Top-Tier Movement Patterns and Scoring (FN, DN, FP, DP)
Domain 2 - Top-Tier Patterns and Scoring (FN, DN, FP, DP)
Every SFMA decision starts with ten top-tier patterns, each scored pass/fail against explicit criteria plus a pain flag, with several scored per side. Scoring looks simple and is where most candidates leak marks, because the four scores are branch points in a decision tree, not grades of severity.
The ten patterns
Cervical flexion, cervical extension, cervical rotation (left and right), upper extremity pattern 1 (shoulder flexion with elbow extension, arm overhead), upper extremity pattern 2 (shoulder extension with internal rotation, hand behind the back), multi-segmental flexion, multi-segmental extension, multi-segmental rotation, single-leg stance (left and right), overhead deep squat.
The four scores
- FN - functional non-painful: meets the criteria, no symptoms. Nothing further is required for that pattern.
- FP - functional painful: meets the criteria but provokes pain. Referral or clearance first.
- DN - dysfunctional non-painful: fails the criteria, no pain. This is the SFMA's working territory; break it out.
- DP - dysfunctional painful: fails the criteria and provokes pain. Highest priority; refer, do not exercise it.
Rules that decide the score
- Pain outranks function: a painful pattern can never be scored functional.
- There is no 1–3 grading; SFMA is dichotomous by design so the score points to an action.
- Score each side separately and record where pain is felt, not just that it exists.
- Criteria are observed, not negotiated: heels stay down and arms stay overhead in the deep squat; the chin reaches the chest in cervical flexion; the trunk stays controlled in single-leg stance.
- Test in the standard sequence and position so retests are comparable.
Worked example
A client's single-leg stance: the left side shows hip drop and trunk sway after eight seconds, no pain - DN left. The right side is steady, but she reports a sharp pinch in the groin - FP right. Reasoning: the two sides need different actions. The FP side is referred and documented; the DN side is broken out for hip abductor control and ankle stability.
Traps that cost marks
- Writing "painful" as a dysfunction and losing the pain flag.
- Testing only the symptomatic side on bilateral patterns.
- Passing a deep squat while the heels lift or the lumbar spine loses position.
- Mixing SFMA's four scores with the FMS 0–3 ordinal scale.