A few months ago I started thinking about what anatomy, as foundational knowledge for physical therapy practice, would look like and how it would be taught in a program considering “knowledge based practice: cause, models and inference” as a clinical epistemology (here). Now I am taking that a step further, in a KBP – concept based curriculum – with core movement concepts including causation, adaptation and systems.
It is easy to see how “cause” is important in the study of anatomy. Cause is, after all, how we use anatomical knowledge in practice. Another way to say this (flipped), is that anatomical knowledge is one set of knowledge from which we reason causally. When using abduction to generate a list of possible “causes” of a set of signs and/or symptoms we generally consider the anatomy: “moving the leg like that could be due to a tight X, or a weak Y, or a stiff Z, …, etc.”
It is also easy to see how adaptation is important in the study of anatomy. After all, all of our current adult anatomical musculoskeletal forms are, within a set of boundary constraints, the result of the sum of adaptations of our life long journey to where we are right now. So how we live is predictive of our future anatomy (causal induction and causal deduction), and our current anatomy testifies to the journey we have taken (causal abduction).
Now how about a system? It is certainly easy to talk about the “systems” of our body anatomically. After all, we learn our anatomy in A&P I and II as a set of systems. This is how A&P books are divided. It is a fine way to divide them. Then we get into gross anatomy and we divide up the body regionally – again a fine way to divide up the body to learn it. But what about learning about the system of the system? For example, the system of the skeletal system.Or the system of the muscular system. Or the system of the musculoskeletal system. There is a modularity balanced with integration in all of these (and other) systems.
Well, this is what we can learn from a rather new application of an emerging analytic approach. The application of network analysis (studying systems by their network structure using graph theory (logical, mathematical), and by the way, for those of you that have been reading along with this blog – a “graphical causal model” is simply a network, a particular type of network, a DAG (directed acyclic graph)). This new application to anatomy has been termed: Anatomical Network Analysis (AnNA).
AnNA is exactly what these authors (Diogo R, Esteve-Altava B, Smith C, Boughner JC, Rasskin-Gutman D) have been doing for the past few years:
AnNA is original, insightful and very useful. Making this particular paper even more useful, the authors have subscribed fully to reproducible research, so their supplements, data, details regarding the analysis including R code – and a vast set of networks – is available on FigShare (here).
The paper citation is:
Article Source: Anatomical Network Comparison of Human Upper and Lower, Newborn and Adult, and Normal and Abnormal Limbs, with Notes on Development, Pathology and Limb Serial Homology vs. Homoplasy
Diogo R, Esteve-Altava B, Smith C, Boughner JC, Rasskin-Gutman D (2015) Anatomical Network Comparison of Human Upper and Lower, Newborn and Adult, and Normal and Abnormal Limbs, with Notes on Development, Pathology and Limb Serial Homology vs. Homoplasy. PLOS ONE 10(10): e0140030. doi: 10.1371/journal.pone.0140030
And I hope it is ok – but here are the first two figures in an attempt to encourage readers to get the paper:
Needless to say, I strongly believe that Anatomical Network Analysis (AnNA) will provide many benefits to the education of anatomy (in addition to the benefits discussed by the authors in this paper (and their other papers)), and potentially to the physical therapy profession as a whole as we work together on the human movement system. I am looking forward to fully exploring the possibilities and implementing an anatomy course and research that utilizes the concepts that emerge (pun intended), when we consider the network structure of the structures we use in practice. What it tells about about anatomical causal associations, what it tells us about anatomical adaption, and what it tells about about the system of anatomical systems with implications for movement.
As a final word – one of the authors on this paper also has a new anatomy book out – from what I have read so far, it is highly recommended (and will be required for PSU – DPT students).
DIOGO, R., D. NODEN, C. M. SMITH, J. A. MOLNAR, J. BOUGHNER, C. BARROCAS & J. BRUNO (2016). Learning and understanding human anatomy and pathology: an evolutionary and developmental guide for medical students. Taylor & Francis (Oxford, UK). 348 pages.
It’s great to be back blogging – it has been a long 18 months getting the PSU-DPT program into the “candidacy” pre-accreditation phase. But now as we look to accept our first class an implement this new program I look forward to blogging more as things unfold.