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DYNAMIC MOVEMENT ASSESSMENT

by / Monday, 06 August 2018 / Published in Articles, Physical Therapy

PATHOKINEMATICS

Sports related and recreational injuries are common and several factors play a role in the risk for injury. There are nearly 300,000 ACL injuries every year in the Unites States. These sports injuries lead us to several relevant questions. Could it have been prevented, and if so, how do I go about preventing injuries? How do we know when it is safe to participate in sports, or return to sport following an injury?

To answer the first question, YES, injuries are very preventable. In answer to the second question, first and foremost, we have to identify the risk factors involved. These are specific not only to the athlete, but the sport as well. The best defense in sports injury prevention is identifying the specific pathokinematics, or faulty movement patterns, specific to the athlete, as well as applying tailored interventions to correct these impairments.

Pathokinematics are defined as pathological alignment of the lower kinetic chain during functional activities that results in abnormal force attenuation along the entire kinetic chain. This leads to inefficient movement and decreased performance.

DYNAMIC MOVEMENT ASSESSMENT

The Dynamic Movement Assessment (DMA) is a research based performance and movement assessment examination. It contains a set of essential athletic movements (applicable across multiple sports) that allows us to objectively identify faulty or uncontrolled movement patterns and to quantify them. Research has shown for the last 15 years that the DMA is able to identify predictable movement patterns which lead to increased risk for injury during athletic participation.
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Some of the common injuries include:
▪ ACL sprains
▪ Ankle sprains
▪ MCL or meniscus injuries
▪ Patellofemoral (anterior knee) pain
▪ Hamstring, quadriceps, or hip flexor strains

The assessment, performed by a licensed physical therapist, uses essential athletic movements along with multiple assessment points to identify the specific risks within the kinetic chain. Quality and symmetry of motion, initiation and control of each movement, as well as safety throughout each movement will be assessed and problematic areas are exposed. For example, if the knee turns inward (Knee Valgus) during a single-leg jump, this could be a result of a weak core or eccentric neuromuscular control in the hip external rotators. This valgus moment arm of the knee moving across midline of the body puts excessive stress and strain on the ligaments of the knee, hip, and ankle. Once the problematic areas are identified, athlete-specific interventions and training can be applied to correct these deficits, reduce the risk of injury, and even optimize sports performance.

TESTING

The exam takes 15-20 minutes to perform and is captured through video using pathokinematic assessment technology that is able to identify angles and planes of motion. This technology allows for correct assessment of faulty movement patterns that the naked eye has difficulty seeing. It also helpful for pre and post testing to determine the effectiveness of the sport specific program in correcting the pathokinematic patterns identified. The videos are extremely helpful in training coaches and athletes in the “why” behind injury prevention and the correlation of injury and movement.

dma_pic_2The exam consists of 6 progressive essential movement patterns that increase in sequential difficulty. Each movement is scored on a scale from 0-3, depending on the number of deviations noted. Specific scores indicate the amount of risk of injury.

Before performing these essential movements, it is critical to first screen the athlete to detect any potential injuries that could be further flared up during the exam. After all, this exam is an athletic event. Another key pre-test item is the fatigue protocol. Most injuries occur when the body is fatigued in what we call, “4th quarter syndrome”. Taking an athlete through a specific protocol that fatigues them before the DMA is critical in order to obtain valid performance indicators and quantifiable data. Failing to do this protocol can lead to false results wherein the athlete appears to have minimal faulty movement patterns even though there are glaring deficits that appear in the “4th Quarter”.

RESULTS

In multiple clinical trials, improved performance with these 6 essential movements based on a specific corrective exercise program has resulted in the following:

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▪ An average of 2-4 inch increase in vertical jump
▪ 1.4 seconds faster in 40 yard dash time
▪ Up to 80% reduction of ACL tears
▪ 60% reduction of all other knee, ankle, and lower extremity related injuries
▪ Lowest recordable injuries in several years with two local schools who have implemented this program.
▪ Female athletes who participated in a corrective exercise training program are 3.6 times less likely to suffer a knee injury than untrained athletes.

This means that faulty movement patterns, weaknesses, and physical limitations identified in the DMA can be specifically re-trained and corrected which reduces the risk of injury as well as improves overall athletic performance.

CONCLUSION

Proper assessment of athletic movements and the implementation of tailored programs specific to the athlete leads to increased athletic performance and decreased injury. The clinicians at Wright Physical Therapy are expertly trained in the proper use of the DMA and the associated interventions necessary for performance and injury prevention.

We look forward to implementing this with you to create solutions that reduce the risk of injuries and enhance sports performance. Contact us today at one of our clinic locations to schedule a DMA.

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