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- 33 -

THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT

FN

SFMA SCORING

Active Cervical Flexion

Active Cervical Extension

Cervical Rotation Bend

L R

Upper Extremity Pattern 1(MRE)

Upper Extremity Pattern 2 (LRF)

L R L R

Multi-Segmental Flexion

Multi-Segmental Extension

Multi-Segmental Rotation

Single Leg Stance

Overhead Deep Squat

SFMA Certification

L R L R

FP

DP

DN

- 34 -

THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT

- 49 -

CERVICAL SPINE PATTERN BREAKOUTS Limited Cervical Spine Patterns

Active Supine Cervical Flexion Test (Chin to Chest)

DN, DP or FP

FN

Passive Supine Cervical Flexion Test

There is a Postural SMCD affecting Cervical Flexion. This includes Cervical Spine, Thoracic Spine and Shoulder Girdle postural dysfunction.

FN

DN, DP or FP

Active Supine OA Cervical Flexion Test (20˚)

Active Cervical Spine Flexion SMCD

DP or FP

DN

FN Bilat.

If Passive Supine Cervical Flexion (PSCF) was DP or

OA Flexion JMD &/or TED

DN then treat as Cervical Spine Flexion JMD &/or

&/or possible Cervical

TED. If PSCF was FP can also be SMCD - perform

Spine Flexion JMD &/or

segmental testing and soft tissue appraisal.

TED

Active Supine Cervical Rotation Test (80˚) FN

DN, DP or FP

There is a Postural SMCD affecting Cervical Rotation. This includes Cervical

Passive Supine Cervical Rotation Test

Spine, Thoracic Spine and Shoulder Girdle postural dysfunction. DN, DP or FP

FN

Active Cervical Spine

Supine Cervical Extension

C1-C2 Cervical Rotation Test

Rotation SMCD FN

DN

FP or DP

FP or DP

DN

FN If Passive Supine Cervical Rotation (PSCR) was DP or DN then treat as

Cervical

There is Postural &/

Extension JMD

or SMCD affecting

&/or TED

Cervical Extension.

Lower Cervical Rotational JMD &/or TED. If PSCR was FP can also be SMCD - perform segmental testing and soft tissue appraisal.

C1-C2 JMD &/or TED &/or possible Lower Cervical Spine JMD &/or TED.

- 60 -

UPPER EXTREMITY PATTERN BREAKOUTS

Limited Upper Extremity Pattern One

Active Prone Upper Extremity Pattern One (IR)

FN

Act. Prone Elbow Flex. Test (Ext.)

DN, DP or FP

DN, DP or FP

Passive Prone Upper Extremity

FN

Pattern One (IR) Passive Prone Elbow FN

DN, DP or FP

Flexion Test (Ext.)

Active Prone Shoulder 90/90 IR

FN

DP or FP

DN

Test (60° &/or Total Arc of 150°) Elbow FN

Flex

DN, DP or FP

SMCD

Passive Prone Shoulder IR Test

Treat

Elbow Flex

Pain

JMD or TED

Lumbar Locked (CH) Act Ext./Rot.

DN, DP or FP

FN FN

DN

DP or FP

Shoulder

Shoulder IR

IR SMCD

JMD or TED

Treat

Lumbar Locked (CH) Passive Ext./Rot.

Chemical Pain If no previous

FN

DP or FP

DN

Orange Boxes

Active Prone Shoulder Ext. Test (50°)

consider this a Postural &/

DN, DP or FP

FN

or Shoulder

Treat

Girdle SMCD.

Pain

Thoracic Ext. JMD,

Otherwise treat orange boxes first.

Passive Prone Shoulder Ext. Test

FN

DN

DP or FP

Shoulder Ext

Shlder Ext.

Treat

SMCD

JMD or TED

Chem Pain

Postural &/or Shoulder Girdle SMCD

TED.

- 61 -

UPPER EXTREMITY PATTERN BREAKOUTS

Limited Upper Extremity Pattern Two

Active Prone Upper Extremity Pattern Two (ER)

FN

Act. Prone Elbow Flex. Test (Flex)

DN, DP or FP

DN, DP or FP

Passive Prone Upper Extremity

FN

Pattern Two (ER) Passive Prone Elbow FN

DN, DP or FP

Flexion Test (Flex)

Prone Shoulder 90/90 ER Test (90°

FN

DP or FP

DN

&/or Total Arc of 150°) Elbow FN

Flex

DN, DP or FP

SMCD

Passive Prone Shoulder ER Test

Treat

Elbow Flex

Pain

JMD or TED

Lumbar Locked (CH) Act Ext./Rot.

DN, DP or FP

FN FN

Shoulder ER SMCD

DN

DP or FP

Shoulder

Treat

ER JMD or

Chemical

TED

Pain

Lumbar Locked (CH) Passive Ext./Rot.

If no previous

FN

DP or FP

DN

Orange Boxes

Active Prone Shldr Flx/Abd Test (170°)

consider this a Postural &/

DN, DP or FP

FN

or Shoulder

Treat

Girdle SMCD.

Pain

Thoracic Ext. JMD,

Otherwise treat orange boxes first.

Passive Prone Shoulder Fl/Ab Test

Postural &/or Shoulder Girdle SMCD

FN

DN

DP or FP

Shoulder Fl/

Shlder Fl/Ab

Treat

Ab SMCD

JMD or TED

Chem Pain

TED.

- 83 -

MULTI-SEGMENTAL FLEXION BREAKOUTS

Limited Multi-Segmental Flexion

Single Leg Forward Bend

Bilateral DN, DP or FP

FN

Unilateral DN, DP or FP

Long Sitting

0

FN (80 Sacral Angle)

DN, DP or FP

Active SLR

Weight Bearing Hip Flexion pattern SMCD

0

FN

DN, DP or FP(80

DN, DP or FP

Core SMCD &/or Active Hip Flexion SMCD

Prone Rocking

FN

FP or DP

Supine Knee to Chest (T)

DN FN

FP or DP

DN

If no previous mobility findings consider this a Weight Bearing

Spinal Flexion

Spine &/or Hip SMCD - otherwise

JMD &/or TED

treat orange boxes first.

Posterior Chain TED or if PSLR

Hip JMD &/or

was FP could

Posterior Chain

be Active Hip

TED

Flexion SMCD

- 97 -

MULTI-SEGMENTAL EXTENSION BREAKOUTS Spine Extension Flowchart

Backward Bend w/o UE Go to DN, DP or FP

FN

UB Ext. Flowchart

Single Leg BB

DN, DP or FP

FN

Symmetrical Stance Core

Press Up

SMCD or Anterior Torso TED. Go to UB Ext. Flowchart

Weight Bearing Spine Extension SMCD. Go to Lower & Upper

FN

DN, DP or FP (>1 Airex Pad)

Body Ext. Flowcharts

Lumbar Locked (IR) - Active Extension/Rotation (50°)

FN

DN, DP or FP

Lumbar Locked (IR) - Passive Extension/Rotation (50°)

FP or DP

Treat Pain - Go to Lower Body Ext. FC

DN

FN

Thoracic Extension SMCD

Thorac Ext./Rot. JMD &/or TED - Go to Lower Body Ext. Flowchart

Active Prone on Elbow Unilateral Extension/Rotation (30°)

FN

DN, DP or FP

If T-spine has SMCD assume L-Spine is normal.

Passive Prone on Elb Uni. Ext./Rot. (30°)

Weight Bearing Spine Ext. FP or DP

DN

FN

SMCD or Ant. Torso TED- Go to LB then UB Ext. FC

Treat Pain Go to LB then UB Ext FC

Lumbar Ext./ Rot JMD &/or TED - Go to LB then UB Ext FC

- 98 -

MULTI-SEGMENTAL EXTENSION BREAKOUTS Lower Body Extension Flowchart

FABER Test

FN

DN, DP or FP

Stabilized FABER Test

FN

DN, DP or FP

Hip/SI JMD &/or TED - Perform Hip/Core SMCD

Local Biomechanical Testing of the Hip and SI.

Modified Thomas

FN with

FN with

FN with Hip Abducted &

Knee Straight

Hip Abducted

Knee Straight

Lower Anterior

Lower Lateral

Lower Anterior and

Hip Ext. JMD &/or TED

Chain TED

Chain TED

Lateral Chain TED

and/or Core SMCD.

DN

FN

DP/FP

If Faber was DN, DP or FP then stop and treat Faber

Prone Active Hip Extension

FN (> or = 10 degrees Extension)

DN, DP or FP

Prone Passive Hip Extension

If Spine Ext. was dysfunctional consider

DN

FP or DP

FN

Hip normal. If not - there is a Weight Bearing Hip Extension

Core SMCD &/

SMCD &/or Limited

Hip Extension

or Active Hip

Ankle Dorsiflexion (Refer

JMD &/or TED

Extension SMCD

to ODS & SLS).

SFMA Certification

- 99 -

MULTI-SEGMENTAL EXTENSION BREAKOUTS Upper Body Extension Flowchart

Unilateral Shoulder Backward Bend

FN

DN, DP or FP

Potential Anterior Torso

Supine Lat Stretch Hips Flexed

TED or Cervical Spine Involvement - Double Check Cervical

DN, DP or FP

FN

Patterns

If no previous Hip or Spine extension mobility dysfunctions

Supine Lat Stretch Hips Extended

consider this a Weight Bearing Upper Quarter Extension SMCD - otherwise treat hips and spine first.

FN

Shoulder Flexion

DN, DP or FP

Improves but not Full

Posterior/Lateral Chain TED &/or Possible Hip Extension dysfunction - Go to Lower Body

Posterior/Lat. Chain TED &/or Possible Hip Extension

Extension Flowchart

dysfunction - Make sure you also run Lower Body Extension Flowchart

Lumbar Locked (ER) - Active Unilateral Ext./Rot. (50°)

FN

DN, DP or FP

Shoulder Girdle SMCD

Lumbar Locked (IR) - Active Extension/Rotation (50°)

Lumbar Locked (IR) - Passive Extension/Rotation

DN

FP or DP

Thoracic Extension / Rotation JMD &/or TED - possible Shld. JMD/TED as well

SFMA Certification

FN

Thoracic Ext./Rot. SMCD

DN, DP or FP

FN

Shoulder Girdle JMD or TED

- 124 -

MULTI-SEGMENTAL ROTATION BREAKOUTS Limited Multi-Segmental Rotation

Seated Rotation (50°)

DN, DP or FP

FN

Go to Hip

Lumbar Locked (ER) - Active Unilateral Ext./Rot (50°)

Rotation Flowcharts

FN

DN, DP or FP & Switches Sides

DN, DP or FP

Lumbar Locked (IR) - Active Unilateral Ext./Rot. (50°)

FN

Shoulder

DN, DP or FP

Lumbar Locked (IR) - Passive Ext./Rot. (50°)

Girdle TED &/or JMD DN

Thorac Ext./Rot. JMD &/or TED - Go to Hip Rotation

FP or DP

Treat Pain - Go to Hip Rotation

Flowcharts

FN

Thorax Rotation SMCD

Flowcharts

Active Prone on Elbow Unilateral Ext./Rot (30°)

FN

DN, DP or FP

Passive Prone on Elb Uni. Ext/Rot. (30°)

FN

If Thor. Rot. SMCD exists lumbar spine is normal. If not consider this a Weight Bearing Spine or Shoulder Girdle Rot. SMCD - Go

FP or DP

DN

Treat Pain

Lumbar Spine

- Go to Hip

Ext./Rot JMD &/or

Rotation

TED - Go to Hip

Flowchart

Rotation FC

SFMA Certification

to Hip Rot FC

- 125 -

MULTI-SEGMENTAL ROTATION BREAKOUTS Hip Rotation Flowchart (Part 1)

Seated Active External Hip Rotation

0)

FN (>40 )

DN, DP or FP

Seated Passive External Hip Rotation

DN

FP or DP

FN

Treat Pain -

Hip JMD &/or TED for Ext.

Go to Tibia

Rotation with Hip Flexed

Rot. Flowchart

Prone Active External Hip Rotation

0)

FN (>40 )

DN, DP or FP

Prone Passive External Hip Rotation

If Seated Passive Rotation was DN stop and Treat the DN. If no previous signs of hip rotation dysfunction consider the

DN

FP or DP

FN

hips normal and go to Tibial Rotation Flowchart. If not consider this a Weight Bearing External Hip Rotation SMCD - Go to Tibial Rotation Flowchart.

Hip JMD &/

Treat Pain -

or TED for Ext.

Go to Tibia

Rot. with Hip

Rot. Flowchart

Extended Go to Tibial Rotation Flowchart and Lower Body Extension Breakout

SFMA Certification

If Seated Passive Rotation was DN stop and Treat the DN. If not consider this a Weight Bearing External Hip Rotation SMCD - Go to Tibial Rotation Flowchart.

- 126 -

MULTI-SEGMENTAL ROTATION BREAKOUTS Hip Rotation Flowchart (Part 2)

Seated Active Internal Hip Rotation

0)

FN (>30 )

DN, DP or FP

Seated Passive Internal Hip Rotation

FP or DP

DN

Hip JMD &/or TED for Medial Rotation with Hip Flexed

FN

Treat Pain Go to Tibia Rot. Flowchart

Prone Active Internal Hip Rotation

0)

DN, DP or FP

FN (>30 )

Prone Passive Internal Hip Rotation

If Seated Passive Rotation was DN stop and Treat the DN. If no previous signs of hip rotation dysfunction consider the hips normal and go to Tibial Rotation

DN

FP or DP

FN

Flowchart. If not consider this a Weight Bearing Internal Hip Rotation SMCD - Go to Tibial Rotation Flowchart.

Hip JMD &/or

Treat Pain -

TED for Med.

Go to Tibia

Rot. with Hip

Rot. Flowchart

Extended Go to Tibial Rotation Flowchart and Lower Body Extension Breakout

SFMA Certification

If Seated Passive Rotation was DN stop and Treat the DN. If not consider this a Weight Bearing Internal Hip Rotation SMCD - Go to Tibial Rotation Flowchart.

- 127 -

MULTI-SEGMENTAL ROTATION BREAKOUTS

Tibial Rotation Flowchart

Seated Act Internal Tibial Rot.

FN

DN, DP or FP

Passive Internal Tibial Rotation

DP or FP

FN

DN

Tibial Rotation

Tibial Int. Rot.

SMCD

TED &/or JMD

Seated Act External Tibial Rot.

FN

DN, DP or FP

Tibia External Rotation Mobility is Normal

Passive External Tibial Rotation

(If no previous Rotation findings - Go to Lower Body Extension Flowchart) FN

SFMA Certification

DP or FP

DN

Tibial Rotation

Tibial Ext.Rot.

SMCD

TED &/or JMD

- 149 -

SINGLE LEG STANCE BREAKOUTS FLOWCHART

Vestibular & Core Flowchart

Vestibular Test - CTSIB (Static Head)

FN

DN, DP or FP

Potential Static Vestibular

CTSIB (Dynamic Head Movement)

Dysfunction

FN

Dysfunctional

Dynamic

Half-Kneeling Narrow Base

Vestibular Dysfunction

FN

DN, DP, or FP

Go to SLS Ankle

Quadruped Diagonals

Flowchart

FN

DP or FP

Weight Bearing Spine

Weight Bearing Hip &/or

&/or Hip/Core SMCD

Treat Pain - Go

Core SMCD (If Hip Extension

- (If Hip Extension is DN

to SLS Ankle

&/or Shoulder Flexion are

treat it first). Go to SLS

Flowchart.

DN treat those first) Go to

Ankle Flowchart.

SFMA Certification

DN

SLS Ankle Flowchart.

- 150 -

SINGLE LEG STANCE BREAKOUTS FLOWCHART

Ankle Flowchart

Heel Walks

FN

DN, DP or FP

Prone Passive Dorsiflexion

DP or FP

FN

Treat Pain

Dorsiflexion SMCD

DN

Lower Posterior Chain TED &/or JMD

Toe Walks

DN, DP or FP

FN

Prone Passive Plantarflexion

FN

DN

DP or FP

Plantarflexion SMCD

Lower Anterior Chain TED &/or JMD

Treat Pain

Seated Active Ankle Inversion/Eversion

FN

DN, DP or FP

Passive Ankle Inversion/Eversion

DN

Ankle (Eversion or

DP or FP

FN

Ankle (Eversion or

Inversion) JMD, TED -

Inversion) SMCD

* Perform local foot/

- * Perform local

ankle exam

foot/ankle exam

SFMA Certification

If no Red, Orange or Positive Blue Boxes so far = Proprioceptive Deficit

- 165 -

OVERHEAD DEEP SQUATTING PATTERN BREAKOUTS

Limited Overhead Deep Squat

Deep Squat

DN, DP or FP

If Squat is now FN - Go to MultiSegmental Extension Breakout.

Half Kneeling Dorsiflexion

FP or DP

DN FN

Lower Posterior Chain TED &/Or Ankle JMD

Treat Pain

Supine Knees to Chest Holding Shins

DN, DP or FP

FN w/ DP or FP

FN w/ DN

FN w/ FN

Dorsiflexion

Dorsiflexion

Dorsiflexion

Treat Dorsiflexion -

Treat Dorsiflexion

Consider Knee & Hip

Chemical Pain

Flexion Normal

Supine Knees to Chest Holding Thighs

FN

Knee JMD (Flexion) &/or Lower Anterior Chain TED

SFMA Certification

FP or DP

Treat Chemical Pain
...