Name: 第 12 章 - 姿勢、動作和表現評估 (Chapter 12 - Posture, Movement, and Performance Assessments)
Uploaded: 2025-05-08T07:49:22.000Z
Duration: 51 min 51 s

and welcome to the continuation of our assessments information.

歡迎繼續收看我們的評估資訊。

So this is chapter 12 of the NASM CPT study information.

這就是 NASM CPT 學習資料的第 12 章。

基礎被動語態

Last class or last lecture was based on chapter 11 which was more of what we would call your health wellness and fitness assessments.

最後一堂課或最後一堂課的內容是第 11 章，我們稱之為健康和體能評估。

This is going to move us into our postural, our movement, and our performance basis.

這將為我們的姿勢、動作和表演奠定基礎。

So more dynamic types of you know I say dynamic because majority of these are movement.

我之所以說 "動態"，是因為其中大部分都是運動。

Understand that some of them might be static based.

要知道，其中一些可能是基於靜態的。

So let's get into that, explain why that's the case and what we are going to do with that.

是以，讓我們來談談這個問題，解釋一下為什麼會這樣，以及我們要怎麼做。

So there are a lot of really good pictures that we're going to be able to see a lot of good diagrams in here.

是以，這裡有很多非常好的圖片，我們可以在這裡看到很多好的圖表。

So pay attention to the locations, pay attention to the verbiage that's on the side of those because those are always going to be really good to stop, pause, and basically have this really good set of you know notes that you could take based on that.

是以，請注意這些地點，注意它們邊上的文字說明，因為這些內容總是非常適合停下來，暫停一下，基本上有一套非常好的筆記，你知道你可以根據這些筆記來做筆記。

So again we did health wellness and fitness so we got baseline information.

是以，我們再次對健康和健身進行了調查，從而獲得了基線資訊。

We got really good like demographic information that's going to tell us about that person.

我們有非常好的人口統計資訊，可以讓我們瞭解這個人。

Well now we want to be able to assess like truly assess the body.

現在，我們希望能夠對身體進行真正的評估。

Well the first thing we want to work on like it says here is posture assessment.

首先，我們要做的是姿勢評估。

Static meaning motionless, dynamic meaning with motion.

靜態的意思是不動，動態的意思是有動作。

Alright so with this with these postural assessments we are going to just basically see what the body is going to do on under specific non-loaded environments.

好了，有了這些姿勢評估，我們基本上就可以看到身體在特定的非負荷環境下會做什麼了。

How the body is shaped, is there any imbalances, are there any specific limitations, are there any other factors that can be associated with that.

身體的形狀如何，是否有任何失衡，是否有任何特定的限制，是否有任何其他相關因素。

So also with that what we're going to do is we're going to do some movement assessments that are going to take us through how we can see any differences in movement impairments.

是以，我們要做的就是進行一些運動評估，讓我們瞭解如何發現運動障礙的差異。

So like if you're doing a push or a pull assessment we can definitely see what's going on and how the optimal motion should be versus what you might see being non-optimal or impaired.

是以，如果你正在做推或拉的評估，我們肯定能看到發生了什麼，以及最佳運動應該是怎樣的，而你可能看到的是非最佳運動或受損運動。

And then lastly we're going to go through the performance assessments that we have that are going to assess strength and muscular endurance, power and then agility.

最後，我們還將通過性能評估來評估力量、肌肉耐力、力量和敏捷性。

And those are again those aren't dictated just you know and dedicated just to athletes.

同樣，這些也不是隻為運動員服務的。

So whenever you see those words understand that it could be for anybody but it's got to be for the right instance.

是以，每當你看到這些字眼時，你就會明白，它可以是為任何人準備的，但必須是為正確的事例準備的。

All right so again this is something that we've hit on before in terms of muscular imbalances.

好吧，這也是我們之前提到過的肌肉失衡問題。

So we have to make sure that we're working through our over and under active.

是以，我們必須確保通過我們的過度活躍和不足活躍來開展工作。

Over active meaning that you're compensating on one side that one side is constantly shortened while the other is under active is that there is no sort of you know impulse to that you know well I don't want to say that that's the wrong way to say it but there's you know less influence of the muscle at that point if it's under active because it's not as strong and it's being influenced by the over activity of another muscle group.

過度活躍的意思是，你在補償一側肌肉，一側肌肉不斷縮短，而另一側肌肉卻不太活躍，這樣就沒有一種你知道的衝動，你知道，我不想說這是錯誤的說法，但你知道，如果肌肉不太活躍，肌肉在這一點上的影響就會減少，因為它沒有那麼強壯，而且受到另一個肌肉群過度活躍的影響。

All right so that's what you know getting into that back into that length tension relationship or muscles basically being at rest and how that would work.

好吧，這就是你所知道的，回到長度張力關係或肌肉基本上處於靜止狀態，這將如何工作。

So with static posture we want to make sure that we're again visually observing looking at somebody from the specific standpoints of anterior frontal position like frontal view side view lateral posterior back view because even though the front and the side may look good the back may not or if the back and the side look good the front might not or the side might not but the front and back do so there's always those ways to work around it.

是以，對於靜態姿勢，我們要確保再次從正面前方位置等特定角度進行視覺觀察，如正面視圖、側面視圖、側後方視圖等，因為即使正面和側面看起來都不錯，但背面可能不好，或者如果背面和側面看起來都不錯，正面可能不好，或者側面可能不好，但正面和背面都不錯，所以總有一些方法可以解決這個問題。

But always understand and I'll highlight right here foot ankle knees lumbopelvic hip complex shoulders and head are our go-to's those are our specific locations that we want to pay attention to the foot and ankle the knee the lumbopelvic hip complex the hip complex you know from the side view that is going to be you know basically where the ball of the femur runs into from the front it's that midsection all right and then the shoulders and then the head all of those have specific alignments that we're going to be looking for especially during like I said that static posture where you're not moving.

但要始終明白，我會在這裡強調腳踝 膝蓋 腰椎髖關節複合體 肩膀和頭部是我們要去的地方這些都是我們要注意的特定位置：腳踝、膝蓋、腰骨盆髖關節複合體、髖關節複合體，你知道從側面看，基本上是股骨球進入的地方，從正面看，是中段，然後是肩膀，然後是頭部，所有這些都有特定的排列方式，我們要注意的是，尤其是像我說的那種不動的靜態姿勢。

So again I'll blow this up a little bit bigger just so you can kind of see it a little bit clearer but here is there's again those five checkpoints there's your foot and ankle your knee your lumbopelvic hip complex your shoulders and thoracic spine and your head and cervical spine.

我再把這個放大一點，這樣你就能看得更清楚一點，但這裡又有五個檢查點，分別是你的腳和腳踝、膝蓋、腰椎髖關節複合體、肩膀和胸椎、頭部和頸椎。

So all of those locations and if you see it's going to form that grid from this this is now from the anterior view what we're looking for is you know are the shoulders having a nice squared appearance to them is the hip complex nice and straight across does the line from the basically the iliac crest of the hip the top part of the hip go straight down through the knee and then directly through the ankle or is there some some sort of sway or some other impairment that we see or imbalance that we see.

是以，所有這些位置，如果你看到它將形成網格，這是從現在的前方視圖，我們正在尋找的是你知道的肩部是否有一個漂亮的方形外觀，髖關節複合體是否漂亮和筆直，從基本上髖關節的髂嵴，髖關節的頂部部分直線向下通過膝蓋，然後直接通過腳踝，或者是否有某種搖擺或其他障礙，我們看到或我們看到的不平衡。

Does the head basically run straight down and the middle of the head does it run straight down through and I know not being graphic but through your midsection your crotch area.

頭部基本上是直向下的，頭部的中間是否直向下穿過，我知道這並不生動，但穿過你的中間部位，你的襠部。

So this is where we are looking for those pinpoint locations.

這就是我們要尋找的精確定位。

Now you are very much welcome to do this with the naked eye.

現在，我們非常歡迎你用肉眼來做這件事。

Okay you're definitely able to look and observe this in a moment.

好吧，你肯定能在一瞬間看到並觀察到這一點。

My suggestion is always to err on the side of caution because you always want to have frame of reference is you know ask if your clients are willing to do pictures.

我的建議是謹慎行事，因為你總是希望有一個參考框架，你知道詢問你的客戶是否願意拍照。

Alright and those pictures will obviously be left in confidence that you're not going to do anything with them and that you are going to use them for the sole purpose that you want to see where imbalances are.

好吧，這些照片顯然會被保密，你不會對它們做任何事情，你使用它們的唯一目的就是想看看哪裡不平衡。

So that definitely helps because you can see all angles at that point.

是以，這絕對有幫助，因為在那個時候，你可以看到所有的角度。

Now again there you know the anterior view also you know straight and parallel for the feet so we're looking at those aspects as well alright because we want those imaginary lines to be where they're shown.

同樣，前視圖中的腳也是筆直平行的，所以我們也要注意這些方面，因為我們希望這些假想的線條就在它們顯示的地方。

From a lateral view there we go again the one thing we want to pay attention to is the ear.

從側面看，我們又要注意耳朵了。

Okay from the head down we want to see that line start right pretty close really kind of more that temporal position but right through the ear basically down through the midpoint of your shoulder running down through just slightly behind that midpoint of the hip definitely behind the knee and then directly through the ankle and that line of sight is what we want to see for optimal positioning.

好的，從頭部向下，我們希望看到這條線從右側開始，非常接近顳部位置，但基本上是通過耳朵向下穿過肩膀的中點，再向下穿過臀部中點稍後的位置，也就是膝蓋後面，然後直接穿過腳踝，這條視線就是我們想要看到的最佳定位。

Alright now we can start seeing especially in this mid section here the the LPHC if we have somebody who has like an anteriorly anteriorly tilted hip what will happen is they might start having a little bit more of that rounded lower back and then you'll start see this midsection line right in the middle here that would be more angled more toward the anterior downward position like you're gonna dump out a pail of water.

好了，現在我們可以開始看到，尤其是在 LPHC 的中段，如果有人的髖關節前傾，那麼他們的下背部可能會變得更圓一些，然後你會開始看到中段線，就在這裡的正中間，會更多地向前方向下的位置傾斜，就像你要倒掉一桶水一樣。

Alright so depending upon where individuals are in their you know their posture you might have a forward head.

好吧，這取決於個人的姿勢，你知道他們的姿勢，你可能有一個前傾的頭部。

Well a forward head is gonna put your shoulders out of alignment it's gonna put your hips and knees and ankles out of alignment so we're always looking again for these locations.

頭部前傾會讓你的肩膀不對齊，會讓你的臀部、膝蓋和腳踝不對齊，所以我們一直在尋找這些位置。

This is where again a side picture and we could basically take a sharpie if we were to or even on a paint app you know we can take and run a line directly through and see you know where these lines of sight are right very very critical to understand that and then from a posterior view again are our five key points that we're looking for but if you look there's a couple additional lines here and that's basically saying are the scapula in alignment at that point you know are they running about the same.

這也是側面圖，我們基本上可以用銳利的筆，甚至可以在油漆應用程序上直接畫一條線，看看這些視線在哪裡，這對理解這一點非常關鍵，然後從後方看，這也是我們要尋找的五個關鍵點，但如果你看一下，這裡還有幾條額外的線，基本上是說肩胛骨在這一點上是否對齊，你知道它們是否運行得差不多。

Now right and left side imbalance can occur we know that we know that from side to side we might have a little bit of a difference but you know understand that this is part of that process of finding out those limitations okay so we're looking for those pinpoints again the hip the shoulder the knees and the ankle but this is from the backside as well okay also with the feet you're looking for you know especially from the back view look at their shoes or look at their feet and see if you're starting to see maybe the heel is in a different position if their toes are starting to swing out you might see their arches being a little bit off in positioning so these are all things we want to pay attention to at these levels.

我們知道，左右兩側可能會出現不平衡，但你要知道，這也是發現限制因素過程的一部分，所以我們要再次從髖部、肩部、膝蓋和踝關節等部位尋找關鍵點，但這也要從背面看。腳部也是如此，尤其是從背面看，看看他們的鞋子或腳，看看他們的腳後跟是否在一個不同的位置，如果他們的腳趾開始向外擺動，你可能會看到他們的足弓在定位上有一點偏差，所以這些都是我們要注意的地方。

So what we want to know though is if anything is out of alignment all right if there seems to be some sort of an imbalance somewhere or if we looked at the going back to some of the terminology if there are any impairments that we're seeing you know with that posture well what are they well pes plantis lower cross and upper cross syndrome all right so if anything make sure that you know these three cat you know characteristics oh you know for the three distortion patterns because this might be something that pops up on your test that might say you know what distortion pattern is characterized by forward head and protracted round or rounded shoulders you'd say upper cross okay so let's get into the three of them first one is pes plantis if you look all right at the ankle joint you can see that you have what we would call a collapsed arch okay that collapsed arch is causing you to have what we would call eversion or the sole of the foot start to flare out all right the knee joint you can see if you look at the line of sight of the femur and of the tib fib you'll see that you're a little bit more bow-legged which we call knee valgus all right and there's a little bit of what we would call internal rotation meaning that the the femur is rotating in at the hip joint you can see here we're adducted we're pushing our knees together so we're going toward the midline and internally rotated as well now going through you can see the potential muscle imbalances pay attention to the over and under active muscles here as an overactive would be the gastrocnemius and the soleus so the calves are overactive the adductors are overactive pulling those knees in and the hip flexors as well which will cause internal rotation under active meaning that they need to be strengthened at some point overactive would need to be stretched under active are the anterior and posterior tibialis so that right in the front part of your shin here and the glute maximus and medius are not causing the femur to kick back and be externally rotated with lower cross that lower cross think about it from the perspective of positioning lower cross means lower back so what we're looking at here from the hip joint is what we would say is it's flexed you can see here that by flex meaning that we're pulling basically almost like the torso downward and you know causing this little bit of a shift in angle from upper to lower body the pelvis is anteriorly tilted you can drastically see that this person you know they almost have like a shifted butt meaning that their their butt is looks like it's raised and it's and you start to see that angled down and then of course your lumbar spine has that shift of really drastic really really drastic concave type of you know basically bending in motion so you're overactive here your hip flexors because the front is pulling so heavy and then your lumbar extensors of your low back are very aggressive at that point as well what are underactive are your glutes your glute maximus medius your hamstrings and your abdomen and they're not strong enough to hold you back into that position so it's basically allowing you to fall forward all right so that's lower cross syndrome then upper cross syndrome now this is extremely exaggerated but you get the idea upper cross is upper back lower cross is lower back upper cross you have that a little bit more of that hunchback shape with a forward head position posture so what we have like we said here the thoracic spine or that mid spine t1 to 12 is what we would call excessive kyphosis or hunchback where that positioning is flexed okay the shoulders are protracted they're a little bit more like rotated forward okay rounded forward not rotated excuse me and there's some internal rotation or like a turning in and then the head and the neck is jutted forward it's not that you are in extension or flexion it's just the cervical spine moves in that way so what are your overactives in this case well your pecs your pecs are gonna pull those shoulders forward the levator scapula and the sternocleidomastoid which are in the front portion of your neck are pulling you pulling that neck forward and your upper traps again are the upper traps are gonna pull forward that's what's rounded shoulder this rounded upper back things that are under active your mid and lower traps down in the lower region and then your rhomboids and they they are basically weak so they're not able to pull that back into posture and then your deep cervical flexors that are deep within the muscles that are gonna flex the neck that are you know those are gonna be weak too so it basically allows for everything to flop forward okay so you have no neck control at that point and that's why the head wants to do what it wants to do so all those are characterized by where the location is pes plantus is in the you know that's not as easy to remember but understand that that pes plantus is all about the feet and the feet and the legs whereas lower cross is lower back and upper cross is our upper back excuse me upper crosses upper back all right so those are what we would look for first these are static positions meaning that you are gonna have a person stand in front of you and you're gonna be looking for these types of environment now some of them are exaggerated but there are conditions that are a little bit you know again this is why pictures really can do a service and one of the other things you want to make sure to appropriate clothing for this is really gonna make a difference so the tighter that the tighter the fit of the clothing the better you can see these shapes of the person's posture so you know unfort like for a guy having a guy wear solely a pair of shorts would help greatly to see everything now again it's based on comfort but it would definitely help females a sports bra a sports bra halter top tank top and then shorts also make a huge difference so that you can see these locations and the more drapier they are the harder it is to see the outline of the body so it's harder to see where the dysfunction lies so we observed static we want to move into movement now now these are dynamic posture this isn't about strength or push-pull this is more about we're gonna put your body through some motion well actually push-pull would be part of this but it's we're gonna get into just body motion first before we introduce equipment is more like what we want to say all right so the movements that we're gonna do include some balancing some squatting some pushing and some pulling and it's gonna go overhead squat single leg squat a pushing exercise and then a pulling exercise in that order overhead squat single leg squat pushing assessment pulling assessment and we want to see again those five kinetic chain points and from anterior posterior and lateral lateral views so your overhead squat there's the starting position here if you notice the palms are facing forward person is extended completely all right and then we're gonna move them through so pay attention to your starting points you know foot and ankle complex is neutral we don't want to have toes flared in or toes flared out you know we want to be able to have our arms completely overhead our elbows this is where it gets tricky some people can't get to this position but we want to be elbows fully extended to that person's limitations now myself I can't mine look like they're not fully extended but it's just my posture or my the way that my structure of my arms are it looks like I have a slight little bend but I don't it's fully extended so you have to be very clear to say okay extend your elbows you know do not lock them unless you're having you know only or if you do lock them only lock them to a very light position all right so that we can get to that overhead in the proper way now it says here shoes off are preferable and I agree with that I mean shoes and socks would be great but if you can get at least the shoes off and have socks only that's what we want to do because we want to see what the feet do when we go into that squatting motion okay so again squatting what is the main thing here I mean obviously this is the anterior view this is the lateral view you can do a posterior view if you'd like but for now what we're seeing here is that we want to make sure that the femur is parallel to the ground that's the key point that's gonna be something that you probably will be asked on in a test okay us but again squat depth depending upon who the person is can be reduced based on their you know their ability level and if maybe they've had a pre-existing injury or anything like that okay so what you're gonna have them do five reps five reps and the first rep might look really good the fifth rep might look a little bit more not so good and that's because the body is adjusting and letting itself kind of you know you're you're a relaxing a little bit more in the positioning and so that when you're relaxed more surprisingly enough the muscles that are imbalanced if they are are gonna move and move you and so when you have the final ending position and you're watching this person go through that final ending range of motion you're gonna see on that fifth rep where that person really is and what they're really doing instead of the first couple reps they're really trying to make sure they're doing the reps right so this is you know again your anterior view looking for some some negatives here feet turning out slightly that would indicate external rotation the knees feet turning out that that could also mean that you might start getting some varus or the knees coming out but for right now we're looking at the toes toes and knees for this one here and if you notice this person's you know again their head is not an optimal alignment their shoulders are not an optimal alignment so there's a lot going on there that we're seeing just from the front but we'll see it more from the lateral side all right lateral can't get into full depth you know they can't get the full they can't get the hips down and that affects that whole upper positioning they might be able to start getting to full depth but then their lower back starts rounding in the center and then the other one is going to be their arms falling forward so although this person in the center has low back arching their arms are still in alignment whereas this person their arms are falling even though they might be an optimal you know spinal alignment so we're always paying attention to those impairments at that point.

所以，我們想知道的是，是否有任何東西不對齊，好嗎，如果似乎有某種失衡的地方，或者如果我們看回一些術語，如果有任何障礙，我們看到你知道的姿勢，好吧，它們是什麼，好吧，足底下交叉和上交叉綜合徵，好吧，如果有的話，確保你知道這三隻貓，你知道的特徵哦，你知道的三種扭曲模式，因為這可能是你的測試中彈出的東西，可能會說，你知道的哪種扭曲模式的特徵是頭部前傾，肩膀圓或圓，你會說是上交叉 好吧，讓我們來了解一下這三種模式 第一種是足底畸形，如果你看一下踝關節，就會發現你有一個我們稱之為足弓塌陷會導致腳底外翻，或者腳底開始

So what we want to do is use this chart here you can you know and you can develop your own but this is the chart that you'd want to do checkpoints for so that you can see what the common conditions are what's overactive what's under active and then we can go from there all right because those muscle imbalances will dictate a lot of information and it'll make us it will actually not a lot of information it'll dictate how we go about correcting them and what we want to do in terms of their their exercises.

是以，我們要做的就是使用這張圖表，你可以知道，你也可以開發自己的圖表，但這是你想要做檢查點的圖表，這樣你就可以看到常見的情況是什麼，什麼是過度活躍，什麼是活躍不足，然後我們就可以從那裡開始，因為這些肌肉失衡將決定很多資訊，它會讓我們它實際上不會很多資訊，它會決定我們如何去糾正他們，以及我們想要在他們的練習方面做什麼。

So the charts here will help us greatly in terms of understanding if you have turnout what's overactive what's under active so we want to pay attention to those as you're going through and studying again pause this if you have your book go through the book chart because this is table 12-5 okay in your book and look at these overactive under actives all right valgus or knees caving in your overactive or your TFL your tensor fascia lata and your adductor complex those are forcing the knees to come in where under active your glutes and your anterior and posterior tibialis are not allowing that knee to stay outward okay so these are just you know again going through for the lateral positioning there's your over actives and your under actives you know hip flexors lumbar extensors what you're gonna notice is that a lot of these like positioning like low back arching you're gonna see a lot of over and under active positions that are very similar to what we saw statically if somebody had that lower cross syndrome okay and then you know going to that lateral view still there's the you know more upper excessive forward trunk and then arms falling forward your overs and your unders there might be some carry over between them you know depending upon what position they're pulling them through so again pause this mark them down look at your book study them so that you know for a test where what you're under and over actives are so you know once we go through and determine our solutions and how we can kind of you know one you know again these are if we know our over actives and we know our under actives again we we stretch our over actives and we strengthen our under actives okay that's the key point here so what we do is if we take care so if we stretch and pay attention more to our hip flexors our calves and then you know just be aware of our rectus abdominis and our external obliques then we know that you know it's tough to stretch your abs but you still can but stretching those will help alleviate that tension that's causing you to pull forward whereas when you start doing strengthening exercises in a corrective format to these three lumbar extensors hamstrings and the glute max you can start pulling that person back into a strengthened positive position so that's just one example of how we can use these solution charts to do that.

是以，這裡的圖表將極大地幫助我們理解，如果你有岔氣，什麼是過度活躍，什麼是活動不足，所以我們要注意這些，因為你正在通過和研究再次暫停這一點，如果你有你的書，去通過書中的圖表，因為這是表12-。5 好的，在你的書中，看看這些過度活躍的肌肉，右膝外翻或膝蓋內陷都是你過度活躍的肌肉，或者是你的TFL，你的筋膜張力和內收肌複合體，這些都是迫使膝蓋內收的肌肉，而你的臀肌和脛骨前、後肌不允許膝蓋保持外展，好的，這些都是你知道的，再次通過橫向定位，有你過度活躍的肌肉，也有你過度活躍的肌肉，你知道的髖屈肌、腰伸肌，你要注

單腿深蹲並不適合所有人，但如果一個人在高抬腿深蹲中得分很高，或者一個人缺乏平衡感，我們可能不想把這個動作扔給他，我們只想確保把這些人放在最佳位置和最佳位置，這樣他們才能正確地做單腿深蹲，所以如果他們在平衡方面有困難，或者如果他們在進入單腿深蹲位置方面有困難，那麼我們會避免這個動作，然後繼續單腿深蹲。所以，如果他們在平衡上有困難，或者很難進入單腿深蹲的狀態，那麼我們就會避開這個動作，繼續單腿深蹲，這不是可選動作，但可以是其中之一，我們寧願優先做高抬腿深蹲，而不是單腿深蹲。離地不超過六英寸 不需要太遠 也不需