Regional Interdependence: A Model That Needs to Be Integrated in the Functional Evaluation and Physiotherapy Treatment—Part 1

Abstract

Background: Rehabilitation is increasing the need to use codes in order to make both a functional diagnosis and a therapeutic intervention as correct and targeted as possible. Thus, it is very important to integrate the model of Regional Interdependence (RI) in the classical rehabilitation evaluation methods, since it will be of help for understanding, solving dysfunctional problems, and improving the patient management, which is often difficult given the fact that there is no concordance on functional tests and timing of treatments. The RI should be added to the functional evaluation each time that a patient presents symptoms in a specific location, which interest also distal regions. This is due to the functional and anatomical connections of the myofascial system, vascular, autonomic nervous system (ANS), the peripheral nervous system (PNS) and the neuroimmunoendocrine system. The RI can be summarized into three groups that are correlated when it comes to applying it practically: upper, bottom and front quadrant. Adding the concept of RI to the clinical and therapeutically practice, it would have positive effects on improving the quality of life and allocate better health's resources. The aim of this paper is to make the functional assessment in clinical practice faster and more standardized.

Effectiveness of mobilisation of the upper cervical region and craniocervical flexor training on orofacial pain, mandibular function and headache in women with TMD. A randomised, controlled trial

“…In summary, the anatomical, neurophysiological, biomechanical and clinical relationship between the upper cervical spine and the orofacial region is an example of a regional interdependency model, which justifies the importance of looking at cervical spine and stomatognathic system as a functional entity when evaluating and treating subjects with TMD . In fact, it is not uncommon that clinicians plan exercises for the cervical spine in patients with TMD based on their intuition, their own experience, but without knowledge of the existence of impairment in the cervical spine and its muscles .…”

Epistemological Flexibility in Person-Centered Care: The Cynefin Framework for (Re)Integrating Indigenous Body Representations in Manual Therapy

“…A linear cause–effect relationship can be observed to sense, categorize, and define a symptom-based approach that the patient can understand well through anatomical–physiological explanations. Practitioner reasoning considers anatomical structures and functions to define manipulative approaches and mobilizations applicable to regional interdependence (RI) [ 91 , 92 ]. RI is a term used to describe clinical observations believed to exist between regions of the body, particularly in the management of MSK disorders proposed in physical therapy [ 94 ] as well as in the COP pan-professional approach [ 91 , 92 ].…”

A Pilot Study In to the Effects of Cervical Manual Therapy Plus Conventional Physical Therapy on Clinical Outcomes and Electrodiagnostic Findings in People With Carpal Tunnel Syndrome

“…( 25 , 26 ) The concept of regional interdependence (RI) stemmed from the review of literature that areas of the body appeared to be musculoskeletal linked, so impairments in one region of the body or one system of the body can have a direct or indirect influence upon the musculoskeletal symptoms and function of another area of the body. ( 27 ) A systematic review compared manual therapies with surgical decompression in women with CTS and found similar improvements of symptoms severity and functional status of the hand in the manual therapy and surgery groups at one, three, six, and 12 months. ( 28 )…”