{"id":79,"date":"2010-05-03T00:27:19","date_gmt":"2010-05-03T00:27:19","guid":{"rendered":"http:\/\/optimumsportsperformance.com\/blog\/?p=79"},"modified":"2019-01-19T23:27:24","modified_gmt":"2019-01-19T23:27:24","slug":"developmental-kinesiology-and-client-assessment","status":"publish","type":"post","link":"https:\/\/optimumsportsperformance.com\/blog\/developmental-kinesiology-and-client-assessment\/","title":{"rendered":"Developmental Kinesiology and Client Assessment"},"content":{"rendered":"<p>Doctors like Janda, Vojta, Lewit and Kolar have made great strides in applying concepts from childhood development to physical rehabilitation of adults.\u00a0 Additionally, Gray Cook and Lee Burton have taken some of these same concepts and applied them in their\u00a0<a href=\"hhttp:\/\/functionalmovement.com\/SITE\/\" target=\"_blank\">Functional Movement Screen<\/a>.<\/p>\n<p>Below are\u00a0a few notes from developmental kinesiology and what they mean to program design for our clients.<\/p>\n<p><strong>Infant Reflexes<\/strong><\/p>\n<p>Reflexes are movements that occur automatically (like blinking).\u00a0 While a number of our reflexes occur throughout our entire life, some reflexes are only present when we are babies.\u00a0 These are referred to as infantile reflexes.\u00a0 There are three kinds of infantile reflexes \u2013 primitive, postural, and locomotor.<\/p>\n<p><strong>Primitive Reflexes<\/strong>\u00a0\u2013 These are reflexes that deal with an infant producing an involuntary response to specific stimuli.\u00a0 An example of this would be when you place your finger in the palm of a baby; the baby reflexively grasps your finger and squeezes it.\u00a0 Other examples of primitive reflexes are:<\/p>\n<ul>\n<li><em>Sucking reflex<\/em>&#8211; brought on by touching the face above or below the lip<\/li>\n<li><em>Asymmetrical<\/em>\u00a0<em>tonic neck reflex<\/em>&#8211; brought on when the head is turned to one side, causing the same side arm and leg to extend<\/li>\n<li><em>Startle reflex<\/em>\u00a0\u2013 brought on by tapping the abdomen or attempting to startle the infant, causing the arms and legs to flex<\/li>\n<li><em>Babinski reflex<\/em>\u00a0\u2013 brought on by stroking the bottom of the foot from heel to toe, causing the toes to extend<\/li>\n<\/ul>\n<p><strong>Postural Reflexes \u2013\u00a0<\/strong>These are reflexes that allow the infant to automatically adapt their posture to changes in environment.\u00a0 These are also referred to as gravitational reflexes, as aside from the derotative righting reflex (which occurs in a supine position), the other reflexes in this category pertain to the baby being supported upright, sitting, or being lowered towards the floor, and how the infant reflexes prepares for different situations in these postures.\u00a0 Some examples of postural reflexes are:<\/p>\n<ul>\n<li><em>Derotative righting\u00a0<\/em>&#8211; In supine, if the infant turns their legs and pelvis towards one side, the trunk and head will follow the rotation.\u00a0 Similarly, if the head is turned towards one side, the body follows the head in that rotation.\u00a0 This occurs around four months of age.<\/li>\n<li><em>Labyrinthe righting &#8211;<\/em>\u00a0When the infant is supported upright, if you tilt the infant, they will reflexively move the head to stay upright<\/li>\n<li><em>Parachute Reflex<\/em>\u00a0&#8211; While holding the infant upright, if you lower them towards the floor rapidly, their legs will extend reflexively in preparation for landing.\u00a0 If you tilt the baby forward, sideways, or backwards, their arms will reflexively extend.<\/li>\n<\/ul>\n<p><strong>Locomotor Reflexes \u2013\u00a0<\/strong>As the name implies, these reflexes have to do with our movement.\u00a0 There are three reflexes that make up this category:<em>crawling<\/em>,\u00a0<em>stepping<\/em>, and\u00a0<em>swimming\u00a0<\/em>(Remember those evil moms that\u00a0you would see\u00a0throwing their\u00a0infants into the swimming pool for swim lessons? It turns out\u2026babies could swim!)<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-84\" alt=\"baby-swim\" src=\"https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/baby-swim.jpg\" width=\"280\" height=\"207\" \/><em>I hope those babies don&#8217;t plan on peeing in the pool!<\/em><\/p>\n<p><strong>What does this all mean to training adults?<\/strong><\/p>\n<p>As we develop, these reflexive movements start to become more refined, coordinated and complex, ultimately leading to the specific movements we produce later in life \u2013 walking, running, jumping, reaching, grasping, etc.<\/p>\n<p>However, developing these skills does not just happen magically.\u00a0 Learning to control the body and developing fundamental skills make up our\u00a0<em>motor milestones.<\/em>\u00a0 Each of these milestones marks a turning point in our development and there is a\u00a0progression that these milestones follow.\u00a0 In simplistic terms, we need to be able to lift our head and support it, roll over, crawl and creep, support ourselves upright, walk with assistance, and then walk without support.<\/p>\n<p>We can draw many parallels between motor milestones\u00a0and the<a href=\"http:\/\/functionalmovement.com\/SITE\/\" target=\"_blank\">Functional Movement Screen<\/a>\u00a0and the way we develop training progressions for our clients.<\/p>\n<p><strong>The Functional Movement Screen and Evaluation of Primitive Movements<\/strong><\/p>\n<p>The Functional Movement Screen evaluates\u00a0seven basic movement patterns, and those patterns are then graded on a 1-3 scale as far as the quality of movement being produced, with a score of 0 meaning that the client experienced pain during the movement.\u00a0 The seven tests are:<\/p>\n<ol>\n<li><em>Overhead Deep Squat<\/em><\/li>\n<li><em>Hurdle Step<\/em><\/li>\n<li><em>Inline Lunge<\/em><\/li>\n<li><em>Shoulder Mobility<\/em><\/li>\n<li><em>Active Straight Leg Raise<\/em><\/li>\n<li><em>Trunk Stability Push Up<\/em><\/li>\n<li><em>Rotary Stability<\/em><\/li>\n<\/ol>\n<p>At first glance the, it looks like a series of movement tests (which is it).\u00a0 The first three tests are looking at large global patterns and basically evaluating how well the joints of the body, both mobility and stability,\u00a0play with each other.\u00a0 Tests four and five\u00a0can be\u00a0considered\u00a0<em>mobility<\/em>\u00a0tests, as they evaluate what kind of range of motion we can move through at specific areas of our body, and the last two are\u00a0<em>stability\u00a0<\/em>tests, which look at how well we stabilize ourselves.<\/p>\n<p>If I re-arrange the order of these tests to represent our motor milestones, suddenly the movement screen will look very different:<\/p>\n<ol>\n<li><em>Active Straight Leg Raise<\/em><\/li>\n<li><em>Shoulder Mobility<\/em><\/li>\n<li><em>Rotary Stability<\/em><\/li>\n<li><em>Trunk Stability Push Up<\/em><\/li>\n<li><em>Overhead Deep Squat<\/em><\/li>\n<li><em>Hurdle Step<\/em><\/li>\n<li><em>Inline Lunge<\/em><\/li>\n<\/ol>\n<p>The tests are now in an order that represents our movement milestones.<\/p>\n<p>The first test,\u00a0<strong>Active Straight Leg Raise<\/strong>, represents the spontaneous movement of supine kicking that we display as infants.\u00a0 When lied on their back, infants will raise their legs up and kick\u00a0them back and forth.\u00a0 Additionally, at a young age, babies lie on their backs and play with their toes, which incorporates both hip flexion (<strong>Active Straight Leg Raise)<\/strong>and shoulder\/arm movement (<strong>Shoulder Mobility).\u00a0\u00a0<\/strong>Furthermore, the<strong>Shoulder Mobility\u00a0<\/strong>test looks not only at shoulder mobility, but really how well the thoracic spine functions, as limitations in thoracic extension will surely lead to a poor score in this test.<\/p>\n<p><strong><\/strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-89\" alt=\"up_2620\" src=\"https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/up_2620.jpg\" width=\"200\" height=\"133\" \/><\/p>\n<p>&nbsp;<\/p>\n<p><strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-88\" alt=\"straight_leg_raise\" src=\"https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/straight_leg_raise.gif\" width=\"118\" height=\"153\" \/><\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-87\" alt=\"shouldermobilityfist\" src=\"https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/shouldermobilityfist.jpg\" width=\"240\" height=\"320\" srcset=\"https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/shouldermobilityfist.jpg 240w, https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/shouldermobilityfist-225x300.jpg 225w\" sizes=\"auto, (max-width: 240px) 100vw, 240px\" \/><\/p>\n<p><em>Creeping\u00a0<\/em>and\u00a0<em>Crawling\u00a0<\/em>patterns are the first ways that the infant actually moves around.\u00a0\u00a0<em>Creeping\u00a0<\/em>is the infants first attempt at crawling and\u00a0can be viewed as a crawl except the infant is moving close to the ground \u2013 belly on the ground \u2013 similar to a combat crawl.\u00a0\u00a0<em>Crawling\u00a0<\/em>is the progression from\u00a0<em>creeping<\/em>, where the infant is now moving on their hands and knees.\u00a0 Before the infant can get to a\u00a0<em>creeping\u00a0<\/em>or\u00a0<em>crawling\u00a0<\/em>position, they must first be able to roll over.\u00a0 The\u00a0<strong>Rotary Stability Test\u00a0<\/strong>not only evaluates the individuals stability in a quadruped (all fours) position, but also tests the individuals rotational stability, which would be needed to perform a proper roll from supine (face up) to prone (face down), which is part of our infantile reflexes.\u00a0 The\u00a0<strong>Trunk Stability Push Up\u00a0<\/strong>is a representation of the infant pushing\u00a0itself up in preparation for standing and upright posture.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-86\" alt=\"ist2_6379522-creeping-small-baby-3-isolated2-200x300\" src=\"https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/ist2_6379522-creeping-small-baby-3-isolated2-200x300.jpg\" width=\"200\" height=\"300\" \/> <img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-85\" alt=\"ist2_6316457-creeping-small-baby-isolated1-300x200\" src=\"https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/ist2_6316457-creeping-small-baby-isolated1-300x200.jpg\" width=\"300\" height=\"200\" \/> <img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-90\" alt=\"funct_mov22-300x205\" src=\"https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/funct_mov22-300x205.jpg\" width=\"300\" height=\"205\" \/><\/p>\n<p>The\u00a0<strong>Overhead Deep Squat\u00a0<\/strong>would represent the infant\u2019s ability to stand up without help.\u00a0\u00a0As a continuation of\u00a0the two previous tests, this is in line with\u00a0our motor milestones\u00a0as the child first rolls over and crawls\u00a0<strong>(rotary stability),<\/strong>\u00a0then pushes\u00a0itself up onto the couch (<strong>trunk stability push up),\u00a0<\/strong>and finally transitions to standing\u00a0<strong>(Overhead Deep Squat).<\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-81\" alt=\"103868776_22b9f895fe\" src=\"https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/103868776_22b9f895fe.jpg\" width=\"500\" height=\"333\" srcset=\"https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/103868776_22b9f895fe.jpg 500w, https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/103868776_22b9f895fe-300x199.jpg 300w\" sizes=\"auto, (max-width: 500px) 100vw, 500px\" \/><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-83\" alt=\"assessing-your-golf-ability-21\" src=\"https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/assessing-your-golf-ability-21.jpg\" width=\"215\" height=\"280\" \/><\/p>\n<p>The\u00a0<strong>Hurdle Step<\/strong>\u00a0is next in the progression as it represents us actually taking a step and how well we can establish single-leg stance.\u00a0 After taking that first step, we typically fall and catch ourselves, and prepare to stand up again (<strong>Inline Lunge).<\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-82\" alt=\"0464180035f80160c1fac83400581205\" src=\"https:\/\/optimumsportsperformance.com\/blog\/wp-content\/uploads\/2010\/05\/0464180035f80160c1fac83400581205.jpg\" width=\"300\" height=\"229\" \/><\/p>\n<p><strong>Rolling Assessment<\/strong><\/p>\n<p>Another important evaluation that can be used in the Functional Movement Screen is the multi segmental rolling pattern, where the client is asked to roll them self from both supine to prone and prone to supine using only their upper or lower extremity.\u00a0 Multi segmental rolling is an evaluation of the pattern of rolling over, which is the part of the derotative righting reflex discussed above.\u00a0 This tests gives us an appreciation for both stability and mobility of the client, as limitations in mobility will lead to the individual attempting to draw stability from somewhere else in order\u00a0to complete the movement and appease the tester\u2026.after all, you asked them to roll over!\u00a0 Basically, they are going to try and get there anyway they can.<\/p>\n<p><strong>What About Exercise?<\/strong><\/p>\n<p>Our training progressions should represent these motor milestones, as people need to master the more primitive positions before moving on to more coordinated\/skilled movements.\u00a0 Essentially, we want to\u00a0<em>\u201cfill in the blanks\u201d\u00a0<\/em>so that our brain can give our body good feedback about how to appropriately move \u2013 you did it once before as a developing infant, and you just need to\u00a0<em>remember<\/em>\u00a0how to do it again!<\/p>\n<p>The goal of correcting movements from the screen should take a similar approach to our motor milestones.\u00a0 Before trying to correct the squat, you would want to first correct the things that came before it, as they would be considered\u00a0<em>\u201cmore primitive\u201d.\u00a0<\/em><\/p>\n<p>The exercises that we prescribe to clients can follow a similar sequence of regression and progression.\u00a0\u00a0Here is an\u00a0example of\u00a0this sequence\u00a0for a chop:<\/p>\n<ul>\n<li>Tall kneeling would be more primitive than half kneeling, so we could start there.<\/li>\n<li>Half kneeling would come next as this would\u00a0alter the clients base of support and make them feel less stable.<\/li>\n<li>A half kneeling chop would be followed by a parallel stance standing chop.<\/li>\n<li>Parallel stance\u00a0standing would be followed by an inline stance standing chop.<\/li>\n<li>Finally we could progress to a single leg chop.<\/li>\n<\/ul>\n<p><strong>Conclusion<\/strong><\/p>\n<p>All of a sudden, training clients looks a lot different!<\/p>\n<p>It isn\u2019t about what exercises we do but what we are actually getting when we\u00a0perform them that is important.\u00a0 Having progressions and regressions of exercises that follow\u00a0the motor developmental sequence can be an effective way to help your clients get the most out of their training.<\/p>\n<p><em>*Special thanks to\u00a0<a href=\"http:\/\/charlieweingroff.com\/\">Charlie Weingroff<\/a>\u00a0for his editing of this article*<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Doctors like Janda, Vojta, Lewit and Kolar have made great strides in applying concepts from childhood development to physical rehabilitation of adults.\u00a0 Additionally, Gray Cook and Lee Burton have taken some of these same concepts and applied them in their\u00a0Functional Movement Screen. Below are\u00a0a few notes from developmental kinesiology and what they mean to program [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[27],"tags":[],"class_list":["post-79","post","type-post","status-publish","format-standard","hentry","category-strength-and-conditioning"],"_links":{"self":[{"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/posts\/79","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/comments?post=79"}],"version-history":[{"count":2,"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/posts\/79\/revisions"}],"predecessor-version":[{"id":91,"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/posts\/79\/revisions\/91"}],"wp:attachment":[{"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/media?parent=79"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/categories?post=79"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/tags?post=79"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}