The Movement System
The definition of the movement system developed at Washington University is ‘‘a system of physiological organ systems that interact to produce movement of the body and its parts.’’ A collection of various systems: cardiovascular, pulmonary, endocrine, nervous and musculoskeletal that work together in coordination to produce body movement. As physiotherapists we are characterized as movement experts and this shapes our unique identity in the medical society.
In 2013, the American Physical Therapy Association (APTA) adopted a new vision, “Transforming society by optimizing movement to improve the human experience.”
This new vision is considered to be an identity for physiotherapists that calls for skills, knowledge and expertise related to the movement system to promote optimal development and prevents activity limitation.
Implications on the Profession
Physiotherapists have always been identified with the treatment thy deliver rather than the body of knowledge, clinical reasoning and diagnostic skills. By adopting this new vision, we are changing how the public and the healthcare professionals view us.
The first principal of this new vision states the following: “The physical therapy profession will define and promote the movement system as the foundation for optimizing movement to improve the health of society. Recognition and validation of the movement system is essential to understanding the structure, function, and potential of the human body. The physical therapist will be responsible for evaluating and managing an individual's movement system across the lifespan to promote optimal development; diagnose impairments, activity limitations, and participation restrictions; and provide interventions targeted at preventing or ameliorating activity limitations and participation restrictions. The movement system is the core of physical therapist practice, education, and research''.
Prior to this, physiotherapists have been using the movement system in their practice but it wasn't promoted as the foundation or conceptual framework of our practice.
Implications on the Clinical Practice
Adapting the movement system sets a clinical framework for physiotherapists to use a holistic approach when assessing and treating individuals.
The following are examples of optimizing the movement system in the physiotherapy practice:
- When addressing patellofemoral pain, assessment and treatment should include other joints such as the hip and ankle
- Assessing patients with high risk of falls, the assessment shouldn't be exclusive to postural and musculoskeletal abnormalities. Other contributing factors, such as neurological or cardiovascular impairments should be put into considerations, ruled out and addressed if found.
- The development of the classification system to replace medical diagnosis that doesn't guide the physical therapy intervention
In 2000, Vision 2020 was developed and stated the goal of the profession to be doctors, diagnosticians, and have direct access to provision of care for patients.The new vision aims to identify physiotherapists as professionals who use their “expertise” to transform society by optimizing movement to enhance the human experience.
However, there are challenges to the physiotherapy business model but it is argued that optimizing movement and the performance of the systems would contribute to maintaining health in a cost effective way by eliminating the use of drug and surgical interventions.
A Board Work Group was adopted by the APTA to develop a definition and a plan to disseminate and implement the Movement System in practice, education and research. A summit was held in December 2016 to discuss terminology, developing a basic movement system exam and diagnosis.
- Sahrmann S, Azevedo DC, Van Dillen L. Diagnosis and treatment of movement system impairment syndromes. Brazilian journal of physical therapy. 2017 Nov 1;21(6):391-9.
- Saladin L, Voight M. Introduction to the movement system as the foundation for physical therapist practice education and research. International journal of sports physical therapy. 2017 Nov;12(6):858.
- What is the Movement System? . Available from: https://www.youtube.com/watch?v=QPktFg0Mjsg [last accessed 29/02/2020]
- American Physical Therapy Association. Physical therapist practice and the movement system. An American Physical Therapy Association White Paper. 2015.
- The Movement System and Your Patient. Available from: https://www.youtube.com/watch?v=-c3mEyAO4Nc[last accessed 09/05/2020]
- Sahrmann S. The how and why of the movement system as the identity of physical therapy. International journal of sports physical therapy. 2017 Nov;12(6):862.
- Movement System: #APTACSM 2016 Dispatch . Available from: https://www.youtube.com/watch?v=Q91PuTc04ls[last accessed 29/02/2020]