“The Selective Functional Movement Assessment (SFMA)”
The Selective Functional Movement Assessment (SFMA) is a series of 7 full-body movement tests designed to assess fundamental patterns of movement such as bending and squatting in those with known musculoskeletal pain. When the clinical assessment is initiated from the perspective of the movement pattern, the clinician has the opportunity to identify meaningful impairments that may be seemingly unrelated to the main musculoskeletal complaint, but contribute to the associated disability. This concept, known as Regional Interdependence, is the hallmark of the SFMA.
The assessment guides the clinician to the most dysfunctional non-painful movement pattern, which is then assessed in detail. This approach is designed to complement the existing exam and serve as a model to efficiently integrate the concepts of posture, muscle balance and the fundamental patterns of movement into musculoskeletal practice. By addressing the most dysfunctional non-painful pattern, the application of targeted interventions (manual therapy and therapeutic exercise) is not adversely affected by pain.
SFMA offers doctors and physical therapists a new approach to the treatment of pain and dysfunction. Our standardized clinical model ensures isolating the cause of injury and efficient care.
Once Clinical Predictive Rules and diagnosis-specific techniques are exhausted, applying the SFMA model will allow for individualized exercise prescription and progression, which encompasses the concept of regional interdependence. As musculoskeletal system experts, it is essential that healthcare providers understand the relationships between body segments and how impairments in one body region may adversely affect function of another body region. Approaching therapeutic exercise prescription from a movement perspective model allows the concepts of muscle imbalance and regional interdependence to be addressed in a logical, methodical manner.
Modeled after Cyriax's selective tissue testing, each test of the SFMA is scored as functional/non-painful, dysfunctional/non-painful, functional/painful or dysfunctional/painful. The goal for the clinician is to identify the most dysfunctional non-painful movement pattern and break the pattern down to identify the underlying cause of the dysfunction. This includes using traditional muscle length and joint assessment tests which lead to corrective manual therapy and exercise interventions. Emphasis is placed on identifying the most dysfunctional patterns. The model calls for the intervention to be directed only at the non-painful patterns. This ensures that the adverse effects of pain on motor control will not hinder corrective strategies.
Considering Patterns of Movement
Normal movement is achieved through the integration of fundamental movement patterns with an adequate balance of mobility and stability to meet the demands of the task at hand.
The human system will migrate toward predictable patterns of movement in response to pain or in the presence of weakness, tightness, or structural abnormality. Over time, these pain-attenuated movement patterns lead to protective movement and fear of movement, resulting in clinically observed impairments such as decreased ROM, muscle length changes, and declines in strength. An isolated or regional approach to either evaluation or treatment will not restore whole function. Functional restoration requires a working knowledge of functional patterns and a map of dysfunctional patterns to gain clinical perspective and design an effective treatment strategy.
Pain-free functional movement for participation in occupation and lifestyle activities is desirable. Many components comprise pain-free functional movement including adequate posture, ROM, muscle performance, motor control, and balance reactions. Impairments of each component could potentially alter functional movement resulting in or as a consequence of pain. Utilizing the SFMA, the clinician is able to identify key functional movement patterns and describe the critical points of assessment needed to efficiently restore functional movement. This approach is designed to complement the clinician's existing exam and intervention model with the prescription of movement based therapeutic exercise.
The SFMA serves to efficiently integrate the concepts of posture, muscle balance and the fundamental patterns of the movement system into musculoskeletal practice. Additionally, it provides feedback for the effectiveness of the therapeutic exercise program, which targets the dysfunctional movement pattern and related impairments.
The SFMA Certification Course
This course will cover the background, philosophy and evidence related to movement testing and regional interdependence in a lecture format. Then participants will enjoy a demonstration and laboratory sessions covering the full body movement tests and corrective exercise strategies of the SFMA. Participants will be taught the assessment criteria and ample lab time will be given to ensure the participants are comfortable integrating the tests immediately into their clinical practice. This course is designed for the healthcare provider who routinely treats patients with musculoskeletal conditions.
Understand the importance of identifying dysfunctional movement patterns
Understand the importance of pain provocation during the examination process and that pain adversely affects motor control.
Immediately apply information gained from the SFMA to select key impairments to address and design appropriate interventions to normalize dysfunctional movement.
Describe the importance of assessing movement patterns in both the loaded and unloaded positions and how this information can be used to guide intervention.
Link the assessment information to the initial therapeutic strategy and initiate the most appropriate treatment interventions (manual therapy and functional exercise) into the traditional rehabilitation program to normalize dysfunctional movement
Click here for information on the Advanced Workshop and Functional Movement Systems certification process.
The SFMA was presented at two conferences in 2009!
Gray Cook gave a keynote address at the 3rd Annual Conference on Movement Dysfunction in Scotland http://www.kcmacp09.com/
Kyle Kiesel and Gray Cook conducted a Pre-Conference seminar on the FMS and SFMA.
Click here to view the Keynote Address in Scotland.
Kyle Kiesel and Phil Plisky conducted a pre-conference seminar at the 2009 Annual Conference of the American Academy of Orthopaedic and Manual Physical Therapists in Washington DC.
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