In clinical practice, it is common to see complex patients with a combination of impairments in the musculoskeletal, urogynecological, respiratory and posture/equilibrium systems and there is little scientific evidence to guide clinicians for these complex, yet common, patients. Clinical reasoning remains the recommended approach for determining best treatment for the individual patient. This interview with Diane and Mark Finch (RMT) will introduce you to the evidence-informed, clinical reasoning approach – the Integrated Systems Model – and its key concepts.

Here is a short clip.

The Integrated Systems Model (ISM)  is a framework to help clinicians organize knowledge and develop clinical reasoning to facilitate wise decisions for treatment. A key feature of this approach is Finding the Primary Driver. In short, this involves understanding the relationships between, and within, multiple regions of the body and how impairments in one region can impact the other. Specific tests are used to determine sites of non-optimal alignment, biomechanics and control  during analysis of a task. Subsequently, the impact of correcting one site on another, is noted. Clinical reasoning of the various results determines the site of the primary driver, or the primary region of the body, that if corrected will have a significant impact on the function of the whole body/person. Further tests of the driver (active mobility, passive mobility, active control, and passive control) then determine the underlying impairment causing the non-optimal alignment, biomechanics and/or control of the primary driver for the specific task being assessed.

The interview is broken into short segments so that you can navigate to sections that interest you; however, it is best listened to from beginning to end.

Course Reviews

  1. Great Advices for young Clinicians


    Diane spoke with alot of science and sense in her approach to patient’s treatment journey and the practitioner’s learning journey. During our work, how we can go about navigating through this forest of information. Slowing down and appreciating its lush and density with a non-bias way, learning to pick your battles, practicing some form of scientific rigour, taking time to learn from your cases in a less threathening environment both for the benefit of patient and the Clinician; in the context of trust. Diane’s wisdom in is seen in her ability to communicated these profound challenges in a simple and relatable way.


  2. Insightful and succinct


    Truly insightful and succinct. I can’t wait to learn more.

  3. Very helpful!


    This was a great introduction to the ISM and has shifted my way of thinking. I look forward to applying this model to my patients.

  4. Inspiring


    What a privilege to hear from you Diane, love your work.

  5. Let the body speak


    Let the body tells you what is going on.. perfect!!! The journey off treating is hard nut is amazing

  6. 5

    This short clip clearly sets up expectations for the ISM framework.

  7. Intrigue


    This short introduction into what future courses will hold is intriguing and motivating

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