base of support, irregular steps, and difficulty maintaining balance.
Parkinsonian Gait:
• Description: A slow, shuffling walk with small steps and minimal arm swing.
• Causes: Parkinson's disease or other parkinsonian syndromes.
• Characteristics: Stooped posture, reduced arm swing, and difficulty initiating or stopping
movements.
Hemiplegic Gait:

• Description: A gait pattern seen in individuals with one-sided weakness or paralysis.

• Causes: Stroke, cerebral palsy, or traumatic brain injury.
• Characteristics: The affected leg is swung in a circular motion (circumduction), and the
affected arm may be held close to the body.
Spastic Gait:
• Description: A stiff, awkward walk with legs that may cross each other (scissoring).
• Causes: Spasticity due to cerebral palsy, multiple sclerosis, or spinal cord injury.
• Characteristics: Stiff, jerky movements, legs crossing midline, and toes dragging.
Trendelenburg Gait:
• Description: A gait pattern characterized by the dropping of the pelvis on the side
opposite the affected leg.
• Causes: Weakness of the hip abductor muscles, particularly the gluteus medius.
• Characteristics: The pelvis tilts downward on the non-weight-bearing side, and the trunk
may lean to compensate.
Steppage Gait:
• Description: A high-stepping walk used to avoid dragging the toes.
• Causes: Foot drop due to peripheral neuropathy, peroneal nerve injury, or muscular
dystrophy.
• Characteristics: Exaggerated lifting of the knee to clear the foot during the swing phase.
Waddling Gait:
• Description: A side-to-side, penguin-like walk.
• Causes: Muscular dystrophy, hip dysplasia, or other conditions causing bilateral hip
weakness.
• Characteristics: Trunk swings from side to side, exaggerated pelvic rotation.
Propulsive Gait:

Description: A walk characterized by a forward-leaning posture.

Causes: Parkinson's disease or other conditions affecting the basal ganglia.
Characteristics: The body appears to be pushed forward, taking small, rapid steps.
Scissor Gait:
• Description: A gait pattern where the knees and thighs touch or cross each other during
walking.
• Causes: Cerebral palsy, multiple sclerosis, or other neurological conditions causing
spasticity.
• Characteristics: Narrow base of support, knees crossing midline, and toes pointing
inward.
Festinating Gait:
• Description: A rapid, short-stepped walk that appears hurried or as if the person is
chasing their center of gravity.
• Causes: Advanced Parkinson's disease.
• Characteristics: Involuntary quickening of steps, forward-leaning posture, and difficulty
stopping.
Hysterical Gait (Functional Gait Disorder):
• Description: A psychogenic gait disorder with bizarre, inconsistent, and often dramatic
presentations.
• Causes: Psychological factors, conversion disorder.
• Characteristics:Variable and often non-anatomical patterns, may include exaggerated
swaying or sudden collapses without injury.