from pptx import Presentation
from pptx.util import Inches, Pt
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR
from pptx.enum.shapes import MSO_SHAPE
from pptx.oxml.ns import qn
from PIL import Image
import copy
from lxml import etree

NAVY = RGBColor(0x0B, 0x3C, 0x49)
TEAL = RGBColor(0x1F, 0x7A, 0x8C)
CORAL = RGBColor(0xE0, 0x7A, 0x5F)
SAND = RGBColor(0xF6, 0xF2, 0xEA)
WHITE = RGBColor(0xFF, 0xFF, 0xFF)
DARK = RGBColor(0x22, 0x2B, 0x31)
GREY = RGBColor(0x5B, 0x67, 0x70)
LTEAL = RGBColor(0xDD, 0xEE, 0xF1)
FONT = "Calibri"

prs = Presentation()
prs.slide_width = Inches(13.333)
prs.slide_height = Inches(7.5)
BLANK = prs.slide_layouts[6]
page = [0]


def bg(slide, color):
    f = slide.background.fill
    f.solid()
    f.fore_color.rgb = color


def rect(slide, x, y, w, h, fill, shape=MSO_SHAPE.RECTANGLE, line=None):
    s = slide.shapes.add_shape(shape, Inches(x), Inches(y), Inches(w), Inches(h))
    s.fill.solid()
    s.fill.fore_color.rgb = fill
    if line is None:
        s.line.fill.background()
    else:
        s.line.color.rgb = line
        s.line.width = Pt(1)
    s.shadow.inherit = False
    return s


def text(slide, x, y, w, h, s, size=18, bold=False, color=DARK, align=PP_ALIGN.LEFT,
         anchor=MSO_ANCHOR.TOP, italic=False):
    tb = slide.shapes.add_textbox(Inches(x), Inches(y), Inches(w), Inches(h))
    tf = tb.text_frame
    tf.word_wrap = True
    tf.vertical_anchor = anchor
    tf.margin_left = tf.margin_right = Inches(0.05)
    tf.margin_top = tf.margin_bottom = Inches(0.03)
    p = tf.paragraphs[0]
    p.alignment = align
    r = p.add_run()
    r.text = s
    r.font.name = FONT
    r.font.size = Pt(size)
    r.font.bold = bold
    r.font.italic = italic
    r.font.color.rgb = color
    return tb


def bullets(slide, x, y, w, h, items, size=18, color=DARK, space=6, bullet_color=CORAL):
    tb = slide.shapes.add_textbox(Inches(x), Inches(y), Inches(w), Inches(h))
    tf = tb.text_frame
    tf.word_wrap = True
    tf.margin_left = tf.margin_right = Inches(0.05)
    first = True
    for it in items:
        p = tf.paragraphs[0] if first else tf.add_paragraph()
        first = False
        level = 0
        if isinstance(it, dict):
            level = it.get("level", 0)
            head, tail = it.get("head"), it.get("tail", "")
        elif isinstance(it, tuple):
            head, tail = it
        else:
            head, tail = None, it
        pPr = p._p.get_or_add_pPr()
        marL = 0.28 + 0.3 * level
        pPr.set("marL", str(int(Inches(marL))))
        pPr.set("indent", str(int(-Inches(0.24))))
        buClr = etree.SubElement(pPr, qn("a:buClr"))
        c = etree.SubElement(buClr, qn("a:srgbClr"))
        c.set("val", "%02X%02X%02X" % (bullet_color[0], bullet_color[1], bullet_color[2]))
        bu = etree.SubElement(pPr, qn("a:buChar"))
        bu.set("char", "•" if level == 0 else "-")
        p.space_after = Pt(space)
        if head:
            r = p.add_run()
            r.text = head
            r.font.bold = True
            r.font.name = FONT
            r.font.size = Pt(size - level * 2)
            r.font.color.rgb = NAVY
        if tail:
            r = p.add_run()
            r.text = tail
            r.font.name = FONT
            r.font.size = Pt(size - level * 2)
            r.font.color.rgb = color
    return tb


def header(slide, title, sub=None):
    bg(slide, SAND)
    rect(slide, 0, 0, 13.333, 1.1, NAVY)
    rect(slide, 0, 1.1, 13.333, 0.06, CORAL)
    text(slide, 0.6, 0.12, 12, 0.7, title, size=32, bold=True, color=WHITE, anchor=MSO_ANCHOR.MIDDLE)
    if sub:
        text(slide, 0.6, 0.68, 12, 0.35, sub, size=14, color=RGBColor(0xBF, 0xDD, 0xE3), italic=True)
    page[0] += 1
    text(slide, 12.2, 7.05, 0.9, 0.3, str(page[0]), size=11, color=GREY, align=PP_ALIGN.RIGHT)
    text(slide, 0.6, 7.05, 8, 0.3, "Posture | Exercise Therapy | BPT revision", size=11, color=GREY)


def card(slide, x, y, w, h, title, items, size=16, head_fill=TEAL, body_fill=WHITE):
    rect(slide, x, y, w, h, body_fill, line=RGBColor(0xD8, 0xD2, 0xC4))
    rect(slide, x, y, w, 0.5, head_fill)
    text(slide, x + 0.1, y, w - 0.2, 0.5, title, size=17, bold=True, color=WHITE, anchor=MSO_ANCHOR.MIDDLE)
    bullets(slide, x + 0.1, y + 0.6, w - 0.2, h - 0.65, items, size=size, space=4)


def table(slide, x, y, w, colw, rows, size=13, row_h=0.5, head_fill=NAVY):
    nrows, ncols = len(rows), len(rows[0])
    gs = slide.shapes.add_table(nrows, ncols, Inches(x), Inches(y), Inches(w), Inches(row_h * nrows))
    t = gs.table
    tblPr = t._tbl.tblPr
    # remove style banding to control fill ourselves
    tblPr.set("bandRow", "0")
    tblPr.set("firstRow", "0")
    tot = sum(colw)
    for i, cw in enumerate(colw):
        t.columns[i].width = Inches(w * cw / tot)
    for r in range(nrows):
        t.rows[r].height = Inches(row_h)
        for c in range(ncols):
            cell = t.cell(r, c)
            cell.margin_left = cell.margin_right = Inches(0.08)
            cell.margin_top = cell.margin_bottom = Inches(0.04)
            cell.vertical_anchor = MSO_ANCHOR.MIDDLE
            cell.fill.solid()
            if r == 0:
                cell.fill.fore_color.rgb = head_fill
            else:
                cell.fill.fore_color.rgb = WHITE if r % 2 else LTEAL
            tf = cell.text_frame
            tf.word_wrap = True
            p = tf.paragraphs[0]
            run = p.add_run()
            run.text = rows[r][c]
            run.font.name = FONT
            run.font.size = Pt(size)
            run.font.bold = (r == 0) or (c == 0)
            run.font.color.rgb = WHITE if r == 0 else (NAVY if c == 0 else DARK)
    return t


def picture(slide, path, x, y, maxw, maxh):
    im = Image.open(path)
    ar = im.width / im.height
    w, h = maxw, maxw / ar
    if h > maxh:
        h, w = maxh, maxh * ar
    px = x + (maxw - w) / 2
    py = y + (maxh - h) / 2
    slide.shapes.add_picture(path, Inches(px), Inches(py), Inches(w), Inches(h))
    return px, py, w, h


def notes(slide, s):
    slide.notes_slide.notes_text_frame.text = s


# ---------- 1 Title ----------
s = prs.slides.add_slide(BLANK)
bg(s, NAVY)
rect(s, 0, 5.2, 13.333, 0.08, CORAL)
text(s, 0.9, 1.7, 11.5, 1.3, "POSTURE", size=72, bold=True, color=WHITE)
text(s, 0.9, 3.0, 11.5, 0.8, "Exercise Therapy revision deck for BPT exams", size=28, color=RGBColor(0xBF, 0xDD, 0xE3))
text(s, 0.9, 3.9, 11.5, 0.8,
     "Definition | Control | Plumb line | Deviations | Assessment | Management | Exam tips",
     size=18, color=CORAL, bold=True)
text(s, 0.9, 5.5, 11.5, 0.5, "Sources: Bailey and Love 28th ed, Kandel Principles of Neural Science 6th ed, Rheumatology 2022, Campbell's Operative Orthopaedics 15th ed, standard physiotherapy teaching",
     size=13, color=RGBColor(0xBF, 0xDD, 0xE3))

# ---------- 2 Definition ----------
s = prs.slides.add_slide(BLANK)
header(s, "Definition and Importance", "Start every essay answer with a clear definition")
card(s, 0.6, 1.5, 6.0, 2.6, "Definitions", [
    ("Posture: ", "the relative arrangement of body parts, or the attitude the body assumes, to balance stability with minimal energy cost"),
    ("Postural orientation: ", "how body parts are aligned with each other and with the environment"),
    ("Good posture: ", "muscle and skeletal balance that protects supporting structures from injury or progressive deformity"),
], size=15)
card(s, 6.8, 1.5, 5.9, 2.6, "Why it matters", [
    "Upright trunk lowers the energy needed to hold the centre of mass over the base of support",
    "Protects ligaments, discs and joints from strain",
    "Affects breathing, balance, performance and pain",
], size=15, head_fill=CORAL)
card(s, 0.6, 4.3, 6.0, 2.6, "Good posture does", [
    "Reduce muscle and ligament strain",
    "Reduce fatigue and energy expenditure",
    "Prevent deformity and early degeneration",
    "Improve breathing, balance, function",
], size=15)
card(s, 6.8, 4.3, 5.9, 2.6, "Poor posture causes", [
    "Neck and back pain, headache, TMJ strain",
    "Muscle imbalance and joint wear",
    "Reduced lung capacity",
    "Higher injury and fall risk",
], size=15, head_fill=CORAL)
notes(s, "Kandel 6th ed: postural orientation and balance control interact but can act independently.")

# ---------- 3 Classification ----------
s = prs.slides.add_slide(BLANK)
header(s, "Classification of Posture", "Know the table and the postural vs structural difference")
table(s, 0.6, 1.5, 12.1, [2, 4, 3.5], [
    ["Type", "Meaning", "Example"],
    ["Static posture", "Body at rest, no movement", "Standing, sitting, lying"],
    ["Dynamic posture", "Body moving, posture maintained during movement", "Walking, running, lifting"],
    ["Good posture", "Minimal stress, maximum efficiency, plumb line alignment", "Standard standing"],
    ["Faulty posture", "Segments malaligned, increased stress on tissues", "Forward head, round shoulders"],
], size=15, row_h=0.62)
card(s, 0.6, 4.8, 5.9, 2.1, "Postural (functional) deformity", [
    "Flexible, correctable actively or passively",
    "Cause: habit, muscle imbalance, fatigue",
    "Corrects on forward bend",
], size=15)
card(s, 6.8, 4.8, 5.9, 2.1, "Structural deformity", [
    "Fixed, bony or soft tissue change",
    "Does not correct voluntarily or passively",
    "Rib hump persists on Adam's test",
], size=15, head_fill=CORAL)

# ---------- 4 Control ----------
s = prs.slides.add_slide(BLANK)
header(s, "Control of Posture", "Postural tone + sensory input + central integration + reflexes")
card(s, 0.6, 1.5, 4.0, 2.7, "Sensory inputs", [
    "Visual",
    "Vestibular",
    "Somatosensory: muscle spindles, joint receptors, plantar surface",
], size=15)
card(s, 4.7, 1.5, 4.0, 2.7, "Central integration", [
    "Brainstem: vestibular nuclei, reticular formation",
    "Cerebellum",
    "Basal ganglia and cortex",
], size=15)
card(s, 8.8, 1.5, 3.9, 2.7, "Effectors and reflexes", [
    "Antigravity (tonic) extensors",
    "Stretch, righting, tonic neck and labyrinthine reflexes",
], size=15, head_fill=CORAL)
rect(s, 0.6, 4.45, 12.1, 2.45, WHITE, line=RGBColor(0xD8, 0xD2, 0xC4))
text(s, 0.75, 4.5, 11.8, 0.45, "Postural tone (Kandel, 6th ed)", size=18, bold=True, color=NAVY)
bullets(s, 0.75, 4.95, 11.8, 1.9, [
    "Antigravity support from tonic trunk, neck and ankle extensors, plus passive bone-on-bone forces (knees locked) and stretched ligaments (front of hip)",
    "Postural tone is not static: it changes constantly with alignment, voluntary movement and task",
    "Tone alone cannot maintain balance. Even breathing causes sway that is actively countered",
], size=15, space=4)

# ---------- 5 Plumb line ----------
s = prs.slides.add_slide(BLANK)
header(s, "Standard Posture: Lateral Plumb Line", "Kendall alignment, top to bottom: EST-HKA")
picture(s, "/tmp/workspace/posture-ppt/assets/img0.jpg", 0.6, 1.4, 4.6, 5.0)
text(s, 0.6, 6.45, 4.6, 0.5, "Lateral view with plumb line at acromion, greater trochanter, lateral malleolus (study image)",
     size=11, italic=True, color=GREY)
card(s, 5.5, 1.5, 7.2, 5.4, "Line of gravity passes through", [
    ("Ear: ", "lobe of the ear (mastoid process)"),
    ("Shoulder: ", "middle of the shoulder joint (acromion)"),
    ("Trunk: ", "middle of the trunk"),
    ("Hip: ", "greater trochanter, slightly behind hip joint axis"),
    ("Knee: ", "slightly in front of the knee axis"),
    ("Ankle: ", "slightly in front of the lateral malleolus"),
    ("Spine (SVA): ", "odontoid, C7/T1 disc, T12/L1 disc, posterosuperior S1"),
], size=17)

# ---------- 6 Curves + AP view ----------
s = prs.slides.add_slide(BLANK)
header(s, "Normal Spinal Curves and Other Views", "Numbers are favourite viva and short note questions")
table(s, 0.6, 1.5, 6.3, [2.6, 2, 2.6], [
    ["Curve", "Normal range", "With age"],
    ["Cervical lordosis", "35 to 45 degrees", "-"],
    ["Thoracic kyphosis", "20 to 50 (mean 35)", "Increases"],
    ["Lumbar lordosis", "40 to 80 (mean 60)", "Decreases"],
], size=15, row_h=0.65)
bullets(s, 0.6, 4.3, 6.3, 2.6, [
    "Most lumbar lordosis lies between L4 and S1",
    "In efficient posture, cervical and lumbar lordosis balance thoracic kyphosis",
    "Primary curves (kyphotic): thoracic, sacral. Secondary (lordotic): cervical, lumbar, from sitting and standing",
], size=15)
card(s, 7.2, 1.5, 5.5, 2.5, "Posterior view", [
    "Head midline, spinous processes in a straight line",
    "Level: shoulder tips, scapulae, iliac crests, PSIS",
    "Gluteal folds level, feet symmetrical",
], size=15)
card(s, 7.2, 4.2, 5.5, 2.7, "Anterior view", [
    "Head straight, shoulders and clavicles level",
    "Equal chest and waist contours",
    "Patellae face forward, knees and ankles equidistant from the line",
    "Weight evenly distributed on both feet",
], size=15, head_fill=CORAL)

# ---------- 7 Factors ----------
s = prs.slides.add_slide(BLANK)
header(s, "Factors Affecting Posture")
card(s, 0.6, 1.5, 3.9, 5.4, "Constitutional", [
    "Heredity and body build",
    "Age: kyphosis rises, lordosis falls",
    "Congenital deformity",
    "Obesity, pregnancy (centre of gravity shifts forward)",
], size=16)
card(s, 4.7, 1.5, 3.9, 5.4, "Functional", [
    "Muscle weakness, tightness, imbalance",
    "Pain and fatigue",
    "Poor habits, occupation, prolonged sitting",
    "Ill-fitting furniture, footwear, foot deformity",
], size=16, head_fill=CORAL)
card(s, 8.8, 1.5, 3.9, 5.4, "Systemic", [
    "Psychological state (depression gives slumped posture)",
    "Visual or hearing defects (head tilt)",
    "Neurological disease (Parkinson disease gives flexed posture)",
    "Arthritis and spinal disease",
], size=16)

# ---------- 8 Deviations table ----------
s = prs.slides.add_slide(BLANK)
header(s, "Common Postural Deviations", "Learn: region, deviation, tight muscles, weak muscles")
table(s, 0.5, 1.4, 12.3, [1.5, 2.4, 4.2, 4.2], [
    ["Region", "Deviation", "Tight / shortened", "Weak / lengthened"],
    ["Head, neck", "Forward head", "Suboccipitals, SCM, upper trapezius", "Deep neck flexors"],
    ["Shoulder", "Round shoulders", "Pectorals", "Rhomboids, middle and lower trapezius"],
    ["Upper back", "Kyphosis", "Anterior chest wall", "Thoracic extensors"],
    ["Lower back", "Lordosis", "Hip flexors, lumbar extensors", "Abdominals, gluteals"],
    ["Lower back", "Flat back", "Hamstrings", "Hip flexors"],
    ["Spine", "Scoliosis", "Concave side", "Convex side (stretched)"],
    ["Knee", "Genu valgum, varum, recurvatum", "Ligament and muscle imbalance", "Variable"],
    ["Foot", "Pes planus, pes cavus", "Variable", "Intrinsics, tibialis posterior"],
], size=13, row_h=0.6)

# ---------- 9 Crossed syndromes ----------
s = prs.slides.add_slide(BLANK)
header(s, "Muscle Imbalance: Crossed Syndromes (Janda)", "Draw the cross in the exam to score marks")
card(s, 0.6, 1.5, 6.0, 4.0, "Upper crossed syndrome", [
    ("Tight: ", "pectorals, upper trapezius, levator scapulae, suboccipitals"),
    ("Weak: ", "deep neck flexors, middle and lower trapezius, rhomboids"),
    ("Picture: ", "forward head, round shoulders, increased cervical lordosis and thoracic kyphosis, winged scapulae"),
], size=16)
card(s, 6.8, 1.5, 5.9, 4.0, "Lower crossed syndrome", [
    ("Tight: ", "hip flexors, lumbar extensors"),
    ("Weak: ", "abdominals, gluteus maximus and medius"),
    ("Picture: ", "anterior pelvic tilt, increased lumbar lordosis, protruding abdomen"),
], size=16, head_fill=CORAL)
rect(s, 0.6, 5.7, 12.1, 1.2, LTEAL)
text(s, 0.8, 5.75, 11.7, 1.1,
     "Sway back: pelvis shifts forward, thoracic spine flexed, long kyphosis. Treat by lengthening the tight muscles and strengthening the weak ones, never the reverse.",
     size=16, color=NAVY, bold=True, anchor=MSO_ANCHOR.MIDDLE)

# ---------- 10 Assessment ----------
s = prs.slides.add_slide(BLANK)
header(s, "Postural Assessment", "History, observation, tests, measurement")
picture(s, "/tmp/workspace/posture-ppt/assets/img1.jpg", 0.6, 1.4, 5.6, 4.6)
text(s, 0.6, 6.05, 5.6, 0.8,
     "Lateral, posterior and anterior views with plumb lines: forward head, kyphosis, lordosis, knee posture, scoliosis, rearfoot, genu valgum or varum (study image)",
     size=11, italic=True, color=GREY)
bullets(s, 6.5, 1.5, 6.3, 5.4, [
    ("History: ", "occupation, pain, habits, onset, family history, aggravating and relieving positions"),
    ("Observation: ", "patient in underwear; anterior, posterior, lateral views against plumb line or posture grid; compare levels of shoulders, scapulae, pelvis, gluteal creases"),
    ("Postural vs structural: ", "ask for active or passive correction; Adam's forward bend test for rib hump"),
    ("Measurement: ", "plumb line, posture grid, flexible ruler, scoliometer, inclinometer, photographs, radiograph (Cobb angle)"),
    ("Muscle tests: ", "length (Thomas test, hamstrings, pectorals) and strength (MMT)"),
    ("Also: ", "leg length, wall-occiput distance, balance and gait"),
], size=16, space=7)

# ---------- 11 Management principles ----------
s = prs.slides.add_slide(BLANK)
header(s, "Exercise Therapy Management", "Find the cause, stretch tight, strengthen weak, re-educate, educate")
card(s, 0.6, 1.5, 3.9, 5.4, "1. Mobilise and stretch", [
    "Relaxation and warm-up",
    "Mobilise stiff segments (thoracic extension)",
    "Stretch pectorals, upper trapezius, levator scapulae, suboccipitals",
    "Stretch hip flexors, lumbar extensors, hamstrings, TFL",
    "Static, PNF hold-relax, self-stretch",
], size=15)
card(s, 4.7, 1.5, 3.9, 5.4, "2. Strengthen", [
    "Deep neck flexors: chin tuck, craniocervical flexion",
    "Scapular retractors and depressors: rows, prone Y/T/W, wall angels",
    "Thoracic extensors",
    "Abdominals: pelvic tilt, curl-up, plank, TrA drawing in",
    "Gluteus maximus: bridging, clamshell",
], size=15, head_fill=CORAL)
card(s, 8.8, 1.5, 3.9, 5.4, "3. Re-educate", [
    "Pelvic tilt: crook lying, then sitting, standing, activity",
    "Mirror training, verbal, tactile and visual cues",
    "Wall standing: heels, buttocks, shoulders, head touch wall",
    "Balance and proprioception (wobble board, single leg stance)",
    "Core stability and Pilates-type work",
], size=15)

# ---------- 12 Specific conditions ----------
s = prs.slides.add_slide(BLANK)
header(s, "Management of Specific Deviations")
table(s, 0.5, 1.4, 12.3, [1.7, 5.4, 5.2], [
    ["Condition", "Exercise programme", "Notes"],
    ["Forward head, round shoulders", "Chin tuck, deep neck flexor training, scapular retraction, pectoral stretch", "Ergonomic correction of workstation"],
    ["Kyphosis", "Thoracic extension, chest stretch, back extensors, scapular retraction", "Postural kyphosis under 50 degrees: exercise improves posture but evidence for changing the curve is limited. Follow with lateral X-ray every 6 to 12 months"],
    ["Lordosis", "Pelvic tilt, abdominal strengthening, hip flexor and lumbar stretch, gluteal work", "Check footwear and obesity"],
    ["Scoliosis (functional)", "Correct cause, stretch concave side, strengthen convex side, Schroth-type exercise", "Structural curves may need bracing and referral"],
    ["Flat foot", "Short foot exercise, heel raises, toe curls", "Arch supports and proper footwear"],
], size=13, row_h=0.8)

# ---------- 13 Ergonomics ----------
s = prs.slides.add_slide(BLANK)
header(s, "Ergonomics, Prevention and Patient Education")
card(s, 0.6, 1.5, 6.0, 5.4, "Workstation and daily habits", [
    "Screen at eye level, head over shoulders",
    "Lumbar curve supported, hips and knees about 90 degrees, feet flat",
    "Elbows at 90 degrees, forearms supported",
    "Change position every 30 to 45 minutes",
    "Bag on both shoulders, light loads",
], size=16)
card(s, 6.8, 1.5, 5.9, 5.4, "Prevention and advice", [
    "Lift with bent knees, load close, no twisting",
    "Firm mattress, low pillow",
    "Proper footwear",
    "Regular exercise and daily posture check",
    "School screening and early correction in children",
    "Home exercise programme with follow-up",
], size=16, head_fill=CORAL)

# ---------- 14 Evidence ----------
s = prs.slides.add_slide(BLANK)
header(s, "Recent Evidence (PubMed)", "Supports exercise for postural problems")
bullets(s, 0.7, 1.6, 11.9, 3.6, [
    ("Systematic review 2024: ", "effect of exercise on postural alignment (J Bodyw Mov Ther, PMID 39593708)"),
    ("Systematic review and meta-analysis 2024: ", "Pilates for postural misalignment (Musculoskelet Care, PMID 39562728)"),
    ("Postural cueing: ", "chin tuck and head inclination instructions can produce immediate improvement in forward head and pelvic tilt in photographic studies"),
], size=19, space=12)
rect(s, 0.7, 5.0, 11.9, 1.6, LTEAL)
text(s, 0.9, 5.05, 11.5, 1.5,
     "Caution: effect sizes were not checked from full texts. Use these as supporting references, and follow your syllabus text (Kisner and Colby, Kendall) for exam wording.",
     size=16, color=NAVY, anchor=MSO_ANCHOR.MIDDLE)

# ---------- 15 Exam revision ----------
s = prs.slides.add_slide(BLANK)
header(s, "Exam Revision: Mnemonics and Likely Questions")
card(s, 0.6, 1.5, 5.9, 2.4, "Mnemonics", [
    ("EST-HKA: ", "Ear, Shoulder, Trunk, Hip, Knee, Ankle (plumb line)"),
    ("Curves: ", "35 to 45 (C), 20 to 50 (T), 40 to 80 (L)"),
    ("Rule: ", "stretch tight, strengthen weak"),
], size=15)
card(s, 6.8, 1.5, 5.9, 2.4, "Answer skeleton (essay)", [
    "Definition, types",
    "Control, plumb line, curves",
    "Deviations, causes, assessment",
    "Exercise management, prevention",
], size=15, head_fill=CORAL)
card(s, 0.6, 4.1, 12.1, 2.8, "Likely questions", [
    "Define posture. Describe standard posture with plumb line landmarks (long essay)",
    "Classify faulty postures. Discuss causes and assessment (long essay)",
    "Management of kyphosis, lordosis, scoliosis by exercise (long or short essay)",
    "Short notes: postural tone, crossed syndromes, pelvic tilt exercise, Adam's test, ergonomics",
], size=15)

prs.save("/tmp/workspace/posture-ppt/output/Posture_Revision_Exercise_Therapy.pptx")
print("saved", len(prs.slides))

from reportlab.lib.pagesizes import A4
from reportlab.pdfgen import canvas
from reportlab.lib.colors import HexColor, white
from reportlab.platypus import Paragraph, Table, TableStyle
from reportlab.lib.styles import ParagraphStyle
from reportlab.lib.utils import ImageReader

NAVY = HexColor("#0B3C49"); TEAL = HexColor("#1F7A8C"); CORAL = HexColor("#E07A5F")
SAND = HexColor("#F6F2EA"); LT = HexColor("#DDEEF1"); DARK = HexColor("#222B31"); GREY = HexColor("#5B6770")

W, H = A4
M = 22
GAP = 10
CW = (W - 2 * M - GAP) / 2
out = "/tmp/workspace/posture-ppt/output/Posture_Cheat_Sheet.pdf"
c = canvas.Canvas(out, pagesize=A4)
c.setTitle("Posture Cheat Sheet - Exercise Therapy BPT")

body = ParagraphStyle("b", fontName="Helvetica", fontSize=7.6, leading=9.2, textColor=DARK)
bul = ParagraphStyle("bul", parent=body, leftIndent=8, bulletIndent=0, spaceAfter=1.2)
cell = ParagraphStyle("cell", parent=body, fontSize=7, leading=8.2)
cellh = ParagraphStyle("cellh", parent=cell, fontName="Helvetica-Bold", textColor=white)
cellb = ParagraphStyle("cellb", parent=cell, fontName="Helvetica-Bold", textColor=NAVY)

# background
c.setFillColor(SAND); c.rect(0, 0, W, H, fill=1, stroke=0)
c.setFillColor(NAVY); c.rect(0, H - 52, W, 52, fill=1, stroke=0)
c.setFillColor(CORAL); c.rect(0, H - 55, W, 3, fill=1, stroke=0)
c.setFillColor(white); c.setFont("Helvetica-Bold", 22); c.drawString(M, H - 34, "POSTURE CHEAT SHEET")
c.setFont("Helvetica", 9); c.setFillColor(HexColor("#BFDDE3"))
c.drawRightString(W - M, H - 30, "Exercise Therapy | BPT exam revision")
c.drawRightString(W - M, H - 42, "Sources: Bailey & Love 28e, Kandel 6e, Thieme Atlas, standard PT texts")

TOP = H - 64
BOT = 30

def box(x, y, w, title, items, color=TEAL, paras=False):
    """items: list of strings (bullets) -> returns new y"""
    ps = [Paragraph(t, bul) for t in items]
    inner = w - 12
    hts = []
    for p in ps:
        _, h = p.wrap(inner - 8, 1000)
        hts.append(h + 1.2)
    total = 13 + sum(hts) + 5
    c.setFillColor(white); c.setStrokeColor(HexColor("#D8D2C4")); c.setLineWidth(0.6)
    c.roundRect(x, y - total, w, total, 3, fill=1, stroke=1)
    c.setFillColor(color); c.roundRect(x, y - 13, w, 13, 3, fill=1, stroke=0)
    c.rect(x, y - 13, w, 6, fill=1, stroke=0)
    c.setFillColor(white); c.setFont("Helvetica-Bold", 8.6); c.drawString(x + 6, y - 9.5, title)
    cy = y - 13 - 3
    for p, h in zip(ps, hts):
        p.wrap(inner - 8, 1000)
        p.drawOn(c, x + 6 + 0, cy - (h - 1.2))
        c.setFillColor(CORAL); c.circle(x + 8, cy - 4.5, 1.1, fill=1, stroke=0)
        cy -= h
    return y - total - 6

def tbl(x, y, w, rows, colw, color=NAVY):
    data = []
    for r, row in enumerate(rows):
        data.append([Paragraph(t, cellh if r == 0 else (cellb if i == 0 else cell)) for i, t in enumerate(row)])
    tot = sum(colw)
    t = Table(data, colWidths=[w * cw / tot for cw in colw])
    st = [("BACKGROUND", (0, 0), (-1, 0), color),
          ("VALIGN", (0, 0), (-1, -1), "MIDDLE"),
          ("GRID", (0, 0), (-1, -1), 0.4, HexColor("#D8D2C4")),
          ("TOPPADDING", (0, 0), (-1, -1), 2), ("BOTTOMPADDING", (0, 0), (-1, -1), 2),
          ("LEFTPADDING", (0, 0), (-1, -1), 3), ("RIGHTPADDING", (0, 0), (-1, -1), 3)]
    for r in range(1, len(rows)):
        st.append(("BACKGROUND", (0, r), (-1, r), white if r % 2 else LT))
    t.setStyle(TableStyle(st))
    _, h = t.wrap(w, 1000)
    t.drawOn(c, x, y - h)
    return y - h - 6

LX = M
RX = M + CW + GAP

# ---------------- LEFT COLUMN ----------------
y = TOP
y = box(LX, y, CW, "1. DEFINITION", [
    "<b>Posture</b>: relative arrangement of body parts; position that balances stability with minimal energy cost.",
    "<b>Good posture</b>: muscle and skeletal balance that protects structures from injury or progressive deformity.",
    "<b>Postural orientation</b>: alignment of body parts with each other and the environment.",
])
y = box(LX, y, CW, "2. TYPES", [
    "<b>Static</b> (standing, sitting, lying) vs <b>dynamic</b> (walking, lifting).",
    "<b>Postural (functional)</b> deformity: flexible, corrects actively or passively, due to habit or imbalance.",
    "<b>Structural</b> deformity: fixed, bony or soft tissue change; rib hump persists on Adam's test.",
], color=CORAL)
y = box(LX, y, CW, "3. CONTROL OF POSTURE", [
    "<b>Inputs</b>: visual, vestibular, somatosensory (spindles, joint, plantar).",
    "<b>Centres</b>: brainstem (vestibular nuclei, reticular formation), cerebellum, basal ganglia, cortex.",
    "<b>Reflexes</b>: stretch, righting, tonic neck, labyrinthine. <b>Effectors</b>: antigravity extensors.",
    "Postural tone is not static; it changes with alignment and task. Tone alone cannot keep balance.",
])

# plumb line box with image
hdr_y = y
img = ImageReader("/tmp/workspace/posture-ppt/assets/img0.jpg")
iw, ih = img.getSize()
imgw = 72; imgh = imgw * ih / iw
items = [
    "<b>Lateral line passes (EST-HKA)</b>:",
    "<b>E</b>ar lobe (mastoid)",
    "<b>S</b>houlder (acromion)",
    "<b>T</b>runk midline",
    "<b>H</b>ip: greater trochanter (slightly behind axis)",
    "<b>K</b>nee: slightly in front of axis",
    "<b>A</b>nkle: slightly in front of lateral malleolus",
]
ps = [Paragraph(t, bul) for t in items]
tw = CW - 12 - imgw - 6
hts = [p.wrap(tw - 8, 1000)[1] + 1.2 for p in ps]
total = 13 + max(sum(hts), imgh) + 20
c.setFillColor(white); c.setStrokeColor(HexColor("#D8D2C4")); c.roundRect(LX, y - total, CW, total, 3, fill=1, stroke=1)
c.setFillColor(TEAL); c.roundRect(LX, y - 13, CW, 13, 3, fill=1, stroke=0); c.rect(LX, y - 13, CW, 6, fill=1, stroke=0)
c.setFillColor(white); c.setFont("Helvetica-Bold", 8.6); c.drawString(LX + 6, y - 9.5, "4. PLUMB LINE (LINE OF GRAVITY)")
c.drawImage(img, LX + 6, y - 13 - 3 - imgh, imgw, imgh, mask=None)
cy = y - 16
for p, h in zip(ps, hts):
    p.wrap(tw - 8, 1000)
    p.drawOn(c, LX + 6 + imgw + 6, cy - (h - 1.2))
    if p is not ps[0]:
        c.setFillColor(CORAL); c.circle(LX + 6 + imgw + 8, cy - 4.5, 1.1, fill=1, stroke=0)
    cy -= h
fp = Paragraph("<b>Posterior</b>: plumb line from C7 spinous process falls through the gluteal crease; if not, lateral spinal tilt. "
               "<b>Anterior</b>: midline of head, sternum, umbilicus, between feet.", body)
_, fh = fp.wrap(CW - 12, 100)
fp.drawOn(c, LX + 6, y - total + 3)
y = y - total - 6

y = box(LX, y, CW, "5. NORMAL SPINAL CURVES", [
    "<b>Cervical lordosis</b> 35 to 45 deg.",
    "<b>Thoracic kyphosis</b> 20 to 50 deg (mean 35); increases with age.",
    "<b>Lumbar lordosis</b> 40 to 80 deg (mean 60); decreases with age; most between L4 and S1.",
    "Sagittal axis: odontoid, C7/T1, T12/L1, posterosuperior S1.",
])
y = box(LX, y, CW, "6. FACTORS AFFECTING POSTURE", [
    "Heredity, age, body build, obesity, pregnancy.",
    "Muscle weakness or tightness, pain, fatigue, habits, occupation.",
    "Footwear, foot deformity, furniture, vision or hearing defects.",
    "Depression, neurological disease (Parkinson flexed posture).",
], color=CORAL)
left_end = y

# ---------------- RIGHT COLUMN ----------------
y = TOP
c.setFillColor(NAVY); c.setFont("Helvetica-Bold", 8.6)
y = tbl(RX, y, CW, [
    ["Region", "Deviation", "Tight", "Weak"],
    ["Head, neck", "Forward head", "Suboccipitals, SCM, upper trap", "Deep neck flexors"],
    ["Shoulder", "Round shoulders", "Pectorals", "Rhomboids, mid and lower trap"],
    ["Upper back", "Kyphosis", "Anterior chest", "Thoracic extensors"],
    ["Low back", "Lordosis", "Hip flexors, lumbar extensors", "Abdominals, glutes"],
    ["Low back", "Flat back", "Hamstrings", "Hip flexors"],
    ["Spine", "Scoliosis", "Concave side", "Convex side"],
    ["Foot", "Pes planus", "Variable", "Intrinsics, tib. posterior"],
], [1.1, 1.3, 2.0, 2.0], color=CORAL)
# label above table
# (table has no title, so put the heading as first row replacement)

y = box(RX, y, CW, "7. CROSSED SYNDROMES (JANDA)", [
    "<b>Upper</b>: tight pectorals, upper trap, levator scapulae, suboccipitals; weak deep neck flexors, lower and mid trap, rhomboids. Gives forward head, round shoulders, kyphosis.",
    "<b>Lower</b>: tight hip flexors, lumbar extensors; weak abdominals, gluteals. Gives anterior pelvic tilt, lordosis.",
    "<b>Sway back</b>: pelvis forward, thoracic spine flexed, long kyphosis.",
])
y = box(RX, y, CW, "8. ASSESSMENT", [
    "<b>History</b>: occupation, pain, habits, onset, family history.",
    "<b>Observation</b>: plumb line or posture grid, 3 views; compare shoulders, scapulae, pelvis, gluteal creases.",
    "<b>Postural vs structural</b>: correct the deformity; Adam's forward bend test.",
    "<b>Measures</b>: scoliometer, inclinometer, flexible ruler, photographs, X-ray (Cobb angle).",
    "<b>Muscle tests</b>: length (Thomas, hamstrings, pectorals) and MMT.",
], color=TEAL)
y = box(RX, y, CW, "9. EXERCISE MANAGEMENT: STRETCH, STRENGTHEN, RE-EDUCATE", [
    "<b>Stretch</b>: pectorals, upper trap, levator, suboccipitals, hip flexors, lumbar extensors, hamstrings (static, PNF hold-relax).",
    "<b>Strengthen</b>: chin tuck and deep neck flexors; rows, prone Y/T/W, wall angels; thoracic extensors; pelvic tilt, curl-up, plank; bridging, clamshell; short foot.",
    "<b>Re-educate</b>: pelvic tilt (crook lying, sitting, standing), mirror and cues, wall standing, balance and proprioception, core stability.",
    "<b>Mobilise</b> stiff segments first (thoracic extension).",
], color=CORAL)
y = box(RX, y, CW, "10. SPECIFIC CONDITIONS", [
    "<b>Kyphosis</b>: extension and chest stretch; postural kyphosis under 50 deg, exercise helps posture but evidence for changing the curve is limited; X-ray every 6 to 12 months.",
    "<b>Lordosis</b>: pelvic tilt, abdominals, stretch hip flexors and lumbar extensors.",
    "<b>Scoliosis (functional)</b>: correct cause, stretch concave, strengthen convex, Schroth-type; structural may need brace and referral.",
    "<b>Flat foot</b>: short foot, heel raises, arch support.",
], color=TEAL)
y = box(RX, y, CW, "11. ERGONOMICS AND ADVICE", [
    "Screen at eye level; lumbar support; hips and knees about 90 deg; feet flat.",
    "Change position every 30 to 45 min; bag on both shoulders.",
    "Lift with bent knees, load close; firm mattress; proper footwear.",
], color=CORAL)
right_end = y

# bottom exam strip
sy = min(left_end, right_end) - 2
sp = Paragraph("<b>EXAM TIPS:</b> Rule = stretch the tight, strengthen the weak. Essay order: definition, types, control, plumb line, curves, deviations, causes, assessment, exercise management, prevention. "
               "Likely: plumb line landmarks, crossed syndromes, pelvic tilt exercise, Adam's test, management of kyphosis, lordosis and scoliosis.",
               ParagraphStyle("t", parent=body, textColor=white, fontSize=7.6, leading=9.2))
_, th = sp.wrap(W - 2 * M - 12, 100)
bh = th + 8
by = BOT - 4
c.setFillColor(NAVY); c.roundRect(M, by, W - 2 * M, bh, 3, fill=1, stroke=0)
sp.drawOn(c, M + 6, by + 4)
print("left_end", round(left_end, 1), "right_end", round(right_end, 1), "strip top", round(by + bh, 1))
c.showPage(); c.save()

import json, subprocess, base64, io
from reportlab.lib.pagesizes import A4
from reportlab.pdfgen import canvas
from reportlab.lib.colors import HexColor, white
from reportlab.platypus import Paragraph, Table, TableStyle
from reportlab.lib.styles import ParagraphStyle
from reportlab.lib.utils import ImageReader

URL = "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_451a1ba79f1a73251ab88e6aa387aa52f46b49f944c6d3deb0d667701aeda723.jpg"
res = json.loads(subprocess.check_output(["python", "/tmp/skills/shared/scripts/fetch_images.py", URL]))
img = None
if res and res[0]["base64"]:
    img = ImageReader(io.BytesIO(base64.b64decode(res[0]["base64"].split(",", 1)[1])))

NAVY = HexColor("#0B3C49"); TEAL = HexColor("#1F7A8C"); CORAL = HexColor("#E07A5F")
SAND = HexColor("#F6F2EA"); LT = HexColor("#DDEEF1"); DARK = HexColor("#222B31")

W, H = A4
M = 22; GAP = 10
CW = (W - 2 * M - GAP) / 2
out = "/tmp/workspace/posture-ppt/output/Scoliosis_Exercise_Sheet.pdf"
c = canvas.Canvas(out, pagesize=A4)
c.setTitle("Scoliosis Exercise Sheet - Exercise Therapy BPT")

body = ParagraphStyle("b", fontName="Helvetica", fontSize=8.2, leading=10, textColor=DARK)
bul = ParagraphStyle("bul", parent=body, spaceAfter=1.2)
cell = ParagraphStyle("cell", parent=body, fontSize=7.5, leading=8.9)
cellh = ParagraphStyle("cellh", parent=cell, fontName="Helvetica-Bold", textColor=white)
cellb = ParagraphStyle("cellb", parent=cell, fontName="Helvetica-Bold", textColor=NAVY)

c.setFillColor(SAND); c.rect(0, 0, W, H, fill=1, stroke=0)
c.setFillColor(NAVY); c.rect(0, H - 52, W, 52, fill=1, stroke=0)
c.setFillColor(CORAL); c.rect(0, H - 55, W, 3, fill=1, stroke=0)
c.setFillColor(white); c.setFont("Helvetica-Bold", 21); c.drawString(M, H - 34, "SCOLIOSIS EXERCISE SHEET")
c.setFont("Helvetica", 9); c.setFillColor(HexColor("#BFDDE3"))
c.drawRightString(W - M, H - 30, "Exercise Therapy | BPT exam revision")
c.drawRightString(W - M, H - 42, "Sources: Campbell's 15e, PubMed meta-analyses, standard PT teaching")

TOP = H - 64
BOT = 30

def box(x, y, w, title, items, color=TEAL):
    ps = [Paragraph(t, bul) for t in items]
    inner = w - 12
    hts = [p.wrap(inner - 8, 1000)[1] + 1.2 for p in ps]
    total = 13 + 3 + sum(hts) + 4
    c.setFillColor(white); c.setStrokeColor(HexColor("#D8D2C4")); c.setLineWidth(0.6)
    c.roundRect(x, y - total, w, total, 3, fill=1, stroke=1)
    c.setFillColor(color); c.roundRect(x, y - 13, w, 13, 3, fill=1, stroke=0)
    c.rect(x, y - 13, w, 6, fill=1, stroke=0)
    c.setFillColor(white); c.setFont("Helvetica-Bold", 8.8); c.drawString(x + 6, y - 9.5, title)
    cy = y - 16
    for p, h in zip(ps, hts):
        p.wrap(inner - 8, 1000)
        p.drawOn(c, x + 14, cy - (h - 1.2))
        c.setFillColor(CORAL); c.circle(x + 8, cy - 4.5, 1.1, fill=1, stroke=0)
        cy -= h
    return y - total - 6

def tbl(x, y, w, rows, colw, color=NAVY):
    data = [[Paragraph(t, cellh if r == 0 else (cellb if i == 0 else cell)) for i, t in enumerate(row)] for r, row in enumerate(rows)]
    tot = sum(colw)
    t = Table(data, colWidths=[w * cw / tot for cw in colw])
    st = [("BACKGROUND", (0, 0), (-1, 0), color), ("VALIGN", (0, 0), (-1, -1), "MIDDLE"),
          ("GRID", (0, 0), (-1, -1), 0.4, HexColor("#D8D2C4")),
          ("TOPPADDING", (0, 0), (-1, -1), 2), ("BOTTOMPADDING", (0, 0), (-1, -1), 2),
          ("LEFTPADDING", (0, 0), (-1, -1), 3), ("RIGHTPADDING", (0, 0), (-1, -1), 3)]
    for r in range(1, len(rows)):
        st.append(("BACKGROUND", (0, r), (-1, r), white if r % 2 else LT))
    t.setStyle(TableStyle(st))
    _, h = t.wrap(w, 1000)
    t.drawOn(c, x, y - h)
    return y - h - 6

def heading(x, y, s):
    c.setFillColor(NAVY); c.setFont("Helvetica-Bold", 9); c.drawString(x, y - 9, s)
    return y - 14

LX = M; RX = M + CW + GAP

# ---------- LEFT ----------
y = TOP
y = box(LX, y, CW, "1. DEFINITION AND TYPES", [
    "<b>Scoliosis</b>: lateral spinal curve with vertebral rotation; 3D deformity; Cobb angle 10 degrees or more.",
    "<b>Nonstructural (postural)</b>: flexible, corrects on forward bend or when the cause is removed (leg length difference, spasm, habit).",
    "<b>Structural</b>: fixed, rib hump on Adam's test. Idiopathic (most), congenital, neuromuscular.",
    "<b>Adolescent idiopathic (AIS)</b>: 10 years to skeletal maturity; commonest type.",
])
y = box(LX, y, CW, "2. AIMS OF EXERCISE", [
    "Slow or stop progression, especially in growth.",
    "Improve symmetry, trunk rotation (ATR) and posture.",
    "Strengthen trunk; improve chest expansion and breathing.",
    "Improve pain, function and self-image; support brace wear and post-op recovery.",
], color=CORAL)
y = heading(LX, y, "CURVE SIZE PATHWAY (usual teaching)")
y = tbl(LX, y, CW, [
    ["Cobb angle", "Approach"],
    ["Under about 20 to 25 deg", "Observation + exercise + education"],
    ["About 25 to 40 deg, growing", "Brace + exercise"],
    ["Above about 40 to 50 deg", "Surgical referral"],
], [1.3, 2.2])
y = box(LX, y, CW, "3. ASSESS FIRST", [
    "<b>Adam's forward bend test</b>: rib hump = structural.",
    "<b>Scoliometer</b> (angle of trunk rotation), plumb line from C7 to gluteal crease.",
    "Shoulder, scapular, pelvic levels; leg length; neurological screen.",
    "<b>X-ray</b>: Cobb angle, Risser sign (maturity). Muscle length and strength, vital capacity, SRS-22.",
])

# image + rule box
imgw = 92
if img:
    iw, ih = img.getSize(); imgh = imgw * ih / iw
else:
    imgh = 0
items = [
    "<b>STRETCH the concave side</b>",
    "<b>STRENGTHEN the convex side</b>",
    "<b>CORRECT in 3D</b>: elongate, derotate, stabilise",
    "<b>CARRY OVER</b> to daily activity",
]
ps = [Paragraph(t, bul) for t in items]
tw = CW - 12 - imgw - 6
hts = [p.wrap(tw - 8, 1000)[1] + 1.2 for p in ps]
cap = Paragraph("<i>Schroth correction, historical photo: active self-correction straightens the midline.</i>",
                ParagraphStyle("cap", parent=body, fontSize=7, leading=8.4))
_, caph = cap.wrap(CW - 12, 100)
total = 13 + 3 + max(sum(hts), imgh) + 3 + caph + 4
c.setFillColor(white); c.setStrokeColor(HexColor("#D8D2C4")); c.roundRect(LX, y - total, CW, total, 3, fill=1, stroke=1)
c.setFillColor(TEAL); c.roundRect(LX, y - 13, CW, 13, 3, fill=1, stroke=0); c.rect(LX, y - 13, CW, 6, fill=1, stroke=0)
c.setFillColor(white); c.setFont("Helvetica-Bold", 8.8); c.drawString(LX + 6, y - 9.5, "4. THE CORE RULE")
if img:
    c.drawImage(img, LX + 6, y - 16 - imgh, imgw, imgh)
cy = y - 20
for p, h in zip(ps, hts):
    p.wrap(tw - 8, 1000)
    p.drawOn(c, LX + 6 + imgw + 14, cy - (h - 1.2))
    c.setFillColor(CORAL); c.circle(LX + 6 + imgw + 8, cy - 4.5, 1.1, fill=1, stroke=0)
    cy -= h + 4
cap.drawOn(c, LX + 6, y - total + 4)
y = y - total - 6
left_end = y

# ---------- RIGHT ----------
y = TOP
y = heading(RX, y, "EXERCISE PROGRAMME (typical dose, not fixed)")
y = tbl(RX, y, CW, [
    ["Step", "Exercise", "Dose"],
    ["Warm-up", "Cat-camel, pelvic tilt in crook lying", "10 reps"],
    ["Stretch concave", "Side-lying over roll at concavity, arm overhead", "Hold 20 to 30 s x 3 to 5"],
    ["", "Side-bend away from concavity (stand or sit)", "Hold 15 to 20 s x 3"],
    ["", "Hip flexor, hamstring, pectoral stretches", "Hold 30 s x 2 to 3"],
    ["Strengthen convex + trunk", "Side-lying trunk lift (convex up)", "8 to 12 x 2 to 3 sets"],
    ["", "Modified side plank (convex side)", "Hold 10 to 30 s"],
    ["", "Prone back extension, bird-dog", "8 to 12 reps"],
    ["", "Curl-up, TrA drawing in; bridging, clamshell", "10 to 15 reps"],
    ["Scapular", "Rows, prone Y/T/W, wall angels", "10 reps x 2"],
    ["Posture, balance", "Mirror self-correction, wall standing, single-leg stance", "Daily"],
], [1.35, 3.0, 1.55], color=CORAL)
y = box(RX, y, CW, "5. SCHROTH SEQUENCE (SCOLIOSIS-SPECIFIC)", [
    "<b>1.</b> Find neutral and identify your curve pattern (3 or 4 curve types).",
    "<b>2.</b> <b>Pelvic correction</b>: shift pelvis to level the lumbar spine.",
    "<b>3.</b> <b>Elongation</b>: grow tall through the spine.",
    "<b>4.</b> <b>Derotation + shoulder/thoracic shift</b> toward the concavity.",
    "<b>5.</b> <b>Rotational breathing</b>: breathe into the collapsed concave chest wall; use mirror and props.",
    "<b>6.</b> <b>Stabilise</b> the corrected shape to the end of the breath; repeat in standing, sitting, side-lying; then use in daily life.",
    "<b>Other methods</b>: SEAS (self-correction + stabilisation), Lyon, Side-Shift, BSPTS.",
], color=TEAL)
y = box(RX, y, CW, "6. EXAMPLE: RIGHT THORACIC CURVE", [
    "Convex right, concave left.",
    "Stretch the left trunk and chest wall; breathe into the left posterior ribs.",
    "Strengthen the right side, thoracic and lumbar extensors.",
    "Check and treat any compensatory lumbar curve by the same rule.",
], color=CORAL)
y = box(RX, y, CW, "7. PROGRESSION AND REVIEW", [
    "Add hold time, then reps, then resistance, then functional tasks.",
    "Supervised sessions several times a week at first; then daily home programme of about 20 to 45 min.",
    "Re-check scoliometer every 3 to 6 months; X-ray as advised. Wear brace as prescribed; exercise is in addition.",
])
y = box(RX, y, CW, "8. PRECAUTIONS AND REFERRAL", [
    "Avoid forced stretch or manipulation of rigid curves.",
    "Refer: rapid progression, neurological signs, severe pain, atypical features (left thoracic curve, early onset).",
    "Post-op: follow the surgeon's limits.",
], color=CORAL)
y = box(RX, y, CW, "9. EVIDENCE", [
    "2024 network meta-analysis, 17 RCTs (PMID 38726971): scoliosis-specific exercise improved Cobb angle, ATR and quality of life; Schroth + SEAS best for Cobb and ATR.",
    "2025 meta-analysis, 9 RCTs (PMID 41175413): benefit for Cobb, ATR, pain, function and self-image.",
    "Campbell's 15e: observation and bracing, often with Schroth-based PT, are the main nonoperative methods; older reports found no scientific support for PT alone. Trials are small and vary in quality.",
])
right_end = y

sp = Paragraph("<b>EXAM TIPS:</b> Define, classify, assess (Adam's, scoliometer, Cobb), aims, then <b>stretch concave, strengthen convex</b>, "
               "Schroth (elongation, derotation, rotational breathing), bracing and surgery thresholds, precautions, review. "
               "Quote both views on evidence: textbooks cautious, recent meta-analyses supportive.",
               ParagraphStyle("t", parent=body, textColor=white))
_, th = sp.wrap(W - 2 * M - 12, 100)
bh = th + 8; by = BOT - 4
c.setFillColor(NAVY); c.roundRect(M, by, W - 2 * M, bh, 3, fill=1, stroke=0)
sp.drawOn(c, M + 6, by + 4)
print("left_end", round(left_end, 1), "right_end", round(right_end, 1), "strip top", round(by + bh, 1), "img", bool(img))
c.showPage(); c.save()