assessment | PT Jess

Tags

assessment, FMS, function, Functional Movement Systems, golf, Gray Cook, physical therapy, SFMA, TPI

This movement assessment tool has changed my whole outlook of looking at the deficits in my patients and athletes. The Functionl Movement Screen (FMS) was developed by Gray Cook, PT and Kyle Kisel PT and endorsed by Titleist Performance Institute front runners Greg Rose, DC and Mike Voight, PT. The team got together and developed the the Selective Functional Movement Screen (SFMA) for healthcare professionals to use in guiding treatment of injuries. The reason I like these tools so much is because they ma

kes sense. In Physical Therapy school you are taught to look for the source of pain and treat it. We are also taught to identify corresponding deficits that may be affecting the source of pain. The problem with identification of those findings is that there was no way of making it a scientific process. The SFMA and FMS has been tested on 10’s of thousands of athletes (primarily advanced football players and golfers) and is continuously collecting data for ongoing improvement of the system.

The FMS

Functional movement screen was developed to identify impairments that may lead to injury. This tool is quick and can be performed by coaches, trainers or anybody trained in using it. We will focus on the SFMA in this blog because it is utilized more in Physical Therapy.

The SFMA

Another reason the SFMA is so great is because the baseline tests can be performed quick (<7 min). When you have more time they can be broken out in a systematic format. Each of the base tests below are graded as dysfunctional/non-functional based on if the client can perform the movement and painful/non-painful based on if it causes discomfort. If a test is graded as dysfunctional non-painful, then it can be broken down to help identify the contributing factor that may be linked to the client’s source of pain or limitation that might potentially injure them.

The Base Tests are:

1) Multi-segmental Flexion

2) Multi-segmental Extension

3) Multi-segmental Rotation

4) Single Leg Stance

5) Squatting Pattern

6) Upper Extremity Movement patterns – 4 variations

7) Cervical Movement Patterns – 4 variations

Here is how the SFMA can help identify contributing factors that may be causing pain:

Joe has pain in his right buttock after running 5 miles. Typically, in Physical Therapy, we attempt to bring on the pain in order to make sure we are treating the structure at fault. We can hypothesize that there may be something wrong with his back or gluteal musculature, but when performing our strength test and assessing the spine, everything looks great. In performing the single leg stance test – he fails drastically. With this we can break out the test in order to identify if he might have vestibular dysfunction, hip mobility limitations, weakness in the core/hip muscles, or limited ankle mobility / stability. Although his back seems to be without pathology, we can ensure that we are treating the correct contributing factors that my be affecting his running.

Mobility before Stability

The SFMA does an excellent job guiding you towards the most limited deficit affecting the client. Once we have a list of things to focus on we can begin treatment. Find the deficits affected by joint or muscular limitations (mobility) and emphasize them first. Once the client has enough mobility, or is improving, stabilize the newly acquired motion. Easy, straight forward. You might not think that when you first look at the breakout charts, but eventually after getting the hang of it the clients will get better quicker. They will be less likely to return to Physical Therapy.
Physical Therapists are known for being the experts at functional movement. Sometimes we can get bogged down by taking Range of Motion measurements, testing in isolation the strength of a muscle, or finding a stiff joint. These do not test function. The Base Tests above are functional movements that should be linked to evaluations to optimize physical therapy assessment and outcomes. Thanks to Gray, Kyle, Mike and Greg spreading the knowledge of the SFMA, it WILL eventually be a vital component of most physical therapy practitioners.