Measures of Movement Health: Taking movement into account
Measuring outcomes is a fundamental component of the skillset of a range of allied disciplines working within movement focussed environments (Strength & Conditioning (S&C), Physiotherapists, Personal Trainers). With respect to physiotherapy, The American Physical Therapy Association's (APTA) Standards for Tests and Measurements in Physical Therapy Practice states that a measurement is the
“numeral assigned to an object, event, or person, or the class (category) to which an object, event, or person is assigned according to rules.”
The APTA further highlight their importance;
‘agreed measures provide the opportunity to compare interventions against key clinical criteria, such as effectiveness’.
Within the S&C arena, the capturing, processing and interpretation of ‘data’ also inform on effectiveness; albeit the criteria which this is defined will be possess a performance rather than a pain reduction and increased participation slant. These measurements can also aid routes of communication between disciplines, helping to remove the barriers that can prevent successful cohesion between performance and clinical focussed professions.
When teams and professionals can speak the same language, it is the client that ultimately benefits.
Different perspectives on being held to account
The methods by which measures can now be taken is growing; exponentially. With the ability to capture more and more information, through an increasing number of devices and software’s, the clinical and performance environment has been transformed. It can be considered that these tools supply the clinician and coach with the capacity to hold their patients, clients and athletes accountable; they have the means to measure whether improvement is being made. Such a view clearly places ownership within the hands of the patient or client. However, this perspective could easily (and justifiably) be reversed; is this coach, clinician and the intervention their delivering, achieving the desired outcomes of the person? Therefore, the ‘measure’ allows all stakeholders within the clinical or performance ‘project’ to be accountable, facilitating a joint commitment to the cause.
Measures of Movement and Movement Health
For those coaches and clinicians who place value in specific characteristics of their clients’ movement, this accountability must then extend to measures that inform upon these elements of movement. Although many components of movement may be assessed (evaluated/measured), the ability to consciously vary the body’s degrees of freedom during the performance of a movement task has been described as an example of the state of an individual’s Movement Health (Dingenen et al., 2018; McNeill & Blandford, 2015). In a ‘perfect’ state of Movement Health, a person could infinitely vary their patterns of joint co-ordination as they achieve a movement outcome. It is inferred such a state would allow challenges to the movement system to be shared amongst tissues (Blandford et al., 2018); in performance situations, this state would always allow the athlete to always find another way to beat the opposition.
Clearly, this possession of an infinite number of ‘movement options’ is not reality, however, when individuals begin to display a very limited range (perhaps just one) of movement options during the performance of a task, their state of Movement Health would seem to be far from robust; the same tissues are consistently exposed to the same challenge/the athlete only has the one strategy. Connecting the concept of Movement Health to the need for accountability and measurement is a systemised process built around ‘The Performance Matrix’ (TPM) (Mottram & Comerford, 2008).
The Performance Matrix; making Movement Health measurable and accountable
This is a movement assessment tool that supplies coaches, clinicians and their clients with the required information on what movement options have been lost. Therefore, those characteristics of movement that represent compromised Movement Health can found, labelled, and targeted by through specific retraining; the options lost can be restored.
The TPM system also offers a systemised route of movement retraining interventions to achieve this goal; it is not just about testing. Support for the use of TPM can be found within the academic literature; for example, the validity of the system (Raja et al., 2011), the reliability for the system (Mischiati et al., 2015), and it’s use in dealing with injury risk and recurrence in elite sport (Blandford et al., 2016; Mottram et al., 2012). The application of the system’s retraining principles also positively impacts kinematics, muscle activation, pain and function (Worsley et al., 2013).
An excellent example of the TPM system in action can be found here.
This case study illustrates how the system found the lost options and helped restore them over time. Testing and re-testing supplied the measures that allowed both clinician and client to work together on the shared goal; both can be held ‘accountable’ for the programme’s success. The technology helped facilitate this interaction, and this interaction achieved the outcome.
If you want to make the Movement Health of your client measurable and accountable, then contact us and we can set up a TPM demo for you to get a practical understanding of the system.
Blandford, L., Pedersen, C., & Mottram, S. (2016). ‘Above & Beyond Biceps Femoris’. Return to Play: Football Medicine Isokinetic Conference, London, UK.
Dingenen, B., Blandford, L., Comerford, M., Staes, F., & Mottram, S. (2018). The assessment of movement health in clinical practice: A multidimensional perspective. Physical Therapy in Sport.
Mischiati, C. R., Comerford, M., Gosford, E., Swart, J., Ewings, S., Botha, N., ... & Mottram, S. L. (2015). Intra and inter-rater reliability of screening for movement impairments: movement control tests from the foundation matrix. Journal of sports science & medicine, 14(2), 427.
Mottram, S., Barr, A., Roussel, N., Comerford, M., 2012. History of hamstring injuries is associated with poor control of lumbar extension. Football medicine strategies for knee injuries. In: International Conference on Sports Rehabilitation and Traumatology Isokinetic 2012 Conference, Stamford Bridge Stadium, Chelsea FC, London UK.
Mottram, S., & Comerford, M. (2008). A new perspective on risk assessment. Physical Therapy in Sport, 9(1), 40-51.
Raja, H., Comerford, M., Mottram, S., Europeo, M., Barton, C., Rashid, S., & Morrissey, D. (2011). Construct Validity of Four Novel Upper Limb Functional Tests from The Performance Matrix. In Conference poster at UKSEM edn. London: Centre for Sport and Exercise Medicine, Barts and the London School of Medicine and Dentistry.
Worsley, P., Warner, M., Mottram, S., Gadola, S., Veeger, H. E. J., Hermens, H., ... & Stokes, M. (2013). Motor control retraining exercises for shoulder impingement: effects on function, muscle activation, and biomechanics in young adults. Journal of shoulder and elbow surgery, 22(4), e11-e19.
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