Purpose & Definition
The purpose of this article is to explain the examination model of regional interdependence. Simply put, regional interdependence is the concept that seemingly unrelated impairments in a remote anatomical region may contribute to, or be associated with, the patient’s primary complaint.
Why Use the Regional Interdependence Model?
The regional interdependence model of examination allows the PT to go beyond tradional, often vague, and even somtimes misleading musculoskeletal diagnoses, and provide optimal care to their patients. Often times, the contributors for these musculoskeletal disorders may not be as straight-forward as they appear. For example, patients who complain of LBP may actually be suffering from disorders of the hip or knee joint. Examination of proximal and distal joints in the same region of the reported pain and dysfunction is vital to the concept of regional interdependence. It is important to remember, that regional interdependence is different than referred pain. The regional interdependence model focuses primarily on impairments present in proximal or distal segments and is distinct from the phenomenon of referred pain.
Examples in Literature
There are numerous examples in the literature of the concept of regional interdependence being a viable option for PT examination and intervention planning. Here are a few examples of regional interdependence at work:
1. Interventions aimed at the hip have been used to treat:
2. Interventions aimed at the lumbar spine have been used to treat:
3. Inteventions aimed at the thoracic spine and ribs have been used to treat:
4. Interventions aimed at the cervical spine have been used to treat:
Recent Related Research (from Pubmed)
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- Childs JD, Fritz JM, Flynn TW, et al. A clinicalfckLRprediction rule to identify patients with low back pain most likely to benefit from spinal ma- nipulation: a validation study. Ann Intern Med. 2004;141:920-928.
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- Strunce JB, Walker MJ, Boyles RE, Young BA. The immediate effects of thoracic spine and rib manipulation on subjects with primary complaints of shoulder pain. J Man Manip Ther. 2009;17(4):230-236.
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