Client Assessment & Treatment Planning

Lesson 3 of 10

Visual and Postural Assessment

Observation can provide useful context about movement, comfort, and how a client uses their body, but it cannot establish a diagnosis. First explain why observation is relevant and obtain appropriate permission. Consider the client in a respectful, nonjudgmental way, recognizing that appearance varies and a static posture is only a moment in time. Ask the client what they notice rather than assigning meaning to an appearance alone.

Key points

• Observe general ease, protective movement, balance, and functional transitions when relevant to the stated concern.
• Use neutral, descriptive language such as ‘weight shifts toward the right’ instead of labeling a body as abnormal.
• Compare sides only when useful, accounting for individual variation, task demands, pain, and the client’s report.
• Ask the client to perform only movements that are relevant, comfortable, and reasonably safe.
• Stop observation or movement if the client reports concerning symptoms or shows distress, and respond within scope.
• Treat observations as one piece of information to guide discussion and possible service adaptation, not as proof of cause.

Key terms

Observation

Attentive noting of visible behavior or movement without assuming a diagnosis.

Posture

The arrangement of body segments in a particular position or task.

Protective movement

A movement pattern that appears guarded or reduced, warranting respectful inquiry.

Functional transition

A movement between positions or activities, such as sitting to standing.