In my first post I discussed what made this course effective, in the second post I will discuss some of the details of the assessment as well as some of the literature around the assessment tool.
The SFMA was created by Grey Cook and Lee Burton in the mid 1990s, but has only recently become a main stream assessment tool. The asssessment is based upon the concept of regional interdepence and the language of Cyriax. Regional interdependence is a concept, that seemingly unrelated impairments in a remote anatomical region may contribute to, or be associated with, the patient’s primary complaint (Wainner, Flynn, & Whitman, 2007). Similar to the terms used by Cyriax in the Selective Tissue Tension Test the SFMA uses the following four terms to describe the movement pattern:
1. FN: functional non-painful
2. FP: functional painful
3. DN: dysfunctional non-painful
4. DP: dysfunctional painful
There are no new, fancy tests within the SFMA; however, they have done a fantastic job of organizing, and prioritizing the assessment pathway. As a young therapist, with a hundred new ideas and way too many things running through my head this system was a breath of fresh air. For the experienced practitioners it may be tougher to change strategies.
The SFMA, like the Functional Movement Screen (FMS), is centred around 7 big moves. They are:
Single leg balance
Upon assessing each movement the client is given a score of FN, DN, DP, or FP. If a patient is either DP or FP for a certain movement you must treat the pain. You should never exercise the painful movement. The DN (dysfunctional non-painful) movement is the movement you want to treat with exercise. By the end of the assessment you will normally have a few DNs. You must now consider which DN is the most important and break out the exam further (each of the big 7 movements has a breakout algorithm to follow). Usually you follow the exam from top to bottom but sometimes fixing the shoulder problem will fix the neck problem or vice verse.
The breakouts will help you decipher whether the pattern is a problem of mobility or motor control. Mobility restrictions must be treated first. I loved the logic behind this – if a patient has yet to regain all mobility there body will compensate and perform the movement pattern incorrectly. However, as soon as mobility is regained you must follow up the treatment with solid motor control exercises.
It is important to remember that the SFMA is an adjunct to many of the assessment skills most therapists will already have. It organizes the assessment, treats bodies as a whole, and aids therapists in choosing the most appropriate treatment technique. In a follow up post I will discuss some of the treatment techniques and exercise progressions that were provided over the weekend. The level two course goes into more detail on treatment, but I will do my best to describe what was given in the level one course.
From a search of google and the UBC library no research has been completed on the effectiveness of the SFMA. Research is apparently ongoing so we can hopefully expect some in the next couple of years.