S.A. Sahrmann, PT, PhD, FAPTA, Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Ave, Box 8502, St Louis, MO 63108 (USA).
Phys Ther. 2014 Jul;94(7):1034-42. doi: 10.2522/ptj.20130319. Epub 2014 Mar 13.
The 2013 House of Delegates of the American Physical Therapy Association adopted a vision statement that addresses the role of physical therapy in transforming society through optimizing movement. The accompanying guidelines address the movement system as key to achieving this vision. The profession has incorporated movement in position statements and documents since the early 1980s, but movement as a physiological system has not been addressed. Clearly, those health care professions identified with a system of the body are more easily recognized for their expertise and role in preventing, diagnosing, and treating dysfunctions of the system than health professions identified with intervention but not a system. This perspective article provides a brief history of how leaders in the profession have advocated for clear identification of a body of knowledge. The reasons are discussed for why movement can be considered a physiological system, as are the advantages of promoting the system rather than just movement. In many ways, a focus on movement is more restrictive than incorporating the concept of the movement system. Promotion of the movement system also provides a logical context for the diagnoses made by physical therapists. In addition, there is growing evidence, particularly in relation to musculoskeletal conditions, that the focus is enlarging from pathoanatomy to pathokinesiology, further emphasizing the timeliness of promoting the role of movement as a system. Discussion also addresses musculoskeletal conditions as lifestyle issues in the same way that general health has been demonstrated to be clearly related to lifestyle. The suggestion is made that the profession should be addressing kinesiopathologic conditions and not just pathokinesiologic conditions, as would be in keeping with the physical therapist's role in prevention and as a life-span practitioner.
2013 年美国物理治疗协会代表大会通过了一项愿景声明，其中阐述了物理治疗在通过优化运动来改变社会的作用。配套的指南将运动系统作为实现这一愿景的关键。自 20 世纪 80 年代初以来，该专业就在立场声明和文件中纳入了运动，但作为一个生理系统的运动尚未得到解决。显然，那些与身体系统相关的医疗保健专业更容易因其在预防、诊断和治疗系统功能障碍方面的专业知识和作用而被认可，而不是那些以干预而不是系统为特色的健康专业。本文简要回顾了该专业的领导者如何倡导明确识别知识体系的历史。讨论了为什么可以将运动视为生理系统的原因，以及推广该系统而不仅仅是运动的优势。在许多方面，关注运动比纳入运动系统的概念更具限制性。促进运动系统也为物理治疗师做出的诊断提供了一个合乎逻辑的背景。此外，越来越多的证据表明，特别是在肌肉骨骼疾病方面，焦点正在从病理解剖学扩大到病理运动学，进一步强调了推广运动作为系统作用的及时性。讨论还将肌肉骨骼疾病作为生活方式问题，就像已经证明的一般健康与生活方式有明显关系一样。有人建议，该专业应该解决运动病理状况，而不仅仅是病理运动状况，这符合物理治疗师在预防和作为全生命周期从业者中的作用。
