Additional Information
Book Details
Abstract
This text is designed as clinical reference to develop knowledge of the examination, diagnosis and classification of uncontrolled movement (motor control dysfunction) and the management of movement dysfunction.
It will help the therapist:
- Develop clinical skills in the assessment and retraining of movement control
- To use movement control tests to identify uncontrolled movement
- To classify uncontrolled movement into diagnostic subgroups
- Access a large range of motor control and movement retraining strategies
- Develop an assessment framework that will provide a diagnosis of dysfunction, pain sensitive tissues and pain mechanisms
- Use a clinical reasoning framework to prioritise clinical decision making
- Provides detailed explanation of evidence and research underpinning motor control dysfunction and movement retraining
- Unique subclassification system of musculoskeletal disorders and pain
- Region specific testing -step by step instructions for assessment, diagnosis, classification and treatment using Movement Performance Solutions unique system
- Highly illustrated with clear step by step instructions for treatment of Lumbar, Cervical and Thoracic Spine, Shoulder and Hip
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Kinetic Control | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Preface | vii | ||
| Foreword | ix | ||
| Acknowledgements | xi | ||
| Reviewers | xi | ||
| 1 | 1 | ||
| 1 Uncontrolled movement | 3 | ||
| Understanding movement and function | 3 | ||
| Movement faults | 3 | ||
| Identification and classification of UCM | 5 | ||
| Symptoms | 5 | ||
| Disability | 5 | ||
| Dysfunction | 6 | ||
| Recurrence | 6 | ||
| Risk of injury | 6 | ||
| Performance | 7 | ||
| A model for the assessment and retraining of movement faults | 7 | ||
| Alternative therapies | 7 | ||
| The assessment and management of UCM | 9 | ||
| The clinical reasoning process | 10 | ||
| The 10 point analysis and clinical reasoning framework for UCM | 10 | ||
| 1 Classify the site and direction of UCM | 10 | ||
| 2 Relate UCMs to symptoms | 11 | ||
| 3 Relate assessment findings to disability | 11 | ||
| 4 Identify the UCM and restrictions | 11 | ||
| 5 Management plan for UCM and restrictions | 12 | ||
| 6 Relate pain mechanisms to presentation | 13 | ||
| 7 Consideration of tissues or structures contributing to symptoms | 14 | ||
| 8 Assess for environmental and personal factors | 14 | ||
| 9 Integrate other approaches or modalities | 14 | ||
| 10 Consider prognosis | 15 | ||
| Clinical reasoning in a diagnostic framework | 15 | ||
| 1 Diagnosis of movement dysfunction (site and direction of uncontrolled motion) | 16 | ||
| 2 Clinical diagnosis of pain-sensitive or pain-generating structure(s) | 16 | ||
| 3 Clinical diagnosis of presenting pain mechanisms | 16 | ||
| 4 Evaluation and consideration of contextual factors | 16 | ||
| The disablement assessment model | 17 | ||
| References | 19 | ||
| 2 Muscle function and physiology | 23 | ||
| Introduction: MOVEMENT CONTROL | 23 | ||
| Analysis of muscle function | 23 | ||
| Stabiliser and mobiliser function | 23 | ||
| Implications of stabiliser–mobiliser characteristics | 24 | ||
| Local and global function | 24 | ||
| Implications of local and global characteristics | 25 | ||
| Functional efficiency | 26 | ||
| Functional classification of muscle roles | 28 | ||
| Muscle characterisation | 28 | ||
| Muscle function: primary role | 31 | ||
| Single task-specific muscles | 31 | ||
| Multitasking muscles | 31 | ||
| Motor recruitment | 31 | ||
| The motor unit | 31 | ||
| Low versus high threshold recruitment | 32 | ||
| Functional implications of recruitment within stabiliser and mobiliser roles | 34 | ||
| Stabiliser roles and slow motor unit recruitment | 34 | ||
| Mobiliser roles and fast motor unit recruitment | 34 | ||
| Muscle stiffness | 34 | ||
| Low threshold recruitment and timing | 35 | ||
| Pain and recruitment | 36 | ||
| Recruitment dysfunction: inhibition and dysfacilitation | 37 | ||
| Altered strategies in a dysfunctional situation | 37 | ||
| Sensation of effort, afferent input and recruitment | 38 | ||
| The dysfunction loop | 39 | ||
| Muscle recruitment training | 39 | ||
| Low threshold recruitment dominance | 39 | ||
| High threshold recruitment dominance | 40 | ||
| Clinical guideline for recruitment training | 40 | ||
| Retraining low threshold recruitment dominance | 40 | ||
| Retraining high threshold recruitment dominance | 40 | ||
| References | 41 | ||
| 3 Assessment and classification of uncontrolled movement | 43 | ||
| Classification of subgroups in neuromusculoskeletal pain | 43 | ||
| Classification based on movement dysfunction | 44 | ||
| Relative stiffness – relative flexibility | 45 | ||
| Movement control dysfunction | 46 | ||
| Movement impairments | 47 | ||
| Motor control impairments (MCI) | 47 | ||
| Uncontrolled movement (UCM) and pain | 48 | ||
| The development of motion restrictions in function | 48 | ||
| A proposition for the aetiology of UCM | 49 | ||
| Integrated model of mechanical movement dysfunction | 52 | ||
| Principles of assessment of UCM | 53 | ||
| Neutral training region | 53 | ||
| Clinical assessment of UCM | 54 | ||
| Movement control rating system (MCRS) | 54 | ||
| Testing for the site and direction of UCM | 55 | ||
| Example of dissociation in ‘series’ | 55 | ||
| Example of dissociation in ‘parallel’ | 55 | ||
| Indications to test for UCM | 56 | ||
| Movement control test procedure | 57 | ||
| Using the MCRS | 57 | ||
| Rating interpretation | 58 | ||
| References | 60 | ||
| 4 Retraining strategies for uncontrolled movement | 63 | ||
| Rehabilitation management and retraining | 63 | ||
| Management overview | 63 | ||
| Therapeutic exercise | 64 | ||
| The site and direction of UCM | 67 | ||
| Retraining in control of the site and direction of UCM | 67 | ||
| Progression of training the site and direction of UCM | 69 | ||
| Management of symptoms using retraining control of the UCM | 69 | ||
| Key principles in the retraining of motor control patterns | 70 | ||
| Motor unit recruitment | 70 | ||
| Cognitive awareness | 71 | ||
| The effect of posture on retraining | 71 | ||
| Challenges in retraining neuromusculoskeletal dysfunction | 71 | ||
| Integration into functional tasks and activities | 72 | ||
| Personality and behavioural traits for motivation and compliance | 74 | ||
| Red dot functional integration | 75 | ||
| Low load (facilitatory) proprioceptive stimulus | 75 | ||
| Integrative dissociation | 75 | ||
| Other approaches | 75 | ||
| Use of training tools/equipment | 76 | ||
| Manual therapy | 76 | ||
| How long does training take? | 77 | ||
| Movement control retraining | 77 | ||
| Conclusion | 77 | ||
| References | 78 | ||
| 2 | 81 | ||
| 5 The lumbopelvic region | 83 | ||
| Introduction | 83 | ||
| Changes in movement and postural control in the lumbopelvic region | 83 | ||
| Reliability of movement observation | 84 | ||
| Efficacy of treatment to retrain control of lumbopelvic UCM | 84 | ||
| Diagnosis of the site and direction of UCM in the lumbar spine | 85 | ||
| Identifying site and direction of UCM at the lumbar spine | 86 | ||
| Segmental and multi-segmental uncontrolled motion in the sagittal plane | 86 | ||
| Segmental UCM | 86 | ||
| Multisegmental UCM | 87 | ||
| Clinical examples | 87 | ||
| Lumbar extension UCM | 87 | ||
| Lumbar flexion UCM | 88 | ||
| Movement and postural control at the sacroiliac joint (SIJ) and pelvis | 88 | ||
| Identifying UCM at the SIJ and pelvis | 88 | ||
| Testing for UCM – review of principles | 90 | ||
| Lumbopelvic tests for uncontrolled movement | 90 | ||
| Lumbar flexion control | 90 | ||
| Flexion control tests and flexion control rehabilitation | 90 | ||
| Observation and analysis of lumbar flexion and forward bending | 91 | ||
| Description of ideal pattern | 91 | ||
| Movement faults associated with lumbar flexion | 91 | ||
| Relative stiffness (restrictions) | 91 | ||
| Relative flexibility (potential UCM) | 91 | ||
| Indications to test for lumbar flexion UCM | 92 | ||
| Tests of lumbar flexion control | 93 | ||
| T1 Standing: trunk lean test (tests for lumbar flexion UCM) | 93 | ||
| Test procedure | 93 | ||
| Lumbar flexion UCM | 94 | ||
| Rating and diagnosis of lumbar flexion UCM | 94 | ||
| Correction | 94 | ||
| T2 4 point: backward push test (tests for lumbar flexion UCM) | 97 | ||
| Test procedure | 97 | ||
| Lumbar flexion UCM | 98 | ||
| Rating and diagnosis of lumbar flexion UCM | 98 | ||
| Correction | 98 | ||
| T3 Crook: double bent leg lift test (tests for lumbar flexion UCM) | 100 | ||
| Test procedure | 100 | ||
| Lumbar flexion UCM | 101 | ||
| Rating and diagnosis of lumbar flexion UCM | 102 | ||
| Correction | 102 | ||
| Multifidus facilitation | 102 | ||
| Static diagonal: isometric opposite knee to hand push | 102 | ||
| Static diagonal heel lift: isometric knee to hand push + 2nd heel lift | 103 | ||
| Alternate single leg heel touch: (Sahrmann level 1) | 103 | ||
| T4 Sitting: forward lean test (tests for lumbar flexion UCM) | 106 | ||
| Test procedure | 106 | ||
| Lumbar flexion UCM | 106 | ||
| Rating and diagnosis of lumbar flexion UCM | 107 | ||
| Correction | 107 | ||
| T5 Sitting: chest drop test (tests for lumbar flexion UCM) | 109 | ||
| Test procedure | 109 | ||
| Lumbar flexion UCM | 110 | ||
| Rating and diagnosis of lumbar flexion UCM | 110 | ||
| Correction | 110 | ||
| T6 Sitting: double knee extension test (tests for lumbar flexion UCM) | 113 | ||
| Test procedure | 113 | ||
| Lumbar flexion UCM | 113 | ||
| Rating and diagnosis of lumbar flexion UCM | 114 | ||
| Correction | 114 | ||
| T7 Stand to sit: ischial weight bearing test (tests for lumbar flexion UCM) | 116 | ||
| Test procedure | 116 | ||
| Lumbar flexion UCM | 116 | ||
| Rating and diagnosis of lumbar flexion UCM | 117 | ||
| Correction | 117 | ||
| Lumbar flexion UCM summary | 119 | ||
| Tests of lumbar extension control | 120 | ||
| Extension control tests and extension control rehabilitation | 120 | ||
| Observation and analysis of lumbar extension and backward arching | 120 | ||
| Description of ideal pattern | 120 | ||
| Movement faults associated with lumbar extension | 120 | ||
| Relative stiffness (restrictions) | 120 | ||
| Relative flexibility (potential UCM) | 120 | ||
| Indications to test for lumbar extension UCM | 121 | ||
| Extension load testing prerequisites | 121 | ||
| Back flattening on wall – standing (prerequisite) | 122 | ||
| Index | 505 | ||
| A | 505 | ||
| B | 506 | ||
| C | 506 | ||
| D | 508 | ||
| E | 509 | ||
| F | 509 | ||
| G | 511 | ||
| H | 511 | ||
| I | 513 | ||
| K | 514 | ||
| L | 514 | ||
| M | 515 | ||
| N | 517 | ||
| O | 518 | ||
| P | 519 | ||
| R | 520 | ||
| S | 523 | ||
| T | 530 | ||
| U | 531 | ||
| V | 532 | ||
| W | 532 |