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)
The LESS is a valid and reliable tool for the biomechanical assessment of the jump landing technique. 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. 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, the effect of fatigue and differences between gender allow for more precise clinical exercise intervention to reduce the risk of injury.

Functional Movement Screen (FMS)
The FMS test was designed by Gray Cook, Lee Bourton, and Barbara Hoogenboom in 2006.

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. 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.

The FMS tests can be a very useful tool to explore functional asymmetries of the musculoskeletal system and postural stability deficits.

Romberg Test
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. 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
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.

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). If this occurs, it is appropriate to consult a physiotherapist or specialist for possible additional evaluations.

Unsupported single leg squat
The single leg squat is an exercise that was developed into a functional test by Liebenson to examine the biomechanics of the lower extremity, assess hip muscle dysfunction and provide an indication of mechanics during daily functional tasks. 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. 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
Single leg hop tests are commonly used to assess functional knee performance by assessing limb symmetry after an anterior cruciate ligament injury    or following anterior cruciate ligament reconstruction. 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). 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.