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Transcript of SFMA:
By: Christi Brooks and Michael Bueti
Criteria and Characteristics
Functional and non-painful (FN, Red Light)
Functional and painful (FP, Yellow Light)
Dysfunctional and non-painful (DN, Green Light, always first breakout)
Dysfunctional and painful (DP, Yellow Light)
Dembowski, S. C., Westrick, R. B., Zylstra, E., & Johnson, M. R. (2013, June). Treatment of hamstring strain in a collegiate pole-vaulter integrating dry needling with an eccentric training program: a resident's case report. International Journal of Sports Physical Therapy, 8(3), 328-339.
Finn, C. (2013, July). Rehabilitation of Low Back Pain in Golfers: From Diagnosis to Return to Sport. Sports Health: A Multidisciplinary Approach, 5(4), 313-320. http://sph.sagepub.com.libproxy.calbaptist.edu/content/5/4/313.full.pdf+html
Richter, R. R., VanSant, A. F., & Newton, R. A. (1989, January). Description of Adult Rolling Movements and Hypothesis of Developmental Sequences. Physical Therapy Journal, 69(1), 63-71. http://ptjournal.apta.org/content/69/1/63.long
Zedka, M., Prochazka, A., Knight, B., Gillard, D., & Gauthier, M. (1999). Voluntary and reflex control of human back muscles during induced pain. The Journal Of Physiology, 520 Pt 2591-604.
Represents a normal movement pattern without pain
Called "The Dead-End"
This pattern does not imply that there is no dysfunction, but merely that a specific movement assessment is functional
Functional and Non-painful
Represents normal movement patterns , but with the presence of pain
Called "The Marker"
This assessment creates a pain provocation for the clinician and is beneficial to the treatment portion for the patient
Great for manual therapy and corrective exercise
Functional and Painful
Represents limited movement without pain
Called "The Corrective Exercise Path"
This assessment lends itself an easier treatment pathway for the clinician because they do not have to wait for a provocation in symptoms
Dysfunctional and Non-painful
Represents a limited movement pattern with pain
Called the "The Logistical Beehive"
This movement pattern presents the most complicated treatment because the clinician must determine whether the dysfunction is causing the pain, or, if the pain is causing dysfunction.
Dysfunctional and Painful
Background of SFMA
SFMA principles were derived from several different influences, among those, the perspectives of Janda, Cyriax, and Sahrmann are also included.
The main approach of treatment for medical science is to understand the relationship between limitations, degeneration, and lesions in the anatomical structure. The addition of biomechanics, neuromuscular control, and functional symmetry create a complete explanation of functional versus dysfunctional movement, and the balance thereof.
Goal of SFMA
"The goal of SFMA is to capture the patterns of posture and function for comparison against a baseline. The SFMA is an organizational method to rank the quality of functional movements and when sub-optimal, their provocation of symptoms."
How dysfunction in one part of the body can create symptoms elsewhere.
If we do not take into account why a pathology is present, other than the obvious, we miss the big picture of dysfunction.
examples of the above? breakout examples?
Zedka et al. studied the lumbar paraspinal muscle response in subjects during natural trunk flexion movements before and after induced pain. The study demonstrated a decrease in ROM of 10-40% in the pain condition. Additionally, after injecting saline into the affected area, EMG readings proved that the muscle activity patterning was altered.
Cervical Spine Breakout
How we use it?
18 year old male collegiate pole vaulter who presented with recurrent hamstring strains; was referred to Physical Therapy for assessment and treatment; PT utilized three different self-reported outcome measures and also used SFMA for an assessment tool
By utilizing SFMA, the PT correctly identified the patients areas of pain and dysfunction and was able to treat the cause.
SFMA vs. FMS
They are not interchangeable. The line remains a pain.
FMS comprises a screening process that denotes a numerical value and is used to help predict the likelihood of an injury.
SFMA is a diagnostic assessment.
SFMA will help the clinician navigate pain and dysfunctional movement patterns by classifying them.
The SFMA is useful if the FMS demonstrates pain and cannot be haphazardly used.
The SFMA breakouts systematically dissect each of the major dysfunctional patterns. When applying the breakout session always begin with the DN. We must look at unilateral vs. bilateral, loaded vs. unloaded, active vs. passive, and consistent vs. inconsistent.
Upper Extremity Patterns
Overhead Deep Squat
Upon finishing the assessment one must follow the hierarchy of procedures.
What does this mean for me? or how do I use this? why?
SFMA Screening Sheet