Movement Analysis Flashcards
4 things that “the old way” examined?
- sensory stimuli
- reflexes
- simple patterns of movement
- postural reflexes
Why does examining effects of sensory stimuli on movements/motor output not work?
the kind of sensory stimuli are not ecologically valid most of the time
why does examining reflexes not work?
that is diagnostic, not functional
why can’t you examine “simple” patterns of movement?
PNF patterns dont match well to adaptive capacity required for function
why does examining postural reflexes/reactions not work?
that is a reactive mode of postural control and ignored the proactive control
Contemporary Model of Health and Disease
- Participate in life roles
- Perform activities using a particular movement strategy
- body structures and functions including components of movement
In the ICF model, body functions/structure and participation are examples of what?
level of functioning
in the ICF model, what are environmental and personal factors considered?
contextual factors
what influences functioning?
health condition and contextual factors
ICF model definition
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
Level of Analysis: What is the problem?
- participation
- activity
- task
- body functions and structure
- movement strategy
- movement contracts/attributes/ underlying factors
what do you write goals based on?
level of participation, activity, and task
What is the problem of relationships among levels of functioning and analysis?
Just because we have the elements doesn’t mean we have the whole
Evaluating functional activities (tasks)
- 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
In order to perform task-oriented analysis and movement analysis, what must you understand?
- the underlying components of movement and their factors affecting the functional performance
- quantification of impairments that affect performance and potentially restrict participation
if movement is the interplay between central and peripheral processes and environmental context, then …
- 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
What are initial conditions?
the state of an individuals system and prevailing environmental conditions
What are the constructs of initial conditions
- Posture
- ability to interact with environment (to extract meaningful information)
- environmental context
Why should you systematically alter the environmental conditions of the initial condition?
to observe changes in movement strategies and determine where challenges to performance lie
Preparation
- the period of time when movement is being organized within the CNS (motor planning)
- generally not observable
- does the patient understand the instructions
Initiation
- Instant when the displacement of the limb/body/segment begins
- Constructs: timing, direction
what might what we see at the initiation of a movement tell us?
- 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
Execution
- Segmental/body/limb motion
- what we see as they get from point A to point B
Constructs of execution
- amplitude
- direction
- speed
- smoothness
Termination
- instant when motion stops
Constructs of Termination
Accuracy
Timing
Stability
Outcome
- Was the goal of the movement achieved successfully or not
- Are they able to determine if the goal is achieved?
- Feedback: intrinsic, extrinsic
Are the phases of movement analysis interactive?
- Yes!
what should you be systematically changing in order to reveal abilities and movement dysfunction?
initial conditions
If you see a problem at termination, what should you do?
- 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
what can the outcome of movement do?
affect the next trial!
General Considerations for Movement Analysis
- 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
why are at least two reps preferred?
- 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
System factors
- clinical components, as part of the movement system, are made possible by the subsets functioning
what should you examine and quantify in order to rule in or rule out your hypotheses?
the clinical components of movement relevant to the observed movement
in order to develop and test hypotheses, what must you determine?
- if there is sufficient evidence/information to prioritize hypothesized problems of the observed movement
Examples of clinical components
- mobility
- force generation
- muscle tone
- endurance
- sensory information
- selective control
- adaptive capacity
- pain
- coordination
- posture
- balance
- cognitive
Is movement a problem?
- 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?
How do we treat the problem?
optimize movement and minimize functional deficits
