Movement System

Question 1

APTA vision statement:

Answer 1

transforming society by optimizing movement to improve the human experience

Question 2

Guiding Principles:

Answer 2

Identity
Quality
Collaboration
Value
Innovation
Consumer centered
Access/ equity
Advocacy

Question 3

Vision Principle: Identity

Answer 3

• define and promote the movement system as the foundation for optimizing movement to improve the health of society
• movement system is the core of PT practice, education, and research

Question 4

So what is the Human Movement System?

Answer 4

represents the collection of systems (cardiovascular, pulmonary, endocrine, integumentary, nervous, and musculoskeletal) that interact to move the body or its component parts

Question 5

1995/Movement System Science: Links to PT Scope of Practice

Answer 5

pathology = interruption or interference with normal cell processes

impairments = anatomical, physiological, mental or emotional abnormality or system level loss

functional limitations = limitation in performance at the level of the person

disability = limitation in performance of socially defined roles and tasks

Question 6

Why do Movement Exam Prior to the Clinical Exam?

Answer 6

• Most patients will present with multiple physical impairments; many of which may not be contributing to the patient’s symptoms
• Only 1‐2 of these impairments may be “primary” with respect to the clinical complaints

Question 7

Required Skill Set of the Physical Therapist

Answer 7

• The ability to analyze a wide range of functional movements
• Identify movement impairments based on knowledge of “normal” movement
• Identify underlying causes of relevant movement impairments

Question 8

Movement Analysis Language

Answer 8

• phase
• objective
• critical event

Question 9

Phase:

Answer 9

A portion of a given movement cycle

Question 10

Objective:

Answer 10

The basic requirement(s) of a given phase

Question 11

Critical event:

Answer 11

Joint or segment motion(s) or positions that are required to accomplish an objective for a given phase

Question 12

Diagnostic Tasks

Answer 12

• QuietSitting
• Reach
• Sit to/ from Stand
• Grasp
• QuietStanding
• In‐handManipulation
• Standing Feet Together
• Step‐Up
• Walking
• Complex Walking
• In‐handManipulation

Question 13

Shoulder Impingement:

Answer 13

• Most common diagnostic label/disorder for the shoulder
• Large number of potential tissue pathologies
• Movement impairments variable between investigations of this condition

Question 14

Problems:
Professional Disagreement

Answer 14

• Using same label for many
• Broad use limits effectiveness of decision making
• Using same label with different meaning
• Not treating or studying homogenous patient groups
• Some physicians advocating for different label

Question 15

“Big Three” Glenohumeral Diagnoses ‐ Opportunity

Answer 15

• Instability
• Adhesive Capsulitis
• “Impingement”/
  Rotator Cuff Syndrome

Question 16

Big Three Diagnoses – Movement Based

Answer 16

• Hypermobility (Instabilities)
  Stability Deficit
• Hypomobility
  (Adhesive Capsulitis, Arthritis, Post‐Fx)
  Mobility Deficit
• Aberrant Motion
  (Rotator Cuff, Impingement, Labral Tears, Nerve Injuries)
  > Pain

Question 17

Concerns with Pathoanatomic Labels

Answer 17

> Often do not adequately direct physical therapy intervention

> Disconnect between our diagnostic and treatment process

> Inconsistent use among providers confounds communication