24 Functional Health Training.docx

Does poor postural control negatively affect health and wellness?

Cause-effect relationships are UNCLEAR

Poor postural alignment or stability may cause problems with health and wellness

Health problems like pain, injury, or disease may cause problems with postural control

Does postural control training improve health and wellness?

• Good evidence for segmental alignment exercises to improve health outcomes in clinical populations

• Poor evidence strength, core, and mobility training improves health and wellness of healthy adults

• Fair evidence that balance training programs reduce the likelihood and effects of falls in elderly and patient populations

  • Successful programs are multifaceted

    • Include real-world environmental and task constraints

    • Address individual constraints like anxiety and self-efficacy 

    • Provide training for fall prevention and fall recovery

High-risk biomechanical profile

increases the risk of knee and ankle injuries in female athletes (various reasons)

Nonmodifiable risk factors

• Less favorable structural alignment 

• Less robust joint and ligament structures

• More body fat and different distribution than males

Modifiable risk factors

Requires training of strength and CNS to be fixed, takes longer to fix (4-6+ months)

• High ratio of quadriceps to hamstring strength

• Valgus knee motion during cutting and landing

• Poor muscle coordination

• Excessive knee wobble

Reduced mechanical stability

• musculomechanical mechanisms

  • Caused by weakened and damaged joint and connective tissues

Altered sensory feedback

• Sensory and CNS mechanisms

  • Caused by damage to sensory receptors and fibers in injured joint tissues

  • Leads to errors in sensory perception and motor planning and regulation

Abnormal muscle activations

• Neuromuscular mechanisms 

  • Caused by joint pain and muscle fatigue due to deconditioning

Compensatory patterns of movement

• CNS mechanisms

  • Caused by fear of reinjury

Does postural control training reduce the risk of joint injury?

• Fair evidence that postural control programs can reduce risk of knee and ankle injuries

  • Involves multifaceted interventions designed to address modifiable risk factors

Multiple exercises

Such as jumping, strength, and agility

Predictive features

Improves proactive joint stability

Unexpected forces

Improves reactive joint stability

High intensity

Exercises that require large muscle forces

Long sessions

Need to induce and train through central and peripheral fatigue

Emphasize…

movement quality and discovery of solutions

Long durations that can…

Produce neural, hypertrophic, and metabolic adaptations

Functional health

Refers to the capacity to perform daily activities (which change over the course of our lives)

Functional health assessments

Evaluate difficulties performing daily activities

Functional health training and rehabilitation…

Improve specificity and meaningfulness

Functional health training

Utilizes exercises based on daily activities to improve functional health

Functional rehabilitation

Utilizes exercises based on daily activities to improve rehabilitation outcomes

Fair evidence that multifaceted programs…

Can improve function health in disabled and elderly populations

Model of Disablement

Tracks progression of health from pathology to disability

Pathology

The issue

Impairments

Issues caused by the pathology

Functional limitations

Things that are difficult to do 

Disability

Participation restriction, can no longer do or need accommodations to perform, loss of leisurely activities and self-care can be seen here