Integrative Motion Analysis for Pain-Free Functional Movement

Integrative Motion Analysis for Pain-Free Functional Movement

Despite technology’s many advantages for enhancing human life, the ubiquitous use of computers and mobile devices is taking a toll on our bodies. Too much time spent sitting and slouching over keyboards and mobile devices, and too little physical activity in general, cause strain and imbalances that lead to pain and injury.

Functional movement allows you to perform everyday tasks efficiently, without pain or discomfort. Integrative motion analysis helps us pinpoint underlying issues that restrict functional movement and inhibit mobility. We are then able to create corrective treatment programs that restore fluid functional movement and improve quality of life.

What is Integrative Motion Analysis?

Despite our similarities, human beings have unique movement patterns and distinct anatomical characteristics. Treatment is often generalized, with exercise prescriptions based on what works in a research setting. IMA lets us look at the unique muscle activation patterns of each individual patient, so we can provide the most effective personalized treatment.

Integrative motion analysis (IMA) provides tools for quantifying various movement parameters, to assess dysfunction and track recovery. In human movement, many factors come into play that define our quality of movement:

What is Integrative Motion Analysis?
  • Joint angles
  • Internal and external forces
  • Muscle recruitment and firing patterns
  • Joint range of motion
  • Muscle and tendon elasticity
  • Overtraining and overuse
  • Compensation patterns from old and new injuries

Most of those factors cannot be assessed with the naked eye, and require advanced technological tools to analyze and quantify. A thorough assessment with IMA is the best way to assess, quantify and restore functional movement.

How Integrated Motion Analysis Works

How Integrated Motion Analysis Works

IMA begins with a biomechanical examination to help us determine if a body part is functioning in an abnormal way. The exam has 3 goals:

  • Identify abnormal function
  • Identify the cause of abnormal function
  • Find the link between the abnormal function and development of the patient’s pathologic condition, or predict how a pathologic condition is likely to develop

The biomechanical exam includes assessments for function and joint range of motion, and muscle testing for tension and strength. Once we have all the information we need, we can craft a personalized treatment plan for our patient, to restore normal function and enhance functional movement.

High-Tech Tools for Accurate Analysis

IMA uses multiple tools to get a comprehensive picture of how well your body moves, and to identify kinematic issues that keep you from moving with optimal efficiency.

High-Tech Tools for Accurate Analysis

Tools for IMA include:

  • Force plates to measure ground reaction forces
  • Surface electromyography (SEMG) to analyze muscle activation patterns
  • High speed video to evaluate joint angles and gait mechanics

The sophisticated technology we use at NYDNRehab is most often used in academia for research. It is rarely found in a private clinic, or available to private patients. We have spent years studying, innovating and integrating our equipment, to improve the functional performance of patients and athletes. Our technological tools are paired with custom software that collects and analyzes patient data, providing a quantified baseline to help us measure patient progress.

IMA for Injury Rehab

Injuries from sports and overuse often arise from faulty movement mechanics. After an injury, your neuromuscular system intuitively protects the damaged tissues by shifting force loads to other structures. In time, compensation patterns can become habitual, creating dysfunctional movement, long after the tissues have healed.

State-of-the-art motion analysis identifies compensation patterns and helps us develop an individualized treatment protocol. IMA eliminates time wasted on ineffective rehab, and speeds up the patient’s return to activity.

We use IMA to diagnose and retrain the following musculoskeletal injuries:

  • ACL ruptures
  • Patellar (knee cap) pain and dysfunction
  • Hip impingement
  • Iliotibial Band Syndrome (ITBS)
  • Meniscus tears
  • Rotator cuff injuries
  • Shoulder impingement

IMA gives us precise quantitative data, taking the guesswork out of rehab and individualizing the rehabilitation process.

Retraining Muscles with IMA Feedback

In addition to assessing movement, IMA helps us retrain muscle activation patterns using real-time feedback. After an injury, neuroplastic changes to the brain and central nervous system can cause compensation patterns that interfere with coordinated muscle recruitment. It is not enough to simply retrain the muscles. We need to retrain the brain to access the right muscles at the right time.

Using SEMG, we take the following steps to retrain efficient muscle activation:

  • We select a movement that integrates an under-active muscle.
  • We use certain techniques to help the patient stimulate activation of the muscle.
  • Once the muscle can be activated by the patient, we use visual biofeedback to help them understand the desired recruitment pattern.
  • As the patient becomes adept at activating the muscle, we gradually eliminate the visual feedback and encourage the patient to “feel” the movement.
  • The movement is included as part of the rehab regimen, with periodic checkups with SEMG.

All too often, rehab programs focus on healing damaged tissues and strengthening the surrounding muscles without addressing brain neuroplasticity. Failure to retrain the brain along with the muscles dramatically increases the risk of reinjury and undermines performance.

Functional Movement Retraining in NYC

In addition to assessing movement, IMA helps us retrain muscle activation patterns using real-time feedback. After an injury, neuroplastic changes to the brain and central nervous system can cause compensation patterns that interfere with coordinated muscle recruitment. It is not enough to simply retrain the muscles. We need to retrain the brain to access the right muscles at the right time.

  • C.A.R.E.N, our computer assisted rehab environment with VR feedback
  • Kineo intelligent load system with AI feedback capabilities
  • Proteus motion system for coordinating muscle activation patterns in multiple planes
  • Musculoskeletal ultrasound for viewing muscle activity beneath the surface
  • SEMG for analyzing and quantifying muscle activation patterns

Resources:

Einarsson, Elinar. “Electromyography and Clinical Reasoning; Why do exercise treatments sometimes fail and how can we overcome this?” ASPETAR Sports Medicine Journal 5.1 (2016).

About the Author

Dr. Lev Kalika is clinical director of NYDNRehab, located in Manhattan. Lev Kalika is the author of multiple medical publications and research, and an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.

130 West 42 Street Suite 1055, New York NY 10036

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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