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Tag: mobility

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By admin 0 Comments Chiropractic Care, Therapy, Work Injury , , , , , , , , , , , , , , , , ,

How Outcome Measurement Tests Can Guide Treatment

Can individuals experiencing difficulty with functional mobility benefit from physical therapy to help them return to normal activities?

Outcome Measurement Tests

Outcome measurement tests assess the effects of a treatment plan on a patient. They can be used to determine a patient’s baseline function, monitor their progress, and evaluate the effectiveness of treatment. They also give the therapy team an effective way to measure mobility, flexibility, and range of motion.

Function and Purpose

Outcome measurement tests serve various purposes. These include: (American Physical Therapy Association, N.D.)

  • To assist in goal-setting
  • Provide motivation
  • To guide treatment
  • To give a prognosis for the specific condition
  • To justify the treatment

The physical therapist may use other functional outcome measurements to help assess physical therapy progress.

  • They may measure your strength and range of motion.
  • Balance and posture may be evaluated.

Effective functional outcome measurement tests must meet certain criteria to be useful in a physical therapy clinic. First, they must be reliable, meaning the results must be consistent with each patient and within groups of patients. They must also be valid to measure exactly what they are intended to measure. An effective measurement test must also be easy to administer, so it must be practical and simple. Outcome measurement tests must also be purposeful. For example, a balance test must reflect a patient’s current function and be related to their balance ability.

Common Outcome Measurement Tests Used

Common functional outcome measurement tools that a physical therapist may use include:

  • The timed up-and-go or TUG test is a simple assessment used to evaluate a person’s mobility and balance by measuring how long it takes them to stand up from a chair, walk a short distance, turn around, walk back, and sit down again; it’s often used to identify potential fall risks in older adults, particularly those with mobility concerns, as a longer time to complete the task may indicate increased fall risk. (Centers for Disease Control and Prevention, 2017)
  • The Tinetti balance and gait evaluation, also known as the Performance-Oriented Mobility Assessment (POMA), is a clinical test used to assess balance and gait abilities, particularly in older adults. It evaluates stability during various standing and walking tests and provides a score that indicates a person’s fall risk potential.
  • The Berg Balance Scale (BBS) is a standardized test for adults that measures balance and the risk of falling. It’s widely used and can be performed in various settings.
  • The six-minute walk test (6MWT) is a medical assessment in which a person walks as far as they can in a designated area for exactly six minutes. This allows healthcare providers to evaluate their functional exercise capacity. It is particularly useful for assessing patients with lung or heart conditions where walking ability might be compromised. The distance covered during the six minutes is the key measurement used to interpret the test results. (Ferreira M. B. et al., 2022)
  • The functional reach test (FRT) is a clinical assessment that measures an individual’s dynamic balance by determining the maximum distance they can reach forward while standing in a fixed position. It assesses their risk of falling by evaluating how far they can extend their arm before losing stability. The FRT is often used to assess older adults or individuals with potential balance issues. 
  • The Oswestry low back pain disability questionnaire is a self-administered questionnaire used to measure the level of disability a person experiences due to low back pain. It assesses how the pain impacts their daily activities in various aspects of life, such as personal care, work, and social life; a higher score indicates greater disability. 
  • The functional independence measure (FIM) assesses a patient’s ability to perform daily activities independently. It also measures the patient’s disability level and how much assistance is needed.

Functional outcome measurement tests provide a starting point for developing physical therapy goals. For example, if the TUG test takes 19 seconds, individuals may aim for 10 seconds. A TUG score that falls at or over 10 seconds indicates reduced physical capacity (Kear B. M., Guck T. P., & McGaha A. L. 2017). This can be the motivation needed to reach physical therapy goals.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Understanding The Effects of Personal Injury

References

American Physical Therapy Association. (N.D.). Outcome Measures in Patient Care. https://www.apta.org/your-practice/outcomes-measurement

Centers for Disease Control and Prevention. (2017). Timed Up & Go Assessment. Retrieved from https://www.cdc.gov/steadi/media/pdfs/steadi-assessment-tug-508.pdf

Ferreira, M. B., Saraiva, F. A., Fonseca, T., Costa, R., Marinho, A., Oliveira, J. C., Carvalho, H. C., Rodrigues, P., & Ferreira, J. P. (2022). Clinical associations and prognostic implications of 6-minute walk test in rheumatoid arthritis. Scientific reports, 12(1), 18672. https://doi.org/10.1038/s41598-022-21547-z

Kear, B. M., Guck, T. P., & McGaha, A. L. (2017). Timed Up and Go (TUG) Test: Normative Reference Values for Ages 20 to 59 Years and Relationships With Physical and Mental Health Risk Factors. Journal of primary care & community health, 8(1), 9–13. https://doi.org/10.1177/2150131916659282

By admin 0 Comments Chiropractic Care , , , , , , , , , , , , , , , , , ,

Effective Back Stretching Exercises for Pain Management

Can knowing how to stretch your back help reduce pain and improve your range of motion?

Stretch Your Back

Over time, muscle tension can cause significant back pain and increase the risk of a back injury. Getting into a regular back stretching routine can help prevent back and spinal issues. These exercises can be performed when your back hurts to ease a backache or to avoid future problems. However, before beginning an exercise or stretch regimen, talk to your healthcare provider about any questions and what is safe for you. A few things to be mindful of are:

  • When stretching, don’t try to push past your pain limit.
  • Listen to your body, which leads to a calmer nervous system.
  • Take special care when stretching during pregnancy, as the hormones supporting your pregnancy could lead to overstretching or injury.

Warm Up

Stretching cold muscles can lead to injury. Always warm up first.

  • Do between five and 10 minutes of mild activity, such as walking.
  • Apply heat for 15 to 20 minutes before stretching.

Knees-to-Chest Back Stretch

To perform:

  • Lie on your back with your feet flat on the floor.
  • Bring your legs toward your chest With your knees bent.
  • Place your hands behind your thighs or on the shins, and pull the legs down toward your chest.
  • Pull until there is a gentle stretch.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Do a total of 10 reps.

Supine Twist Back Stretch

To perform:

  • Lie on your back with your knees bent and feet flat on the floor.
  • Keep your back flat on the floor, rotate your hips to the left, and lower your legs until you feel the stretch.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Next, rotate the hips to the right and lower your legs to the floor until you feel a gentle stretch.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Repeat for nine reps.

Prone Bridging Back Stretch

To perform:

  • Lie on your stomach.
  • Prop yourself up on your elbows.
  • Extend your back.
  • Start straightening your elbows, further extending the back.
  • Continue straightening the elbows until the stretch is felt.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Repeat for nine reps.

Supine Butt Lift Back Stretch

To perform:

  • Lie on your back with your knees bent and feet flat on the floor.
  • Push down through the feet as you slowly raise yourself off the floor.
  • Hold for 10 seconds.
  • Return to starting position.
  • Repeat for nine reps.

Seated Forward Curl Back Stretch

To perform:

  • Sit in a chair with your feet flat on the ground.
  • Bend forward until your chest is on your thighs, and you can touch the ground with your hands.
  • Hold for 10 seconds.
  • Return to the starting position.
  • Repeat for nine reps.

Side Stretch

To perform:

  • Stand up straight with your arms at your sides and feet shoulder-width apart.
  • Bend sideways to the left while sliding your left hand down your thigh and reaching your right arm over your head.
  • Hold for 10 seconds.
  • Return to the starting position.
  • Now, bend to the right while sliding your right hand down your thigh and reaching your left arm over your head.
  • Hold for 10 seconds.
  • Repeat for nine reps.

Other Treatments to Loosen a Tight Back

Many healthcare providers recommend other treatments for back pain before using medication. Recommended treatments that can help loosen the back include: (Sudhakaran P. 2021)

Acupuncture

  • Acupuncture needles are inserted in release points to unblock stagnated blood and energy circulation.
  • They have an analgesic, pain-relieving effect. (Foley C., & Litscher G. 2024)

Massage Therapy

  • Various massages involve kneading soft tissue in the back with hands, fingers, elbows, or instruments/tools/devices to relieve stress or pain.

Spinal Manipulation

  • Practiced by chiropractors, this therapy involves using the hands or instruments/tools/devices to manipulate the joints in the spine to relieve pain.

Tai Chi

  • Based on martial arts, slow movements, and deep breaths help to work muscle groups in flowing motions, supporting back strength and overall health.

Yoga

  • Yoga combines physical poses, breathwork, and meditation to help build strength, be restorative, and relax the body.

Anti-inflammatory Diet

  • An anti-inflammatory diet can also benefit tight muscles. (U.S. Department of Defense, 2012)
  • Incorporating foods like those on the Mediterranean diet, which emphasizes fish, vegetables, and olive oil, can help reduce chronic inflammation and help with back pain.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. We build optimal health and wellness solutions with primary healthcare providers and specialists to integrate a treatment plan to resolve musculoskeletal problems.

Stretching Benefits

References

Sudhakaran P. (2021). Acupuncture for Low-Back Pain. Medical acupuncture, 33(3), 219–225. https://doi.org/10.1089/acu.2020.1499

Foley, C., & Litscher, G. (2024). The Biggest Obstacle to the Integration of Acupuncture: The Meaning of Qi from the Ancients to Einstein. Medical acupuncture, 36(1), 5–11. https://doi.org/10.1089/acu.2023.0054

U.S. Department of Defense. (2012). Complementary Alternative Medicine for Low Back Pain. Retrieved from https://media.defense.gov/2019/Oct/22/2002198454/-1/-1/0/CAM%20FOR%20LOW%20BACK%20PAIN.PDF

By admin 0 Comments Chiropractic Care , , , , , , , , , , , , , , , , , , ,

Exploring the Importance of Planes of Motion

Can understanding the planes of motion help individuals adjust fitness training to maximize fitness for physical and sports performance and reduce the risk of injury?

Planes of Motion

The body’s planes of motion are the sagittal, frontal, and transverse planes, which divide it into left and right, front and back, and top and bottom halves. The body moves in different dimensions during daily work, house chores, and physical activity/exercises. The movements in each plane correspond to forward/backward, side-to-side, and rotational motions. Think of each plane as an imaginary line or a pane of glass that divides the body into opposing segments when standing in the anatomical position. (National Academy of Sports Medicine, 2024)

  • Sagittal plane -Divides the body into right and left sides.
  • Frontal plane – Divides the body into front and back.
  • Transverse plane – Divides the body into top and bottom sections.

To determine the plane of motion of a particular movement, consider how the movement would interact with the imaginary lines or plates. When a movement runs parallel to the imaginary line, the movement is occurring in that plane of motion. For example, when going upstairs, the forward and upward movement at the hip, knee, and ankle occurs primarily in the sagittal plane because that movement runs parallel to the imaginary line that divides the body into right and left sides. Frontal plane movements occur while you walk up the stairs and reach for the handrail. The movement is in the frontal plane because the lateral hand reach runs parallel to the line, dissecting the body into front and back sections. If you turn around to look behind, the rotational movement occurs in the transverse plane because your upper torso runs parallel to the line, dissecting the body into an upper and lower section. Individual movements at any joint in the body can occur in a single plane or multiple planes. Complex movements usually happen in several planes of motion concurrently.

Sagittal Plane

Movement in the sagittal plane generally happens in front or behind. This is the most familiar plane of motion because many typical day-to-day activities happen within arm’s reach in front. Walking, texting, or computer work involves movement primarily in the sagittal plane.  Several eating mechanics occur in the sagittal plane. Movements include:

  • Flexion – A bending movement that decreases the angle at a joint
  • Extension – An extending movement that increases the angle at a joint
  • Hyperextension – Extending the angle at a joint beyond neutral
  • Dorsiflexion – Bending at the ankle so the top of the foot moves toward the shin
  • Plantarflexion – Pushing the foot down and away from the body

Many strength-training exercises in the sagittal plane include biceps curls, forward or reverse lunges, squats, vertical jumping, running, downward dog, and yoga chair poses.

Frontal Plane

The frontal plane divides the body into front/anterior and back/posterior sections. Frontal plane movements are lateral or side-to-side and include:

  • Abduction – Moving the body or a limb laterally and away from the body’s midline.
  • Adduction – Moving the body or a limb towards the body’s midline.
  • Elevation – Moving the shoulder blades up.
  • Depression – Moving the shoulder blades down.
  • Eversion – Rolling the foot towards the inside/medial side.
  • Inversion – Rolling the foot towards the outside/lateral side.

Frontal plane movements are less common than sagittal movements. For example, individuals walk forward more than side to side or reach for something in front rather than directly to the side. Frontal plane movements in fitness include side lunges, lateral shoulder raises, and side shuffles, and in yoga poses, standing side bends and the triangle.

Transverse Plane

The transverse plane divides the body into upper/superior and lower/inferior sections. Transverse plane movements generally involve rotation. Movement in this plane is less common. Exercise injuries most often occur during transverse/rotational movements. (National Academy of Sports Medicine, 2024) Movements include:

  • Rotation – Moving the torso or a limb around its vertical axis.
  • Pronation – Rotating the forearm or foot to a palm-side or foot-side down position.
  • Supination – Rotating the forearm or foot to a palm-side or foot-side-up position.
  • Horizontal Abduction – Moving the upper arm away from the body’s midline when elevated to 90 degrees.
  • Horizontal Adduction – Moving the upper arm towards the body’s midline when elevated to 90 degrees.

Typical everyday activities in the frontal plane include turning the head to look behind or turning a doorknob. Exercises in the transverse plane include hitting a golf ball, swinging a baseball bat, or performing a seated twist.

Training Within the Planes of Motion Benefits

Training in all three planes can help with movement in several ways, providing greater ease in life and sports.

Prepares Body for Daily Tasks

Many traditional strength-training programs focus on training one muscle at a time, often in a single plane of motion. For example, weight lifters might do bicep curls to primarily work the biceps in the sagittal plane, a chest fly exercise to primarily work the pectoral muscles in the transverse plane, or lateral raises to work the shoulders in the frontal plane. However, compound exercises have recently become much more common. Compound movements allow individuals to train several muscle groups simultaneously and in different planes of motion.

In this way, training activities mimic daily living activities. For example, individuals often lift several heavy bags of groceries and turn to open the car or trunk, involving both sagittal and transverse movement. Preparing the body for complex activities with compound exercises allows individuals to perform them more easily throughout the day.

Prepares Body for Sports and Physical Activities

Complex multi-planar movements help prepare for safe and effective physical activity and sports performance (National Academy of Sports Medicine, 2024). Researchers and experts understand that many physical and athletic activities require the body to move in different directions, often quickly and under high stress. Several studies have found that anterior cruciate ligament/ACL injuries are more likely to occur during multi-planar rather than single-planar movements. (Quatman C. E., Quatman-Yates C. C., & Hewett T. E. 2010) Training the body to perform multi-planar movements safely and effectively through exercise can help reduce the risk of injury during daily activities or stressful athletic competitions.

Encourages Variation For Full Body Strengthening

Individuals tend to fall into certain movement patterns, such as repeatedly performing the same fitness activity or exercises. This can cause them to have a favorite plane of motion. One way to break away from the same routine is to include movement from all planes of motion. For example, many abdominal workout machines help train in multiple planes of motion, challenging your body to move in different ways. Dumbbells, kettlebells, TRX straps, and bands allow individuals to move joints freely in various planes of motion and work several muscles.

Runners train primarily in the sagittal plane, even if they cross-train by swimming, cycling, or using cardio machines. For this reason, trainers and coaches often recommend doing some form of yoga or weight training that allows them to move their joints in different ways, including lateral movements or rotation. Even flexibility training should incorporate all three planes of motion. For example, walkers might choose to do a simple calf or hamstring stretch at the end of their workout but may also benefit from a seated spine rotation or a lying hip stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

Understanding the concept and importance of training in the three planes of motion can help improve sports and physical performance and prevent musculoskeletal injuries. Chiropractic care aims to help individuals enhance movement with less pain due to condition, after injury, or surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

The Difference of Using Custom Foot Orthotics

References

National Academy of Sports Medicine. (2024). Sagittal, Frontal and Transverse Body Planes: Exercises & Movements. NASM. https://blog.nasm.org/exercise-programming/sagittal-frontal-traverse-planes-explained-with-exercises?utm_source=blog&utm_medium=referral&utm_campaign=organic&utm_content=ReasonsToBecomeCES

Quatman, C. E., Quatman-Yates, C. C., & Hewett, T. E. (2010). A ‘plane’ explanation of anterior cruciate ligament injury mechanisms: a systematic review. Sports medicine (Auckland, N.Z.), 40(9), 729–746. https://doi.org/10.2165/11534950-000000000-00000