Today I attended the weekly back pain clinic and started a new post cancer rehabilitation clinic which runs once every week for 4 weeks total. In the back-pain clinic, we briefly went over the daily steps taken (pedometer) and went through the patient’s food diary which we will analyse for next weeks session. We took the patients to the gym where we introduced them to resistance band exercises and resistance machines (rows, chest press, triceps extensions, bicep curls), to give them options for both at home and in a gym environment. After the gym session, we looked at how pain can affect sleep and how a lack of good sleep can cause pain (two-way cycle). A study by Gerhart et al., (2017) confirmed that poor sleep quality related to significantly higher pain ratings, lower mood, and a decreased physical function but when looking at the reverse effect on pain on sleep, they found a less strong effect. This suggests that poor sleep has more of an effect on pain than pain does on poor sleep. The session concluded with further core strengthening exercises (side bridge, plank) and a breathing exercise (4s inhale, 7s hold, 8s exhale) to help reduce stress and calm the mind.
Before the cancer clinic I spent 20 minutes preparing by looking at the programme material we were going to cover for this session. After introducing ourselves and the three post cancer patients going through some admin we calculated their body composition (Tanita MC-780MA P) and their grip strength using a hand grip dynamometer to get a better understanding of their general health and strength. Grip strength has been shown to be a good predictor of overall strength and endurance (Trosclair et al., 2011). They then received pedometers to count their steps until next week to get an activity baseline value. Finally, we introduced the patients to Nordic walking and its benefits over normal walking. After the clinic session I looked up the validity of aerobic exercise such as Nordic walking for cancer survivors and found a study by (Burnham & Wilcox, 2002) confirming that low & moderate aerobic exercise programmes improve physiological and psychological function in cancer survivors.
For future reference I will look up exercise guidelines for osteoarthritis as one patient in the back-pain clinic had arthritis in her left wrist. This forced me to adapt and provide single arm exercise variations. I will also spend some time researching the effect of breathing exercises on stress and pain.
Marjon back pain clinic: http://sites.marjon.ac.uk/activechoices/backgym/
Burnham, T., & Wilcox, A. (2002). Effects of exercise on physiological and psychological variables in cancer survivors. Medicine & Science In Sports & Exercise, 34(12), 1863-1867. doi: 10.1097/00005768-200212000-00001
Gerhart, J. I., Burns, J. W., Post, K. M., Smith, D. A., Porter, L. S., Burgess, H. J., … Keefe, F. J. (2017). Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 51(3), 365–375. doi:10.1007/s12160-016-9860-2
Trosclair, D., Bellar, D., Judge, L., Smith, J., Mazerat, N., & Brignac, A. (2011). Hand-Grip Strength as a Predictor of Muscular Strength and Endurance. Journal Of Strength And Conditioning Research, 25, S99. doi: 10.1097/01.jsc.0000395736.42557.bc