Role of the PT and PTA

Specific interventions for posture are introduced in Kinesiology. In this class, we set the foundation for postural assessment by ensuring you are able to recall anatomical planes, movement planes, and begin working on observation and documentation of those observations in static (non-moving) positions.

PT Examination and Evaluation

Posture is a component of every PT examination, regardless of pathology. The PT is responsible for establishing or elaborating on movement/activity precautions, contraindications, safety considerations, and differentially diagnosing the role of posture as a primary impairment contributing to functional limitations and disability. The PT documents postural observations in supine, sitting, standing, and/or functional activities depending on the patient's level of function at the time of the assessment. Muscle atrophy, hypertrophy, spasm and symmetry are noted, along with the postural impacts of ligamentous laxity, footwear, and assistive devices.

PTA Tests, Measures and Intervention

PTAs review the medical record and reassess posture using observations and patient instruction.

PTAs follow up on safety considerations and evaluate the patient and situation for ability to safely participate in postural interventions

PTAs can assess muscle length using multiple intervention strategies. PTAs provide exercise instruction, make recommendations for activity, equipment and workplace modifications in order to optimally affect modifiable contributors while minimizing stress to non-modifiable contributors to impaired posture.

PTAs make comparisons between the patient's current status and their baseline postural examination in order to determine if there is progress or if there is some barrier to progress which required further assessment by the supervising PT. PTAs actively listen to patients and relay information (through documentation and meetings) about additional contextual factors impacting progress.

PTAs document preferred posture and postural observations using appropriate medical terminology. PTAs document progress toward postural goals so the PT and the health care team are well-informed of the patient's participation, response, compliance, and safety throughout the treatment plan.

Boxes 4.5 through 4.9 in Pierson outline some clinical examples of how principles of postural control are integrated into patient education and exercise recommendations.

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