The article discusses a symposium on the topic of pathokinesiology and whether it could define the profession of physical therapy. It notes that while the term has been used, there is no consensus on its meaning or implications. The symposium aimed to critically examine the concept. The subsequent papers in the journal issue present diverse viewpoints from clinicians and researchers on pathokinesiology and defining physical therapy. The author aims to promote discussion on this important issue of professional identity.

1. Pathokinesiology−−A Name for Our Times?
Jules M Rothstein
PHYS THER. 1986; 66:364-365.
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2. PATHOKINESIOLOGY.
The purpose ofpublishing this series of articles is to document a few current concepts and
viewpoints related to the topic ofpathokinesiology. The opinions expressed here are of some
of the invited speakers from "A Symposium on Pathokinesiology: Theory, Research, and
Practice" held at the Sixtieth Annual Conference of the American Physical Therapy Associ-
ation, Las Vegas, NV, June 17-21, 1984. The Associate Editors and the Editor invited all
the speakers of that symposium to adapt their presentations for publication so our readers
can ponder and, perhaps, debate one of the most important issues of our times.
The symposium critically addressed the following questions:
• Does pathokinesiology have the potential for becoming the basic science of physical
therapy and the source of theory in physical therapy?
• What is pathokinesiology?
• Why is the concept ofpathokinesiology becoming so central to our profession's identity?
• What kinds of research questions are being addressed by research in pathokinesiology?
• What are the implications ofpathokinesiology for our body of knowledge?
• What might theory in pathokinesiology be?
• What is theory, and what is the role of theory in science?
• What are the implications of theory and research in pathokinesiology for the practice of
physical therapy?
Pathokinesiology—A Name for Our Times?
JULES M. ROTHSTEIN
Key Words: Pathokinesiology, Physical therapy.
In a Las Vegas room that could have fit easily into a Boeing thought the content of these papers might be of only parochial
747, a remarkable number of physical therapists took time interest, I now hope that all physical therapists will take the
from other activities of the Sixtieth Annual Conference of the time to read and contemplate these papers and the issues they
American Physical Therapy Association to listen to a sym- raise. One effect of the symposium was to convince me that
posium on pathokinesiology—its definition and whether the the topic was neither esoteric nor as remote from the everyday
term could be used to describe the profession of physical practice of physical therapists as I had imagined.
therapy. I say a remarkable number because, despite the To understand why the topic is of importance, one needs
outstanding reputations of the speakers, there was little ad- to consider the historical context of the symposium. Nearly a
vanced publicity about the session and, in the midst of the decade earlier in her 1975 Mary McMillan lecture, Helen
research papers, clinical sessions, and inevitable socializing, it Hislop had suggested that physical therapy was then in an
would have been easy to avoid going to what promised to be identity crisis, one that she felt could be lessened if we could
a philosophical session. collectively accept the idea that pathokinesiology was the
As the session co-moderator along with Sandy Burkart, I distinguishing clinical science of physical therapy.1
looked at the cavernous meeting room and anticipated feeling Since that lecture, pathokinesiology has become what I
quite lonely. The several hundred therapists who attended the consider a professional buzzword. An analogy, perhaps, will
session showed me that I had misjudged the interests of my make clear what I mean. When a therapist administers passive
peers and that something was going on in our profession that range of motion one day and decides on another day to call
I did not quite understand. For some reason, therapists were it "basic implementation of manual therapy procedures," he
taking time to listen to papers on a relatively esoteric subject. is using the buzzword as a form of elevating jargon. Similarly,
Almost all of those papers have been somewhat reworked and when teaching progessively more difficult activities of daily
are now offered here to a larger audience. Where once I living skills becomes "implementation of a developmental
sequence for life skills," a therapist also may be resorting to
Dr. Rothstein is Assistant Professor, Department of Physical Therapy, School jargon to create an aura of change that is in reality only a
of Allied Health Professions, Medical College of Virginia, Virginia Common- change in name and not in substance.
wealth University, Box 224, MCV Station, Richmond, VA 23298 (USA). Dr.
Rothstein and Dr. Sandy Burkart moderated "A Symposium on Pathokinesi-
If one reads the Hislop lecture, it is clear that she gave
ology: Theory, Research, and Practice" at the Sixtieth Annual Conference of considerable thought to the meaning and implications of the
the American Physical Therapy Association, Las Vegas, NV, June 17-21, 1984. term "pathokinesiology." Unfortunately, many who have
This paper was not presented at that symposium; rather, it has been written as
an introduction to the revised papers of the participants that are published in used the term since have not. And that is one reason why the
this issue. symposium was so important. Clearly, Hislop's intent was not
364 PHYSICAL THERAPY
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3. PATHOKINESIOLOGY
for schools to change course names so that pathokinesiology exists. This, in many ways, is in contrast to Rose, who also
could be said to be in the course content but to cause educators offers a theoretical framework based on a historical perspec-
to rethink what and how they were teaching. She also meant tive, but who suggests that the process of physical therapy
for pathokinesiology to be a focus for research. In a very real growing into what Kuhn might call a "mature science"2 can
sense, she contended that it could be the center around which be expedited by immediate action. Specifically, he suggests a
our profession organizes all of its activities. conference that would develop a Nomina Pathokinesiologica
In 1982, the APTA House of Delegates even considered that would unify terminology and give an orienting center to
endorsing the term pathokinesiology so that it would have a divergent body of knowledge. On the other hand, Walker
been our official raison d'être. Ironically, this symposium, suggests that this, to some extent, has begun through the
with its invited speakers bringing their scholarship, pragma- research course taken at the University of Southern California.
tism, clinical orientations, and biases followed what may be Readers can judge for themselves whether the papers that
considered the House's political consideration of the topic. follow show that someday we can collectively define ourselves
Interestingly, one of the prime movers in bringing the motion or whether they indicate that we are not even close to that
before the House suggested after the symposium that she then goal. For that matter, the reader may even determine that
realized that pathokinesiology could no more define physical definition, now or in the future, is not necessarily a good
therapy than pathophysiology could define the medical thing. But because we, as a profession, define our competen-
profession. One may now ponder how the business of the cies, accredit our schools, and judge our ethics and profes-
House might in the future be expedited by symposia that deal sional standards, this is an issue that will not go away. The
with critical issues before, rather than after, votes. ideas presented must be examined critically, rhetoric and
So, one of the reasons why all therapists should read the unrealistic thinking must be identified, and parochial con-
papers presented here is that they reveal something about the cerns should be noted—but that is your task.
decision making process used within our profession. But I No physical therapist with a sense of history can deny that
suggest there is a more vital reason. The identity crisis Hislop we have seen fundamental change in our profession in the
saw a decade ago has worsened. We, as a profession, may be decade since Hislop's speech. Clearly, that is why so many
doing more things, but in no way have we developed a true people came to the symposium. Hislop called her address
sense of who and what we are. All too often, we are defined "The Not-So-Impossible Dream," and in it she described the
by the tasks we do, and, as a result, only those who have seen basis for her dream in the words Pericles spoke to the Ath-
therapists in practice have the vaguest notion of who and enians:
what we are. We have many faces to those who know us and Fix your eyes on the greatness of your profession as you have
no singular image that we can present to those who do not. it before you day by day; fall in love with her; and when you
My bias is that this is not good, but as can be seen in some of feel her greatness, remember that her greatness was won by
the papers, this concern is not universal. people with courage, with knowledge of their duty, and with a
vision that all things are possible.1
The papers that follow this essay are a divergent lot. Schlegel
urges that we take a pragmatic approach in defining ourselves. Ten years later, we still may be inspired to believe that all
Zadai cautions against exclusionary definitions that could things are possible. But how can we dream together when the
splinter us. Because both are primarily clinicians, they speak visions are divergent? How can we follow a vision when we
from the "trenches" and with a conviction that they manifest do not know what it is? We must realize that our collective
through the commitment they have to the specialties they task as members of a great profession is to identify those with
practice. That they have no simple solutions means that they the visions worth following so that we might be a profession
have exemplified the perseverance that Purtilo calls for when with a face to the world, rather than a consortium of practi-
she warns in her paper that,"Theconcept of pathokinesiology tioners loosely tied together by historical accidents. The pur-
surely will become chillingly vacuous or be reduced to simply pose of the papers that follow is to reflect on this issue that
a shrill slogan if physical therapists neglect to engage in a goes to the very heart of whether tomorrow will be ours to
diligent search for its roots and appropriate shape in today's shape or merely a recapitulation of yesterday.
practice of physical therapy."
Smidt, if I may interpret, suggests that, as he has "walked REFERENCES
the trail of physical therapy research," he has observed that
we have begun to evolve a sense of self that will lead eventually 1. Hislop HJ: Tenth Mary McMillan lecture: The not-so-impossible dream.
Phys Ther 55:1069-1080,1975
toward an acceptance of terms that can be used to define our 2. Kuhn TS: The Structure of Scientific Revolutions. Chicago, IL, University
profession. Furthermore, he suggests a framework that already of Chicago Press, 1962
Volume 66 / Number 3, March 1986 365
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4. Pathokinesiology−−A Name for Our Times?
Jules M Rothstein
PHYS THER. 1986; 66:364-365.
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