In this video Dr. Kelly Brouwer, DPT, of Merz Physical Therapy demonstrates how she assesses movement for each and every one of her patients!
Hi guys! Today we're here to do a selective functional movement assessment test with my good friend Jessica. This test is a way for physical therapists to look at gross movement so we can eventually break it down and help you move better, so that you can feel better. We're going to have Jess go ahead and face to her left I'm going to step out so you guys can see her. With all of our screens we want to make sure we have Jessica set up in a great way. We want her feet together and we definitely want her barefoot.
Our first test, Jess, (she's going to let us know also if she has any pain), I want you to bring your chin down to your chest. Good. What we're looking for is that there's no space between her chin and her chest and that she's not experiencing any pain. Great. Alright test number two. We'll have you stay right there. Jess, I want you to look up as far as you can towards the ceiling. Good! On this test, go ahead and try that again, we want to see her get to about 80 or 90 degrees in her neck, meaning that her face is almost flat when she gets to the top, and a nice c-curve through the back of her neck. Great! Jess let's have you turn and face forward, feet together and touching. Now, Jess let's have you turn just your head as far as you can towards your right. Good. We're looking to see her chin get to her clavicle-the midline or the center of her collarbone. Let's have you go the other way and back to the middle. Let's have you do that again from the side. Alright Jess let's go left first, alright. We're looking for her chin to sit right over her collarbone. And back to the middle, alright. And then same thing to the right, looking for that chin to center over that collarbone. Alright go ahead and back to the middle Jess. With all those patterns we want to make sure they're pain-free, and we're also looking at symmetry. We want to see that the right side is completely equal to the left side.
Alright let's go into some upper body patterns. Jess let's have you turn all the way around so you're facing backwards. Again, feet together and touching. Let's have you take your right hand, reach behind your head, and touch your opposite shoulder blade. Good. We're looking to see that her hand touches that bony prominence, the boniest part in the back of the shoulder blade. Go ahead and come back down and then same thing on the left side. Good. We can see that she has a slight symmetry difference. She can reach a little farther with that left side. Go ahead and come back down. You can stay in that same position. Let's take the right arm and I'm going to have you reach it up behind your back, touching the bottom of your shoulder blade. And back down. And we're going to watch that one a few times because as Jess does it we're going to watch her right shoulder blade. We don't want to see the shoulder blade rotating forward. We want to see it stay nice and still, which you can tell she's having a little bit of trouble with. Alright let's try the left side Jess. Same thing, touch the right shoulder blade. And back down. Alright go ahead and give that a few more repetitions. Same thing, we can see she kind of picks up that left side a little bit to clear that shoulder. Good.
Alright Jess let's have you turn all the way around to the front. We're going to go into our trunk patterns now. So feet together and touching. Our first pattern, we're going to have Jess keeping her knees straight we'll have you try and touch your toes without bending your knees. Good. And back up. We're looking for the fingertips to touch the ground, go ahead and try that again, which she can easily do but let's have her turn to her left and we're going to watch that pattern again. Jess, go ahead. Touch your toes, if you can, keep those knees straight. We're looking to see her hips get behind her heels, keep going there Jess, and we're looking to see a nice c-curve through her spine. So Jess has just a little bit of trouble with that, you don’t have a totally uniform c-curve quite yet. Alright let's have you turn and face back to the front. Our next pattern is going to be an extension pattern so we're going to have her just raise her arms above her head. Now, let's actually have you turn to the left again. When you're running someone through this test, if they can't get their arms overhead it's actually an automatic fail. Jess does pretty dang well. We want to see those hands centered right over the top of the shoulders. From here, we're going to have Jess bend backwards as far as she can. Go for it Jess. Good. And come back up. Go ahead and try a few more reps there. With this test, we want to see the front of her hips clear over her toes, past her toes, we want to see her shoulder blades pass the back of her heels. Good. We also want to see a nice c-curve in the back. Try a couple more there Jess. Which she, she has a little bit of a hinge, but she has lots of motion. Alright, go ahead and bring those arms back down.
We're going to go into a rotational test now. Jess let’s have you turn and face opposite the camera, again feet together and touching. Alright, let's have you, moving everything but your feet and we want to keep your knees locked out, turn as far as you can over that right shoulder. Good. And then come back. Let's try that a few times. We want to see her whole body moving together uniform, and we want to see that left shoulder as she turns around. We want to see that left shoulder clear her body, which we can see. Go ahead and try a few more reps Jess. But Jess gets a lot of extension in her back, meaning a lot of sway back or back bending, so she does have a movement compensation with that one. Alright Jess let's try the other direction, going to the left. Go ahead and turn and back, and turn. And we can see she clears that right shoulder but just barely we're not totally uniform, and there we'd mark her as having an asymmetry. Good. Alright Jess let's have you turn all the way around.
Now we're going to go into a balance test. So let's have you stand shoulder-width apart, comfortable. Starting with your right leg, let's have you lift your leg so your knee is at the height of your hip. And we're going to have her balance here for 10 seconds. During this test we can see a little bit of foot wiggle, that's called an ankle strategy. It's a really good strategy to see. We don't want to see her standing hip drop, we don't want to see her tilting side to side, we want to see her shoulders stay nice and even, and she's doing a nice job with this one. Alright let's have you go ahead and switch, try the other side. Good. Same thing, want that hip to stay up. She's just using that foot to help her balance a little bit, but we don't see any big movement. Good. Go ahead and bring that back down Jess. Alright. For our last test, we're going to run Jess through a deep squat. Let's have you do it to the camera facing first. So we're going to have her set up so her second toe is straight forward on both feet. We're really picky with this one. About shoulder-width apart. We're going to have her bring her arms in front and her cue is reach forward as you sit back and down, as close as you can to the floor. You want to bring your butt down to the ground. Good, and back up. Keep going, give us a few reps there Jess. What we're looking for here is that her feet stay straight forward, we're not seeing any turnout through the foot, we're not seeing any dropping in or, kind of, a kissing of the knees. Try a few more reps. She does a pretty good job, I see a little bit of turnout on that right foot but, overall, pretty good. Alright Jess let's have you turn and face to the left, same set up. We're going to watch her from the side this time. Same thing, we're going to have her reach forward sit back and back up. And we want to make sure she resets between each rep so we have uniformity in our testing. Good! And back down. You can see Jess clears her hips below her knees which is a trademark of this one. Her back stays pretty nice and uniform. She's got a little bit of pelvic rotation, as you see when she comes up and down, you can see that low back position changes but we don't get too picky about that. And back up. Great.
Well Jess thank you so much for letting me run you through the SFMA! This is Kelly Brouwer reminding you to Move Well to Live Well.