Biofeedback is an established learning method, whereby a person learns how to control a bodily function through measurement and feedback. In another cutting edge development Lifestyle Therapies physiotherapist John Havill has developed a world class device and system for posture correction using biofeedback.
Called Spineangel, this medical device is the perfect posture trainer for patients suffering from recurrent back pain.
This is important because poor posture and movement are a major driver of recurrent back pain.
Have a look through the information on the link above on how it works, the published research and a number of remarkable case studies.
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Current Subjective History
Maria is a 47 year old, 178 cm tall, primary school teacher. She is fit and healthy, exercising regularly with walking and kayaking.
On Jan 10th 2012 Maria had an acute flare low back radiating bilaterally down the posterior of her legs as far as the heals. Maria was unable to sit and struggled to do the normal activities of daily living with pain levels at 7/10 NRS. Maria admitted to some ongoing low back pain issues over the 2 years, but this tended to be local and settled without needing any medical intervention.
Objective Examination
Maria had grossly restricted lumbar flexion, was acutely tender to palpate the low lumbar spine and had bilateral restriction of SLR to 60 degrees, which was positive to dorsiflexion sensitisation. Reflexes and muscle strength were normal.
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Workstation desk setup following ergonomic recommendations.
As part of our occupational rehabilitation services, we often go into businesses and provide advice and training for setting up workstations ergonomically.
The following is from an information sheet we often hand out which refers to the above image. Often poor postures can be corrected using Spineangel as a biofeedback learning device.
The following checklist will help people adjust their workstation so they can be comfortable and look after their bodies in their daily duties. It may be a good idea to work through it with a friend and observe each other’s body position, as often it is difficult to determine your own body position. It may take several tries to get the best set up, so give yourself some time to perfect the position for you.
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Sam, a fifty year old man with a history of chronic lower back pain was referred to Lifestyle Therapies from a local health provider. Sam was initially referred for an electrotherapy called InterX, which is an advanced electrical nerve stimulator utilising skin conductivity. Sam had been suffering with constant deep pain and numbness in his right foot for 15 years, initially injuring his back when he was 20 years old. In his thirties, Sam underwent a laminectomy, followed by lumbar fusion of L5-S1 a few years later. Since then he has not lived a day without pain, significantly affecting his quality of life. In addition Sam was suffering hyperalgesia in his lower back due to an incident with a TENS machine. His skin in the lumbar spine was so sensitive, wearing clothes was unbearable which was an indication of Central Sensitization. He was unable to sit in a car for more than one hour without suffering significantly. Sam had one goal, which was to return to his hobby of painting.
Initial assessment findings:
- Muscle inhibition of core muscles
- High tones in gluteal muscles
- Tender to touch adductors, ITB, and Quadricep muscles.
- InterX readings were >100 at 2% intensity in the lumbar region with high sensitivity and pain, even with light touch; a sign of static mechanical allodynia.
InterX was used in the chronic setting for 15 minutes during the first visit. Immediately after, Sam was able to tolerate a 5 minute massage. He was also sent home wearing the OF50-3 Octapolar Q magnet, a breakthrough in magnetic therapy. This neuromagnetic device was selected since it’s large enough to cover the adjoining lumbar vertebrae L5,S1 and L4/5.
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Even with the successful treatment of Lower Back Pain, the research shows it tends to recur. While undergoing treatment the patient is full of enthusiasm and adheres well to advice and programs. They see the benefits at the end of the treatment, feel empowered and notice the improvement and are very knowledgeable about their problem. However after treatment has finished, when asked if they would continue to carry out the prescribed exercises at home, many were so much better they didn’t feel the need and because of a lack of time couldn’t see themselves carrying on with their exercises. So what does this tell us?

lower Back Pain
Should our therapists relinquish any responsibility for patient outcomes after they have been discharged and expect re-occurrences? Clearly this a choice for each and every patient and what we do at Lifestyle Therapies is offer a range of take home therapies, self management programs and ongoing exercise programs such as Pilates. This provides the patient with a range of post treatment support that will reduce the chances of the injury recurring. Post treatment support includes:
– Pilates classes – both larger mat classes and small group equipment classes
– Home programs – printed with diagrams
– Advice and education – with regard to prevention
– A range of educational materials including Pilates and stretching DVD’s and a range of books.
– Self massage tools including Muscle Mate
– Ergonomic changes and advice
– Ongoing preventative physiotherapy treatment
– Self-management tools including Q magnets and ice packs.
Reference:
Capitalising on effective treatment strategies for low back pain – How do we bridge the self-management gap? Manual Therapy 15 (2010) 133-134 An Moore, Gwen Jull
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