An Introduction To The Integrated Systems Model (ISM) For The Complex Patient

Overview

This course introduces the Integrated Systems Model (ISM) — an evidence‑informed clinical reasoning framework designed to guide physiotherapists and movement specialists in assessing and managing complex patients with persistent pain and multiple impairments. Traditional models that link pain directly to pathology are insufficient for many real‑world clinical cases; instead, skilled clinical reasoning is necessary to determine what to treat, and in what order, when multiple factors contribute to dysfunction.

The ISM integrates concepts from motor control, posture, movement analysis, and pain neuroscience to help clinicians understand how body regions are interdependent and how impaired systems interact to influence function. This course includes a synopsis of these foundational principles and demonstrates how to apply the ISM framework to identify key impairments — or “drivers” — in complex clinical presentations. 

Why This Course Matters

In clinical practice, many patients present with complex symptoms that cannot be explained solely by localized pathology. Research reinforces that pain intensity and the presence of tissue damage are not reliably correlated, making clinical reasoning and individualized assessment essential for effective care. 

The ISM provides an organized approach to interpret multiple interacting impairments, prioritize assessment strategies, and design treatment plans tailored to the patient’s unique meaningful tasks and goals. It equips clinicians with reasoning tools that improve decision‑making, reduce the risk of mis‑management, and enhance functional outcomes for individuals with persistent pain or multifactorial dysfunction. 

Learning Objectives

By the end of this course, participants will be able to:

1. Explain foundational principles of motor control and pain neuroscience that inform clinical reasoning

2. Describe the core concepts of the Integrated Systems Model

3. Outline an ISM clinical reasoning framework for approaching complex patients

4. Identify where to begin assessment and how to interpret findings to change the clinical “story”

5. Introduce individualized assessment and treatment planning for the whole person rather than isolated regions

6. Recognize specific clinical reasoning strategies to determine relationships between impaired regions

7. Explain how to find the “driver” and underlying system impairments — whether articular, neural, myofascial, or visceral

8. Develop treatment plans based on the patient’s meaningful tasks and goals — not just symptoms 

Audience

This course is designed for health professionals and movement specialists who want to deepen their clinical reasoning skills and apply an evidence‑informed framework to complex cases. Ideal participants include:

• Physiotherapists (Physical Therapists)

• Chiropractors

• Osteopaths

• Movement specialists and other healthcare providers interested in advanced reasoning frameworks for multi‑system dysfunction