This was the penultimate session of the back pain clinic. Today, the focus was on resistance training exercises using free weights, so they can be done at home which is specific to the group.

Reflective Summary

During our first discussion, the group emphasised that they wanted to begin planning a weekly programme of activities, which they could take away from the back pain clinic, so they have a specific plan in place once the clinic had finished. Planning is important as it creates a mental association between engaging in a desired behaviour and a specific future moment, that in turn can help people to attain their goals (Carrera, Royer, Sydnor & Taubinsky, 2018). It can also increase the groups adherence at it will remind them of the variations of exercises that we have covered across the six weeks, that they can engage in so they stay interested and motivated. Despite this, Conn et al. (2003) reported that a planned intention cannot always predict the actual event and it may need to be modified if something unexpected happens; we want to prevent it from becoming a barrier to exercise. Therefore, it is important to have a ‘plan B” in place, so if you are unable to complete your original goal regarding exercise, you can still make time to achieve something, rather than feeling like you have failed.

For a larger proportion of the session we went to the gym and explored different resistance exercises that can be completed at home. The majority of members in the group would rather work out at home and it makes it specific, especially with lockdown as gyms are shut.

Finally we considered mindfulness and if it can help with pain. Mindfulness involved making an effort to note what is happening in the present moment regarding your mind, body and surroundings (Mind, 2018). Mindfulness can help decrease pain; patients are encouraged to change the way they relate to pain by preventing judgments towards the thoughts accompanying the perception of pain (Majeed, Ali & Sudak, 2018). Not only is mindfulness important for the client, this intervention can be used with healthcare professionals in order to reduce burnout, improve mental health and well being and enhance therapeutic relationships (Baldini, Parker, Nelson & Siegal, 2014). This can ensure the therapist is more resilient and effective in clinical practice .

Areas for Improvement	Action Plan
Start planning different prehab and rehab programmes for a variety of common pathologies	Compose a generic template with the phases of rehab, generic goals for each stage, outcome measures and the progression criteria for the next stage
Research regressions and progressions for different exercises and make them creative	Create folders for different pathologies/weaknesses on Instagram so I can easily access them when needed
Explore and practice different mindfulness techniques	Find out if there is evidence for mindfulness and decreasing pain within the literature

Closing the Loop

As I have a rehab exam coming up, I have made 8 different programmes for generic/common injures with the phases of rehab, goals, outcome measures, clinical measures and exercises including progressions and regressions. Furthermore, on instagram I have now created many folders of different exercises I can use for a variety of pathologies as well as increasing strength and improving mobility for different areas of the body.

References 

Baldini, L. L., Parker, S. C., Nelson, B. W., & Siegel, D. J. (2014). The clinician as neuroarchitect: The importance of mindfulness and presence in clinical practice. Clinical Social Work Journal, 42(3), 218-227.

Carrera, M., Royer, H., Stehr, M., Sydnor, J., & Taubinsky, D. (2018). The limits of simple implementation intentions: Evidence from a field experiment on making plans to exercise. Journal of health economics, 62, 95-104.