Movement Analysis: The Role of Person, Task, and Environmental Factors on Patient Performance

Motion =

specifically to the ability of a joint or tissue to be moved passively

- judged as hypomobile, normal, or hypermobile

how do we test motion?

ROM, end feel, flexibility, spasticity, neurodynamic test

Force =

ability of the contractile (muscles) and noncontractile structures (tendons) to produce movement and provide dynamic stability around joints during static and dynamic tasks

how do we test force?

mmt and dynamometry

what type of factors for force?

peripheral (body) vs central (brain)

Energy =

ability to perform sustained or repeated movements is dependent on the integrated functioning of the cardiovascular, pulmonary, and neuromuscular systems

energy is strongly influenced by

other systems and psychological factors

how do we test energy?

Assessment via questions, RPE, maximal or submaximal testing, 6MWT

Motor Control =

ability to plan, execute, and adapt goal-directed movements such that they are accurate, coordinated, and efficient

what is motor control dependent on?

receiving and processing task-relevant sensory inputs from visual, somatosensory, and vestibular systems

what does motor control do with that input?

selecting, planning, and executing the action to accomplish task goals

Treatment of motor control =

impairment restitution in other systems (range of motion/strength)

what 2 mechanisms are with motor control?

feedforward

feedback

5 things that go with functional movement tasks

control

amount

speed

symmetry

symptoms

Control =

smoothness, coordination, and timing of the movement

Amount =

amplitude of movement at each joint during the task

Speed =

velocity controlled appropriately with normal acceleration and deceleration during the task

Symmetry =

bilateral tasks (gait,sit,<>stand) or symmetry between each side of unilateral task

Symptoms =

Pain, clicking, dyspnea, fatigue, a sense of instability, or urinary incontinence with coughing

6 Core Tasks

1. Sitting

2. Sit to stand

3. Standing

4. Walking

5. Step up/down

6. Reach/grasp/manipulate

Environmental setup and instructions are designed to ________ __________

minimize constraints

Therapist provides the _____ _______ of assistance in order to do the task safely

least amount

ideally, do all 6 in the ___ _____, every time

same order (looking for theme)

Perform the task at least ____ _____?

two times

why do we do the task 2 times?

1. understand the task and assistance/safety

2. observation overall, how does it change with practice?

Initial conditions =

- Environment

- observing their starting posture

for dynamic tasks, focus on observable stages of the movement continuum. what are the 3?

initiation

execution

termination

Initiation =

instant when the displacement of the segments begins

Execution =

period of actual segment movement

Termination =

instant when motion stops

lastly, was the movement reached ______?

successfully

movement analysis: symmetry =

agreement of the external kinetics and kinematics of movement

movement analysis: speed =

rate of change or velocity of segment or body displacement from start to finish of a task

movement analysis: amplitude =

the extent or ROM used to complete a task

movement analysis: alignment =

biomechanical relationship of body segments to one another as well as to the BOS, and environment, in order to achieve the task

movement analysis: postural control, verticality =

ability to orient the body in relation to the line of gravity

movement analysis: postural control, stability =

the ability to control the body's COM in relation to the BOS under quasi-static and dynamic conditions

movement analysis: coordination, smoothness =

a movement is perceived to be smooth when it happens in a continual fashion without an interruptions in velocity or trajectory

movement analysis: coordination, sequencing =

specific order of motor output required to achieve the intended goal of the action

movement analysis: coordination, timing =

the overall temporal structure of movement that includes the relative percentage of time devoted to movement segments, including initiation, execution, and termination

movement analysis: coordination, accuracy =

the closeness of a measured value to a standard or known value; freedom from error

movement analysis: symptom provocation =

an observation or patient report of symptoms; movement that evokes a particular response

Factors Effecting Functional Performance: Intrinsic Factors

Person Specific Factors:

Physical, Cognitive, Psychological

Factors Effecting Functional Performance: Extrinsic Factors

- Environmental

- Task requirements

what other factors can have an impact?

going to the bathroom, motivation, the PT