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Movement Science and Its Relevance to Physical Therapy



The purpose for a special series of articles in Physical Therapy devoted to movement science is threefold. First, physical therapists will be exposed to current research in this broad behavioral domain. This may have important implications for the discipline and profession of physical therapy. Second, physical therapists will have access to a body of knowledge that may have been overlooked because it was not seen as immediately relevant to clinical practice. Third, the series could serve as a basis for curriculum development and study in physical therapy education programs. By providing this exposure in Physical Therapy, unjustified barriers to particular research questions, methodologies, and related literatures may be overcome. Two concepts are presented that provide a framework for the 23 contributions to the movement science special series.
Movement Science and
Physical Therapy
Movement science and its relevance to physical therapy.
Phys Ther.
1990; 70: 759-762.1
The purpose for a special series of
articles in
Physical Therapy
devoted to
movement science is threefold. First,
physical therapists will be exposed to
current research in this broad behav-
ioral domain. This may have impor-
tant implications for the discipline
and profession of physical therapy.
Second, physical therapists will have
access to
body of knowledge that
may have been overlooked because it
was not seen as immediately relevant
to clinical practice. Third, the series
could serve as a basis for curriculum
development and study in physical
therapy education programs. By pro-
viding this exposure in
Physical Ther-
unjustified barriers to particular
research questions, methodologies,
and related literatures may be over-
Two concepts are presented that pro-
vide a framework for the 23 contribu-
tions to the movement science special
series. The first deals with the diver-
sity of topics within the scope of
movement science, and the second
deals with the need for interdiscipli-
nary interactions. The first concept,
diversity of topics, is revealed from an
examination of the contents. There
are topics such as the use of animal
models to provide insights into motor
development (see article by Bradley
in this issue) and the importance of
psychosocial factors with respect to
motivation governing involvement in
physical activity (see article by Lewth-
waite in this issue). These topics span
a broad spectrum and seem to be
only casually related and perhaps dis-
careful look at the fun-
damental questions raised by these
and the other contributing authors
reveals an important commonality
among the topics. The common
ground shared by our contributors is
that their work is motivated by the
desire to understand the nature of
human movement behavior. This
commonality may be seen as the ma-
jor theme of the special series.
How does the scope of movement
science relate to the contents of this
special series? There is no single disci-
pline of movement science per se.
Instead, scientists from multiple disci-
plines have converged to piece
gether theoretical perspectives and
methodologies necessary to deal with
such multifaceted and complex ques-
tions as how an organism coordinates
a multipledegree-of-freedom system
to produce functional movements or
how practice repetitions afect the
learning and retention of skilled ac-
tions. The amalgamation of diverse
viewpoints is clearly evident by noting
the academic departments in which
our contributors hold appointments.
CJ Winstein,
PhD, is Assistant Professor, Department of Physical Therapy, University of Southern
California, 2025 Zonal Ave, CSA 208, Los Angeles,
90033 (USA).
EdD, is Director of Research, Orthosport Inc, 7736
Madison St, Forest Park,
IL 60130.
These include human kinetics, human
movement studies, kinesiology, neurol-
ogy, neurophysiology, physical educa-
tion, physical therapy, and rehabilita-
tion medicine. The fields represented
in the special series most certainly do
comprise all of the relevant move-
ment science subdisciplines. The sub-
disciplines of exercise, physiology, and
biomechanics, for example, are not
formally represented.
You might ask, "What then is move-
ment science?" The origin of the
phrase is unknown; however, terms
such as "human movement studies"
have been used at least since the
early 1970s, primarily by those in
physical education, to delineate a field
of study.' Recently, some individuals*
have declared that movement science
should be the foundation for physical
therapy, particularly for rehabilitation.
Movement science, or "biological
movement," was the underlying
theme of a recent scientific confer-
ence held in Collingwood, Ontario,
Canada. In describing the mixture of
participants and speakers, Meijer and
Whiting3 captured the dilemma of
defining movement science:
Drawing the lines between levels of
analysis, it could be said that those
arriving in Collingwood came mainly
from Psychology (behavior), Physiology
(mechanisms), and Physics
(constraints), but recent years have
witnessed a complete blurring of such
level-restricted boundaries. Robotics,
for example, would not fit into such a
. .
indeed, the very
emergence of
reveals a
Physical Therapy /Volume 70, Number 12 /December 1990
tendency to cluster around fields of
study rather than levels of analysis.
Such, apparently, is the case with the
Science of Mo~ernent.~(~~~3)
Movement science is clearly a multi-
disciplinary field of study. This was
the prevailing sentiment in Colling-
wood and is reflected in the contents
of this special series. Without a doubt,
parent disciplines of biology, com-
puter science, physics, physiology,
and psychology contribute to the sci-
ence of human movement. The partic-
ular field from which each contribu-
tor to this special series comes is, in
most cases, apparent. Even more ap-
parent is that each article is exem-
plary of the science of movement.
Beyond discipline boundaries, the
invited articles fall into three general
areas of movement science research.
These are concerned primarily with
development, control, or learning.
This December issue, which has the
largest number of articles, contains
contributions from all these major
areas to set the stage for the articles
that follow in subsequent issues.
Those special series articles in the
January 1991 issue will be concerned
primarily with disorders of movement
control, whereas those in the Febru-
ary issue will be devoted to issues in
motor learning. The special series
articles in the March issue will focus
on developmental and pediatric
The diverse perspectives represented
in the special series reflect a particu-
lar subset
work, primarily within
the behavioral areas of movement
science. The authors have attempted
to provide a theoretical foundation
for their work and to relate this per-
the concerns of physical
therapy. Recently, Tammivaara and
Shepard4 stated that theory in physical
therapy research is all too often miss-
ing. Such theories would provide ex-
planations for
certain practices
are most effective rather than
one should perform those practices.
Moreover, certain research areas, al-
though relatively unknown
physical therapy community, were
thought by the guest editors to have
important theoretical and practical
implications to the developing knowl-
edge base of physical therapy.
Nearly 50% of our contributors,
though not themselves physical thera-
pists, have interacted with physical
therapy professionals as mentors, col-
leagues, or research collaborators.
The overwhelmingly positive re-
sponse from these people to contrib-
ute to the flagship journal of our pro-
fession is one indication that these
scientific interactions have been per-
ceived favorably, with perhaps mutu-
ally beneficial effects.
The second point focuses on the need
for enhancement rather than restric-
tion of scientific interactions for pro-
fessional growth. Kroll captured the
essence of this issue with regard to
developing disciplines:
Concern that
discipline cannot be
born unless
can possess
body of knowledge is not a critical
. .
Overlapping of disciplines
reflects only the multiple efforts
required in the pursuit of knowledge
and disciplines have long functioned in
symbiotic harmony. Territorial rights
are less important than territorial
In inviting our colleagues from re-
lated disciplines to contribute, this
special series of articles on movement
science in physical therapy represents
a move
the recognition that we are
one among many scientific communi-
ties dedicated to understanding the
nature of movement and its disorders.
This is not to imply redundancy. In-
deed, the way in which research
questions among the different scien-
tific communities are posed differs
considerably. For example, the exper-
imental psychologist asks, "What is the
role of feedback in motor learning?"
This entails comprehension of the
relation between feedback and motor
learning. Although this comprehen-
sion is of direct importance to physi-
cal therapy, the physical therapist who
seeks to use feedback
control or
manipulate motor learning for the
benefit of the patient asks a different
question. This mighr be, "How can
feedback be used to enhance motor
learning?" Each is concerned with
issues fundamental
feedback and
motor performance, but the ultimate
aim for gaining that knowledge differs
Fifteen years ago, Hislop6 declared
that physical therapy was a profession
in search of an identity. Over the
years, as we attempted to define the
boundaries of our profession, it ap-
peared that we either consciously or
unconsciously adopted a rather insu-
lar approach. Only 5 years ago,
M~lder,~ an experimental psychologist
in the Netherlands and a contributor
to this special series, bemoaned the
communication gap between the
physical therapist and the movement
psychologist. In Mulder's view, the
movement psychologist, through labo-
ratory experimentation, is concerned
with determining the fundamental
principles governing motor control;
the movement clinician (eg, physical
therapist) is concerned with the de-
velopment of treatment approaches to
restore motor control. He argued that
communication between those in the
laboratory and those in the clinic
would be mutually beneficial. For
example, an understanding of the mo-
tor control deficits associated with
specific neuropathologies can contrib-
ute to the development of basic prin-
ciples of motor control (see, for
ample, articles by Corcos and by
Stelmach and Phillips in the January
issue). Conversely, theoretical con-
cepts such as those associated with
feedback, generalized motor pro-
grams, and functional synergies may
have implications for the develop-
ment of treatment procedures for the
retraining of motor control (see, for
example, articles by Scholz in this
issue and by Mulder and Winstein in
the February issue). In retrospect, the
communication gap seemed to have
been a necessary and important part
of our growth.
our profession and
discipline mature, it has become time
to foster dialogue with our colleagues
in related fields and to recognize ar-
eas of mutual interest.
Physical Therapy /Volume 70, Number
/December 1990
Movement Sclence and Its
Relation to the Profession
and Discipline of Physical
The importance of knowledge from
the related field of movement science
to the profession and discipline of
physical therapy is clearly related in
the profession's obligation to keep
abreast of scientific advances perti-
nent to its practice. In particular, a
profession has an inherent responsi-
bility to improve and expand the
scope of its services to society. This
often involves the incorporation of
new knowledge obtained from related
disciplines. The knowledge obtained
from related disciplines is often not
directly or obviously translatable into
practice. The profession thus may as-
sume a research role to obtain the
directly relevant knowledge for devel-
opment of its practices. If the profes-
sion chooses to produce new knowl-
edge itself, an interesting shift in
orientation ensues. That shift implies
a role change from profession to dis-
cipline. The line between profession
and discipline may become blurred.
While the development of new knowl-
edge that affects practice is consid-
ered a necessary service to society
that earmarks a profession, the acqui-
sition of knowledge for fundamental
understanding (ie, to advance sci-
ence) characterizes the orientation of
scholar-researchers within an aca-
demic discipline.
Henry defined an academic disci-
pline as
organized body of knowledge
collectively embraced in a formal
course of learning. The acquisition of
such knowledge is assumed to be an
adequate and worthy objective as such,
without any demonstration or
requirement for practical appli~ation.~
Movemerit science can be viewed as
an academic discipline in the sense of
Henry's definition. The acquisition of
the knowledge in the academic disci-
pline of physical therapy is assumed
to be a requirement necessary for
of its professional prac-
tices and for the improvement of its
professional services.
Over the last 10 years, the physical
therapy profession has developed an
academic discipline that is considered
in some colleges and universities
worthy of postprofessional graduate
training and graduate degrees that are
considered scholarly in orientation. In
1975, in her Mary McMillan Lecture,
Hislop6 authored the seminal concept
implicating pathokinesiology as the
"distinguishing clinical science of
physical therapy." Hislop argued that
pathokinesiology (ie, the study of
movement dysfunction) embodied the
fundamental and unique concepts of
the "discipline" of physical therapy.
Ten years after Hislop's proposal, aca-
demicians and clinicians debated the
advantages and disadvantages of
adopting "movement dysfunction" as
the academic domain of the physical
therapy profession.g-15 It seems clear
that the debate continues. Despite
definitional disputes related to the
collective scope of a physical therapy
discipline, however, postprofessional
academic programs have been devel-
oped throughout the United States,
Canada, and Australia. In some cases,
scholarly degrees related to the physi-
cal therapy discipline are offered in
exercise science and physical educa-
tion, rehabilitation science, and most
recently movement science. These
programs can be easily characterized
as contributing to and drawing upon
the broader domain of movement
It can be argued that the scientific
foundation of our clinical practice can
be supported by the emerging and
broader science of movement. Carr et
al's recent textbook entitled
ment Science: Foundations for Physi-
cal Therapy in Rehabilitation2
for the potential usefulness to physical
therapy of the research emerging
from movement science. More impor-
tantly, and beyond its impact on phys-
ical therapy, there is the potential to
contribute to the knowledge base of
movement science. This potential for
a mutually beneficial relationship has
only recently been recognized by sci-
entists working with clinicians.7 The
relationship between physical therapy
and movement science must be culti-
vated slowly, with vision and care.
The partnership of physical therapy
and movement science should be
guided with objectives to develop
the practice and the science of
physical therapy. This is clearly a
gradual process, but one that will ulti-
mately lead to more refined and su-
perior practices, based upon appro-
priate theoretical underpinnings that
are needed for any developing
Is Immediate Application
Necessary for Relevance?
A narrow view holds that any research
that is not done in a clinical setting,
with patients as subjects, is useless to
the practice of physical therapy. This
view is perhaps more prevalent in
our profession than we suspect. Is
movement science research relevant
to physical therapy
has an
obvious, direct, and immediate appli-
cation to clinical practice? If physical
therapists view themselves as techni-
cians or craftspersons who allow
someone else to tell them that "this
technique works best for this disabili-
ty,"l6 then nonclinically based re-
search in movement science is defi-
nitely useless to physical therapy.
Physical therapy, however, is not a
craft; it is a profession and a disci-
pline. With this recognition comes the
inherent responsibility to integrate
knowledge from related research into
clinical practice. All physical therapists
should be proficient consumers of
knowledge. This requirement entails
the capability to evaluate and apply
new information to professional prac-
tices.17 Integration and application of
new knowledge may not be straight-
forward, particularly if the knowledge
comes from nonclinical research. It is
the physical therapist, however, who
is best suited to take research, refine
it to allow proper integration, and
apply it, if appropriate, to clinical
practice. Much of the research pre-
sented in this series of articles on
movement science will provide an
opportunity for this process and po-
tential for important new growth.
A recent 4-year citation analysis of
Physical Therapy18
claimed that during
Physical Therapy /Volume 70, Number
/December 1990
the period from June 1980 through
May 1984 there were 67 different
journals cited 10 or more times. Of
these, nearly 50% of the citations
were from only 6 different journals.
Nearly 20% of the citations were from
Physical Theram
alone. Surprisingly,
movement science journals such as
Journal of Motor Behavior,
Journal of Human Movement Studies,
Human Learning,
and the
Journal of
Sport and
not among those cited 10 or more
times. Probably, the cited journals
were appropriate, given the subject
matter of the articles that referenced
this literature. It could be argued that
the topics of these articles constituted
only a portion of the relevant knowl-
edge base. Perhaps most disturbing
was the suggestion that this list of 67
journals may represent the journals
"most relevant" to physical therapy.
the physical therapy community be-
comes more aware of the various fac-
ets of movement science through ef-
forts such as this special series, we
will begin to see more integration of
these highly relevant literatures into
our practices, our research, our librar-
ies, and our education programs.
In this introduction, we argue that
interaction between movement sci-
ence and physical therapy could be
mutually beneficial. In the series of
articles that follow, physical therapists
are exposed to the diversity and
scope of movement science research.
Many of the articles present concepts,
theoretical perspectives, research
methodologies, and terminology that
may be unfamiliar, yet the challenge
presented by these perspectives al-
lows for both scientific and practical
advances in physical therapy.
Brooke JD, Whiting HTA, eds.
Human Move-
Field of Study.
London, England:
Henry Kimpton Publishers; 1973.
Carr JH, Shepherd
Gordon J, et al, eds.
Movement Science: Foundations for Physical
Therapy in Rehabilitation.
Rockville, Md:
pen Publishers Inc; 1987.
Meijer 0, Whiting HTA. Report of the 1988
Motor Neuroscience Symposium, Collingwood,
Ontario, Canada.
Jouml of Motor Behavior.
1989;21: 163-175.
Tammivaara J, Shepard
Theory: the
guide to clinical practice and research.
Perspectives in Physical Education.
New York,
Academic Press Inc; 1971:109.
Hislop HJ. Tenth Mary McMillan Lecture: the
not-so-impossible dream.
Phys Ther.
Mulder T.
The Learning of Motor Control
Following Brain Damage: Experimental and
Clinical Studies.
Berwyn, Pa: Swets North
America; 1985.
Henry FM. Physical education: an academic
Journal of HeaNh, Physical Educa-
tion, and Recreation.
Rothstein JM. Pathokinesiology: a name for
our times?
Phys Ther
Is pathokinesiology synony-
mous with physical therapy?
Phys Ther.
Zadai CC. Pathokinesiology: the clinical
implications from a cardiopulmonary perspec-
Pbvs Ther.
Definitional issues in pathoki-
nesiology: a retrospective and look ahead.
Smidt GL. Walking the trail of physical
therapy research.
Phys Ther.
Rose SJ. Description and classification: the
cornerstones of pathokinesiological research.
Phys Ther.
Walker JM. Research in pathokinesiology:
what, why, and how.
Phys Ther.
Cubelli MG. Bridging the research gap.
Clinical Management in Physical Therapy.
1989;9(3):7. Letters.
Rothstein JM. Letters: Rothstein responds.
Clinical Management in Physical Therapy.
1989;9(4):7. Letters.
Bohannon RW, Gibson DF. Citation analy-
sis of
Physical Therapy:
a special communica-
Phys Ther.
Physical Therapy /Volume 70, Number 12 /December 1990
... 1,2 Over the past several decades, many clinicians and academics have expanded the profession's base of knowledge and understanding of the human movement system and advanced recognition of physical therapists' role as movement impairment specialists of choice. [2][3][4][5] In 1975, Hislop 5 proposed pathokinesiology, the study of anatomy and physiology pertaining to abnormal human movement, as the foundational science of our profession. In 2014, Sahrmann 2 broadened this view to involve consideration of conditions caused by "imprecise or insufficient movement" or, kinesiopathology. ...
Full-text available
Treatment plans employed by physical therapists involved in musculoskeletal rehabilitation may follow a conventional medical-model approach, isolating care at the tissue level but neglecting consideration for neurocognitive contributions to recovery. Understanding and integration of motor learning concepts into physical therapy practice is integral for influencing the human movement system in the most effective manner. One such motor learning concept is the use of verbal instruction to influence the attentional focus of the learner. Evidence suggests that encouraging an external focus of attention through verbal instruction promotes superior motor performance, and more lasting effects of a learning experience than an internal focus of attention. Utilizing an external focus of attention when instructing a patient on a motor task may facilitate improved motor performance and improved functional outcomes in treatment plans devised to address musculoskeletal injury and movement disorders. The purpose of this review is to summarize the basic principles of motor learning and available evidence on the influence an external focus of attention has on motor learning and performance, including the benefits of an external focus of attention over an internal focus of attention and how therapists may inadvertently encourage the latter. Furthermore, the benefits of possessing greater awareness of neurocognitive mechanisms are discussed to exhibit how implementing such concepts into musculoskeletal rehabilitation can maximize treatment outcomes. Level of evidence: 5.
... El concepto de ejercicio terapéutico engloba y amplía la disciplina cinesiterápica. Asimismo, el uso del movimiento dentro del entrenamiento aeróbico y en el marco de la fisioterapia respiratoria sitúan al fisioterapeuta nuevamente frente al reto de clasificar, aun reduciéndola, la ciencia del movimiento terapéutico 14 . El empleo de sistemas robotizados para la asistencia del movimiento y/o su producción tampoco se contempla dentro de la clasificación, aunque su empleo es cada vez más utilizado en fisioterapia, y, particularmente, dentro del enfoque de la neurorrehabilitación. Por lo tanto, la clasificación que se propone a continuación, aunque reduccionista, sistematiza en dos grandes grupos la cinesiterapia: activa y pasiva, en función de si el origen del movimiento articular es generado directamente por la musculatura periarticular en la articulación diana, o por otras fuerzas externas, incluyéndose aquí la actividad de grupos musculares que actúen sobre otras articulaciones a distancia. ...
... In the textbook "Motor control -Translating research into clinical practice", Shumway-Cook and Woollacott state …"understanding motor control and, specifically, the nature and control of movement is critical to clinical practice" (2007a). However, understanding the nature of movement and movement control requires interdisciplinary research collaboration (Winstein & Knecht, 1990), and physiotherapy is one of many important disciplines contributing to the rehabilitation sciences in this area (Richards, 2005). ...
Purpose: To analyze the possibilities of using ICF core sets for musculoskeletal conditions in primary care physiotherapy units of the Health Service of "Castilla y León" (Spain). Methods: A three-round Delphi study was conducted by physiotherapists working in a primary care setting. The data obtained were linked to second-level ICF categories and their relevance was assessed by the participants. The most relevant categories were compared with those present in the existing ICF core sets for musculoskeletal conditions. Results: Eighty-four physiotherapists participated in the survey. The consensus was reached for 45 ICF categories and 5 personal factors after the survey. Thirty-five of these categories were present in the Comprehensive Core Set for post-acute Musculoskeletal Conditions. In addition, 35 categories present in the core set were not considered relevant from the participants' perspective. Conclusions: Physiotherapists mainly considered movement-related categories as relevant. The ICF core set for post-acute musculoskeletal conditions comprises many of these categories and can therefore be taken as a basis for the adoption of ICF in the clinical context. Relevance: Primary care physiotherapists should be aware of the advantages of using ICF in their clinical settings.Implications for RehabilitationThis study shows which body functions and structures, activities and participation, environmental factors, and personal characteristics are relevant from primary care physiotherapists' perspective assessing persons with musculoskeletal conditions.The Comprehensive ICF Core Set for Subacute Musculoskeletal Conditions includes most of the categories identified in this study, but they need to be refined to fully represent the primary care physiotherapists' perspective.The results of this study support the use of the Comprehensive ICF Core Set for Subacute Musculoskeletal Conditions as a basis for operationalizing ICF in this clinical setting.
Low back pain (LBP) is one of the most common causes of disability and work loss in Western society, yet there exists little consensus about its most effective management. Undoubtedly, one of the greatest contributing factors to this confusion has been the inadequate and conflicting research base upon which clinical management decisions are made. This paper is aimed at discussing the common problems inherent within low back pain research, identifying some avoidable pitfalls and many unanswered questions. Some helpful directions for further research, including improvements in the research methodology, are also included. Finally, the review considers the physiotherapist's role in research of the management of LBP.
There are only a few studies focusing on the content of doctoral dissertations in the field of PT even though academic dissertations are important for shaping a discipline. The aim of this study was to explore and describe a paradigm and criteria for an academic discipline in Nordic doctoral dissertations written by physiotherapists. The study was based on content analysis of the abstracts in 418 doctoral dissertations conducted over three decades. A descriptive and retrospective research approach was used. The results show that the PT dissertations focus on clinical questions within a broad range of PT practise areas. They are mainly applied research studies with a quantitative approach, although qualitative and mixed methods are used. The dissertations are conducted in different academic faculties, however, mainly in medical and health sciences. Theoretical reflection about conceptual, ontological and epistemological issues is scarce. The concept analysis in the Swedish dissertations (n = 219) demonstrates a health- and function-oriented approach to reality. The results of this study indicate that PT as a discipline is clinically oriented and might be guided both by the implicit PT practise paradigm and by various scientific disciplines. Further theoretical reflections and studies about the theory of science in PT are needed.
Discover new perspectives and recent research findings to apply to the children and families on your caseload. With Movement Sciences: Transfer of Knowledge into Pediatric Therapy Practice, you will explore the motor control, learning, and development of children with movement disorders, allowing you to increase the effectiveness of intervention. This book provides cutting-edge information on motor disabilities in children—such as cerebral palsy, Down syndrome, or Erb's palsy—and how prehension, balance, and mobility are affected. Expert researchers and practitioners offer their findings and techniques for improving motor processes, using figures, tables, and extensive resources to help you create more effective pediatric rehabilitation programs. With this book, you will gain a better understanding of: • motor control for posture and prehension • the motor learning challenges of children with movement dysfunction • predictors of standing balance in children with cerebral palsy • the effect of environment setting on mobility methods of children with cerebral palsy • the reliability of a clinical measure of muscle extensibility in preterm and full-term newborn infants • Movement Sciences: Transfer of Knowledge into Pediatric Therapy Practice will help physical therapists, occupational therapists, and other health care professionals implement motor learning concepts safely and effectively. This book also delivers practical advice for achieving the best results with a younger population by utilizing interventions that address the needs of their clients. With this guide, you will be able to determine which approaches are acceptable to the children and families in your practice, and ensure the therapy is meaningful to their daily.
Multiple sclerosis is a chronic, progressive, and disabling disease of the central nervous system, for which no cure exists. By die advent of immune modulating pharmacological treatments during recent years, it has become possible to slow down the disease process. Nevertheless, treatment of symptoms and help to overcome disability and handicap are still die mainstay in die management of MS patients. A multidisciplinary team of professionals comprising a neurologist, neuropsychologist, physiotherapist, occupational therapist, social worker, and nurse is regarded as the optimal approach to a successful rehabilitation. Very few studies have addressed the outcome and cost-effectiveness of die rehabilitational efforts. More studies are needed to provide knowledge of the many aspects of rehabilitation, for example, treatment regimes, in- and outpatient management, treatment duration, etc. Traditionally, physical treatment has been a central part of the rehabilition, but during die last decade the focus has changed against coping strategies, cognitive dysfunction, and psychological reactions. From this new insight it has become clear that an optimal rehabilitation starts at die time of diagnosis. In this article the present knowledge of MS rehabilitation is reviewed and commented on in light of the clinical experiences of the authors.
Full-text available
Management research often bears little resemblance to management practice. Although this research-practice gap is widely recognized and frequently lamented, there is little discussion about how it can be bridged. We partly remedy this problem in this paper by describing our experiences with the Network for Business Sustainability. Our experiences showed that the paradoxes underlying the relationship between research and practice make bridging this gap difficult. We argue that the reason why the research-practice gap endures is that bridging it is beyond the capabilities and scope of most individuals, and we call for the creation of intermediary organizations like the Network for Business Sustainability. We close by outlining some of the activities that can be undertaken by these boundary-spanning intermediary organizations, with the hopes of better aligning management research and practice.
Thesis--Catholic University of Nijmegen. Includes bibliographical references.
Physical therapists are becoming increasingly aware of the importance of theory in physical therapy research and practice. In this article, we define theory and discuss its uses in both clinical practice and clinical research. We argue that both the quality of current practice and growth of physical therapy as a profession will be enhanced as more physical therapists appreciate and use theory to guide their work.
The University of Southern California Department of Physical Therapy (USC-PT) is honored in being invited to present a review of some of our research activities in pathokinesiology. Specifically, I will address the following questions posed by the organizers of this symposium: 1) Why has USC-PT been conducting research in the field of pathokinesiology? 2) What has been accomplished? 3) How was it accomplished? and 4) How has this effort contributed, if it has, to the science of pathokinesiology? Many individuals deserve credit for providing the impetus, inspiration, and opportunity to conduct research on normal and abnormal movement. I recognize Dr. Helen Hislop, Chairman of USC-PT and author of the pivotal paper “The Not-So-Impossible Dream”¹ that today retains its relevance. As presenter, I am simply a voice for the many who have contributed to these research efforts.
Historically, the body of knowledge in most science-based disciplines has been developed by initially focusing investigative efforts on observing and describing phenomena of interest.1–3 Subsequent to the initial observation and description, refinements were suggested and, eventually, consensus was achieved regarding specific observations. Finally, the observed phenomena were arranged according to systematic rules into classes or groups. I believe we should adopt this model, which has been effective in other disciplines, and commit ourselves to the objectives of observing, describing, and classifying pathokinesiological phenomena that exist in the patients we serve. Our efforts then should provide us with a clinically relevant body of knowledge and substance from which theories regarding treatment can evolve. Fundamental Tasks In the process of describing and classifying disorders of movement, we will need to establish rigorous methods of investigation and experimentation that will enable us to define our observations unquestionably.
In the “Plan to Foster Clinical Research in Physical Therapy,” adopted by the American Physical Therapy Association, clinical research is defined as “a systematic process for formulating and answering questions about the uses of, the bases for, and the effectiveness of physical therapy practice.”¹ Central to physical therapy is the notion of movement dysfunction.² Pathokinesiology is a term that, in my judgment, is analogous to movement dysfunction. In this context, how do we conceptualize the trail of research and where does the trail lead? Physical therapy is a health profession whose primary purpose is the promotion of health and function through the application of scientific principles to prevent, identify, correct, and alleviate acute or prolonged movement dysfunction. To be consistent with science at large, the basic aim of the research in physical therapy should be to generate and test theories.
Ten years have passed since the concept of pathokinesiology was introduced into physical therapy. Examining it from a philosopher's perspective, this article provides a brief retrospective on how the concept originally was described, poses some questions about the type of concept it has become, and suggests what it might now be able to help the profession of physical therapy achieve. INITIAL DESCRIPTION What was the initial description of the concept of pathokinesiology? Many physical therapists in the audience experienced a swell of excitement—like a wave that had been approaching and suddenly broke at the shore—when Hislop introduced the term pathokinesiology into physical therapy during her presentation as a Mary McMillan lecturer stating, “What is physical therapy? Physical therapy is knowledge. Physical therapy is clinical science … pathokinesiology is the distinguishing clinical science of physical therapy.”
By way of introducing this material to you, I believe a few confessions are in order. Number one, I know why I was invited to participate in this symposium. It is no secret that squeaky wheels get greased, and the cardiopulmonary physical therapists have been somewhat squeaky on the topic of pathokinesiology. I credit and compliment the symposium's program committee for their sagacity and chutzpah in inviting the squeaky wheels to participate. They recognized that physical therapists need to get to the business of “making honey” as Dr. Hislop directed us.¹ Yet, you cannot stir up the bees if you know where the nest is and walk around it or if you have been living contentedly inside. To make the best honey, the bees must examine old flying routes, find new routes, and sample pollen from all the flowers. Number two, I am not intimately familiar with the term “pathokinesiology.”