Selective Functional Movement Assessment (SFMA)
Brodie Pack is certified in administering The Selective Functional Movement Assessment. The Selective Functional Movement Assessment (SFMA) is a comprehensive assessment used to classify movement patterns, identify regions for further local biomechanical examination, and ultimately, direct manual therapy and therapeutic exercise interventions.
The SFMA allows the clinician to identify both movement dysfunction and pain specific to the individual they are assessing. This identifies the importance of looking beyond the medical diagnosis and/or patient’s structure when formulating the most efficient and effective plan of care. As rehabilitation professionals, we no longer guess at the cause of the patient’s pain – the SFMA gives us a complete differential diagnosis. Often the cause of the pain is not the source of the pain.
The SFMA is based on 3 key concepts:
Concept 1: Regional Interdependence – “This refers to the concept that seemingly unrelated impairments in a remote anatomical region may contribute to or be associated with the patient’s primary complaints.”
Concept 2: Altered Motor Control – “Necessary input, sufficiently processed, with an acceptable output.” Injury and pain can alter motor control. Previous injury is by far the strongest factor related to future injury. Pain alters motor control in a somewhat unpredictable manner and that it is most likely related to the task at hand. Depending on a given task, when pain is present, the system may increase or decrease muscle activation. Furthermore, injury can result in limited mobility which will reduce the sensory input, creating a situation where ideal motor control cannot be achieved. With mobility deficits managed first, the opportunity for ideal motor control exists, but is not guaranteed.
Concept 3: Neurodevelopmental Sequence – the neurodevelopmental progression has taught us that movement was developed in patterns and not in individual muscles. “Poor movement can exist anywhere in the body. Poor movement patterns exist only in the brain.”
Selective Functional Movement Assessment (SFMA) is a series of 7 full-body movement tests designed to assess fundamental patterns of movement such as bending and squatting in those with known musculoskeletal pain. When the clinical assessment is initiated from the perspective of the movement pattern, the clinician has the opportunity to identify meaningful impairments that may be seemingly unrelated to the main musculoskeletal complaint, but contribute to the associated disability. This concept, known as Regional Interdependence, is the hallmark of the SFMA.
The assessment guides the clinician to the most dysfunctional non-painful movement pattern, which is then assessed in detail. This approach is designed to complement the existing exam and serve as a model to efficiently integrate the concepts of posture, muscle balance, and the fundamental patterns of movement into musculoskeletal practice. By addressing the most dysfunctional non-painful pattern, the application of targeted interventions (manual therapy and therapeutic exercise) is not adversely affected by pain.
Pain-free functional movement for participation in occupation and lifestyle activities is desirable. Many components comprise pain-free functional movement including adequate posture, ROM, muscle performance, motor control, and balance reactions. Impairments of each component could potentially alter functional movement resulting in or as a consequence of pain. Utilizing the SFMA, the clinician is able to identify key functional movement patterns and describe the critical points of assessment needed to efficiently restore functional movement. This approach is designed to complement the clinician’s existing exam and intervention model with the prescription of movement-based therapeutic exercise. The SFMA serves to efficiently integrate the concepts of posture, muscle balance, and the fundamental patterns of the movement system into musculoskeletal practice. Additionally, it provides feedback for the effectiveness of the therapeutic exercise program, which targets the dysfunctional movement pattern and related impairments.
ImPackt Physical Therapy performs this screening methodology on nearly all patients as a starting point in the evaluation process. If a dysfunctional pattern of movement is identified a corrective exercise program and possibly other forms of manual therapy would be instituted with the goal of normalizing mobility, functional strength, balance, and return to pain-free function. If you would like the therapists at ImPackt Physical Therapy to provide you with a Selective Functional Movement Assessment, please contact us to set up a consultation.