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| Testing |
| We offer a wide range of advanced testing
procedures and protocols, in our physical therapy and
wellness programs, which are extraordinarily useful in
helping your therapist to design the best program for
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| Core Stability
Test |
| Why is the core important?
Core Stability is the ability of your trunk to effectively
and efficiently, absorb and transfer the forces from
your limbs to allow normal function in optimal spinal
alignment. Core stability muscles e.g. transversus abdominus
and multifidus are deep-seated abdominal and spinal
muscles. These muscles act as stabilizers of the spine
and create a natural protective corset around your mid
section. Research has shown that individuals with back
pain have a delayed activation of the core in anticipation
of movement. Conversely those without back pain activate
their core muscles in the correct sequence (before stress
in placed on the spine). This is the essential reason
why core training has become such an integral part of
modern back pain treatment.
The Sahrmann Core Stability Test (see
below) is an excellent method for determining and grading
core stability. It is a series of movements that are
performed while maintaining lumbo-pelvic stability in
neutral alignment. The tester will be using a blood
pressure cuff under your back to determine if there
is any movement of the spine by watching for a pressure
change. You can try a rough test at home by placing
your hands under your low back and feeling for any change
in pressure while attempting the stated positions.
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| Functional
Movement Screen (FMS) |
The idea behind the Functional Movement
Screen (FMS) is actually quite simple. An athlete’s
body functions in the optimal way when it is in a state
of balance. ‘Balance’ as we are using the
term, relates to ‘Muscle Balance’ and it
describes the fine line that exists between mobility
and stability in posture and movement patterns. As you
might expect, when an athlete’s musculoskeletal
system is imbalanced (tight hamstrings for example)
athletic performance often suffers. Additionally, recent
research has shown that muscle imbalances can be a factor
in sports injuries. Hip weakness for instance has been
linked to certain knee injuries and core weakness is
known to be associated with back problems.
The seven screens of the FMS allow an experienced practitioner
to evaluate an athlete’s functional movements
and provide an objective score based on this evaluation.
The highest possible score is 3 for each of the seven
screens, so a perfect score would be 21. Each time the
evaluator notices an issue with a screen a point will
be taken off the total score.
The seven screens include the following:
1. Deep Squat
2. Hurdle Step
3. Inline Lunge
4. Shoulder Mobility
5. Active Straight Leg Raise
6. Trunk Stability Push-Up
7. Rotational Stability
Recent research has shown that if a person scores
below a 14 on the FMS, there is an increased risk
of injury (studies were done on NFL football players
and firefighters).
What Your Score Means
If you score ABOVE 14 but have imbalances, a recommendation
is usually made to do certain exercises to address your
asymmetries.
If you score BELOW 14 a recommendation for an improvement
program will probably be made. Depending on the outcome
of the screening, an athlete may be advised to see a
physical therapist for further evaluation or treatment.
If you have pain during any of the screens, it is an
indication of a broader issue, and those who experience
pain are strongly urged to see a physician.
For more information about the Functional Movement Screen
see www.functionalmovement.com.
If you have any questions or would like to schedule
a Functional Movement Screen for yourself, another individual
or a team, please contact Specht Physical Therapy at
508-675-3200.
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| Lifting Assessment |
| The Lifting Assessment consists of
a series of observational and manual tests directed at
analyzing the biomechanical structure and function of
the upper body, lower body and core as it relates to the
specific demands of weight training. Includes:
- Exercise technique analysis
during selected lifting movements.
- Biomechanical and joint integrity
analysis of common injury sites (i.e. back, knee,
shoulder).
- Joint mobility and muscle length tests.
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| Muscle Balance
Assessment (MBA) |
The Muscle Balance Assessment consists
of a series of strength and flexibility tests that are
performed to the upper body, lower body, back and core.
The results of the MBA will indicate dysfunctional patterns
of weakness and or tightness that exist in your body.
Just as important, test results will show what is moving
properly; so unnecessary exercises are not prescribed.
This testing procedure yields a blueprint for your exercise
program and allows your therapist to design a truly
personalized exercise program for you.
Note: The MBA can be modified based
on age and fitness level so that the testing process
is completely safe and appropriate for everyone.
Background of the MBA: Mobility
vs. Stability
To produce the properly orchestrated segmental
movements of any functional movement it is essential
for an athlete to have a balanced body. ‘Balanced’
as we think of it in the fitness and therapy world,
relates to Muscle Balance and it describes the fine
line that exists between mobility and stability in your
posture and movement patterns.
How muscle imbalances can cause
pain
If you are too loose-jointed, or have mobility that
you are unable to control during normal functional movement,
any number of compensations or injuries can result.
On the other hand, if your muscles and joints are stiff
and limiting your ability to move – your muscle
tissue will be unable to sufficiently absorb the forces
of your activities such as running, jumping and twisting.
This will create excess stress on your joints, tendons
and other connective tissues, predisposing you to injury.
Now let’s dig a little deeper to
see how this concept relates to each segment of your
body!
The best way to explain optimal body mechanics
is to discuss the 'Mobility-Stability Pattern’.
This conceptual model explains how the body ideally
works, in an alternating pattern of stable segments
connected by mobile joints. If this pattern of mobile
joints and stable body segments is altered in any way,
dysfunctional movement patterns will occur.
Normal Mobility-Stability Pattern
Foot - Stable
Ankle - Mobile
Knee - Stable
Hip - Mobile
Low Back/Core - Stable
Upper Back - Mobile
Shoulder Blade - Stable
Shoulder - Mobile
Elbow - Stable
Wrist - Mobile
Simply put, when joints needing mobility
are tight, or body segments that require stability are
weak, biomechanical compensations in functional movements
will occur. This is because the body tends to follow
the path of least resistance and we move in whatever
way feels the least restriction, whether or not it is
the correct movement pattern. The best way to know if
your body is adversely affecting your ability to move
efficiently is to have a Muscle Balance Assessment performed
by a physical therapist who understands the Mobility-Stability
Pattern.
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| Plyometric
Hop Tests |
| Plyometric
Hop Tests are a practical way to measure functional
hip, knee, ankle and core stability, balance, neuromuscular
control, strength, power and coordination. The beauty
of these tests lies in their simplicity and the fact that
research
has shown them to be helpful for measuring leg function
in patients who have had ACL reconstruction surgery to
the knee. Clinical experience with these tests has demonstrated
that they are helpful for identifying asymmetry between
right and left lower extremities to help predict future
injury risk. Asymmetry that is greater than 10% between
right and left sides is considered abnormal and should
be addressed with a functional strength and conditioning
program. |
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| Postural Measurements |
| The foundation for good neck and
back care starts with posture. Bad posture can be the
cause of spinal pain, it can make existing pain worse,
and it can certainly make pain from an injury last a lot
longer than it would if you had good posture.
If you have bad posture you probably already
know it. You might feel yourself slouching in standing
or sitting and you may say things like ‘my posture
is awful!’ If you are like many of our patients,
and have tried unsuccessfully to correct your posture,
you know how hard a task this can be. Bad posture can
be corrected, but the first step to a solution is identifying
where your posture has gone wrong. Two useful tests
for measuring the severity and location of postural
deficiency are the Flexicurve Test and Wall Test.
 Craniovertebral
Angle Test
- Craniovertebral angle = the angle between
the horizontal line passing through C7 and a line
extending from the tragus of the ear to C7.
- A smaller craniovertebral angle indicates
a greater forward head posture.
- 50° = average in pain free population.
- <50° = associated with neck
pain, tension headaches, reduced cervical range of
motion and carpal tunnel syndrome.
Flexicurve Test
The Flexicurve Test evaluates
thoracic and lumbar posture with the use of a flexicurve
or flexible ruler. This test is a reliable method of
measuring posture of the upper and lower back and evaluating
postural change over a course of therapy.
Self-test your posture with
The Wall Test:
1. Stand with your back and buttocks
against a wall with your heels six inches from the baseboard
and knees slightly bent. Note: It is normal to have
a small space between the wall and your lower back.
2. Can your head touch the wall without
arching your lower back excessively or straining your
neck?
3. With your head against the wall, use your hand to
check the distance from the wall to:
a. Your lower back
b. The back of your neck
- If you cannot get your head against
the wall without arching your lower back excessively
or straining your neck then you have a significant
forward head posture.
- If you cannot feel any space between
the wall and your lower back (with your buttocks on
the wall) you have a severely ‘kyphotic’
or rounded posture.
- If the space between the wall and
your lower back is within an inch or two and two to
three inches at the neck, your posture is probably
quite good.
- If you pass this test but still have
poor posture in sitting or standing positions then
your problem probably has more to do with core strength
or stability.
- If your posture seems to be deficient
based on the self-test above, you may need professional
assistance to restore the normal curves of your spine.
Contact your doctor or physical therapist for a professional
posture assessment.
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| Research-Based
Balance Tests |
| According to the American Geriatrics
Society, British Geriatrics Society, and American
Academy of Orthopaedic Surgeons Panel on Falls Prevention,
prior to any intervention for balance deficiency, assessment
of an individual’s risks and deficits is required
to determine specific needs. Balance
Tests that are used at Specht PT:
Fullerton
Advanced Balance Scale
For Higher – Functioning Adults
Berg
Balance Test
For Moderate – Functioning Adults
Tinetti
Balance Test
For lower –Functioning Adults
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| Running Assessment |
| The Running Assessment consists of
a series of specialized tests, directed at analyzing the
biomechanical structure and function of the lower body
and core as it relates to the specific demands of distance
running. Includes:
- Gait efficiency analysis during
running and walking.
- Biomechanical analysis of foot, ankle
and knee joint – functional tests in full weight
bearing.
- Joint integrity/mobility testing of
foot, ankle and knee joint – manual testing
in non-weight bearing.
- Manual assessment of soft tissue and
myofascial structures to determine specific areas
of restriction or tightness.
- Muscle length and strength tests.
- Footwear and orthotics assessment.
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Selected
Functional Movement Assessment (SFMA)
www.functionalmovement.com
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The SFMA:
- Is a comprehensive system designed
to capture impaired posture and functional movement
patterns.
- Is an assessment system that provides
an orderly and repeatable clinical process with respect
to functional movement assessment and intervention.
- Is a system that looks at fundamental
movement and the effect of movement on symptoms, pain
and injury.
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Is an evidence-based system to address regional interdependence
- Captures seemingly unrelated impairments
in movement patterns and relates them to the main
musculoskeletal diagnosis that is contributing to
the primary complaint (regional
interdependence).
Background of the SFMA
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 the whole of function.
Functional restoration requires a map of dysfunctional
patterns and a working knowledge of functional patterns
to gain clinical perspective and design an effective
treatment strategy. |
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| Senior Fitness
Test |
The Senior Fitness Test is a research-validated
test that uses the only suite of fitness assessments
specifically designed for the 60+ population. The protocol
features fitness tests that are functional and focused
on the needs and capabilities of the senior population.
By obtaining your test results, our therapists are able
to compare your fitness level with known 'normal values'
for your age group. At the conclusion of testing, you
will be given a report indicating how your fitness level
compares to those from your age group and exercise ideas
to address deficits identified in testing.
The test was developed and scientifically validated
by the Ruby Gerontology Center at California State University
and consists of:
- Chair Stand Test: # of stands from a chair in 30
seconds
- Arm Curl Test: # of curls in 30 seconds, 5 lbs.
for women, 8 lbs. for men
- 6-minute walk test: # of yards walked in 6 minutes
- Back Scratch Test: how far hands can reach behind
back
- 8-ft. Up-and-Go Test: time required to get up from
a chair, walk 8 feet, and return to chair
Please be advised that any form of fitness testing
requires physical activity. If your doctor has restricted
your physical activities for any reason, you will be
required to bring a medical-clearance form, signed by
your doctor to the clinic.
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| Strength Testing
with Dynamometer |
| A dynamometer is a device used in physical
therapy and rehabilitation clinics for measuring muscle
force or strength. Research
done by physical therapists has established normal
strength values that are seen in people aged 20-79. By
measuring muscle strength with the ErgoFet
Dynamometer our therapists are able to compare your
muscle strength with known normal values to assist in
determining the best strategy for your personalized strength
development program. |
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Y-Balance
Test
www.ybalancetest.com
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| Based on the latest research(1) the
Y-Balance Test is a quick and easy way to assess a patient’s
risk for injury. This test can be used for measuring pre
and post rehabilitation functional performance and return
to sport readiness. What
it Does – Predicts Injury Risk
Findings from the Y-Balance Test can be used to determine
when an athlete is ready to safely return to sport participation.
Additionally, this test can identify at-risk athletes,
who can go through appropriate treatment or training
to reduce risk of injury
References:
1. Plisky PJ, Rauh MJ, Kaminski TW, Underwood FB. Star
Excursion Balance Test as a predictor of lower extremity
injury in high school basketball players. J Orthop Sports
Phys Ther. 2006;36(12):911-919. |
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