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During growth and development, an individual’s An alternative explanation for development of poor
proprioceptors are developed through reflexive move- movement patterns is the presence of previous injuries.
ments in order to perform basic motor tasks. This Individuals who have suffered an injury may have a
development occurs from proximal to distal, the infant decrease in proprioceptive input, if untreated or treated
learning to first stabilize the proximal joints in the spine inappropriately.14,19 A disruption in proprioceptive
and torso and eventually the distal joints of the extremi- performance will have a negative effect on the kinetic
ties. This progression occurs due to maturation and linking system. The result will be altered mobility, stabil-
learning. The infant learns fundamental movements by ity, and asymmetric influences, eventually leading to
responding to a variety of stimuli, through the process of compensatory movement patterns. This may be a reason
developmental motor learning. As growth and develop- why prior injuries have been determined to be one of the
ment progresses, the proximal to distal process becomes more significant risk factors in predisposing individuals to
operational and has a tendency to reverse itself. The repeat injuries.19,20
process of movement regression slowly evolves in a distal
Determining which risk factor has a larger influence on
to proximal direction.15 This regression occurs as individ-
injury, previous injuries or strength/flexibility imbal-
III
• Upper torso is parallel with tibia or toward
vertical
• Femur below horizontal
• Knees are aligned over feet
• Dowel aligned over feet
II I
• Upper torso is parallel with tibia or toward • Tibia and upper torso are not parallel
vertical • Femur is not below horizontal
• Femur is below horizontal • Knees are not aligned over feet
• Knees are aligned over feet • Lumbar flexion is noted
• Dowel is aligned over feet • 2x6 board required under feet
• 2x6 board required under feet
Hurdle Step
Purpose. The hurdle step is designed to challenge the Tips for Testing:
body’s proper stride mechanics during a stepping motion. • Score the leg that is stepping over the hurdle
The movement requires proper coordination and stabili- • Make sure the individual maintains a stable torso
ty between the hips and torso during the stepping motion
• Tell individual not to lock knees of the stance limb
as well as single leg stance stability. The hurdle step
during test
assesses bilateral functional mobility and stability of the
hips, knees, and ankles. • Maintain proper alignment with the string and the
tibial tuberosity
Description. The individual assumes the starting position
• When in doubt score subject low
by first placing the feet together and aligning the toes
touching the base of the hurdle. The hurdle is then adjust- • Do not try to interpret the score when testing
ed to the height of the athlete’s tibial tuberosity. The
dowel is positioned across the shoulders below the neck. Clinical Implications for Hurdle Step
The individual is then asked to step over the hurdle and Performing the hurdle step test requires stance-leg
touch their heel to the floor while maintaining the stance stability of the ankle, knee, and hip as well as maximal
leg in an extended position. The moving leg is then closed-kinetic chain extension of the hip. The hurdle step
returned to the starting position. The hurdle step should also requires step-leg open-kinetic chain dorsiflexion of
be performed slowly and as many as three times bilater- the ankle and flexion of the knee and hip. In addition, the
ally. If one repetition is completed bilaterally meeting the athlete must also display adequate balance because the
criteria provided, a III is given. (Figures 5-8) test imposes a need for dynamic stability.
III
• Hips, knees and ankles remain aligned in the
sagittal plane
• Minimal to no movement is noted in lumbar
spine
• Dowel and string remain parallel
Figure 11. In Line Lunge lateral Figure 12. In Line Lunge anterior
view. view.
II I
• Dowel contacts do not remain with lumbar spine • Loss of balance is noted
extension
• Movement is noted in torso
• Dowel and feet do not remain in sagittal plane
• Knee does not touch behind heel of front foot