» FMS for Clinicians
» The Selective Functional Movement Assessment (SFMA)
Gray Cook, MSPT, OCS, CSCS
Kyle Kiesel PT, PhD, ATC, CSCS
» The Workshop
This workshop is designed for the musculoskeletal healthcare professional who routinely treat patients with orthopedic conditions.
The workshop will combine lecture, demonstration, and lab experience to introduce and demonstrate a model of movement assessment and subsequent therapeutic exercise choices that target dysfunctional movement patterns.
» Considering Patterns of Movement
Normal movement is achieved through the integration of fundamental movement patterns with an adequate balance of mobility and stability to meet the demands of the task at hand.
The human system will migrate toward predictable patterns of movement in response to pain or in the presence of weakness, tightness, or structural abnormality. Over time, these pain attenuated movement patterns lead to protective movement and fear of movement, resulting in clinically observed impairments such as decreased ROM, muscle length changes, and declines in strength. An isolated or regional approach to either evaluation or treatment will not restore the whole of function. Functional restoration requires a map of dysfunctional patterns and a working knowledge of functional patterns to gain clinical perspective and design an effective treatment strategy.
It is the goal of this workshop to outline a system to capture impaired patterns of posture and functional movement which will assist in the deductive process and determination of a functional diagnosis. To this end, functional assessment information and movements presently available will be used. But, the main objective is for the learner to understand the assessment system which provides an orderly and repeatable clinical process with respect functional movement assessment and intervention, and the effects fundamental movement has on provocation of the patient’s main symptom.
After completing this workshop, the therapist should be able to do the following:
- Understand the importance of identifying dysfunctional movement patterns.
- Understand the difference between disability, dysfunction, and impairment as defined.
- Describe why it is important to assess movement patterns in both the loaded and unloaded positions and how this information can be used to guide intervention.
- Discuss the relationship between automatic balance reactions and the fundamental movement patterns of squatting, lunging, and forward bending.
- Understand the importance of pain provocation during the examination process and appreciate that pain alters motor control.
- Use the information gained from the SFMA to select key impairments to assess and design appropriate interventions to normalize dysfunctional movement.
- Link the assessment information to the initial therapeutic exercise strategy and initiate treatment.
- Monitor initial changes in dysfunction and impairment to guide the therapeutic exercise progression.
Pain-free functional movement for participation in occupation and lifestyle activities is desirable. Many components comprise pain-free functional movement including adequate posture, ROM, muscle performance, motor control, and balance reactions. Impairments of each component could potentially alter functional movement resulting in or as a consequence of pain. In this workshop we will identify key functional movement patterns through the Selective Functional Movement Assessment (SFMA) and describe the critical points of assessment needed for clinical application to identify dysfunctional movement. Traditional muscle length, strength, and special tests should be used to help the clinician identify the impairments, which are associated with dysfunctional movement. This approach is designed to complement existing exam and intervention with therapeutic exercise. It should serve as a model to efficiently integrate the concepts of posture, muscle balance and the fundamental patterns of the movement system into musculoskeletal practice. It should also serve as a feedback system for the effectiveness of the therapeutic exercise program, which should target the dysfunctional movement pattern as well as the impairments that have been identified.
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