Application of the 4-Element Movement Model to Cardiovascular and Pulmonary Physical Therapy Practice

The 4-Element Movement Model (4EMM) has been proposed as framework to guide clinical decision making in the physical therapy management of individuals with movement disorders. The model is centered on the primary elements of movement, including motion, force, control, and energy. Clinical application of the model begins with the selection of a movement task, followed by systematic observation of the performance of the task, including control, amount, speed, symmetry, and symptoms provoked during the movement. Testable hypotheses about the impairments contributing to movement problems are then generated, which inform the examination and intervention. A major advantage of the model is its broad applicability to a range of patient populations and settings. In this clinical perspective, we describe the application of the 4EMM to patients with cardiac, vascular, and pulmonary impairments.