Theory and Concepts

Understanding Movement and Function, Assessment and Retraining of Uncontrolled Movement

Theory and Concepts in a Clinical Reasoning Framework

Learn what goes wrong with the movement system with pain, how to recognise it and how to deal with it.

There are principles of anatomy physiology and biomechanics that underpin good movement. This course presents evidence based ‘rules’ that determine non-painful movement and the ‘rules’ about fixing uncontolled movement.

Course Outline

Current research demonstrates that people with pain use different patterns of movement to people without pain. People with the same diagnosis of pathology frequently present with different movement dysfunction patterns. This can critically influence how the pain episode is managed and can affect the incidents of recurrence. Research in the last 5 years has shown that Uncontrolled Movement (UCM) is linked to pain and recurrence. Uncontrolled Movement (UCM) is diagnosed by a series of motor control tests that identify both the site and direction of UCM.

Key Features

This course addresses:

• what goes wrong with the movement system when people have pain
• why it’s hard to fix
• how to fix it

A functional classification of the muscle system is presented along with the typical dysfunction patterns in the local and global muscle systems. Motor Control mechanisms for the control of inter-segmental translation and functional range of motion are outlined.

Learning Outcomes

At the end of this course the student should be able to:

• Understand and discuss the concept of movement & stability dysfunction
• Consider the relationship between symptoms, dysfunction and disability and justify the need to examine for dysfunction as well as treating symptoms
• Discuss the term Core Stability and understand the differences between ‘motor control stability’, ‘core strength’ and ‘traditional limb strength’
• Identify the site, direction and threshold of uncontrolled motion (‘give or weak link)
• Assess for dysfunction in local and global muscle function and identify potential retraining strategies
• Use the assessment to design a stability management plan and prescriptive exercise programme
• Demonstrate the application of principles of motor control retraining to correct local and global stability dysfunction

The participant should understand and discuss key concepts in muscle function:

• Classification of muscle functional roles
• Low and high threshold recruitment
• Recruitment dysfunction and inhibition
• Restriction and compensation (relative stiffness / relative flexibility)
• The neutral training region
• Stability dysfunction

The participant should demonstrate the ability to apply principles of assessment and motor control retraining to:

• Follow a systematic and logical approach to the assessment of stability dysfunction
• Develop an integrated management plan
• Prioritise and retrain optimal recruitment strategies to correct movement dysfunction
• Consider integration into physiotherapy practice

Programme Outline

Movement System

• Overview of the development of the understanding of the influence of the muscle function on the movement system
• The development of movement dysfunction and Uncontrolled Movement
• Clinical decision making – assessment analysis and management planning

Physiological Considerations

• Slow motor unit recruitment

Muscle Function

• Classification of muscles
• Dysfunction patterns

‘Core Stability’

• Presetnation of new model of core stability

Uncontrolled Movement

• Relative flexibility / Relative stiffness
• Contributing factors to Uncontrolled Movement
• Diagnosis of Uncontrolled Movement
• Uncontrolled Movement & Restrictions

Clinic Assessment of Stability Dysfunction

Rehabilitation Strategy – for uncontrolled movement

• Principles of retraining Uncontrolled Movement

  • Control of direction

  • Control of translation

  • Control of imbalance

• Integration into function

• Proprioception and the neutral training region