Functional Kinetics

This textbook describes the author's concept of functional kinetics and presents her theory concerning the systematic observation and analysis of human movement. The purpose of functional kinetics is to improve observation, analysis and instruction of human movement. The physiotherapist must be able to analyze movement in order to find and define the functional problem. He must be able to effect the required change in movement, whether through manipulation, instructing the patient how to move or both. The ideas outlined in this book are basic to physical therapy and rehabilitation and should be familiar to active therapists.

General Introduction.- 1 Orientation of the Individual.- 1.1 Orientation Within the Body.- 1.2 Orientation in Space.- 1.3 Orientation Outwards from the Body.- 1.4 Orientation of the Individual and ‘Patient Language’.- 1.5 Summary.- 2 Orientation of the Physiotherapist.- 2.1 Homunculus: The Man in a Cube.- 2.2 Planes ― Lines ― Points.- 2.2.1 Transverse Planes.- 2.2.2 Frontal Planes.- 2.2.3 Sagittal Planes.- 2.2.4 Body Diagonals and the Body’s Functional Centrepoint.- 2.2.5 Vertex and Long Axis of the Body.- 2.2.6 Diameter of the Thorax.- 2.2.7 Summary.- 2.3 Proximal ― Distal.- 2.4 Joints as Pivots, Switch Points and Levels of Movement.- 2.4.1 Degrees of Freedom and Components of Movement.- 2.4.2 Distance Points.- 2.4.3 Influence of Position on Interdependency of Movements at the Joints.- 2.4.4 Movement About Frontotransverse Axes.- 2.4.5 Movement About Sagittotransverse Axes.- 2.4.6 Movement About Frontosagittal Axes.- 2.5 Capsules and Ligaments of Joints as End-Stops of Movement.- 2.6 Muscles as Effectors of Posture and Movement.- 2.6.1 Isometric and Isotonic Muscle Activity.- 2.6.2 Motive and Compressive Components of Muscle Activity on Joints.- 2.6.3 Muscles as Agonists, Antagonists and Synergists.- 2.6.4 Passive and Active Muscle Insufficiency.- 3 Fundamental Observation Criteria.- 3.1 Functional Body Segments.- 3.2 Activity States.- 3.2.1 Economical Activity.- 3.2.2 Parking Function.- 3.2.3 Dynamic Stabilization.- 3.2.4 Potential Mobility.- 3.2.5 Support Area.- 3.2.6 Supporting Function.- 3.2.7 Pressure Activity.- 3.2.8 Supported Leaning.- 3.2.9 Free Play.- 3.2.10 Hanging Activity.- 3.2.11 Bridging Activity.- 3.2.12 Pushing-Off Activity.- 3.2.13 Practical Use of Activity Sates in Functional Analysis of Starting Positions and Movement Sequences.- 3.3 Analysis of Movement by Differentiating Between Equilibrium Reactions.- 3.3.1 Continuing Movement.- 3.3.2 Buttressing Continuing Movement and Changing the Support Area.- 3.3.3 Avoidance Mechanisms and Their Influence on the Patient’s Contact with the Environment.- 3.3.4 Summary.- 3.4 Observer’s Planes.- 3.4.1 Observer’s Horizontal Plane.- 3.4.2 Observer’s Parallel Plane.- 3.4.3 Observer’s Bisecting Plane.- 4 Instruction.- 4.1 Functional Analysis in Therapist Language.- 4.1.1 Conception of the Exercise.- 4.1.2 Position and Activation in the Starting Position.- 4.1.3 Actio ― Reactio of the Movement Sequence.- 4.1.4 Conditio ― Limitatio of the Movement Sequence.- 4.2 Formula for Instructions in Patient Language.- 4.2.1 Instructions Appealing to the Patient’s Perceptions.- 4.2.2 Verbal-Perceptual Instruction.- 4.2.3 Manipulative-Perceptual Instruction.- 4.3 Adapting an Exercise to the Patient’s Constitution and Condition.- 4.3.1 Role of Lengths, Widths, Depths and Distribution of Weights in Adapting an Exercise.- 4.3.2 Common Causes of Error in Adapting an Exercise to the Patient’s Condition.- 5 Functional Measuring.- 5.1 Points, Lines and Axes of BS Thorax.- 5.1.1 Movements of the Thoracic Spine in the Plane of Symmetry.- 5.1.2 Movements of the Thoracic Spine in the Frontal Plane.- 5.1.3 Movements of the Thoracic Spine in the Transverse Plane.- 5.1.4 Movements of the Thorax in Transverse Planes.- 5.1.5 Movements of the Ribs in Inspiration and Expiration.- 5.2 Points, Lines and Axes of BS Head.- 5.2.1 Movements of the Cervical Spine in the Plane of Symmetry.- 5.2.2 Movements of the Cervical Spine in the Frontal Plane.- 5.2.3 Movements of the Cervical Spine and the Atlanto-occipital and Atlanto-axial Joints in Transverse Planes.- 5.2.4 Movements of the Head in Transverse Planes.- 5.2.5 Movements at the Temporomandibular Joints.- 5.3 Points, Lines and Axes of BS Pelvis and BS Legs.- 5.3.1 Movements of the Lumbar Spine in the Plane of Symmetry.- 5.3.2 Movements of the Lumbar Spine in the Frontal Plane.- 5.3.3 Movements at the Hip Joints About the Frontotransverse Axis.- 5.3.4 Movements at the Hip Joints About the Sagittotransverse Axis.- 5.3.5 Movements at the Hip Joints About Frontosagittal Axes.- 5.3.6 Movements at the Knee Joints.- 5.3.7 Movements at the Talocrural Joints.- 5.3.8 Movements at the Subtalar Joints.- 5.3.9 Movements at the Chopart and Lisfranc Joints.- 5.3.10 Movements at the Toe Joints.- 5.4 Points, Lines and Axes of BS Arms.- 5.4.1 Movements of the Clavicle at the Sternoclavicular and Acromioclavicular Joints (Proximal Shoulder Joints).- 5.4.2 Movements at the Humeroscapular Joints (Distal Shoulder Joints).- 5.4.3 Movements at the Elbow Joints and of the Forearm.- 5.4.4 Movements at the Wrist Joints.- 5.4.5 Movements at the Phalangeal Joints.- 6 Functional Status.- 6.1 Condition.- 6.2 Constitution.- 6.3 Mobility.- 6.4 Postural Statics.- 6.5 Basic Gait Test.- 6.6 Motor Behaviour in Bending Down.- 6.7 Respiration.- 6.8 Formulating the Functional Problem.- 6.9 Guidelines to Planning Therapy.- 6.10 Examples.- 7 Treatment Techniques.- 7.1 Mobilizing Massage.- 7.2 Buttressing Mobilization.- 7.3 Lift-Free/Reduced-Lift Mobilization of the Vertebral Column.- 8 The Concept of Movement Training.- 9 Glossary.- 10 Bibliography.- 11 Subject Index.