The Human Movement System: What’s the Big Deal?

Special Interest Report
Population: Both

Patricia L. Scheets, PT, MHS, DPT, NCS, Director, Quality and Clinical Outcomes, Infinity Rehab plscheets@infinityrehab.com

Keywords: Prediction, Movement System, Diagnosis

Purpose and Description:  In 2013, the House of Delegates of the American Physical Therapy Association adopted a new vision statement and set of guiding principles.  In the guiding principles, the Human Movement System (HMS) is described as the foundation of the profession’s identity.   The purposes of this special interest poster are to present the value of using the HMS as an organizing principle for physical therapy (PT) practice and to stimulate discussion.

Summary of Use:  This poster will focus on four commonly asked questions:

  • What are the advantages of using the HMS as an organizing principle for practice as compared to health conditions (HC)?  In few instances does the patient’s HC provide the necessary information to guide and select PT intervention.  In children and adults, we find the same HMS problem associated with different HCs.  This separation of patients based on HC when they have similar HMS dysfunctions contributes to failure to recognize the patterns of HMS dysfunction and disparities in practice.
  • How does the HMS fit with the International Classification of Functioning, Disability, and Health (ICF)? The ICF is a model that provides a common language and categorization of patient characteristics.  The physical therapist’s clinical examination consists of tests and measures of the body function and structures of the HMS and the impact of the HMS impairments on activity and participation.  The contextual factors of the ICF describe the “setting” of the patient’s HMS problem that may impact overall outcome but are not the HMS problem itself.
  • What do standardized outcome measures tell us about the HMS? Standardized test results can yield meaningful information about a patient’s status but are limited in providing an analysis of the HMS.  Standardized tests describe the level of function or deficits in specific tasks but do not provide a structure for analyzing impairments that compromise task performance.
  • How is using the HMS as an organizing principle for practice superior to classifying patients based on the severity of their activity limitations? Identifying a patient’s activity limitations is critical to framing the extent of the patient’s HMS problem, but it is not sufficient to guide intervention.  PTs must understand the underlying impairments in HMS control and activation, determine a prognosis for improvement of these impairments, and select specific interventions designed to maximize skill of the HMS.

Importance to Members:  Organizing our practice around the HMS is important in all areas of physical therapy.  Defining our clinical examination around analysis of the HMS articulates the skill of our discipline and defines our area of expertise.  Focusing on HMS problems rather than HCs allows us to define the common HMS problems we see and determine best clinical approaches.  Identifying the patterns we see makes practice more efficient and effective.   The HMS provides an organizing framework for teaching students how to observe and synthesize data and provides a structure for research that aligns with clinical practice.

Citation:
Scheets, Patricia L., PT, MHS, DPT, NCS. The Human Movement System: What’s the Big Deal?. Poster Presentation. IV STEP Conference, American Physical Therapy Association, Columbus, OH, July 17, 2016. Online. https://u.osu.edu/ivstep/poster/088_scheets/

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