The 4-Element Movement System Model to Guide Physical Therapist Education, Practice, and Movement-Related Research

Philip McClure, Michael Tevald, Ryan Zarzycki, Shailesh Kantak, Philip Malloy, Kristen Day, Kshamata Shah, Amy Miller, Kathleen Mangione
Physical Therapy 2021 January 22
The movement system has been adopted as the key identity for the physical therapy profession and recognition of physical therapists' primary expertise as 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.

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