Subjective eval
Hx location type intensity irritability of symtpoms special regional questions
Posture eval
- Saliba classifications
- Postural relationship of movement segments - mechanical stress points
- Vertical alignment: VCT, EFT. Functional vs structural compensations
- rotations and asymmetries
Soft tissues eval
FM1
- symmetries
- contours, bands, constrictions
- patterns of sofft tissue changes
3D proportions
Judith Aston
Length, width, depth
Movement eval
Physiological: Flex, ext, SB, rot Combined mvmts: sheard, quadrants Hands and knees FMPs Functional activities
Strength eval
MMT
Isokinetic testing
LPM and balancing reactions
PNF
Palpation eval
Play, tone, functional excursion
- Passive palpation - end feel, excursion, recoil
- Motion - folding lengthening
- FMP
- Resisted PNF patterns
Functional Movement Pattern defined
Any movement or combo of motions that can be used to evaluate function, functional capacity, integration of movement segments, differentiation of individual segments, sequencing of motion, and /or passive and active ROM.
Treatment of symptoms approach
Treat symptomatic structures.
- Use specific jt and STM to decrease dysfunction of symptomatic structures
- Consider type, location, and irritability
Biomechanical/functional approach
Tx to enhance function.
Goal: find and tx the primary driver
-Movement patterns
-Compare subjective vs objective
Lower Quadrant Evaluation
- Iliac crest height - compare to greater trochanter
- Passive trunk rotation
- VCT
- Leg swing - innominate mobility
- Pelvic shears
- Extension quadrants
- Knee tracking
- C/S rotation
- Shoulder abd ROM
FM tx strategies
- ID mechanical articular/soft tissue hypomobility
- Dynamic localization of restriction (localize!)
- Treatment hand applies localizing sustained pressure to IDed restriction
Sacrolumbar motions
Sacrum’s motion on l/s during motion:
- extension of lumbar motions
- Named in accordance to L5/S1 articulation
Sacroiliac motions
Motion of sacrum in relation to innominates - sacrum is extension of LE, motions named in accordance to LE
-Normal: nutation (nod), counternutation (move back)
Nutation
Nodding
Superior sacrum moves forward
Form closure
Counternutation
Moving backward
Force closure
Iliosacral motions
innominate on sacrum mobility during LE motion
Importance of Coccyx
- Dural anchoring to coccyx
- Pelvic floor muscles tension and slack
- Fascial tension and slack
- Biomechanical impact on surrounding structures
- Impact on viscera
