Advanced Biomechanics & Movement Diagnosis

Movement Screening (Level 2 — M2.06):
- Identify movement faults
- Generic protocols based on fault patterns
- Suitable untuk most healthy populations
- Pattern recognition dominan

Movement Diagnosis (Level 3):
- Understand WHY the fault exists
- Tissue-specific reasoning (joint capsule, muscle length, neural control)
- Individualized intervention
- Mechanistic reasoning dominan
- Bridges PT scope dan fisioterapis scope

Critical distinction: PT Level 3 tidak diagnose pathology — itu medical/fisioterapis scope. PT Level 3 diagnose movement — mengapa pattern muncul, intervention apa yang appropriate dalam scope.

Layer 1 — Observation:
- What I see (visible movement)
- What klien feels (subjective report)
- What testing reveals (objective measures)

Layer 2 — Hypothesis Generation:
- Multiple possible causes per finding
- Differential thinking, bukan first-impression
- Tissue-specific reasoning

Layer 3 — Testing Hypothesis:
- Specific tests untuk discriminate causes
- Iterative refinement
- "If X causes Y, then Z should change with W intervention"

Layer 4 — Intervention:
- Targeted, not generic
- Re-test after intervention (in-session re-assessment)
- Adjust based on response

Shirley Sahrmann (PT, PhD) — pioneer Movement System Impairment classification.

Core principle: Movement disorders bukan random — they follow patterns based on:
- Muscle length-tension relationships
- Joint stiffness directions
- Neural recruitment patterns
- Habitual postures dan movements

MSI Categories (selected for PT Level 3 relevance):
- Lumbar flexion syndrome: low back excessive flexion preference
- Lumbar extension syndrome: excessive extension preference
- Lumbar rotation syndrome: excessive rotation preference
- Hip adduction syndrome: hip adduction during functional movements
- Scapular depression syndrome: scapula low resting position
- Tibiofemoral rotation syndrome: knee tracking issues

PT Level 3 boleh:
- ✅ Identify movement preferences/patterns
- ✅ Apply corrective strategies appropriate
- ✅ Understand WHY patterns exist (educational)
- ✅ Refer dengan informed reasoning
- ✅ Collaborate dengan fisioterapis specialist

PT Level 3 TIDAK boleh:
- ❌ Diagnose pathology (herniated disc, labral tear, etc.)
- ❌ Provide manual therapy beyond myofascial release basic
- ❌ Make medical claims about findings
- ❌ Replace fisioterapis dalam kasus pain-driven

Litmus test: kalau ragu, refer fisioterapis. Better err on side of referral for Level 3 cases.