LADy Manual
The Lay-out for Assessing Dynamic Posture (LADy) was developed to analyze the dynamic posture in ADLs of children who are school age using digital recording. The LADy is designed to help health professionals interested in assessing body posture in nine activities of daily life (ADLs) of children who are school age: (1) carrying bags; (2) carrying a backpack; (3) sitting at a desk to write; (4) lifting up an object from the ground; (5) carrying an object; (6) sitting at a desk to use a portable computer; (7) sitting on a seat with no back support; (8) sleeping; and (9) sitting at a desk to use a desktop computer.
This file contains instructions for using the LADy including necessary materials and relevant information for the analysis of each posture, the layout of the materials and the sequence of the performance.
Performing and recording the LADy requires a minimum space of 35 m² (5 m x 7 m). The same researcher should record the children who are school age performing the LADy from either the frontal or sagittal plane, depending on the task. For this purpose the digital camera should be supported on a mobile tripod so that the subject can be followed during the evaluation. The LADy should be performed by each school-age child individually, so that, each participant completes the tasks in the circuit as they would do in everyday life, without specific instructions. The order in which the tasks in the circuit should be completed should be explained to the group of participants. The students complete the circuit individually with their colleagues outside the room in order to avoid undue influence. The time to complete the circuit is about 4 minutes.
The recording is used to analyze the dynamic posture. Use of the “slow motion” command is suggested when completing the “Assessment form” (Appendix 2) according to the information contained in the LADy manual. The average time required to complete the assessment form is 8 to 10 minutes for each participant.
Below the essential aspects for the use of the LADy are described in detailed according to each evaluated posture.
1. Carrying bags
Materials: 2 plastic bags (with approximately 5% of the body weight of the participant in each bag).
Postural analysis: The evaluator should choose between options “a” and “b” at the beginning of the assessment, based on the body posture was maintained for the longest amount of time.
2. Carrying a backpack
Materials: 1 school backpack (2 straps) (with approximately 10% of the body weight of the participant).
Postural analysis: The evaluator should choose between options “a” and “b” at the beginning of the assessment, based on the body posture was maintained for the longest amount of time.
3. Sitting at a desk to write
Materials: 1desk and 1 school chair (the same size as the furniture used by the students being evaluated)
Postural analysis: The participant remains in the same position for at least 15 seconds. The body posture was maintained for the longest amount of time is considered.
4. Lifting an object from the ground
Materials: 1 box (30 x 30 x 30 cm) (with approximately 10% of the body weight of the participant).
Postural analysis: The participant performs the movement while the body posture is evaluated in the sagittal plane at the moment the participant grasps the box.
5. Carrying an objects
Materials: 1 box (30 x 30 x 30 cm) (with approximately 10% of the body weight of the participant).
Postural analysis: The participant performs the movement, and the body posture maintained for the longest amount of time is considered in the sagittal plane.
6. Sitting on a chair to use a portable computer
Materials: 1desk and 1 school chair (the same size as the furniture used by the students being evaluated) and 1 laptop computer.
Postural analysis: The participant remains in the same position for at least 15 seconds. The body posture maintained for the longest amount of time is considered, in the sagittal and frontal planes.
7. Sitting on a seat with no back support
Materials: 1 seat with no back support (the same size as the furniture used by the students being evaluated).
Postural analysis: The participant remains in the same position for at least 15 seconds. The body posture maintained for the longest amount of time is considered, in the sagittal and frontal planes.
8. Sleeping
Materials: 1 mattress and 3 pillows.
Postural analysis: The evaluator should choose between options “a”, “b” or “c” at the beginning of the assessment. The participant remains in the same position for at least 15 seconds. The body posture maintained for the longest amount of time is considered, in the sagittal and frontal planes.
9. Sitting at a desk to use a desktop computer
Materials: 1desk and 1 school chair (the same size as the furniture used by the students being evaluated) and 1 desktop computer.
Postural analysis: The participant remains in the same position for at least 15 seconds. The body posture maintained for the longest amount of time is considered, in the sagittal and frontal planes.
The total score achieved by each student should be calculated. The points awarded for each posture, according to the criteria listed in the Assessment Form (Appendix 2), should be added together to give the total score for the LADy. The maximum possible score is 50 points.
In order to standardize the interpretation of the postures, the terms “erect trunk”, “head in neutral” and “lower limbs separated” are defined below:
Erect trunk: According to Kendall et al (2007) and O´Sulivan et al (2002) this criterion is defined as a position in which the subject maintains the pelvis in a neutral position, neutral lumbar lordosis and neutral thoracic kyphosis. Figure 1 illustrates the erect trunk in the extensor, neutral and flexor patterns.
Head in neutral position: Defined as a position in which the head is held upright without lateral inclination or rotation, while maintaining the cervical lordosis (without flexion or extension).
Lower limb separated: Defined as a position in which the lower limbs are placed approximately below or slightly beyond the width of the shoulders.
(A) / (B) / (C)Figure 1. Illustrative images: trunk in extensor pattern (A), neutral pattern (B), and flexor pattern (C).
LADy: layout and the order of execution.
SCRIPT FOR PERFORMING THE LADy
The LADy assessment includes instructions that should be given to the students before recording begins. While the participant is performing the circuit, the researcher only supplies basic information regarding the correct sequence, as described for each posture below:
1 – The student is positioned ready to begin the LADy. Following a signal given by the researcher, the student picks up the two bags and carries them to point P1, and then walks towards the backpack and places both bags inside the backpack.
2 – The student picks up the backpack, walks until P2 and then until P3, continues walking towards to the basket and leaves the backpack in the basket.
3 – The student walks towards the desk, sits on the chair and writes a paragraph predefined by the researcher, for approximately 15 seconds.
4 – The student picks up the basket from the ground, carries it to P4 and places it on the table.
5 – The walks towards to desk where there is a portable computer, sits on the chair and types a paragraph predefined by the researcher, for approximately 15 seconds.
6 – The student stands and walks towards the seat (with no back support), sits and remains seated for 15 seconds.
7 – The student walks towards the mattress, lies down and remains lying down for 15 seconds (three pillows should be available).
8 – The student walks towards the desk where there is a desk top computer, sits on the chair and types a paragraph predefined by the researcher, for approximately 15 seconds.
9 – The student smiles and waves to the camera closing the LADy session.