Movement assessment is the practice of analysing movement performance during
functional tasks to determine the
kinematics
In physics, kinematics studies the geometrical aspects of motion of physical objects independent of forces that set them in motion. Constrained motion such as linked machine parts are also described as kinematics.
Kinematics is concerned with s ...
of individual
joints
A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw- ...
and their effect on the
kinetic chain. Three-dimensional or two-dimensional
analysis
Analysis (: analyses) is the process of breaking a complex topic or substance into smaller parts in order to gain a better understanding of it. The technique has been applied in the study of mathematics and logic since before Aristotle (38 ...
of the
biomechanics
Biomechanics is the study of the structure, function and motion of the mechanical aspects of biological systems, at any level from whole organisms to Organ (anatomy), organs, Cell (biology), cells and cell organelles, using the methods of mechani ...
involved in sporting tasks can assist in prevention of
injury
Injury is physiological damage to the living tissue of any organism, whether in humans, in other animals, or in plants.
Injuries can be caused in many ways, including mechanically with penetration by sharp objects such as teeth or with ...
and enhancing athletic performance. Identification of
abnormal movement mechanics provides
physical therapists
Physical therapy (PT), also known as physiotherapy, is a healthcare profession, as well as the care provided by physical therapists who promote, maintain, or restore health through patient education, physical intervention, disease prevention ...
and
Athletic trainer
An athletic trainer is a certified and licensed health care provider who practices in the field of sports medicine. Athletic training has been recognized by the American Medical Association
The American Medical Association (AMA) is an American ...
s the ability to prescribe more accurate corrective
exercise
Exercise or workout is physical activity that enhances or maintains fitness and overall health. It is performed for various reasons, including weight loss or maintenance, to aid growth and improve strength, develop muscles and the cardio ...
programs to
prevent injury and improve exercise
rehabilitation and progression following
injury
Injury is physiological damage to the living tissue of any organism, whether in humans, in other animals, or in plants.
Injuries can be caused in many ways, including mechanically with penetration by sharp objects such as teeth or with ...
and assist in determining readiness to
return to sport.
Movement has to be differentiated from the concept of motion. Movement assessment means to estimate inability, means to examine something based on different factors.
A good examination of joint movement, in addition to helping the physical therapist diagnose the patient's functional loss, can provide an objective criteria to determine the effectiveness of a treatment program. The complete or partial movement of an articulation is called range of movement. The range of movement differs from one joint to another. The maximum limit of a joint movement can be reached in two ways: actively or passively.
Landing Error Scoring System (LESS)
The LESS is a valid and reliable tool for the
biomechanical assessment of the jump landing technique. The LESS involves the scoring of 22 biomechanical criteria of the
lower extremity and
trunk, with the outcomes being associated with the risk of
anterior cruciate ligament
The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee. The two ligaments are called "cruciform" ligaments, as they are arranged in a crossed formation. In ...
(ACL) and
patellofemoral injury. LESS scoring is split into the following categories: excellent (0-3); good (4-5); moderate (6-7); and poor (>7). Identification of biomechanical abnormalities in landing technique, the effect of
fatigue
Fatigue is a state of tiredness (which is not sleepiness), exhaustion or loss of energy. It is a signs and symptoms, symptom of any of various diseases; it is not a disease in itself.
Fatigue (in the medical sense) is sometimes associated wit ...
and differences between gender allow for more precise clinical
exercise intervention to reduce the risk of
injury
Injury is physiological damage to the living tissue of any organism, whether in humans, in other animals, or in plants.
Injuries can be caused in many ways, including mechanically with penetration by sharp objects such as teeth or with ...
.
Functional Movement Screen (FMS)
The FMS test was designed by Gray Cook, Lee Bourton, and Barbara Hoogenboom in 2006.
The primary purpose of this test is to early detect possible pathologies or dysfunctions in a specific group or individual. It is used to identify certain anomalies in the movement system. The creators consider it primarily as an evaluation of the subject's functional status, rather than simply an exploratory examination of functional movement. The FMS is a practical tool that allows the professional to evaluate the fundamental basic movement patterns.
It is composed by 7 different tests evaluated from 0 to 3 points. 0 means the patient has some pain realizing the movement and 3 means the patient feel perfect doing the movement.
The FMS tests can be a very useful tool to explore functional asymmetries of the musculoskeletal system and postural stability deficits.
Romberg Test
The Romberg test evaluates static balance and it consists of maintaining a standing position with your feet together, arms at your sides and eyes closed. During this test, the ability to maintain the posture without losing balance is evaluated. This test is very helpful with elderly population or people recovering from any type of injuries.
Adams test
The Adams test consists of observing a person's spine from different angles to detect possible deviations or misalignments. This test is especially useful in detecting scoliosis and other spinal disorders.
It consists of doing a forward flexion of the trunk with the feet hip-width apart, the knees extended and the hands straight, trying to touch the tips of the feet. When bending down, and if you look at the patient from the front, you can see if there is a considerable elevation on one side of the trunk (presence of a hump on the ribs). If this occurs, it is appropriate to consult a physiotherapist or specialist for possible additional evaluations.
Unsupported single leg squat
The single leg squat is an
exercise
Exercise or workout is physical activity that enhances or maintains fitness and overall health. It is performed for various reasons, including weight loss or maintenance, to aid growth and improve strength, develop muscles and the cardio ...
that was developed into a functional test by Liebenson to examine the
biomechanics
Biomechanics is the study of the structure, function and motion of the mechanical aspects of biological systems, at any level from whole organisms to Organ (anatomy), organs, Cell (biology), cells and cell organelles, using the methods of mechani ...
of the
lower extremity, assess
hip muscle dysfunction and provide an indication of mechanics during daily functional tasks. The test requires the person to stand on the limb being tested, with the non-weight bearing limb in about 45° of
hip flexion and about 90° of
knee flexion. The person's arms should be in 90° of
shoulder flexion and full
elbow extension. The
athlete
An athlete is most commonly a person who competes in one or more sports involving physical strength, speed, power, or endurance. Sometimes, the word "athlete" is used to refer specifically to sport of athletics competitors, i.e. including track ...
is required to
squat down to at least 60° of
knee flexion and return to the start position within 6 seconds.
Single Leg Hop for Distance
Single leg hop tests are commonly used to assess functional
knee
In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). It is the largest joint in the hu ...
performance
A performance is an act or process of staging or presenting a play, concert, or other form of entertainment. It is also defined as the action or process of carrying out or accomplishing an action, task, or function.
Performance has evolved glo ...
by assessing limb symmetry after an
anterior cruciate ligament
The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee. The two ligaments are called "cruciform" ligaments, as they are arranged in a crossed formation. In ...
injury or following
anterior cruciate ligament reconstruction. The hop tests mainly used are: the single leg hop for distance; crossover hop test; triple hop test; 6m timed hop test; square hop test and side-to-side hop test. The limb symmetry is assessed by means of the limb symmetry index (LSI). Normal values for
return to play criteria following
ACL reconstruction indicate that the injured limb should be greater than or equal to 90% of the uninjured limb.
[Thomee R, Kaplan Y, Kvist J, Myklebust G, Risberg MA, Theisen D, et al. "Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surgery, Sports Traumatology, Arthoscopy: Official Journal of the ESSKA. 2011;19(11):798-805.]
References
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Biomechanics
Physical exercise
Sports science