RESEARCH REPORT PLATFORM PRESENTATION

PARTICIPANT PERCEPTION OF MOVEMENT ABILITY ACROSS SIX DIMENSIONS WITH AND WITHOUT PHYSICAL THERAPY INTERVENTION: TESTING THE EXTENDED MOVEMENT CONTINUUM THEORY. Allen D^1-3; ¹Health and Disability Research Institute, School of Public Health, Boston University, Boston, MA, USA. ²University of California, Berkeley, CA, USA. ³Samuel Merritt College, Oakland, CA USA

PURPOSE: The purpose of this study was to test two hypotheses: participants will perceive differences across six dimensions of movement ability associated with 1) having a diagnosed movement disorder, and 2) receiving physical therapy intervention. RELEVANCE: These hypotheses arose from the Movement Continuum Theory (MCT). Proposed as a grand theory of physical therapy, the MCT links the scientific basis of movement with physical therapy principles and the effect of physical therapy in improving current movement capability. Subdividing the MCT’s unified construct of movement into multiple dimensions extends the MCT. If movement is composed of multiple dimensions, different disorders should affect designated movement dimensions in predictable ways. Furthermore, patients should improve in affected dimensions upon successful completion of physical therapy intervention. PARTICIPANTS: 69 volunteers participated in the study. 35 adults having diagnosed movement disorders (from post-operative musculoskeletal and pain syndromes) and beginning outpatient physical therapy formed the intervention group (mean age 47, range 19-85, 25 females). Adults without diagnosed movement disorders formed the 34-person no-intervention group (mean age 54, range 19-78, 17 females). METHODS: A 24-item self-report questionnaire based on the extended MCT assessed perceived movement ability across six dimensions: flexibility, strength, accuracy, speed, adaptability, and endurance. The intervention group responded at the beginning of and about two weeks into an episode of outpatient physical therapy as prescribed by the attending clinician. The no-intervention group responded twice with approximately two weeks between exposures. ANALYSIS: Item response theory methods allowed estimation of participant locations on each of the dimensions at baseline and two weeks, anchoring item parameters on the same calibration for comparability. Multiple regression controlled for baseline differences while examining significance of group membership on two-week data. Paired t-tests across times, effect sizes, and minimal clinically important differences (MCIDs) were examined for each dimension. RESULTS: The intervention group perceived lower movement ability at baseline compared to the no-intervention group. At two weeks, the intervention group had increased in their perception of movement ability in all dimensions; the no-intervention group perceived no change. When controlling for differences in baseline data between groups, group membership was significant only for strength and speed dimensions (p = 0.002 and 0.013 respectively). Effect sizes were highest for strength and speed, at 0.42 and 0.39 and with 63% and 57% of participants over the calculated MCID post-intervention, respectively. CONCLUSIONS: Having a diagnosed movement disorder and receiving intervention were both associated with perceived differences in dimensions of movement ability. Participants in the intervention group perceived greater change in strength and speed than in other dimensions after two weeks of intervention when controlling for baseline status. Effect sizes were moderate for these dimensions after only two weeks. Evidence for the alternative hypothesis of a unified construct of movement consists of significant increase in all dimensions with intervention for this sample. IMPLICATIONS: Physical therapy management and research can benefit from a well-supported theory linking movement and clinical practice. The extended MCT provides a potential basis for focusing on specific movement dimensions affected by particular disorders. KEYWORDS: theory testing; research implementation; outcomes research. FUNDING ACKNOWLEDGEMENTS: Post-doctoral Fellowship from the National Institute on Disability and Rehabilitation Research, Grant number H133P0001. CONTACT: allendianed@gmail.com

ETHICS COMMITTEE: Exempt status was given by the Committee for the Protection of Human Subjects, University of California, Berkeley, USA