The Movement System and the Kinesiopathologic Model
Shirley Sahrmann, PT, PhD, FAPTA
Professor Emerita Physical Therapy, Neurology, Cell Biology & Physiology
Washington University School of Medicine St. Louis
A major evolution in the understanding of disease is that a large majority of conditions begin early in life and slowly develop over time until they reach a threshold that requires diagnosis and treatment. Many of these diseases have their roots in lifestyle combined with genetic factors. So too is there growing recognition that musculoskeletal conditions are related to lifestyle particularly related to the movement pattern used in daily activities as well as in work, fitness, and sports activities.
Recognition of the importance of physical activity for maintaining health and yet also how physical activity can induce musculoskeletal pain problems, is resulting in a culture change in physical therapy.
This presentation discusses the culture change from therapists providing treatment based on a diagnosis made by a physician, to practitioners responsible for a body system, the Movement System.
The Movement System, a system of physiological systems that interact to produce motion of the body and its parts, was designated as the identity of physical therapy by the American Physical Therapy Association in 2013. As practitioners responsible for a body system, therapists should 1) provide monitoring and guidance during the growth and development of the system, 2) make diagnosis of kinesiopathologic and pathokinesiologic conditions, and 3) develop treatment programs. As implied by these responsibilities, phyiotherapists need to be lifespan practitioners providing yearly exams. In addition to the pathokinesiologic conditions, such as hemiplegia, para and quadriplegia from central nervous system lesion, are kinesiopathologic conditions in which movement induces pathology.
The kinesiopathologic model, a theoretical construct of the Movement System is also discussed along with the evidence for the model in patients with low back pain.