living university of postural care simple stuff works connor's story

Connor’s Story

©Simple Stuff Works Associates Ltd 2015

I used to lie in bed like this – I didn’t know this would add to the difficulty I had walking

I have a condition called diplegia, I have had difficulty controlling the movement of my legs since I was born


So……. my shoulders were pushed up and forwards

……….my chest was squashed

and my back was bent©Simple Stuff Works Associates Ltd 2015

My pelvis was rotated… my knees were

squashed together My left hip was turned in

There were plans to perform a

de-rotation osteotomy to turn my left leg out

I kept my hips and knees bent

to feel comfortable and

relaxed


Measurements of the Goldsmith Indices of Body Symmetry show that on 8th June 2006 I had a

“Windswept Index” of 20.25 degrees to the right

This means the way I have been lying has made my body asymmetric

The explanation and results are on the next slides


These Measurements have been carefully designed, they are standardised and have been shown to be reliable

when carried out properly by suitably skilled and qualified measurers

“Physiotherapy” April 1992, vol. 78, no 4, 235 – 242.

“Thus it appears that the measurements were mainly determined by real differences between subjects and

that there was negligible systematic disagreement between the testers. It can be concluded that the measurements obtained in this way consistently

differentiated among subjects even when made by different testers”


Anticlockwise: (0.?)

Goldsmith Indices 0f Body Symmetry : Procedure 1.3

Measurements are taken from the xyphoid process to the lateral border of the chest each

side with the pelvis level 1 Clockwise: (1.?)


Procedure 1.3 showed that the measures from my sternum to the lateral border of my chest were 9.5 to

my right and 10.5 to my left

My chest used to rotate anticlockwise This is a Right/Left ratio of 0.9

9.5cm 10.5cm


The Angle Between Legs and Pelvis (ABLAP) was calculated

If my movement was symmetrical the ABLAPs would be the same so the INDEX would be zero

To measure Procedure 2 my knees were gently taken from side to side with my shoulders and feet fixed A comparison was made between how far my legs would go comfortably and how my pelvis lifted as a result of the leg movement


Knees to Right = Leg angle 140 – pelvic angle 20 = ABLAP 120Knees to Left = Leg angle 140 – pelvic angle 20 = ABLAP 120ABLAP to right: 120 minus ABLAP to left: 120 = 0 = Symmetry

In real life there will be error in the measurements so they are repeated 4 times to reduce the standard error and provide a range of possible results

Leg Paddle Angle140 degrees

Leg Paddle Angle140 degrees

Pelvic Angle20 degrees both sides

This is what a perfect measurement of perfect symmetry would look like


Mean

leg angle 145 146 147 147 146.25

pelvic angle 36 35 41 40 38

ABLAP 109 111 106 107 108.25

leg angle 150 151 152 150 150.75

pelvic angle 64 65 61 61 62.75

ABLAP 86 86 91 89 88

to R mean to L

25 20.25 -15

Knees to the Right

Knees to the Left

I had been sleeping in this position for 10 hours a night

By June 2006 my muscles were tight and my pelvis rotated so it lifted to 62.75 degrees when my knees were taken to the left. This asymmetry meant that the ABLAPs were different by 20.25 degrees

The results also show a large range of possible results because it was quite difficult to take the measures

Windswept Index Results


Knees to Right = Leg angle 146.25 – pelvic angle 38 = ABLAP 108.25Knees to Left = Leg angle 150.75 – pelvic angle 62.75 = ABLAP 88

ABLAP to right: 108.25 minus ABLAP to left 88 = Windswept Index 20.25 The range of possible results is calculated by comparing the

highest Right ABLAP with the lowest Left (25 degrees) and then the highest Left ABLAP with the lowest Right (-15 degrees)

Leg Paddle Angle150.75 degrees


This is what my measurements looked like in

June 2006

Pelvic Angle62.75 degreesPelvic Angle

38 degrees

108.25

88


Comparing my ABLAPs with normative data shows my results are below the norm, 108.25 when my knees are taken to the right and 88 degrees when taking my knees to the left

This is because my body is tight and my pelvis is rotated from lying scrunched up on my side


Then I began to lie straight in bed on my back with support


My chest used to rotate anticlockwise

With support this could be corrected


My knees used to turn in

With this support my knees are relaxed outwards


Sam and Carl can help me to straightenmy pelvis

My right side back left side forward


I worked hard to change the way I

slept and by 15th September 2006

my measurements showed that I had

succeeded in straightening my

body


June 2006My shoulders were hunched

with sleeping on my side

Right/Left ratio of o.9

9.5cm 10.5cm

11.5cm

11.5cm

September 2006 My shoulders have relaxed

with sleeping on my back

Right/Left ratio of 1


Knees to the Right

Knees to the Left

Windswept Index Results

Mean

leg angle 142 141 136 140 139.75

pelvic angle 21 19 16 19 18.75

ABLAP 121 122 120 121 121

leg angle 144 142 139 138 140.750

pelvic angle 28 24 21 19 23

ABLAP 116 118 118 119 117.75

Windswept Index to R mean to L

6 3.25 -1

By sleeping symmetrically on my back for 3 months my body has straightened and relaxedSome people might be surprised but this provides…

10 hours therapy a night

70 hours a week

280 hours a month

840 hours in 3 months

…when the body is most susceptible to restoration

The band of possible results was smaller because I was more relaxed and it was easier to take the measures


Knees to Right = Leg angle 139.75 – pelvic angle 18.75 = ABLAP 121Knees to Left = Leg angle 140.75 – pelvic angle 23 = ABLAP 117.75

ABLAP to right: 121 minus ABLAP to left 117.75 = Windswept Index 3.25 The range of possible results is calculated by comparing the

highest Right ABLAP with the lowest Left (6) and then the Highest Left ABLAP with the lowest right (-1)



This is what my measurements looked like in

September 2006

Pelvic Angle23 degreesPelvic Angle

18.75degrees

121 117.75


Comparing my ABLAPs with normative data shows that once I have been lying on my back for 3 months my results are within the norm

121 to the right and 117.75 to the left

This is because my body is relaxed and rotation of my pelvis has reduced


The Summary Result sheet can show progress towards symmetry….

Here are my Results!

Goldsmith Indices of Body Symmetry Results: Summary Procedure 2

Name

Date of Birth Measurer

25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Date

20 10 0 10 20

Connor **** ****

08/06/06

15/09/06

When the body is symmetrical results will span the midline because measurement error will occur randomly so measurements of a symmetrical body look something like this

A tighter band of possible results indicates more confidence in the result and that the measurements were easier to take

Symmetry


This is Good News!

I am off the list for surgery

I can run and ride a bike more easilyOnce I am grown and in the habit of lying

straight I can use less equipmentThis will help me to do things I want to do…

Catch me on YouTube

“Connor’s Success Story”


living university of postural care simple stuff works connor's story

Healthcare

relaxed simple stuff

slides simple stuff

degrees pelvic angle

mean leg angle

degrees leg paddle angle

left leg

pelvis ablap

i didnt