You must be logged in to take this course  →   |

This keynote presentation was captured during the Physiotherapy New Zealand Conference in Auckland in September 2014 and outlines key features of the ISM approach to illustrate how all regions of the body are connected and how to determine which region is creating a kink in the linked chain.


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.

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.

Course Reviews

  1. Eye opener


    Thank you for sharing your words of wisdom. I caught a glimpse of the thoracic ring correction as well as how the ISM might work. -check for Failed load transfer and which one occurs first. Now, for the treatment. .. enjoyed the humour that came with it. 🙂

  2. A heartened encouragement that my practise is moving in the right direction


    Diane has made her point of an integrative model and was honest about her approach. Especially helping me to understand inter-testing reliability which sometimes I doubt myself despite having done the hours honing them. In my practice, I played special attention to form and force closure integrities through Movement and manual muscle testing assessments. It is refreshing to see how Diane introduce her way of assessment, gives me another opportunity of broadening my perspective. Looking forward to sponging up. Thank you Diane for providing these lectures avaliable for learning. It certainly encourages a young clinician such as me. I do hope more will find your resources through the internet.

    Joe, Singapore

  3. 5

    One of the best speakers I have heard in my career. Really makes you look at the hold body in an integrated way. Will help me be a better clinician.

  4. Intro to ISM Model


    Good introduction to the ISM.

  5. Fantastic introduction


    Thank you for providing such a wonderful free resource. Improved my knowledge of what the ISM is and got my brain thinking about my clinical practice.

  6. Intro to ISM


    Great overview of system and inspiring regarding clinical decision making. Awesome

  7. The Clinical Puzzle


    Creating space..finding the primary driver…using individual skills and collaborating thoughts and tests….I want more knowledge bombs from D Lee…onto the next one…thank YOU!!

  8. Introduction to The Integrated Systems Model


    So many pearls of wisdom.
    The clinic is the place to be to learn from those we help and those whom we are not able to help
    The lecture, videos, lab reflect years of Experience, Innovation,Functional Relevance, Thinking Outside the Box, Individualized Approach
    Tremendous amount of humor, the key to getting everyone hooked and remembering what is said
    Could watch it over and over again and learn more each time

  • FREE
© Diane G. Lee Physiotherapist corporation All rights reserved.