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Akasha Studio - South Surrey, BC


January 27, 2024





Who is Inspire for ISM for?

This is the first of hopefully several 4 hour workshops led by Diane Lee & Kate Pearsall with the intention of inspiring young, newly graduated (0-3 years) physiotherapists to explore the world of regional interdependence. What’s that? Regional Interdependence is a term coined by Josh Cleland in 2007 to describe approaches that consider the relationship between remote impairments to determine where best to focus treatment.  This is an approach that Canada has embraced throughout the evolution of the Orthopaedic Division courses from 1977 to date.

In the early 1980’s a group of passionate physiotherapists including Cliff Fowler, John Oldham, Erl Pettman and Diane Lee to name a few, were determined to develop an approach, or model, that focused on function and not pain. Biomechanics were the foundation of this approach that over time, and with the contribution of many other passionate physio learners, evolved into The Integrated Systems Model (ISM).

ISM is a model, not a methodology.  It is a framework to help clinicians organize their knowledge and provide the best possible assessment and treatment for the individual patient.  Since every clinician has a different skill set, an ISM therapist will never be a clone of someone else nor will they only adhere to specific therapies or algorithms. Each therapist is as unique and individual as the people they seek to help, why would therapy be any different?

The first few years of a newly graduated physiotherapist’s work life can be confusing. There isn’t enough evidence to apply an evidence-based approach to every patient seen in private practice and sometimes (most times in fact) clinical reasoning and best hypotheses are required. These workshops will introduce the participant to the world of regional interdependence through the Integrated Systems Model (introduction only) that help to develop sound hypotheses. We will also provide an opportunity to share cases, both during the workshop and on a private forum, to support each other, as you navigate these first years.

Here is our agenda for the first workshop (limited to 20 people only):

Registration and welcome: 8:30am

9am – 10am: Principles of Regional Interdependence and the Integrated Systems Model – how to address the complex patient with multiple impairments and sites of nociceptive or neuropathic pain – Diane

10-10:30 How to determine from the story if this patient is applicable for ISM (phenotypes of pain, how to choose a meaningful task and screening task for evaluation of function)

Short coffee break in studio (coffee tea and light snack provided)

10:50 – 12pm Squat task – we will demonstrate and practice tests of the pelvis for alignment and SIJ control, then consider the talocrural and subtalar joint for their ability to dorsiflex and pronate respectively. We will then determine which body region demonstrates impaired function (suboptimal alignment, biomechanics and/or control for the task), demonstrate and practice ‘corrections’ of each body region to find the priority body region to further assess to improve performance of this task. Sometimes, it’s the foot and sometimes it’s the pelvis – do you have tools to differentiate this other than the pain location?  During this time Kate and Diane will demonstrate treatment techniques relevant to what they find and show how remote body regions can change when drivers are treated.

12 – 1pm This final hour will be for discussion of material covered as well as time for you to present some cases yourself that you would like some help with. We will ask you questions about the case and try to help you through the lens of ISM, or at least give you some suggestions of what to look for during your next appointment.

If this type of supportive workshop interests you, sign up soon! We think this will fill quickly.

Diane Lee & Kate Pearsall


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