Assessment of human movement in clinical practice

Loss of motion is a frequent finding in those suffering from pain. In fact, one of the most common findings during pain is altered movement strategies. Most people will experience this at some point with one example being limping after distorting and ankle or reducing the range of motion when during the head after waking up with neck pain. This strategy is a way of protecting against further pain caused by movement.

It is usually at this point, when people can no longer move the way they used to, that they consult a healthcare professional. As part of a consultation, the clinician will usually assess the available movement and its quality by observing the patient move the body part of interest into specific directions.

How accurate can clinicians be?

For many clinicians, the pragmatic approach to evaluate movement usually consists of a visual estimation the movement range along with its quality. In some cases, this assessment is supplemented by using a manual goniometer to estimate available degrees of movement. While this approach is readily available, quick and cheap, the downside is a very poor level of accuracy.

Several studies have shown that the measurements differ depending on how many clinicians perform the assessment and also, the same clinicians often struggle with finding the same result when performing the assessment several times. Due to this inaccuracy in determining movement quality and range of motion, valuable information are lost. This is problematic for two reasons:

1. Research, where advanced equipment is used to assess human movement has consistently shown that various patient populations (e.g. people with neck pain, shoulder pain and knee pain) demonstrate not only changes in range of motion but also a poorer quality of movement (e.g. the smoothness of movement) and reduced joint positioning sense which is evident in their lack of ability to find back the starting position of a movement

2. Consultation times within the primary sector are often too short to allow for more accurate assessments using high-tech equipment that take a long time, regardless of whether they add valuable information or not.

These findings may often be sub-clinical i.e. difficult or even impossible to identify and / or quantify with the human eye.

Applying research knowledge in clinical practice

Getting an accurate evaluation of human movement similar to what is done is research requires the right equipment, expertise and time for performing the assessment as well as time in the extracting and analyzing the data. This in addition to the price of the equipment makes such evaluations unfeasible for use in clinical practice. However, this may change with the introduction of Moti; a new device capable of measuring the variables described above and providing the results in real-time.

In this day and age, where the requirements of documentation of both assessment findings and progression in the rehabilitation period are increasingly being prioritized, having such a device can be of great help and provide the clinician with necessary

information in clinical decision making.

The device is very easy to use and the user interface in the mobile application is very intuitive, making it easy to include in the clinical assessment. Moreover, the visual feedback which becomes available only seconds after the movement has been recorded is easy to understand and can be used when explaining assessment findings to the patient.

A very exciting potential feature, is the possibility of using the device as biofeedback where the focus is e.g. to perform specific movements such as head movement as part of the rehabilitation strategy. As rehabilitation progresses, the device can be used to monitor improvements in e.g. movement quality, control and range; features that today are very much related to subjective assessments.

We look forward to start using Moti in our clinic every day to improve the care we provide.

Apex Fysio