In clinical practice, it is common to see individuals with a combination of impairments in multiple regions of their body that collectively impact the musculoskeletal, urogynecological and respiratory systems.
The story often reveals many past injuries, thoughts/beliefs, emotional states and movement habits that have collectively led to changes in strategies for posture, movement, continence and breathing. These individuals have often seen multiple practitioners who have focused on one body area or one system.
The Integrated Systems Model (ISM Lee & Lee 2011) is an approach which provides an understanding of how all past injuries, poor posture and movement habits are linked and have contributed to the current state of health, or lack thereof. 
The ISM approach evolved over Diane Lee’s 40 years of clinical practice, research, and collaboration with many leading health care professionals in their fields. This model allows clinicians to be more effective and efficient with their assessment and treatment in order to help patients develop better movement strategies and habits to help reduce symptoms and improve function and performance.
The ISM assessment is centered around your unique story. We begin by identifying your meaningful complaint(s), in other words what would being better mean to you? This often goes beyond pain and can include things like reaching performance goals (doing the Sun Run or Grouse Grind or driving your car), or stopping urinary leakage (this is NEVER normal or acceptable), or merely being able to get a good night’s sleep.
From your story we decide (with you) what your goals would be from treatment, in other words what activity can we help you with (sitting, walking, swimming, climbing stairs, riding your bike, standing on your head, you name it!)? This is called your meaningful task. We then analyze specific movements and postures that are related to your specific meaningful task. This is a whole body/person assessment that considers the relationship between all the things that are not performing well in your body, including suboptimal alignment, biomechanics and/or control. We have special ways to determine which impairments are ‘driving’ or causing others, which ones are primary and which ones are compensating. It is not uncommon for the compensating body parts to be sore and the primary ones to be quite quiet (less painful). In the ISM approach this way of assessing the connections between multiple regions of the body and finding out which area is the most important to treat is called ‘Finding the Driver’.
The video below with Cathy Rogers will show you how ISM is practiced at Diane Lee & Associates.
All the clinicians at Diane Lee & Associates are trained in the ISM approach and integrate their unique professional training and skills into this method. We collaborate and often co-consult with each other to offer you the best opportunity to restore better posture, movement and thoughts/beliefs – yes, what you think and believe does influence how your body works.
Our goal is to help you understand your body better and to learn new ways to improve and self-manage your unique story/body/mind. It is not uncommon for us to hear ‘That is the first time anyone has made sense and been able to link all my injuries and sore parts of my body!’
When hope is restored, things can change.
Related Practitioners
Cathy Rogers
Cathy received a Bachelor of Science degree from the University of British Columbia in 2000. As a member of the varsity women’s volleyball team at UBC during those years she was first exposed to physiotherapy and it’s positive impact on her own personal athletic career.
Leigh Fortuna
After studying kinesiology in university for two years, Leigh decided that pursuing a career in physiotherapy was the path she wanted to follow. She graduated from The University of British Columbia in 2005 with a Bachelor of Science in Physical Therapy.
Eric Perkio
Eric has been practicing Physiotherapy since 2006. He received his Masters of Physiotherapy from the University of Sydney, Australia and began his career working in a private clinic where he gained valuable experience in working with Rugby, Soccer, and Aussie Rules Football clubs.
Brittany Wade
Brittany graduated from the University of Ottawa with an undergraduate degree in Human Kinetics followed by a Master’s Degree in Physical Therapy from the University of Toronto.
Judit Orban
Judit has a special interest in helping people with various spinal conditions such as back pain, scoliosis, kyphosis, chest conditions and spinal fusions.
Since graduating in 2010 from the Semmelweis University of Hungary, Judit has been working in various spine specific clinics around the world. She started dancing at a young age and after high school she completed a Contemporary Dance Teacher course. Learning about the capabilities of the human body influenced her to study more and to earn a degree in Physiotherapy
Sarah Hamanishi
Sarah received her Bachelor of Science with a minor in Nutritional Sciences at the University of British Columbia. She then pursued a Master of Physical Therapy degree, graduating in 2013 from UBC. Sarah has taken post-graduate courses for dry needling, rehabilitation Pilates, visceral and neuromeningeal manipulation, and temporomandibular joint (TMJ) dysfunction.
Megan Davis
Megan graduated from the University of Ottawa, with a Master of Health Science in Physiotherapy and a BSc honours in Biomedical Sciences. She also completed her Master’s in French. Megan carries a wealth of knowledge from a patient perspective as she has worked hard to rehabilitate multiple injuries, as she has made it back to competitive powerlifting at the Canadian National level after hip surgery.
Cheri Le Cappelain
While working as a nurse Cheri saw the importance of physiotherapy on the rehabilitation ward to help patients regain their independence. As a result of these positive experiences she decided to go back to school to become a physiotherapist so she could have a more direct role in rehabilitation and help others regain their independence. Cheri graduated in 2018 with a Doctor of Physiotherapy from the University of Melbourne in Australia.
Lily Han
Lily is passionate about assisting her clients in gaining and regaining their function. She obtained her Master’s of Science degree in Physical Therapy from the University of Alberta. She has diverse experience within the healthcare field, including in diagnostic laboratory, pharmacy, medical first aid, and with other interdisciplinary teams allowing Lily to approach each patient’s condition holistically. Lily is fluent in both English and Mandarin.
Josh Toor
Josh graduated from the University of British Columbia with a Bachelor of Science (with distinction) in 2019 and a Master of Physical Therapy degree in 2024. He grew up in North Delta and is fluent in both English and Punjabi. His journey into physiotherapy was fueled by a passion for movement and sports, as well as a dedication to helping individuals of all ages and activity levels overcome injuries, restore mobility, and achieve their personal goals, whether that involves returning to daily activities, excelling in sports, or managing chronic conditions.
Olivia Zawadiuk
Olivia graduated from the University of British Columbia (UBC) with a Master of Physical Therapy in 2024. Prior to this, she completed her Bachelor of Kinesiology at UBC, where she was also a member of the UBC artistic (synchronized) swimming team. Olivia’s desire to become a physiotherapist was inspired by personal experiences as a competitive athlete, coach, and kinesiologist.
Tina Lin
Tina began her career in rehabilitation by completing a Bachelor’s of Kinesiology with a minor in Nutritional Science at the University of British Columbia. She then went on to pursue a Master’s Physical Therapy degree from the University of British Columbia. Tina has experience in a variety of settings including medical and critical care units in the hospital, a Clinical Pilates studio, and volunteering with Skate Canada and Women’s Rugby teams. Tina has a special interest in helping both women and men with their pelvic health (incontinence and prolapse).
Noëlle Trotter
Noelle Trotter graduated in 1996 from the University of Waterloo’s Health Sciences Faculty with an honours degree. In 2000, she obtained her Certified Pedorthist designation after completing 3000 hours of clinical work and Pedorthic exams.
Leanne Kitteridge
Leanne is a Registered Yoga Teacher with Yoga Alliance and has been teaching yoga since 2004. In 2006, Leanne became interested in Anusara Yoga®, a style of yoga that assisted with the healing of chronic pain issues in her shoulder.
