Effects of a Total Motion Release (TMR®) Protocol for the Single Leg Squat on Asymmetrical Movement Patterns

Abstract

# BACKGROUND Improving single leg squat (SLS) movement symmetry may benefit rehabilitation protocols. The Total Motion Release® (TMR®) protocol has been theorized to evaluate and improve patient-perceived movement asymmetries. # HYPOTHESIS/PURPOSE The purpose of this study was to evaluate whether perceived asymmetries identified by a TMR® scoring protocol were related to biomechanical asymmetries and whether improving perceived asymmetries influenced movement mechanics. It was hypothesized that participants with perceived asymmetries would also present with biomechanical asymmetries. A secondary hypothesis was that participants would reduce their perceived asymmetries after performing the TMR® protocol and subsequently have greater biomechanical symmetry. # STUDY DESIGN Descriptive Cohort (Laboratory Study). # METHODS Twenty participants (10 female, 10 male) with self-identified bilateral differences of 10 points or greater on the TMR® scoring scale were recruited for the study. The non-preferred side was defined as the side that scored higher. 3Dimensional motion capture was used to bilaterally assess baseline SLS depth as well as hip, knee, and ankle kinematics and kinetics. For the TMR® protocol, sets of 10 SLSs were performed on the preferred leg until their perceived asymmetries were resolved (i.e., both sides scored equally), or four sets had been completed. Kinematics and kinetics were collected immediately after the intervention and after a 10-minute rest period. # RESULTS Participants had biomechanical asymmetries at baseline for knee flexion, ankle flexion, and knee moments. Following the intervention, participants had reduced TMR® scores on the non-preferred leg, and this coincided with increased knee joint moments on that side. Although perceived asymmetries were resolved after the intervention, kinematic and kinetic asymmetries at the knee and ankle were still present. # CONCLUSIONS A TMR® intervention could benefit rehabilitation protocols by reducing factors of dysfunction and increasing the ability of patients to load the non-preferred knee. Further investigations are necessary to elucidate the importance of asymmetrical movement patterns. # LEVEL OF EVIDENCE 3b