After completion of this chapter, the physical therapist should be able to do the following:
Explain the benefits of a functional, comprehensive movement screening process versus the traditional impairment-based evaluation approach.
Differentiate between movement, testing, and assessment.
Explain how poor movement patterns and dysfunctional movement strategies can result in injury or reinjury.
Explain the use and components of the Functional Movement Screen and the Selective Functional Movement Assessment.
Describe, score, and interpret the movement patterns of the Functional Movement Screen and the Selective Functional Movement Assessment and how the results from each can have an impact on clinical interventions.
Articulate the difference between movement screening and specific functional performance tests.
Apply specific functional performance test to clinical practice.
Movement is at the core of the human journey. It is foundational to the human experience and allows us to interact with our environment in ways different from other mammals. Movement, which begins in the womb, is the basis of early growth and development. It proceeds in a highly predictable manner in infants and young children and is known as the developmental sequence or traditional motor development. Once an individual reaches a certain age, full integration of reflexive behavior allows the development of purposive, highly developed, and unique mature motor programs. We continue to move functionally throughout a lifetime until the effects of aging alter the normalcy of movement.
Because movement is complex, it must be differentiated from the simpler construct of motion. We believe that many professionals lack a true understanding of movement; they err on the side of quantitative assessment of motion and fail to understand the hierarchic progression from general, fundamental movement patterns to specific, highly specialized movements. These highly specialized movements have complex, fine-tuned motor programs that support their consistency and intricacy. Most rehabilitation and medical professionals have been trained to measure isolated joint motion with goniometers, inclinometers, linear measurements, and ligament laxity tests. These types of motion assessment are not wrong, but rather only a piece of a much bigger puzzle of “movement” and the inherent stability and mobility demands that are part of the synchronous, elegant, coordinated activities that make up activities of daily living, work tasks, and sport maneuvers. Mere motion measurements cannot capture the whole spectrum of human movement or the complexity of human function.
Systems Approach to Movement
The premise of this chapter and the chapter that follows is that impairment-based, highly specialized motion assessment is far too limiting, and predisposes practitioners to errors in professional judgment. It is too narrow an approach, which focuses on small, discrete pieces of an integrated functional task or movement. The alternative of a more functional, comprehensive movement screen is vitally important for understanding human function and identifying impairments and dysfunctional movement patterns that diminish the quality of function. In many cases, weakness or tightness ...