Functional performance models: an approach to the evolution of clinical analysis in high-performance sport

Abstract

Dear Editor, this letter was written with the aim of introducing readers to a process of reasoning about the modalities of intervention and their structure within a process of rehabilitation and sports readaptation, seeking criticism and construction towards the development of knowledge in physical therapy based on the evolution of knowledge and its application to real environments. High-performance sports are evolving at an exponential rate, confirming paradigms such as the increase in the potential rate of athletic development, amplified physical abilities, exponential growth rates, specialized training methodologies, and performance-focused nutrition. In fact, all these elements have proven to create elite athletes who demonstrate superiority in physical and mental performance variables, opening a gap for the inclusion of a piece of the puzzle in the development of high-performance athletes who can achieve perfection in sport^1,2. The objective of this letter is to encourage the reader to think critically about clinical reasoning in the creation of functional performance models in high-performance athletes. Human body movement is characterized as an area of study at the structural and functional level that has anatomical, physiological, and biological elements that allow for the development of known physical abilities^3,4. However, many questions arise surrounding the development of the potential of these abilities and athletic success. For example, scientific evidence shows that the human body functions based on bone, muscle, cardiovascular, and tendon structures that work to provide mechanisms for daily activities focused on a specific environment^5,6. In high-performance sports, managing structure and function is vital for the development of essential movement skills. Thus, considering that structure and function are the basis of athletic evolution, creating training models based on these pillars is the process for developing specific methodologies and models emphasized in clinical reasoning^7,8. Models and methodologies are processes developed to standardize the dynamics of interaction between anatomical structure and its expression in functionality. However, the greatest unknown arises from the premise of standardizing movement, which continues to be a global debate given that athletes do not respond in the same way to certain stimuli as others⁹. Based on this concept, how are successful methodologies developed that lead to athletic development? Everything is based on managing concepts and systematizing the process based on moments that allow for the development of physical condition. Within these moments, the following stand out: release focused on the induction of soft tissues to increase range of motion; mobilization focused on the preparation of specific muscles for the activity; activation focused on stabilization and connection between joint, tendon, and muscle segments; and integration focused on neuromuscular development based on functional expressions given by the context^10,11. Taking these principles into account as the basis of systemic work on human body movement for structure and function.  For example, mobilization aims to impact the osteoarticular and capsuloligamentous components based on range of motion and active control for stability, emphasizing freedom of movement as the basis for movement construction. Secondly, preparing the movement allows for lubrication and promotes active control focused on sporting gestures with precision, speed, symmetry, and amplitude, generating the right mechanical conditions for development. Now, activation aims to transfer to the function based on the musculo-tendinous component, predisposing the contractile component from motor recruitment, producing expressions of force as the central axis of functional capacities such as accelerations, decelerations, changes of direction, and jumping, optimizing biomechanical factors such as torque, production and reduction peaks, propulsion, and absorption. This is done by performing a dynamic transmission process against the movement demand known as analytical activations based on stimuli in open and closed kinetic chains, seeking the integration of the total movement segment. Finally, coordinative activations are integrated into an associative and integrative phase of movement that seeks to make the muscle chains of movement work together to produce complex movement circuits focused on the actions of the sport^12-15. Taking into account the aforementioned premises, having the basics of movement does not guarantee good work if you do not have an adequate model of work to adapt to the load. For example, there are athletes who do not respond to a specific work methodology. This is due to different characteristics such as inadequate adaptation, lack of control of variables, not impacting the structure before the function, and thinking more about performance than preparation for it. Thus, the concept of functional movement models is based on the combination of elements such as the moment of induction and release that predisposes the tissue for the start of activity, the moment of mobilization that prepares the joints, capsules, and muscles of the thoracic spine, hip, knee, and ankle segments with the intervention of muscle chains; activation moment, which initiates the process of analytical recruitment at the multi-joint level based on the impact on the main muscles of the lower and upper limbs through differential exercises in open and closed kinetic chains with isometric, concentric, and eccentric contractions. Finally, the moment of integration, which combines neuromuscular elements based on fundamental movement patterns for the development of skills such as propulsion, landing, acceleration, deceleration, change of direction, kicking, pushing, and pulling^15-19. In conclusion, with clarity on the pillars of movement and how they combine, individual models can be developed based on unique working methodologies designed under professional clinical reasoning as a fundamental element in the development of knowledge. Thus, each functional performance model is unique because it is based on evidence-based medicine and the experience of the professional who develops it, where the path to the evolution of this topic is to revolutionize teaching through the graphing of models with interaction dynamics that are measurable and modifiable over time.