Journal of Physiotherapy & Physical Rehabilitation

The Paradox of Human Movement: An Observational Study of a Neuro-Musculo-Skeletal Screening Technique, within an Outpatient Physiotherapy Service, Highlighting the Instantaneous Nature of an Asymptomatic, Recovered Movement Pattern as a Behavior

Abstract

Michael Gannon and Claire Desmond

Objective: We can demonstrate the presence of a movement pattern as a behavior for presenting signs and symptoms which is being distinct from a medical aetiology for presenting signs and symptoms. Subsequent to being able to demonstrate the presence of a symptomatic legacy movement pattern behavior causative for presenting signs of symptoms, this enables us to highlight the existence and subsequent access to a paradoxical asymptomatic recovered movement pattern. Both patterns are sensory-based which is instantly demonstrable in self-reporting by the client and observable and testable by the therapist.

Methods: A random consecutive sample of thirty individuals (18 to 82 years) presented to a community physiotherapy musculoskeletal outpatient service, having been referred by their medical practitioner as part of the service pathway. Informed consent was obtained to gather information. Each individual was able to congruently self report their presenting lumbar/lower body signs and symptoms. Collection of audio-visual data in a workshop setting enabled us to both capture and demonstrate functional sit-to-stand movement patterns, presenting (legacy) patterns and the instant recovered pattern for each individual. We chose a within-subject, and within group fully crossed mixed methods study design.

Results: All thirty participants were instantly symptom free and sign free whilst accessing the recovered pattern. We were able to observe and distinguish between a medical and movement pattern aetiology for presenting signs and symptoms for each and every individual. Both movement patterns –legacy and recovered - were congruently self-reported by each participant and objectively testable instantly in real-time by the physiotherapist.

Conclusion: We have demonstrated the clients’ ability to access an asymptomatic recovered pattern of movement, subjectively self-reported in sensory-based evidence by the client, and objectively testable by the therapist, in being that change is instant. Therefore, the question of the persistence of the pattern of movement behavior in recovery is more than a question of behavior and capability.

As part of our role as physiotherapists, we are now in a strong position to support the changes in the development of social attitudes, and provide strategies in relation to recovery based on a future orientated outcome model, as opposed to supporting an ongoing a causal limitation in experience for the client.