Movement assessment

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Movement assessment is the practice of analysing movement performance during functional tasks to determine the kinematics of individual joints and their effect on the kinetic chain. Three-dimensional or two-dimensional analysis of the biomechanics involved in sporting tasks can assist in prevention of injury and enhancing athletic performance. Identification of abnormal movement mechanics provides physical therapists and Athletic trainers the ability to prescribe more accurate corrective exercise programs to prevent injury and improve exercise rehabilitation and progression following injury and assist in determining readiness to return to sport.

Contents

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. [1] [2] 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 (ACL) and patellofemoral injury. [3] [4] [5] [6] 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, [7] [8] the effect of fatigue [9] and differences between gender [10] allow for more precise clinical exercise intervention [11] to reduce the risk of injury.

Functional Movement Screen (FMS)

The FMS test was designed by Gray Cook, Lee Bourton, and Barbara Hoogenboom in 2006. [12]

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. [13] 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. [14]

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. [15] 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. [16]

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). [17] 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 that was developed into a functional test by Liebenson [18] to examine the biomechanics of the lower extremity, assess hip muscle dysfunction [19] and provide an indication of mechanics during daily functional tasks. [20] 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. [21] The person's arms should be in 90° of shoulder flexion and full elbow extension. The athlete 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 performance by assessing limb symmetry after an anterior cruciate ligament injury [22] [23] [24] [25] [26] or following anterior cruciate ligament reconstruction. [27] [28] [29] 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). [30] 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. [31] [32] [33] [34] [35] [36] [37]

Related Research Articles

<span class="mw-page-title-main">Knee</span> Leg joint in primates

In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation. The knee is vulnerable to injury and to the development of osteoarthritis.

<span class="mw-page-title-main">Hamstring</span> Any of the three muscles in the thigh

In human anatomy, a hamstring is any one of the three posterior thigh muscles between the hip and the knee.

<span class="mw-page-title-main">Posterior cruciate ligament</span> One of four major ligaments of the knee

The posterior cruciate ligament (PCL) is a ligament in each knee of humans and various other animals. It works as a counterpart to the anterior cruciate ligament (ACL). It connects the posterior intercondylar area of the tibia to the medial condyle of the femur. This configuration allows the PCL to resist forces pushing the tibia posteriorly relative to the femur.

<span class="mw-page-title-main">Anterior cruciate ligament</span> Type of cruciate ligament in the human knee

The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments in the human knee. The two ligaments are also called "cruciform" ligaments, as they are arranged in a crossed formation. In the quadruped stifle joint, based on its anatomical position, it is also referred to as the cranial cruciate ligament. The term cruciate translates to cross. This name is fitting because the ACL crosses the posterior cruciate ligament to form an "X". It is composed of strong, fibrous material and assists in controlling excessive motion. This is done by limiting mobility of the joint. The anterior cruciate ligament is one of the four main ligaments of the knee, providing 85% of the restraining force to anterior tibial displacement at 30 and 90° of knee flexion. The ACL is the most injured ligament of the four located in the knee.

<span class="mw-page-title-main">Lachman test</span> Clinical test to diagnose injury to ligaments

The Lachman test is a clinical test used to diagnose injury of the anterior cruciate ligament (ACL). It is recognized as reliable, sensitive, and usually superior to the anterior drawer test.

<span class="mw-page-title-main">Segond fracture</span> Avulsion fracture of the lateral tibial condyle of the knee

The Segond fracture is a type of avulsion fracture from the lateral tibial plateau of the knee, immediately below the articular surface of the tibia.

The drawer test is used in the initial clinical assessment of suspected rupture of the cruciate ligaments in the knee.

<span class="mw-page-title-main">Anterior cruciate ligament reconstruction</span> Surgical process

Anterior cruciate ligament reconstruction is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury. The torn ligament can either be removed from the knee, or preserved before reconstruction through an arthroscopic procedure. ACL repair is also a surgical option. This involves repairing the ACL by re-attaching it, instead of performing a reconstruction. Theoretical advantages of repair include faster recovery and a lack of donor site morbidity, but randomised controlled trials and long-term data regarding re-rupture rates using contemporary surgical techniques are lacking.

<span class="mw-page-title-main">Vastus medialis</span> Extensor muscle located medially in the thigh that extends the knee

The vastus medialis is an extensor muscle located medially in the thigh that extends the knee. The vastus medialis is part of the quadriceps muscle group.

The knee examination, in medicine and physiotherapy, is performed as part of a physical examination, or when a patient presents with knee pain or a history that suggests a pathology of the knee joint.

<span class="mw-page-title-main">Cruciate ligament</span> Type of ligament shaped like an X

Cruciate ligaments are pairs of ligaments arranged like a letter X. They occur in several joints of the body, such as the knee joint, wrist joint and the atlanto-axial joint. In a fashion similar to the cords in a toy Jacob's ladder, the crossed ligaments stabilize the joint while allowing a very large range of motion.

<span class="mw-page-title-main">Anterior cruciate ligament injury</span> Ligament injury near the knee

An anterior cruciate ligament injury occurs when the anterior cruciate ligament (ACL) is either stretched, partially torn, or completely torn. The most common injury is a complete tear. Symptoms include pain, an audible cracking sound during injury, instability of the knee, and joint swelling. Swelling generally appears within a couple of hours. In approximately 50% of cases, other structures of the knee such as surrounding ligaments, cartilage, or meniscus are damaged.

<span class="mw-page-title-main">Unhappy triad</span> Medical condition of the knee

The unhappy triad, also known as a blown knee among other names, is an injury to the anterior cruciate ligament, medial collateral ligament, and meniscus. Analysis during the 1990s indicated that this 'classic' O'Donoghue triad is actually an unusual clinical entity among athletes with knee injuries. Some authors mistakenly believe that in this type of injury, "combined anterior cruciate and medial collateral ligament disruptions that were incurred during athletic endeavors" always present with concomitant medial meniscus injury. However, the 1990 analysis showed that lateral meniscus tears are more common than medial meniscus tears in conjunction with sprains of the ACL.

<span class="mw-page-title-main">Merv Cross</span> Australian rugby league footballer and orthopaedic surgeon (1941–2023)

Mervyn John Cross was an Australian rugby league footballer and orthopaedic surgeon. He played in Australia's major competition the New South Wales Rugby League (NSWRL) but Cross, a doctor, was better known for his achievements in the field of sports medicine as an orthopaedic surgeon.

<span class="mw-page-title-main">Meniscus tear</span> Rupturing of the fibrocartilage strips in the knee called menisci

A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci. When doctors and patients refer to "torn cartilage" in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae. Menisci can be torn during innocuous activities such as walking or squatting. They can also be torn by traumatic force encountered in sports or other forms of physical exertion. The traumatic action is most often a twisting movement at the knee while the leg is bent. In older adults, the meniscus can be damaged following prolonged 'wear and tear'. Especially acute injuries can lead to displaced tears which can cause mechanical symptoms such as clicking, catching, or locking during motion of the joint. The joint will be in pain when in use, but when there is no load, the pain goes away.

<span class="mw-page-title-main">Medial patellofemoral ligament</span> Ligament of the knee

The medial patellofemoral ligament (MPFL) is one of several ligaments on the medial aspect of the knee. It originates in the superomedial aspect of the patella and inserts in the space between the adductor tubercle and the medial femoral epicondyle. The ligament itself extends from the femur to the superomedial patella, and its shape is similar to a trapezoid. It keeps the patella in place, but its main function is to prevent lateral displacement of the patella.

Posterolateral corner injuries of the knee are injuries to a complex area formed by the interaction of multiple structures. Injuries to the posterolateral corner can be debilitating to the person and require recognition and treatment to avoid long term consequences. Injuries to the PLC often occur in combination with other ligamentous injuries to the knee; most commonly the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). As with any injury, an understanding of the anatomy and functional interactions of the posterolateral corner is important to diagnosing and treating the injury.

<span class="mw-page-title-main">Medial knee injuries</span> Medical condition

Medial knee injuries are the most common type of knee injury. The medial ligament complex of the knee consists of:

High tibial osteotomy is an orthopaedic surgical procedure which aims to correct a varus deformation with compartmental osteoarthritis. Since the inception of the procedure, advancements to technique, fixation devices, and a better understanding of patient selection has allowed HTO to become more popular in younger, more active patients hoping to combat arthritis. The idea behind the procedure is to realign the weight-bearing line of the knee. By realigning the knee, the force produced from weight-bearing is shifted from the arthritic, medial compartment to the healthy, lateral compartment. This decrease in force or load in the diseased part of the knee joint decreases knee pain and can delay the development or progression of osteoarthritis in the medial compartment.

<span class="mw-page-title-main">Posterior cruciate ligament injury</span> Medical condition

The function of the posterior cruciate ligament (PCL) is to prevent the femur from sliding off the anterior edge of the tibia and to prevent the tibia from displacing posterior to the femur. Common causes of PCL injuries are direct blows to the flexed knee, such as the knee hitting the dashboard in a car accident or falling hard on the knee, both instances displacing the tibia posterior to the femur.

References

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