Movement assessment

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.

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)

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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)

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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

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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

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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

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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

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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]

## References

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1. ^ Padua DA, Boiling MC, DiStefano LJ, Onate JA< Beutler AI, Marshall SW. "Reliability of the landing error scoring system-real time, a clinical assessment tool of jump-landing biomechanics." J of Sport Rehabil. 2011;20(2):145-56
2. ^ Padua DA, Marshall SW, Boiling MC, Thigpen CA, Garrett WE, Jr., Beutler AI. "The landing error scoring system (LESS) is a valid and reliable clinical assessment tool of jump-landing biomechanics:The Jump-ACL study." The American Journal of Sports Medicine. 2009;37(10):1996-2002
3. ^ Paterno MV, Schmitt LC, Ford KR, Rauh MJ, Myer GD, Huang B, et al. "Biomechanical measures during landing and postural stability predict second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport." The American Journal of Sports Medicine. 2010;38(10):1968-78
4. ^ Boiling MC, Padua DA, Marshall SW, Guskiewicz K, Pyne S, Beutler A. "A prospective investigation of biomechanical risk factors for patellofemoral pain pain syndrome: the Joint Undertaking to Monitor and Prevent ACL injury (Jump-ACL) cohort." The American Journal of Sports Medicine. 2009;37(11):2108-16
5. ^ Boiling MC, Padua DA. "Relationship between hip strength and trunk, hip and knee kinematics during a jump-landing task in individuals with patellofemoral pain." International journal of sports physical therapy. 2013;8(5):661-9
6. ^ Beutler A, de la Motte S, Marshall S, Padua D, Boden B. "Muscle strength and qualitative jump-landing differences in male and female military cadets: The Jump-ACL study." Journal of Sports Science and Medicine. 2009;8:663-71
7. ^ Boiling MC, Padua DA. "Relationship between hip strength and trunk, hip and knee kinematics during a jump-landing task in individuals with patellofemoral pain." International journal of sports physical therapy. 2013;8(5):661-9
8. ^ Blackburn JT, Padua DA. "Influence of trunk flexion on hip and knee joint kinematics during a controlled drop landing." Clin Biomech (Bristol, Avon). 2008;23(3):313-9
9. ^ Goekler A, Eppinga P, Dijkstra PU, Welling W, Padua D, Otten E, et al. "Effect of fatigue on landing performance assessed with the landing error scoring system (LESS) in patients after ACL reconstruction. A pilot study." The International Journal of Sports Physical Therapy. 2014;9(3):302-11
10. ^ Beutler A, de la Motte S, Marshall S, Padua D, Boden B. "Muscle strength and qualitative jump-landing differences in male and female military cadets: The Jump-ACL study." Journal of Sports Science and Medicine. 2009;8:663-71
11. ^ Padua DA, Frank B, Donaldson A, de la Motte S, Cameron KL, Beutler AI, et al. "Seven steps for developing and implementing a preventive training program: lessons learned from Jump-ACL and beyond." Clinics in Sports Medicine. 2014;33(4):615-32
12. ^ "FMS valoración funcional del movimiento y su importancia". mundoentrenamiento.com (in Spanish). Retrieved 2024-04-17.
13. ^ "FMS valoración funcional del movimiento y su importancia". mundoentrenamiento.com (in Spanish). Retrieved 2024-04-17.
14. ^ "FMS valoración funcional del movimiento y su importancia". mundoentrenamiento.com (in Spanish). Retrieved 2024-04-17.
15. ^ Pomares, Gloria (2023-06-30). "Pruebas de valoración del equilibrio más utilizadas en rehabilitación". Rehametrics (in European Spanish). Retrieved 2024-04-17.
16. ^ Pierdepesoencasa (2023-12-22). "Importancia de evaluar y analizar la calidad del movimiento: FMS, goniometría y testeos posturales". Pierde peso en casa (in Spanish). Retrieved 2024-04-17.
17. ^ Rivero, Paula (2022-04-11). "Test de Adams, una maniobra para detectar la escoliosis en casa". Consejos de tu Farmacéutico (in Spanish). Retrieved 2024-04-17.
18. ^ Liebenson C. "Functional Exercises." Journal of Bodywork and Movement Therapies. 2002; April
19. ^ Crossley KM, Zhang WJ, Schache AG, Bryant A, Cowan SM. "Performance on the single-leg squat task indicates hip abductor muscle function." The American Journal of Sports Medicine. 2011;39(4):866-73
20. ^ Bailey R, Selfie J, Richards J. "The single leg squat test in the assessment of musculoskeletal function: A review." Physiotherapy Ireland.2010;31(1):18-23.
21. ^ Livengood A, DiMattia M, Uhl T. "Dynamic Trendelenburg: Single-leg squat for gluteus medius strength." Athletic Therapy Today. 2004;9(1):24-5.
22. ^ Barber SD, Noyes FR, Mangine RE, McCloskey JW, Hartman W."Quantitative assessment of functional limitations in normal and anterior cruciate ligament-deficient knees." Clinical Orthopaedics and Related Research. 1990;255:204-14
23. ^ Fitzgerald GK, Lephart SM, Hwang JH, Wainner RS. "Hop tests as predictors of dynamic knee stability." The Journal of Orthopaedic and Sports Physical Therapy. 2001;31(10):588-97
24. ^ Itoh H, Kurosaka M, Yoshiya S, Ichihashi N, Mizuno K. "Evaluation of functional deficits determined by four difference hop tests in patients with anterior cruciate ligament deficiency." Knee Surgery, Sports Traumatology, Arthoscopy: Official Journal of the ESSKA. 1998;6(4):241-5.
25. ^ Noyes FR, Barber SD, Mangine RE. "Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture." The American Journal of Sports Medicine. 1991;19(5):513-8
26. ^ Rudolph KS, Axe MJ, Snyder-Mackler L. "Dynamic stability after ACL injury: Who can hop?" Knee Surgery, Sports Traumatology, Arthoscopy: Official Journal of the ESSKA. 2000;8(5):262-9.
27. ^ Augustsson J, Thomee R, Linden C, Folkesson M, Tranberg R, Karlsson J. "Single-leg hop testing following fatiguing exercise: reliability and biomechanical analysis." Scandinavian Journal of Medicine and Science in Sports. 2006;16(2):111-20.
28. ^ Logerstedt D, Grindem H, Lynch A, Eitzen I, Engebretsen L, Risbger MA, et al. "Single-legged hop tests as predictors of self-reported knee function after anterior cruciate ligament reconstruction: The Delaware-Oslo ACL cohort study." The American Journal of Sports Medicine. 2012;40(10)"2348-56.
29. ^ Briem K, Axe MJ, Snyder-Mackler L. "Medial knee joint loading increases in those who respond to hyaluronan injection for medial knee osteoarthritis." Journal of orthopaedic research: Official publication of the Orthopaedic Research Society. 2009;27(11):1420-5.
30. ^ Barber SD, Noyes FR, Mangine RE, McCloskey JW, Hartman W."Quantitative assessment of functional limitations in normal and anterior cruciate ligament-deficient knees." Clinical Orthopaedics and Related Research. 1990;255:204-14
31. ^ Augustsson J, Thomee R, Linden C, Folkesson M, Tranberg R, Karlsson J. "Single-leg hop testing following fatiguing exercise: reliability and biomechanical analysis." Scandinavian Journal of Medicine and Science in Sports. 2006;16(2):111-20.
32. ^ Logerstedt D, Grindem H, Lynch A, Eitzen I, Engebretsen L, Risbger MA, et al. "Single-legged hop tests as predictors of self-reported knee function after anterior cruciate ligament reconstruction: The Delaware-Oslo ACL cohort study." The American Journal of Sports Medicine. 2012;40(10)"2348-56.
33. ^ Gustavsson A, Neeter C, Thomee P, Silbernagel KG, Augustsson J, Thomee R, et al. "A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction." Knee Surgery, Sports Traumatology, Arthoscopy: Official Journal of the ESSKA. 2006;14(8):778-88.
34. ^ Grindem H, Logerstedt D, Eitzen I, Moksnes H, Axe MJ, Snyder-Mackler L, et al. "Single-legged hop tests as predictors of self-reports knee function in non-operatively treated individuals with anterior cruciate ligament injury." The American Journal of Sports Medicine. 2011;39(11):2347-54.
35. ^ Bizzini M, Hancock D, Impellizzeri F. "Suggestions from the field for return to sports participation following anterior cruciate ligament reconstruction: Soccer." The Journal of orthopaedic and sports physical therapy. 2012;42(4):304-12.
36. ^ Myer GD, Paterno MV, Ford KR, Hewett TE. "Neuromuscular training techniques to target deficits before return to sport after anterior cruciate ligament reconstruction." Journal of strength and conditioning research/National Strength & Conditioning Association. 2008;22(3):987-1014.
37. ^ 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.