This past weekend I was lucky enough to attend a 1 day introduction into the Integrated Systems Model (ISM) in Seattle. The one day course took place at Union Phyisotherapy where owners Mitch and Elisa graciously hosted a group of 12 physiotherapists. This was the first time Diane Lee and her associate Cathy had offered such a course. The course was designed to offer an introduction to the system through 8 hours of online lectures combined with practical skills for assessing the pelvis, hip, and thorax. Two chapters from the Pelvic Girdle 4th ed. were also recommended. The full series is a 15 day course run over one year, so this was definitely only a taste of what the system offers.
As I see it, the online lectures in combination with hands on tutorials are the future of adult learning especially in a field like physiotherapy (Ref 1, Ref 3). As research has shown, when online lectures are used as a complimentary tool to face to face lectures, they work well. However, if they are used as a substitute they show no additional benefit (Ref 2.).
The online lectures provided information on the following:
– an introduction to the ISM model
– an introduction to pelvic and thoracic biomechanics
– an introduction to the assessment protocol
– an introduction to treatment techniques for the thorax, pelvis, and hip.
The book chapters go deeper into the background, key terms, and assessment used in the ISM.
The course itself began with a few test questions pertaining to the online lectures. From the answers it appeared that everyone had taken the time to review the online material. Becuase the course was only one day, the focus was going to be on hands on application. With the background information covered in the online lectures this was made possible to do in one day. After a brief overview of a pelvic girdle assessment the therapists began assessing each other. Due to the small size of the class each therapist was provided with feedback from the instructors in an ongoing basis. The class continued like this for the full day.
To summarize, I would like to describe how the model works. This will help me better articulate the model and hopefully peak some interest in a very powerful tool.
1. In your assessment determine the primary complaint, the meaningful task (which movement are they struggling with / which movement produces the most pain).
2. From your meaningful task you break it down into simpler components: sqaut, standing, stride, forward bend, etc
3. Analyze the components by assessing the SI joint, the hip, the thorax, the foot. From experience or your preference you can start at any area. Diane usually starts at the SI joint.
A. While assessing you are looking for assymmetries, rotations, fluidity of movement, and client feedback.
4. identify areas of failed load transfer (FLT).
5. Make corrections to area of FLT. Does this make a difference to the primary complaint or meaningful task? Compare to other areas of FLT and decide upon your primary driver.
6. Once the primary driver has been identified look deeper into the area to decide whether the dysfunction is neuromuscular, articular, visceral or emotional.
7. Treat the appropriate tissue and of course test, retest!
There are more components then I can go into a simple post but I think this outlines the basic premise of the system.