Arcadia University, Department of Physical Therapy, Glenside, Pennsylvania, USA.
Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, USA.
Phys Ther. 2021 Mar 3;101(3). doi: 10.1093/ptj/pzab024.
The movement system has been adopted as the key identity for the physical therapy profession, and recognition of physical therapists' primary expertise in managing movement dysfunction is an important achievement. However, existing movement system models seem inadequate for guiding education, practice, or research. Lack of a clear, broadly applicable model may hamper progress in physical therapists actually adopting this identity. We propose a model composed of 4 primary elements essential to all movement: motion, force, energy, and control. Although these elements overlap and interact, they can each be examined and tested with some degree of specificity. The proposed 4-element model incorporates specific guidance for visual, qualitative assessment of movement during functional tasks that can be used to develop hypotheses about movement dysfunction and serve as a precursor to more quantitative tests and measures. Human movement always occurs within an environmental context and is affected by personal factors, and these concepts are represented within the model. The proposed scheme is consistent with other widely used models within the profession, such as the International Classification of Functioning, Disability and Health and the Patient Management Model. We demonstrate with multiple examples how the model can be applied to a broad spectrum of patients across the lifespan with musculoskeletal, neurologic, and cardiopulmonary disorders.
运动系统已被采纳为物理治疗专业的主要特征，认识到物理治疗师在管理运动功能障碍方面的主要专业知识是一项重要成就。然而，现有的运动系统模型似乎不足以指导教育、实践或研究。缺乏一个清晰的、广泛适用的模型可能会阻碍物理治疗师真正采用这种身份的进展。我们提出了一个由 4 个主要元素组成的模型，这些元素对于所有运动都是必不可少的：运动、力、能量和控制。尽管这些元素相互重叠和相互作用，但它们都可以在一定程度上进行具体检查和测试。所提出的四元素模型包含了对功能任务中运动的视觉、定性评估的具体指导，这些指导可以用来提出关于运动功能障碍的假设，并作为更定量的测试和测量的前奏。人类运动总是在环境背景下发生的，并受到个人因素的影响，这些概念在模型中都有所体现。该方案与该专业内的其他广泛使用的模型（如国际功能、残疾和健康分类和患者管理模型）一致。我们通过多个例子展示了该模型如何应用于跨越整个生命周期的患有肌肉骨骼、神经和心肺疾病的广泛患者群体。
