- Functional efficiency – The ability of the neuromuscular system to perform functional tasks with the least amount of energy, decreasing stress on the body’s structure.
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- Muscle imbalances – when present generally a muscle associated with a joint will be shortened and the reciprocal muscle will be lengthened. For example many people have shortened pectorals and lengthened muscles in the rear delts causing an imbalance.
- Altered arthrokinematics – Altered joint motion caused by altered length-tension relationships and causes poor movement efficiency. Basically when you have muscle groups that are shorter and longer than they’re supposed to be then they create poor movement patterns.
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- Cumulative Injury Cycle– Poor posture and repetitive movements create dysfunction within the connective tissue of the body. This dysfunction is treated by body as another injury, and as a result, body will initiate repair process termed cumulative injury cycle.
- Relative Flexibility – The tendency of the body to seek the path of least resistance during functional movement patterns. Prime example are people who squat with feet externally rotated, because of tight calf muscles they lack proper dorsiflexion at the ankle to perform squat with proper mechanics. Another example is overhead press with excessive lumbar extension(arched lower back). Individuals who possess tight latissimus dorsi will have decreased sagittal-plane shoulder flexion (inability to lift arms directly overhead), and as a result they compensate for this lack of ROM at shoulder in lumbar spine to allow them to press load completely overhead.
- Pre-assessment information pg. 284 – Just read over it. Very unlikely to be tested over this and it’s common sense information.
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- Postural distortion pattern pg. 286 – Predictable patterns of muscle imbalances.
- Pronation distortion syndrome – postural distortion syndrome characterized by foot pronation(flat feet) and adducted and internally rotated knees(knock knees)
- Lower crossed syndrome – postural distortion syndrome characterized by anterior tilt to the pelvis(arched lower back)
- Upper crossed syndrome – postural distortion syndrome characterized by a forward head and rounded shoulders. Very important to understand and be able to visualize all three distortion patterns – they WILL be tested.
- Static Postural Assessment pg. 289
- One should be checking for neutral alignment, symmetry, balanced muscle tone, and specific postural deformities.
- Kinetic chain checkpoints refer to major joint regions of the body including – Foot and ankle, knee, lumbo-pelvic-hip complex (LPHC), shoulders, head and cervical spine
- Anterior View:
- Foot/ankles – straight and parallel, not flattened or externally rotated
- Knees – In line with toes, not adducted or abducted
- LPHC – Pelvis level with both posterior superior iliac spines in same transverse plane
- Shoulders – Level, not elevated or rounded
- Head – Neutral position, not tilted or rotated
- Lateral View:
- Foot/ankle – Neutral position, leg vertical at right angle to sole of foot
- Knees – Neutral position, not flexed nor hyperextended
- LPHC – Pelvis neutral position, not anteriorly (lumbar extension) or posteriorly (lumbar flexion) rotated
- Shoulders – Normal kyphotic curve, not excessively rounded
- Head – Neutral position, not in excessive extension (jutting forward)
- Posterior View
- Foot/ankle – Heels are straight and parallel, not overly pronated
- Knees – Neutral position, not adducted or abducted
- LPHC – Pelvis is level with both posterior superior iliac spines and in same transverse plane
- Shoulders/scapulae – Level, not elevated or protracted
- Head – Neutral position, neither tilted nor rotated
- Memorize the tables on page 292. Tables 9.4, 9.5, and 9.6. You will see test questions over these. The simplest way is to visualize the distortion, take a forward head tilt for upper crossed syndrome and then from there touch your muscle groups to literally feel which groups would be shortened and which lengthened by this distortion.
- Overhead Squat Assessment pg. 293 – another very important thing to study, heavily tested over.
- Designed to assess dynamic flexibility, core strength, balance, and overall neuromuscular control. Shown to reflect lower extremity movement patterns during jump-landing tasks. Knee valgus(knock-knees) during overhead squat test is influenced by decreased hip abductor and hip external rotation strength, increased hip adductor activity, and restricted ankle dorsiflexion.
- 1. Client stands with feet shoulders width apart and pointed straight ahead. Foot and ankle complex should be in a neutral position. Assessment performed with shoes off to better view foot and ankle complex.
- 2. Have client raise his or her arms overhead, with elbows fully extended.
- Movement – Instruct client to squat roughly to height of chair seat and return to starting position. 2. Repeat movement for 5 reps, observe from each position(anterior and lateral)
- Views – View feet, ankles, and knees from front. Feet should remain straight with knees tracking in line with foot. View lumbo-pelvic-hip complex, shoulder, and cervical complex from side. Tibia should remain in line with torso while arms also stay in line with torso.
- Compensations Anterior View – Feet, do feet flatten and/or turn out? Knees, do knees move inward(adduct and internally rotate)
- Compensations Lateral View – Lumbo-pelvic-hip complex – does the low back arch? Does the torso lean forward excessively? Shoulders: do the arms fall forward?
- Memorize the table on page 295. Table 9.7. It really really helps to physically mimic every compensation and then literally feel which muscle groups have to be shortened/lengthened in order for this compensation to occur. It seems like a lot at first but when you go through a few rounds of mimicking different compensations it becomes very obvious which muscle groups are underactive and overactive.
- Single Leg Squat Assessment pg. 297
- Transitional movement assessment also assesses dynamic flexibility, core strength, balance, and overall neuromuscular control.
- Reliable and valid measure of lower extremity movement patterns when standard application protocols are applied.
- Position – Client should stand with hands on hips and eyes focused on object straight ahead. Foot should be pointed straight ahead, and foot, ankle, and knee and lumbo-pelvic-hip complex should be in neutral position
- Movement – Have client squat to a comfortable level and return to starting position. Perform up to 5 repetitions before switching sides.
- Views – View knee from the front. Knee should track in line with the foot.
- Compensation – Does knee move inward(adduct and internally rotate?)
- Memorize table 9.8 on pg. 298. Again it helps to act it out and then feel the muscles that will be short/long.
- Pushing Assessment pg. 299
- Like overhead and single leg squat assessments, this assesses efficiency and potential muscle imbalances during pushing movements.
- Position – Instruct client to stand with abdominal drawn inward, feet in a split stance and toes pointing forward
- Movement – Viewing from the side, instruct client to press handles forward and return to the starting position. Perform up to 20 repetitions in a controlled fashion. Lumbar and cervical spines should remain neutral while shoulders stay level.
- Compensations – Low back – does low back arch? Shoulders – do the shoulders elevate? Head – does the head migrate forward?
- Memorize table 9.9 on page 299. Same goes for the others it helps to act out the movements.
- Pulling Assessment pg. 301
- To assess movement efficiency and potential muscle imbalances during pulling movements
- Position – Stand with abdomen drawn inward, feet shoulders-width apart and toes pointing forward
- Movement – Viewing from side, instruct client to pull handles toward the body and return to starting position. Like pushing assessment lumbar and cervical spines should remain neutral while shoulders stay level.
- Compensations – Low back – does low back arch? Shoulders – Do shoulders elevate? Head – Does head migrate forward?
- And again memorize table 9.10 on page 302.
- Push-up test – Keep ankles, knees, hips, shoulders and head in a straight line. Chest within 3 inches of floor on the bottom. Repeat for 60s or to exhaustion. Record number of reps. The form they show in the book is laughably bad.
- Davies Test pg. 304– Measures upper extremity agility and stabilization. Two pieces of tape, 36 inches apart. Client assumes push-up position. Alternating touch on each side for 15 seconds.
- Shark skill test – assess lower extremity agility and control. Nine box grid is taped out on the floor, 3×3 boxes each measuring 6×6 inches. Client is at the center of the box grid with hands on hips standing on one leg. Have the client hop in a diagonal pattern always returning to the center of the box. One practice run then two tests with each foot.
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- The bench press, squat, vertical jump, 40 yard dash, pro shuttle, LEFT, and standing broad jump are self explanatory and rarely tested over. Understand their fundamentals and you’ll be good to go.
- YMCA 3-Minute Step Test pg. 311 You are tested over the YMCA and Rockport walk tests. Most likely the test will give you an example of a test then ask you to identify the test amid other tests.
- Designed to estimate individual’s cardiorespiratory fitness level on the basis of a submaximal bout of stair climbing at a set pace for 3 minutes.
- Step one – perform 3-minute step test by having client perform 24 steps per minute on 12 inch step for total of 3 minutes, roughly 96 steps total. Important that client performs steps with correct cadence.
- Step two – Within 5 seconds of completing exercise, client’s resting heart rate is measured for period of 60 seconds and recorded as recovery pulse.
- Step three – locate recovery pulse number in one of following categories.
- Step four – determine appropriate starting program using appropriate category. Poor Zone one(65-75%), Fair Zone one(65-75%), Average Zone Two(76-85%), Good Zone two(76-85%), Very good zone three(86-95%)
- Step five – determine client’s maximal heart rate by subtracting client’s age from the number 208- (.70 X Age), then take maximal heart rate and multiply by zones to determine heart rate ranges for each zone.
- Rockport Walk Test pg. 312
- Designed to estimate cardiovascular starting point. Starting point is then modified based on ability level.
- Step one – Record client’s weight. Have client walk one mile, as fast as he or she can control, on treadmill. Record time. Immediately record client’s heart rate at the 1 mile mark.
- Weight in lbs, gender male = 1, female = 0, time expressed in minutes and 100th of minutes, HR is beats per minute, age is years.
- There’s a formula on the bottom of page 312. Just recognize it to know that it is part of the Rockport Walk test. Don’t memorize the formula.
- Translating Assessment Results into Robust Goal Plan pg. 314 – Good practical information here for when you’re training clients. Study table 9.13, it will be tested over. Otherwise the information in this section is more for your benefit than testing purposes.
- Assessment Modifications for Specific Populations pg. 318 – Again good practical information to know but it likely won’t be tested except for table 9.14. They do like to throw one questions in about medication complications.