Good reasoning!

Are they? If so, they expand the base of support. I am not sure you are correct but I can't see clearly due to the size of the picture. Also this contradicts your previous sentence

What kinds of forces?

Good!

The lumbar curve is somewhat flattened as her spine is flexed forward; however the thoracic kyphosis does not appear exaggerated. Her cervical curve is exaggerated in extension because she is protruding her head forward.

Femurs are flexed at the hip

Which one? or do you mean both?

Good!

Good!

R femur is flexed as well.

The rotation of the pelvis causes the rotation of the spine. The lateral tilt causes side bending of the spine--lateral flexion

You are describing a right lateral tilt (right side down)

Describe the direction of the tilt--is the pelvis tilted to the left or right?

In which direction?

The lumbar curve is flattened. Since you accurately stated her head is in the forward head posture, what is happening in her neck?

How are the joints being compressed? In spinal flexion, the anterior body becomes compressed. Also there is likely shear force in this position.

Leaning forward places additional shear forces on the vertebrae.

Do you mean joint alignment? Joint compression is not a desirable thing, you would not want to support it.

Yes!

Her BOS is very large and includes her forearms on the desk. Her COG is also lower (than if she were standing) and even though she is leaning forward bringing the COG forward (which results in more mobility and less stability), it is counterbalanced by the large BOS created by her forearms taking up a large space on the table.

Her upper extremities are also being supported by the desk. She is very stable due to multiple points of contact with support surfaces.

If she had an anterior pelvic tilt, her lumbar curve wouldn't be as flexed; she would have more extension in the lumbar spine. However, her sacrum and lumbar curves are both flexed, leading me to believe she is in a posterior pelvic tilt.

Spine is also rotated to the right.

He is more stable than mobile, although leaning forward also brings his COG forward, which makes one less stable. The instability created by the forward COG is counterbalanced by his L arm being supported by the table. So, in general, this position is more stable than mobile.

Position of scapulae?

Which curve? Lumbar is flattened; thoracic is slightly exaggerated. What is going on with the cervical curve?

Not sure what this means

Lovely. As a runner, perhaps you would like to participate in the Navy Nautical 10-miler in June in Millington. It is the only race I have participated in which has a wheelchair division. I have tried in the past to get students interested in volunteering to check the course for accessibility or in any other capacity. Something to think about for PDP.

Very good!

Yes!

Perhaps one minute!

This is not a stable position, she could easily fall over making it a more mobile position.

head is protruded forward. "Tilt" is used to describe the pelvis.

Her lumbar curve is flattened and her cervical spine is also somewhat flattened by the forward head protrusion

Not sure what you mean--we all naturally have two kyphotic and two lordotic curves.

The lumbar curve is flattened; I would say the cervical curve is exaggerated with the forward head protrusion

Do you think the neck is in flexion or extension?

Posterior

Great!

Outstanding!

Very nice analysis!

flexed shoulders and elbows...not sure which part is extended besides the wrists

The lumbar curve is flattened as well.

No! Forward head posture is detrimental! It's not a good position.

https://www.medicalnewstoday.com/articles/forward-head-posture#what-is-it

It would be torture for anyone to stay in this position for longer than a few seconds!

Nice!

Is this a stable position?

Both femurs are flexed at the hips.

Unclear what you are describing--tilt in which direction?

Very nice!

Agree! Unfortunately you did not describe what's going on in the cervical and lumbar areas which would result in discomfort over time.

What's going on in the lumbar and cervical areas?

The head is protruded forward---would you say they neck is flexed or extended?

Would you say they were slightly elevated?

and upwardly rotated (relative to anatomical position)

How would you educate Warren on lifting his backpack?

What does this mean?

What forces are acting on his vertebrae in this position, especially when he rises to stand?

Capitalize proper names

The femurs are flexed at the hip and externally rotated; the knees are extended.

Lumbar lordosis is flattened; thoracic appears neutral and cervical lordosis appears slightly exaggerated because he is extending his neck to look at his hands.

vice versa

Very nice

Yes, because there would be less points of contact with a stable surface.

I disagree; it is relaxing while the left is bearing most of the body weight.

The right femur is flexed

Very nice!

lumbar

Very nice

I see most of your weight on the left leg, in which the knee is extended to support the weight as opposed to the right knee which is slightly flexed, therefore less in a position to accept the body weight.

Good. The tight fit also increases points of contact between his body and another surface creating friction, and therefore less mobility (more stability).

Thanks for sharing! Cute pictures!

Tilt is used to describe the pelvis; the head is described as protruded forward

What is happening to the head? Is it rotated? Usually it is protruded forward.

Not sure I understand.

This position is more efficient for mobility because the base of support is relatively small and there are no additional points of contact with support surfaces other than the feet.

Incorrect word

The whole body? Where specifically?

stay in

Yes

I don't understand. Pelvis is tilted either anteriorly or posteriorly. When someone has exaggerated lumbar lordosis, they typically have an anterior pelvic tilt. In a swayback posture, they lean back and the pelvis is tilted posteriorly.

I don't see this--both upper extremities appear to be slightly flexed at the shoulders. I can't see the right UE but the left elbow is flexed too.

this

Great idea

Do you think the lack of support of the lumbar spine will be tolerable for an extended period?

I would disagree about hips being in alignment--they are adducted and internally rotated

retracted

flexed and adducted. The knees are extended

extended

The spine is flexed causing the lumbar lordosis to flatten and the thoracic kyphosis to be exaggerated. The cervical vertebrae are hyperextended and the head is forward. Scapulae are elevated.

Which picture?

You contradict your earlier statement that he is in good alignment. What would lead to poor posture?

The BOS is large because he has contact with a lot of surfaces: his back and thighs; his R wrist on the desk and his B elbows resting on the chair's armrests. This is a very stable position which does not allow for a whole lot of mobility.

In the picture it looks like his shoulders are posterior to his hips because he is slightly reclining. If he was sitting forward, with more hip flexion, I might agree with you, but that is not what the picture shows.

This sentence is contradictory: either the pelvis is neutral, or in an anterior tilt. However, I disagree with your description., From the picture it looks like he is more likely in a slight posterior tilt, because he is sitting with a large area of contact between his back and the back of the chair.

Need more specifics regarding the various curves of the spine

The sheer force is between each adjacent vertebrae.

This is too vague--what are the specific interventions you would use/teach?

Good

Not sure what you meant here. If you are describing the arthrokinematics, then this is wrong, because the moving segment is the pelvis.

I don't know what this means

Great pictures! I wish they came with an explanation!!

Splitting computer screen from keyboard is also helpful.

and torque (rotational)

The right is creating additional point of contact with a support surface; the left is being supported by her thigh.

Excellent list!

I would disagree; also, pronation usually goes along with internal rotation. However, it's hard to see in this picture. Just something for you to consider.

Excellent!

Looks also like both femurs are abducted to create a wider, more stable BOS.

Yes!

The opposite is true: when the lumbar lordosis is decreased, the pelvis tilts posteriorly.

How lovely. Thanks for sharing!

How creative! Thanks for sharing!

decrease pressure where?

spelling

Good reasoning!

Posterior pelvic tilt results in flattened lumbar lordosis, not exaggerated lumbar curve. Therefore, one of your descriptions is wrong.

This is a bit too vague.

I would disagree because a large portion of his body is resting/reclining on a support surface--resulting in a lower COG than if he was sitting upright, increasing stability.

Not sure what this means "slight bend"--not sure how you would flex hips with only a slight bend at the knees. Needs clarification.

This is incorrect. Both UEs are in contact with support surface, making this BOS larger than just the two feet. The seat is also part of the BOS.

Also because of what I mentioned in previous comment: LOG approaching edge of BOS

The LOG is approaching the edge of the BOS, which makes this position less stable.

What makes it stable?

Nice!

Good points!

She would have to uncross her legs...not so sure it would be that easy--but it is all speculation!

Very good analysis!

True! I would recommend a separate keyboard rather than a laptop which combines the keyboard and display monitor (as seen in the second picture). Good job with this blog post!

Excellent!

Good analysis!

Does not make sense considering the rest of the sentence.

He is more stable in this position because he is leaning his pelvis on the counter for additional support.

There is no cause and effect--he has a posterior tilt of the pelvis most likely due to the forward head posture and excessive thoracic kyphosis.

Tilt is used to describe the pelvis, not the head.

Larger BOS is more stable and therefore more difficult to come out of.

Neck flexed?

Not sure what this means. Be precise in descriptions.

What is the BOS?

Head does not tilt. Tilting is a descriptor for the pelvis.

there is no such description

There are two kyphotic curves--which one?

Incorrect

Very good! Another potential intervention is stretching muscles that are typically concentrically contracted during climbing, to promote flexibility and prevent tightness which could translate into an abnormal resting posture.

Grammar--not sure what you mean in this sentence.

Outstanding!

Excellent

This is a great analysis overall.

Be specific--which one? There are two kyphotic curves in the spine.

Great analysis!

Such cute pictures! Thank you!

Good idea!

Another intervention is to separate the screen from keyboard to better position BUEs and allow a more neutral (less kyphotic) thoracic curve.

Great!

Great!

No cause and effect here. The muscle doesn't make it stable. The size of the BOS and relative position of the COG, and therefore the LOG, is what make this a stable position. Also, her COG is very low, which increases stability.

Nice reasoning.

Different size font?

What is this? Citation?

There is a different intervention in your notes.

grammar

Good observation

missing word

This is incompatible with what you described regarding the lordotic curve (of the lumbar vertebrae).

Be specific. There are 2 lordotic curves--which one are you referencing?

Neck. There is no such thing as an anterior tilt to the head. Anterior tilt is a descriptor for the pelvis.

spelling

Lovely!

Great!

As soon as he lets go of the dog, he will become much less stable.

lunge?

Looks like slight external rotation of the left and possible internal rotation of the right. Hard to tell from this angle.

See previous comment

Spell out

Still don't understand what you mean

Example?

place abbreviation is parentheses here, (AOTA)

This is not formatted correctly. Place (NYT) after you spelled it out in the previous sentence, and here remove the parentheses.

Does not make sense

This is still very broad. Can you give an example? What was the client's level of function? How much supervision or assistance did they need? What adaptive technique did you suggest?

This is a general statement. Can you provide one specific example, perhaps related to a client or caregiver?

I don't understand this--please rewrite for clarity.

I don't understand. Please revise.

see previous

patients with hemiplegia--first person language

spell out

Spell out

Spell out aconym

Put TA in parentheses here

Check previous comment--copy the title from the certificate.

spell out

typo

spell out

Can you give a specific example? This is very general.

Expand--this is still very vague

This is still very vague. Please provide a specific example.

spelling

spell out for the first itme

spell out

Capitalize