Shirley Sahrmann

Shirley Sahrmann
Washington University in St. Louis | WUSTL , Wash U · School of Medicine

PT, PhD

About

120
Publications
83,579
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
7,099
Citations

Publications

Publications (120)
Article
Synopsis: Many approaches for low back pain (LBP) management focus on modifying motor control, which refers to motor, sensory and central processes for control of posture and movement. A common assumption across approaches is that the manner an individual loads the spine by their typical postures, movements and muscle activation strategies, contri...
Article
Full-text available
Synopsis: Although biomechanics play a role in the development of low back pain (LBP), and perhaps in the persistent and/or recurrent nature of LBP, there is debate regarding whether biomechanics alone can provide the basis for intervention. Biomechanics, which refers to the mechanics of the body including its neuromuscular control, has been exten...
Article
Background Several sacroiliac joint (SIJ) provocative tests used to assess posterior pelvic pain involve moving and stressing the hip. It is unknown if there is a subgroup of patients with posterior pelvic pain that have underlying hip deformity that could potentially influence performance and interpretation of these tests. Objective To describe t...
Article
Full-text available
Study Design Ancillary analysis, time-controlled randomized clinical trial. Background Movement pattern training (MPT) has been shown to improve function among patients with chronic hip joint pain (CHJP). Objective Determine the association among treatment outcomes and mechanical factors associated with CHJP. Methods Twenty-eight patients with CHJP...
Article
The Movement System was adopted as the identity of physical therapy as one of the 8 guiding principles accompanying the Vision Statement of 2013. At its inception physical therapy was considered more of a technical field rather than that of a professional field. Physicians were to diagnose the patient's problem and the therapist was to follow the p...
Article
Background: Diagnoses and treatments based on movement system impairment syndromes were developed to guide physical therapy treatment. Objectives: This masterclass aims to describe the concepts on that are the basis of the syndromes and treatment and to provide the current research on movement system impairment syndromes. Results: The conceptu...
Article
Background and purpose: There are several systems of classification and treatment of patients with low back pain (LBP) based on assessment of the effect of lumbar postures and movements on symptoms. The efficacy of one of these systems, The Movement System Impairment (MSI) method, has not yet been demonstrated in the literature. The purpose of thi...
Article
Full-text available
Study Design Feasibility randomized clinical trial. Background Rehabilitation may be an appropriate treatment strategy for patients with chronic hip joint pain (CHJP), however the evidence related to the effectiveness of rehabilitation is limited. Objectives Assess feasibility of performing a randomized clinical trial to investigate the effectivene...
Article
Background: It is unknown if low back pain (LBP) outcomes are enhanced by classification-specific treatment based on the Movement System Impairment classification system. The moderating effect of adherence to treatment also is unknown. Objectives: Compare the efficacy of a classification-specific treatment (CS) and a non classification-specific...
Article
Postural vertical refers to a component of an individual's perception of verticality that is derived from information about the direction of gravitational forces. Backward disequilibrium (BD) is a postural disorder observed in some older adults who have a distortion in their perception of postural vertical. Individuals with BD sustain their center...
Article
Full-text available
Study design: Controlled laboratory cross-sectional study. Objectives To assess strength differences of the hip rotator and abductor muscle groups in young adults with chronic hip joint pain (CHJP) and asymptomatic controls. A secondary objective was to determine if strength in the uninvolved hip of those with unilateral CHJP differs from that in...
Article
Anterior hip pain is common in young, active adults. Clinically, we have noted that patients with anterior hip pain often walk in a swayback posture, and that their pain is reduced when the posture is corrected. The purpose of this study was to investigate a potential mechanism for the reduction in pain by testing the effect of posture on movement...
Article
Full-text available
The 2013 House of Delegates of the American Physical Therapy Association adopted a vision statement that addresses the role of physical therapy in transforming society through optimizing movement. The accompanying guidelines address the movement system as key to achieving this vision. The profession has incorporated movement in position statements...
Article
Background: Previously, we demonstrated that people in the Rotation with Extension low back pain subgroup display greater asymmetry of passive tissue characteristics during trunk lateral bending than people without low back pain. The purpose of this secondary analysis is to examine factors that explain the group differences. Methods: Twenty-two...
Article
Full-text available
Transient abdominal pain commonly occurs during running. There is limited information to guide the physical examination and treatment of individuals with this transient pain with running (TAPR). The purposes of this report are to describe the movement-system examination, diagnosis, and treatment of 2 female adolescent athletes with TAPR and highlig...
Article
Full-text available
I read with interest the perspective on the PASS meeting.1 Obviously, a great deal of work and thought went into the deliberations. Understandably, only general directions can be described at this stage of planning, but, for the naive reader, a few examples with some details would be useful. For example, there was frequent reference to the “paradig...
Article
Anterior hip or groin pain is a common complaint for which people are referred for physical therapy. We have observed that people with anterior hip pain often walk in greater hip extension than people without anterior hip pain, and that the pain is reduced when they walk in less hip extension. Therefore, we investigated anterior hip joint forces wh...
Article
Full-text available
The purpose of the current report is to describe the classification, treatment, and outcomes of a patient with lumbar extension syndrome. The patient was a 40-year-old female with an 18-month history of mechanical low back pain (LBP). The patient reported a history of daily, intermittent pain (mean intensity of 9/10) that limited her ability to sit...
Article
Full-text available
The consistency of muscle activation order during prone hip extension has been debated. To investigate whether women use a consistent and distinguishable muscle activation order when extending the hip while prone and to explore the effects of verbal cues on muscle activation and movement. Single-session, repeated-measures design. University laborat...
Article
Full-text available
Hip function has been proposed to be related to low back pain (LBP) because of the anatomical proximity of the hip and lumbopelvic region. To date, findings have been inconclusive, possibly because the samples studied were heterogeneous. Sub-grouping samples based on characteristics such as activity demand, LBP classification, and sex might clarify...
Article
Understanding the magnitude and direction of joint forces generated by hip strengthening exercises is essential for appropriate prescription and modification of these exercises. The purpose of this study was to evaluate hip joint forces created across a range of hip flexion and extension angles during two hip strengthening exercises: prone hip exte...
Article
Case report. Selecting the most effective conservative treatment for knee pain continues to be a challenge. An understanding of the underlying movement system impairment that is thought to contribute to the knee pain may assist in determining the most effective treatment. Our case report describes the treatment and outcomes of a patient with the pr...
Article
Our purpose was to examine the effect of modifying symptomatic movement and alignment tests in a sample of people with LBP referred to physical therapy. Fifty-one patients (19 males, 32 females; mean age 37+/-10.59 yr) with LBP and a mean Oswestry Disability Index score of 34+/-18% were examined. The examination included 28 primary tests in which p...
Article
Use of the tibia as a lever to produce hip rotation for the purpose of measuring passive hip rotation range of motion (ROM) could result in inaccurate values if motion is allowed at the tibiofemoral joint (TFJ). The purpose of this study was to examine the effect of stabilizing the TFJ during measurement of prone hip rotation ROM in men and women....
Article
To examine the effect of elevating the scapulae on symptoms during neck rotation. A retrospective analysis of clinical records was conducted. One physical therapist examined 46 patients with neck pain (30 women, 16 men; mean age 45.89+14.39 y) using a standardized examination. Patients had a long-standing history of neck pain with a moderate level...
Article
Full-text available
Case report. Based on our assumption that subtle deviations in the precision of shoulder movement cause tissue injury, we have developed a set of movement-related diagnoses for shoulder problems. The purposes of this case report are to (1) illustrate the use of a movement system impairment (MSI) diagnosis in a patient with shoulder pain, (2) illust...
Article
Full-text available
Background and purpose: Medical diagnoses are not sufficient to guide physical therapy intervention. To provide a rational basis for treatment selection by physical therapists, we developed a set of diagnoses at the level of impairment that are relevant to the human movement system. The diagnoses describe the primary human movement system problem...
Article
Full-text available
Little is known about the relationship between upper-extremity (UE) sensorimotor impairment and reaching performance during the first few months after stroke. The purpose of this study was to examine: (1) how measures of UE sensorimotor impairment are related to the speed, accuracy, and efficiency of reaching in subjects with hemiparesis during the...
Article
Full-text available
The movement system impairment (MSI) system is one proposed system for classifying low back pain (LBP) problems. Prior clinical data and observations for the MSI system suggest that different LBP subgroups demonstrate different patterns of movement during clinical tests, such as trunk lateral bending (TLB). The purpose of this study, therefore, was...
Article
To examine whether lumbopelvic motion associated with a clinical test of active hip lateral rotation (HLR) systematically varied between people classified into 1 of 2 low back pain (LBP) subgroups: lumbar rotation (Rot) or lumbar rotation with extension (RotExt); and, specifically, to determine whether the timing of hip and lumbopelvic rotation wit...
Article
Abnormal or excessive force on the anterior hip joint may cause anterior hip pain, subtle hip instability and a tear of the acetabular labrum. We propose that both the pattern of muscle force and hip joint position can affect the magnitude of anterior joint force and thus possibly lead to excessive force and injury. The purpose of this study was to...
Article
To investigate upper extremity muscle activation and recovery during the first few months after stroke. Subjects with hemiparesis following stroke were studied performing a reaching task at an acute time point (mean=9 days post-stroke) and then again at a subacute time point (mean=109 days post-stroke). We recorded kinematics and electromyographic...
Article
Full-text available
The authors recently found that grasping was not relatively more disrupted than reaching in people with acute hemiparesis. They now extend this work to the recovery of reach versus grasp. Hemiparetic subjects were tested acutely, after 90 days, and then after 1 year poststroke, and a control group was evaluated once. Using kinematic techniques, sub...
Article
Full-text available
To determine the relationships between sensorimotor impairments and upper extremity reaching performance during the acute phase of stroke and to determine which, if any, measures of sensorimotor impairment can predict variance in reaching performance during this phase. Sensorimotor impairments of upper extremity (UE) strength, active range of motio...
Article
Full-text available
This study explored relationships between upper-limb (UL) functional limitations and self-reported disability in stroke patients with relatively pure motor hemiparesis who were enrolled in an acute rehabilitation treatment trial. All participants were enrolled in the VECTORS (Very Early Constraint Treatment for Recovery from Stroke) study. VECTORS...
Article
Findings from previous studies suggest gender may affect the pattern of hip and lumbopelvic motion during a multi-segmental movement. To date, no studies have examined movement patterns and low back pain symptom behavior during hip lateral rotation. Forty-six people (27 males and 19 females) with low back pain were examined. Three-dimensional kinem...
Article
Cross-sectional, secondary analysis. To examine whether there were differences in the numbers and types of impairments on examination between 2 groups of people with low back pain (LBP), those who participated in symmetric leisure activities and those who participated in asymmetric leisure activities. It has been proposed that people who repeatedly...
Article
Study Design: Cross-sectional, secondary analysis. Objectives: To examine whether there were differences in the numbers and types of impairments on examination between 2 groups of people with low back pain (LBP), those who participated in symmetric leisure activities and those who participated in asymmetric leisure activities. Background: It has be...
Article
Acetabular labral tears are a recently recognized source of hip pain, particularly in the anterior hip or groin region. Except in cases of specific trauma, the etiology of labral tears is often difficult to determine. Labral tears often evade detection by noninvasive means. Once they are diagnosed, conservative medical treatment has not proven to b...
Chapter
Opzet van het onderzoek: Casusbeschrijving.Achtergrond: Op basis van de aanname dat weefselschade kan ontstaan door minieme afwijkingen in het precieze verloop van de bewegingen van de schoudergordel hebben we een indeling van bewegingsgerelateerde diagnoses bij schouderklachten ontwikkeld. De doelstellingen van deze casusbeschrijving zijn: (1) ton...
Chapter
Opzet van het onderzoek: Casusbespreking.Doel: Een behandeling beschrijven die bestaat uit een specifiek programma met actieve oefeningen en verbetering van de houding bij een persoon met cervicogene hoofdpijn.Achtergrond: De patiënt was een 46-jarige man met een voorgeschiedenis van cervicogene hoofdpijn sinds zeven jaar. Zijn symptomen waren cons...
Article
We studied how acute hemiparesis affects the ability to perform purposeful movements of proximal versus distal upper extremity segments. Given the gradient of corticospinal input to the spinal motoneuron pools, we postulated that movement performance requiring distal segment control (grasping) should be more impaired than movement performance requi...
Article
Full-text available
The purpose of this case report is to describe the classification, intervention, and outcomes for a patient with lumbar rotation with flexion syndrome. The patient was a 22-year-old man with a medical diagnosis of low back strain. Impairments in lumbar flexion and right rotation and lateral bending were identified. Daily activities and positions as...
Article
Full-text available
Case report. To describe an intervention approach consisting of a specific active-exercise program and modification of postural alignment for an individual with cervicogenic headache. The patient was a 46-year-old male with a 7-year history of cervicogenic headache. He reported constant symptoms with an average intensity of 5/10 on a visual analogu...
Article
Full-text available
Cross-sectional. To test the assumption that postural alignment and gender have a bearing on the specific type of low back pain (LBP) a person manifests. Measurements of static sagittal lumbar curvature are used by clinicians in the management of patients with LBP, but no investigator has reported differences in curvature related to specific catego...
Article
Full-text available
Hemiparetic subjects present with movement deficits including weakness, spasticity and an inability to isolate movement to one or a few joints. Voluntary attempts to move a single joint often result in excessive motion at adjacent joints. We investigated whether the inability to individuate joint movements is associated with deficits in functional...
Article
To examine the effect on symptoms of modifying patient-preferred movements and alignments of the lumbar spine during patient examination. Repeated-measures study in which patients with low back pain (LBP) participated in a standardized examination that included tests of symptoms with various movements and positions. Six university-affiliated outpat...
Article
Full-text available
Cross-sectional study of patients with mechanical low back pain (MLBP). To test the construct validity of 3 categories of a movement system impairment-based classification proposed for use with patients with MLBP. A pathoanatomic basis for directing treatment has not proven useful in a wide variety of patients with MLBP. In addition, there is a pau...
Article
Hemiplegia, or hemiparesis, severe impairment of purposeful activation of striated musculature, is the most conspicuous and often most disabling symptom of acute cerebrovascular lesions. Spontaneous improvement of voluntary strength may extend over many months. In this archetypical upper motor neuron syndrome we wish to ascertain the degree of func...
Article
Full-text available
Author Shirley A. Sahrmann explores whether the examination of posture is just a tradition of physical therapy practice or if the information gathered from this assessment useful for diagnosis and treatment. J Orthop Sports Phys Ther 2002;32(8):376–379. doi:10.2519/jospt.2002.32.8.376
Article
Full-text available
A descriptive, correlational study of patients with mechanical low back pain (LBP). To assess the effect of active limb movements on symptoms in patients with LBP and to examine the relationship between symptoms with limb movements and select patient characteristics. Limb movements result in forces applied to the spine and, thus, may be important i...
Article
This case report described the use of a classification system in the evaluation of a patient with chronic low back pain (LBP) and illustrated how this system was used to develop a management program in which the patient was instructed in symptom-reducing strategies for positioning and functional movement. The patient was a 55-year-old woman with a...
Article
Full-text available
This case report describes the use of a classification system in the evaluation of a patient with chronic low back pain (LBP) and illustrates how this system was used to develop a management program in which the patient was instructed in symptom-reducing strategies for positioning and functional movement. The patient was a 55-year-old woman with a...