Posture means many things to different people. The words “good posture” often conjure memories of being told to “sit up straight” as a kid or images of ramrod stiff military posture – but that is not what we are talking about here!
At Posture 24/7 we focus on how habitual postures (used persistently and frequently as a habit) can have a huge impact on the lives of people with motor disabilities – and not necessarily for the best! While most of us take for granted that we can choose the postures we assume, this is not the case for many people with impaired movement. When we have the intrinsic ability to control our bodies against gravity we can choose to move in all manner of ways, to assume and maintain all kinds of positions. We may choose whether to slouch as we relax or sit erect with good core stability as we work, but what if we did not have that choice?
When a person has limited ability to move the whole game changes. This is true not only for those who can move very little or not at all, but also for individuals who move only in limited ways. This can be related to irregularities in muscle tone, paralysis, sensory impairment, poor coordination, joint contractures and many other factors. We can describe this as having a limited movement repertoire. When one cannot easily, independently and frequently move into a variety of different postures during the day and night, gravity and time can become the foe.
When the body is positioned unequally between its two sides we call it postural asymmetry. This is not a bad thing for short periods of time, when it is counteracted by movements or postures in the opposite direction so that the body is in balance. It is even important for function – we all use one side of the body differently than the other for certain activities. The problem arises when a person spends many hours over weeks, months or years in the same or similar posture without the ability or assistance to move out of it and into better balance.
When that happens a person’s body shape can slowly and inexorably change from symmetry to distortion. It can be so gradual that the progression toward scoliosis, dislocated hips and a flattened chest is not noticed and addressed until it is so obvious that it cannot be ignored. By then the person’s health has already been compromised and surgery is considered to be the only alternative. Over 30+ years of living and working as an occupational therapist in my community, I have seen what happens over time to children born with impairments and beautiful, symmetrical little bodies.
24 hour postural care augments traditional therapies and treatments to provide the foundation that every person with a disability needs in order to develop and/or rehabilitate to their own personal best functional level – a symmetrical, balanced body shape.
Tamara Kittelson-Aldred, MS, OTR/L, ATP/SMS