A few weeks ago, I read an article about the need for developing a system for assessing hip rotation ROM in weight-bearing compared to our standard NWB positions. While it is great that researchers are becoming aware of the differences between anatomical ROM and functional ROM, the study has a somewhat limited focus on female golfers. In reality, the importance of these differences apply to all patients, not just athletes.
As we have stated in previous posts, we strongly encourage the type of systematic assessment for mobility that is included in the Selective Functional Movement Assessment (SFMA). The beauty of the evaluation method is that it takes the patient through various levels of required motor control for each combined or single movement. This is an essential concept as it can get to the root of the problem. With our standing tests of combined patterns, mobility, motor control/stability, and postural control are all required. If a dysfunctional movement pattern is found, the patient then is taken into a NWB (or less WB) position, where the test may be performed again. You may be surprised to find your patient's pattern is now fully functional! Should the pattern still be dysfunctional, each pattern can be broken down and tested actively versus passively to determine if mobility or stability/motor control is the primary concern.
Whether you use the SFMA system or another method, assessing movement with various levels of stability is something we should consider with all our patients. Without adequate examination, we may be mistreating the impairments of our patients. Why stretch a hamstring in someone that can't touch their toes if they have 80 degrees of active SLR? By breaking down each level of stability, we can better determine the true source of the patient's limitations.
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