Movement Science Exam 1 (Part 1) - Introduction

What are the 7 individual physical factors that impact our movements? (TQ)

1) Joint mobility

2) Tissue mobility

3) Motor control & nervous system tone

4) Proprioception

5) Overall joint health

6) Mental Health

7) Morphology of body tissues

What 14 other factors do we need to consider when assessing movement?

1) Quality of movement

2) Frequency of movement

3) Timing of movement

4) Duration of movement

5) Repetitions of movement

6) Variety of movement

7) Effort of movement

8) Beliefs about movement

9) Purpose of movement

10) Enjoyment of movement

11) Preparedness for movement

12) Previous movement experience

13) Is movement pain-free?

14) Does it challenge the nervous system?

What are the 3 roles movement plays in patient care? Which of the three roles is where movement science is based?

(TQ)

1) General health & wellness -->

Movement as medicine, optimized movement/function/performance, crucial for prevention of pain/injury/disease

2) Assessment --> WHERE MOVEMENT SCIENCE IS BASED

-- movement screens/tests/assessments, regional interdependence, source vs cause

3) Treatment & Management -->

Movement as part of patient (better outcomes), movement caused to movement cured, reduced fear of movement/activities (EMPOWER patients)

T/F: Static assessment helps diagnose the movement problem

FALSE

What 3 effects does resistance training and overall strength have on health and disease?

(TQ)

1) Protective against ALL CAUSE MORTALITY & weight/fat gain

2) Counteracts adverse cardiovascular profiles

3) Inversely related to insulin resistance, cardiometabolic markers, inflammatory proteins

Strength promoting exercise will result in a 23% reduction in ________ and a 31% reduction in ________ mortality.

All-cause mortality

Cancer

Aerobic promoting exercise will result in a reduced risk of _____ & _______.

CVD & All-cause mortality

According to the ACSM, for moderate-intensity exercise (40-60% of HRR), the recommendation is _____ minutes on ____ or more days a week, for a total of ______ minutes/week.

30 mins

5 mor more days a week

150 mins/week

According to the ACSM, for vigorous-intensity exercise (60-85% of HRR), the recommendation is _____ minutes on ____ or more days a week, for a total of ______ minutes/week.

20-25 mins

3 mor more days

75 mins/week

According to the ACSM, the amount of resistance training that is recommended is a minimum of ____ non-consecutive days each week

2

NOTE:

- One set of 8-12 reps for healthy adults; 10-15 reps for older/frail

- 8-10 exercises would be performed that target the major muscle group

Overall physical fitness has the highest effect on what two things?

Mental health & Body pain

What are some examples of other mortality predictors related to physical health?

1) Depression/Anxiety

2) Migraines

3) Immune system

4) Memory Improvements

5) Cancer mortality (muscle strenght)

6) Ability to sit/rise from floor

7) Pushups

8) Grip strength

T/F: An increase in exercise will increase the immune function

TRUE

What is an independent predictor of all-cause mortality and CVD?

(TQ)

Grip Strength

When looking at movement evaluation, what is the order for the hierarchy of movement (3)?

(TQ)

1) Functional Patterning --> 2) Motor Control --> 3) Mobility

When looking at management, what is the order for the hierarchy of movement (3)?

(TQ)

1) Mobility --> 2) Motor Control --> 3) Functional Patterning

What injuries commonly result from a fall? (2)

1) Hip fractures (95%), usually from falling sideways

2) Traumatic Brain injuries (TBI) --> falls MC cause

What are the most important components of fall prevention? (3)

1) Strength

2) Coordination

3) Proprioceptive stimulation

Out of the sensory motor training for fall prevention (toe strength, foot strength, standing progression, and training sit-to-stand and initiation of gait), which category is when we see most falls happen?

Sit-to-stand & Initiation of gait

What is the single best predictor of a senior citizen falling?

(TQ)

Toe strength

Why is it important to develop the hip hinge?

Learn to bend properly at hips as needed to pick up objects form floor; learn to dissociate hips and lumbar spine

(ex: standing, tall kneeling, half kneeling, quadruped, laying)

What does hip hinge allow/provide in terms of movement and stability? (2)

1) Allows patient to generate lumbar stability

2) Allow hip joint to increase movement through proper orientation of pelvis

Is hip hinge an example of a movement that is biased toward mobility, motor control, or functional patterning? Deadlift? Toe touch?

Hip Hinge = Motor control

Dead Lift = Functional Patterning

Toe Touch = Mobility

What are the 3 movements that occur within the sagittal plane?

1) Flexion/Extension

2) Forward/Backward bending

3) Dorsi/Plantar flexion

What are the 3 movements that occur within the horizontal/transverse plane?

1) Internal/External rotation

2) Horizonal abduction/adduction

3) Axial rotation

What are the 4 movements that occur within the frontal/coronal plane?

1) Abduction/Adduction

2) Lateral flexion

3) Ulnar/radial deviation

4) Eversion/inversion

For the scapula-clavicle region of the shoulder, what is the agonist and antagonist for Elevation? Depression?

Elevation:

Agonist = Upper trap (levator scap, rhomb.)

Antagonist = Latissimus dorsi

Depression:

Agonist = Latissimus dorsi (lower trap, serratus ant.)

Antagonist = Upper trap

For the scapula-clavicle region of the shoulder, what is the agonist and antagonist for Protraction? Retraction?

Protraction:

Agonist = serratus anterior

Antagonist = rhomboids

Retraction:

Agonist = Rhomboids (traps)

Antagonist = serratus anterior

For the scapula-clavicle region of the shoulder, what is the agonist and antagonist for Upward Rotation? Downward Rotation?

Upward Rotation:

Agonist = Upper trap (serratus ant)

Antagonist = Lower trap

Downward Rotation:

Agonist = Lower trap (rhomboids)

Antagonist = Upper trap

For the glenohumeral region of the shoulder, what is the agonist and antagonist for Adduction? Abduction?

Adduction:

Agonist = Latissimus dorsi (ant. deltoid, teres major/minor)

Antagonist = Middle deltoid

Abduction:

Agonist = Middle deltoid (supraspinatus)

Antagonist = Latissimus dorsi

For the glenohumeral region of the shoulder, what is the agonist and antagonist for Flexion? Extension?

Flexion:

Agonist = Pec major (ant deltoid, coracobrachialis)

Antagonist = post deltoid / latissimus dorsi

Extension:

Agonist = Posterior delt (lat dorsi, teres major)

Antagonist = Pec major

For the glenohumeral region of the shoulder, what is the agonist and antagonist for Internal rotation? External Rotation?

Internal Rotation:

Agonist = Latissimus dorsi (post delt, pec major, subscapularis)

Antagonist = Teres minor / infraspinatus

External Rotation:

Agonist = teres minor / infraspinatus

Antagonist = latissimus dorsi / pec major

For the glenohumeral region of the shoulder, what is the agonist and antagonist for Horizontal adduction? Horizontal abduction?

Horizontal Adduction:

Agonist = Pec major (anterior delt)

Antagonist = Post deltoid / rhomboids

Horizontal Abduction:

Agonist = posterior deltoid (trap, lat dorsi)

Antagonist = Pec major

For the forearm region of the elbow, what is the agonist and antagonist for Flexion? Extension?

Flexion:

Agonist = bicep brachii (brachialis)

Antagonist = Triceps brachii

Extension:

Agonist = Triceps brachii (anconeus)

Antagonist = Biceps brachii

For the forearm region of the elbow, what is the agonist and antagonist for Supination? Pronation?

Supination:

Agonist = Supinator (biceps brachii)

Antagonist = pronator teres

Pronation:

Agonist = pronator teres (pronator quadratus)

Antagonist = supinator / biceps brachii

For the wrist-hand region of the elbow, what is the agonist and antagonist for Extension? Flexion?

Extension:

Agonist = Ext carpi ulnaris (extens digitorum)

Antagonist = Flex carpi radialis

Flexion:

Agonist = Flex carpi radialis (Flex carpi ulnaris)

Antagonist = Ext. carpi ulnaris

For the hip region, what is the agonist and antagonist for Flexion? Extension?

Flexion:

Agonist = iliopsoas (TFL, sartorius, rectus fem.)

Antagonist = Glut max (hamstrings)

Extension:

Agonist = Glute maximus (hamstrings)

Antagonist = Iliopsoas (TFL, Sart, Rectus fem)

For the hip region, what is the agonist and antagonist for Abduction? Adduction?

Abduction:

Agonist = glute medius & minimus (sup fibers glut max, TFL)

Antagonist = Adductors (QL, inf. fibers glut max)

Adduction:

Agonist = Adductors (inf fibers max, semi T/M)

Antagonist = Glutes

For the hip region, what is the agonist and antagonist for Internal rotation? External rotation?

Internal rotation:

Agonist = Glute medius (ant fibers) (glut minimus, TFL)

Antagonist = Glute max, piriformis

External rotation:

Agonist = Glute max, psoas major (adductors, piriformis)

Antagonist = TFL, ant fibers glute med

For the hip region, what is the agonist and antagonist for Horizontal Abduction? Horizontal Adduction?

Horizontal Abduction:

Agonist = Piriformis (glutes)

Antagonist = Pectineus, adductors

Horizontal Adduction:

Agonist = Adductors (ant side)

Antagonist = Glutes, TFL

For the knee region, what is the agonist and antagonist for Extension? Flexion?

Extension:

Agonist = quads (closed chain soleus, glutes)

Antagonist = Hamstrings (gastrocnemius)

Flexion:

Agonist = Hamstrings, Gastrocnemius, politeus

Antagonist = Quads

For the knee region, what are the medial stabilizers (4)?

1) Vastus MO

2) Semimembarnous

3) Pes anserine

4) Popliteus

For the knee region, what are the lateral stabilizers? (5)

1) Glute max

2) Vastus lat

3) TFL

4) bicep femoris

5) gastrocnemeus

For the ankle region, what is the agonist and antagonist for Plantar flexion? Dorsiflexion?

Plantar flexion:

Agonist = Gastroc-straight; Soleus-bent (Tib P, fibularis, flex digi brevis

Antagonist = Tibialis anterior (digi long, ext hallicus long)

Dorsiflexion:

Agonist = Tibialis anterior (digi long, ex hall lon)

Antagonist = Gastroc-straight, Soleus-bent, (tib P, fibularis, fex digi brevis)

For the ankle region, what is the agonist and antagonist for Inversion? Eversion?

Inversion:

Agonist = Tib A & P (medial gast., fl hall/digi lon)

Antagonist = Soleus, lat gastroc, Fib brevis/tertius

Eversion:

Agonist = Fibularis longus/brevis (lat gastroc, ex digi lon)

Antagonist = Tibialis anterior (ext. digi long, ex hall lon)

For the ankle region, what is the agonist and antagonist for Dorsiflexion & Inversion? Plantar flexion & Eversion?

Dorsiflexion & Inversion:

Agonist = Tib anterior

Antagonist = Soleus, lateral gastroc, fibularis

Plantar flexion & Eversion:

Agonist = Soleus, lateral gastrocnemius

Antagonist = Tib anterior, extensor hallucis longus

For the trunk region of the spine, what is the agonist and antagonist for Flexion? Extension?

Flexion:

Agonist = Rectus Absominus (Ext Obl, Psoas, Int Obl)

Antagonist = Erector spinae, Latissimus d.

Extension:

Agonist = Erector spinae, lats

Antagonist = Rectus abdominus (Ext Obl, Psoas, Int Obl)

For the trunk region of the spine, what is the agonist and antagonist for Lateral Flexion?

Agonist = Ipsilateral QL (ipsi EO/IO/ErSp/Lats)

Antagonist = Contralateral QL (contra EO/IO/ErSp/Lats)

For the trunk region of the spine, what is the agonist and antagonist for Rotation?

Agonist = Contra Ext Obl, Ipsi Int Obl (ipsi lats, contra psoas)

Antagonist = Ipsi Ext Obl, Contra Ext Obl (Contra lat, ipsi psoas)

For the trunk region of the spine, what is the agonist and antagonist for Rotation & Flexion? Rotation & Extension?

Rotation & Flexion:

Agonist = Rectus Ab, Contra ext Obl, Ipsi Int Obl (ipsi lat, contra psoas)

Antagonist = Erector sp., contra Int Obl, Ipsi Ext Obl (Contra lat, ipsi psoas)

Rotation & Extension:

Agonist = Erector sp, contra int Obl, ipsi Ext Obl (contra lat, ipsi psoas

Antagonist = Rectus Ab, Contra Ext Obl, ipsi Int Obl (ipsi lat, contra psoas)

For the cervical region of the spine, what is the agonist and antagonist for Flexion? Extension?

Flexion:

Agonist = SCM, Long. colli/capit, RCPA/L (scalenes)

Antagonist = Traps, Spl. cap/cer., semi cap/cerv

Extension:

Agonist = Traps, Spl. cap/cer, semi cap/cerv

Antagonist = SCM, Long colli/capit, RCPA/L (scalenes)

NOTE: RCP = Rectus capitis posterior

For the cervical region of the spine, what is the agonist and antagonist for Rotation?

Agonist = Contra SCM, traps

Antagonist = Ipsi SCM, contra scalenes

For the cervical region of the spine, what is the agonist and antagonist for Lateral flexion?

Agonist = scalenes, levator scap

Antagonist = Contra scalenes, levator

What describes how the human body can be considered in terms of interrelated links/segments, with groups of body segments, connecting joints, muscles, and fascia that are linked in segments across different regions?

(TQ)

Kinetic Chain

What happens when one part of the body moves in reference to the kinetic chain? What is the only tissue that can mediate this responsiveness?

(TQ)

When one part moves, the body as a whole responds

CONNECTIVE TISSUE

What is the seemingly unrelated impairments in a remote anatomical region that may contribute to, or be associated with, the patients primary complain? What does this lead to?

(TQ)

Regional interdependence

Leads to compensation

(ex: stiff hips lead to sloppy lumbar spine mobility, leading to thoracic spine stiffness)

According to the joint-by-joint approach, what joints are intended to produce movement in 3 places?

(TQ)

Mobile Joints

When mobile joints for the joint-by-joint approach are dysfunctional, it presents most often as what?

(TQ)

Inadequate mobility

(Mobility restrictions/dysfunction)

What are the 6 Mobile Joints?

(TQ)

1) Ankle

2) Hip

3) Thoracic

4) Glenohumeral (shoulder)

5) Upper Cervical (Occiput)

6) Wrist

According to the joint-by-joint approach, what joints are intended to produce movement primarily in 1 plane?

(TQ)

Stable joints

When stable joints for the joint-by-joint approach is dysfunctional, it presents as what?

(TQ)

Inadequate stability

(Stability limitations/dysfunction)

What are the 5 Stable joints?

(TQ)

1) Knee

2) Lumbar

3) Scapula

4) Lower Cervical

5) Elbow

SUMMARY of Mobile vs Stable Joints

From Bottom Up, it alternates; starting and ending with MOBILE -->

Ankle (mobile)

Knee (stable)

Hip (mobile)

Lumbar (stable)

Thoracic (mobile)

Scapula (stable)

Glenohumeral (mobile)

Lower cervical (stable)

Upper cervical (mobile)

Elbow (stable)

Wrist (mobile)

What is a movement limitation problem?

(TQ)

Mobility dysfunction (MD)

What is the general rule for determining a true Mobility Dysfunction (MD)?

Active & Passive movement DYSFUNCTIONAL

What is a dysfunctional strategy?

Stability/Motor Control Dysfunction (SMCD)

What is the general rule for determining a true Stability/Motor Control Dysfunction (SMCD)?

Active DYSFUNCTIONAL, Passive FUNCTIONAL

What impact does nociception have on efferent (motor) output?

(TQ)

Reduced efferent activity of corresponding muscles

What impact does nociception have on afferent (sensory) input?

(TQ)

Reduced afferent activity

What impact do compensation patterns have on movement?

Compensatory patterns are inefficient, they are ENERGY COSTLY

What are the three components/systems that contribute to dysfunctional movement when atlered?

1) Altered length-tension relationship (muscular system)

2) Altered force couple relationship (nervous system)

3) Altered arthrokinematics (skeletal system)

What impact does dysfunction have on sensorimotor and neuromuscular efficiency? What does this lead to?

Altered sensory (afferent) input and altered neuromuscular efficiency (efferent) output

-- leads to dysfunctional movement, compensation, and tissue injury

Why should movement be part of an assessment?

Musculoskeletal health is #1 chrnoic disability, w/ 1/3 of people seeking medical care

In what 4 ways does movement assessments lead to a better diagnosis?

1) Finding cause

2) Explaining source

3) Determining effective treatment

4) Shortening treatment time

Within musculoskeletal care, what is our current process for screening?

We wait for SYMPTOMS and then value the signs we that we think contribute to the problem, instead of screening for SIGNS

In terms of pain and injury, what is the difference between source and cause?

(TQ)

Source = location individual is feeling pain

Cause = What is creating pain in the individuals system

T/F: The cause is always the same location as the source (ex: shoulder pain (source) stemming from a shoulder injury (cause)).

FALSE

-- The cause may or may not be the same location as the source

(Ex: shoulder pain (source) that could stem from cervical spine herniated disc (cause))

What is the #1 predictor of injury?

(TQ)

PREVIOUS INJURY

What are the 3 reasons as to why previous injury is the #1 predictor of injury?

1) Protective mechanism

2) underlying dysfunction that led to initial injury

3) Resultant dysfunction present following injury

How are pain, altered motor control, and injury interrelated and how does one impact the other?

Cyclic cycle

- injury leads to altered motor control or pain, altered motor control can lead to injury or pain, pain can lead to injury or altered motor control, etc.

What is the necessary input that is sufficiently processed, with an acceptable output and involves problems such as poor timing, sequencing, coordination, synergy of neuromuscular system which manifests in dysfunctional movement?

(TQ)

Motor Control

Why might pain persist after a tissue has fully healed?

Altered movement patterns or underlying dysfunction

- mobility and/or stability deficits

T/F: Pain = tissue damage

FALSE

- NO; pain is often used as a protective mechanism

What is the average tissue healing timeline?

4-8 weeks for musculoskeletal injuries

Should we incorporate movement assessment as part of our standard operating procedure to look at patterns or parts?

Should start by categorizing human movement PATTERNS, not by measuring body parts

What is the one way your body and brain get all of your parts working together without a fitness load?

Human movement patterns

When do we have justification to go look at the individual parts in the movement assessment?

(TQ)

When a pattern is DYSFUNCTIONAL

- you now have justification to look at the parts

What are any movement or series of movements that involve multiple joints/tissues to complete, gibing insight on their movement bias and overall movement strategy, serving as an entry point for more specific functional tests?

Global Movement Screens

T/F: All patients can benefit from movement assessments.

TRUE

When should movement assessments be utilized within patient care? (3)

(TQ)

1) 1st visit baseline --> IMPORTANT

2) Post-intervention check

3) Ongoing assessment

We want to use movement assessments within patient care to find the cause, explain source, determine effective treatment, and shorten treatment time, and avoid common ___________ errors.

Treatment plan

Why do some people not like movement screens? (4)

1) Don't understand results

2) Argue takes too long/impossible to remember everything

3) Don't know what to do w/ diagnosis they come up with, creating cognitive dissonance

4) Implement SFMA or other movement screens when its too early or patients needs to be desensitized

Which procedure is relatively equal parts qualitative and quantitative?

(TQ)

Screen

Which procedure is almost entirely quantitative?

(TQ)

Test

Which procedure is primarily qualitative with some quantitative markers?

Assessment

What are the 5 golden assessment rules? What is the overall key point?

1) Systems are your friends

2) Keep it simple stupid

3) Look for big limitations and big asymmetries

4) Effectively communicate findings

5) Confidence is key

LESS IS MORE