A model of movement dysfunction provides a classification system guiding diagnosis and therapeutic care in spinal pain and related musculoskeletal syndromes: a paradigm shift-Part 1.

An integrative functional model largely based upon clinical observation and analysis of the more common features of neuromusculoskeletal-dysfunction encountered in clinical practice is presented as a working hypothesis in Part 1. This endeavours to incorporate contemporary knowledge and practice. The enlightened work of Professor Vladimir Janda has undoubtedly been seminal in the development of this model; however a further evolution of his work is elaborated on in this paper. Thinkers from the human potential movement as well as the scientific community have provided further valuable insights to assist our understanding of function. A related simple classification system of two main clinical subgroups with back pain and related disorders is offered in Part 2. These are based upon the most usual dysfunctional postural and movement strategies. Further distillation provides a number of dysfunction syndromes which will have predictable consequences. This is not a mathematical, computer generated or theoretical biomechanical model. This model describes 'what it is' that we see in our patients, and endeavours to be an overview of the movement related causes of back pain. It provides a clinically useful and practical framework to assist the practitioner in diagnosis and to better understand the development and perpetuation of most spinal pain and related disorders. In so doing, more rational, functional and effective manual and exercise therapy interventions can ensue.

A model of movement dysfunction provides a classification system guiding diagnosis and therapeutic care in spinal pain and related musculoskeletal syndromes: a paradigm shift-Part 2.

An integrative functional model largely based upon the observation and analysis of the more common features of neuromusculoskeletal dysfunction encountered in clinical practice was presented as a working hypothesis in Part 1. The functional inter relationships between these regional and general features and their contribution to the development and perpetuation of local and or referred spinal pain syndromes was explored. Here we look more closely at clinical patterns of presentation. A simple classification system of clinical subgroups with back pain and related disorders is offered. These more commonly observed dysfunctional postural and movement strategies have been distilled into a number of dysfunction syndromes which will have predictable consequences. In beginning to provide a map of the tendencies towards, or actual, changed postural and movement responses seen in people with spinal pain and related disorders, this model provides a valuable reference for those working in the body work and movement therapies realm. It is a practical and useful clinical tool to assist diagnosis and help better understand the development and perpetuation of most spinal pain and related disorders. In so doing, more rational, functional and effective therapeutic and research interventions can ensue.