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Postural Assessment

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Postural Assessment

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Postural Assessment is important to identify the defects in body, which lead to various musculoskeletal problems.

What are the tools used in Postural Assessment?

The Postural Assessment tools used by the Kendalls consists of the following:

Posture Boards

These are boards on which footprints have been drawn. Footprints may be painted on the floor of the examining room, but the posture boards have the advantage of being portable.

posture boards
Posture boards

Plumb Line

This line is suspended from an overhead bar, and the plumb bob is hung in line with the point on the posture board that indicates the standard base point (anterior to the lateral malleolus in side view, midway between the heels in back view).

Postural Assessment tools - plump line
Plump line & Marking Pencile

Folding Ruler with Spirit Level

This is used to measure the difference in level of the posterior iliac spines. It also may be used to detect any differences in shoulder level. A background with squares is a more practical aid in detecting differences in shoulder level.

Set of Six Blocks

These blocks measure 4 inches by 10 inches and are of the following thicknesses: Vs, ‘A, 3/s, ‘/2, 3A and 1 inch. They are used for determining the amount of lift needed to level the pelvis laterally.

Postural Assessment tools - ruler and blocks
Folding Ruler and set of Blocks

Marking Pencil

This is used for marking the spinous processes to observe the position of the spine in cases of lateral deviation.

Tape Measure

This may be used for measuring leg length and forward bending in reaching the Fingertips toward or beyond the toes.

Postural Assessment tools - protractor
Postural Assessment tools – protractor

Appropriate Clothing

Clothing, such as a two-piece bathing suit for girls or swim trunks for boys, should be worn by subjects for a posture analysis. Such an examination of schoolchildren is unsatisfactory when children are clothed in ordinary gym suits. In hospital clinics, gowns or other suitable garb should be provided.

Alignment in Standing

In standing posture analysis, the patient stands on the posture boards with their feet in the position indicated by the footprints.

Anterior View

Observe the position of the feet, knees, and legs. Toe positions, appearance of the longitudinal arch, alignment in regard to pronation or supination of the foot, rotation of the femur as indicated by position of the patella, knock-knees, or bowlegs should be noted. Any rotation of the head or abnormal appearance of the ribs should also be noted.

Lateral View

With the plumb line hung in line with a point just anterior to the lateral malleolus, the relationship of the body as a whole to the plumb line is noted. It should be observed from both the right and left sides for the purpose of detecting rotation faults.

Segmental alignment faults may be noted with or without the plumb line. Observe whether the knees are in good alignment, hyperextended, or flexed. Note the position of the pelvis as seen from the side view and whether the anteroposterior curves of the spine are normal or exaggerated. Also note the head position (forward or tilted up or down), the chest position (whether normal, depressed, or elevated), and the contour of the abdominal wall.

Posterior View

With the plumb line hung in line with a point midway between the heels, the relationship of the body or parts of the body to the plumb line are expressed as good or as deviations toward the right or left.

From the standpoint of segmental alignment, one should note the alignment of the tendo calcaneus, postural adduction or abduction of the hips, relative height of the posterior iliac spines, lateral pelvic tilt, lateral deviations of the spine and positions of the shoulders and the scapulae. For example, a lateral pelvic tilt may result from one foot being pronated or one knee being habitually flexed, fallowing a dropping of the pelvis on that side in standing.


  1. Singla D, Veqar Z. Methods of postural assessment used for sports persons. J Clin Diagn Res. 2014 Apr;8(4):LE01-4. doi: 10.7860/JCDR/2014/6836.4266. Epub 2014 Apr 15. PMID: 24959470; PMCID: PMC4064851.
  2. Griegel-Morris P, Larson K, Mueller-Klaus K, Oatis CA. Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. Phys Ther. 1992 Jun;72(6):425-31. doi: 10.1093/ptj/72.6.425. PMID: 1589462.
  3. Saxton JB. Normal and abnormal postures in the sagittal plane and their relationship to low back pain. Physiotherapy Practice. 1988;4(2):94–104.
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