Movement analysis

Movement analysis

• the systematic process of observing and evaluating the quality of a movement as it relates to a functional movement

Why do physiotherapists anaylse movement

• to identify movement dysfunction

• allows for the theorisation of underlying reasons for particular movement patterns

• to make movement system diagnose that support treatment decisions

Functional movement

• any movement sequence based on real-world situations

• can be task specific or sports specific movement

• example: sitting down, standing up, walking etc

How do physiotherapists analyse movement

• visual observation

• 2D/3D computerised motion analysis

Observational movement analysis

• an approach for the qualitative and systematic analysis of visually observed movements

The advantages and disadvantages of using OMA

• advantages = practical, always available, effective, quick, inexpensive

• disadvantages = precise, subjective, requires repeated performance

Important variables for building the analysis

• the actual actions which occur at joints involved

• the plane and axis in which the movement occurs

• the muscles producing the movement

• the action of muscles producing the movement

• the type of contraction

• the range of muscle action

Framework for analysis

1. Starting position

2. Movement sequence

3. The finishing position

The starting position

• a position of readiness from which the movement can take place

• used as a foundation for activity

• joint position and muscle work should be analysed

• EXAMPLES: lying, kneeling, sitting and standing

Initiation phase

• which body part move first?

• direction of movement

• any changes in the base of support

• any weight shift

Transition phase

• position of the body during weight shift

• new direction of movement

Completion of movement

• position of the body and limbs come to rest

• base of support reestablished

Different types of movement sequences

• transitional movement: sitting to standing

• mobility sequences: walking and crawling

• task-related sequences: drinking from a cup

Transitional movements

1. Initiation Phase

2. Transition Phase

3. Completion Phase

Trunk control

• the ability of the trunk muscles to allow the body to remain upright, adjust weight shifts, perform selective movements of the trunk and maintain the base of support during static and dynamic postural adjustments

Static control during functional movement

• enables the body to maintain a certain position

• little muscle activity is needed to maintain an upright posture the muscles of the body become more active as soon as movement occurs

Dynamic control during functional movement

• enables you to move into and out of a position

Equilibrium reactions

• coordinate muscle changes in the trunk and extremities to bring the body back to stable support

Activation of trunk and proximal extremity muscles

• the arch of the bridge is maintained by muscles on the underside of the arch being activated

• if one foot is raised then the abdominal muscles are activated to support the limb

Sitting to standing

• sit to stand is a functional ability significantly correlated with independence for activities of daily living

• main phases: the raising phase, during which the person achieves the steady posture necessary for the performance of other tasks

• the stabilisation phase, during which the person achieves the steady standing posture necessary for the performance of other tasks

Why is sitting to standing (STS) considered a complex movement

• requires trunk and lower limb coordination, balance and stability

• this stabilisation of upright standing after STS requires both neurocognitive skills and muscular strength

Sit to stand phases

1. Flexion of momentum phase

2. Momentum transfer phase

3. Extension phase

Flexion momentum phase

• flexion at the hips moves the trunk forward

• anterior tilt at the pelvis and trunk remains extended

• this moves the COM of the head and arms in the direction of the feet

Momentum transfer phase

• a rapid transfer of weight from the buttocks to the feet

• initiation of action in the lower limb extensor muscles

• at life off, COM moves forward and upward

• Range of movement at the ankle increases

Extension phase

• extension of the hips and knees to bring the body erect

• at the end of the extension phase the momentum of the COM must be controlled to maintain balance

Stepping up - 4 phases

1. Preparatory phase

2. Swing phase

3. Lifting the trailing leg onto the step and foot placement

4. Redistribution of weight onto both feet

Preparatory phase

• visual information gathering about the position and height of the step

• weight transference to the stance leg

• COM moves laterally and slightly backwards in anticipation of the forward movement of the leading leg

• the muscles in the stance leg will stiffen to accomodate the full weight of the body

Swing phase

• the hip and knee of the leading leg flexes to lift the foot onto the step

• contraction of plantarflexors enables the heel of the leading leg to rise off the ground

• contraction of hip flexors to lift the leg off the ground

• the knee extends to move the foot over the step for accurate foot placement

Stepping up (leading leg)

• the foot is lowered to the step

• body weight is transferred forward onto the leading leg

• rapid isometric contraction of hip extensors and knee extensors on weight acceptance

Stepping up phase (extension phase and completion)

• lateral shift of COM redistributes the weight equally over both legs

• the foot of the trailing leg is lowered onto the step

Stepping down phases

1. Preparatory phase

2. Swing phase

Stepping down prepatory phase

• weight shift to the stance leg

• co-contraction in the stance leg

• leading leg relaxed and ready to swing forward

Stepping down swing phase

• lifting the leading leg up to clear the edge of the step

• leading leg moves forward ]hip flexion with knee extension

Rolling initiated from the upper body

• initial phase: head and upper body move up off the bed in a diagonal towards the right

• transition: left pelvis rotates to the right and leaves supporting surface so that body weight can be shifted onto the right

• completion: the left leg leaves the bed and rests on the right leg or on the bed

Rolling initiated from the lower body

• initial phase: lower trunk and pelvis lift off supporting surface and move towards right, pelvis moves anterior to the left shoulder, left hip and knees are flexed to assist in extension rotation pattern of trunk

• transition: rotation moves up the spine and left upper body rotates to the right and leaves the supporting surface so that full body weight is shifted onto right pelvis/ hip/ shoulder

• completion: upper body rotates into plane of pelvis and sidelying is attained