Posted on by Kyle Ridgeway

What Problem Does The Human Movement System Solve?

Apparently evolving from the new vision statement, the APTA and the board of directors introduced the “human movement system” as the potential professional identity and rallying cry for physical therapists. The definition of the human movement system is:

The human movement system comprises the anatomic structures and physiologic functions that interact to move the body or its component parts.

Chris Powers, PT, PhD, FAPTA recently discussed the concept of the human movement system on Karen Litzy’s podcast Healthy, Wealthy, and Smart. He stressed it’s conciseness, applicability to educating consumers, and it’s ability to be a unifying theme across practice settings. Dr. Power’s asserts the profession of physical therapy needs an identity, a central theme, and something that applies across patient populations and settings. He describes the human movement system as a system comprised of many systems. “We treat the entire movement system, and in order to do that you have to be an expert in all of the subsystems.”

Matt Sremba, PT, DPT, OCS Paul Mitalski, MS, and myself are interviewed by Adam Van Cleave on the Conatus Athletics’ Podcast regarding the Human Movement System and Role of the Physical Therapist. We think there are issues in regards to the definition and it’s implications. All of us agree with Dr Powers that there are problems within the field of physical therapy spanning education, research, and clinical practice. But, we do not see the creation of a “human movement system” nor the definition as assisting in either solving nor identifying any significant problems.

It’s over ambitious and under precise…this definition allows for a misinterpretation of the physical therapy profession…The first example I’ll give is the word components and how it’s used. In this instance the word is too broad….The word movement is too narrow…do they really mean ALL components of all anatomical systems involved in movement? Because that is what they say. In fact, what system wouldn’t be involved? What system or component of human anatomy doesn’t directly or indirectly contribute to movement? This is too broad. Didn’t narrow the scope…

When you propose a definition that has no bounds you end up not defining anything. And definitions have to be precise. So, this is a lack of precision. On the other hand, the word movement also has a lack of precision, but it’s opposite. The word movement, to me, is too constraining. It’s inconsistent with what the physical therapist does and it limits what the physical therapists does. PTs should have a medical role…for the human whether or not the human is moving. The therapist should be involved in non-movement aspects of the human. -Paul Mitalski, CEO of Conatus Athletics

Sure, this may appear like nit picking, minutia, and nothing but semantics. Is the human movement system really a system? Is this our professional identity? Do we want to create something else that no one knows about? If the physical therapy profession senses there are issues communicating our knowledge and roles to various stakeholders any proposed solution must be clear. Precision in language is needed.

The problems have not been specifically identified or labeled meaningfully. Is the definition for marketing and branding only? One liners and advocacy for physical therapy are not bad. In fact, rallying generally around PTs helping people move is a likely a meaningful cause. And of course, PTs deal in human movement quite frequently. But, we remain skeptical that attempts to create a human movement system will contribute meaningfully to education, research, clinical practice, or advocacy efforts. Further, this definition will not contribute meaningfully to communication. We think creating new systems with broad definitions that demand assumptions may only complicate an already cloudy communication problem.

Are the problems properly identified? And, does the creation of the human movement system and it’s definition address them? Some of the issues we identify (and will discuss further in future podcasts) are leadership, collaboration, and education modifications.

Listen to The Human Movement System with Dr. Chris Powers on Healthy, Wealthy, and Smart as well as our reply The Human Movement System and the Role of the Physical Therapist on The Conatus Athletics’ Podcast. Our goal is to open a dialogue on this topic.

So, what do you think?

Resources
The Human Movement System with Dr. Chris Powers on Healthy, Wealthy, and Smart
The Human Movement System and the Role of the Physical Therapist on The Conatus Athletics’ Podcast
Human Movement System information on APTA website
Rothstein Roundtable Debates Implementation of Human Movement System
Rothstein Debate: Putting All our Eggs in One Basket: Human Movement System on PTJ Podcast
Discussion: The Human Movement System on PTJ Podcast
Shirley Sahrmann explains why PT’s are THE Movement System Specialists on PTPintCast
‘Movement System’ Is Our Professional Identity
The human movement system: our professional identity by Shirley Sarhmann
On “The human movement system: our professional identity…”

6 Replies to “What Problem Does The Human Movement System Solve?”

  1. The Lack of Meaning in “The Movement System” by Eric Kruger, PT, DPT

    The term movement system implies an agnostic stance with respect to what causes movements and to what movements belong. What do I mean? First movements are produced by intentions: a mix of ideas, emotion and motivation. Second, they are carried out as part of behaviors—which are coordinated with environments in ways to produce effects on environments. Motor control and the physiological adaptations that occur due to movement occur at this narrow junction that binds intentions to behavior. When we approach the problems of humanity from the narrow stance of the movement system we are admitting we either don’t know or don’t care about the other parts. This is the agnostic position that is implied via the treatment of the movement system.

    We have been there, done that, tried that, and it has gotten us nowhere. In fact there is a fairly robust literature in biology, motor control, and muscle physiology about how the nervous system optimizes itself WITHOUT a physical therapist ever being involved. In fact one could easily ask, why would evolution require a physical therapist for such optimization—probably a very important topic to be tackled later given the broad claims by the APTA.

    I am advocating that it is time as therapists we ditch this agnostic position and put some real skin in the game and start dealing with concepts of intentions and behavior. Whoa, those terms again, those sound like psychological terms one might rejoinder. When does a movement dysfunction become a behavior and when is that behavior guided by an intention? These are the hard questions that our profession faces and it does so with a poverty of language and experience in such fields. Movement unbounded from behavior and intention is essentially meaningless. Last time I checked human behavior is hallmarked by meaning.

  2. Capturing Physiotherapy by Dave Nicholls

    How does the HMS model explain everything that defines physiotherapy that is not simply about biomechanics or the anatomy and patho-physiology of movement? Models can enable much, but they can also deny important facets of our professional roles, identities, behaviours, influences, responsibilities, attitudes and values. Not least, if they claim to be ‘all-encompassing’ but are, in fact, only all encompassing of a very narrow functionalist definition of a profession, they can be the source of a dramatic miscommunication about what physiotherapy is or can be. (And thereby undermine the very purpose of the HMS in the first place which is to provide clarity and a communicable message about who we are and what we do).

  3. Looking at physiotherapy through fresh eyes by Dave Nicholls

    It occurred to me that taking on roles that required us to understand and embrace the perspectives of colleagues who have different priorities to us would be beneficial for lots of people. And to fight and lobby not from one’s own position, but from the position of the ‘other’, is something we ought to be good at as physiotherapists – given that we advocate for our clients/patients each and every day.

    For me, it has felt at times as if I am learning an entirely new language, and although it has sometimes been destabilising and unsettling, it has also been enlightening and invigorating.

    These experiences have given me infinitely more pause to reflect on my own professional ideologies than if I had remained within the comfortable confines of the physiotherapy profession itself. I would encourage everyone else who has the opportunity to do the same, given half the chance.

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