The assessment of function. Part II: clinical perspective of a javelin thrower with low back and groin pain

Abstract

Assessment of an individual's functional ability can be complex. This assessment should also be individualized and adaptable to changes in functional status. In the first article of this series, we operationally defined function, discussed the construct of function, examined the evidence as it relates to assessment methods of various aspects of function, and explored the multi-dimensional nature of the concept of function. In this case report, we aim to demonstrate the utilization of a multi-dimensional assessment method (functional performance testing) as it relates to a high-level athlete presenting with pain in the low back and groin. It is our intent to demonstrate how the clinician should continually adapt their assessment dependent on the current functional abilities of the patients.

Keywords: Functional testing; Physical performance tests; Physical therapy.

Figure 1

Flow diagram of function assessment utilized in case. LBP, low back pain; PA, posterior–anterior joint play assessment; L4-5, lumbar 4 and 5 vertebrae; PPM, physical performance measure; SRM, self-report measure; PILE, progressive inertial lifting evaluation; SIJ, sacroiliac joint; IR, internal rotation; DF, dorsiflexion; LEFT, lower extremity functional test; OHMB, overhead medicine ball; SMB, side medicine ball; T6-8, thoracic 6 through 8 vertebrae; ODI, Oswestry disability index; FABQ, fear-avoidance beliefs questionnaire.

Figure 2

PILE testing. Reproduced with permission [reprinted, by permission from M Reiman and R Manske, 2009. Functional testing in human performance (Champaign, IL, Human Kinetics), 231. © Human Kinetics].