Dynamics of multi-joint hip muscles on sitting and lying


Date: 5/12/20
Credit: .1 CEU
Presenters: Tamara Kittelson-Aldred, MS, OTR/L, ATP/SMS and T. Sammie Wakefield, OTR/L, ATP (retired)
Medical Terminology, ATP/SMS Prep Content, Advanced Level



A multi-joint hip muscle passes over more than one joint and so what happens at one joint will affect the motion of others. Understanding how this works is very important in wheelchair seating and 24-hour posture care and management. The lumbar spine and lower leg below the knee joint are connected by multi-joint muscle groups with the pelvis caught in the middle. We will consider three muscle groups that have major effects on pelvic posture, and thus impact function throughout the body. More than one of these muscle groups may be affected in a single individual, resulting in complex seating needs. An understanding of these multi-joint movement patterns of the pelvis is key to successful, functional seating and positioning outcomes. We will suggest how seating accommodations and 24-hour posture care management can minimize and improve problems caused by multi-joint muscle dysfunction.

Learning Content:
The participant will be able to list three multi-joint muscle groups that affect pelvic posture.
The participant will be able to describe differences between the effects of shortened hamstrings and shortened hip flexors on pelvic posture.
The participant will be able to list 2 seating accommodation techniques for shortened hip flexors and hamstrings, and 2 corrective strategies in supine lying.

Tamara Kittelson-Aldred is an occupational therapist, RESNA Assistive Technology Professional/Seating and Mobility Specialist, and holds advanced postural care certificates through the U.K. Open College Network West Midland. She directs the Montana Postural Care Project and Eleanore’s Project, promoting posture care and management with responsible wheelchair provision in low resource settings. Tamara has written and presented on these topics in the United States, Peru and Colombia. She has served individuals with complex neurodisabilities in Montana since 1983, currently through Moving Mountains Therapy Center, and is a Friend of NRRTS. She credits her daughter Eleanore, born with cerebral palsy and profound deafness, as her best teacher.
T. Sammie Wakefield is an occupational therapist who has worked in seating and mobility for over 37 years. She has degrees from Berea College and Texas Woman’s University and is a founding mother of New Hampshire ATECH – an assistive technology program that served clients in New Hampshire for over thirty years. Now retired from paid work, she continues her 13 years of volunteer work with Eleanore’s Project both as a board member, and by sharing her knowledge and skills with American OT students and therapists in Peru.