Movement

Continuum Theory

Proposing 6 Dimensions Within the

Construct of Movement in the
Movement Continuum Theory
Diane D Allen
DD Allen, PT, PhD, is Adjunct Associate Professor, Department of
Physical Therapy, Samuel Merritt
College, Oakland, Calif, and PostDoctoral Fellow, Health and Disability Research Institute, Boston
University, Boston, Mass. Address
all correspondence to Dr Allen at:
allendianed@gmail.com.
[Allen DD. Proposing 6 dimensions within the construct of
movement in the Movement Continuum Theory. Phys Ther.
2007;87:888 898.]
2007 American Physical Therapy
Association

Background and Purpose

The Movement Continuum Theory (MCT) provides a potential basis for movement
assessment and intervention, but movement lacks specificity. The purposes of this
study were to propose and evaluate a subdivision of movement into multiple
dimensions.

Subjects
A convenience sample of 318 adults completed a 24-item self-report measure of
movement ability.

Methods
A multimethod approach was used to identify, operationalize, and test a multidimensional model of movement. Data analysis included a comparison of the fit of unidimensional and multidimensional models using item response theory methods and
inspection of response patterns.

Results
A model specifying 6 dimensionsflexibility, strength, accuracy, speed, adaptability,
and endurancefit respondent data significantly better than the unidimensional
model, even with high pair-wise correlations between dimensions. Response patterns
showed large differences rather than uniform scores across dimensions for over half
of the respondents.

Discussion and Conclusion

Subdividing movement into the proposed dimensions fits the data and potentially
strengthens the usefulness of the MCT as a theoretical foundation for managing
movement effectively.

Post a Rapid Response or

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Dimensions of Construct of Movement in the Movement Continuum Theory

he Movement Continuum Theory (MCT),1 first published in

1995, establishes links among
movement sciences, the movement
capability of individuals, and the role
of movement specialists in maximizing peoples movement capability.
The MCT1 presents movement as the
central unifying construct for the assessment and management of movement and movement disorders instead of the common clinical
practice of focusing on function or
disability.2 Its authors proposed it as
a possible grand theory of physical
therapy,1 but the MCT and its principles can enhance the understanding of movement and potential interventions by other professions as
well.
Despite broad relevance and a need
for theoretical foundations for clinical practice,1,3 the MCT has inspired
little empirical research since its introduction. In a search of CINAHL
and MEDLINE databases as of August
2005, none of the 24 articles referring to the MCT since its publication
contained accounts of prospective
testing of the MCT or any hypotheses stemming from it.
This study initiates testing of the
MCT in a direction that could ease
the application of this theory to empirical research. In this study, the
construct of movement is subdivided
into multiple components or dimensions that may prove more readily
measurable than the singular generic
movement construct presented in
the MCT. A multidimensional model
such as the model proposed here
may stimulate both the generation of
testable hypotheses and the association of current evidence of effectiveness with a unified theory. A multidimensional model of movement
also may promote the characterization of peoples different movement
abilities, enhancing the specificity
with which clients and movement
specialists can pinpoint deficits and
July 2007

identify appropriate interventions.

The purposes of this study were to
propose a multidimensional model
of movement as an extension of the
MCT and to perform an initial evaluation of this new model of
movement.

level on the continuum) and for identifying physical, psychological, social, and environmental factors that
influence the movement,1 these aspects of observable behavior do not
require redundant description. Only
the movement itself requires further
specification.

Literature Review
The MCT presents 3 general and 6
physical therapy principles that link
movement science with movement
capability and clinical practice.1 In
essence, movement, defined as an
actual change in position, occurs at
multiple interacting levels along a
continuum from microscopic to the
level of a person acting in society.
Each level is influenced by physical,
social, psychological, and environmental factors. Physical agents and
therapeutic exercise generally have
entry points at the tissue level or
higher, but because the levels interact, these interventions can affect
molecular and cellular movement as
well as body part and person movement. The MCT specifies that each
person has maximum, current, and
preferred movement capabilities. If a
movement specialist successfully addresses movement problems with a
patient or client, then current movement capability will increase and the
gap between current and preferred
movement capabilities will narrow.1

The specification of multiple subdivisions or dimensions of movement

has support in the movement science and clinical literature. Clinical4
and motor control5 sources present
strength, flexibility, proprioception,
and coordination as candidates for
intervention following orthopedic or
neurologic pathology. Some of these
sensorimotor aspects overlap with
the list that Hedman et al6 compiled
as the components of movement
or that Majsak7 identified as constraints delineating the range of
movement behaviors. Additional
overlap and alternative ways of specifying aspects of movement appear
in Craiks discussion of issues for defining normal motor behavior8 and
the classification that Scheets et al9
formulated for diagnosing impairment of the movement system. Each
of the movement aspects and components mentioned in these sources
could contribute to a multidimensional model of movement.

Phases of Study
Testing the principles presented by
the MCT requires an assessment of
peoples current and preferred
movement capabilities and the effect
of intervention on them. The construct of movement as presented in
the MCT, however, is too generic for
clinical assessment. Specifying subdivisions or dimensions of movement
may assist in identifying clinically
measurable constructs that have a
definitive relationship to the movement capabilities presented in the
MCT. Because the MCT already presents a framework for identifying
what part of the person moves (eg,
at the tissue, body part, or person

This article describes 3 phases of a

multimethod study. The purposes
were to formulate and evaluate a
multidimensional model of movement to extend the MCT. In the identification phase, components of
movement from the literature were
evaluated on the basis of a set of
criteria for inclusion into an economical model. In the operation phase,
the set of dimensions and the MCT
formed the basis of a new measure
constructed to incorporate both generic and multidimensional constructs of movement. In the test
phase, data were collected with the
new measure. The proposed multi-

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Dimensions of Construct of Movement in the Movement Continuum Theory

dimensional model then was compared with a unidimensional model
of movement and with a multidimensional model with randomly attributed dimensions. Because the phases
necessarily occurred sequentially,
the results follow the method for
each phase in sequence.
Identification Phase:
Method and Results
Generating the set of potential movement dimensions consisted of setting
evaluative criteria, identifying from
literature sources common features
of movement to propose as candidates, and comparing those candidates with the criteria to ensure
alignment. The criteria for potential
dimensions of movement to extend
the MCT included the following:
(1) Descriptive: The complete set of
dimensions, with an added reference to the body parts or substances doing the moving,
should fully describe normal human movement, a series of
movements, or actively holding
a position against a force.
(2) Efficient: The set of dimensions
should describe movement efficiently, subsuming related concepts, with the fewest number
of separate dimensions while
completely describing movement.
(3) Distinct: The dimensions should
identify observable features of
movement distinct from the part
of the body doing the moving or
different physical, psychological, social, or environmental factors that influence movement.
(4) Measurable: The dimensions
should be measurable.
(5) Understandable: The dimensions
should make sense to both
movement specialists and their
patients or clients.

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A comparison of possible movement

dimensions with the criteria led to
the addition, modification, or elimination of candidates. Tables 1 and 2
show comparisons of the first 4 criteria with the proposed (Tab. 1) and
some of the rejected (Tab. 2) candidates for movement dimensions. The
fifth criterion implies that people
can differentiate among and use the
various dimensions in their observations and descriptions of movement.
Testing this implication or otherwise
providing evidence of understanding
of any of the movement dimensions
will require empirical data.
The resulting set of dimensions includes flexibility, strength (force exerted), accuracy, speed, adaptability,
and endurance. These 6 dimensions
describe observed movement comprehensively and efficiently (criteria
1 and 2). The proposed dimensions
of flexibility, strength, and speed apply to all human movement; accuracy applies specifically to purposeful movement; and adaptability and
endurance apply to movement when
encountering unexpected obstacles
or when approaching the limits of a
persons capacity. All of these dimensions have direct relationships with
but remain distinct from the physical, psychological, social, and environmental factors that influence
movement (criterion 3). Each candidate dimension can be measured
clinically (criterion 4). Although further research may justify modification of this set, these 6 dimensions
provide a starting point for characterizing movements readily observed
by movement specialists and their
patients or clients (toward criterion
5). In addition, these 6 dimensions
present interesting possibilities for
categorizing movement abilities
maximized by athletes or performing
artists or diminished in people with
a particular pathologic condition
(Tab. 3).

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Operation Phase:
Method and Results
The next step in determining the
usefulness of this set of dimensions
was to construct or locate measures
for assessing movement. If the same
measure could evaluate both generic
and multidimensional movements,
then it would facilitate the direct
comparison of a generic or overall
idea of movement with the dimensions of movement proposed in the
model. In addition, because the MCT
and the proposed model apply to a
broad range of ability levels and to
the movements of people with or
without pathologic conditions, the
ideal measure for comparing generic
and multidimensional constructs
would apply to a similar range. Many
measures of movement exist for testing individual dimensions, specific
diagnostic groups, or particular body
parts exist, but few existing measures assess generic movement ability or apply to multiple groups or
across the proposed dimensions.
Generation of the self-report Movement Ability Measure (MAM) operationalized the MCT and the proposed
model and facilitated direct comparison of unidimensional and multidimensional models of movement.
For addressing a generic or unidimensional construct of movement,
all items in the MAM were given a
similar item construction and standard levels of item responses. If people marked every item with the same
level of response, then a generic
movement construct could specify
their movement ability quite adequately. For addressing a multidimensional construct of movement,
variations in the wording of items in
the MAM referred specifically to the
6 proposed dimensions of movement. If people marked items associated with one dimension quite differently from items associated with
other dimensions, then specification
of their ability on that dimension

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Table 1.
Proposed Movement Dimensions Aligned With 4 Criteria
Dimension

Descriptive (eg,
Ascending
Stairs)

Efficient (Summarizes
and Subsumes These
Related Concepts)

Distinct (Requires, But

Is Distinct From, Each of
These Physical Factors)

Measurable (Can Be
Assessed With These
Clinical Measures,
Among Others)

Flexibility4

Extent and ease of

movement at
joints to reach
next step

Extent of linear or angular

displacement, range of
motion,8,9 amplitude,
ease of movement, and
mobility6

Appropriate muscle stiffness,

muscle tone,6,7 and
muscle length7; joint and
ligament integrity; and
skin and connective tissue
integrity

Range of motion (goniometer

or electrical potentiometer)
and extent of movement
(video or optoelectric
systems)

Strength4

Force to propel or
withstand
against forces to
lift mass

Force behind
displacement, force
generation,6,8 and
tension generation

Appropriate number, size,

and type of muscle fibers;
muscle integrity and
recruitment7; and neural
integrity

Myometry, manual muscle

testing, force transducer,
and electromyographic
amplitude (relative to
maximum)

Accuracy

Attainment of
target position
on each
subsequent step

Direction and timing of

displacement,
coordination,6,7,9 timing
and sequencing,7,9
fractionating or
isolating movement,9
and selective capacity6

Cerebellar integrity and

neuromuscular integrity

Distance between result of

movement and target; error
scores; distance or number
of deviations from target
trajectory; and synchrony
with a timing target,
cadence, and
electromyographic timing

Speed6,8,9

Velocity of ascent
of steps

Speed of displacement
and velocity

Neuromuscular integrity and

biomechanical integrity

Distance divided by time and

cinematography

Adaptability

Change when
unexpected
step height or
texture is
encountered

Adjustment during
displacement,
adaptation to
environmental
changes,5 adaptive
capacity,6 and
sensorimotor
interaction7

Sensory integrity, reflexes,7

and integrity of
sensorimotor cortical areas
and pathways

Sensory integration tests and

reaction times following
encounter of unexpected
stimuli

Endurance68

Persistence of
ascent up all
steps without
flagging

Continuation through
completion of
displacement,
persistence, and
perseverance

Cardiopulmonary health and

vascular integrity

Duration plus extent of

movement, perceived
exertion, and change in
cardiopulmonary measures
or vital signs

could enhance the description of

their movement ability.
The self-report format allowed subjects to interpret movement as a
whole or differentiate movement dimensions within the context of their
own lives. The MAM placed minimal
constraints on subject interpretation. In avoiding the specification of
tasks that may have limited relevance
across groups, the MAM also applied
to a broad range of subjects across
movement ability levels and with or
without pathologic conditions.
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The MAM was developed and tested

for reliability and for content and
construct validity with procedures
recommended by Wilson10; evidence of reliability and validity is presented elsewhere (see the article by
Allen on the validity and reliability of
the Movement Ability Measure in
this Special Series).11 Each item in
the MAM consisted of 6 statements
indicating levels of movement ability. Respondents were instructed to
choose the statement that most
closely matched how they thought
they moved now and how they

would like to be able to move. Three

sample items and instructions are
shown in Figure 1. The MAM included 4 items for each of the 6 dimensions, for a total of 24 items. The
same instructions applied to all
items. Consistency of responses
across items was high, with person
separation reliability ranging from
.92 to .96 for the 6 dimensions and
equaling .98 for the whole measure.
Test Phase: Method
For the test phase, a heterogeneous
sample of people completed the

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Table 2.
Representative Movement Features Not Aligned With Criteria
Feature of Movement

Unmet Criteria

Posture6,7

Efficient and distinct: posture, when active, as during holding of a

position against a force such as gravity, can be described
adequately with a combination of other dimensions; when
passive, it influences but does not describe subsequent
movement

Balance6

Efficient: balance is a complex set of sensorimotor activities that

can be described with a combination of the proposed
dimensions, such as adaptability, strength, and flexibility

Cognitive capacity,6 psychological capacity,6 ability to learn,9

and motivation and alertness7

Distinct and descriptive: these psychological factors influence

movement and the intention behind movement but do not
describe movement itself

Pain6

Distinct and descriptive: pain, perhaps a physical or psychological

factor influencing movement, does not describe movement
itself

Alignment, center of mass, and base of support7

Distinct and descriptive: these physical (biomechanical) factors

influence movement but do not describe movement itself

Proprioception,4 sensory modalities,9 perception of vertical,9

perception of motion,9 and sensory information6

Distinct and descriptive: sensation and perception are physical

and psychological factors that influence the ability to learn
movement or to adapt to an environment but do not describe
movement itself

MAM. The expectation was that

most people who move normally
might perceive themselves to have
about the same level of movement
ability on all 6 dimensions; therefore,
a unidimensional model would fit
the data very well. If people perceive
differences in the effects of different
dimensions on their movement ability, then they might respond quite
differently to items associated with
those dimensions. In this situation, a

multidimensional model would fit

the data better than a unidimensional
model. The proposed multidimensional model was compared with a
unidimensional model and with a
multidimensional model in which
items were randomly assigned to
dimensions.
Recruitment of volunteers to respond to the MAM targeted a broad
spectrum of groups in order to ob-

Table 3.
Proposed Dimensions and Sample Activities or Pathologies Relevant to Each
Dimension

Sport or Activity

Pathology

Flexibility

Gymnastics, ballet

Arthritis, Parkinson disease

Strength

Weight lifting, moving furniture

Muscular dystrophy, stroke, peripheral

nerve injury

Accuracy

Archery, tap dancing

Cerebellar disease

Speed

Sprinting, piano playing

Parkinson disease, other diseases of

the basal ganglia, loss of fast-twitch
muscle fibers

Adaptability

Skiing, tennis, juggling, reactive

balance

Sensory or perceptual loss from

auditory, visual, vestibular, or
somatosensory systems

Endurance

Running a marathon, singing an

opera

Cardiovascular or pulmonary diseases

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tain a heterogeneous representation

of movement abilities. Adults volunteered from religious and community groups, personal contacts, a college sports team, physical therapy
outpatient clinics, and a senior day
activity event. In addition to the
MAM, respondents completed a
cover sheet of information about
health status and any movement
problems. Respondents were informed that completing and returning the questionnaire constituted
consent for their (anonymous) responses to be included in the study.
The data were analyzed with item
response theory (IRT) methods12
and ConQuest13,* software, and only
the now responses to items were
analyzed. Two models were compared. One model assigned all items
to 1 dimension in a unidimensional
construct; the other assigned items
to the 6 dimensions in a multidimensional construct. Fit was analyzed on
the basis of the differences in the
* Australian Council for Educational Research,
Hawthorn, Victoria, Australia.

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Dimensions of Construct of Movement in the Movement Continuum Theory

deviances and the numbers of parameters (obtained from ConQuest)
by use of the G2 likelihood ratio statistic. For a more complex (multidimensional) model to fit better than
a simpler nested (unidimensional)
model, it must result in a lower deviance (a measure of lack of fit of the
data to the model) than can be accounted for simply by the greater
number of parameters estimated.
The difference between the deviances for the 2 models functions like
a chi-square distribution with the difference in the number of parameters
as the degrees of freedom. Correlations also were obtained for each pair
of dimensions in the multidimensional
model.
To assess whether any multidimensional model would fit better than
the unidimensional model for these
data, a random multidimensional
model was generated, with items assigned randomly, but without replication, to generic dimensions. That
is, no more than one item from any
proposed dimension was allowed
per generic dimension. This random
multidimensional model also was
compared with the unidimensional
model with the G2 likelihood ratio
statistic as described previously.
In addition to the comparisons of
models with the G2 statistic, the patterns of responses of individual respondents were examined. Examining uniform or uneven patterns of
responses across dimensions might
provide insight into the constructs in
the proposed model. A sum of
squares indicator, DI, was calculated
to indicate the sizes of the differences in responses across dimensions.14 For this calculation, movement levels and respondent abilities
() were examined in logits, the log
of the odds of choosing the statement indicating a given level of
movement ability within each item.
The DI sums differences from movement ability estimates across the 6
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Figure 1.
Example of 3 Movement Ability Measure items directed toward the dimensions of
flexibility, speed, and strength. Respondents were instructed to choose the one statement within each box that most closely described their usual ability to move now, this
week, and the one statement that most closely described the ability that they would like
to have even if they had to work hard for it. They were instructed to mark one number
on the left (Now) and one number on the right (Would Like) for each set of 6
statements.

dimensions (d) for each person p, as

follows:

DI p

d1

If the sum of the squared deviations

from an average estimate is low, then
that person perceives his or her
movement to be about the same
across all 6 dimensions. If DIp is
high, then that person perceives

movement ability on at least one of

the dimensions to be quite different
from the average of the rest. Representative respondents with low and
high DI values were selected; movement ability plots (MAPs) depicted
the asymmetry of dimensions for
these selected respondents with low
and high DI values. Designation of
low and high DI values within any
particular study is arbitrary.15 For
this study, the lowest and highest
average logits for any dimension

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Dimensions of Construct of Movement in the Movement Continuum Theory

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Figure 2.
Respondent 201 reported low movement ability (low logit values) on all dimensions.
This respondent was an 86-year-old woman who reported that she was clumsy and
had low back problems. The sum of the squared deviations from an average dimensional logit value, DI2010.47 logit2.

were inspected for each respondent;

the DI cutoff was assigned to the
value above which all respondents
had differences from their lowest to
their highest dimensions that were
large enough to be outside of a 98%
confidence interval.
Test Phase: Results
A total of 318 adults completed the
MAM. Respondent ages ranged from
18 to 101 years, with modes (10
each) at ages 49 and 76. Women constituted 206 (65%) of the respondents; 178 (56%) acknowledged at
least a little movement difficulty in
the previous week. Forty-six respondents (14%) indicated that they were
starting or undergoing physical therapy at the time of responding to the
MAM.
With items specifically assigned to 6
corresponding dimensions, the mul894

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side of their respective 98% confidence intervals (standard errors for

average dimension estimates were
about 1 logit), and the spread signified at least 0.5 and up to 1.25 movement ability level differences between the dimensions. At a DI value
of 5.3, 165 (52%) of the respondents
showed differences between the dimensions of movement rather than a
uniform average across dimensions.
Movement ability plots of sample
cases (Figs. 2, 3, 4, 5, 6, and 7) chosen to represent low and high DI
values depict dimensional abilities in
logits along 6 respective axes in a
hexagon (range for all axes11 to
9 logits). Greater asymmetry indicates larger differences between dimensions. Demographic information
is provided when known from responses and comments on completed questionnaires.

Discussion and Conclusion

tidimensional model fit significantly

better than the unidimensional
model (225280.9, P.0001), even
with high internal consistency across
all items (Cronbach .94) and high
correlations between pairs of dimentions (r.87.99). In contrast, when
items were randomly assigned to 6
generic dimensions, the multidimensional model fit no differently than
the unidimensional model (225
23.3, P.56).

The 3 phases of this study resulted in

a proposed set of dimensions to extend the construct of movement
within the MCT. The proposed dimensions included aspects of movement that were described in the literature and that were aligned with
evaluative criteria. Testing the proposed dimensions required the construction of a new measure targeting
these movement constructs along
with a generic movement construct.
Model comparisons carried out with
data obtained with the new measure
showed that the proposed multidimensional model fit better than a
unidimensional model.

When response patterns were examined with the DI statistic (mean

9.25 logits2, standard deviation
11.62), 5.3 logits2 was designated as
the cutoff between low and high. No
person who had a DI value above
this cutoff had less than 2.5 logits
between the lowest and the highest
average dimension estimates. At 2.5
logits, the lowest and highest average dimension estimates were out-

Despite
the
dimension-specific
wording of the MAM, many respondents provided no discernible indication that their movement was different across dimensions. For them,
responses across the dimensions indicated about the same level of
movement ability, although that
movement ability might have been
low or high, as shown in Figures 2
and 3. The associated demographic

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data indicated that symmetry in responses across dimensions might
have been associated with debilitation or physical capability in general.
For more than half of the respondents in this study, MAM responses
were different across dimensions.
Some respondents showed exceptionally low levels of ability on some
dimensions (Figs. 5 and 7), and
others showed exceptionally high
levels of ability on 1 or 2 dimensions
(Fig. 6). These responses imply sufficient understanding of the dimensions in the MAM to reflect consistent differences (with person
separation reliability ranging from
.92 to .96) across designated groups
of items. This is initial evidence that
this set of dimensions may meet criterion 5. Determining whether such
differences across dimensions have
clinical meaning depends on future
research. Comparing the demographic data to the MAPs suggested a
link between responses and respondent characteristics rather than either uniform or random responses to
items.

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Figure 3.
Respondent 244 reported high movement ability on all dimensions. This respondent
was a 72-year-old man who was healthy. The sum of the squared deviations from an
average dimensional logit value, DI2443.15 logits2.

Although these results provide some

initial evidence supporting the subdivision of the movement construct
of the MCT into the 6 proposed dimensions, validation of the proposed
model requires further research. For
example, the MAM deliberately allowed respondents to interpret
items without specifying standard
tasks; this property increased its applicability across individuals with different experiences of functional activities but restricted the absolute
comparison of one individual with
another or of MAM responses with
instrumented measures. To determine whether differences in perceived movement ability correlate
with measurable differences in dimensions, future research might examine the association between MAM
responses and performance-based
measures or clinicians judgments of
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Figure 4.
Respondent 39 reported higher movement ability on flexibility, strength, and endurance and lower movement ability on accuracy, speed, and adaptability. This respondent
was a 65-year-old man. The sum of the squared deviations from an average dimensional
logit value, DI3928.22 logits2.

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movement ability. To determine
whether the magnitude of perceived
movement ability has meaning, future research might examine group
data for each dimension and compare healthy control subjects with
subjects who have identified deficiencies. To explore the possible
clinical meaning of the proposed dimensionality, future research might
examine people before and after
therapy to determine whether those
who respond well to therapy started
with a generic lack of movement
ability across all dimensions or a specific and predictable lack of movement ability in one dimension or a
few dimensions. Further research
also might indicate that MAPs reveal
identifiable patterns of asymmetry
for certain clinical groups.
Asymmetry across different dimensions should follow predictable patterns according to the proposed multidimensional model of movement.
For example, athletes should test
higher in predictable subsets of
these dimensions, depending on the
requirements of their specific sporting events, as proposed in Table 3.
Likewise, patients should test lower
in predictable ways if they have diagnoses affecting 1 or several designated dimensions. Furthermore, if
these dimensions extend the MCT,
then patients should improve in affected dimensions upon successful
completion of a clinical intervention.
If research confirms predictable patterns among the dimensions related
to athletic ability or pathologyrelated disability, then characterization of movement ability along the
dimensions may prove useful in determining prognosis and planning
for client intervention.
A common alternative statistical
method for determining dimensionality, factor analysis, proved unhelpful in this study. Exploratory or confirmatory factor analysis of an
instrument relies on a lack of corre896

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Figure 5.
Respondent 186 reported moderate movement ability on adaptability and much lower
movement ability on the other dimensions, especially flexibility. This respondent was a
76-year-old woman who had had a stroke. The sum of the squared deviations from an
average dimensional logit value, DI18668.34 logits2.

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Figure 6.
Respondent 316 reported higher movement ability on endurance and moderate movement ability on the other dimensions. This respondent was a 25-year-old woman who
was a long-distance runner. The sum of the squared deviations from an average
dimensional logit value, DI31629.35 logits2.

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Dimensions of Construct of Movement in the Movement Continuum Theory

lation between groups of items or
dimensions to determine whether
different factors are represented. For
perceived movement ability as assessed with the MAM, the dimensions had an extremely high pairwise correlation that negated
confirmation of factors with factor
analysis. Choosing IRT methods to
test dimensionality proved more useful in this study because these methods estimate item and respondent locations on the same (logit) scale on
the basis of all of the recorded responses to all of the items. Thus, IRT
methods retain the distinctions between items and groups of items
made by individual respondents
rather than subsuming all of those
differences in pooled correlation
data across a sample.
Although the MCT describes movement at all levels, from the molecular
and cellular levels to the level of a
person acting in society, the MAM
incorporates the 6 dimensions of
readily perceivable movement only.
Further research is needed to determine whether these 6 dimensions
apply to the molecular and cellular
levels of the continuum described by
the MCT or whether separate movement descriptors are more applicable for these levels.
Although numerous discussions with
professional informants helped refine the set of dimensions described
here and although these dimensions
met the evaluative criteria, the literature search for movement dimension candidates was neither exhaustive nor systematic. Further research
may provide support for the exclusivity of these dimensions or provide
some other criteria for accepting different dimension candidates. Research also may modify the concepts
of these dimensions, splitting some
into smaller subdivisions or merging
others on the basis of some alternative criteria. It is hoped that the identification of the 6 dimensions in this
July 2007

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Figure 7.
Respondent 309 reported low movement ability on flexibility and strength and moderate movement ability on the other dimensions. This respondent was a 40-year-old
man with limited neck and arm function because of impingement. The sum of the
squared deviations from an average dimensional logit value, DI309123.02 logits2.

study will promote discussion of

movement and all of its possible
dimensions.
The subjects in this study were not a
randomized sample; subjects who
volunteered to complete the selfreport measure may have selfselected either because they thought
they moved well or because they
were conscious of movement problems. Neither of these motivations
was thought to bias the results particularly, as this study focused on dimensionality and not the level of
movement ability.
An alternative to the disablement
models described as the basis of
the Guide to Physical Therapist
Practice,2 the MCT1 presents a potential grand theory of physical
therapy3 that also could be relevant
to movement specialists in other
professions. Without testable hy-

potheses, however, the MCT will

fail to provide a foundation for assessment and intervention. The proposed multidimensional model may
promote hypothesis generation because the specificity of the dimensions makes measuring movement
with the MCT more concrete.
Strength, for example, as a dimension within the movement construct of the MCT, has links among
the assessment of strength in the
laboratory, the problems of weakness, and the intervention used to
improve current ability to generate force. Characterizing movement
capabilities across dimensions and
testing any narrowing of the gap between current and preferred movement capabilities as a result of intervention become possible.
If the research suggested in this discussion further supports the MCT
and the proposed dimensions of

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897

Dimensions of Construct of Movement in the Movement Continuum Theory

movement, it will have implications
affecting research, education, and
clinical practice. In research, the
MCT and dimensions of movement
could provide a framework for revealing relationships among flexibility, strength, and speed, for example, providing a needed unification
for effectiveness evidence. In education, a focus on movement dimensions provides a natural link between
basic and movement sciences and
the movement deficits associated
with particular pathologic conditions, perhaps improving student
understanding of assessment and intervention relationships across diagnostic groups. In clinical practice,
the dimensions of movement may
help patients and movement specialists more readily specify and focus
assessment and intervention on the
dimensions having the most difficulty. Across all areas, dissemination
and use of the MCT and dimensions
of movement could enhance effectiveness in investigating and managing movement. Although this study
addressed only the initial testing
of the proposed multidimensional
model of movement and the MCT,
the potential usefulness of this
theory makes further research
worthwhile.
The author acknowledges Mark Wilson for
sparking the original idea of dimensions of
movement and for his direction in the meth-

898

Physical Therapy

Volume 87

odology of testing. The author also thanks

Rick Allen for support and editing advice
throughout the process of conceptualizing,
testing, and writing.
A version of this study was presented as a
poster at the Combined Sections Meeting of
the American Physical Therapy Association;
February 15, 2006; San Diego, Calif. This
study was completed as part of the authors
doctoral dissertation at the University of California, Berkeley.
The Committee for the Protection of Human
Subjects at the University of California,
Berkeley, designated this study exempt from
further review.
This article was received June 27, 2006, and
was accepted March 1, 2007.
DOI: 10.2522/ptj.20060182

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July 2007