30.04.19 Back pain Clinic Hours

I spent 2 and a half hours assisting in a back plain clinic which runs for 6 weeks at Marjon University. Before the session I looked up their website to familiarise myself with the programme. This was the second week of the 6-week programme, but I couldn’t attend the first one due to exams. The patients were given a pedometer to keep track of the number of steps they were doing each day. We asked them how they were progressing with the pedometers and then calculated their average steps per day. Average steps per day for a healthy active person is 3000-4000 steps. Then we educated the patients on persistent pain (nociception) and how the body can get used to pain and be more sensitive of said pain. Then we took the patients for a 10-minute Nordic walking session which has shown to use 30% more energy than normal walking as well as incorporating the upper body more and providing support via the sticks. The session concluded with giving the patients an introduction to the gym (treadmill) and providing them with a core exercise (curl up).

I really liked this placement session as it has given me a new way to look at chronic back pain which comes up quite often in the injury clinic. I also enjoyed learning about nociception and how the body can get used to pain and thus can become more sensitive to experience said pain. The session went well although when it came to the treadmill I was unclear on what to do with the participant I was looking after, as she had AF (atrial fibrillation) and I couldn’t remember the precautions that came with this condition. As such I found a study by Elshazly et al., (2017) showing that people with AF had reduced peak exercise tolerance (lower VO2, less circulation power) but that their sub-maximal exercise capacity was similar to people without AF. As such, the treadmill work we were doing in the session was fine as long as it was kept at a lower intensity.

Links: 

Marjon back pain clinic: http://sites.marjon.ac.uk/activechoices/backgym/

References:

Elshazly, M., Senn, T., Wu, Y., Lindsay, B., Saliba, W., Wazni, O., & Cho, L. (2017). Impact of Atrial Fibrillation on Exercise Capacity and Mortality in Heart Failure With Preserved Ejection Fraction: Insights From Cardiopulmonary Stress Testing. Journal Of The American Heart Association6(11). doi: 10.1161/jaha.117.006662