Objective Markers of Rehab Progress Paul Thawley.
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Transcript of Objective Markers of Rehab Progress Paul Thawley.
![Page 1: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/1.jpg)
Objective Markers of Rehab Progress
Paul Thawley
![Page 2: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/2.jpg)
Olympic Medical Institute
FEEDBACK TO ATHLETE/COACH
REVIEW
EVALUATE
ASSESSMENT
PLAN
DELIVERFEEDBACK TO
ATHLETE/COACH
MEDICAL
S&CPHYSIOTHERAPY
PHYSIOLOGYNUTRITION
PSYCHOLOGYSOFT TISSUE SPECIALSIST
![Page 3: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/3.jpg)
SITUATION
• World Class rehabilitation centre• Subjective markers of progress
![Page 4: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/4.jpg)
Why Objective?
• Athlete• Coach• Support Staff• Validate what we do• Accountable for what we do
![Page 5: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/5.jpg)
IMPORTANT
• Indicators of progress• Not prescriptive or diagnostic
![Page 6: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/6.jpg)
Sports Science vs Sports Medicine• Test• Plan • Implement• Evaluate
• Diagnose• Plan• Implement • Review
![Page 7: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/7.jpg)
Sports Science AND Sports Medicine• Diagnose• Test• Plan• Implement • Evaluate (Objective)• Review
![Page 8: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/8.jpg)
Where does it fit in to OMI?
FEEDBACK TO ATHLETE/COACH
REVIEW
EVALUATE
ASSESSMENT
PLAN
DELIVERFEEDBACK TO
ATHLETE/COACH
MEDICAL
S&CPHYSIOTHERAPY
PHYSIOLOGYNUTRITION
PSYCHOLOGYSOFT TISSUE SPECIALSIST
![Page 9: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/9.jpg)
The Tests
• Lower Extremity Function/Performance• Balance & Proprioception• Upper Extremity Function/Performance• Lumbar – Pelvic Function/Performance
![Page 10: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/10.jpg)
Balance
• Single Leg Balance • Eyes open/closed• Postural Sway (Good v bad? Variability paper…)• 45 s • Kidgell et al., 2007
-200
0
200
400
600Anterior
Medial
Posterior
LateralLeft
Right
![Page 11: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/11.jpg)
Lower Extremity Performance
• 30 cm single leg drop jump• Force Attenuation & Production• EMG Pre-activity? (glute med, TA)• 10-20% Sensitivity
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Left Right
F[M
ax]/
BW
(N
/BW
)
0.09
0.095
0.1
0.105
0.11
0.115
0.12
Ju
mp
Heig
ht
(m)
Take Off Force
Impact Force
Jump Height
![Page 12: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/12.jpg)
Vertical Jumps
0
0.05
0.1
0.15
0.2
0.25
CMJ SJ L SJ RSJ Ave SJ
Vert
ical
Dis
plac
emen
t (m
)
04/03/2008
17/03/2008
0
0.5
1
1.5
2
2.5
CMJ SJ L SJ RSJ Ave SJ
F [m
ax]/B
W (N
)
04/03/2008
17/03/2008
• Single Leg/Double Leg• Non-injured/Injured• SJ/CMJ (Normative) (quad:ham activation)• 10-20% Sensitivity
![Page 13: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/13.jpg)
Overhead Squat
• Fundamental Movement Competencies• Hip/shoulder & ankle ROM• L-P/scapula & knee control
![Page 14: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/14.jpg)
Overhead Lunge
• Fundamental Movement Competencies• Hip/Shoulder & ankle ROM• L-P/Scapula & knee control• Posterior Sling?
![Page 15: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/15.jpg)
New Areas of Interest
![Page 16: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/16.jpg)
Shoulder
• External rotation EMG Pre-activity (bicep, LFT, infraspinatus)?
• Wall Slide?• EMG & Weight Distribution
![Page 17: Objective Markers of Rehab Progress Paul Thawley.](https://reader036.fdocuments.net/reader036/viewer/2022081519/56649f065503460f94c1c5af/html5/thumbnails/17.jpg)
Ankle
• Trap Door• EMG pre-activity• TA-GA activity & timing