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Questions and Answers
What is primarily responsible for the development of 1st order movement stereotypes?
What is primarily responsible for the development of 1st order movement stereotypes?
Which of the following is NOT a basic movement pattern analyzed?
Which of the following is NOT a basic movement pattern analyzed?
What is a significant reason for conducting a basic examination by a physiotherapist?
What is a significant reason for conducting a basic examination by a physiotherapist?
In the context of muscle imbalance theory, which syndrome is associated with the upper body's muscle imbalances?
In the context of muscle imbalance theory, which syndrome is associated with the upper body's muscle imbalances?
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Which characteristic defines stereotypes of the 2nd order?
Which characteristic defines stereotypes of the 2nd order?
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Walking is considered one of the basic movement patterns. What aspect of walking is typically evaluated?
Walking is considered one of the basic movement patterns. What aspect of walking is typically evaluated?
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What is the main purpose of screening during a basic examination in physiotherapy?
What is the main purpose of screening during a basic examination in physiotherapy?
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What is the definition of movement stereotypes or patterns?
What is the definition of movement stereotypes or patterns?
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What are the three components involved in shoulder abduction?
What are the three components involved in shoulder abduction?
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At what point in shoulder abduction does movement typically stop?
At what point in shoulder abduction does movement typically stop?
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What is a common indicator of an altered shoulder abduction pattern?
What is a common indicator of an altered shoulder abduction pattern?
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Which of the following is NOT a component of therapy for changes in movement patterns?
Which of the following is NOT a component of therapy for changes in movement patterns?
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What does fixation of newly learned movement patterns aim to achieve?
What does fixation of newly learned movement patterns aim to achieve?
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What consequence can arise from incorrect movement stereotypes?
What consequence can arise from incorrect movement stereotypes?
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What compensation mechanism is observed in altered hip abduction?
What compensation mechanism is observed in altered hip abduction?
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Which muscle group is primarily observed during the hip extension test?
Which muscle group is primarily observed during the hip extension test?
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In the curl-up movement, what is the primary role of the iliopsoas?
In the curl-up movement, what is the primary role of the iliopsoas?
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What indicates an altered pattern in push-up mechanics?
What indicates an altered pattern in push-up mechanics?
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In which position is the hip abduction test performed?
In which position is the hip abduction test performed?
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Which muscle is typically delayed or absent during an altered hip extension pattern?
Which muscle is typically delayed or absent during an altered hip extension pattern?
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What is a sign of inhibited deep neck flexors during neck flexion?
What is a sign of inhibited deep neck flexors during neck flexion?
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Which muscle is primarily associated with scapular winging during a push-up?
Which muscle is primarily associated with scapular winging during a push-up?
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What is observed during the testing of habitual movement patterns?
What is observed during the testing of habitual movement patterns?
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Which muscles act as prime movers during hip abduction?
Which muscles act as prime movers during hip abduction?
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What movement pattern is commonly observed when performing a curl-up incorrectly?
What movement pattern is commonly observed when performing a curl-up incorrectly?
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What diagnostic method is used to observe muscle action potentials?
What diagnostic method is used to observe muscle action potentials?
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What aspect is evaluated during neck flexion examinations?
What aspect is evaluated during neck flexion examinations?
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Which of the following is NOT characteristic of normal movement patterns?
Which of the following is NOT characteristic of normal movement patterns?
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Which condition results from the dominance of the levator scapulae during a push-up?
Which condition results from the dominance of the levator scapulae during a push-up?
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Study Notes
BTM III - Basic Movement Patterns (Stereotypes)
- Course: PFYZ 104C - WS 2024/2025
- Instructor: Dr. Dagmar PAVLU, CSc.
- Date: 23.10.2023
- Topic: Functional approach to musculoskeletal pain syndromes, muscle imbalance theory, and basic movement pattern analysis
Muscle Imbalance Theory
- Upper crossed syndrome
- Lower crossed syndrome
- Layer (stratification) syndrome
Evaluation of Muscle Imbalance
- Evaluation of tight muscles
- Analysis of muscular imbalance in standing
- Analysis of basic movement patterns
Basic Movement Patterns Analysis
- Overall information about movement quality of the subject
- Hip extension
- Hip abduction
- Curl up (trunk flexion)
- Push up
- Neck flexion
- Shoulder abduction
- Walking (one of the basic movement patterns)
- Repetition of walking pattern from 1st year
- Definition of walking pattern
- Walking phases
- Difference between walking and running
- Evaluation parameters for walking
- Walking with aids
Characteristics of Movement Stereotypes
- Set of conditioned and unconditioned reflexes that repeat stereotypically
- Temporally invariant set of stereotypically repeating stimuli
- Unchanging in the short term
Two Basic Types of Stereotypes
- Stereotypes of the 1st order: primarily determined by the anatomical structure of the body.
- Stereotypes of the 2nd order: developed over the course of life, influenced by many factors, and differ between individuals in movement quality.
Why Examine Movement Patterns?
- Important part of a physiotherapist's examination
- Provides information about movement quality
- Screening tool, basis for further considerations during the assessment
- Incorrect movement stereotypes can lead to painful functional and structural disorders of the movement system
Procedure of Testing Basic Movement Patterns
- Movement patterns are individualized; normal and abnormal patterns can be recognized.
- Habitual movement testing: start position, no verbal instructions, no tactile stimulation, 3 repetitions of movements, observation of muscle timing and activation, and evaluation.
Electromyography (EMG)
- Diagnostic method for measuring muscle action potentials.
- Surface EMG and needle EMG are used to study movement patterns.
6 Basic Movement Patterns
- Hip extension
- Hip abduction
- Curl up (trunk flexion)
- Push up
- Neck flexion
- Shoulder abduction
Hip Extension
- One of the most important phases of gait.
- Test performed with the patient lying prone
- Sequencing and degree of muscle activation are observed, including gluteus maximus, hamstrings, spinal extensors, and shoulder girdle muscles.
Hip Extension - Altered Pattern
- Hamstrings and erector spinae are readily activated, while gluteus maximus contraction is delayed, decreased, or absent
- Erector spinae on the ipsilateral side or shoulder girdle muscles may initiate movement; gluteus maximus activation is weak and delayed.
Hip Abduction
- Evaluates quality of lateral pelvic bracing and indirectly stabilizes the pelvis during walking when performed from the side-lying position.
Hip Abduction - Muscles Involved
- Gluteus medius
- Gluteus minimus
- Tensor fascia lata(prime movers)
- Quadratus lumborum(pelvic stabilizer).
Hip Abduction - Altered Pattern
- Compensatory hip flexion observed instead of pure abduction.
- Quadratus lumborum initiates movement by elevating the pelvis.
Curl Up (Trunk Flexion)
- Interplay between iliopsoas and abdominal muscles.
- Examiner observes spontaneous sitting-up pattern.
- Plantar flexion is noted.
Curl Up - Altered Pattern
- Trunk curling is minimal; movement is characterized by almost straight back and anterior pelvic tilt.
Push Up
- Evaluates stability of the scapula.
- Push-up from a prone position evaluates scapular stability.
Push Up - Altered Pattern
- Excessive scapular rotation, elevation, adduction, or abduction.
- Elevation/downward rotation: dominance of levator scapulae.
- Winging of the scapula: inadequate function of the serratus anterior muscle
Neck Flexion
- Evaluates interplay between sternocleidomastoid and deep neck flexors, essential for estimating cervical spine dynamics.
- Testing is performed with the patient lying supine.
Neck Flexion - Altered Pattern
- Inhibited deep neck flexors and overactive sternocleidomastoid cause jaw jutting and hyper-extension at the cervicocranial junction.
Shoulder Abduction
- Evaluates coordination of shoulder girdle muscles during movement.
- Patient is seated with elbows flexed to avoid undesired rotation.
Shoulder Abduction - Components
- Glenohumeral joint abduction, scapula rotation, and shoulder girdle elevation.
- Shoulder girdle elevation usually begins and is complete at approximate 60° degree elevation.
Shoulder Abduction - Altered Pattern
- Shoulder girdle elevation occurs earlier or initiates movement.
- Trunk lateroflexion is observed.
Therapy for Changes in Movement Patterns
- Cause of movement pattern disorder: relaxation/stretching of overactive/shortened muscles.
- Mobilization/therapy of functional joint blockages.
- Facilitation/strengthening of weakened muscles
- Re-education of movement patterns; fixation at subcortical level.
Other Movement Patterns
- Walking (1st year)
- Bending over
- Lifting weights
- Sitting down
- Getting up from chair (and others)
Analysis - Correction - Exercise - Training
- Knowledge of ergonomics is included in the process.
Recommended Literature
- Janda et al., Evaluation of Muscular Imbalance, Liebenson (Ed.), Rehabilitation of the Spine
- Lewit K., Manipulative Therapy, Churchill Livingstone
- Kolář P., Clinical rehabilitation, Czech Republic
Required Knowledge
- Characteristics of movement patterns (stereotypes) according to Janda
- Characteristics of six basic movement patterns according to Janda
- Examination principles
- Reasons for examination
- Examination procedure
- Normal vs. deviation
- Principles of therapy for changes in movement patterns
Required Skills
- Examine six basic movement patterns according to Janda
- Evaluate the performed movement pattern
- Recommend further investigation procedures based on the examination results
- Examine and evaluate any movement pattern, considering possible consequences of poor movement quality.
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Description
This quiz covers the concepts of muscle imbalance theory and basic movement patterns analysis as part of the PFYZ 104C course. Students will evaluate various syndromes and learn to assess movement quality and muscle function through practical analysis. Test your knowledge on key principles related to musculoskeletal pain and movement evaluation.
