HEMME APPROACH TO SOFT-TISSUE THERAPY

Lines and arrows show which directions of movement are possible within
the model. Therapy begins when the patient enters the system. Step one is
titled ENTER PATIENT. The first two basic steps in the model, titled HISTORY
and EVALUATION, define the patient's problem. History refers to medical
history and evaluation refers to physical evaluation.
The next step in the model is ALTERNATIVES. This step is a link between
the problem as defined by HISTORY and EVALUATION and possible solutions
as defined by MODALITIES, MANIPULATION, and EXERCISE.
Alternatives should be specifically defined. If modalities, manipulation, or
exercise are needed, practitioners should know specifically which modalities,
manipulations, and exercises are needed. Workable plans for therapy should
include goals, timetables, and measurable results. If therapy involves more
than one practitioner, responsibilities are assigned.
The steps MODALITIES, MANIPULATION, and EXERCISE are situated on one
line to emphasize that therapy can include one or more of these three steps.
MANIPULATION was given a central position because soft-tissue therapy
focuses on manipulation, with modalities and exercise secondary.
The next step is FEEDBACK. Like homeostatic mechanisms that regulate
blood pressure, the HEMME APPROACH uses positive and negative feedback to
regulate the course of therapy. Positive feedback validates the course of
therapy being followed and negative feedback indicates a need for change.
Changes can be made in several ways: (1) repeat steps (2) change the sequence
for using steps, (3) seek new information and reenter the system, or (4) exit the
system.
The step for entering new information, upper left-hand corner of the
HEMMEGON, is titled OUTSIDE INFORMATION. Like any living system, the
HEMME APPROACH is capable of receiving and processing input from the
outside. This step can be used to enter outside information from sources such
as consultation, research, or laboratory testing. After receiving and processing
the new information, the practitioner can enter the model at four points: (1)
HISTORY, (2) EVALUATION, (3) ALTERNATIVES, or (4) FEEDBACK.
Practitioners can exit the system by using FEEDBACK to reach the steps
titled OBJECTIVES SATISFIED or OBJECTIVES NOT SATISFIED. If the objectives of
therapy are not satisfied, the patient may exit the system or reenter at any of
the five basic steps. HISTORY and EVALUATION can be reentered directly,
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HEMME Approach to Soft-Tissue Therapy