The 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 pain. When the clinical assessment is initiated from the perspective of the movement pattern, there is 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 identifies 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.
Once Clinical Predictive Rules and diagnosis-specific techniques are exhausted, applying the SFMA model will allow for individualized exercise prescription and progression, which encompasses the concept of regional interdependence. As musculoskeletal system experts, the Active Wellness Team knows that it is essential that healthcare providers understand the relationships between body segments and how impairments in one body region may adversely affect function of another body region. Approaching therapeutic exercise prescription from a developmental movement perspective model allows the concepts of muscle imbalance and regional interdependence to be addressed in a logical, methodical manner.
The goal of the Selective Functional Movement Assessment is to identify the most dysfunctional non-painful movement pattern and break the pattern down to identify the underlying cause of the dysfunction. This includes using traditional muscle length and joint assessment tests which lead to corrective manual therapy and exercise interventions. Emphasis is placed on identifying the most dysfunctional patterns. The model calls for the intervention to be directed only at the non-painful patterns. This ensures that the adverse effects of pain on motor control will not hinder corrective strategies.
The human system will migrate toward predictable patterns of movement in response to pain or in the presence of weakness, tension, or structural abnormality. Over time, these pain-attenuated movement patterns lead to protective movement and fear of movement, resulting in impairments such as decreased ROM, muscle length changes, and declines in strength. An isolated or regional approach to either evaluation or treatment will not restore whole function. Functional restoration requires a working knowledge of functional patterns and a map of dysfunctional patterns to gain clinical perspective and design an effective treatment strategy.
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 Active Wellness Team is able to identify key functional movement patterns and describe the critical points of assessment needed to efficiently restore functional movement. This approach is used to complement the existing exams and intervention models 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.