The Movement System and Diagnosis: Are We There Yet?

Abstract

In the 29th Maley lecture, Phil McClure PT, PhD, FAPTA, shares a Perspective regarding the movement system and diagnosis. Despite declarations from the House of Delegates >10 years ago, the concept of a movement system has not been widely embraced in either education or practice. In this perspective, he offers critical analysis and 3 proposals that could potentially make the concept of a movement system more relevant and meaningful. The first is to operationally define the movement system, arguing that the current definition is too vague and not operational, and therefore not meaningful. The second is to intentionally separate the movement system from any specific diagnostic classification scheme which would allow the focus to remain on movement and movement analysis. He argues that diagnostic classification schemes require a biopsychosocial framework and that movement, while important, cannot be the only consideration. The third proposal is that diagnostic schemes must be developed by clinical scientists through appropriate research guided by sound theory, not by administrative or political process. He further argues that a greater focus on determining which patients are likely to be helped by physical therapists is necessary and offered the example of developing "appropriateness criteria" as a tool toward promoting value-based care. Achieving broad consensus around these proposals could unify our professional focus and assist toward the vision of optimizing movement to enhance the human experience.