This was my first session as part of a 6 week back pain clinic alongside clinical professionals.
Reflective Summary
On reflection, I found it very interesting to see how back pain affects different populations of people. Some of the patients were told that their pain was psychological, however recent evidence has emerged that suggests otherwise; neuropathic pain is a condition that affects the somatosensory system and can cause symptoms such as spasms, weakness, dysesthesia and poor proprioception (Kumar, Kaur & Singh, 2018). According to the International Association for the Study of Pain (IASP) 7-8% of adults suffer from chronic neuropathic pain.
Some of the clients found it frustrating as they had been given conflicting advice in the past, despite this they were still motivated to make the most out of the course.
SMART goals are written based off of the following guidelines: specific (what exactly do they want to achieve), measurable (use a time period to track completion), attainable (can the goal be achieved), realistic and time-related (Lawlor, 2012). We encouraged the group to use this acronym in order to support their progress. SMART goal setting is an effective way of achieving behavioural changes in people (Bovend’Eerdt, Botell & Wade, 2009). Nevertheless, SMART targets can be used in an instrumental manner and prevent students from active engagement and reflection on their practice (Day & Tosey, 2011).
We took the group through a variety of exercises for core stability including some stretches for the hips. A study by Javadian, Akbari, Talebi, Taghipour-Darzi & Janmohammadi (2015) found that patients with non-specific chronic lower back pain who completed core stability and general exercises were more effective than general exercises alone in the improvement of this condition. This is because core stabilisation exercise address intersegmental stability by facilitating neuromuscular control in the lumbar spine (Muthukrishnan, Shenoy, Jaspal, Nellikunja & Fernandes, 2010). I found this very helpful as I have always struggled to think of exercises at the most basic of levels.
To end the session we completed a lifestyle questionnaire on a one to one basis with the clients. This will allow us to evaluate if progress has been made relating to activities of daily living (ADLs) within the 6 weeks.
References
Bovend’Eerdt, T. J., Botell, R. E., & Wade, D. T. (2009). Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide. Clinical rehabilitation, 23(4), 352-361.
Day, T., & Tosey, P. (2011). Beyond SMART? A new framework for goal setting. Curriculum Journal, 22(4), 515-534.
Javadian, Y., Akbari, M., Talebi, G., Taghipour-Darzi, M., & Janmohammadi, N. (2015). Influence of core stability exercise on lumbar vertebral instability in patients presented with chronic low back pain: A randomized clinical trial. Caspian journal of internal medicine, 6(2), 98.
Kumar, A., Kaur, H., & Singh, A. (2018). Neuropathic pain models caused by damage to central or peripheral nervous system. Pharmacological Reports, 70(2), 206-216.
Lawlor, K. B. (2012). Smart goals: How the application of smart goals can contribute to achievement of student learning outcomes. Developments in business simulation and experiential learning: Proceedings of the annual ABSEL conference, 39(1) 259-267.
Muthukrishnan, R., Shenoy, S. D., Jaspal, S. S., Nellikunja, S., & Fernandes, S. (2010). The differential effects of core stabilization exercise regime and conventional physiotherapy regime on postural control parameters during perturbation in patients with movement and control impairment chronic low back pain. BMC Sports Science, Medicine and Rehabilitation, 2(1), 13.