A video taken in a physical therapy clinic shows an athlete with a recent ACL reconstruction taking a running jump and landing—poorly. There's a collective groan in the audience. How do they all know that this athlete is not ready to return to play? Chris Powers, PT, PhD, FACSM, FAPTA, can tell them: "We're the experts in movement."
Powers and colleagues presented "The Human Movement System: Physical Therapist Practice" on Saturday to a capacity crowd. The 2-part session followed the conference's annual Rothstein Roundtable, which also addressed the movement system and included many of the same panelists.
The human movement system is our professional identity, Lisa Saladin, PT, PhD, FAPTA, said, as described in the guiding principle "identity" of APTA's vision for the profession. That principle calls the movement system "the core of physical therapist practice, education, and research." And developing this identity is needed, she indicated, because despite inroads in making other providers and the public aware of physical therapy's unique role in health care, the profession still is too often mischaracterized.
Physical therapists need to be defined not by the techniques they use but by their body of knowledge and skills, Saladin said. "We have to be done talking about what we do. We need to talk about what we know."
To that end, an association work group, charged by APTA's House of Delegates, has developed a definition: "The human movement system comprises the anatomic structures and physiologic functions that interact to move the body or its component parts."
The definition is purposely broad, noted Sharon Dunn, PT, PhD, OCS. "APTA or physical therapy shouldn't ‘own' the human movement system," she said. The definition must resonate with the profession's collaborative partners in health care.
However, because of the nonspecific definition, the work group added language on the roles of physical therapy that describes, among other things, their unique perspective on purposeful, precise, and efficient movement across the lifespan.
Shirley Sahrmann, PT, PhD, FAPTA, put the movement system into context with other disciplines, saying, "Highly respected professions gain their respect because they're experts about the body systems they treat." Think of cardiologists, neurologists, and endocrinologists, she suggested. For the physical therapy community to gain respect as human movement system experts, we need to assume the role of a lifespan practitioner, one that sees individuals over the years, not as separate, unrelated episodes of care.
Included in that is development of a standardized movement system exam, bringing in common language that facilitates communication. "By having a rubric that allows us to describe the situation, we can communicate with others," Cyndi Zadai, PT, DPT, MS, FAPTA, explained.
There are obstacles to integrating a defined "movement system" into practice, education, and research, the panelists agreed, but cost shouldn't be one of them. While expensive monitoring systems in the clinic are nice, PTs can use their observational skills, noted Sue Whitney, PT, DPT, PhD, NCS, ATC, FAPTA. "We see things other providers don't. And you have to see it to fix it."
A simple cell phone can capture video of the patient moving. That said, PTs need to be aware of limitations—facilities may prohibit use of video because of HIPAA regulations, for example. It was suggested that using the patient's phone may be an alternative.
Turning to obstacles in physical therapist education, panelists noted that if movement is integrated into the other more-established systems such as musculoskeletal and neurological, then current teaching approaches need to change, as they compartmentalize students by addressing those systems separately.
Andrew Guccione, PT, DPT, PhD, FAPTA, addressed the movement system and research. "Research oriented toward the human movement system will have a visual component," he said, indicating that visual analysis of movement will come to the fore of research.
The bottom line for Guccione is that there is a set of determinants of optimized movement. These are: ideation, initiation, execution, regulation, equilibrium, and sustainability. "These are ‘buckets' of knowledge, within which are huge bodies of literature. The brilliance of this profession is our ability to look across these buckets," he said. To do so, however, he cautioned that "we must stop being orthopedic or neurologic or cardiopulmonary PTs and be movement PTs."
Last Updated: 6/8/2015
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