WHAT A RELIEF

What A Relief Active Spine Care Protocol

Call 1-214-A-RELIEF or visit www. WAR. clinic

Patient referral and Intake for back pain relief programs

programinvolveshowthepatientgetstothisDBCclinic. The referring physician(s) have been presented the evidenced based background of DBC Active Spine Care®, and therefore have chosenthismethodologyfortheirpatient(s)basedonthosefacts. Acontinuedcommunicationbetweenyourselfandthe physician is paramount in gaining his/her confidence in you and DBC Active Spine Care®, thus maintaining a continuous referral of patients to sustain the business aspect in which this methodology was based. It is of the utmost importance that physician questions or complaints be addressed promptly, accurately, and truthfully. (Spine Trust Program)

3.2 Understanding the  Spine Care®Concept:
Everyone in the DBC clinic should have a basic understanding of the program. Explanation and correct terminology are

vital to communicating with patients, insurance, physicians and employers. An explanation of the program is included in the reference section of this manual.

3.3 Patient insurance, verification and scheduling:

Before any patient can be seen in the  program, their insurance must be verified before they are scheduledfortreatment. Theremustbeacontinuousopenlineofcommunicationbetweentheschedulerandthe clinician on dates and times of service that will be provided. Regularly scheduled (weekly) staff meetings are mandatory to assure a complete agreement between marketing, scheduling and clinician staff. This will help maintain an uninterrupted referral of patients and continuity within the DBC Active Spine Care® clinic to maintain the business.

3.4 Patient screening questionnaires:

Spine Care® has a battery of evidenced based screening questionnaires that the patient should fill out before coming for their initial baseline evaluation. It is imperative that all of these questionnaires be completed to assure a comprehensive analysis (software) of their individual situation that will be paramount in structuring the DBC Active Spine Care® program to fit their pathology.

3.5 Initial patient visit:

Thesayingthat“theinitialimpressionisthemostlasting”istrue. Whenthepatientarrivestheyareapprehensive, probably in pain, and may have other issues. Even if your day is going poorly, make sure that patient’s priority is number 1. From the initial greeting in the reception area through the one-on-one evaluation process it is your responsibility to make sure the patient feels they are in a facility that has their best interest at hand.
DO NOT show the patient the treatment area before you do your one-on-one evaluation.

Spine Functional Restoration Program

Spine Functional Restoration Program and Treatment Options

There are many devices (fitness machines, balls, rubber bands, etc.) used for the treatment of spinal disorders, but according to the evidence you must be “spine specific” in isolating the problematic area(s) to return segmental control and function.
The DBC Active Spine Care® program is intended for the treatment and functional restoration of lumbar and thoracic problems providing proven results to patients experiencing prolonged, recurrent, post-operative or post-traumatic problems.

The system suits the needs of most lumbar and thoracic problem patterns:

  • Inflammatory
  • Post-traumatic
  • Post-operative
  • Failed Back Surgery Syndrome
  • Nerve root compression
  • Narrowing of the spinal canal
  • Pelvic and general low back pain
  • Spondylolisthesis / spondylolysis
  • Non-specific painThe physical aspect of the DBC Active Spine Care® program consists of a comprehensive, objective analysis of the patients spine function. Once the data is analyzed, an individual treatment program is formulated and the patient is treated in 4 separate FDA medical devices that isolate the spine to illicit muscle co-ordination and segmental movement control. Therapeutic exercises are facilitated by correct body positions supported in the DBC devices. The devices support the correct gradual regaining of the physiological arcs of movement. The specificity of design used in the DBC treatment devices is carefully controlled for patient safety and ease of use. For example, the patented hip-lock system allows precise targeting of exercise impacts on the most important muscles in the back. Controllers for range of motion and loading as well as patient supporting mechanisms ensure the safety of patients. Anatomical cushions complement the ergonomic design. Inertia and friction during movement are minimal. Each device can be easily adapted to meet individual requirements, thus reducing further risk of excessive strain or injury. The devices are intended for sustained use in professional settings with large numbers of patients.

    FDA DBC Active Spine Care® devices:

    • DBC LTE 110 / lumbar and thoracic extension
    • DBC LTR 120 / lumbar and thoracic rotation
    • DBC LTF 130 / lumbar and thoracic flexion
    • DBC LTL 150 / lumbar and thoracic lateral flexion

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2.2 DBC device biomechanics:

One issue to be considered in assessing the possible efficacy of exercises for the treatment of low back pain is whether the training effects are back specific. Back specificity can be obtained by employing a “hip-lock mechanism.”

Pelvic stabilization excluding the strong gluteus and hamstringmusclesisrequiredtospecificallytestandre-conditionthelumbarextensorfunction. Thepatented“hip-lock” system prevents pelvic sagittal rotation and subsequently provides an isolated and safe movement.
This also holds true for the DBC 120 (rotation), DBC 130 (flexion) and DBC 150 (lateral flexion).

2.3 DBC device validity:

The efficiency of the hip-lock mechanism was investigated using motion analysis (Peak Performance Technologies Inc.) by video precise filming, digitalization and analysis of the isolated spinal movement. The results showed that the DBC patented hip-lock mechanism is effectively locking the hip, stabilizing the pelvis, and isolating the lumbar and thoracic segments. Alp, Denner, etal (1991)

Test-retest reliability analyses with different experimental groups with correlation coefficients for trunk mobility in the sagittal plane were 0.97-1.0 (p<0.001), while correlation coefficients were between 0.82 (p<0.001) and 0.98 (p<0.001) for isometric maximum strength and between 0.89 (p<0.05) and 0.95 (p<0.001) for dynamic endurance capacity of the lumbar/thoracic extensors. Denner, Ilvesmaki, Wdra, etal (1993)

The validity of muscle activation was confirmed by elctromyographic studies (MEGA Electronics). Activities of muscle groups for isolated movements were quantified under defined isometric and dynamic working conditions with coefficients of 0.88-0.98 (p< 0.001) for lumbar/thoracic mobility in the transverse plane and 0.97-0.99 (p<0.001) for isometric maximum strength of lumbar/thoracic rotators. Denner, Konrad, Meier, etal (1993)