Functional Movement Analysis flashcards

What is movement analysis?

The systematic process of observing and analysing the quality of a movement as it relates to a functional movement

Why do physiotherapists analyse movement

• to identify movement dysfunction (which either contributed to an injury or developed because of injury)

• Helps us understand the reasons behind how and why people move a certain way.

• to make movement system diagnoses that support treatment decisions

What is a functional movement?

• Can be task specific (e.g. tying shoes) or sport specific movement (e.g. throwing a cricket ball)

• Can be broken down into subtasks, phases and components

• Difficulty with any of the components required for a specific functional movement can make tasks very difficult

• In other words, functional movements are the things you do during your day to help you accomplish essential tasks

What are the advantages of using observational movement analysis

• Practical

• always available

• quick

• cheap

What are the disadvantages of observational movement analysis

• Not precise

• subjective )based on personal factors)

• requires repeated performance

Movement components

Components (give a description)

• Part of body that initiates movement

• joints involved

• direction body moves

• weight shift

Extended arm reach:

•The movement is initiated by the hand

•The shoulder joint acts as a fulcrum

• Direction is forward

• Weight is shifted forward.

Framework for movement analysis

Starting position:

• Position of readiness

• foundation of activity

• Joint position and muscle work must be considered

• e.g.: lying, kneeling, sitting, standing

Movement Sequence (timing and order):

• Different types of movement sequences:

  • transitional movement sequences (e.g. sitting to standing) (initiation → transition → completion)

    • Initiation: forward movement of trunk + arms

    • Transition: shift weight from pelvis + hips to feet, moving from sitting to standing

    • Completion: standing, trunk balanced over feet

  • mobility sequences (e.g. walking and crawling)

  • task related movement sequences (e.g. drinking from a cup)

• Finishing position:

  • Returning to the original position

  • Beginning of a new phase

  • Starting position for a new movement

  • A position of rest.

Rolling from supine and prone (body parts and movement of each)

Sitting to standing (body parts and movement of each)

Going up and down stairs

Trunk control

• Trunk control is the ability of the trunk muscles to:

• Allow the body to remain upright,

• Adjust weight shifts

• Perform selective movements of the trunk

• Maintains the base of support during postural adjustments

How does trunk control fulfil its role

• All movements of the trunk require muscle activity to oppose the pull of gravity.

• The moment the body moves away from COG, the muscles have to act.

• Trunk control is needed to maintain balance + moving extremities

Static control during functional movement

• S.C. enables the body to maintain a certain posture

• The postural role of the trunk is most significant in sitting and standing.

• little muscle activity is needed to maintain posture

Dynamic control during functional movement

• Trunk functions dynamically when moving centre of mass over base or to new base

• allows movement in and out of a position.

• When trunk is unstable + cant move w/o losing balance → arms and legs stabilise → therefore increase base of support

Equilibrium reactions

• When position changed:

  • trunk muscles strongly contract

  • extremities bring COG back to stable support

  • Arm muscles → provides additional stability to the upper trunk

• EQ reactions = not present in normal functional movements → is a backup system when balance is disturbed

• Happens when:

  • normal postural adjustments + weight shift cant maintain posture

  • small BOS + environment conditions that destabilise the body

When describing a movement, comment on:

NB: Start at the head/neck and work your way down!!

• Joint movements (range)

• Muscle action

• Joint ROM

• Movement quality (e.g. smooth, coordinated)

How to analyse using the S.I.T.C framework

TAKE NOTE OF:

• S = starting position

  • Base of support

  • Any asymmetries in weight distribution

  • Postural deviations

  • Obvious differences between the two sides of the body

• I = Initiation

  • Which body part moves first?

  • Direction of movement

  • Any changes in the base of support

  • Any weight shift

• T = transition

  • Position of the body

  • Base of support

  • New direction of movement

• C = completion

  • Position of body and limbs

  • Base of support

Movement needed to memorise

• Sit to stand

• Stepping up

• Stepping down

• Rolling supine to side lying

2 main phases of STS

• the raising phase, during which the person must move from sitting to upright posture

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

Why is sit to stand considered a complex movement?

• Needs trunk and lower limb coordination, balance, and stability + neurocognitive skills and muscular strength.

Sit-to-stand action

Consists of 3 phases:

1. Flexion momentum phase

   • Flex hips

   • trunk forward

   • anterior pelvic tilt

   • trunk extension

2. Momentum transfer phase

   • transfer weight from bum to feet

   • leg extensors contract

   • COM moves forward

   • dorsiflexion at ankle increases

3. Extension phase

   • hips and knees extend → body erect

   • COM controlled to maintain balance

Stepping up action

Consists of 4 phases:

1. Preparatory phase

   • Analyse height + position of step (get visual info)

   • Weight transference onto stance leg

   • COM moves lateral + backward anticipating forward movement of LL

   • Muscles in stance leg stiffen to support body weight.

2. Swing phase

   • The hip and knee of the LL flex to lift foot onto the step.

   • Plantar-flexors contract allowing heel of LL lift off ground.

   • Hip flexors contract to lift leg off the ground.

   • The knee extends to move the foot over the step (hover) for accurate foot placement.

3. Stance phase + Lifting the trailing leg onto the step

   • Foot placed on step

   • body weight transfers forward onto LL

   • Isometric contraction of hip flexors + knee flexors

   • The trailing leg lifted up + forward by hip, knee and ankle flexion.

4. Redistribution of weight onto both feet (extension + completion)

   1. Lateral shift of COM redistributes the weight equally over both feet

   2. The foot of trailing leg is lowered onto the step.

Stepping down action

Consists of 4 phases:

1. Preparatory phase

   • Weight shift onto stance leg

   • Co-contraction in the stance leg

   • LL relaxed and ready to swing forward

2. Swing phase — Leading leg

   • Lift LL up to pass edge of step (hip + knee flexion)

   • LL moves forward w/ hip flexion + knee extension

   • LL touch down in plantarflexion

   • COM moves forward + down → transferring weight onto the leading leg

   • Flexion at knee absorbs momentum

   • Extend hip + knee

3. Stance phase (of LL) + trailing leg lowering & COM

   • The stance knee continues to flex

   • The heel of TL is lifted off the supporting surface

   • The wight is shifted onto the forefoot

   • The centre of motion is moving forwards and downwards. The knee is slightly flexed with the foot on plantarflexion.

   • Continuous flexion of the trailing leg to lower the centre of motion in a controlled way.

4. Trailing leg swing phase (Redistribution of weight onto both feet (completion))

   • Weight on LL as COM continues moving forward

   • LL then extends

   • TL hip flexes → brings boot in line with LL (stance leg) → foot lowered to ground

Rolling: Initiated from upper body (Rolling from supine to right side)

1. Initial phase:

• Head + upper body move up off surface, diagonal to the right

• head, left shoulder + upper rib cage moves off and away from surface → causing them to be anterior to the left pelvis.

2. Transition:

• Left pelvis rotates to the right and leaves supporting surface so the body weight shifts to the right

• left arm crosses midline to assist trunk flexion.

3. Completion:

• left leg leaves surface and rests on right leg

• when pelvis and body are in side-lying position, spine will have moved out of flexion rotation into neutral

Rolling: Initiated from lower body (rolling form supine to right side)

1. Initiation:

   • Lower trunk + pelvis lift off surface and move towards the right

   • left pelvis moves anterior to left shoulder

   • left hip + knee is flexed to assist extension rotation of trunk as foot pushes into supporting surface

   • head + upper body remain on supporting surface

2. Transition:

   • Rotation moves up spine and left upper body rotates to the right + leaves surface → full body weight shifted onto right pelvis/hip/shoulder

3. Completion:

   • Upper body rotate into plane of pelvis and side-lying is achieved

Nonsegmental (log) rolling

• Left shoulder and left pelvis remain aligned in the same plane and the whole trunk moves together as a unit.

1. Initiation:

   • Upper and lower trunk are in neutral alignment as movement is initiated so that the head, shoulders + pelvis leave the bed at the same time

   • Rolling can start either with the whole body moving together or with just the head, neck, and trunk moving first, using the arms and legs very little.

2. Transition:

   • Body weight is shifted from the back onto the right shoulder and hip as the pelvis and shoulder leave the surface

3. Completion:

   • Pelvis and shoulder reach side-lying position at the same time