Observation and palpation of the spine is important especially if a subject loses ambulation before they reach puberty. This puts the spine at increased risk from significant scoliosis. You should assess the spinal mobility of any curvature to see if it is correctable. Asking the subject to bend forwards (either in standing or whilst they are sitting) can make scoliosis and or rib rotation more evident and help your assessment. Make a note of cervical spinal posture too.

Pelvic obliquity, leg length, foot posture and any asymmetry can be assessed in standing, sitting or in a wheelchair to guide postural advice and wheelchair requirements and adaptations.
Logging these on a simple body diagram or chart can be very useful.

KEY OBSERVATIONS:

• Observation and palpation of the spine
• Pelvic obliquity
• Leg length
• Particular attention to the foot posture
• Any asymmetry
• Muscle wasting and hypertrophy
• Spinal mobility / rigidity
• Winging of scapulae both at rest and when the arms are raised through full abduction
• Posture in their wheelchair if applicable including observation / palpation of the spine