How does TPM Active deliver improved movement outcomes?
Movement analysis technology for improved movement efficiency:
REPORT ON PROFESSIONAL RUGBY PLAYER
Professional Rugby Player age 20, Fly-half
10 month history of low back pain. Acute onset with clinical signs of stress fracture of L4/5 and confirmation with MRI. Managed with rest, anti-inflammatory/cortisone injections, physiotherapy and general rehab exercise programme. Symptom relief. Cycle of relief with rest and aggravated with running and kicking. Referred by neurosurgeon to movement specialist.
22/08/2017: Activity level: no strength based training. No training except cycling and swimming. Running and kicking aggravated symptoms.
Impression: Potential talent for professional senior rugby career, limited by recurrent back pain aggrevated by running and kicking.
TPM Examining Movement Health to direct retraining
Movement health has been defined as a 'state in which individuals are not only injury free, but possess choice in their movement outcomes' (McNeill & Blandford 2015).
Cognitive movement control assessment was used on the player to evaluate his ability to cognitively control movement at a specific joint or region (site) in a particular plane of movement (direction), under low and high threshold loading during multi-joint tests within sport orientated tasks (Mischiati et al 2015). This testing system identifies uncontrolled movement, defined as 'an inability to cognitively control movement at a specific site and direction while moving elsewhere to benchmark standards' and demonstrates loss of choice of movement (uncontrolled movement), and therefore inefficient movement.
The player was tested with The Foundation Matrix - a battery of cognitive movement control tests, 5 low threshold and 5 high threshold. Low threshold tests explore the control of non-fatiguing alignment and co-ordination skills and high threshold tests assess deficits in movement control during fatiguing strength and speed challenges.
Clinical reasoning links this loss of choice of movement control in this rugby player with the inability to be able to run, kick and play contact sport.
The first test with The Foundation Matrix was on 22/08/2017 - score 32/50 (lower score = better movement efficiency). The report details the site, direction and threshold © of uncontrolled movement and illustrates the detail of the movement inefficiency.
First movement analysis report
Sites and directions of movement inefficiency low threshold are detailed below: report indicates results of algorithm and sorts high risk areas, low risk and assets.
Sites and directions of movement inefficiency high threshold are detailed below
Reasoning for programme design
Initial programme: improving movement efficiency for control, to match aggravation on running an sprint
- Low threshold low back extension
- Low threshold low back rotation
- High threshold low back extension
Followed with a focus on
- Low threshold hip flexion
- HIgh threshold hip flexion
- High threshold low back rotation
Second movement analysis report - for follow up for medical team
The Foundation Matrix was on 18/10/2017 score 21/50
Improvement in Movement Health
Movement efficiency, from the TPM metrics improved from 37% to 60%.
The players low threshold uncontrolled movements improved from 78.9% high risk to 42.1%. See charts below for percentage of high risk areas.
Scores for low threshold assets (no loss of efficiency noted in region) improved from 21.1% to 52.6%. Scores for high threshold uncontrolled movements improved from 50% to 44.4%. Assets under high threshold testing improved from 44.4% to 55.6%. He was rescreened at 8 weeks for a medical review. At this time he completed 6 weeks of retraining as 2 weeks were on leave. We would expect greater improvements for strength and speed (high threshold) at 10 - 12 week for greater physiological adaptations.
Activity levels at 8 weeks: resumed strength and conditioning training in gym, and running sessions for 15 minutes. The players retraining programme will focus further improving movement efficiency guided by the report at 12 weeks.
Comerford M, Mottram, S. (2012) Kinetic Control: The management of uncontrolled movement. Elsevier
McNeill W, Blandford L. (2015) Movement Health; J Bodywork Movement Therapies 19(1):150-159
Mischiati CR, Comerford M. et al. (2015) Intra and inter-rater reliability of screening for movement impairments, Movement control tests from The Foundation Matrix. J Sports Science Medicine 14(2):427-440
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