Movement Analysis

Question 1

4 things that “the old way” examined?

Answer 1

• sensory stimuli
• reflexes
• simple patterns of movement
• postural reflexes

Question 2

Why does examining effects of sensory stimuli on movements/motor output not work?

Answer 2

the kind of sensory stimuli are not ecologically valid most of the time

Question 3

why does examining reflexes not work?

Answer 3

that is diagnostic, not functional

Question 4

why can’t you examine “simple” patterns of movement?

Answer 4

PNF patterns dont match well to adaptive capacity required for function

Question 5

why does examining postural reflexes/reactions not work?

Answer 5

that is a reactive mode of postural control and ignored the proactive control

Question 6

Contemporary Model of Health and Disease

Answer 6

• Participate in life roles
• Perform activities using a particular movement strategy
• body structures and functions including components of movement

Question 7

In the ICF model, body functions/structure and participation are examples of what?

Answer 7

level of functioning

Question 8

in the ICF model, what are environmental and personal factors considered?

Answer 8

contextual factors

Question 9

what influences functioning?

Answer 9

health condition and contextual factors

Question 10

ICF model definition

Answer 10

An individual’s functioning in a specific domain is an interaction or complex relationship between health condition and contextual factors. This is a dynamic interaction among these entities: interventions in one entity have the potential to modify one or more of the other entities. These interactions are specific and not always in a predictable one to one relationship

Question 11

Level of Analysis: What is the problem?

Answer 11

• participation
• activity
• task
• body functions and structure
• movement strategy
• movement contracts/attributes/ underlying factors

Question 12

what do you write goals based on?

Answer 12

level of participation, activity, and task

Question 13

What is the problem of relationships among levels of functioning and analysis?

Answer 13

Just because we have the elements doesn’t mean we have the whole

Question 14

Evaluating functional activities (tasks)

Answer 14

• requires movement analysis to highlight the strategies used to accomplish a particulate task or functional activity
• start with standard set of task and environmental constraints (initial conditions) then adjust

Question 15

In order to perform task-oriented analysis and movement analysis, what must you understand?

Answer 15

• the underlying components of movement and their factors affecting the functional performance
• quantification of impairments that affect performance and potentially restrict participation

Question 16

if movement is the interplay between central and peripheral processes and environmental context, then …

Answer 16

• movement is a continuum (from the environment when visually guided or intention when self directed to the outcome of the movement)
• environments influence from initial conditions to outcome cannot be overstated

Question 17

What are initial conditions?

Answer 17

the state of an individuals system and prevailing environmental conditions

Question 18

What are the constructs of initial conditions

Answer 18

• Posture
• ability to interact with environment (to extract meaningful information)
• environmental context

Question 19

Why should you systematically alter the environmental conditions of the initial condition?

Answer 19

to observe changes in movement strategies and determine where challenges to performance lie

Question 20

Preparation

Answer 20

• the period of time when movement is being organized within the CNS (motor planning)
• generally not observable
• does the patient understand the instructions

Question 21

Initiation

Answer 21

• Instant when the displacement of the limb/body/segment begins
• Constructs: timing, direction

Question 22

what might what we see at the initiation of a movement tell us?

Answer 22

• about how it was planned
• Timing issues: problems of preparation/planning
• direction issues: problem in preparation stage unless there is an absence of available ROM or muscle force

Question 23

Execution

Answer 23

• Segmental/body/limb motion
• what we see as they get from point A to point B

Question 24

Constructs of execution

Answer 24

• amplitude
• direction
• speed
• smoothness

Question 25

Termination

Answer 25

• instant when motion stops

Question 26

Constructs of Termination

Answer 26

Accuracy
Timing
Stability

Question 27

Outcome

Answer 27

• Was the goal of the movement achieved successfully or not
• Are they able to determine if the goal is achieved?
• Feedback: intrinsic, extrinsic

Question 28

Are the phases of movement analysis interactive?

Answer 28

• Yes!

Question 29

what should you be systematically changing in order to reveal abilities and movement dysfunction?

Answer 29

initial conditions

Question 30

If you see a problem at termination, what should you do?

Answer 30

• well, problems in execution/termination may be due to problems in earlier stages
• so, your analysis (evaluation) will require you to decide if the problem is during a different period of movement

Question 31

what can the outcome of movement do?

Answer 31

affect the next trial!

Question 32

General Considerations for Movement Analysis

Answer 32

• Provide the least amount of assistance possible
• At least two reps is preferred
• Explanations of movement dysfunction for actions/tasks are addressed through identifying the components of movement and underlying factors across systems interfering with movement

Question 33

why are at least two reps preferred?

Answer 33

• first trial determines patients understanding and whether the pt can perform without assistance or support
• second trial, focus switches to evaluating key movement constructs and patterns and what factors may be involved in any movement dysfunction

Question 34

System factors

Answer 34

• clinical components, as part of the movement system, are made possible by the subsets functioning

Question 35

what should you examine and quantify in order to rule in or rule out your hypotheses?

Answer 35

the clinical components of movement relevant to the observed movement

Question 36

in order to develop and test hypotheses, what must you determine?

Answer 36

• if there is sufficient evidence/information to prioritize hypothesized problems of the observed movement

Question 37

Examples of clinical components

Answer 37

• mobility
• force generation
• muscle tone
• endurance
• sensory information
• selective control
• adaptive capacity
• pain
• coordination
• posture
• balance
• cognitive

Question 38

Is movement a problem?

Answer 38

• should the movement be changed? depends on activity and participation
• is the way the patient moves an optimal compensation or solution to another issue? will it work in the long term?
• can PT help change the movement?

Question 39

How do we treat the problem?

Answer 39

optimize movement and minimize functional deficits