Monday, July 27, 2015

Are we listening?

Nice work coming out of the Journal of Orthopedic and Sports Medicine with this information;

In the article, authors Paul Beattie and Sheri Silfies ask if its time for us to start thinking different about chronic low back pain.

Three key elements they mention the our CUSTOMERS EXPECT:

1.  Emphasize importance of self-management.

Folks with CLBP what us to make it a fundamental goal of treatment right from the beginning, and  points to an abundance of strong evidence that suggests education on a pro active plan for management of the back pain.  They write Physical Therapist need to communicate and listen better, since many patients never get the message to self management is necessary for long-term conditions

Supporting their message are studies addressing patient satisfaction with physical therapy, where they consistently find respondents are less satisfied with the degree of instruction they received towards understanding injury prevention (posture, dynamic movement, Back first aide, etc), and performing a home program. 

2.  Fundamental to a program:  consider patient preference 

Beattie and Silfies point to evidence that suggest a strong link to patient preference and expectations playing the largest part in adherence to and exercise program.

As an example,  evidence suggest meaningful strength and motor control games for atrophied back muscles and people with chronic low back pain take considerably longer to achieve and overcome (expect some bumpy roads, small setbacks to start, a good PT will help you manage bumps with education, modalities, their hands, and other resources), so a long term program outline starting with the patients (customers) preferences (and passions!) will help achieve greater success.  

The take home; a good PT will listen to the patient goals!

3.  The value of physical therapy improves if the patient can attend periodic follow-up visits for tuneups

If your PT is practicing at the highest level, they will arrange for you to periodically come back (perhaps once a month), to maintain therapeutic alliance for long-term follow-up.  They reflect that it's the patient satisfaction with these long-term follow-up treatment is likely to improve if the patient establishes an ongoing relationship and therapeutic alliance

More aggressive long-term patient centered approach the self-management is likely to increase accumulative dosage of exercise and successful outcomes, and is likely to shift attitudes and beliefs such as quality-of-life benefits associated with health and fitness.

In the perfect world we have no back pain.

But if you do, find a PT that educates you on posture, movements, self care, while offering home programs that are simple and understandable, all together wrapped up in helping you manage your active wellness/fitness lifestyle program that takes your likes and dislikes into account.

Consider PTW, where practicing industry best standards are our norm.

Robert Babb, PT