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A Clinical reasoning approach to determine where to begin treatment for those with multiple impairments and persistent pain.

Understanding the relationship between, and within, body regions and systems (neural, articular, myofascial, visceral etc.) and the consequences of impaired function of one region/system on another is complex. Many health practitioners specialize in body regions, and/or systems and treatment is often based on the practitioner’s training and experience. However, this reductionistic approach may not be optimal in that each body region is not only an integrated system within itself (i.e. comprised of many differentiated yet linked parts (Siegel 2010)) but is also integrated, and interdependent, as part of the whole body/person.  No studies have correlated persistent pain anywhere in the body to a consistent impairment. Therefore, in persistent pain conditions such as low back pain, metatarsalgia, TMD, headache etc., understanding what body region and system should be treated requires an individual clinical reasoning approach. The Integrated Systems Model (ISM - Lee & Lee 2011, Lee 2015) is an evidence-informed, clinical reasoning approach that embraces, and enhances, the concepts of the regional interdependence model (Sueki et al 2013).  

This 2-day course will introduce the participant to ISM and provide a structured clinical reasoning model for understanding where to focus treatment for those with multiple impairments and persistent pain. Where is the criminal and who is the victim?

The Thorax - An Integrated Approach, the textbook that will be the resource for this course and a highly recommended purchase for all participants.  Available through Handspring Publishing, click here to purchase.
Hours of CE:  15 hours
Program Instructor:    Diane Lee, BSR, FCAMPT, CGIMS       


  • All Northeast Seminars online and live seminars held in the State of Hawaii are approved by the Hawaii State Physical Therapy Board for continuing education through reciprocity with the New York State Educational Board. 

  • New York State Education Department State Board for Physical Therapists and Physical Therapy Assistants recognizes this course for Continuing Education for 15 CE Hours

  • Pending approval with the ILPTA (once approved we will update website)

Announcing New for 2019

An Introduction to the Integrated Systems Model for the Complex Patient