Kompass Motion Lab - the art & science of motion analysis - Final

Kompass Motion Lab 360°

Located at: 7A Piermark Drive, Rosedale, North Shore & 39B Rennie Dr. Airport Oaks. t. 64 9 6240281 e. [email protected] w. www.nilpain.org

The art & science of human kinesiology assessment: a clinical perspective.

Kenneth Craig – Director Kompass MotionLab 360°

Many practitioners today conduct ‘biomechanics’ assessment on a daily basis, however there

are many aspects to such an assessment. Most assessments that are conducted may be

considered as being plain-simple movement observation, and is very basic and most certainly

inaccurate! I say this with much disgust and concern especially when patients are not clearly

informed as to the nature of these observations, and the lack of precision of these

observations. Furthermore many of these so-called biomechanics observation are conducted

in poorly lit corridors, and some on treadmills utilising outdated programmes such as silicon

coach. The addition of video cameras and foot mat-scanners in some instances do not

significantly improve the measurement capacity of these observations at all. Of even greater

concern is when often times some practitioners observe gait and running patterns only

focused on the lower extremity, without considering the upper extremity and its pertinent

contribution to the entire motion process. Then armed with poor data they proceed to

Figure 1. “EMG tracings during a reaction time study conducted by Wynne Lee”; IN: Anticipatory control of postural and task muscles during rapid arm flexion; Journal of Motor Behavior, Sep; 12(3):185-96. Reprinted with permission of the Helen Dwight Reid Educational Foundation. Published by Heldref Publications, 1319 Eighteenth St., NW, Washington, DC 20036-1802.



deliberate on performance and rehabilitation solutions. This is why most of these

interventions do not work and at times even aggravate the condition and increase injury risk.

When considering any form of motion assessment be it for high-performance athletic

optimisation, or for injury rehabilitation there are fundamentally three pillars of motion to

consider, which are: Kinematics, Kinetics and Energetics.

Kinematics describes the movement itself involving distance, acceleration, velocity, and

angles. Kinetics is associated with forces and torques involved in motion (ie. ground reaction

forces during gait and running). Energetics encompasses the production of energy by muscles

in terms of onset of activation, output and fatigue.

Example

In Figure 1. we utilise the demonstration of a simple activity: the rising of the left arm. When

conducting a plain simple observation without the use of wearable sensor technology (ie.

sEMG, dorsaVi) the therapist / clinician can only appreciate the movement of the arm.

However with wearable sensor technology, the clinician detects interesting ‘HIDDEN’ (for

the plain eye) occurrences. The left bicep femoris (left lateral or outside hamstring muscle),

activates first as an anticipatory reflex, before the left arm muscle (left anterior deltoid) is

activated. This is followed by the activation of the opposite side (contra-lateral) / or right

biceps femoris muscle which is now acting a postural stabiliser of the whole action process

(rapid left arm raise). This information suggests that issues with postural stability or poor

activation of muscles in the lower extremity may have an impact on upper body function, and

vice-versa. Therefore when considering athletic performance and rehabilitation the entire

motion and pattern of associates muscle(s) and structures must be considered in order for

them to be effective.

So the question arises; is there a mechanical explanation for the hamstring firing ahead of the

anterior deltoid? No, from a purely mechanical point of view the data makes no sense. What

does make sense is the contra-lateral (Right) hamstring firing after the left anterior deltoid is

rapidly raised, acting as a stabiliser of the action. However, there are other factors besides the

purely structural and mechanical factors, that influence and order human movement

(kinesiology). The use of wearable sensor technology is an effective marriage of technique

and technology to help identify with greater precision the various concurrent muscular



actions and influences in a particular movement and help us manage individual needs more

effectively without the guess work.

Human kinesiology in not restricted to these three pillars alone. Although these three motion

pillars are pertinent to motion analysis, the human being is a physical, electrical, chemical

(Figure 2) and psychologically functioning and evolving organism, and each of these

systemic components are essential for our growth, performance, and functional wellbeing.

Figure 2.

Psycho-cognitive motion behaviour – feed forward.

The body being only partially mechanical and attention is necessary to the entire systemic

components of the human being. Therefore when it comes to motion analysis and

rehabilitation science the difficult choice which has to be made: to either ignore this fact and

stick with the plain old mechanical theory (mechanical model), or seek another explanation.

Fortunately, this study included and quite possibly originated the term “feed forward”, to

describe the observation of apparent anticipatory muscle control (Figure 1). This term is used

to describe how the system anticipates instability and feeds forward neural drive / electrical

nerve energy to contract a stabilizing muscle.



How it actually does this is YET to be fully elucidated but it may be considered as something

anticipatory: such as shivering at the thought of going outside on a cold day, or salivating at

the sight of enticing food. Human motion is a sequence of anticipation, action, stabilisation,

and counter stabilisation all acting in concert when in physiological (healthy) states.

The feed forward - feedback synchronicity theory is a fitting term for what happens in this

experiment. But again, naming something is not the same as explaining it.

Motor Learning & Neural Drive

A computer programmer will explain the learning system in this manner: The system makes

multiple attempts to accomplish preferred outcomes. It logs (memorizes) and repeats those

actions that lead to desired outcomes and drops actions that don’t accomplish this. The

human being is constantly a: perpetually-on, perpetually adapting & learning system.

Motor learning and motion science provides the simplest explanation for the hamstring firing

ahead of the anterior deltoid i.e. these actions always occur in this sequence – or always

should – since one of the earliest learned motor patterns in the human motor system is the

cross-crawl or x-pattern. When the CNS fires the hamstring in advance of the deltoid it does

this because these actions were learned together as part of normal cross-crawl pattern in the

womb and infancy.

Interestingly, this pattern forms the basis of an individual’s gait pattern. If ever there was an

idea with consequences it is this: no muscle contraction occurs in isolation. So the key to

effective muscular skeletal motion assessment is to identify which are the muscle(s) that do.

sEMG studies repeatedly confirm that when shoulders and hamstrings function

interdependently they are functioning normally. To recognize this as an absolute essential

for the development of an effective assessment and rehabilitation programme. In plain terms:

the shoulders, hip, thighs and lower leg complexes are all interdependent on the proper

functioning of each other.

Learned Motor Patterns Underlie the Elusive Twenty-Five Percent

The prevailing view is that mechanical causes account for the roughly seventy-five percent

(75%) of what presents as a biomechanical motion or functional distress. My conclusion at

this point, having studied motion patterns utilising wearable sensor technology is that when



we take a closer look at the learned patterns that underlie the mechanical events that we

observe daily, we will discover the dysfunctional patterns underlying this elusive twenty-five

percent (the Achilles heel of therapy). We can then develop training and rehabilitation

programmes that are effective, time efficient and economical. Wearable sensor technology

takes the guess work out of musculoskeletal and movement assessments, allowing for

valuable feedback and feed-forward monitoring in real-time movement both in and out of the

clinical setting. At Kompass Health Associates we believe in continuous medical education,

innovation, research and the total health approach to performance optimisation and injury

solutions.

OUT PERFORM THE PACK!

Out wearable sensor technology utilise

the state of the art ViMove

(ViPerform), and Delsys wireless

Trigno sEMG systems along with

years of experience in nutrition and

rehabilitation sciences.



Low back, knee, hamstring, running, cycling, rowing

assessments are carried out in both clinical and outdoor

settings.

Detailed motion patterns and

muscle activation patterns

are captured in real time then

tabulated by research grade

software and translated into

visual reports and used to

monitor progress at any

given time. This allows our

clients to have visual insights

into their performance and

recovery protocols, as well as

co-monitor their progress.



Resources Reference

Learch C. & Matthie F. (2013). The Potential of Biomechanical Movement Analyses in Therapy Process. Journal for Unified Manual Healthcare, 1(1), 36 – 37. Kenji Doma , Glen B. Deakin & Kevin F. Ness (2013): Kinematic and electromyographic comparisons between chin-ups and lat-pull down exercises. Sports Biomechanics, DOI:10.1080/14763141.2012.760204 Liang-Ching Tsai & Christopher M. Powers (2013). Increased Hip and Knee Flexion During Landing Decreases Tibiofemoral Compressive Forces in Women Who Have Undergone Anterior Cruciate Ligament Reconstruction. The American Journal of Sports Medicine 41(2), 423 - 429. Wyndowa, S.M. Cowan, T.V. Wrigley & K.M. Crossley (2013). Triceps surae activation is altered in male runners with Achilles tendinopathy. Journal of Electromyography and Kinesiology 23 (2013) 166–172. S.A. Jobson, J. Hopker, M. Arkesteijn & L. Passfield (2013). Inter- and intra-session reliability of muscle activity patterns during cycling. Journal of Electromyography and Kinesiology 23 (2013) 230–237. Theodoros Ntousis, Dimitris Mandalidis, Efstathios Chronopoulos & Spyros Athanasopoulos (2013). EMG activation of trunk and upper limb muscles following experimentally-induced overpronation and oversupination of the feet in quiet standing. Gait & Posture 37, 190 - 194. Athanasios Katis, Emmanouil Giannadakis, Theodoros Kannas, Ioannis Amiridis, Eleftherios Kellis & Adrian Lees (2013). Mechanisms that influence accuracy of the soccer kick. Journal of Electromyography and Kinesiology 23 125–131. Derek J. Rutherford, Cheryl L. Hubley-Kozey & William D. Stanish (2013). Changes in knee joint muscle activation patterns during walking associated with increased structural severity in knee osteoarthritis. Journal of Electromyography and Kinesiology. Han-Yi Huang, Jiu-Jenq Lin, Yueliang Leon Guo, Wendy Tzyy-Jiuan Wang & Yu-Jen Chen (2013). EMG biofeedback effectiveness to alter muscle activity pattern and scapular kinematics in subjects with and without shoulder impingement. Journal of Electromyography and Kinesiology 23 (2013) 267–274 Fernando Diefenthaeler , Edward F. Coyle , Rodrigo Rico Bini , Felipe Pivetta, Carpes & Marco Aurélio Vaz (2012): Muscle activity and pedal force profile of triathletes during cycling to exhaustion, Sports Biomechanics, 11:1, 10-19.

Stacey A. Meardon , Samuel Campbell & Timothy R. Derrick (2012): Step width alters iliotibial band strain during running, Sports Biomechanics, 11:4, 464-472



Young-Tae Lim , John W. Chow & Woen-Sik Chae (2012): Lumbar spinal loads and muscle activity during a golf swing, Sports Biomechanics, 11:2, 197-211 Erik Giphart, Justin D. Stull, Robert F. LaPrade, Michael S. Wahoff & Marc J. Philippon (2012). Recruitment and Activity of the Pectineus and Piriformis Muscles During Hip Rehabilitation Exercises: An Electromyography Study. The American Journal of Sports Medicine 40(7), 1654 - 1663. Ruth Barn, Daniel Rafferty, Deborah E. Turner & James Woodburn (2012). Reliability study of tibialis posterior and selected leg muscle EMG and multi-segment foot kinematics in rheumatoid arthritis associated pes planovalgus. Gait & Posture 36, 576 - 571. Georg Lajtai, Karl Wieser, Michael Ofner, Gustav Raimann, Gernot Aitzetm, & Bernhard Jost (2012). Electromyography and Nerve Conduction Velocity for the Evaluation of the Infraspinatus Muscle and the Suprascapular Nerve in Professional Beach Volleyball Players. The American Journal of Sports Medicine 40(10), 2303 - 2308. Esther Zwaan, Jules G. Becher & Jaap Harlaar (2012). Synergy of EMG patterns in gait as an objective measure of muscle selectivity in children with spastic cerebral palsy. Gait & Posture 35, 111 -115. Knudson D. (2007). Fundamentals of Biomechanics, (2 Ed.), Springer, USA. Jay Dicharry (2010). Kinematics and Kinetics of Gait: From: Lab to Clinic. Clinics in Sports Medicine 29, 347 - 364.doi:10.1016/j.csm.2010.03.013J.

Kompass Health Associates – Always ahead & investing in YOU!!

The information in this document in its entirety does not constitute as medical advice.

Kompass Motion Lab - the art & science of motion analysis - Final

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