It may be hard for an egg to turn into a bird: it would be a jolly sight harder for it to learn to fly while remaining an egg.
—C. S. Lewis
As C. S. Lewis reminds us, there are crucial steps in the process of growth; these steps are necessary if one is to achieve full potential. These steps are no less necessary in the realm of growth of a profession. The profession of physical therapy, and more specifically neurologic physical therapy, is in the midst of a watershed epoch in our development. Building on our strong historic foundations of progress, we are evolving in a way that is essential if we are to fully assume our obligations as movement scientists.
In 2015, when the American Physical Therapy Association (APTA) published the white paper affirming the movement system as the core organizing principle of our professional practice,1 the momentum that had begun 40 years earlier with Dr Helen Hislop's historic McMillan Address,2 reached a new level. Soon after the APTA's publication of Physical Therapist Practice and the Movement System White Paper, the Academy of Neurologic Physical Therapy (ANPT) released a call to our membership inviting members to volunteer in the formation of the ANPT Movement System Task Force. The charge of the Task Force was to address issues related to diagnostic classifications of movement system problems for patients/clients with neurologic conditions.
The ANPT has an impressive track record in efforts to standardize practice through the identification of recommended outcome measures, and more recently, through the ongoing efforts to develop clinical practice guidelines. The efforts of the ANPT Movement System Task Force represent a milestone in that record. In this issue, the Task Force presents the White Paper on Movement System Diagnoses in Neurologic Physical Therapy. The key recommendations of the Task Force are presented in the Table below.
Recommendations of the Academy of Neurologic Physical Therapy Movement System Task Forcea
||Develop and test a systematic process for movement observation and analysis of standardized tasks.
||Clinicians and researchers should work together to develop a set of movement system diagnoses that addresses the identified attributes using both experience-based and data-driven approaches ... [These] movement system diagnoses should ...
||... be based on a sound, evidence-based theoretical framework.
||... emphasize movement observation and analysis of core standardized tasks as central to the clinical examination and evaluation.
||... represent a unique cluster of movement observations and associated examination findings that can impact a variety of tasks.
||... provide unique and non-ambiguous labels for each movement system diagnosis.
||Test movement system diagnoses for their validity (including their ability to predict outcomes and responsiveness to intervention), their clinical utility and their relationship to clinical practice guidelines.
||Promote the movement system and movement system diagnoses as the core of entry-level curricula through publications, continuing education, mentoring and modification of Commission on Accreditation in Physical Therapy Education (CAPTE) criteria.
||Promote the establishment, dissemination, utilization and refinement of movement system diagnoses as priorities of the ANPT.
The Journal of Neurologic Physical Therapy (JNPT) applauds the work of the Task Force, and fully supports the recommendation that “any publications related to the development of these diagnoses should include the search term ‘movement system diagnosis.’” In addition, the JNPT encourages all authors to consider using the term “human movement system” as one of their keywords. In doing so, authors can contribute to the education of the wider health care services and research communities who are consumers of our scientific literature.
We have reached many milestones in our development as a profession, among the most momentous of these were forming our first professional association in 1921, creating our first national examination in 1954, adopting policies related to direct access in the 1980s, and defining the role of physical therapists via the Guide for Physical Therapist Practice in the mid-1990s. Decades from now when we look back upon the trajectory our profession has taken, I have no doubt that the development of movement system diagnoses will be among the defining stages in our history. I encourage you to read, contemplate, and discuss the full text of the White Paper on Movement System Diagnoses in Neurologic Physical Therapy in this issue.
1. American Physical Therapy Association. Physical Therapist Practice and the Movement System White Paper. http://www.apta.org/MovementSystem/WhitePaper
. Published August 2015. Accessed January 28, 2018.
2. Hislop HJ. Tenth Mary McMillan Lecture. The not-so-impossible dream. Phys Ther. 1975;55(10):1069–1080.
3. Hedman LD, Quinn L, Gill-Body K, et al. White Paper: Movement System Diagnoses in Neurologic Physical Therapy. J Neurol Phys Ther. 2018;42:110–117.