15th June 2018
The value of movement and the benefit of individualised movement retraining programmes has been in the press recently. In March, the Lancet published a series on back pain (1). Although back pain is the number one cause of disability globally, little impact is being made on the condition.
The message in the scientific press is clear; there needs to be less emphasis on surgery, imaging techniques and medication and more focus on giving people tools to help themselves become active again.
In March, I was privileged to meet Professor Eva Roos at The 2018 Movement Conference (Southampton FC 21st March 2018). Her keynote lecture “Good Life with osteoArthritis in Denmark (GLA:D(R) - implementation of clinical guidelines for osteoarthritis nationwide” highlighted her ground breaking work for patient focused management of hip and knee osteoarthritis. The focus on patient education, patient empowerment, exercises and self-management have shown remarkable improvements in health, with less pain, less disability, consumption of less pain medication, increase in physical activity, reduced sick leave and return to work (www.glaid.dk).
Clearly, ‘movement matters’, impacting not only quality of life but also the bottom line of over-stretched public health services.
Now engaging in the movement debate through social media, @Move_lifespan my profile reads ‘passion for enhancing the health of movement, across life spans, for quality of life & participation’. This passion for movement started in the early 90’s when I met Mark Comerford at a course with Louis Gifford and David Butler. He talked a lot (…and fast!); but his passion for the value of movement was infectious. I was working as a manual therapist, but I wanted to expand my skill set. I explored the value of movement, loved the results, and in 1995 we set up Kinetic Control. Out of Mark’s development of the Kinetic Control clinical reasoning process, a clinical solution has evolved to manage pain and functional impairments and loss of participation. All physiotherapy skills, pain education and manual therapy fit into this process, which puts movement and patient empowerment at its heart.
Each and every day I am amazed how small changes in movement patterns can make such a difference to an individual’s participation and quality of life.
Our first courses presented the same basic principles we teach today – however, a rapidly expanding evidence base is now giving ever more support to the rationale behind the assessment and retraining of movement control impairments. In 2001, we published 2 articles in Manual Therapy (2, 3), a review and masterclass on the Kinetic Control process. I understand these papers have been cited over 916 times. We recently published our latest paper which we hope will make the same impact (Dingenen 2018). It is good to reflect on how far we have come and how the Movement Health message has evolved, alongside the growing body of research that is supporting the value of movement. Our own body of research from within the team, has continued to build the case for the principles for a rigorous assessment and retraining process. See publications here.
A recent paper by Deborah Falla and Paul Hodges (5) emphasise that:
‘Exercise is the most effective treatment for the management and prevention of spinal pain; yet on average, it delivers small to moderate treatment effects, which are rarely long lasting’.
They suggest that the outcome of exercise interventions can be optimized when targeted toward the right patients and when tailored to address the neuromuscular impairments of each individual.
Kinetic Control set out on this ‘movement-centric- mission in 1995. Our strength has been to develop a clinical reasoning framework to help therapists put movement into their practice. Our journey has been exciting and certainly challenging. We have seen fashions and fads come and go in which the value of movement has sometimes been questioned, at other times, diluted. Helping us weather these storms are our brilliant team of tutors, who have helped aid our delivery of courses in 35 countries and in 12 different languages.
WHERE NEXT:
We will continue to develop our international presence with new territories and expert tutors, broaden our network of Kinetic Control Movement Therapists, continue publishing and researching and being passionate about what we value most: Movement Health.
KC HIGHLIGHTS 1995 – 2018
Courses in 35 countries
Presented in 12 languages
International Conference Movement Dysfunction hosted with MACP (Musculoskeletal
Association of Chartered Physiotherapists) 2001, 2005, 2011
The 2018 Movement Conference (Southampton FC 21st March 2018)
2011 Publication of The Management of Uncontrolled Movement (Elsevier) Comerford & Mottram
Development of the KC process and Movement Health Message
Digital resource to support education and patient empowerment
24 educational units ranging from 1 day to 15 days
References:
(1) Clark & Horton Low back pain: a major global challenge, The Lancet 2018 (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30725-6/fulltext)
(2) Comerford MJ, Mottram SL Movement and stability dysfunction – contemporary developments Comerford MJ, Mottram SL Manual Therapy 6:15-26 2001
(3) Comerford MJ, Mottram SL Functional stability re-training: principles and strategies for managing mechanical dysfunction Manual Therapy 6:3-14 2001
(4) Dingenen B, Blandford L, Comerford M, Staes F, Mottram S. The assessment of movement health in clinical practice: A multidimensional perspective. Phys Ther Sport. 2018.
(5) Falla D, Hodges PW. Individualized Exercise Interventions for Spinal Pain.Exerc Sport Sci Rev. 45(2):105-115. 2017