Chapter 3: Research and Technology
October 02, 2018
By Alexander Germanis
Most good writing begins with extensive research. In fact, two fiction writers in particular, the late Tom Clancy and the late Michael Crichton, garnered a lot of praise, not only for their compelling and memorable stories, but also for the extensive research they conducted and their handling of highly technical information.
When it comes to writing an individual’s story of rehabilitation, the McLean County Orthopedics (MCO) Therapy Department and Director of Therapy Bryan Jasker, PT, DPT, understand that each story begins with deciphering research followed by prudent application of technical knowledge.
As mentioned briefly in Chapter 2, in the Gait and Kinematics Lab at MCO, that technical knowledge is gathered through myriad tests: surface electromyography (sEMG), 3D motion analysis (Virtuesense), force plate analysis (Kistler), Cellular Respiratory Analytics or metabolic testing (Method-CRA) and functional movement screens (FMS/SMFA/Y-Balance).
These tests are meant to help answer the questions Bryan puts forth: “What is ‘normal’ movement? How is my body working after surgery? Am I moving well or am I moving poorly? Am I at risk for injury or wear and tear? Am I generating enough power or force for my sport? Am I using the right fuels and energy systems to support my goals?”
Measuring muscle activity is a good place to start, says Bryan. “We use sEMG in order to understand patient effort and the communication between nerves and muscles before and after surgery.”
As we exist and function in a three-dimensional world, 3D motion analysis is an essential tool in seeing how a recovering athlete moves within a three-dimensional space.
“We utilize a video camera that, in real time, looks at posture and range of motion in multiple joints at once, which is generally a challenging thing to do in real time. Typically, a physical therapist will intuitively pick up on those cues after years of practice,” Bryan explains. “Utilizing this 3D motion analysis programming has been very helpful to explore movement patterns that people may need for certain sports as well.”
Before and after comparisons are a big part of analyzing how an injured limb is recuperating. Using force plate analysis, the force or power output of a person’s uninjured leg can be compared to the output of one that has recently undergone surgery. For instance, an athlete might perform actions such as a single leg squat or a single leg jump on the force plate. “Understanding what that data means then helps us make better decisions on when we can allow them to progress their return to sport or sports,” Bryan says.
Further comparisons are done through FMS, also called functional movement tests. In that test, data is collected and added to a database called Move2Perform, comparing an individual’s results to those of a similar gender, age, and competitive level. “Move2Perform gives us feedback on what those scores mean in relation not only to people who have had injuries, but also healthy, non-injured athletes at a similar competitive level,” Bryan adds.
Combining technologies provides overall better observations of total movement. “We can see how the joints move in relation to others through a task such as a squat jump or a single leg jump,” Bryan says. “This means we can look at force output in a limb and at the same time look at 3D motion of that athlete.” This technology not only aids in the rehabilitation of an athlete, it is invaluable in making that final return-to-play decision.
“We also include the metabolic testing (CRA) early on,” he adds. Not only does CRA help pinpoint a person’s optimal heart rate and workload to facilitate safer and more efficient exercise, it aids physical therapists in creating guidelines on how to best prescribe exercise for returning from injury and in reestablishing their metabolic demands for their return to a specific sport or activity.
However, no matter the amount of data collected and research conducted, Bryan points out the technology only serves its purpose when it is incorporated directly into an individual’s rehabilitation story, returning them to perform as well or better than they did before their injury.
For more information on Physical Therapy or any type of orthopedic problem or injury, contact McLean County Orthopedics, 309-663-6461 or visit them online at www.McleanCountyOrthopedics.com. Their new office is located at 1111 Trinity Lane in Bloomington.
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