Effects of Exercise-Based Interventions on Symmio Self-Movement Screen

Musculoskeletal screening for physical risk factors requires equipment and a trained healthcare or fitness professional to perform and interpret the scoring so that appropriate exercise interventions can be prescribed. However, barriers such as healthcare costs and accessibility, low perceived need to seek medical care, and previous unfavorable evaluation of seeking medical care are associated with healthcare avoidant behaviors. This research aims to explore the effectiveness of the Symmio Self-Screen application to generate specific exercise interventions to address an individual's associated physical risk factors. The ability of the Symmio application to prescribe a targeted exercise program which can reduce asymmetries, improve movement quality, and enhance overall function is unknown. Therefore, the purpose of this study is to determine the effectiveness of the Symmio application in designing individualized exercise interventions which target the unique movement limitations and asymmetries in adults.

Musculoskeletal disorders (MSDs) are currently the largest category of workplace injuries, accounting for 30% of all workers compensation costs, and are on the rise. Globally, MSDs are also on the rise in the general adult population with 1 in 3 adults with some report of an MSD. In the United States, MSDs are even more prevalent with 1 in 2 adults presenting with a musculoskeletal disorder. The financial implications of MSDs are extensive. In the United States, annual healthcare costs associated with MSDs have surpassed $380 billion. Among the most prevalent musculoskeletal disorders were low back pain and neck pain, accounting for a 6.7% spending increase annually from 1996 to 2016.

Increased physical activity is a proven way to decrease the prevalence of MSK risk factors and improve overall health. However, trends suggest MSK disorders and physical inactivity are becoming more prevalent. Generalized exercises programs may not be specific enough to effectively manage physical risk factors. Furthermore, starting a general exercise program to address the adverse effects of inactivity is now considered a risk factor for the development of an MSD. This is likely due to inappropriate functional foundations which cannot withstand the rigors of moderate to high level physical activity. Identification and mitigation of physical risk factors could establish a better movement foundation and provide individuals the durability to achieve their long-term fitness goals.

Several musculoskeletal movement screens exist which can identify physical risk factors and are associated with injury prediction. The Functional Movement Screen (FMS™) and Y-Balance Test - Lower Quarter (YBT-LQ™) are reliable, movement-based tests which can identify modifiable risk factors related to mobility and motor control deficits. However, both the FMS™ and YBT-LQ™ require equipment and are administered by a trained healthcare or fitness professional. Furthermore, the professional is required to interpret the scoring and to prescribe appropriate exercise interventions to improve specific movement limitations or asymmetries. However, barriers such as healthcare costs and accessibility, low perceived need to seek medical care, and previous unfavorable evaluation of seeking medical care are associated with healthcare avoidant behaviors.

The Symmio Self-Screen (Symmio) is a downloadable application developed to be a user-friendly and cost-effective tool for the early identification of physical risk factors that may lead to MSK injuries. The Symmio Self-Screen application provides step by step directions to screen for basic movement pattern limitations and asymmetries. Recently, the Symmio application was found to be highly reliable and valid when used as a self-screening tool to assess MSK risk factors. The simplistic scoring criteria and video guided instructions offered through the application allows for untrained adults to self-score their own movement patterns similarly to a trained healthcare provider. Additionally, the accuracy of Symmio to identify painful movement, movement dysfunction on the FMS™, and dynamic balance deficits on the YBT-LQ™ was 0.74, 0.73, 0.69, respectively. Information gained from this screening approach could allow the general population to self-screen and monitor for the development of physical risk factors and intervene with targeted exercises interventions prior to the onset of symptoms or injury.

To date, the effectiveness of the Symmio Self-Screen application to generate specific exercise interventions to address an individual's associated physical risk factors has not been explored. The ability of the Symmio application to prescribe a targeted exercise program which can reduce asymmetries, improve movement quality, and enhance overall function is unknown. Therefore, the purpose of this study is to determine the effectiveness of the Symmio application in designing individualized exercise interventions which target the unique movement limitations and asymmetries in adults. It is hypothesized that individuals who receive specific exercise interventions recommended by the Symmio application will have less asymmetries, improve performance on the Symmio Self-Movement Screen, and better function compared to a control group which will not receive individualized exercises.

Eligibility Criteria:
Inclusion Criteria:

* Willing participants between the ages of 18 to 65 years of either sex
* At least 1 less than optimal movement pattern scored on the Symmio Self-Movement Screen.

Exclusion Criteria:

* Optimal scores on all Symmio movement patterns
* Current lower extremity injury
* Lower extremity or upper extremity amputation
* Lack of medical clearance from physician/primary care to participate in exercise
* Undergoing current medical treatment for musculoskeletal injury
* Concussion within the past 3 months
* Inability to read and comprehend English.