Although acknowledging that the "movement system" is not a system in the truest sense, Maury Hayashida, PT, DPT, OCS, CSCS, described ways in which technology can be used to analyze movement in order to address pain and reduce the risk of injury. Hayashida and Tom Walters, PT, DPT, OCS, CSCS, presented "Movement System Analysis: Using Technology to Differentiate Your Practice" on June 12.
Posing the question "Do physical therapists (PTs) treat pain or movement?" Hayashida answered, "What we are treating is pain," which sometimes may be addressed by altering or addressing movement.
Walters explained that there are different types of pain, including neuropathic, sensitization, and nociceptive pain—pain arising from actual or threatened damage to non-neural tissue due to the activation of nociceptors. He said that nociceptive pain "fits best with movement systems analysis."
He described the goals of the practice that he and Hayashida operate. "We want to identify movements that potentially are activating nociceptors. Then we want to adjust the aberrant movement patterns and resolve the symptoms to prevent sensitization."
The practice uses a variety of technologies to identify those aberrant movement patterns, including force plate technology, surface electromyography (sEMG), 2D and 3D video analysis, Zebris MyoPressure, dynamometry, electroencephalography (EEG), and real-time ultrasound.
The objective, Hayashida said, is to establish a patient's risk for biological tissue breakdown and a nociceptive event, and then to reduce that risk. A physical examination helps identify why someone is hurting. A movement system analysis can help determine what is causing the pain, he added.
Most of the technologies used by the practice provide quick feedback, some even real-time, instantaneous feedback. Hayashida said, "Patients want to see themselves moving. When they see themselves move [and see the aberrant movement patterns], patient education is very easy. " In fact, some sessions are structured so that a patient may be tested, then practice a corrected movement, return to be tested again, practice again, and be tested yet again—seeing a progression of improvement during a single session.
Walters and Hayashida operate a cash-based business primarily targeted to youths aged 7-18. However, Walters conceded that many of those patients and clients lack the financial resources to use their services, so the practice also works with athletes and weekend warriors. Another challenge encountered by the practice is prospective clients who ask why they should receive examination and possible interventions if they are not yet injured. The answer, Hayashida says, is that the process seeks to reduce the risk of injury.