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Movement Screens as a Biofeedback in
Motor Learning.

 

As clients come through your clinic, with either acute or chronic injury, the primary objectives are to alleviate the pain and try to stop it returning. But we can’t control how the client moves when they are out in their daily activity, undoing much of our hard work. Assessments for pain and alignment give us a great view on what might be causing the problem but they don’t show us completely how the person moves. This is where Movement Screening comes in.


Movement Screening was popularised by an American Physiotherapist called Gray Cook in his book ‘Athletic Body in Balance’ in early 2000 as a way to test clients. This screening method shows up the unique ways in which a client adjusts for restrictions throughout their body and where hyper-mobility is increased. Screens like the Crucifix Overhead Stretch challenge the shoulder girdle in external rotation with upward scapula rotation, to show how the client may increase lumbar lordosis or forward head carriage in order to achieve the task. Whilst it is not an everyday movement the screen does show up how stable the client is through overhead tasks such as changing a light bulb, or putting groceries in a high cupboard for example.

 

crucufix screen


Movement Screens therefore become a very useful tool to the Functional Exercise professional. We tend not to work with clients in the acute phase of injury like Osteopaths and Chiropractors but instead take over client rehabilitation when the client is upright and stable or in a more chronic phase. The screen then shows us where to improve both their flexibility and motor control. It also works as a great biofeedback to the client which, as we are all aware, is useful for long-term improvement. Biofeedback allows rapid improvement in motor learning because the client is engaged with the limitations of their body. Functional Exercises can then be used to learn subtle ways of controlling those movements in a safe and effective manner.


Try the Crucifix Overhead Stretch for yourself and see how well you perform. Here’s how:


1. Stand with your feet one foot’s length away from a wall.


2. Bend your knees a little and rest yourself back against the wall so your glutes, inter-scapula region and occiput are all touching the wall with even but not excessive pressure. You should be able to just slide your fingers between the wall and your lumbar spine to make sure you are in spinal neutral.


3. Abduct your arms to 90 degrees and flex your elbows also to 90 degrees. Shoulders, elbows and dorsal surface of your forearms and hands should all touch the wall evenly.


5. Now check to see if your low back has arched or your head has come off the wall (or your neck has extended so you are now resting above the occiput). If so you’ve failed the test!


6. If you are still comfortable, can you reach your arms up above the head keeping elbows and forearms in good contact with the wall? Stop where you feel restricted and notice what you have done at the spine to push as far as you have.


7. If you failed the screen, have someone hold your pelvis level for you to keep a neutral spine. If this improves your shoulder range you have poor motor control of your pelvis, which is affecting your shoulder ROM. If you have no change, or shoulder ROM gets worse, then your shoulder restriction is affecting your spinal stabilisation putting you at risk of shear force injury.


Conclusion


Having a client return to full function requires several elements in the rehabilitation process. Once they’re through the initial pain stage and have been able to regain much of the their original movement it makes sense to continue progressing their function. By moving on to learning how their body moves, the client learns tools that will reduce incidence of pain in the future. This multi-disciplinary approach stops the client feeling that they’re stuck with a recurrent problem. If you failed the screen yourself then maybe you too can feel more comfortable in your body.

 

 

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