• Author / Uploaded
• Stuart Meints

• Categories
• Términos anatómicos de movimiento
• Columna vertebral
• Hombro
• Cadera
• Sistema musculoesquelético

Citation preview

SCORE SHEET AND FLOWCHARTS

Scoresheets and Flowcharts

Web: FunctionalMovement.com | Phone: (434) 432-3677 | Email: [email protected] This manual is protected by copyright, 2011 by SFMA, LLC. All rights reserved. Reproduction of this manual or any part thereof without prior written consent from SFMA, LLC is strictly prohibited.

- 33 -

THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT FN

SFMA SCORING Active Cervical Flexion

Active Cervical Extension

Cervical Rotation

Upper Extremity Pattern 1(MRE)

Upper Extremity Pattern 2 (LRF)

/ 5 L R L R

Multi-Segmental Flexion

Multi-Segmental Extension

Multi-Segmental Rotation

Single-Leg Stance

Overhead Deep Squat

SFMA Certification - Ver 16

L R L R

FP

DP

DN

- 34 -

THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT !



 











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SFMA Certification - Ver 16

- 53 -

CERVICAL SPINE PATTERN BREAKOUTS Limited Cervical Spine Patterns Active Supine Cervical Flexion Test (Chin to Chest) DN, DP or FP

FN

Passive Supine Cervical Flexion Test FN

There is a Postural SMCD affecting Cervical Flexion. This includes Cervical Spine, Thoracic Spine and Shoulder Girdle postural dysfunction.

DN, DP or FP

Active Cervical Spine Flexion SMCD

Active Supine OA Cervical Flexion Test (20Ý) FN Bilateral

DP or FP

DN

If Passive Supine Cervical Flexion (PSCF) was DP or DN then treat as Cervical Spine Flexion JMD &/or TED. If PSCF was FP can also be SMCD - perform segmental testing and soft tissue appraisal.

OA Flexion JMD &/or TED &/or possible Cervical Spine Flexion JMD &/or TED

Active Supine Cervical Rotation Test (80Ý) FN

DN, DP or FP

There is a Postural SMCD affecting Cervical Rotation. This includes Cervical Spine, Thoracic Spine and Shoulder Girdle postural dysfunction.

Supine Cervical Extension DN

FP or DP

FN Active Cervical Spine Rotation SMCD

DN, DP or FP

C1-C2 Cervical Rotation Test (40°) FN

FP or DP

DN

FN

Cervical There is Postural &/ Extension JMD or SMCD affecting &/or TED Cervical Extension. SFMA Certification - Ver 16

SFMA Certification - Ver 15

Passive Supine Cervical Rotation Test (80°)

If Passive Supine Cervical Rotation (PSCR) was DP or DN then treat as Lower Cervical Rotational JMD &/or TED. If PSCR was FP can also be SMCD - perform segmental testing and soft tissue appraisal.

C1-C2 JMD &/or TED &/or possible Lower Cervical Spine JMD &/or TED.

- 64 -

UPPER EXTREMITY PATTERN BREAKOUTS Limited Upper Extremity Pattern One Active Prone Upper Extremity Pattern One (IR)

Active Prone Elbow Flexion Test (Ext.)

DN, DP or FP

DN, DP or FP

Passive Prone Upper Extremity Pattern One (IR) DN, DP or FP

DN, DP or FP

Passive Prone Shoulder IR Test (60° &/or Total Arc of 150°) FN

DN

DP or FP

Shoulder IR SMCD

Shoulder IR JMD or TED

Treat Chemical Pain

Active Prone Shoulder Extension Test (50°) DN, DP or FP

FN

Passive Prone Shoulder Extension Test (50°) FN

DN

Shoulder Extension SMCD

Shlder Extension JMD or TED

SFMA Certification - Ver 16 SFMA Certification - Ver 15

FN

Passive Prone Elbow Flexion Test (Ext.)

FN

Active Prone Shoulder 90/90 IR Test (60° &/or Total Arc of 150°) FN

FN

DP or FP Treat Chem Pain

FN

DP or FP

DN

Elbow Flexion SMCD

Treat Pain

Elbow Flexion JMD or TED

Active Lumbar Locked (CH) Extension/Rotation Test (50°) DN, DP or FP

FN

Passive Lumbar Locked (CH) Extension/Rotation Test (50° (50°)) If no previous Orange Boxes consider this a Postural &/ or Shoulder Girdle SMCD. Otherwise treat orange boxes first.

FN

DP or FP

DN

Treat Pain

Thorax Extension/ Rotation JMD or TED

Thorax &/or Shoulder Girdle SMCD

- 65 -

UPPER EXTREMITY PATTERN BREAKOUTS Limited Upper Extremity Pattern Two Active Prone Upper Extremity Pattern Two (ER)

Active Prone Elbow Flexion Test (Flex)

DN, DP or FP

DN, DP or FP

Passive Prone Upper Extremity Pattern Two (ER) DN, DP or FP

DN, DP or FP

Passive Prone Shoulder ER Test (90° &/or Total Arc of 150°) FN

DN

DP or FP

Shoulder ER SMCD

Shoulder ER JMD or TED

Treat Chemical Pain

Active Prone Shoulder Flexion/ Abduction Test (170°) DN, DP or FP

FN

Passive Prone Shoulder Flexion/ Abduction Test (170°) FN

DN

Shoulder Flexion/ Shoulder Flexion/ Abduction SMCD Abducction JMD or TED

SFMA Certification - Ver 16 SFMA Certification - Ver 15

FN

Passive Prone Elbow Flexion Test (Flex)

FN

Prone Shoulder 90/90 ER Test (90° &/or Total Arc of 150°) FN

FN

DP or FP Treat Chem Pain

FN

DP or FP

DN

Elbow Flexion SMCD

Treat Pain

Elbow Flexion JMD or TED

Active Lumbar Locked (CH) Extension/Rotation Test (50°) FN

DN, DP or FP

Passive Lumbar Locked (CH) Extension/Rotation Test (50°) If no previous Orange Boxes consider this a Postural &/ or Shoulder Girdle SMCD. Otherwise treat orange boxes first.

FN

DP or FP

Treat Pain

Thorax &/or Shoulder Girdle SMCD

DN

Thorax Extension/ Rotation JMD or TED

- 87 -

MULTI-SEGMENTAL FLEXION BREAKOUTS Limited Multi-Segmental Flexion Single Leg Forward Bend Bilateral DN, DP or FP

FN

Unilateral DN, DP or FP

Long Sitting Test 0

FN (80 Sacral Angle)

DN, DP or FP

Active SLR Test (70°)

Weight-Bearing Hip Flexion pattern SMCD

0

FN

DN, DP or FP(80

DN, DP or FP

Core SMCD &/or Active Hip Flexion SMCD

Prone Rocking Test FN If no previous mobility findings consider this a Weight-bearing Spine &/or Hip SMCD - otherwise treat orange boxes first.

SFMA Certification - Ver 15 SFMA Certification - Ver 16

FP or DP

Supine Knee to Chest Test DN

FN

FP or DP

DN

Spinal Flexion SLR Hip Flexion Treat JMD &/or TED TED or if PSLR Hip JMD &/ Chemical was FP could or Posterior Pain in be Active Hip Chain TED Hip Flexion SMCD

- 101 -

MULTI-SEGMENTAL EXTENSION BREAKOUTS Spine Extension Flowchart Backward Bend w/o UE DN, DP or FP

FN

Go to UB Extension Flowchart

Single Leg BB DN, DP or FP

FN

Press Up

Symmetrical Stance Core SMCD or Anterior Torso TED. TED. Go to UB Extension Flowchart

Weight-bearing Spine Extension SMCD. Go to Lower & Upper Body Extension Flowcharts

FN

DN, DP or FP (>1 Airex Pad)

Active Lumbar Locked (IR) Extension/Rotation Test(50°) FN

DN, DP or FP

Passive Lumbar Locked (IR) Extension/Rotation Test(50°) FP or DP

DN

FN Thorax Extension/ Rotation SMCD

Treat Pain - Go to Lower Body Extension Flowchart

Thorax Extension/Rotataion JMD &/ or TED - Go to Lower Body Extension Flowchart

Active Prone on Elbow Extension/Rotation Test (30°) DN, DP or FP

FN

If Thorax has SMCD assume L-Spine is normal. normal.

Passive Prone on Elbow Extension/Rotation Test(30°) FP or DP

DN

FN

Lumbar Extension/ Treat Pain - Go Rotation JMD &/or to Lower Body then Upper TED - Go to Lower Body Extension Body then Upper Body Flowchart Extension Flowchart SFMA Certification - Ver 16

SFMA Certification - Ver 15

Lumbar Spine Extension/ Rotation SMCD or Anterior Torso TED TED-- Go to Lower Body then Upper Body Extension Ext ension Flowchart

- 102 -

MULTI-SEGMENTAL EXTENSION BREAKOUTS Lower Body Extension Flowchart FABER Test FN

DN, DP or FP

Stabilized FABER Test FN

DN, DP or FP

Hip/Core SMCD

Hip/SI JMD &/or TED - Perform Local Biomechanical Testing of the Hip and SI.

Modified Thomas Test FN with Knee Straight

Lower Anterior Chain TED

FN with Hip Abducted & FN with Knee Straight Hip Abducted

Lower Lateral Chain TED

Lower Anterior and Lateral Chain TED

DN

DP/FP

FN

If FABER was DN, DP or FP Hip Extension JMD &/or then stop and TED and/or Core SMCD. SMCD. treat FABER

Prone Active Hip Extension Test (10°) DN, DP or FP

FN (> or = 10 degrees Extension)

Prone Passive Hip Extension Test (10°) If Spine Extension was dysfunctional consider Hip normal. If not - there is a Weightbearing Hip Extension SMCD &/or Limited Ankle Dorsiflexion (Refer to ODS & SLS).

SFMA SFMA Certification Certification -- Ver Ver 16 15

DN

Hip Extension JMD &/or TED

FP or DP

FN Core SMCD &/ or Active Hip Extension SMC SMCD

- 103 -

MULTI-SEGMENTAL EXTENSION BREAKOUTS Upper Body Extension Flowchart Unilateral Shoulder Backward Bend FN

DN, DP or FP

Potential Anterior Torso TED or Cervical Spine involvement - Double Check Cervical Patterns

Supine Lat Stretch Hips Flexed FN

DN, DP or FP

If no previous Hip or Spine extension mobility dysfunctions consider this a Weight-bearing Upper Quarter Extension SMCD - otherwise treat hips and spine first.

Supine Lat Stretch Hips Extended FN

Shoulder Flexion improves but not Full

DN, DP or FP

Posterior/Lateral Chain TED &/or Possible Hip Extension dysfunction - Go to Lower Body Extension Flowchart

Posterior/Lateral Chain TED &/or Possible Hip Extension dysfunction Make sure you also run Lower Body Extension Flowchart

Active Lumbar Locked (ER) Extension/Rotation Test(50°) FN

DN, DP or FP

Shoulder Girdle SMCD

Active Lumbar Locked (IR) Extension/Rotation Test (50°) Passive Lumbar Locked (IR) Extension/Rotation Test (50°) DN

FP or DP

Thorax Extension/ Rotation JMD &/or TED possible Shoulder JMD/TED as well

SFMA Certification - Ver 16 15

DN, DP or FP

FN Thorax Extension/Rotation SMCD &/or possible Shoulder Girdle dysfunction

FN

Shoulder Girdle JMD &/or TED

- 132 -

MULTI-SEGMENTAL ROTATION BREAKOUTS Limited Multi-Segmental Rotation Seated Rotation Test (50°) FN

DN, DP or FP

Go to Hip Rotation Flowchart I

Active Lumbar Locked (ER) Extension/Rotation Test (50°) FN

DN, DP or FP & Switches Sides

DN, DP or FP

Active Lumbar Locked (IR) Extension/Rotation Test (50°) DN, DP or FP

FN

Passive Lumbar Locked (IR) Extension/Rotation Test (50°) Shoulder Girdle Rot. JMD &/or TED

DN

FP or DP

FN

Thorax Extension/ Rotation JMD &/ or TED - Go to Hip Rotation Flowchart I

Treat Pain - Go to Hip Rotation Flowchart I

Thorax Rotation SMCD

Active Prone on Elbow Extension/Rotation Test (30°) FN

DN, DP or FP

Passive Prone on Elbow Extension/ Rotation Test (30°) FP or DP

Treat Pain - Go to Hip Rotation Flowchart I

16 SFMA Certification - Ver 15

DN Lumbar Spine Extension/Rotation JMD &/or TED - Go to Hip Rotation Flowchart I

FN

If Thorax Extension/Rotation SMCD exists lumbar spine is normal. If not consider this a Weight-bearing Spine or Shoulder Girdle Rotation SMCD Go to Hip Rotation Flowchart 1

- 133 -

MULTI-SEGMENTAL ROTATION BREAKOUTS Hip Rotation Flowchart (Part 1) Active Seated External Hip Rotation (40°) (40°) FN (>400))

DN, DP or FP

Passive Seated External Hip Rotation (40°) (40°) FP or DP

DN Hip JMD &/or TED for External Rotation with Hip Flexed

FN

Treat Pain - Go to Hip Rotation Part 2 Flowchart

Active Prone External Hip Rotation (40°) (40°) DN, DP or FP

FN (>400))

Passive Prone External Hip Rotation (40°) (40°) DN

Hip JMD &/ or TED for Extension Rotation with Hip Extended - Go to Hip Rotation 2 Flowchart and Lower-body Extension Breakout

FP or DP

FN

Treat Pain - Go to Hip Rotation 2 Flowchart

If Seated Passive Rotation was DN stop and treat the DN. If not consider this a Weight-bearing or Active External Hip Rotation SMCD - Go to Hip Rotation 2 Rotation Flowchart.

16 SFMA Certification - Ver 15

If Seated Passive Rotation was DN stop and treat the DN. If no previous signs of hip rotation dysfunction consider the hips normal and go to Tibial Rotation Flowchart. If not consider this a Weightbearing or Active External Hip Rotation SMCD - Go to Hip Rotation 2 Flowchart.

- 134 -

MULTI-SEGMENTAL ROTATION BREAKOUTS Hip Rotation Flowchart (Part 2) Active Seated Internal Hip Rotation (30°) (30°) FN (>300))

DN, DP or FP

Passive Seated Internal Hip Rotation (30°) (30°) FP or DP

DN Hip JMD &/or TED for Medial Rotation with Hip Flexed

FN

Treat Pain Go to Tibia Rotation Flowchart

Active Prone Internal Hip Rotation (30°) (30°) DN, DP or FP

FN (>300))

Passive Prone Internal Hip Rotation (30°) (30°) DN Hip JMD &/or TED for Medial Rotation with Hip Extended - Go to Tibial Rotation Flowchart and Lower-body Extension Breakout

FP or DP Treat Pain Go to Tibia Rotation Flowchart

SFMA Certification Certification -- Ver Ver 16 15 SFMA

FN

If Seated Passive Rotation was DN stop and treat the DN. If not consider this a Weightbearing or Active Internal Hip Rotation SMCD - Go to Tibial Rotation Flowchart.

If Seated Passive Rotation was DN stop and treat the DN. If no previous signs of hip rotation dysfunction consider the hips normal and go to Tibial Rotation Flowchart. If not, consider this a Weightbearing or Active Internal Hip Rotation SMCD - Go to Tibial Rotation Flowchart.

- 135 -

MULTI-SEGMENTAL ROTATION BREAKOUTS Tibial Rotation Flowchart Active Seated Internal Tibial Rotation (20°) (20°) FN

DN, DP or FP

Passive Seated Internal Tibial Rotation (20°) (20°) DP or FP

FN

DN

Tibial Internal Rotation SMCD

Tibial Internal Rotation TED &/or JMD

Active Seated External Tibial Rotation (20°) (20°) FN

Tibia External Rotation Mobility is Normal (If no previous Rotation findings Go to Lower-body Extension Flowchart)

DN, DP or FP

Passive Seated External Tibial Rotation (20°) (20°) FN

DP or FP

Tibial Extenal Rotation SMCD

SFMA Certification - Ver 15 16

DN

Tibial External Rotation TED &/ or JMD

- 157 -

SINGLE-LEG STANCE BREAKOUTS Vestibular & Core Flowchart Vestibular Test - CTSIB (Static Head) DN, DP or FP Potential Static Vestibular Dysfunction

FN

CTSIB (Dynamic Head Movement) FN

Half-Kneeling Narrow Base Test

Dysfunctional Dynamic Vestibular Dysfunction

DN, DP, or FP

FN

Go to SLS Ankle Flowchart

Quadruped Diagonals Test FN

Weight-bearing Spine &/or Core SMCD - (If Hip Extension is DN treat it first). Go to SLS Ankle Flowchart.

SFMA Certification - Ver 15 SFMA Certification - Ver 16

DP or FP

Treat Pain - Go to SLS Ankle Flowchart.

DN

Weight-bearing Hip &/or Core SMCD (If Hip Extension &/or Shoulder Flexion are DN treat those first) Go to SLS Ankle Flowchart.

- 158 -

SINGLE-LEG STANCE BREAKOUTS Ankle Flowchart Heel Walk Test FN

DN, DP or FP

Passive Prone Dorsiflexion Test DP or FP

FN

DN

Treat Pain

Dorsiflexion SMCD

Dorsiflexion TED &/or JMD

Toe Walk Test DN, DP or FP

FN

Passive Prone Plantarflexion Test FN

DN

DP or FP

Plantarflexion SMCD

Plantarflexion TED &/or JMD

Treat Pain

Active Seated Ankle Inversion/Eversion Test FN

DN, DP or FP

Passive Ankle Inversion/Eversion Test DN

DP or FP

Ankle (Eversion or Inversion) JMD, TED * Perform local foot/ ankle exam

15 SFMA Certification - Ver 16

FN Ankle (Eversion or Inversion) SMCD - * Perform local foot/ankle exam

If no Red, Orange or Positive Blue Boxes so far = Proprioceptive Deficit

- 173 -

OVERHEAD DEEP SQUATTING PATTERN BREAKOUTS Limited Overhead Deep Squat Deep Squat DN, DP or FP

If Squat is now FN - Go to MultiSegmental Extension Breakout.

Half-Kneeling Dorsiflexion Test FP or DP

DN

FN

Dorsiflexion TED &/Or Ankle JMD

Treat Pain

Supine Knees to Chest Holding Shins Test

DN, DP or FP

FN w/ DP or FP Dorsiflexion

FN w/ DN Dorsiflexion

Treat Dorsiflexion Chemical Pain

Treat Dorsiflexion Consider Knee & Hip Flexion Normal

Supine Knees to Chest Holding Thighs Test

FN

Knee Flexion JMD &/or TED

FP or DP

Treat Chemical Pain

SFMA SFMA Certification Certification -- Ver Ver 15 16

DN

Hip Flexion JMD &/or TED, but still can have Knee Flexion JMD

FN w/ FN Dorsiflexion

Assisted Squat Test

FN

DN

DP or FP

Weight-bearing Ankle, Knee Treat Weightand/or Hip/Core Chemical bearing Ankle, Flexion SMCD Pain in Hip, Knee and/ &/or Normal Knee or or Hip/Core Anatomical Ankle Flexion SMCD Variances. Go to MSE Breakouts