12/19/2023 0 Comments 4 elements ii level 54The 4-Element Model encourages a systematic approach to the observation by using five o bservation targets abbreviated as CASSS ( control, amount, speed, symmetry, symptoms). The 4-Element Movement System Model.ĬASSS is a pneumonic for the five observation targets of the model: C-Control, A-Amount, S-Speed, S-Symmetry, S-SymptomsĪpplication of the model begins with the identification of an activity or task that the patient will perform, and consists of qualitative observation leading to hypothesis generation. 5 The comprehensive description of movement in the 4-Element Model is consistent with theories of human movement being a dynamic system involving complex interactions between the task, the person, and the environment. Personal factors include age, gender, comorbidities, self-efficacy, confidence, fear of movement and motivation. Environmental factors are external items that can influence movement such as terrain, support surface, and external distractions. Since all movement occurs within an environmental context and is affected by personal factors specific to the individual, the model depicts how the environment and personal factors surround the 4 elements. The elements overlap in many patient conditions, but can be examined and tested separately. Lastly, energy refers to the ability to perform sustained or repeated movements, and is dependent on the integrated functioning of the cardiovascular, pulmonary, and neuromuscular systems. Motor control refers to the ability to plan, execute and adapt goal-directed movements such that they are accurate, coordinated and efficient. Force refers to the ability of the contractile (i.e. muscles) and non-contractile structures (i.e. tendons) to produce movement, and provide dynamic stability around joints during static and dynamic tasks. Motion refers specifically to the ability of a joint or tissue to be moved passively. ![]() The 4-Element Model describes the primary elements essential to all movement: motion, force, motor control, and energy ( Figure 1). 2 There have been several approaches to defining the movement system, 3–5 but the 4-Element Movement System Model (4-Element Model) has the advantage in that it captures a wide variety of disorders, can meaningfully guide practice and education, can readily be incorporated into entry level and residency training, and is consistent with existing professional models such as the International Classification of Functioning (ICF) 6 and the Patient-Client Management Model. The movement system was adopted by the American Physical Therapy Association in 2015 and has been defined as the integration of body systems that generate and maintain movement at all levels of bodily function. Movement analysis and interpretation is a hallmark skill of expert practitioners. ![]() Physical therapists analyze movement in order to identify impairments that contribute to activity limitations and participation restrictions in their patients. The analysis of human movement is central to the practice of physical therapy.
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